Dyslipidaemias and their treatment in high complexity centres in Colombia.

Background And Objective: Data is scarce on the distribution of different types of dyslipidaemia in Colombia. The primary objective was to describe the frequency of dyslipidaemias. The secondary objectives were: frequency of cardiovascular comorbidity, statins and other lipid-lowering drugs use, frequency of statins intolerance, percentage of patients achieving c-LDL goals, and distribution of cardiovascular risk (CVR).

Deforestation in Colombian protected areas increased during post-conflict periods.

Protected areas (PAs) are a foundational and essential strategy for reducing biodiversity loss. However, many PAs around the world exist on paper only; thus, while logging and habitat conversion may be banned in these areas, illegal activities often continue to cause alarming habitat destruction. In such cases, the presence of armed conflict may ultimately prevent incursions to a greater extent than the absence of conflict.

A better Amazon road network for people and the environment.

The rapidly expanding network of roads into the Amazon is permanently altering the world's largest tropical forest. Most proposed road projects lack rigorous impact assessments or even basic economic justification. This study analyzes the expected environmental, social and economic impacts of 75 road projects, totaling 12 thousand kilometers of planned roads, in the region.

Edoxaban Versus Warfarin in Latin American Patients With Atrial Fibrillation: The ENGAGE AF-TIMI 48 Trial.

Background: There is limited information about the use of antithrombotic therapies and outcomes of Latin American (LatAm) subjects with atrial fibrillation. The global ENGAGE AF-TIMI 48 (Effective Anticoagulation With Factor Xa Next Generation Atrial Fibrillation-Thrombolysis In Myocardial Infarction 48) trial compared the efficacy and safety of edoxaban versus warfarin over a median follow-up of 2.8 years.

Current controversies in cholangiocarcinoma.

Cholangiocarcinoma represents 10% of primary liver malignancies and accounts for less than 3% of all gastrointestinal malignant tumors, with an enormous geographical variation. This neoplasia can arise from the biliary tract epithelium or hepatic progenitor cells. Depending on the anatomic localization, it is classified into three subtypes: intrahepatic, perihilar and distal.

Review of the genus Susuacanga (Coleoptera, Cerambycidae, Cerambycinae).

The genus Susuacanga Martins, 1997 is redescribed. A new combination, S. blancaneaui (Bates, 1880) comb.

[Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome].

The present document has been prepared by a group of experts, members of cardiology, endocrinology, internal medicine, nephrology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is a useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high-risk population, usually underestimated and undertreated.

[Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome].

The present document has been prepared by a group of experts, members of Cardiology, Endocrinology, Internal Medicine, Nephrology and Diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of metabolic syndrome is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that metabolic syndrome is useful nosography entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particular high- risk population, usually underestimated and undertreated.

Portal hypertensive biliopathy: A single center experience and literature review.

Portal hypertensive biliopathy (PHB) is characterized by anatomical and functional abnormalities of the intrahepatic, extrahepatic and pancreatic ducts, in patients with portal hypertension associated to extrahepatic portal vein obstruction and less frequently to cirrhosis. These morphological changes, consisting in dilatation and stenosis of the biliary tree, are due to extensive venous collaterals occurring in an attempt to decompress the portal venous blockage. It is usually asymptomatic until it progresses to more advanced stages with cholestasis, jaundice, biliary sludge, gallstones, cholangitis and finally biliary cirrhosis.

Latin American consensus on hypertension in patients with diabetes type 2 and metabolic syndrome.

The present document has been prepared by a group of experts, members of cardiology, endocrinology and diabetes societies of Latin American countries, to serve as a guide to physicians taking care of patients with diabetes, hypertension and comorbidities or complications of both conditions. Although the concept of 'metabolic syndrome' is currently disputed, the higher prevalence in Latin America of that cluster of metabolic alterations has suggested that 'metabolic syndrome' is a useful nosographic entity in the context of Latin American medicine. Therefore, in the present document, particular attention is paid to this syndrome in order to alert physicians on a particularly high-risk population, usually underestimated and undertreated.

Effect of nesiritide in patients with acute decompensated heart failure.

Background: Nesiritide is approved in the United States for early relief of dyspnea in patients with acute heart failure. Previous meta-analyses have raised questions regarding renal toxicity and the mortality associated with this agent.

Methods: We randomly assigned 7141 patients who were hospitalized with acute heart failure to receive either nesiritide or placebo for 24 to 168 hours in addition to standard care.

Methane production in low-cost, unheated, plug-flow digesters treating swine manure and used cooking grease.

A co-digestion investigation was conducted using small-scale digesters in Costa Rica to optimize their ability to treat animal wastewater and produce renewable energy. Increases in methane production were quantified when swine manure was co-digested with used cooking grease in plug-flow digesters that operated at ambient temperate without mixing. The co-digestion experiments were conducted on 12 field-scale digesters (250 L each) using three replications of four treatment groups: the control (T0), which contained only swine manure and no waste oil, and T2.

Drug-induced liver injury: hepatotoxicity of quetiapine revisited.

