Biomedica : revista del Instituto Nacional de Salud最新文献

{"title":"Exploring the challenges: main contraindications in organ donation in Colombia","authors":"Andrea Gómez-Montero, Andrea García-López, William Cruz-Mususú, Luisa Vargas, Ximena Escobar, Milena Orellano-Salas, Santiago Cabas, Fernando Girón-Luque","doi":"10.7705/biomedica.7730","DOIUrl":"https://doi.org/10.7705/biomedica.7730","url":null,"abstract":"<p><p>Introduction. Organ transplantation is crucial for improving the quality of life of patients with organ failure, but the shortage of donors is a global challenge. In Colombia, the demand exceeds the supply, increasing mortality rates on waiting lists.\u0000Objective. To evaluate the causes of contraindications in potential organ donors assessed by Fundonar across three regional centers in the country during 2022.\u0000Materials and methods. A descriptive cross-sectional study was conducted based on retrospective data from potential donors reported to the Red de Donación y Trasplantes de Colombia. A total of 1451 cases were evaluated. The causes of contraindications were categorized into medical, medico-legal, and logistical categories. Descriptive statistics were used, the normality of the variables was assessed, and contraindicated donors from each regional center were compared using ANOVA. R software, version 4.0.3, was used.\u0000Results. Of the 1451 donors evaluated, 849 had contraindications. Among these, 29.8% presented multiple organ failure, 20.8% had a comorbidity, and 15.3% did not meet the diagnostic criteria for brain death.\u0000Conclusion. Most of the medical contraindications could be reconsidered by balancing risks and benefits for the recipients. A personalized and multidisciplinary approach, with evidence-based criteria and real-time decisions tailored to Colombia, could improve organ donation approval rates.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"83-96"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obtention of conditional media from Wharton’s gelatin mesenchymal stromal cells in a dynamic culture system","authors":"Juan David Caicedo, Luisa Fernanda Martínez, Elga Johana Vargas, Ítali Linero, Orlando Chaparro","doi":"10.7705/biomedica.7485","DOIUrl":"https://doi.org/10.7705/biomedica.7485","url":null,"abstract":"<p><strong>Introduction: </strong>Mesenchymal stem cells have great therapeutic potential due to their antiinflammatory, anti-apoptotic and pro-angiogenic effects through their secretome. Wharton’s gelatin is one of the best sources of mesenchymal stromal stem cells; their secretome is rich in bioactive molecules with the ability to maintain cellular and tissue homeostasis for the treatment of pathologies such as inflammation, skin wounds, neurodegenerative disorders, and diabetes.</p><p><strong>Objective: </strong>To describe a protocol for obtaining conditioned media from mesenchymal stromal stem cells isolated from Wharton’s jelly through dynamic cell cultures, considering that 3D systems offers advantages over 2D by better replicating the conditions of the cellular microenvironment in vivo.</p><p><strong>Materials and methods: </strong>The mesenchymal stromal stem cells obtained were characterized in vitro: their immunophenotype by flow cytometry and their multipotency by induction of differentiation to mesenchymal lineages. The stem cells were grown in 2D monolayer cultures and 3D cultures, in a 3L Applikon Biotechnology bioreactor using plastic microbeads as microcarriers. Obtention of the conditioned media was standardized and 43 angiogenic factors were detected, using an antibody microarray system for human angiogenesis.</p><p><strong>Results: </strong>Isolated cells showed typical characteristics of mesenchymal stromal stem cells. 3D cultures facilitated scalability and improved secretion of angiogenic factors compared to 2D cultures.</p><p><strong>Conclusions: </strong>The secretome was obtained with 2D and 3D cultures. Significantly larger volumes of conditioned medium with a potentially increased angiogenic capacity were obtained with 3D cultures.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"109-120"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the quality of vaginal discharge smear analysis reporting in five clinical laboratories in the Colombian Pacific Region","authors":"Mercedes Salcedo-Cifuentes, Javier E Fonseca-Pérez","doi":"10.7705/biomedica.7551","DOIUrl":"https://doi.org/10.7705/biomedica.7551","url":null,"abstract":"<p><strong>Introduction: </strong>Vaginal flow analysis plays a key role in clinical diagnosis and medical decision-making. Standardizing report formats remains essential to ensure diagnostic reliability.</p><p><strong>Objective: </strong>To assess the quality of vaginal smear reporting in five clinical laboratories located in Colombia’s Pacific region.