Biomedica : revista del Instituto Nacional de Salud最新文献

{"title":"The Operative Link on Gastritis Assessment (OLGA) system as a marker for gastric cancer and dysplasia in a Colombian population at risk: A multicenter study","authors":"Yeison Harvey Carlosama, Claudia Patricia Acosta, Carlos Hernán Sierra, Carol Yovanna Rosero, Harold Jofre Bolaños","doi":"10.7705/biomedica.6995","DOIUrl":"10.7705/biomedica.6995","url":null,"abstract":"<p><p>Introduction. The OLGA system has been proved to be useful in Asia and Europe as a risk marker of gastric cancer. However, its usefulness in high-risk populations in Colombia is still unknown.\u0000Objective. To assess potential associations between the OLGA staging system and an increased risk of gastric cancer and dysplasia in a high-risk Colombian population and to establish diagnostic capacity of the scale to assess the risk.\u0000Materials and methods. We carried out a multicenter study including patients with cancer and dysplasia (cases) and patients with atrophy and intestinal metaplasia (controls). A total of 506 patients were recruited from three centers in an area with a high risk population in Colombia. The endoscopic and histopathologic studies were evaluated according to the Sydney system and the OLGA staging system proposed by Rugge. The effect of each variable on the disease (gastric cancer and dysplasia) was evaluated using bivariate and multivariate models. Statistical significance was set considering a p value inferior to 0.05.\u0000Results. Advanced stages of the OLGA system (III-IV) were associated with a higher risk of dysplasia and gastric cancer (adjusted OR = 8.71; CI95% = 5.09-14.9; p=0.001), sensitivity=54.9%, specificity=89.3% and positive likelihood ratio=5.17.\u0000Conclusions. The OLGA staging system is a risk marker for gastric cancer and dysplasia in the studied population. We recommend its implementation to improve the timely\u0000diagnosis and follow-up of patients with the highest cancer risk.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence model for early detection of diabetes","authors":"William Hoyos, Kenia Hoyos, Rander Ruiz-Pérez","doi":"10.7705/biomedica.7147","DOIUrl":"10.7705/biomedica.7147","url":null,"abstract":"<p><p>Introduction. Diabetes is a chronic disease characterized by a high blood glucose level. It can lead to complications that affect the quality of life and increase the costs of healthcare. In recent years, prevalence and mortality rates have increased worldwide. The development of models with high predictive performance can help in the early identification of the disease.\u0000Objective. To develope a model based on artificial intelligence to support clinical decisionmaking in the early detection of diabetes.\u0000Materials and methods. We conducted a cross-sectional study, using a dataset that contained age, signs, and symptoms of patients with diabetes and of healthy individuals. Pre-processing techniques were applied to the data. Subsequently, we built the model based on fuzzy cognitive maps. Performance was evaluated with three metrics: accuracy, specificity, and sensitivity.\u0000Results. The developed model obtained an excellent predictive performance with an accuracy of 95%. In addition, it allowed to identify the behavior of the variables involved using simulated iterations, which provided valuable information about the dynamics of the risk factors associated with diabetes.\u0000Conclusions. Fuzzy cognitive maps demonstrated a high value for the early identification of the disease and in clinical decision-making. The results suggest the potential of these approaches in clinical applications related to diabetes and support their usefulness in medical practice to improve patient outcomes.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10946312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between physical activity, sedentarism and obesity in adults, Colombia, 2015","authors":"Ana Yibby Forero, Gina Emely Morales, Luis Carlos Forero","doi":"10.7705/biomedica.7014","DOIUrl":"10.7705/biomedica.7014","url":null,"abstract":"<p><p>Introduction. Physical inactivity and sedentary behaviors were shown to be risk factors in the prevalence of diseases such as obesity.\u0000Objective. To conduct an analysis of the relationship between physical activity, sedentary lifestyle and nutritional status in the population aged 18 to 64 years in Colombia, 2015.