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Search Results: 1 - 10 of 458464 matches for " Carlos Alberto; Múnera "
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Endocarditis por Coxiella burnetii: fiebre Q
Betancur,Carlos Alberto; Múnera,Ana G;
Acta Medica Colombiana , 2012,
Abstract: q fever is a zoonosis caused by coxiella burnetii. q fever may present as subacute or chronic endocarditis, has a high incidence of embolic phenomena and is often fatal, representing 1% of all cases of endocarditis worldwide. q fever most commonly presents an insidious course. the diagnosis is made by clinical suspicion after serial blood cultures for conventional pathogens are negative and by serological confirmation. this article describes the clinical case of a patient with endocarditis caused coxiella burnetii and updated review of the literature. (acta med colomb 2012: 37: 31-33).
Endocarditis por Coxiella burnetii: fiebre Q Coxiella burnetii endocarditis: Q fever
Carlos Alberto Betancur,Ana G Múnera
Acta Medica Colombiana , 2012,
Abstract: La fiebre Q es una zoonosis causada por Coxiella burnetii; más frecuente en Europa pero reportada en otros continentes, puede cursar en forma aguda o crónica. La endocarditis es una forma de presentación crónica con curso insidioso y se asocia frecuentemente a fenómenos embólicos, representa 1% de todos los casos de endocarditis en el mundo. El diagnóstico se realiza por la sospecha clínica, cultivos negativos para patógenos convencionales y la confirmación serológica. Este artículo describe el caso clínico de un paciente con endocarditis causada por Coxiella burnetii y se revisa la literatura. (Acta Med Colomb 2012: 37: 31-33). Q fever is a zoonosis caused by Coxiella burnetii. Q fever may present as subacute or chronic endocarditis, has a high incidence of embolic phenomena and is often fatal, representing 1% of all cases of endocarditis worldwide. Q fever most commonly presents an insidious course. The diagnosis is made by clinical suspicion after serial blood cultures for conventional pathogens are negative and by serological confirmation. This article describes the clinical case of a patient with endocarditis caused Coxiella burnetii and updated review of the literature. (Acta Med Colomb 2012: 37: 31-33).
La calidad de la atención en salud, más allá de la mirada técnica y normativa
Múnera Gaviria,Hugo Alberto;
Investigación y Educación en Enfermería , 2011,
Abstract: objective. to understand the perceptions the users have about health care quality received in three health care institutions in the city of medellin, colombia. methodology. qualitative approach from the perspective of focused ethnography. data were obtained through semi structured interviews, non participant observation, field journey and documentary revision. informed consent from the participants and hospitals authorization was obtained. the participants were 18 users. results. categories resulting from the analysis were: the health care way, meeting with the other, health care differences, and how to solve the complaint. conclusion. from the users view, there are difficulties with health care associated with health care providers, especially with the daily relationship with the users. this situation is a consequence of the efficiency and technical model, where the user as a subject and person is every time more invisible.
