Colombia Medica最新文献

{"title":"Cardiac resynchronization therapy in acute heart failure and left bundle-branch block in a real-life registry.","authors":"Oriol Aguiló, Joan Carles Trullàs, Begoña Espinosa, Pedro López-Ayala, Víctor Gil, María Luisa López-Grima, Pablo Herrero-Puente, Javier Jacob, María Pilar López-Díez, José Manuel Garrido, Javier Millán, Alfons Aguirre, Pascual Piñera, Christian E Müller, Pere Llorens, Òscar Miro","doi":"10.25100/cm.v54i4.5850","DOIUrl":"10.25100/cm.v54i4.5850","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence, characteristics, timing of implementation and prognosis of patients with left bundle branch block (LBBB) and acute heart failure (AHF) treated with cardiac resynchronization therapy (CRT) in a real-life registry.</p><p><strong>Methods: </strong>We analysed the characteristics of patients with AHF and LBBB at the time of inclusion in the EAHFE (Epidemiology Acute Heart Failure Emergency) cohort to determine the indication for CRT, the timing of implementation and its impact on 10-year all-cause mortality.</p><p><strong>Results: </strong>729 patients with a median age of 82 years and there was a high burden of comorbidities and functional dependence. The median left-ventricle ejection fraction (LVEF) was 40%. Forty-six (6%) patients were treated with CRT at some point during follow-up, with a median time of delay for CRT implementation of 960 (IQR=1,147 days) and at least 108 more untreated patients fulfilled criteria for CRT. Patients receiving CRT were younger, had different comorbidities, less functional dependence (higher Barthel index) and lower LVEF values. The median follow-up was 5.7 years (95% CI: 5.6-5.8) and CRT was not associated with changes in 10-year mortality (adjusted HR 1.33, 95% CI: 0.72-2.48; p-value 0.4). When compared with untreated patients fulfilling criteria for CRT, very similar results were observed (adjusted HR 1.34, 95% CI: 0.67-2.68).<b></b></p><p><strong>Conclusions: </strong>CRT implementation was delayed and underused in patients with AHF and LBBB. Under these circumstances, CRT is not associated with a reduction in all-cause mortality in the long term.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 4","pages":"e2015850"},"PeriodicalIF":0.7,"publicationDate":"2023-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074479","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":"Clinical characterization and outcomes of a cohort of colombian patients with AL Amyloidosis.","authors":"Jorge Andrés Lacouture Fierro, Daniel Andrés Ribero Vargas, Juanita Sánchez Cano, Lina Maria Gaviria Jaramillo, Oliver Gerardo Perilla Suarez, Kenny Mauricio Galvez Cárdenas, Sigifredo Ospina Ospina","doi":"10.25100/cm.v54i3.5667","DOIUrl":"https://doi.org/10.25100/cm.v54i3.5667","url":null,"abstract":"<p><strong>Background: </strong>Amyloid light chain (AL) amyloidosis is characterized by amyloid fibril deposition derived from monoclonal immunoglobulin light chains, resulting in multiorgan dysfunction. Limited data exist on the clinical features of AL amyloidosis.</p><p><strong>Objective: </strong>This study aims to describe the clinical characteristics, treatments, and outcomes in Colombian patients with AL amyloidosis.</p><p><strong>Methods: </strong>A retrospective descriptive study was conducted at three high-complexity centers in Medellín, Colombia. Adults with AL amyloidosis diagnosed between 2012 and 2022 were included. Clinical, laboratory, histological, treatment, and survival data were analyzed.</p><p><strong>Results: </strong>The study included 63 patients. Renal involvement was most prevalent (66%), followed by cardiac involvement (61%). Multiorgan involvement occurred in 61% of patients. Amyloid deposition was most commonly detected in renal biopsy (40%). Bortezomib-based therapy was used in 68%, and 23.8% received high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HDCT-ASCT). Hematological response was observed in 95% of patients with available data. Cardiac and renal organ responses were 15% and 14%, respectively. Median overall survival was 45.1 months (95% CI: 22.2-63.8). In multivariate analysis, cardiac involvement was significantly associated with inferior overall survival (HR 3.27; 95% CI: 1.23-8.73; <i>p</i>=0.018), HDCT-ASCT had a non-significant trend towards improved overall survival (HR 0.25; 95% CI: 0.06-1.09; <i>p</i>=0.065).</p><p><strong>Conclusions: </strong>In this study of Colombian patients with AL amyloidosis, renal involvement was more frequent than cardiac involvement. Overall survival and multiorgan involvement were consistent with data from other regions of the world. Multivariate analysis identified cardiac involvement and HDCT-AHCT as possible prognostic factors.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 3","pages":"e2025667"},"PeriodicalIF":1.1,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10723764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813027","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":"JAK2, CALR, and MPL Mutation Profiles in Colombian patients with BCR-ABL Negative Myeloproliferative Neoplasms.","authors":"Ana Isabel Giraldo-Rincón, Sara Naranjo Molina, Natalia Gomez-Lopera, Daniel Aguirre Acevedo, Andrea Ucroz Benavidez, Kenny Gálvez Cárdenas, Francisco Cuellar Ambrosí, Jose Domingo Torres, Sigifredo Ospina, Katherine Palacio, Lina Gaviria Jaramillo, Carlos Mario Muñeton, Gonzalo Vasquez Palacio","doi":"10.25100/cm.v54i3.5353","DOIUrl":"10.25100/cm.v54i3.5353","url":null,"abstract":"<p><strong>Background: </strong>Among the chronic myeloproliferative neoplasms (MPNs) not associated with BCR-ABL mutations are polycythemia vera, primary myelofibrosis, and essential thrombocythemia. These diseases are caused by mutations in genes, such as the JAK2, MPL, and CALR genes, which participate in regulating the JAK-STAT signaling pathway.</p><p><strong>Objective: </strong>This study aimed to establish the frequencies of mutations in the JAK2, MPL, and CALR genes in a group of Colombian patients with a negative clinical diagnosis of BCR-ABL chronic myeloproliferative neoplasms.