\u0000Materials and methods. A secondary analysis of the 2015 Colombian nutrition survey was done, using sociodemographic variables (age, sex, ethnicity, geographic area, region, wealth index), along with weight, height, physical activity and sedentary lifestyle. Proportions and 95% confidence intervals, chi-square, logistic regression and odds ratio were estimated.\u0000Results. The analyzed population included 16,607 individuals (54.8% women and 45.2% men) aged 18 to 64 years. Men were more overweight (37.6%) than women, while obesity was more frequent in women (22.1%). It was observed that 48.3% did not meet the physical activity recommendations; 56.9% of adults spent two or more hours a day watching screens. There was a significant association (p<0.050) between non-compliance with physical activity recommendations and obesity. In addition, complying with the physical activity recommendation decreases the probability of obesity by 1.25 times.\u0000Conclusion. Obesity is a health problem for the adult population, with a higher prevalence in women and in those over 30 years old. It is related to non-compliance with the recommendations about physical activity and sedentary behaviors (which are more prevalent in Afro-descendants), high wealth quartile status, and to reside in urban areas and to live in the Bogotá area.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941826/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of patients with acutely decompensated cirrhosis who received care in different highly complex emergency services of Medellín, Colombia.","authors":"Juan Luis Vélez, Andrea Pérez, Juan David Blanco, Marie Claire Berrouet, Lorena Valencia, Sofía Soto, Ana Sofía Ramírez, Víctor Martínez, Juan Luis Gallego, Julia Jaillier","doi":"10.7705/biomedica.6963","DOIUrl":"10.7705/biomedica.6963","url":null,"abstract":"<p><strong>Introduction: </strong>Cirrhosis is one of the ten leading causes of death in the Western hemisphere and entails a significant cost of health care.</p><p><strong>Objective: </strong>To describe the sociodemographic, clinical, and laboratory characteristics of patients older than 18 years who received care for acute decompensation of cirrhosis in the emergency services of three highly complex centers in Medellín, Colombia.</p><p><strong>Materials and methods: </strong>This was an observational retrospective cohort study from clinical records. The results were analyzed by frequency measures and represented in tables and graphics.</p><p><strong>Results: </strong>In total, 576 clinical records met the inclusion criteria; 287 were included for analysis, and 58.9% were men, with an average age of 64 (± 13.5) years. The most frequent causes of cirrhosis were alcohol intake (47.7%), cryptogenic or unspecified etiology (29.6%), and non-alcoholic fatty liver disease (9.1%). The main reasons for visiting the emergency department were the presence of edema and/or ascites (34.1%), suspicion of gastrointestinal bleeding (26.5%), abdominal pain (14.3%) and altered mental status (13.9%). The most frequent clinical manifestations of an acute decompensation of cirrhosis were ascites (45.6%), variceal hemorrhage (25.4%), hepatic encephalopathy (23.0%), and spontaneous bacterial peritonitis (5.2%). During their treatment, 56.1% of the patients received intravenous antibiotics; 24.0%, human albumin; 24.0%, vasoactive support, and 27.5%, blood products; 21.3% required management in an intensive or intermediate care unit, registering 53 deceased patients for a mortality of 18.5%.</p><p><strong>Conclusion: </strong>Patients who consult the emergency services due to acute decompensation of cirrhosis demand a high amount of health resources, frequently present associated complications, and a high percentage requires management in critical care units and shows a high in-hospital mortality rate.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to pharmacological treatment in non-communicable chronic diseases in the Colombian population: Systematic review and meta-analysis","authors":"Catalina Cáceres, Álvaro José Lora, Silvia Juliana Villabona, María Catalina Rocha, Paul Anthony Camacho","doi":"10.7705/biomedica.7077","DOIUrl":"10.7705/biomedica.7077","url":null,"abstract":"<p><p>Introduction. Non-communicable chronic diseases represent the leading cause of death worldwide, and their prevalence is increasing due to the epidemiological transition. Despite the advances in their management, control rates are deficient, attributed to multiple factors like adherence to pharmacological treatment, one of the most significant and least studied in the Colombian population.