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Enlace permanente de la investigaciónGenetic diversity of hepatitis C virus and resistance associated substitutions to direct-acting antiviral treatment in Colombia / Sergio Iván Hoyos Duque ; Juan Carlos Restrepo Gutiérrez
Título : Genetic diversity of hepatitis C virus and resistance associated substitutions to direct-acting antiviral treatment in Colombia Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, ; Juan Carlos Restrepo Gutiérrez, Fecha de publicación : 2022 Títulos uniformes : Virus Research Idioma : Inglés (eng) Palabras clave : Hepatitis C virus Infection Epidemiology Genetic diversity Evolution Resumen : Hepatitis C virus (HCV) infection is one of the leading risk factors for end-stage liver disease development worldwide. This RNA virus displays high genetic diversity with 8 genotypes and 96 subgenotypes with heterogeneous geographical distribution around the world. In this study, we carried out an active case finding of individuals with a history of transfusion events before 1996 in three cities in Colombia. Then, the characterization of the HCV genotypes, subgenotypes, and resistance associate substitutions (RAS) was performed in samples positives for antibodies anti-HCV + from this study population. In addition, samples from PWID and patients with end-stage liver disease submitted to liver transplantation were included in the phylogenetic and RAS analysis. The 5′UTR, NS5A, and NS5B regions of the HCV genome were amplified in serum or liver explants samples. After the edition, assembly, and alignment of the sequences, genotyping through phylogenetic analysis was performed using IQTREE V2.0.5 based on the maximum likelihood approach. The identification of RAS was carried out by alignments based on the reference sequence (GenBank NC_004102). Two hundred sixty individuals with blood transfusion events before 1996 were recruited. The seroprevalence of antibodies anti-HCV was 2.69% in this population. The HCV genotypes 1, 2, and 4 and subgenotypes 1a, 1b, 2a, 4a and 4d were characterized in samples of the study populations. Three RAS (Q30R, C316N, and Y93H) were identified in samples obtained from 2 individuals who received blood transfusion before 1996 and without previous antiviral treatment and 6 samples obtained from patients with end-stage liver disease. Among the 20 samples analyzed, the HCV genotype 1, subgenotype 1b, was the most frequent (60%). We report the first characterization of HCV subgenotypes 4a and 4d and the first RAS identification in patients in Colombia. Mención de responsabilidad : Maria C Lopez-Osorio, José Aldemar Usme-Ciro, José William Martínez, Dioselina Peláez-Carvajal, Javier Hernández, Sergio Hoyos, Juan Carlos Restrepo, Maria-Cristina Navas Referencia : Virus Res. 2022 Sep;318:198847. DOI (Digital Object Identifier) : 10.1016/j.virusres.2022.198847 PMID : 35697300 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0168170222001757 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6090 Genetic diversity of hepatitis C virus and resistance associated substitutions to direct-acting antiviral treatment in Colombia [documento electrónico] / Sergio Iván Hoyos Duque, ; Juan Carlos Restrepo Gutiérrez, . - 2022.
Obra : Virus Research
Idioma : Inglés (eng)
Palabras clave : Hepatitis C virus Infection Epidemiology Genetic diversity Evolution Resumen : Hepatitis C virus (HCV) infection is one of the leading risk factors for end-stage liver disease development worldwide. This RNA virus displays high genetic diversity with 8 genotypes and 96 subgenotypes with heterogeneous geographical distribution around the world. In this study, we carried out an active case finding of individuals with a history of transfusion events before 1996 in three cities in Colombia. Then, the characterization of the HCV genotypes, subgenotypes, and resistance associate substitutions (RAS) was performed in samples positives for antibodies anti-HCV + from this study population. In addition, samples from PWID and patients with end-stage liver disease submitted to liver transplantation were included in the phylogenetic and RAS analysis. The 5′UTR, NS5A, and NS5B regions of the HCV genome were amplified in serum or liver explants samples. After the edition, assembly, and alignment of the sequences, genotyping through phylogenetic analysis was performed using IQTREE V2.0.5 based on the maximum likelihood approach. The identification of RAS was carried out by alignments based on the reference sequence (GenBank NC_004102). Two hundred sixty individuals with blood transfusion events before 1996 were recruited. The seroprevalence of antibodies anti-HCV was 2.69% in this population. The HCV genotypes 1, 2, and 4 and subgenotypes 1a, 1b, 2a, 4a and 4d were characterized in samples of the study populations. Three RAS (Q30R, C316N, and Y93H) were identified in samples obtained from 2 individuals