Universidad Pontificia Bolivariana
  • Medellín, Departamento de Antioquia, Colombia
Recent publications
Background The detection of coinfections is important to initiate appropriate antimicrobial therapy. Molecular diagnostic testing identifies pathogens at a greater rate than conventional microbiology. We assessed both bacterial coinfections identified via culture or the BioFire® FilmArray® Pneumonia Panel (FA-PNEU) in patients infected with SARS-CoV-2 in the ICU and the concordance between these techniques. Methods This was a prospective study of patients with SARS-CoV-2 who were hospitalized for no more than 48 h and on mechanical ventilation for no longer than 24 h in 8 ICUs in Medellín, Colombia. We studied mini-bronchoalveolar lavage or endotracheal aspirate samples processed via conventional culture and the FA-PNEU. Coinfection was defined as the identification of a respiratory pathogen using the FA-PNEU or cultures. Serum samples of leukocytes, C-reactive protein, and procalcitonin were taken on the first day of intubation. We analyzed the empirical antibiotics and the changes in antibiotic management according to the results of the FA-PNEUM and cultures. Results Of 110 patients whose samples underwent both methods, FA-PNEU- and culture-positive samples comprised 24.54% versus 17.27%, respectively. Eighteen samples were positive in both techniques, 82 were negative, 1 was culture-positive with a negative FA-PNEU result, and 9 were FA-PNEU-positive with negative culture. The two bacteria most frequently detected by the FA-PNEU were Staphylococcus aureus (37.5%) and Streptococcus agalactiae (20%), and those detected by culture were Staphylococcus aureus (34.78%) and Klebsiella pneumoniae (26.08%). The overall concordance was 90.1%, and when stratified by microorganism, it was between 92.7 and 100%. The positive predictive value (PPV) was between 50 and 100% and were lower for Enterobacter cloacae and Staphylococcus aureus . The negative predictive value (NPV) was high (between 99.1 and 100%); MecA/C/MREJ had a specificity of 94.55% and an NPV of 100%. The inflammatory response tests showed no significant differences between patients whose samples were positive and negative for both techniques. Sixty-one patients (55.45%) received at least one dose of empirical antibiotics. Conclusions The overall concordance was 90.1%, and it was between 92.7% and 100% when stratified by microorganisms. The positive predictive value was between 50 and 100%, with a very high NPV.
Each day, an increasing number of objects for several industries, including automobile, aerospace, biomedical, construction, and even electronics industry, are manufactured using bast fiber-based composites. Composite manufacturing depends on the matrix and reinforcement configuration. Many techniques can be used, and the selection depends on the final use or purpose of the composites. For example, it is possible to obtain simple laminates by casting or using a most expensive technique like compression molding. In this chapter, the main aspects of the processing techniques are discussed. Comments are provided on alternatives to improve the final quality of composites, and in some cases, aspects of how nanostructures can be included during composite manufacturing are introduced. The analyzed techniques are for polymer and cementitious matrices.KeywordsBast fiberProcessing compositesPolymer matrixSelf-reinforced compositesAll-cellulose compositesCementitious composites
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objective: Pneumocystis jirovecii Pneumonia is one of the diseases that most affect immunocompromised patients today, and under certain circumstances, it can be fatal. One of the most widely used techniques in diagnostic laboratories for the detection of its etiological agent is optical microscopy. However, some of the disadvantages of this technique are its low sensitivity, low accuracy, and high dependence on an expert to make the diagnosis. Then, this work aims to develop a computational tool based on a deep learning approach to automatically detect the presence of P. jirovecii Pneumonia fungus from optical images, and to increase the accuracy of this conventional technique. Methods The study involved 29 randomized patients, from whom respiratory samples (bronchial lavage, and bronchoalveolar lavage) were collected. Methenamine silver staining was then used to prepare the samples. Subsequently, the slides of the analyzed patients were observed using the Leica DM500 microscope using a Leica ICC50 HD camera, and the optical images were taken in at least four random positions on the specimen holder. Thus, an image dataset of 29 different patients was created to detect whether a patient is positive or negative for P. jirovecii Pneumonia. Finally, a deep learning approach based on convolutional neuronal networks (CNN) was proposed and evaluated to improve the accuracy of the microscopy technique. The proposed CNN method incorporates global and local features for pixel-wise segmentation. Results First, the dataset image was processed and segmented using the connected components methodology. Likewise, the segmented images were labeled with the help of an expert to train the algorithm. To validate the response of the proposed deep learning approach the obtained results were compared with the obtained conventional image classification techniques like co-occurrence matrix and K-NN. The obtained results reveal that the proposed methodology allows to increase in the accuracy in the P. jirovecii Pneumonia identification up to 98%, while the co-occurrence matrix and K-NN only achieve accuracies of 89% and 85% respectively. Conclusion It is possible to demonstrate that techniques based on digital image processing are a useful tool to support the processes of analysis and diagnosis of samples in medical patients with P. jirovecii Pneumonia. In addition, the obtained results demonstrate that methods based on deep learning allow us to develop more precise and accurate analysis methodologies for the analysis of patient samples with P. jirovecii Pneumonia. Our model can be improved by adding new layers, but this would introduce even more hyperparameters that should be adjusted. We intend to extend our model architecture in other areas of medical imaging with the usage of deep learning and computer vision techniques.
