Investor Presentaiton

IJMS XXVI CECIM S12 INTERNATIONAL JOURNAL of MEDICAL STUDENTS Abstracts Abstracts 05 Prescription Patterns Of New Oral Anti-Coagulants And Their Economic Costs In Colombia Federico Villegas Cardona, Santiago García Betancurt, Diego Alejandro Medina Morales, Jorge Enrique Machado Alba. Scientific Society: Asociación Científica de Estudiantes de Medicina de Risaralda, ACEMRIS. Introduction: Atrial fibrilatrion is the the most common arrhythmia with an incidence of 8% in people older than 80. It creates a risk of thromboembolic events but this can be prevented by using warfa- rine and new oral anticoagulants (NOACS), which can reduce this risk in 83%. Objective: To determine the patterns of prescription of NOACS and variables associated with its use in a population of patients affiliated to the Colombian Health System during the year 2014. Methods: Cross sectional observational descriptive study. A group of patients treated with dabigatran, rivaroxaban and apixaban were observed, from February to April 2014 using a database with 6,5 million patients affiliated to the Colombian Health System. Socio- demographic, pharmacologic, comedication and economic variables were measured. SPSS 22.0 was used with statistical tools such as: T student, chi squared and logistic regression. Results: A total of 1310 patients were treated with NACOS, 57.2% were men; treated in monotherapy (88%); and the association with inhibitors of platelet aggregation was presented in an 10.5%. Comedication was present in 77% of cases. The most commonly drug prescribed was ribaro- xaban (52.9%). The cost by 1000 inhabitants/day was COP$143.9 to dabigatran, COP$106.0 to rivaroxaban and COP$12.3 to apixaban. Dis- cussion: Dabigatran was the drug with higher cost by patients and day. From these patterns can be determined that are being emplo- yed primarily NOACS in monotherapy. Further studies evaluating the effectiveness and safety in Colombians are required. Keywords: Dabigatran, Rivaroxaban, Apixaban, Drug Prescriptions, Pharmacoepidemiology, Colombia. 06 Prevalence of Respiratory Symptoms And Risk Of Obstruction To The Air Flow In Ginebra - Valle Del Cauca. Alirio Rodrigo Bastidas Goyes, Jorge Luciano Villán Gaona, Valeria Betancourt, Andrea Suarez, Gustavo Adolfo Hincapié Díaz. Scientific Society: Asociación de Estudiantes de Medicina de la Universidad Militar Nueva Granada, ACEMED-UMNG. Introduction: The research of Respiratory Symptoms provide informa- tion about the condition of health of the community. It's a Commu- nity research with the purpose of determine the prevalence of res- piratory symptoms and prediction of airflow obstruction. Methods: Transversal cohort research in April 2014 in Ginebra (Valle del Cauca), was maked a sampling by conglomerate, minimum sample size of 115 subjects (prevalence 50%, accuracy 10{5 and loss rate 20%}), application of validated questionnaire about symptoms respiratory and lung function. Results: 146 subjects, 2 loss, median of age 60,5 years (IQR:22), 55.1% male, Prevalence of cough 18,1% (CI: 95% 11.8 to 24,3), expectoration 20,1 (Cl: 95% 13,9 to 27,1), wheezing 28,2 (CI: 95% 14,6 to 28,5) Dyspnea 33,3% (CI: 95% 25 to 41), people at risk airflow limitation 19,4% (CI: 95%: 14,2 to 28,4). Discussion: Respira- tory Symptoms of cough, expectoration, wheezing and dyspnea are common in the community and theirs frequency distribution is simi- lar in other countries worldwide, the reporting of chronic bronchitis is 2,8%, emphysema 0,7%, COPD 3,5% ASMA 4,9% is low with lesser extent than that observed with a questionnaire of lung function, the smoking history 41,7% and cooking with firewood ever is 54,4% are most common risk factors, as well as smoking, the number of packs year and the exposure to wood smoke is associated with the presence of cough, expectoration and wheezing (p<0,05). Conclusion: Dyspnea is the most common symptom mentioned, the use of a questionnaire about the respiratory symptoms shows the highest percentage in patients with possible airflow limitation that usually referred. Keywords: Signs and respiratory symptoms, cough, dyspnea, test of pulmonary function. 