who received blood transfusion before 1996 and without previous antiviral treatment and 6 samples obtained from patients with end-stage liver disease. Among the 20 samples analyzed, the HCV genotype 1, subgenotype 1b, was the most frequent (60%). We report the first characterization of HCV subgenotypes 4a and 4d and the first RAS identification in patients in Colombia. Mención de responsabilidad : Maria C Lopez-Osorio, José Aldemar Usme-Ciro, José William Martínez, Dioselina Peláez-Carvajal, Javier Hernández, Sergio Hoyos, Juan Carlos Restrepo, Maria-Cristina Navas Referencia : Virus Res. 2022 Sep;318:198847. DOI (Digital Object Identifier) : 10.1016/j.virusres.2022.198847 PMID : 35697300 En línea : https://linkinghub.elsevier.com/retrieve/pii/S0168170222001757 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6090 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001937 AC-2022-098 Archivo digital Producción Científica Artículos científicos Disponible
Título : Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review Tipo de documento : documento electrónico Autores : Paula Andrea Granda Carvajal, Fecha de publicación : 2021 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus clinical prediction models infection prognosis systematic literature review Resumen : Introduction: Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions. Objective: To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature. Methods: A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings' archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model. Results: We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic. Conclusions: To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures.Protocol registration number: PROSPERO CRD42020171638. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula A Granda-Carvajal, Daniel C Aguirre, Johanna Hernández-Zapata, Gloria M Vásquez, Fabián Jaimes Referencia : Lupus. 2021 Mar;30(3):421-430. DOI (Digital Object Identifier) : 10.1177/0961203320983462 PMID : 33407048 En línea : https://journals.sagepub.com/doi/10.1177/0961203320983462 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5763 Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review [documento electrónico] / Paula Andrea Granda Carvajal, . - 2021.
Obra : Lupus
Idioma : Inglés (eng)
Palabras clave : Systemic lupus erythematosus clinical prediction models infection prognosis systematic literature review Resumen : Introduction: Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions. Objective: To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature. Methods: A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings' archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model. Results: We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic. Conclusions: To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures.Protocol registration number: PROSPERO CRD42020171638. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula A Granda-Carvajal, Daniel C Aguirre, Johanna Hernández-Zapata, Gloria M Vásquez, Fabián Jaimes Referencia : Lupus. 2021 Mar;30(3):421-430. DOI (Digital Object Identifier) : 10.1177/0961203320983462 PMID : 33407048 En línea : https://journals.sagepub.com/doi/10.1177/0961203320983462 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5763 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001688 AC-2021-014 Archivo digital Producción Científica Artículos científicos Disponible 
Título : Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia Otros títulos : Asociación entre el sitio de infección y la mortalidad hospitalaria en pacientes con sepsis atendidos en urgencias de hospitales de tercer nivel en Medellín, Colombia Tipo de documento : documento electrónico Autores : Elisa Bernal Sierra, Fecha de publicación : 2019 Títulos uniformes : Revista Brasileira de Terapia Intensiva Idioma : Inglés (eng) Palabras clave : Sepsis septic shock shock mortality prognosis infection intensive care Resumen : Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality.Results: The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p Mención de responsabilidad : César Caraballo, Johana Ascuntar, Carolina Hincapié, Camilo Restrepo, Elisa Bernal, Fabián Jaimes Referencia : Rev Bras Ter Intensiva. 2019 Jan-Mar;31(1):47-56 DOI (Digital Object Identifier) : 10.5935/0103-507X.20190011 PMID : 30970091 Derechos de uso : CC BY En línea : http://www.rbti.org.br/artigo/detalhes/0103507X-31-1-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4254 Association between site of infection and in-hospital mortality in patients with sepsis admitted to emergency departments of tertiary hospitals in Medellin, Colombia = Asociación entre el sitio de infección y la mortalidad hospitalaria en pacientes con sepsis atendidos en urgencias de hospitales de tercer nivel en Medellín, Colombia [documento electrónico] / Elisa Bernal Sierra, . - 2019.