\u0000Objective. To calculate adherence to treatment in Colombian patients with arterial hypertension, cerebrovascular disease, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and dyslipidemia between 2005 and 2022.\u0000Materials and methods. We performed a systematic literature review and a meta-analysis of studies identified through the Medline and LILACS databases to quantitatively synthesize treatment adherence percentage.\u0000Results. Fourteen studies met the inclusion criteria, and 5,658 patients were analyzed. The treatment adherence was 59%, with significant heterogeneity among the included studies (95% CI= 46- 71%; I2 = 98.8%, p< 0.001). Higher adherence rates were observed for diabetes mellitus (79%; 95% CI = 65- 90%) and dyslipidemia (70%; 95% CI = 66- 74%). Adherence to arterial hypertension treatment was 51% (95 %; CI = 31- 72%).\u0000Conclusions. This systematic review showed low adherence to recommendations regarding pharmacological management in non-communicable chronic diseases, which can have implications for long-term clinical outcomes and disease burden.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between anthropometric measurements and indices to evaluate general and abdominal obesity, Colombia ENSIN 2015","authors":"Ana Yibby Forero Torres, Luis Carlos Forero","doi":"10.7705/biomedica.7011","DOIUrl":"10.7705/biomedica.7011","url":null,"abstract":"<p><p>Introduction. Excess weight represents a problem in the adult population, has increased in recent years and is associated with noncommunicable diseases.\u0000Objectives. To make comparisons between anthropometric measurements and indices and to evaluate their relationship with individual and sociodemographic variables to generate information on the use of the main measurements in the evaluation of general and abdominal obesity as indicators of cardiovascular risk.\u0000Materials and methods. Secondary analysis of the ENSIN survey for Colombia with data collected between 2015 and 2016, the 2005 Population and Housing Census of the\u0000Departamento Administrativo Nacional de Estadística (DANE) was used as a sampling frame. The sample was 44,202 households with 151,343 people aged 0 to 64 years;\u000070,315 records of adult population were selected for this analysis. Proportions, confidence intervals, measures of central tendency and dispersion were calculated.\u0000Results. The means of body mass index (BMI) and waist-height index were higher than the cutoff point in both sexes, while the means of waist circumference were below the cutoff point for men and higher for women (p<0.05). The prevalence of obesity by BMI was 17.5%, while abdominal obesity by waist circumference and waist-height index of 50.2% and 62.6% respectively.\u0000Conclusions. Abdominal obesity regardless of the indicator used, is about 3 times higher than general obesity by BMI and waist-height index identifies more people, especially men, with abdominal obesity compared to waist circumference.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"De la investigación a la acción: estrategias para el manejo de las enfermedades crónicas no transmisibles.","authors":"Ricardo A Peña-Silva","doi":"10.7705/biomedica.7354","DOIUrl":"10.7705/biomedica.7354","url":null,"abstract":"","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of cryotherapy delivered by nurses for treatment of cervical preneoplasic lesions","authors":"Edwin Pulido, Mauricio González, Óscar Gamboa, Jairo Bonilla, Joaquín Luna, Raúl Murillo","doi":"10.7705/biomedica.6966","DOIUrl":"10.7705/biomedica.6966","url":null,"abstract":"<p><p>Introduction. Cervical cancer is a relevant public health problem for low- and middleincome countries. Follow-up of positive-screened women and compliance with treatment of precancerous lesions are major challenges for these settings.\u0000Objective. To evaluate the efficacy of cryotherapy delivered by nurses for cervical intraepithelial neoplasia (CIN).\u0000Materials and methods. Direct visual inspection with acetic acid and lugol iodine (VIAVILI), and colposcopy/biopsy were performed on women 25 to 59 years old, residents of low-income areas in Bogotá, Colombia. Trained nurses offered immediate cryotherapy to every woman with positive visual inspection. Colposcopy/biopsy was performed before treatment and at a 12-month follow-up. The effectiveness was measured as cure (outcome: no-lesion) and regression (outcome: CIN1) rates of CIN2/3 using colposcopic and histological verification.