Drug hepatotoxicity is the most common cause of fulminant hepatic failure in the USA. We describe a rare case of a patient who developed an acute liver injury after initiation of therapy with quetiapine, but after conservative management and a trial of steroids, has fully recovered. This is the second reported case of quetiapine-induced liver injury in the published literature.

Significance of overexpression of alpha methylacyl-coenzyme A racemase in hepatocellular carcinoma.

Background: alpha-Methylacyl-CoA racemase (AMACR), an immunomarker for prostatic adenocarcinoma, has been shown to be expressed in a variety of other neoplasms. This study aims to evaluate immunohistochemical expression of the AMACR in neoplastic and nonneoplastic liver lesions, and assess its value in the diagnosis of hepatocellular carcinoma (HCC).

Methods: Formalin-fixed paraffin-embedded tissue sections of 51 HCC (14 well, 22 moderately and 15 poorly differentiated), 9 hepatocellular adenoma (HCA), 48 cirrhotic nodules (CN) and 16 normal liver tissues (NLT) were immunostained for AMACR.

Waste treatment and biogas quality in small-scale agricultural digesters.

Seven low-cost digesters in Costa Rica were studied to determine the potential of these systems to treat animal wastewater and produce renewable energy. The effluent water has a significantly lower oxygen demand (COD decreased from 2,968 mg/L to 472 mg/L) and higher dissolved nutrient concentration (NH(4)-N increased by 78.3% to 82.

Antihypertensive efficacy of amlodipine and losartan after two 'missed' doses in patients with mild to moderate essential hypertension.

We compared the effects of amlodipine (5-10 mg, n=94) and losartan (50-100 mg, n=94) on the lowering of blood pressure (BP) at steady state and after two missed doses, as well as on tolerability. This was a randomized, double-blind study of 12 weeks of active treatment followed by 2 days of placebo treatment. Twenty-four-hour ambulatory blood pressure monitoring and office BP measurements were performed at baseline, week 12 and after the 2-day drug holiday.

A double-blind, controlled, multicenter, randomized study comparing the antihypertensive effectiveness and tolerance of a daily dose of two nifedipine formulations: nifedipine microgranules versus nifedipine osmotic pump.

Introduction: Controlled clinical studies have clearly established the advantages of blood pressure (BP) reduction. However, optimal control of BP in the population is still not adequate. Monotherapy is ineffective in the majority of hypertensive patients, and multidrug therapy increases costs.

Is hepatitis B immunoglobulin prophylaxis needed for liver transplantation in the era of new antivirals?

Chronic infection with hepatitis B virus (HBV) is one of the most common causes of cirrhosis of the liver and hepatocellular carcinoma worldwide, frequently requiring liver transplantation. Other nonliver organ transplants get infected de novo or through reactivation from previous active or inactive infections. With significant improvements in the surgical techniques and immunosuppressive regimens over the last 20 years, organ transplantation has become the most effective and lifesaving therapy for patients with chronic renal failure, cirrhosis, hepatocarcinoma, and heart failure.

Should patients with chronic hepatitis C infection be transplanted?

Chronic hepatitis C (HCV) infection affects more than 170 million people throughout the world and 2 to 3 million Americans. End-stage liver disease secondary to chronic HCV infection is the most frequent indication for liver transplantation in this country. Currently, the gold standard for treatment for immunocompetent patients is a combination of peginterferon (PEG-IFN) and ribavirin for 6 to 12 months depending on the genotype.

Organ allocation: model for end-stage liver disease, Child-Turcotte-Pugh, Mayo risk score, or something else.

The discovery of a single test of liver function has been a goal of hepatologists for many years. The great complexity of the liver and its many diverse functions, however, has prevented such an accomplishment. An analogy can be made with the way one currently uses liver tests where several individual tests are combined into a profile.

Efficacy and safety of two different formulations of nifedipine (GITS) vs. slow release microgranules in patients with mild and moderate hypertension.

The objective of this study was to compare the safety and efficacy of nifedipine in two different formulations (osmotic pump and slow release microgranules) in patients with essential hypertension. A total of 91 patients with mild and moderate essential hypertension were recruited in a randomised, double-blinded trial, to receive a daily dose of 30 mg of nifedipine GITS or nifedipine slow release microgranules for 8 weeks. Patients who did not respond to the above-mentioned dose at week 4 of treatment received an increased dose of 60 mg per day of either drug for the remaining trial period.

Efficacy and safety of valsartan compared with enalapril at different altitudes.

Objective: To compare the safety, tolerability, and antihypertensive efficacy of valsartan with enalapril at different altitudes.

Method: A total of 142 adult Colombian outpatients with mild to moderate essential hypertension were recruited in 3 cities at different altitudes (Bogotá at 2600 m, Medellin at 1538 m and Barranquilla at 100 m) and randomized in an open label fashion to receive either valsartan 80 mg once daily or enalapril 20 mg once daily for 8 weeks. Those patients not responding at 4 weeks received additional 1.