RESUMO

Currently, there are no confident prognostic markers in patients with coronary artery disease (CAD) undergoing angioplasty. The present study aimed to explore whether basal coronary circulating Mononuclear Progenitor Cells (MPCs) and vascular injury biomarkers were related to development of major adverse cardiovascular events (MACEs) and may impact clinical prognosis. METHODS: The number of MPCs and soluble mediators such as IL-1ß, sICAM-1, MMP-9, malondialdehyde, superoxide dismutase and nitric oxide were determined in coronary and peripheral circulation. Prognostic ability for MACEs occurring at 6 months follow up was assessed by time-to-event and event free survival estimations. RESULTS: Lower coronary circulating MPCs subpopulations CD45+ CD34+ , CD45+ CD34+ CD133+ CD184+ , lower MMP-9 and higher sICAM-1 significantly associated with MACEs presentation and showed prognostic ability; while peripheral blood increase in malondialdehyde and decreased superoxide dismutase were observed in patients with MACEs. CONCLUSION: Coronary concentration of biomarkers related with vascular repair, such as MPCs subpopulations and adhesion molecules, may predict MACEs and impact prognosis in patients with CAD undergoing angioplasty; whereas peripheral pro-oxidative condition may be also associated.

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RESUMO

A partir de la aprobación de la Norma Cubana del Sistema de Gestión Integrada del Capital Humano y en correspondencia con la decisión del Ministerio de Salud Pública de comenzar a evaluar al personal médico en las siete especialidades médicas priorizadas, se plantea la necesidad de identificar y normalizar las competencias laborales que garanticen su implementación en el sistema nacional de salud, a fin de incrementar la calidad de los servicios que se brindan a la población. Una vez efectuada la identificación de las competencias laborales se hace necesario proceder a su normalización a fin de establecer el patrón que posibilite realizar su evaluación. Se presenta una propuesta metodológica para realizar la normalización de las competencias laborales en las especialidades médicas priorizadas. Este trabajo recaerá en los Grupos Nacionales de Especialidades Médicas de conjunto con los Grupos Provinciales Respectivos. Esta estandarización posibilitará poner de acuerdo a los profesionales médicos, los empleadores y las instituciones educacionales hacia la integración y enrumbamiento de sus respectivas responsabilidades. Se establece un modelo para el registro de la normalización de las competencias y sus elementos de competencias en el sistema nacional de salud

After the approval of the Cuban standard for the integrated management system of the human capital, and in line with the Ministry of public health's decision of evaluating the medical staff in the seven prioritized specialties, it is required to identify and to standardize the work competencies backing up the standard implementation in the health care system, in order to increase the quality of services offered to the population. Once the work competencies are identified, it is necessary to proceed to their standardization so as to set the pattern of evaluation. A methodological proposal for the work competency standardization in the priority medical specialties was submitted. The national groups of medical specialties and the respective provincial groups will be in charge of doing this work. This standardization will help to unify the criteria of the medical professionals, the employers, and the educational institutions towards integration and orientation of their respective responsibilities. A model was presented to register the standardization of the work competencies and their elements in the national health care system

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