Colombia Medica最新文献

{"title":"Laparoscopic surgical alternative in the treatment of ruptured cornual heterotopic pregnancy.","authors":"Enrique Herrera Castañeda, Gustavo Luna, Jessica Sejnaui Sayegh, Luisa M Vacca Orrego, Juan Manuel Tobar Parra","doi":"10.25100/cm.v56i1.5576","DOIUrl":"10.25100/cm.v56i1.5576","url":null,"abstract":"<p><strong>Case description: </strong>A 35-year-old woman with a history of intrauterine device use for family planning presented with a spontaneously conceived heterotopic pregnancy.</p><p><strong>Clinical findings: </strong>The patient developed a ruptured cornual ectopic pregnancy, leading to hemodynamic instability and an acute abdomen, while concurrently carrying a viable intrauterine pregnancy.</p><p><strong>Treatment and outcome: </strong>A laparoscopic intervention was performed to manage the ruptured ectopic pregnancy. The surgical technique employed minimized the impact on maternal blood volume, ensuring patient stabilization and favorable progression of the intrauterine pregnancy.</p><p><strong>Clinical relevance: </strong>Heterotopic pregnancy is the coexistence of gestation in two different implantation sites, both intrauterine and extrauterine. This condition is associated with significant maternal morbidity and mortality. Management remains a challenge due to the lack of consensus and limited clinical experience. The primary goal is maternal stabilization while preserving the intrauterine pregnancy whenever possible. This case highlights the importance of modern surgical strategies tailored to optimize maternal and fetal outcomes.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"56 1","pages":"e5005576"},"PeriodicalIF":0.7,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12097782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychiatric medicalization in university life.","authors":"María Adelaida Arboleda-Trujillo","doi":"10.25100/cm.v55i4.6757","DOIUrl":"https://doi.org/10.25100/cm.v55i4.6757","url":null,"abstract":"","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 4","pages":"e1006757"},"PeriodicalIF":0.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perıostın and fıbronectın ın nasal lesıons: key players ın polyps and ınverted papıllomas.","authors":"Mehmet Birinci, Oğuzhan Okçu, Tuğba Yemiş, Oğuz Gül, Suat Terzi, Metin Çeliker, Özlem Çelebi Erdivanlı, Tolga Mercantepe, Levent Tümkaya, Başar Erdivanlı, Engin Dursun","doi":"10.25100/cm.v55i4.6411","DOIUrl":"https://doi.org/10.25100/cm.v55i4.6411","url":null,"abstract":"<p><strong>Background: </strong>Sinonasal lesions are common benign masses with overlapping clinical and histopathological features. Extracellular matrix proteins such as periostin, fibronectin, and tenascin-C play key roles in tissue remodeling and inflammation, yet their distinct expression profiles in these lesions remain poorly defined.</p><p><strong>Aim: </strong>This study aimed to compare the immunohistochemical staining patterns of periostin, fibronectin, and tenascin-C in sinonasal lesions to elucidate their roles in pathogenesis and enhance differential diagnosis.</p><p><strong>Methods: </strong>In this retrospective study, pathological specimens from 70 patients who underwent surgery for sinonasal polyps were analyzed. Immunohistochemical expression of periostin, fibronectin, and tenascin-C was assessed separately in epithelial and stromal compartments using a semi-quantitative scoring system. Associations between staining patterns and lesion types were evaluated using multinomial logistic regression.</p><p><strong>Results: </strong>The cohort had a male-to-female ratio of 5:2 with a mean age of approximately 40 years. Nasal polyps demonstrated significantly higher stromal periostin staining compared to both antrochoanal polyps and inverted papillomas. Conversely, antrochoanal polyps exhibited significantly elevated epithelial periostin expression relative to inverted papillomas. Fibronectin expression was markedly increased in nasal polyps, especially in the stroma, supporting its role in inflammatory tissue remodeling. Tenascin-C expression did not differ significantly among the lesion types.</p><p><strong>Conclusion: </strong>Differential expression of periostin and fibronectin suggests distinct pathogenic mechanisms in sinonasal lesions. The compartment-specific staining patterns of periostin, along with the prominent fibronectin expression in nasal polyps, suggest these biomarkers could serve as valuable diagnostic tools and potential therapeutic targets. Further research is needed to explore these pathways in sinonasal disease management.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 4","pages":"e2026411"},"PeriodicalIF":0.