La calidad de la atención en salud, más allá de la mirada técnica y normativa A qualidade do atendimento em saúde, além da mirada técnica e normativa Quality of health care, beyond the technical and rules view
Hugo Alberto Múnera Gaviria
Investigación y Educación en Enfermería , 2011,
Abstract: Objetivo. Comprender las percepciones que tienen los usuarios sobre la calidad de la atención en salud recibida en tres instituciones de salud en la ciudad de Medellín, Colombia. Metodología. Enfoque cualitativo desde la perspectiva de la etnografía focalizada. Los datos se obtuvieron mediante entrevistas semiestructuradas, observación no participante, diario de campo y revisión documental. Se tuvo en cuenta el consentimiento informado de los participantes y la autorización de las instituciones hospitalarias. Los participantes fueron 18 usuarios. Resultados. Las categorías que surgieron producto del análisis fueron: el camino hacia la atención en salud, el encuentro con el otro, las diferencias en la atención en salud y cómo resolver la queja. Conclusión. Desde la mirada de los usuarios existen dificultades en la atención brindada por el personal de salud, especialmente en lo que tiene que ver con relaciones cotidianas con los usuarios. Esta situación es consecuencia del modelo de salud eficientista y tecnicista, donde el usuario como sujeto y persona es cada vez más invisible. Objetivo. Compreender as percep es que têm os usuários sobre a qualidade do atendimento em saúde recebida em três institui es de saúde na cidade de Medellín, Col mbia. Metodologia. Enfoque qualitativo desde a perspectiva da etnografia focalizada. Os dados se obtiveram mediante entrevistas semi-estructuradas, observa o n o participante, diário de campo e revis o documentário. Teve-se em conta o consentimento informado dos participantes e a autoriza o das institui es hospitalares. Os participantes foram 18 usuários. Resultados. As categorias que surgiram produto da análise s o: o caminho para o atendimento em saúde, o encontro com o outro, as diferen as no atendimento em saúde, e como resolver a queixa. Conclus o. Desde o ponto de vista dos usuários existem dificuldades no atendimento brindado pelo pessoal de saúde, especialmente no que tem que ver com rela es cotidianas com os usuários. Esta situa o é conseqüência do modelo de saúde eficiente e tecnicista, onde o usuário como sujeito e pessoa é cada vez mais invisível Objective. To understand the perceptions the users have about health care quality received in three health care institutions in the city of Medellin, Colombia. Methodology. Qualitative approach from the perspective of focused ethnography. Data were obtained through semi structured interviews, non participant observation, field journey and documentary revision. Informed consent from the participants and hospitals authorization was obtained. The participants wer
Democracias prepago? El control de la financiación de la política, un reto para Colombia y Latinoamérica . David ROLL (ed.). Bogotá: Universidad Nacional de Colombia, 2010. 297 pp. ISBN 978-958-719-436-4.
Carlos Andrés PéREZ MúNERA
América Latina Hoy , 2011,
Abstract:
Rese a de " Democracias prepago? El control de la financiación de la política, un reto para Colombia y Latinoamérica" de David ROLL (ed.)
Carlos Andrés PéREZ MúNERA
América Latina Hoy , 2010,
Abstract:
Terapia de resincronización cardiaca: experiencia, seguimiento clínico y ecocardiográfico, y optimización del dispositivo con ecocardiografía Heart resynchronization therapy: experience, clinical follow-up and optimization of the device with echocardiography
Ana G Múnera,Gustavo Restrepo,Mauricio Duque,Carlos Cubides
Revista Colombiana de Cardiología , 2007,
Abstract: Antecedentes: en pacientes con falla cardiaca avanzada, clase funcional III-IV, la mortalidad alcanza el 50% a un a o y el 80% a dos a os. Algunos permanecen sintomáticos y tienen pobre estado funcional a pesar del tratamiento farmacológico. La terapia de resincronización cardiaca es una alterativa terapéutica que mejora la hemodinámica y los síntomas en estos pacientes. Objetivo: analizar la experiencia en el manejo de la falla cardiaca con dispositivos de terapia de resincronización cardiaca con o sin cardiodesfibrilador. Dise o metodológico: se realizó un estudio de intervención, sin asignación aleatoria de los pacientes, con evaluación antes y después de la intervención. Resultados: la población estuvo constituida por 82 pacientes, 73% hombres. La edad promedio fue de 65,4 ± 11,9 a os. La etiología fue no isquémica en 50 pacientes e isquémica en 32. La fracción de expulsión promedio inicial fue de 19,4% ± 11,7%. La clase funcional inicial fue clase III-IV en el 85,4% de los casos y todos los pacientes recibían tratamiento médico óptimo. Durante el seguimiento se observó mejoría de clase funcional, función diastólica, diámetro diastólico del ventrículo izquierdo, fracción de expulsión, insuficiencia mitral, área de la aurícula izquierda, presión