07 Chronic Use Of Drugs Related To Long Qt Syndrome In Elderly Population From Colombia Andrés Gaviria Mendoza, Paula Andrea Moreno, Mauricio Montoya Cañón, Jorge Enrique Machado Alba. Scientific Society: Asociación Científica de Estudiantes de Medicina de Risaralda, ACEMRIS. Introduction: Medication is the main cause of long QT syndrome (LQTS) and elderly population is at higher risk. Objective: To describe the prescription patterns of drugs that may cause LQTS in Colom- bian elderly population. Methods: Descriptive retrospective study. Patients older than 65 years whom received medication that causes LQTS during three months, were selected. The medication was obtai- ned and classified according to the list from Crediblemeds.org. The data was analyzed using SPSS 22, a p<0.05 was considered signifi- cant. Results: 37559 patients were receiving chronically drugs that cause LQTS; 61.8% of them were woman and average age was 76.2 years. One drug related to LQTS was consumed by 92.3% (n=34682) of patients and 6.7% (n=2521) received two. Conditional risk drugs were consumed by 97.4% of patients, 3.0% received known risk drugs and 2.0% received drugs with possible risk. Patients had an ave- rage of 2,9 risk factors for LQTS (Range: 0-7, sd: 0.86). Discussion: Most patients consume medication with conditional risk of LQTS, which means that it depends on the presence of another risk factors. However, a great proportion of patients had additional risk factors. Conclusion: The widespread use of medication related to LQTS and the extensive presence of additional risks in elderly population, raise the need of a warning system for this issue. Keywords: Colombia, Drug-Related Side Effects and Adverse Reac- tions, Elderly, Long QT Syndrome. rentiation of Human Stromal Cell-Derived Adipose Tissue. Liliana Elizabeth Sussmann Estrada, Carlos H. Escobar-Soto, Luz Dary Gutierrez, Orlando Chaparro. Scientific Society: Sociedad de Investigación Científica de Estudiantes de Medicina de la Fundación Universitaria de Ciencias de la Salud, SICEM-FUCS. Introduction: TRPM8 is a nonspecific channel of mono- and divalent cations, which is blocked by activated clotrimazole and menthol. It has been linked to the proliferation and viability of undifferentiated cells, but has not been described expression in mesenchymal stem cells derived from human adipose tissue (HASC). Objective: Evaluate the expression of TRPM8 in hASC and its modulation effect menthol and clotrimazole, have on the proliferation and differentiation of hASCs. Methods: By immunofluorescence TRPM8 expression was de- monstrated in the hASC. The effect Clotrimazole (10 uM) and Menthol (300 mM), on the proliferation of hASC and PC3 cell lines (positive control) and SH-SY5Y cells (negative control) was characterized. By staining with alizarin red oil red O and the effect Clotrimazole (10) uM) and Menthol (300 mM), on the adipogenic and osteogenic di- fferentiation of hASC evaluated. Results: TRPM8 expression in hASC is demonstrated. Both as menthol clotrimazole significantly reduced proliferation hASC (46 and 53% respectively) after 14 days of culture and clotrimazole abolished the ability of the osteogenic differentia- tion hasC. Conclusion: HASC demonstrated that express TRPM8 and blocking its activity suppresses the proliferation clotrimazole and osteogenic differentiation of these cells. Keywords: Adult Stem Cells, cell proliferation, cell differentiation, Ca- tionic Channel TRPM8. 