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomics of e-cigarette use in Colombia: 2019 National Substance Use Survey.","authors":"José Moreno-Montoya, Silvia Marcela Ballesteros, José A De la Hoz-Valle","doi":"10.25100/cm.v55i4.6562","DOIUrl":"https://doi.org/10.25100/cm.v55i4.6562","url":null,"abstract":"<p><strong>Background: </strong>E-cigarettes have been extensively marketed and popularized worldwide despite their harmful effects. To effectively plan and implement preventive measures, comprehensive analyses are needed to understand the influence of individual and contextual factors on their use.</p><p><strong>Objective: </strong>This study aimed to analyze the influence of poverty and demographic and socioeconomic patterns on e-cigarette use in Colombia.</p><p><strong>Methods: </strong>This study is based on a secondary analysis of the 2019 Colombian Survey on Psychoactive Substance Use, which included 49,756 individuals aged between 12 and 68. State-level multidimensional poverty and individual health-related, socioeconomic, and demographic characteristics were analyzed. Two-level regression models adjusted for the individual and contextual effects.</p><p><strong>Results: </strong>The prevalence of vaping was 4.4% (95% CI: 4.2%-4.6%), with substantial variation across departments, ranging from 0.0% to 9.6%. In the multilevel models, younger age, male sex, technical or higher education, middle-income stratum, not contributing economically to the household, affiliation with the subsidized health scheme, history of tobacco smoking, alcohol consumption, and self-reported use of other drugs were all significantly associated with vaping. The estimated median odds ratio for multidimensional poverty was 1.23 (95% CI: 1.14-1.33; <i>p</i>= 0.012).</p><p><strong>Conclusions: </strong>E-cigarette use in Colombia is a health risk and an indicator of social vulnerability that is influenced by structural determinants. Urgent action from health authorities, the education system, regulatory bodies, and civil society is needed to prevent the normalization of vaping among youth. If left unaddressed, vaping could worsen health inequalities and lead to chronic addiction-related disorders in underserved communities.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 4","pages":"e2006562"},"PeriodicalIF":0.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of the intramedullary nail size by fibula length in bilateral femur fractures.","authors":"Rubén Darío Hernández-Salazar, Juan Pablo López-García, Nathaly Patiño-Vargas, Andrés Felipe Rivera","doi":"10.25100/cm.v55i4.6078","DOIUrl":"10.25100/cm.v55i4.6078","url":null,"abstract":"<p><strong>Case description: </strong>A 23-year-old male patient, with no relevant medical history, who received direct contusion to the lower limbs at the level of the thighs due to a fall from a sheet bending machine.</p><p><strong>Clinical findings: </strong>Clinical and radiographic findings compatible with bilateral comminuted sub-trochanteric fractures, with extension towards the diaphysis in both, with a Trauma Severity Index of 16.</p><p><strong>Treatment and outcome: </strong>Favorable clinical and radiological outcome after early definitive surgical stabilization of both extremities with cephalomedullary nails, rehabilitation with physical therapy and clinical follow-up.</p><p><strong>Clinical relevance: </strong>High energy trauma, due to different causes, constitutes a challenge for all health personnel, due to the patient's own conditions, the individual inflammatory response, the associated musculoskeletal injuries, some not detected at the beginning, and additionally in other systems. Patients with bilateral femur fractures may present the conditions listed above, which requires early identification of the risks of respiratory and multi-organ failure, knowledge of their metabolic status and definition of their clinical situation, considered potentially or truly critical, which even with timely treatment Mortality figures of 6.9% to 27% are found. According to defined parameters, early and definitive osteosynthesis of fractures can be performed, but its characteristics may represent difficulties for surgical planning.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 4","pages":"e5006078"},"PeriodicalIF":0.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polygraphy in hospitalized pediatric patients: A real-life practice.","authors":"Daniel Zenteno, Gerardo Torres-Puebla, Camila Sánchez, Víctor Oviedo, Jaime Tapia, Rodrigo Torres-Castro","doi":"10.25100/cm.v55i4.6622","DOIUrl":"https://doi.org/10.25100/cm.v55i4.6622","url":null,"abstract":"<p><strong>Introduction: </strong>The gold standard test for diagnosing sleep-disordered breathing is polysomnography; however, its limited availability has led to the emergence of alternatives such as polygraphy, which is more accessible and cost-effective.