Obra : Revista Brasileira de Terapia Intensiva
Idioma : Inglés (eng)
Palabras clave : Sepsis septic shock shock mortality prognosis infection intensive care Resumen : Objective: To determine the association between the primary site of infection and in-hospital mortality as the main outcome, or the need for admission to the intensive care unit as a secondary outcome, in patients with sepsis admitted to the emergency department.Methods: This was a secondary analysis of a multicenter prospective cohort. Patients included in the study were older than 18 years with a diagnosis of severe sepsis or septic shock who were admitted to the emergency departments of three tertiary care hospitals. Of the 5022 eligible participants, 2510 were included. Multiple logistic regression analysis was performed for mortality.Results: The most common site of infection was the urinary tract, present in 27.8% of the cases, followed by pneumonia (27.5%) and intra-abdominal focus (10.8%). In 5.4% of the cases, no definite site of infection was identified on admission. Logistic regression revealed a significant association between the following sites of infection and in-hospital mortality when using the urinary infection group as a reference: pneumonia (OR 3.4; 95%CI, 2.2 - 5.2; p Mención de responsabilidad : César Caraballo, Johana Ascuntar, Carolina Hincapié, Camilo Restrepo, Elisa Bernal, Fabián Jaimes Referencia : Rev Bras Ter Intensiva. 2019 Jan-Mar;31(1):47-56 DOI (Digital Object Identifier) : 10.5935/0103-507X.20190011 PMID : 30970091 Derechos de uso : CC BY En línea : http://www.rbti.org.br/artigo/detalhes/0103507X-31-1-8 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4254 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001233 AC-2019-022 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2019-022.pdfAdobe Acrobat PDF
Título : Cutibacterium avidum: A rare but expected agent of breast implant infection Tipo de documento : documento electrónico Autores : Isabel Cristina Ramírez Sánchez, Fecha de publicación : 2019 Títulos uniformes : IDCases Idioma : Inglés (eng) Palabras clave : Breast cutibacterium avidum implants infection Resumen : Cutibacterium avidum is largely commensal and part of the skin microbiota, recently recognized as a pathogen that causes surgical site infections, especially in the presence of implants or medical devices. We present a 50-year-old woman with Cutibacterium avidum infection associated with breast implant augmentation, which required the removal of the implants to achieve the cure. As a skin commensal, Cutibacterium avidum previously was considered of low pathogenicity, but is now recognized as a causative organism of serious spontaneous and surgical site infections. It should not be routinely disregarded without further investigation, particularly if clinical signs of infection are present. Mención de responsabilidad : Ramírez Isabel, Manrique Monica Referencia : IDCases. 2019 May 4;17:e00546 DOI (Digital Object Identifier) : 10.1016/j.idcr.2019.e00546 PMID : 31110944 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2214250919300319 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4249 Cutibacterium avidum: A rare but expected agent of breast implant infection [documento electrónico] / Isabel Cristina Ramírez Sánchez, . - 2019.
Obra : IDCases
Idioma : Inglés (eng)
Palabras clave : Breast cutibacterium avidum implants infection Resumen : Cutibacterium avidum is largely commensal and part of the skin microbiota, recently recognized as a pathogen that causes surgical site infections, especially in the presence of implants or medical devices. We present a 50-year-old woman with Cutibacterium avidum infection associated with breast implant augmentation, which required the removal of the implants to achieve the cure. As a skin commensal, Cutibacterium avidum previously was considered of low pathogenicity, but is now recognized as a causative organism of serious spontaneous and surgical site infections. It should not be routinely disregarded without further investigation, particularly if clinical signs of infection are present. Mención de responsabilidad : Ramírez Isabel, Manrique Monica Referencia : IDCases. 2019 May 4;17:e00546 DOI (Digital Object Identifier) : 10.1016/j.idcr.2019.e00546 PMID : 31110944 Derechos de uso : CC BY-NC-ND En línea : https://linkinghub.elsevier.com/retrieve/pii/S2214250919300319 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4249 Reserva
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Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD001228 AC-2019-017 Archivo digital Producción Científica Artículos científicos Disponible Documentos electrónicos
2019-017.pdfAdobe Acrobat PDF