\u0000Results. A group of 4.957 women with VIA/VILI was valuated. In total, 499 were screen positive and 472 accepted immediate treatment. A total of 365 women (11 CIN2/3) received cryotherapy by nurses. Cure rate was 72% (95%CI: 39%-94%) and 40% (95%CI: 22%-85%) by colposcopic and histological verification, respectively. Regression rates were 100% and 60%. There were two related non-serious adverse events.\u0000Conclusions. Cure and regression rates by colposcopic verification are like those reported for cryotherapy delivered by doctors. The sample size (CIN2/3) hinders comparisons by type of verification. Our findings support the implementation of screen-and-treat algorithms by nurses among populations with limited access to health services.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frailty syndrome and end-stage kidney disease outcomes at a Latin American dialysis center.","authors":"Luis David Moreno, Carlos Eduardo Ruiz, Juan Carlos Urrego, Miguel Oswaldo Cadena, Silvia José Maldonado, Daniel Andrés Niño, Andrea Maldonado","doi":"10.7705/biomedica.7057","DOIUrl":"10.7705/biomedica.7057","url":null,"abstract":"<p><strong>Introduction: </strong>Frailty syndrome generates a high risk of adverse outcomes and mortality, and its prevalence is elevated in patients with end-stage kidney disease. Few studies have reported the prevalence and outcomes of frailty in populations from less developed countries.</p><p><strong>Objective: </strong>To identify the clinical outcomes and factors associated with the frailty syndrome in patients with stage five chronic kidney disease who started renal replacement therapy - both hemodialysis and peritoneal dialysis- in a dialysis center in Bucaramanga, Colombia.</p><p><strong>Materials and methods: </strong>This was a prospective study of patients with end-stage kidney disease who initiated dialysis at a center in Colombia and had a twelve-month follow-up.</p><p><strong>Results: </strong>The overall frailty prevalence was 50.47% and two out of three patients older than 65 years had the syndrome. We found significantly higher followup mortality among patients with frailty: odds ratio of 2.95 (CI: 1.07- 8.13; p=0.036) in unadjusted analysis.</p><p><strong>Conclusions: </strong>Literature shows that compared to developed nations, Latin American adults are facing a higher prevalence of chronic diseases, and frailty syndrome is raising. In this study, according to the FRAIL scale, having a frailty syndrome predicts a higher mortality; hypoalbuminemia and low creatinine levels at the beginning of dialysis could act as predictors of its diagnosis.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10911819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spot urinary sodium as a prognostic marker for mortality in patients with acute decompensated heart failure","authors":"Jessica M Londoño, Kelly J Betancur, Lina Fonseca, Paula Fonseca, Eliana M Cañas, Clara I Saldarriaga","doi":"10.7705/biomedica.6920","DOIUrl":"10.7705/biomedica.6920","url":null,"abstract":"<p><p>Introduction. Urinary sodium has been proposed as a prognostic marker and indicator of the diuretic response in patients with heart failure. However, study results are\u0000heterogeneous.\u0000Objective. To evaluate the spot urinary sodium level as a risk factor for mortality in patients with decompensated heart failure.\u0000Materials and methods. We conducted a case-control study nested in a prospective cohort of patients with decompensated heart failure. The primary outcome was mortality at 180 days. The risk factors associated with mortality were evaluated through a bivariate analysis. Differences in clinical variables between groups with urinary sodium greater than or lesser than 70 mEq/L were analyzed.\u0000Results. The study included 79 patients; 15 died at 180 days. Their mean age was 68.9 years (SD=± 13.8); 30 were women (38%), and 15 (18.9%) had urinary sodium <70 mEq/L. In the bivariate analysis, a significant association was found between mortality and past medical history of hospitalizations, SBP<90 mm Hg, the use of inotropes, and urinary sodium <70 mEq/L. Regarding clinical characteristics, patients with low urinary sodium level in the last year were hospitalized more frequently with hyponatremia and hypotension at admission.\u0000Conclusion. Patients with urinary sodium <70 mEq/L had more severe signs. In a bivariate analysis, urinary sodium was associated with mortality at 180 days.</p>","PeriodicalId":101322,"journal":{"name":"Biomedica : revista del Instituto Nacional de Salud","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139428245","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}