Browsing by Autor "Thomas Medina"

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Characterization of HLA Class II Alleles in Patients with Neuromyelitis Optica in Bogotá, Colombia (P13-5.008)
(Lippincott Williams & Wilkins, 2023) Jaime Toro; Jairo Gaitan Alfonso; Habib Georges Moutran Barroso; Helena Groot; Juan Sebastian Rivera Perez; Thomas Medina; Daniela Rodríguez; Laura Serna; David Cuellar Giraldo; Carolina Restrepo-Aristizábal
<h3>Objective:</h3> Our objective was to characterize the human leukocyte antigen (HLA) class II alleles in patients with Neuromyelitis Optica (NMO) and a control population in Bogotá, Colombia. <h3>Background:</h3> NMO is a demyelinating disease of the central nervous system with a low prevalence in Latin America. International studies have found associations between the development of NMO and alleles of the HLA class II complex. However, to date, there are no studies in Colombia. <h3>Design/Methods:</h3> This case-control study used blood samples to isolate and purify genomic DNA. The SSP-PCR method was employed to determine if the HLA-DRB1 or HLA-DQB1 alleles were present. AQP4-IgG and MOG-IgG seropositivity was determined using the cell-based assay technique. The study population’s allele frequencies were analyzed, and differences between the groups were determined by bivariate and multivariate logistic regression analysis. <h3>Results:</h3> A total of 51 subjects were enrolled, 28 patients with NMO (mean age 42.5 ± 13.6 years; 79% females) and 23 healthy controls (mean age 31.3 ± 11 years; 74% females). HLA-DRB1*16 was present in 28.5% of cases and 0% of controls (odds ratio by the Agresti-Coull CI method [OR] = 19.48, 95% CI: 1.05 – 358.83, p=0.008) and HLA-DRB1*08 was present in 7.1% of the cases and 28% of controls (OR = 0.17, 95% CI: 0.03 – 0.95, p = 0.044). After the multivariate model, none of the alleles were statistically significant. <h3>Conclusions:</h3> The HLA-DRB1*16 allele could be a risk factor for the development of NMO in our population. Although it is a small cohort, these preliminary results are consistent with studies conducted in Brazil, Mexico, China, and Japan. Furthermore, it helps to build more solid literature on the genetic characterization of NMO in Latin America. <b>Disclosure:</b> Dr. Toro has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Watch Neurology . Dr. Gaitan Alfonso has nothing to disclose. Dr. Moutran Barroso has nothing to disclose. Helena Groot, 9922 has nothing to disclose. Dr. Rivera Perez has nothing to disclose. Thomas Medina has nothing to disclose. Ms. Rodriguez has nothing to disclose. Miss Serna has nothing to disclose. Dr. Cuellar Giraldo has nothing to disclose. Dr. Restrepo has nothing to disclose. Miss TORRES has nothing to disclose. Dr. Franco Ruiz has nothing to disclose. Fabián Cortés has nothing to disclose. Mr. León Tramontini has nothing to disclose. Diana Narváez, 9920 has nothing to disclose. Mrs. Lago has nothing to disclose. Ms. Marquez has nothing to disclose. Dr. Reyes has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck. Dr. Reyes has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Reyes has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for BIIB. Dr. Reyes has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Merck. Dr. Reyes has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Novartis. Dr. Reyes has received personal compensation in the range of $0-$499 for serving on a Speakers Bureau for Biogen.
Improving stroke care access through a public-private partnership, an estimation of Disability-Adjusted Life Years in patients with Ischemic Stroke undergoing mechanical thrombectomy in a IV level care center in Bogotá D.C., Colombia
(2025) Thomas Medina; Alfonso de Hoyos; Jairo E. Martínez; Milcíades Ibáñez‐Pinilla; Luis Felipe Alva López; Carlos Martínez; Jaime Rodrı́guez
Abstract Background Ischemic stroke (IS) is a significant contributor to morbidity and mortality. In Colombia, there’s limited access to mechanical thrombectomy (MT). Public-private partnerships for interhospital referral may offer a solution to improve access, but their impact on health outcomes like disability-adjusted life years (DALYs) hasn’t been studied, opening possibilities to improve care and expand these strategies to other middle to low-income countries facing access barries to life-saving procedures. Aim To quantify and compare DALY accumulation from MT in patients directly treated (non-referred) at a IV level care center in Bogotá-Colombia (Fundación Santa Fe de Bogotá/FSFB) versus those referred from other centers. Materials and Methods A retrospective cohort analytical study, estimating DALY accumulation from medical records. Patients meeting inclusion criteria were included via non-probabilistic sampling. Data analysis is utilized for SPSS. Results 51 patients underwent MT, 27 were referred and 24 non-referred. The median DALY accumulation was 19.8 and 9.15 years respectively, with a significant difference between groups (p=0.003). However, after adjusting by confounding variables, including time from symptoms onset to arrival to the advance stroke center, no significant difference was found (p=0.147). Conclusions While socioeconomic and demographic differences existed between groups, adjusting by confounding variables showed comparable DALY accumulation. Prioritizing timely interhospital secondary referral strategies in acute stroke treatment is crucial, potentially offering comparable outcomes with direct care. This study provides insights into stroke management effectiveness and paves the way for future economic modeling studies justifying this care model of partnerships to guarantee access to lifesaving procedures and improve health outcomes in patients, making it a great alternative for hospitals with similar access barriers.