Poster session 3, September 23, 2022, 12:30 PM - 1:30 PM Objective: To identify and produce novel biomarkers with potential use for the specific diagnosis of H. capsulatum infection. Methods Here, we design a novel strategy to search and select new Candidate genes for biomarkers that integrates the use of a computational analysis model that includes the application of bioinformatic tools such as OrthoMCL, BLASTp, TargetP, and SignalP, applied on a local collection of proteome database obtained manually from GenBank-NCBI, and the analysis of previously published biological and experimental data sets, including a secreted proteome database obtained from pathogenic yeast-phase H. capsulatum culture filtrates, a Histoplasma yeast and mycelial transcriptomes database, and a urine-peptides database from Histoplasma-immunoassay-positive patients. For the synthesis of the Candidates, an internal protocol for the production of recombinant proteins in prokaryotic and eukaryotic systems was applied. Obtaining polyclonal antibodies (PAb) specific for each biomarker was carried out by adapting a rapid immunization protocol for BALB/c mice. Finally, the computational model was experimentally validated, evaluating the reactivity and specificity of PAb anti-Histoplasma with fungus culture extracts and samples from patients with histoplasmosis. Results Using the computational analysis model, 2 Candidate genes for diagnostic biomarkers were identified. Subsequently, the construction of expression vector for each Candidate and the production of these genes were achieved using a standardized protocol for the production of recombinant proteins. Polyclonal antibodies (PAb) anti-histoplasma were obtained and shown to be reactive against purified H. capsulatum-antigens. Finally, we confirmed the presence of these antigens in yeast culture extracts of H. capsulatum and demonstrated the immunoreactivity of anti-Histoplasma PAb with urine samples from patients previously diagnosed with histoplasmosis. Conclusion The generation of novel strategies that combine data analysis, computational tools, and transcriptomic and proteomic techniques could be very useful for the identification of new biomarker genes and the development of microbiological diagnostic tests for important pathogens.
This study is focused on vernacular features from eclectic architecture from the Colombian tropics, particularly on the San Jeronimo de Monteria Cathedral, one of the most important architectural symbols from this Colombian city. During the 19th and early 20th centuries, architecture in Europe and America was characterized by a resumption of historical styles, generally called ‘revivals’, and the blend of these, ‘eclecticism’. Montería was no stranger to this situation, also assisted by national and international migrations into the territory and the adaptation of local vernacular techniques. This cathedral is explored as an example where elements from vernacular tradition are recognized, which guaranteed the operation of foreign models, especially in the bioclimatic functioning of this tropical region.
Background: Although psoriasis burden and treatment have been well characterized in developed countries, there are scarce in-depth epidemiological studies in Latin American countries. Objectives: To describe the sociodemographic and clinical features and the economic burden of psoriasis among children and adult patients from Colombia. Methods: This cross-sectional study included patients from dermatology private practice offices, health provider institutions and hospitals in seven Colombian cities. We collected data on disease distribution, weight, height, body mass index, waist-hip ratio, disease severity, therapy, personal history of comorbidities, and direct costs. Multiple logistic regression analyses were conducted to assess the associations between severity scales and sociodemographic and clinical variables. Results: Two-hundred-three patients (43.8% women, 56.2% men) with an age range between 7 to 89 years old were included. The main subtype was psoriasis vulgaris and mean age of diagnosis was 37.1 years. The most common comorbidities were obesity, hypertension, psoriatic arthritis, dyslipidemia and diabetes. Women had a significant increased odds of presenting with psoriatic arthritis. Body-mass-index and hypertension were significantly associated with a higher psoriasis severity, whereas being female and non-obese was associated with a lower risk. A third of the patients had a family history of psoriasis and sleeping disorders. Forty-one percent of participants either had no income or had an income below 224 US dollars per month and >20% of their income was spent on their disease. Conclusions: This study is supported by robust scientific data and contributes to understanding the burden of psoriasis in Latin America. This study adds well-supported data through an in-depth clinical and economical characterization of Colombian children and adult patients with psoriasis and shows the high impact and burden of the disease on patients and their families.