10 08 Efectiveness of Lipid-Lowering Therapy In A Sample Of Co- lombian Patients Maria Camila Yepes Echeverri, Santiago Manrique Castaño, Manuel Enrique Machado Duque, Luisa Marcela Patiño, Jorge Enrique Machado Alba. Scientific Society: Asociación Científica de Estudiantes de Medicina de Risaralda, ACEMRIS. Introduction: The prevalence of cardiovascular disease has increased and is associated with hypercholesterolemia as a risk factor. Few pa- tients take adequately lipid-lowering therapy and treatment effecti- veness is unknown in some populations. It was set out to determine the effectiveness of the lipid lowering therapy in patients affiliated to the Colombian Health System. Methods: Case-control study to compare the effect of lipid lowering drugs, in a random sample of 211 patients treated with statins, over 18 years, in four Colombian cities between 2012 and 2013. Sociodemographic, anthropometric, cardiovascular, pharmacological and laboratory variables (total cho- lesterol (TC), LDL, HDL, triglycerides) were obtained. Results: Female predominance (56.4%), mean age 64±12 years, monotherapy with atorvastatin (63.9%) or with lovastatin (35.0%) was found. The 91.5% of the sample had hypertension, 32.2% diabetes mellitus and 19.9% history of cardiovascular disease. On average the reduction of TC was 11.5% and 8.8% at 6 months and 7.4% and 12.0% at 12 months with atorvastatin and lovastatin respectively. There were no statisti- cally significant differences found between the final LDL treated with lovastatin and atorvastatin (p=0.059). Discussion: The therapy was effective in reducing TC in patients with atorvastatin and lovastatin. The effectiveness was comparable for the two statins. It is important to adjust the therapy according to comorbidities and patient needs. Conclusions: It is important to adjust the therapy according patient's needs and their comorbidities. Finally, it was found significant va- riables associated to a major risk of control, as: being treated with atorvastatin, co-medicated with ẞ-Blockers and have had a previous heart attack. Keywords: Dyslipidemia, effectiveness, therapy, cardiovascular disea- se, lovastatin, atorvastatin, pharmacoepidemiology. 09 Clotrimazole Represses Proliferation And Osteogenic Diffe- Alterations In Brain Imaging In Congenital Toxoplasmosis: Case Series In Quindio (Colombia) 2004-2014 Carlos Fernando Moreno Rendón, Jorge Gómez Marín. Scientific Society: Asociación Científica de Estudiantes de Medicina de la Universidad del Quindío, ASEIMUQ. Introduction: There are few studies analyzing brain imaging in conge- nital toxoplasmosis and presumptive diagnosis sometimes is based on imaging characteristics. Objective: to report the cerebral imaging characteristics of children with confirmed congenital toxoplasmosis. Methods: A case series based on clinical charts of 85 patients with confirmed congenital toxoplasmosis (2004-2014) in the external con- sultation of the health care center of the Quindio's University. Were selected those with cerebral tomography (CT). Results: 25 patients had brain imaging studies, between them, 19 had imaging abnorma- lities. Of these, 5 (26,3%) presented only calcifications, in 2 (10,5%) there were hydrocephalus + calcifications, 4 (21,1%) other findings, 1 (5,3%) had hydrocephalus + other findings, in 1 (5,3%) other fin- dings and calcifications. In 6 (31,6%) there were calcifications + hydrocephalus + other findings. The incidence of hydranencephaly in symptomatic congenital toxoplasmosis was 5,3 %. In 1 case there were periventricular calcifications exclusively. Improvement in brain imaging (reduction in size and number of calcifications) was ob- served in 4 patients treated with pyrimethamine- sulfadoxine. Dis- cussion: The most frequent finding was diffuse parenchymal calci- fications. Postnatal treatment was associated with improvement in neurological imaging. Isolated periventricular calcifications are also found in congenital toxoplasmosis. Conclusion: postnatal treatment with Pyrimethamine-Sulfadoxine could reduce the finding of altera- tions in brain tomography. Keywords: Hydranencephaly; Hydrocephalus; Pyrimethamine; Sulfa- doxine; Toxoplasmosis, Congenital. CASE REPORTS 01 Bone Cyst Of The Sacrum Post Hemophilic Pseudotumor Laura Alejandra Chica Quintero, Francisco Mesa Cadavid, Mauricio Montoya Cañón Scientific Society: Asociación Científica de Estudiantes de Medicina de Risaralda, ACEMRIS. Introduction: Pseudotumor is an encapsulated hematoma secondary to chronic bleeding