sistólica pulmonar, parámetros de sincronía e índice de función miocárdica con diferencia estadísticamente significativa con relación al valor inicial (p<0,05). La supervivencia a 44 meses fue del 72%. Conclusión: la experiencia con terapia de resincronización cardiaca y seguimiento clínico y ecocardiográfico de los pacientes estudiados, es similar a la de los hallazgos de otros estudios descritos en la literatura. Antecedents: in patients with advanced heart failure, functional class III-IV, mortality reaches 50% at one year and 80% at two years. Some remain asymptomatic and have a poor functional state, regardless of the pharmacologic treatment. Heart resynchronization therapy is a therapeutic alternative that improves hemodynamic and symptoms in these patients. Objective: to analyze the experience in the management of heart failure with heart resynchronization therapy devices with or without cardio defibrillator. Methodologic design: an intervention study without aleatory patients' assignment, with evaluation before and after the intervention. Results: the cohort was constituted by 82 patients. 73% were men. Mean age was 65.4 ± 11.9 years. The etiology was non-ischemic in 50 patients and ischemic in 32. Mean initial ejection fraction was 19.4%± 11.7%. Initial functional class was class III - IV in 85% of c
Aplicación del modelo diagnóstico del grupo internacional para la hepatitis autoinmune (GHAI) en una población de pacientes de Medellín
Luis González,Verónica Múnera,Deisser Suárez,Fabián Alberto Jaimes Barragán
Iatreia , 2001,
Abstract: En nuestro medio no se conocen estudios donde se aplique el sistema de puntaje propuesto por el GIHAI (1). Nuestro objetivo fue evaluar la aplicabilidad del modelo y describir las características de este grupo de pacientes.
Encefalopatía hepática
Londo?o Múnera,Juan Pablo; Bejarano Pineda,Lorena; Restrepo Gutiérrez,Juan Carlos;
Iatreia , 2008,
Abstract: encephalopathy is a progressive but reversible complication in patients with acute or chronic hepatic disease. it can reduce the expectancy of life and affect its quality. the most accepted pathogenic theory to explain this syndrome is that of the ammonium toxicity, which may also explain other hypotheses such as edema of the astrocytes, and magnesium toxicity. the present classification system for hepatic encephalopathy was proposed in 1998 at the world congress of gastroenterology. it is based on the nature of the hepatic dysfunction, and the characteristics of the neurological manifestations. in order to make the diagnosis, a good clinical knowledge is necessary, since it is based mainly on the exclusion of other diseases. the west haven criteria are presently used to classify the severity of its clinical presentation. to control the manifestations of this syndrome and to improve the quality of life of patients, different therapeutic measures are used, namely: a diet that includes proteins, non-absorbable disaccharides, and the administration of antibiotics; however, the most important therapeutic measure is to control the precipitating factors. the aim of this article was to review recent concepts on hepatic encephalopathy, with emphasis on its pathogenesis, classification, diagnosis, and treatment.
La renovación curricular en el programa de Medicina de la Universidad de Antioquia
VILLEGAS MúNERA,ELSA MARíA; ARANGO RAVE,áNGELA MARíA; AGUIRRE MU?OZ,CARLOS;
Iatreia , 2007,
Abstract: in the article, an analysis is made of curricular renovation in the medical program at universidad de antioquia, in medellín, colombia, especially between 2000 and 2005; its purpose focused on moving from a traditional and technological concept of the curriculum to an integrationist tendency, centered on the student, flexible, focused on the cognitive processes and on achieving the training of a physician capable of answering to social, local and global needs. the implementation of problem based learning is analyzed as well as other didactic strategies, the role of the tutor and internal debate on competences. the study plan was organized around problematic areas, while the previous plan was structured starting from disciplines. the program included new areas of knowledge, among them medical information technology, analysis of human sexuality, communication and phases of the vital cycle not previously contemplated, such as adolescence and old age. disciplines oriented to health and society were posed in a longitudinal manner and health promotion, disease prevention and attention, and rehabilitation were considered as transcurricular axes. however, a fragmentary mentality that separates disciplines continues to predominate, there is a need to increase practice areas outside the hospital environment, evaluation remains as one of the critical aspects and administrative adjustment is pending. curricular management should be permanent with ample participation of both faculty and students.
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