Título : Development of a prediction rule for diagnosing postoperative meningitis: a cross-sectional study Tipo de documento : documento electrónico Autores : Fabián Humberto Muñoz Ramírez, Fecha de publicación : 2018 Títulos uniformes : Journal of Neurosurgery Idioma : Inglés (eng) Palabras clave : Postoperative meningitis nosocomial meningitis prediction rule lactate infection Resumen : Objective: Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. Methods: A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants. Their CSF was studied for suspicion of infection and a bivariate analysis was performed between the dependent variable (confirmed/probable NM) and the identified independent variables. Those variables with a p value ≤ 0.2 were fitted in a multiple logistic regression analysis with the same dependent variable. After determining the best model according to its discrimination and calibration, the β coefficient for each selected dichotomized variable obtained from the logistic regression model was used to construct the score for the prediction rule. Results: Among 320 patients recruited for the study, 154 had confirmed or probable NM. Using bivariate analysis, 15 variables had statistical associations with the outcome: aneurysmal subarachnoid hemorrhage (aSAH), traumatic brain injury, CSF leak, positioning of external ventricular drains (EVDs), daily CSF draining via EVDs, intraventricular hemorrhage, neurological deterioration, age ≥ 50 years, surgical duration ≥ 220 minutes, blood loss during surgery ≥ 200 ml, C-reactive protein (CRP) ≥ 6 mg/dl, CSF/serum glucose ratio ≤ 0.4 mmol/L, CSF lactate ≥ 4 mmol/L, CSF leukocytes ≥ 250 cells, and CSF polymorphonuclear (PMN) neutrophils ≥ 50%. The multivariate analysis fitted a final model with 6 variables for the prediction rule (aSAH diagnosis: 1 point; CRP ≥ 6 mg/dl: 1 point; CSF/serum glucose ratio ≤ 0.4 mmol/L: 1 point; CSF leak: 1.5 points; CSF PMN neutrophils ≥ 50%: 1.5 points; and CSF lactate ≥ 4 mmol/L: 4 points) with good calibration (Hosmer-Lemeshow goodness of fit = 0.71) and discrimination (area under the receiver operating characteristic curve = 0.94). Conclusions: The prediction rule for diagnosing NM improves the diagnostic accuracy in neurosurgical patients with suspicion of infection. A score ≥ 6 points suggests a high probability of neuroinfection, for which antibiotic treatment should be considered. An independent validation of the rule in a different group of patients is warranted. Mención de responsabilidad : Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes Referencia : J Neurosurg. 2018 Jan;128(1):262-271. DOI (Digital Object Identifier) : 10.3171/2016.10.JNS16379 PMID : 28298047 En línea : https://thejns.org/view/journals/j-neurosurg/128/1/article-p262.xml Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4103 Development of a prediction rule for diagnosing postoperative meningitis: a cross-sectional study [documento electrónico] / Fabián Humberto Muñoz Ramírez, . - 2018.
Obra : Journal of Neurosurgery
Idioma : Inglés (eng)
Palabras clave : Postoperative meningitis nosocomial meningitis prediction rule lactate infection Resumen : Objective: Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. Methods: A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants. Their CSF was studied for suspicion of infection and a bivariate analysis was performed between the dependent variable (confirmed/probable NM) and the identified independent variables. Those variables with a p value ≤ 0.2 were fitted in a multiple logistic regression analysis with the same dependent variable. After determining the best model according to its discrimination and calibration, the β coefficient for each selected dichotomized variable obtained from the logistic regression model was used to construct the score for the prediction rule. Results: Among 320 patients recruited for the study, 154 had confirmed or probable NM. Using bivariate analysis, 15 variables had statistical associations with the outcome: aneurysmal subarachnoid hemorrhage (aSAH), traumatic brain injury, CSF leak, positioning of external ventricular drains (EVDs), daily CSF draining via EVDs, intraventricular hemorrhage, neurological deterioration, age ≥ 50 years, surgical duration ≥ 220 minutes, blood loss during surgery ≥ 200 ml, C-reactive protein (CRP) ≥ 6 mg/dl, CSF/serum glucose ratio ≤ 0.4 mmol/L, CSF lactate ≥ 4 mmol/L, CSF leukocytes ≥ 250 cells, and CSF polymorphonuclear (PMN) neutrophils ≥ 50%. The multivariate analysis fitted a final model with 6 variables for the prediction rule (aSAH diagnosis: 1 point; CRP ≥ 6 mg/dl: 1 point; CSF/serum glucose ratio ≤ 0.4 mmol/L: 1 point; CSF leak: 1.5 points; CSF PMN neutrophils ≥ 50%: 1.5 points; and CSF lactate ≥ 4 mmol/L: 4 points) with good calibration (Hosmer-Lemeshow goodness of fit = 0.71) and discrimination (area under the receiver operating characteristic curve = 0.94). Conclusions: The prediction rule for diagnosing NM improves the diagnostic accuracy in neurosurgical patients with suspicion of infection. A score ≥ 6 points suggests a high probability of neuroinfection, for which antibiotic treatment should be considered. An independent validation of the rule in a different group of patients is warranted. Mención de responsabilidad : Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes Referencia : J Neurosurg. 2018 Jan;128(1):262-271. DOI (Digital Object Identifier) : 10.3171/2016.10.JNS16379 PMID : 28298047 En línea : https://thejns.org/view/journals/j-neurosurg/128/1/article-p262.xml Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4103 Reserva
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