Publications by authors named "Juan Pablo Alzate-Granados"

3 Publications

  • Page 1 of 1

Human mesenchymal stem cells for the management of systemic sclerosis. Systematic review.

Autoimmun Rev 2021 Apr 18;20(6):102831. Epub 2021 Apr 18.

Research Institute, Fundación Universitaria De Ciencias De La Salud, University of Health Sciences, Bogota, Colombia.

Introduction: Sistemic Sclerosis (SSc) is a heterogeneous autoimmune disease with a high rate of progression and therapeutic failure, and treatment is a challenge, new therapeutic proposals being needed, being mesenchymal stem cells (MSCs) considered as alternative therapy for SSc for its immunomodulatory capacity. We evaluated the efficacy and safety of human MSC (hMSC) in patients with SSc through a systematic literature review (SLR).

Methods: SLR (PRISMA guideline) on MEDLINE/OVID, LILACS, EMBASE, and Cochrane/OVID bases (until July 2020, without limits). All types of clinical studies were considered: patients ≥18 years old with SSc and treatment with hMSC.

Exclusion Criteria: animal models, autologous/allogenic hematopoietic stem cell transplants, narrative reviews, letters to the editor. MeSH and "Key word" terms were used. The level of evidence and the quality rating were rated [Joanna Briggs Institute (JBI) lists]. Registration in PROSPERO repository (ID CRD42020185245) The Synthesis Without Meta-analysis (SWiM) guideline was followed.

Results: We initially identified 508 articles, of which 11 were finally included (8 case series and 3 case reports). The 11 articles included 101 patients (85 female, age range 18-75 years). The level of evidence was mostly 4 (JBI); the quality of evidence was met (≥50% of JBI items). SWiM showed that vascular skin involvement (digital ulcers, necrosis, and gangrene) and associated pain were the predominant outcomes, while improvements were found in almost all cases. One patient died in the first month, and the frequency of complications was low. Expanded hMSCs were used in 24 patients and other cell sources in the remaining patients.

Conclusion: There is too little reported data to reach definite conclusions about the use of hMSC in SSc. Further studies with better epidemiological designs are needed to evaluate the benefit of hMSCs in SSc patients.
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April 2021

[Kidney transplantation into the urological training in Colombia.]

Arch Esp Urol 2021 Apr;74(3):287-292

Unidad de Urología. Facultad de Medicina. Universidad Nacional de Colombia. Ciudad Universitaria. Bogotá. Colombia.

Kidney transplantation (KTx) is the best therapeutic modality for end stage renal disease. Currently in Colombia there are approximately 2800 patients waiting for KTx. Historically, urologists have beenin close contact with KTx, however in Colombia the interaction between urology and KT is scarce. OBJECTIVES: To determine the perceptions and KTx training level into colombian urology residents. MATERIAL AND METHODS: We conducted a retrospective and descriptive study through 14 items survey applied to colombian urology residents. Data are summarizedas means and Pearson Chi2 test was used to evaluate differences between qualitative variables.RESULTS: The study included 76 participants. More than half of the programs of urology residency in Colombia includes KTx training into their academic programs, 36.84% of participants have received formal training (lectures, rounds, clinical rotation, seminars) on KTx, 28.95% have participated into KTx procedure, 97.37% considered the KTx as a urological field, KTx is the urological area with least academic interest for the residents, 76.32% consider their training in KTx as insufficient. The main barrier identified to increase training in KTx during urology residency is the non-availability of a formal rotation. CONCLUSIONS: KTx is not an area of primary interest for the colombian urology residents. Although most residents identify the KTx as an area related to urology and that exposure to some phases of the KTx is acceptable, 76% of residents consider their transplant training as insufficient. The main barriers identified for the urology resident's approach to KTx are modifiable.
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April 2021

Unstimulated whole salivary flow in Sjögren's Syndrome: systematic literature review and meta-analysis.

Adv Rheumatol 2021 02 3;61(1). Epub 2021 Feb 3.

Research Institute, Fundación Universitaria de Ciencias de la Salud (FUCS), Bogotá, Colombia.

Background: Sjögren's Syndrome compromises the exocrine function, producing xerostomia and xerophthalmia. It can appear as an isolated condition or associated with other autoimmune diseases (polyautoimmunity). The Unstimulated Salivary Flow rate (UWSF) is used to quantify saliva production. There is no objective evidence to differentiate the values in patients with Sjögren's versus healthy people or patients with non-Sjögren's sicca. The objective of the present review was to evaluate the UWSF in patients with Sjögren's syndrome in comparison to controls (healthy and non-Sjögren's sicca patients).

Methods: A systematic literature review was carried out (PRISMA guidelines). Analytical observational studies of cases and controls, cross-sectional studies, cohort studies and randomized clinical trials (including healthy controls) were considered. The Medline/OVID, Lilacs, Embase, and Cochrane/OVID databases were consulted. MeSH, DeCS, keywords, and Boolean operators were used. The meta-analysis (RevMan 5.2) was done through the random-effects model [mean difference (MD)]. Level and quality of evidence were evaluated by the Oxford Center Levels of Evidence and Joanna Brigs list respectively.

Results: Thirty-two articles were included (20 were case-control studies, 6 were cross-sectional, 2 prospective cohort, 2 retrospective cohort, and 2 studies were abstracts) and 28 were meta-analyzed. The unstimulated whole salivary flow rate in the Sjögren's group was lower than in controls (healthy and patients with non-Sjögren Sicca syndrome) (MD-0.18 ml/min; 95% CI, - 0.24 to - 0.13; chi-P-value < 0.00001). Heterogeneity was 97% and there was publication bias (funnel plot). The level of evidence was mostly 3 or 4. The quality of evidence was met (97% of items valued).

Conclusion: For the first time, the unstimulated whole salivary flow rate is found to be lower in patients with Sjögren's syndrome compared to controls (healthy and non-SS sicca) through a meta-analysis.

Trial Registration: PROSPERO CRD42020211325 .
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February 2021