In this paper, social capital was analyzed through the lens of the resources and capabilities theory, understanding it as a capability that has a role in the performance of the Smart City. Social capital relates to the technological capabilities and the technological learning process. The objective of this investigation was to build a representation model of the social capital resources and technological learning, taking social capital as a capability of the Smart City. First, on a methodological level, a preliminary exercise that shows the relation and the gaps between the concepts and the process to build the model are presented. Later, the Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to build the conceptual and measured model. Based on the configuration of the tangible variables, the model was tested with the information provided by the final users of the public urban bicycle system of the Medellín–EnCicla technological system. The impact of technological learning is interpreted by relating it to the sources of social capital, to its resources (trust, social interaction, and shared vision), and to the technological system chosen. As a result, the construction of an exploratory model is presented that interprets the resources of social capital and their relation to technological learning in a smart city. The investigation aims to contribute to the decision-making exercise in the public policies regarding the sustainable mobility of the smart city that was the object of study.
Este artículo presenta una revisión bibliográfica en bases de datos multidisciplinarias para identificar elementos centrales en el desarrollo de experiencias educativas STEM (Science, Technology, Engineering, and Mathematics) desde diversas acepciones como STEM+A o STEAM, para su integración con las artes; STEM+H, por las humanidades; o STEM + Agriculture; entre otros. Este enfoque ha incrementado su presencia en diversos niveles educativos, en parte por la promoción realizada a través de organismos multilaterales como la OCDE y el BID, y por la definición de políticas públicas, en especial en Norteamérica. Se analizaron 67 artículos de investigación, de los cuales se seleccionaron 53 como muestra porque dan cuenta de experiencias STEM desarrolladas en 19 países de cuatro continentes. La mayoría (54.72 %) relaciona experiencias de Norteamérica, especialmente de Estados Unidos, que aporta un 47.17 % del total de las fuentes del estudio. La revisión identifica las siguientes tendencias: los propósitos de aprendizaje, enfocados en el desarrollo de competencias; la colaboración entre grupos y la generación de buenas prácticas para el aprendizaje a lo largo de la vida; el uso de estrategias de aprendizaje activo; el rol de las TIC, que se identifican como articuladoras del desde su rol didáctico; y los factores de éxito del enfoque, en el que el rol del docente que prioriza el aprendizaje es preponderante. De estas tendencias se concluye que el papel del docente en la ejecución de experiencias de aprendizaje con enfoque STEM es fundamental, dadas las implicaciones pedagógicas, didácticas y humanas que supone desarrollarlo. https://revistas.udistrital.edu.co/index.php/revcie/article/view/19298/18534
Las enfermedades del sistema circulatorio constituyen la primera causa de muerte en el mundo. En Colombia, la enfermedad cardíaca isquémica se ubica como la principal causa de muerte, tanto en hombres como en mujeres. En la población femenina es la causa de más de la mitad de las muertes, cercana al 53%. La enfermedad isquémica en jóvenes, definidos como aquellos menores de 45 años, se ha descrito en cohortes en hasta un 11,6%, con una menor tasa de mortalidad. La dificultad para el abordaje de estos pacientes es mayor, dado que, al consultar al servicio de urgencias, pocas veces se sospecha enfermedad cardíaca isquémica.
Red blood cell distribution width (RDW) has been shown to have prognostic value in a number of different clinical settings, such as cardiovascular disease, including heart failure. However, its prognostic value in heart transplant (HT) recipients remains unknown. The aim of this systematic review is to determine the prognostic value of pre-transplant RDW for mortality in HT recipients. There is a pre-published protocol of this review. The terms "Heart transplant", "Red cell distribution width" and their synonyms were used in the search strategy. PubMed/Medline, Embase, Scopus, Web of Science and LILACS were searched until May 17th, 2022, without date or language restrictions. Two authors independently carried out the selection, first by title and abstract, second by full-text revision. Discrepancies were discussed and resolved with three other authors. Quality of individual studies was assessed with Newcastle Ottawa Scale (NOS) for cohorts. After removing the duplicates, 3885 articles were identified. Four articles were included in the qualitative synthesis. Three studies were classified as “good quality”: whereas one as “poor quality” according to NOS scale. All the included articles evaluated long-term mortality and one study also evaluated short-term mortality. In this one, a correlation between higher RDW values and short-term mortality was reported. Meanwhile, in all the studies, a high pre-HT RDW was a marker of long-term mortality following cardiac transplantation. Our review shows that an elevated on-admission RDW is associated with long-term mortality in heart transplantation recipients.
