Sistematización de experiencias de medicina alternativa y terapias complementarias en el sistema de atención formal de Bogotá, D. C / Systematization of alternative medicine experiences and complementary therapies from the formal medical care system of Bogota, D. C

Introducción: La Secretaria Distrital de Bogota ha liderado un proceso para implementar áreas demostrativas de prestación de servicios de medicina alternativa y terapias complementarias en la red pública distrital. Como parte de la revisión de los antecedentes, la Secretaria Distrital de Salud de Bogota y el Hospital Pablo VI Bosa ESE sistematizaron experiencias de prestación de este tipo de servicios. Objetivos: Identificar avances, dificultades y aprendizajes obtenidos por diferentes experiencias en las que se han integrado servicios de Atencion convencional con servicios de medicina alternativa. Métodos: Se diseño un instrumento de sistematización, diligenciado por los responsables de los servicios; se sistematizo la información disponible. Resultados: Las experiencias de implementación de servicios de medicina alternativa y terapias complementarias son diversas. En la red pública estos servicios no se han articulado con los servicios convencionales, cuentan con poco tiempo de implementación y se enfrentan a las dificultades de la productividad financiera. Aun existe gran desinformación sobre la medicina alternativa en los profesionales de la salud. Conclusiones: Se debe avanzar en la discusión de lo que implica integrar la medicina alternativa en un sistema de salud como el colombiano. Es imperativo consolidar una política especifica para disminuir las brechas inequitativas de acceso a estos servicios.

Background: Bogota’s District Secretariat has led a process to implement demonstration areas for the provision of alternative medicine and complementary therapies in the public district’s network with the aim of generating evidences of the benefits and difficulties of their integration to the city’s formal health care system. As part of the background review, experiences of this type of services were systematized by Bogota’s Health Secretariat and Pablo VI, Bosa E.S.E. Hospital. This paper documents the process and its main findings. Aims:To identify advances, difficulties and lessons learned from different experiences in which alternative medicine services have been integrated with conventional medical health care services. Methods: A Sistematization tool was designed and filled out by the Service officials. Afterwards, a seminar-workshop was done in order to present the experiences, and each one of the objectives stated for the systematization process was discussed. Finally, the information available was systematized. Results: The experiences of implementation of alternative medicine services and therapies are diverse. These services have not been articulated with the conventional services into the public network. They have been implemented very recently and are facing financial productivitydifficulties. There is still disinformation about alternative medicine among health care service professionals. Conclusions: Further discussions have to be developed on the implication ofintegrating alternative medicine to a health system such as the Colombian one. The main difficulties are the result of an absence of a health care model that respects the philosophy ofthese therapeutic options. A specific policy to fill the gap of inequality regarding the access to these services must be consolidated.

Self-excision of the antibiotic resistance gene nptII using a heat inducible Cre-loxP system from transgenic potato.

Resistance to antibiotics mediated by selectable marker genes remains a powerful selection tool for transgenic event production. However, regulatory agencies and consumer concerns favor these to be eliminated from food crops. Several excision systems exist but none have been optimized or shown to be functional for clonally propagated crops. The excision of the nptII gene conferring resistance to kanamycin has been achieved here using a gene construct based on a heat-inducible cre gene producing a recombinase that eliminates cre and nptII genes flanked by two loxP sites. First-generation regenerants with the Cre-loxP system were obtained by selection on kanamycin media. Following a heat treatment, second generation regenerants were screened for excision by PCR using nptII, cre, and T-DNA borders primers. Excision efficiency appeared to be at 4.7% depending on the heat treatment. The footprint of the excision was shown by sequencing between T-DNA borders to correspond to a perfect recombination event. Selectable marker-free sprouts were also obtained from tubers of transgenic events when submitted to similar heat treatment at 4% frequency. Spontaneous excision was not observed out of 196 regenerants from untreated transgenic explants. Biosafety concerns are minimized because the expression of cre gene driven by the hsp70 promoter of Drosophila melanogaster was remarkably low even under heat activation and no functional loxP site were found in published Solanum sequence database. A new plant transformation vector pCIP54/55 was developed including a multiple cloning site and the self-excision system which should be a useful tool not only for marker genes in potato but for any gene or sequence removal in any plant.