</p><p><strong>Objective: </strong>To analyze the association between underlying conditions and obstructive sleep apnea-hypopnea syndrome in children with suspected sleep-disordered breathing.</p><p><strong>Methods: </strong>Retrospective cross-sectional study. Polygraphy studies of hospitalized children aged ≥1 year with suspected sleep-disordered breathing were included. Demographic, clinical, and polygraphic variables were collected. A logistic regression analysis was performed to evaluate the presence of obstructive sleep apnea-hypopnea syndrome according to underlying conditions.</p><p><strong>Results: </strong>Of 1,000 polygraphy studies, 407 were analyzed. The median age was 8.2 years (range 4.1-12.2), with 56% male patients. The main diagnoses were neurological impairment (19.4%), neuromuscular diseases (16.0%), upper airway obstruction (15.5%), and chronic lung disease (15.5%). Abnormal polygraphy was found in 56.0% of cases, with obstructive sleep apnea syndrome classified as mild in 63.0%, moderate in 21.0%, and severe in 16.0%, with obesity and neuromuscular diseases being most prominent. Significant differences were found in age (p=0.001) and apnea-hypopnea index (p=0.002) across diagnostic categories. Children with Down syndrome had a 5.5-fold higher risk of obstructive sleep apnea-hypopnea syndrome compared to those with chronic lung disease.</p><p><strong>Conclusions: </strong>There was a high prevalence of obstructive sleep apnea-hypopnea syndrome, particularly in children with obesity and neuromuscular diseases. Patients with Down syndrome had a higher risk of obstructive sleep apnea-hypopnea syndrome compared to those with chronic lung disease. Polygraphy is a potentially implementable tool in healthcare centers with similar characteristics.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 4","pages":"e2016622"},"PeriodicalIF":0.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can we address the surge of low-quality systematic reviews and their impact on high journal rejection rates?","authors":"Marilina Santero, Samanta Díaz Menai","doi":"10.25100/cm.v55i4.6597","DOIUrl":"10.25100/cm.v55i4.6597","url":null,"abstract":"<p><p>Journals have experienced a significant rise in submissions of systematic reviews and other types of reviews that often fall short of acceptable quality standards. These shortcomings typically stem from insufficient rigor in their methodology, reporting, or critical appraisal. As a result, these submissions are frequently rejected raising concerns about the standards authors are following when preparing such work. This growing trend of low-quality reviews not only places a burden on editorial teams but also poses a risk to the scientific community by potentially disseminating flawed or unreliable conclusions. Ensuring that articles maintain high standards is crucial for preserving the integrity of the scientific literature and facilitating evidence-based decision-making. In an effort to address this problem, this viewpoint editorial aims to offer concepts and recommendations on available tools for future authors to improve the quality of their reviews, as well as to guide readers and potential journal reviewers on how to critically interpret these articles.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 4","pages":"e4006597"},"PeriodicalIF":0.7,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087455/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Limitations of the MBI-HSS in Colombian health personnel psychometric: Evaluation after modification of its response options.","authors":"Ana Carolina Amaya-Arias, Fabián A Jaimes, Jenny García Valencia","doi":"10.25100/cm.v55i3.5818","DOIUrl":"https://doi.org/10.25100/cm.v55i3.5818","url":null,"abstract":"<p><strong>Objective: </strong>To establish the construct validity, internal consistency, and difficulty and discrimination of the items in the <i>Maslach Burnout Inventory- Human Services Survey</i>, with modified response options, for measuring burnout in healthcare workers in Colombia.</p><p><strong>Methods: </strong>A descriptive study of validation of measurement instruments was conducted. With the support of a panel of experts, the response options were modified, and the new version was administered to 377 healthcare workers. Internal consistency was evaluated, and confirmatory factor analysis was conducted to assess the structural construct validity. The structural Equation Modeling model was calculated using the diagonally weighted least squares estimation method. Finally, item discrimination and difficulty thresholds of the response options were calculated using the generalized partial credit model of Item Response Theory.