Production of bacterial cellulose and its evaluation as a proton exchange membrane (PEM) was evaluated. Initially, the bacterial cellulose (BC) was produced by fermentation in a 600 mL bioreactor with a 300 mL medium volume, 10% v/v inoculum with Komagataeibacter hansenii under static conditions, and a temperature of 30°C. The bacteria were cultivated in Hestrin-Schramm (HS) medium with pH adjustment to 6.6 with HCl and/or NaOH. Five culture media were evaluated: HS (M1), M1 + green tea extract (M3), M1 + mixture of extra thyme and green tea (M4), and M1 + glycerin (M5). The kinetics of BC production was followed by digital images. Subsequently, BC production cellulose was carried out using M5 under the same operating conditions. After 3, 5, 10 and 13 days of fermentation, the thickness of formed BC formed was measured, respectively, as 0.301 ± 0.008 cm, 0.552 ± 0.026 cm, 0.584 ± 0.03 cm and 0.591 ± 0.018 cm. Finally, BC was characterized by porosity, water absorption capacity, ion exchange capacity, mechanical strength and diffusivity. The results showed that thinner membranes favor the processes of ion exchange (0.143 H ⁺ mmol g − 1 ) and water absorption (93%). On the other hand, thicker membranes enhance physical parameters of transport across the membrane and its operability. Nevertheless, BC membranes can be a good alternative as PEM once they are functionalized.
We present the case of a patient with a history of symptomatic hypoglycaemic episodes and a negative 72-hour fasting test with histological confirmation of insulinoma. A literature review of hyperinsulinaemic hypoglycaemia with a negative fasting test was performed. LEARNING POINTS • The 72-hour fasting test is the gold standard for insulinoma diagnosis. • Few cases of insulinoma with a negative fasting test have been reported. • New strategies for insulinoma diagnosis are being investigated.
The pandemic caused by the new coronavirus named SARS-CoV-2 poses unprecedented challenges in the health care. Among them is the increase in cases of delirium. The severe SARS-CoV-2 disease, COVID-19, has common vulnerabilities with delirium and produces alterations in organs such as the lungs or the brain, among others, which have the potential to trigger the mental disorder. In fact, delirium may be the first manifestation of the infection, before fever, general malaise, cough or respiratory disturbances. It is widely supported that delirium increases the morbidity and mortality in those who suffer from it during hospitalization, so it should be actively sought to carry out the relevant interventions. In the absence of evidence on the approach to delirium in the context of COVID-19, this consensus was developed on three fundamental aspects: diagnosis, non-pharmacological treatment and pharmacological treatment, in patients admitted to the general hospital. The document contains recommendations on the systematic use of diagnostic tools, when to hospitalize the patient with delirium, the application of non-pharmacological actions within the restrictions imposed by COVID-19, and the use of antipsychotics, taking into account the most relevant side effects and pharmacological interactions.
Background Despite the need for specific weaning strategies in neurological patients, evidence is generally insufficient or lacking. We aimed to describe the evolution over time of weaning and extubation practices in patients with acute brain injury compared with patients who are mechanically ventilated (MV) due to other reasons.Methods We performed a secondary analysis of three prospective, observational, multicenter international studies conducted in 2004, 2010, and 2016 in adults who had need of invasive MV for more than 12 h. We collected data on baseline characteristics, variables related to management ventilator settings, and complications while patients were ventilated or until day 28. ResultsAmong the 20,929 patients enrolled, we included 12,618 (60%) who started the weaning from MV, of whom 1722 (14%) were patients with acute brain injury. In the acutely brain-injured cohort, 538 patients (31%) did not undergo planned extubation, defined as the need for a tracheostomy without an attempt of extubation, accidental extubation, and death. Among the 1184 planned extubated patients with acute brain injury, 202 required reintubation (17%). Patients with acute brain injury had a higher odds for unplanned extubation (odds ratio [OR] 1.35, confidence interval for 95% [CI 95%] 1.19–1.54; p < 0.001), a higher odds of failure after the first attempt of weaning (spontaneous breathing trial or gradual reduction of ventilatory support; OR 1.14 [CI 95% 1.01–1.30; p = 0.03]), and a higher odds for reintubation (OR 1.41 [CI 95% 1.20–1.66; p < 0.001]) than patients without brain injury. Patients with hemorrhagic stroke had the highest odds for unplanned extubation (OR 1.47 [CI 95% 1.22–1.77; p < 0.001]), of failed extubation after the first attempt of weaning (OR 1.28 [CI 95% 1.06–1.55; p = 0.009]), and for reintubation (OR 1.49 [CI 95% 1.17–1.88; p < 0.001]). In relation to weaning evolution over time in patients with acute brain injury, the risk for unplanned extubation showed a downward trend; the risk for reintubation was not associated to time; and there was a significant increase in the percentage of patients who underwent extubation after the first attempt of weaning from MV.Conclusions Patients with acute brain injury, compared with patients without brain injury, present higher odds of undergoing unplanned extubated after weaning was started, lower odds of being extubated after the first attempt, and a higher risk of reintubation.