that presents in 1 to 2% of all patients. Depen- ding on its localization, it may affect bones, nerves or surrounding tissues and organs, although the bone cyst is an uncommon pre- sentation of this rare condition. Case report: In this case report, a 53 years old male patient with moderate type A haemophilia con- sulted because of pelvic mass sensation. The patient was receiving prophylactic management with 2500 units of recombinant VII factor and had a factor activity of 1.3%. Previous medical history included a haemophilic recidivate pseudotumor dependent of the right iliac psoas that was surgically removed 16 years ago. Additionally, the patient was diagnosed in 2012 with inhibitors of low response and managed successfully through immunotolerance. A contrast-enha- ced magnetic resonance found an expansive haemophilic pseudotu- mor dependent of the right iliac muscle that caused emaciation of the iliac aileron. In addition, there was an image with non-contrast uptake located in the right iliac fin, in relation with a unicameral bone cyst. Conclusion: Pseudotumor surgical resection has been the first choice of treatment for this condition. However, the localization and size of this particular mass increased significantly the risk of large bleedings, therefore other treatment options like tumor artery embolization or irradiation are being considered. 02 Thyrotoxic Hypokalemic Periodic Paralysis, A Case Report Adriana Margarita M Trejos Tenorio, Farah El-Sharkawy Nava- rro Scientific Society: Asociación Científica de Estudiantes de Medicina de la Universidad del Valle, ACEMVAL. Introduction: Thyrotoxic hypokalemic periodic paralysis (THPP) is a rare complication of hyperthyroidism and an unusual initial presen- tation of the disease. Its pathophysiology is yet not well known and there are few cases reported in the literature. Case report: We present the case of a 22-year-old Colombian male, with no rele- vant personal or family history of disease. He was admitted to the emergency department in the context of sudden upward and rapidly progressive paraparesis, inability to stand, and multiple emetic epi- sodes. Several hours before the onset of symptoms he had drunk a moderate amount of alcohol. The initial findings on the physi- cal examination were diaphoresis, tachycardia, and areflexia in the lower limbs. His symptoms progressed to quadriplegia and marked respiratory compromise, requiring intubation and management in an Intensive Care Unit. Guillain-Barré syndrome and methanol poisoning were considered amongst the differential diagnoses, but were dis- missed by the Internal Medicine and Toxicology departments. The lab report showed severe hypokalemia (potassium 1,7mEq/L) and hy- perthyroidism (TSH 0.0023 mU/L and free T4 2.37 mg/dL). Treatment was ensued with potassium chloride, propranolol, methimazole, hy- drocortisone, and lugol, obtaining a positive clinical and paraclinical response with resolution of the paralysis. Conclusion: THPP is not well known or suspected in our healthcare setting despite being a life threatening condition. Treatment is directed towards a rapid control of hypokalemia and hyperthyroidism, by which the condition is reversed. Keywords: Hypokalemic periodic paralysis, hypokalemia, hyper- thyroidism. 03 Globicatella Sanguinis: Descripción De Un Caso De Meningitis En El Hospital Militar Central Sergio Díaz Martínez, Jorge Luciano Villán Gaona, Samuel Vega Hurtado, Alberto Fabio Caballero Restrepo, Diana Patri- cia Pachón. Scientific Society: Asociación de Estudiantes de Medicina de la Universidad Militar Nueva Granada, ACEMED-UMNG. Introduction: Globicatella Sanguinis is a rare pathogen, Gram positive coccus, catalase negative, which is isolated but in sheep, has been described as an infectious agent causing meningitis in humans. Part of the cases was reported as meningitis due to S. viridans could be INTERNATIONAL JOURNAL of MEDICAL STUDENTS www.ijms.info • 2015 Vol 3 Suppl 1 www.ijms.info . 2015 Vol 3 Suppl 1 INTERNATIONAL JOURNAL of MEDICAL STUDENTS XXVI CECIM S13