</p><p><strong>Results: </strong>The emotional exhaustion and personal accomplishment subscales showed good internal consistency (α= 0.87 and 0.77), while the depersonalization subscale was low (0.45). The confirmatory factor analysis indicated an acceptable but not ideal fit (NFI and RFI <0.95; RMSEA >0.06). Inadequate functioning of the response options and measurement bias were identified.</p><p><strong>Conclusions: </strong>The previously validated version of the <i>Maslach Burnout Inventory- Human Services Survey</i> and the adapted version in this study have limitations in Colombian healthcare workers, especially in the depersonalization subscale. A thorough revision is suggested to appropriately measure burnout in healthcare personnel in our context.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 3","pages":"e2015818"},"PeriodicalIF":0.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12017342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The contribution of advanced nursing practice to quaternary prevention and universal health coverage.","authors":"Claudia Yaneth Rodriguez Triviño, Diana Marcela Rengifo","doi":"10.25100/cm.v55i3.6615","DOIUrl":"https://doi.org/10.25100/cm.v55i3.6615","url":null,"abstract":"<p><p>Advanced Nursing Practice (ANP) is a key strategy for achieving universal health coverage as it focuses on the individual. Additionally, it is evidence-based, which improves health outcomes. This strategy contributes to achieving \"Health for All,\" an initiative led by the United Nations within the Sustainable Development Goals, by reducing costs and expanding care in underserved areas. Since its inception in the United States, ANP has taken on roles in diagnosis, prescription, and treatment coordination, becoming established in primary care and other clinical settings. In this century, ANP has strengthened quaternary prevention by protecting individuals from overmedicalization through ethical and personalized care, enhancing the quality of life, and optimizing health system efficiency. This paper will focus on the role of ANP in achieving \"<i>One Health</i>,\" promoted by the World Health Organization, and on how it will contribute to improving coverage and transforming the health system according to the population's needs while maintaining a preventive and holistic.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 3","pages":"e4006615"},"PeriodicalIF":0.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12023882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of loneliness and its associated factors in caregivers of patients with dementia: a cross-sectional study.","authors":"Angie Nathalia Hernandez Rico, Bibiana Flórez Vargas, Santiago Guadarrama Vega, Carmen Juliana Pino Pinzón, Claudia Patricia Agamez Insignares","doi":"10.25100/cm.v55i3.6604","DOIUrl":"https://doi.org/10.25100/cm.v55i3.6604","url":null,"abstract":"<p><strong>Objective: </strong>To identify the levels of loneliness and the factors associated with the prevalence of loneliness in caregivers of patients with dementia.</p><p><strong>Methods: </strong>An observational cross-sectional study was conducted, including unpaid caregivers of patients with dementia who were receiving home care in Bogotá, Colombia. The prevalence of loneliness was estimated using the UCLA Loneliness Scale. Participants were also assessed regarding their satisfaction with providing care and whether they felt they received the necessary emotional support from family and friends. The association between loneliness and the patient's clinical variables, as well as the sociodemographic characteristics of the caregiver, was evaluated by calculating the odds ratio (OR) between the groups.</p><p><strong>Results: </strong>A total of 52 caregivers of patients with dementia were included. Severe loneliness was present in 5.77% of caregivers, while 26.92% experienced moderate loneliness. All caregivers reported feeling satisfied with providing care to their relatives, and 71% felt that their family or friends provided the emotional support they required. Loneliness was more common among caregivers of patients with total functional dependence (OR: 4.061, <i>p</i>= 0.0278). Conversely, the perception of receiving emotional support from family and friends was identified as a potential protective factor against loneliness (OR: 0.184, <i>p</i>= 0.0104).</p><p><strong>Conclusions: </strong>The prevalence of loneliness in this study is lower than that reported in previous studies. All caregivers reported satisfaction in providing care; most perceived adequate emotional support from family and friends. These factors could be contributing to the lower prevalence of loneliness observed.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"55 3","pages":"e2006604"},"PeriodicalIF":0.7,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}