Introduction According to the World Health Organization (2016), adolescence is one of the most important transitional steps in the life of a human being, recognized by an accelerated rate of growth and changes in behavior. Adolescents from Colombia have reached this step, immersed in a context with a history of social, interpersonal and economic violence. In this sense, study of constructs such as empathy and aggressive behaviors are crucial to appease a healthy school coexistence and thus, contribute to a peace cultur Objectives Analyze the relationship between empathy and aggressive levels from adolescents. Methods This study was done through a cross-sectional study of correlational scope in 240 (N= 240) students. The Prosocial Behavior Questionnaire developed by Martorell and Gonzalez (1922) and the Aggressive questionnaire, developed by Buss and Perry (1992) were applied. The first one was used to measure empathy and the latter to appraise aggressiveness. Results There was evidenced of adequate levels of empathy and a great percentage of medium levels of verbal and physical aggressiveness. (Graph 1). In addition, there was a significant statistical correlation of negative magnitude between these variables (Table 1). Conclusions It was concluded that the higher the optimal levels of empathy, the lower the aggressive behavior presented by teenagers. Disclosure No significant relationships.
Immunomodulators such as tumour necrosis factor (TNF) inhibitors are used to treat autoimmune conditions by reducing the magnitude of the innate immune response. Dampened innate responses pose an increased risk of new infections by opportunistic pathogens and reactivation of pre-existing latent infections. The alteration in immune response predisposes to increased severity of infections. TNF inhibitors are used to treat autoimmune conditions such as rheumatoid arthritis, juvenile arthritis, psoriatic arthritis, transplant recipients, and inflammatory bowel disease. The efficacies of immunomodulators are shown to be varied, even among those that target the same pathways. Monoclonal antibody-based TNF inhibitors have been shown to induce stronger immunosuppression when compared to their receptor-based counterparts. The variability in activity also translates to differences in risk for infection, moreover, parallel, or sequential use of immunosuppressive drugs and corticosteroids makes it difficult to accurately attribute the risk of infection to a single immunomodulatory drug. Among recipients of TNF inhibitors, Mycobacterium tuberculosis has been shown to be responsible for 12.5-59% of all infections; Pneumocystis jirovecii has been responsible for 20% of all non-viral infections; and Legionella pneumophila infections occur at 13-21 times the rate of the general population. This review will outline the mechanism of immune modulation caused by TNF inhibitors and how they predispose to infection with a focus on Mycobacterium tuberculosis, Legionella pneumophila, and Pneumocystis jirovecii. This review will then explore and evaluate how other immunomodulators and host-directed treatments influence these infections and the severity of the resulting infection to mitigate or treat TNF inhibitor-associated infections alongside antibiotics.
This paper explores the hyperbolic heat transfer effects in processes involving high heating rates. The behavior of the model is analyzed in detail under different boundary conditions and the circumstances under which a non-Fourier law could be used to describe thermal conduction processes established from physical mathematical analysis. Finally, the model developed here is coupled to a previous population balance framework to predict the bubbling phenomenon that occurs during the fast pyrolysis of biomass. We found that a transient overheating occurs in the central zone of the generated liquid phase due to the high heating rates that take place during that process.