</p><p><strong>Materials and methods: </strong>This descriptive, retrospective study examined records from five laboratories (three public, two private) across three cities in the Colombian Pacific region. The evaluation followed the BACOVA ERIGE guidelines to assess the completeness of the analytical components. Researchers used XLSTAT Premium, version 2024, to compute means, standard deviations, proportions, and ratios. They applied the chi square test to compare reporting compliance across laboratories and used multiple correspondence analysis and discriminant analysis to identify reporting patterns and inter-city differences.</p><p><strong>Results: </strong>The study analyzed 1260 records from women aged 18 to 60 years. Of these, 56.8% were pregnant, and 57% were affiliated to the subsidized healthcare system. Compliance with the BACOVA ERIGE guidelines was higher in Ipiales (54.44%) compared to Cali (24.21%) and Quibdó (21.35%) (c², p = 0.047). The multiple correspondence analysis and discriminant analysis identified three distinct reporting profiles by city.</p><p><strong>Conclusions: </strong>The variability in vaginal smear reports underscores the need to standardize post-analytical procedures. Unifying technical criteria among laboratories would improve the diagnostic quality of vaginal flora imbalance and enhance clinical decision-making.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"97-108"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of ivermectin on Toxocara canis larvae in vitro and in vivo at different migratory stages","authors":"Iman Fathy Abou-El-Naga, Suzanne M F El-Nassery, Mona M El-Temsahy","doi":"10.7705/biomedica.7828","DOIUrl":"https://doi.org/10.7705/biomedica.7828","url":null,"abstract":"<p><strong>Introduction: </strong>Ivermectin has shown potent activity against various nematodes.</p><p><strong>Objective: </strong>Evaluation of the efficacy of ivermectin against Toxocara canis larvae.</p><p><strong>Materials and methods: </strong>In vitro assessment was conducted using larval migration inhibition test and scanning electron microscopy (SEM). In vivo, ivermectin was administered orally to mice at a single 0.2 mg/kg dose at 2 (group I), 7 (group II), or 15 days (group III) post-infection. Efficacy was evaluated through brain larval counts and histopathological examination of liver and brain.</p><p><strong>Results: </strong>In vitro, ivermectin at concentrations of 10 μg/ml and 100 μg/ml inhibited larval migration by 8.5% and 87%, respectively. SEM showed cuticular damage after 24 and 48 hours with 100 μg/ml ivermectin. In vivo, brain larval counts significantly decreased in groups I and II (22.67 ± 5.41 and 37.17 ± 5.98), with no significant reduction in group III (130.5 ± 9.01). Histopathology of the liver at four weeks post-infection in groups I and II revealed numerous granulomas with degenerated larvae. The brain showed a marked reduction in larval presence and inflammation in groups I and II, while group III findings were similar to those of the control group.</p><p><strong>Conclusion: </strong>Ivermectin is effective against T. canis larvae during early migratory stages but shows limited efficacy against late-stage larvae.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"128-140"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dramatic increase in consumption of antibiotics in Colombia, 2020-2023","authors":"Yeimi López-Mejía, Nelson Nelson Alvis Guzmán, Daniela Paternina, Camilo Guzmán, Francisco Camargo, Manuela Beltrán, Alejandro Sanjuan, Augusto León-Rosso, Salim Mattar","doi":"10.7705/biomedica.7702","DOIUrl":"https://doi.org/10.7705/biomedica.7702","url":null,"abstract":"<p><strong>Introduction: </strong>Antibiotic consumption and resistance have increased worldwide. Antibiotic resistance results in longer hospital stays and higher healthcare costs.</p><p><strong>Objective: </strong>To describe the consumption of antibiotics and associated expenses in Colombia.</p><p><strong>Materials and methods: </strong>A meticulous descriptive cross-sectional study of antibiotic consumption and expenditure in Colombia from 2020 to 2023 was conducted. Between 2020 and 2023, a description of the consumption and expenditure of antibiotics in Colombia was made. Data were obtained from IQVIA™ (IMS Health and Quintiles). The prominent families of antimicrobials used in Colombia were selected. Twelve pharmacological families were classified, including 27 antimicrobials and three β-lactamase inhibitors. The defined daily dose was used to measure antibiotic consumption, identify variations, and evaluate medical prescription practices. The defined daily dose per 1,000 inhabitants per day was estimated to obtain information from the population receiving daily antibiotic treatment. The amount of antibiotics used was estimated in grams and tons per year.