Examinando por Autor "Durán Hernández, Álvaro-Hernán"
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- PublicaciónAcceso abiertoAre nutrition-induced epigenetic changes the link between socioeconomic pathology and cardiovascular diseases?(2008-07) Lopez-Jaramillo, Patricio; Silva, Sandra Y.; Rodríguez Salamanca, Narella; Durán Hernández, Álvaro-Hernán; Mosquera, Walter; Castillo, Victor R.The prevalence of cardiovascular diseases (CVD) and diabetes mellitus type 2 (DM 2) is decreasing in developed countries despite the increase in the percentage of subjects with obesity and other wellrecognized cardiovascular risk factors. In contrast, the recent transition of the economic model experienced by developing countries, characterized by the adoption of a Western lifestyle, that we have named ‘‘socioeconomic pathology,’’ has led to an increase in the burden of CVD. It has been demonstrated that conventional cardiovascular risk factors in developed and developing countries are the same. Why then does the population of developing countries currently have a higher incidence of CVD than that of developed countries if they share the same risk factors? We have proposed the existence of a higher susceptibility to the development of systemic inflammation at low levels of abdominal obesity in the population of developing countries and the consequent endothelial dysfunction, insulin resistance, DM 2, and CVD. In contrast, an important percentage of obese people living in developed countries have a healthy phenotype and low risk of developing CVD and DM 2. Human epidemiologic studies and experimental dietary interventions in animal models have provided considerable evidence to suggest that nutritional imbalance and metabolic disturbances early in life may later have a persistent effect on an adult’s health that may even be transmitted to the next generations. Epigenetic changes dependent on nutrition could be key in this evolutionary health behavior, acting as a buffering system, permitting the adaptation to environmental conditions by silencing or increasing the expression of certain genes.
- PublicaciónAcceso abiertoCalidad de vida antes y después de cirugía cardiovascular correctiva o paliativa en niños de 2 a 12 años con cardiopatía congénita intervenidos en la FCV (CARDIOLIFE)(Bucaramanga : Universidad de Santander, 2018, 2018-07-27) Rojas Torres, Juan P.; Durán Hernández, Álvaro-Hernán; Plata Vanegas, Silvia C.The concept of quality of life has been associated with that of illness and conceived as the relationship between the effects of this disease, those attributed to treatment, and subjective experiences that allow knowing the physical, social and emotional functioning of the patient. Given the lack of studies that evaluate the quality of life in children with congenital heart disease in our country, and even more so the lack of knowledge of the impact of surgical correction in this age group, this study was proposed with the objective of determining the quality level of life perceived by children and their caregivers, in a population of 2 to 12 years with congenital heart disease before and after a corrective or surgical palliative procedure through the application of the PEDSQL pediatric cardiovascular life scale. Through a prospective observational study, with a sample size of 28 patients aged 2 to 12 years with congenital heart disease before and after a corrective or surgical palliative procedure in the Cardiovascular Foundation of Colombia through the application of the quality scale of life PEDSQL. This study has the endorsement of the ethics committee. The population had an average age of 5.6 years, 64.3% of males. The CIA was the most frequent diagnosis and the most frequent procedure was the repair of atrial septal defect. 76% had an Aristotle of 2 or less, 82.6% had a STAT scale of 2 or less and the total of the study population had a RACHS of 3 or less. The global average of PEDSQL in children before was 67.5 and then was 80.6 (p = 0.003), in the parents it was 68.1 before and 67.4 after (p = 0.825).
- PublicaciónAcceso abiertoValor diagnóstico del biomarcador de neutrófilos CD64 para la detección temprana de sepsis de origen bacteriano durante el postoperatorio de pacientes pediátricos con cardiopatía congénita(Bucaramanga : Universidad de Santander, 2018, 2018-07-27) Meneses Silvera, Keyla M.; Prada Macias, Carlos-Enrique; Durán Hernández, Álvaro-Hernán; Plata Vanegas, Silvia C.; Torres Dueñas, DiegoLuego de cirugías cardiacas la incidencia de respuesta inflamatoria es del 8.9% aproximadamente, y el desarrollo de sepsis sucede entre el 0.39 al 2.5 %, considerándose un evento raro. El uso de biomarcadores tempranos puede mejorar la detección de infección en pacientes con severa respuesta inflamatoria según la literatura. Dentro de estos biomarcadores se menciona el marcador de neutrófilos CD64. El propósito de este estudio fue determinar el valor diagnóstico del CD64 para detectar sepsis en pacientes postoperatorios de cirugía cardiaca. Métodos: Cohorte retrospectivo, población pediátrica con cardiopatías congénitas, realizado entre los años 2014 y 2015. Pacientes postoperatorios de cardiopatías congénitas que presentara SIRS en las primeras 72 horas, que les hayan tomado el CD64, reactantes de fase aguda y cultivos, documentando el inicio o no de antibióticos entre otras variables. Resultados: Fueron 100 pacientes, menores de 18 años, con un mínimo de edad de 23 días. La incidencia de sepsis fue del 26% (IC95% 17,7; 35,7). El punto de corte del CD64 para predecir sepsis temprana fue ≥2,63 con una sensibilidad de 57,7% (IC95% 36,9; 76,6), una especificidad de 60,8% (IC95% 48,8; 72,0) con un área bajo la curva de 0,5686. Con este punto de corte, se incrementa el riesgo ocho veces de presentar sepsis. El factor de riesgo que puede influir en el desarrollo de sepsis es el tiempo de bomba prolongado. Conclusiones: El Biomarcador CD64 en este estudio retrospectivo, predice mejor sepsis bacteriana con un punto de corte ≥2,63 comparado con el punto original de >1,2.