Resumen Introducción La enfermedad pulmonar intersticial (EPI) suele tener una pobre respuesta terapéutica y un mal pronóstico. Uno de los métodos que podrían ayudar a su diagnóstico y optimizar el manejo de estos pacientes es la capilaroscopia. El objetivo del estudio fue determinar las características clínicas y capilaroscópicas de pacientes con EPI y la frecuencia de los hallazgos que sugieran enfermedad autoinmune. Métodos Estudio observacional descriptivo que evaluó pacientes con EPI, sin diagnóstico previo de enfermedad autoinmune, atendidos entre los años 2010 y 2019, a quienes se les realizó entrevista, capilaroscopia y se tomó laboratorio. Resultados Se evaluaron 28 pacientes, 16 (57,1%) de los cuales fueron mujeres y 17 (60,7%) tenían HTA. Tres pacientes (10,7%) refirieron rigidez matinal mayor de 60 min y uno edema digital inexplicable. No se encontraron telangiectasias, fenómeno de Raynaud, manos de mecánico, esclerodactilia o signo de Gottron, ni ANA con títulos superiores a 1:80. El resto de los paraclínicos fueron negativos en el 100% de los pacientes. En las capilaroscopias, 13 (46,4%) pacientes tenían un patrón capilaroscópico normal y 15 (53,6%) tenían anormalidades capilaroscópicas con significado indeterminado. No hubo ninguno con patrón de esclerosis sistémica o similar. Conclusiones No se hicieron hallazgos de laboratorio o capilaroscópicos que sugirieran enfermedad intersticial con características autoinmunes, posiblemente debido a la baja prevalencia de la enfermedad, su alta mortalidad y subdiagnóstico. Estos hallazgos refuerzan el concepto de la normalidad capilaroscópica en pacientes con EPI no autoinmune y constituyen un llamado a la búsqueda activa de la EPI con características autoinmunes para fines pronósticos.
Introduction: Tension band plates (TBP) for guided growth (GG) are the gold standard treatment for angular deformities around the knee. EPIFLEX® is a novel flexible TBP that adjusts to the patient's bone anatomy. Hypothesis: GG using a flexible TBP produces satisfactory correction rates with minor complications in the pediatric population with angular deformities around the knee. Materials and methods: A retrospective evaluation of 33 patients (60 knees) treated for genu varum and valgum with hemiepiphysiodesis using a flexible TBP between 2017 and 2020 was performed. The study aimed to assess correction and complication rates; patients who completed treatment were included regardless of the follow-up times after implant removal. Results: 13 females and 20 males with a median age of 10 years were included. The median treatment duration and follow-up were 10 and 22 months. The median monthly rate of change of mLDFA and mMPTA was 0.67° and 0.57°, respectively. A successful correction was achieved in 90% of the cases. There were no cases of infection or implant failure. Four cases presented overcorrection and two undercorrection; no significant relation with deformity or obesity was found. Discussion: GG using this flexible TBP showed satisfactory correction rates with a low incidence of complications and no implant failure. It provides flexibility through good adaptability to the bone anatomy and mobility of the screws avoiding implant protrusion or breakage. Level of Evidence: IV; observational descriptive case series
The prevalence of Heart Failure is growing alarmingly; its treatment consumes health resources and affects the quality of life of patients. Objective to describe the changes in NYHA functional Class, ejection fraction, hospitalizations and mortality after 8 years of follow up in a multidisciplinary heart failure program in Colombia as a model for lower and middle income countries. Methods An observational study was performed with the retrospective analysis of the information Results 1757 patients were included, The NYHA functional class at the beginning of the program was: NYHA I 23.5%, NYHA II 50.3%, NYHA class Improvement was observed at the end of the follow-up with an increase in the percentage of patients in Functional Class NYHA I and II. The reduction in hospitalizations were 35% less (mean: 0.68 ± 0.95, p < 0.0001), a reduction in the length of stay in the hospital was 13.2% (before: 4.46 ± 7.16, after 3.87 ± 8.1 days, p < 0.001). The total mortality after eight years of follow-up was 6.6 % (n = 116). Conclusion Multidisciplinary follow-up in HF programs improves Functional Class and EF, decreases hospital admissions as well as hospitalization and the length of stay. This is a very simple and successful model of care for this disease that can be implemented for countries of lower- and middle-income countries.
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Cesar A. Isaza-Roldan
  • Facultad de Ingeniería Mecánica
Alicia Krikorian
  • Escuela de Ciencias de la Salud
Carlos Arboleda
  • Facultad de Teología
Vladimir Martínez
  • Facultad de Ingeniería Mecánica
Cristina Castro
  • Escuela de Ingenierías
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Cir 1a No. 70 - 01, Laureles, Campus Universitario, Medellín, Departamento de Antioquia, Colombia
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www.upb.edu.co
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