</p><p><strong>Results: </strong>The top 10 most consumed antimicrobials by defined daily dose per 1,000 inhabitants per day in Colombia were amoxicillin, azithromycin, metronidazole, cephalexin, ciprofloxacin, trimethoprim-sulfamethoxazole, ampicillin, sulbactam, clarithromycin, cefazolin, and dicloxacillin. The total consumption of antibiotics was 2,139 tons, which represented an expense of USD$ 708,112,587, for an increase of 17 and 8%, respectively, during the period.</p><p><strong>Conclusions: </strong>The progressive increase in consumption and spending on antimicrobials in Colombia requires a set of interventions that include promoting changes in medical prescribing behaviour and a public education campaign that leads to the adoption of a sustainable public health policy.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"71-82"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between susceptibility to neurodegenerative diseases and genetic factors in populations exposed to mercury in Medellín, Colombia","authors":"Efrén de Jesús Avendaño, Andrea Paola Castillo","doi":"10.7705/biomedica.7634","DOIUrl":"https://doi.org/10.7705/biomedica.7634","url":null,"abstract":"<p><strong>Introduction: </strong>Neurodegenerative diseases such as Alzheimer’s and Parkinson’s are associated with genetic and environmental factors, including exposure to mercury, a heavy metal with neurotoxic effects.</p><p><strong>Objectives: </strong>To identify and analyze alleles and genes linked to neurodegenerative diseases in relation to mercury exposure in Colombia.</p><p><strong>Materials and methods: </strong>Scientific literature and population genotype data from public databases were reviewed, covering 94 Colombian adults genotyped under the CLM (Colombians from Medellín) reference. Data traceability was ensured through ID registration in the 1000 Genomes project database, guaranteeing informed consent and bioethical approval. Eleven genes (GSTP1, ATP7B, BDNF, GCLC, GCLM, MT1A, MT4, ABCC2, ABCB1, GPX1 y GPX4) with 18 polymorphisms distributed across ten chromosomes were analyzed using the SNPstatsTM program. The c² test was applied to evaluate the Hardy-Weinberg equilibrium, considering deviations with p < 0.05 as significant.</p><p><strong>Results: </strong>The results showed a high probability of an association between neurodegenerative diseases such as Alzheimer’s and Parkinson’s and mercury exposure in individuals with genetic variants related to glutathione metabolism and mercury transport and excretion pathways.</p><p><strong>Conclusions: </strong>Genetic alterations or their expression involving mercury bioaccumulation, its crossing of the blood-brain barrier, central nervous system inflammation, and oxidative stress from reactive oxygen and nitrogen species increase the risk of developing Alzheimer’s and Parkinson’s disease.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"30-47"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genomic surveillance of SARS-CoV-2 variants in hospitalized patients: a cohort study from the metropolitan area of valle de Aburrá, Colombia","authors":"Olga H Hernández-Ortiz, Laura Pérez-Restrepo, Jaime Úsuga, Melissa Moreno, Andrés Naranjo, Juan Vélez, Jorge Sará, Francisco Molina-Saldarriaga, Fabián Jaimes, Jorge Osorio, Juan P Hernández-Ortiz","doi":"10.7705/biomedica.7783","DOIUrl":"https://doi.org/10.7705/biomedica.7783","url":null,"abstract":"<p><p>Introduction. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been one of the most significant pandemics of the modern era. This coronavirus has a high mutation rate, resulting in variants with changes in the spike protein, which hinder containment efforts. Genomic surveillance is crucial for public health and vaccination strategies, especially in lowand middle-income countries, where the impact has been considerable.\u0000Objective. To identify viral variants and their clinical presentations in a prospective cohort of hospitalized patients with SARS-CoV-2 infection between October 2021 and February 2023.\u0000Materials and methods. We collected patients’ demographic data, medical histories, vaccination status, and clinical progression. Viral genome sequencing was performed on nasopharyngeal swab samples confirmed by real-time reverse transcription polymerase chain reaction to classify strains and detect variants.\u0000Results. The predominant variant in the 63 SARS-CoV-2-positive samples was omicron (84%), followed by delta (14%). A higher proportion of critical illness was observed in delta cases (100%) compared to omicron (30%). Mutations in the spike protein were identified and classified into four categories (A-D), along with specific mutations in the S gene.\u0000Conclusion. The mutational patterns observed in this study are consistent with global reports, with delta cases presenting greater clinical severity. We identified spike protein mutations that may confer distinctive properties to the virus. These findings underscore the need for ongoing genomic surveillance to better understand viral dynamics and guide public health strategies.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"48-70"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Controversies in neuroimmunology: Multiple sclerosis and other demyelinating disorders","authors":"Ana C Villegas, David Cuéllar-Giraldo, Estefanía Rojo-Bustamante, María Paula Zafra-Sierra, Lisseth Burbano, Thomas Medina, Laura Andrea Serna-Corredor, María Camila Ramírez, Daniela Sofía Rodríguez, Marcela Urbano, Arístides Duque, Jaime Toro, Saúl Reyes","doi":"10.7705/biomedica.7882","DOIUrl":"https://doi.org/10.7705/biomedica.7882","url":null,"abstract":"<p><p>Multiple sclerosis is the most prevalent demyelinating disease affecting the central nervous system. In the past two decades, significant milestones have been achieved in this domain, including the identification of critical immunological pathways, novel biomarkers, and effective immunotherapies. Nonetheless, several areas of uncertainty and challenges persist. Globally, there has been a notable increase in multiple sclerosis cases. In Colombia, recent studies indicate a rise in prevalence from fewer than 5 cases per 100 000 inhabitants to 7.5 cases per 100 000. It is imperative for neurologists to stay informed about current treatments to offer appropriate guidance to these patients.\u0000This review analyzes eight pertinent controversies surrounding multiple sclerosis, and other demyelinating diseases, based on the most current scientific evidence. Topics explored include: 1) prevention of postpartum relapses, 2) neuromyelitis optica spectrum disorder, 3) the role of genetic testing in diagnosis, 4) risks of malignancy associated with immunotherapy, 5) discontinuation of treatment in older adults, 6) management strategies for lymphopenia, 7) what is the indication for stem cell therapy in multiple sclerosis? and 8) approaches to mitigate rebound effects after discontinuing disease-modifying therapy. Each controversy is supported by a thorough analysis and practical recommendations aimed at informing decision-making in daily clinical practice and adapting to the realities of countries like ours, where advancements in neurological training and access to treatments are crucial.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"141-162"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147517972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Crataegus mexicana root-based supplement intoxication in a woman with weight loss persistent preoccupation: Case report","authors":"Sebastián Abad-Cuenca","doi":"10.7705/biomedica.7794","DOIUrl":"https://doi.org/10.7705/biomedica.7794","url":null,"abstract":"<p><p>Body image preoccupation is increasingly common, particularly among Latin American women, influenced by societal beauty standards favoring thinness. This often drives individuals to use unregulated weight loss supplements, which can lead to serious health risks. This case reports a rare instance of acute diarrhea resulting from the unsupervised use of a Crataegus mexicana root-based supplement, a product frequently marketed for weight loss. A 41-year-old Hispanic woman presented to the emergency department with a 15-day history of daily diarrhea, epigastric pain, and malaise. She reported using the supplement for weight loss. Physical examination revealed moderate dehydration and localized tenderness in the precordial and epigastric regions. The diagnosis was acute diarrhea related to the herbal supplement, with moderate dehydration. The patient received intravenous saline and analgesics and was discharged in stable condition after 48 hours. Follow-up showed no recurrence of symptoms, but persistent body image concerns. This case highlights the dangers of unsupervised herbal supplement use for weight los and underscores the need for proper medical guidance when using supplements.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"25-29"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infecciones por Ehrlichia spp., Anaplasma spp. y Babesia spp. en Puerto Ordaz, estado Bolívar, Venezuela","authors":"David A Forero-Peña, Fhabián S Carrión-Nessi, Sebastián Muñoz-Leal, Carlos Ramiro Silva-Ramos, Álvaro A Faccini-Martínez","doi":"10.7705/biomedica.8337","DOIUrl":"https://doi.org/10.7705/biomedica.8337","url":null,"abstract":"","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":"46 1","pages":"163-170"},"PeriodicalIF":0.6,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147518158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}