</p><p><strong>Methods: </strong>The JAK2 V617F and MPL W515K mutations and deletions or insertions in exon 9 of the CALR gene were analyzed in 52 Colombian patients with polycythemia vera, primary myelofibrosis, and essential thrombocythemia.</p><p><strong>Results: </strong>The JAK2V617F mutation was carried by 51.9% of the patients, the CALR mutation by 23%, and the MPL mutation by 3.8%; 23% were triple-negative for the mutations analyzed. In these neoplasms, 6 mutation types in CALR were identified, one of which has not been previously reported. Additionally, one patient presented a double mutation in both the CALR and JAK2 genes. Regarding the hematological results for the mutations, significant differences were found in the hemoglobin level, hematocrit level, and platelet count among the three neoplasms.</p><p><strong>Conclusion: </strong>Thus, this study demonstrates the importance of the molecular characterization of the JAK2, CALR and MPL mutations in Colombian patients (the genetic context of which remains unclear in the abovementioned neoplasms) to achieve an accurate diagnosis, a good prognosis, adequate management, and patient survival.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 3","pages":"e2035353"},"PeriodicalIF":1.1,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10726695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813032","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":"Human intelligence for authors, reviewers and editors using artificial intelligence.","authors":"Mauricio Palacios Gomez","doi":"10.25100/cm.v54i3.5867","DOIUrl":"10.25100/cm.v54i3.5867","url":null,"abstract":"","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 3","pages":"e1005867"},"PeriodicalIF":0.7,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10702474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813030","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":"Chatbots, generative AI, and scholarly manuscripts: WAME recommendations on chatbots and generative artificial intelligence in relation to scholarly publications.","authors":"Chris Zielinski, Margaret A Winker, Rakesh Aggarwal, Lorraine E Ferris, Markus Heinemann, Jose Florencio Lapeña, Sanjay A Pai, Edsel Ing, Leslie Citrome, Murad Alam, Michael Voight, Farrokh Habibzadeh","doi":"10.25100/cm.v54i3.5868","DOIUrl":"https://doi.org/10.25100/cm.v54i3.5868","url":null,"abstract":"<p><p>This statement revises our earlier \"WAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications\" (January 20, 2023). The revision reflects the proliferation of chatbots and their expanding use in scholarly publishing over the last few months, as well as emerging concerns regarding lack of authenticity of content when using chatbots. These recommendations are intended to inform editors and help them develop policies for the use of chatbots in papers published in their journals. They aim to help authors and reviewers understand how best to attribute the use of chatbots in their work and to address the need for all journal editors to have access to manuscript screening tools. In this rapidly evolving field, we will continue to modify these recommendations as the software and its applications develop.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 3","pages":"e1015868"},"PeriodicalIF":1.1,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10712422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813026","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":"Survival of patients living with HIV and cancer in Cali, Colombia.","authors":"Luis Gabriel Parra-Lara, Juan Pablo Arango-Ibañez, Juan J Martínez-Arboleda, Juan C Bravo, Ángela R Zambrano, Paola Collazos, Francisco Andino, Angélica Badillo, Sebastián Estrada, Fernando Rosso","doi":"10.25100/cm.v54i3.5588","DOIUrl":"https://doi.org/10.25100/cm.v54i3.5588","url":null,"abstract":"<p><strong>Background: </strong>People living with HIV have an increased risk of cancer compared to the general population. However, with the increase in life expectancy and advances in antiretroviral therapy, the survival of patients with cancer and HIV has changed.</p><p><strong>Objective: </strong>To determine the survival of patients living with HIV and cancer in Cali, Colombia.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted at the Fundación Valle del Lili, Cali, Colombia. Data from the HIV database was crossed with data from the hospital and population-based cancer registries between 2011-2019. Patients <18 years, limited available clinical information on the diagnosis and treatment of HIV and cancer, and non-oncological tumor diagnosis were excluded.</p><p><strong>Results: </strong>A total of 173 patients were included. The frequencies of AIDS-defining neoplasms were: Non-Hodgkin lymphoma (42.8%), Kaposi sarcoma (27.8%), and cervical cancer (4.6%). Overall survival was 76.4% (95% CI 68.9-82.3) at five years. Poorer survival was found in patients with AIDS-defining infections (56.9% vs. 77.8%, p=0.027) and non-AIDS-defining infections (57.8% vs. 84.2%, p=0.013), while there was better survival in patients who received antiretroviral therapy (65.9% vs. 17.9%, p=0.021) and oncological treatment (66.7% vs. 35.4%, p<0.001). The presence of non-AIDS-defining infections increases the risk of dying (HR = 2.39, 95% CI 1.05-5.46, p=0.038), while oncological treatment decreases it (HR = 0.33, 95% CI 0.14-0.80, p=0.014).</p><p><strong>Conclusions: </strong>In people living with HIV, Non-Hodgkin lymphoma and Kaposi sarcoma are the most common neoplasms. Factors such as AIDS-associated and non-AIDS-associated infections have been identified as determinants of survival. Cancer treatment seems to improve survival.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 3","pages":"e2015558"},"PeriodicalIF":1.1,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10719985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813037","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":"Clinimetric properties of the Perme Intensive Care Unit Mobility Score -a multicenter study for minimum important difference and responsiveness analysis.","authors":"Ricardo Kenji Nawa, Marcio Luiz Ferreira De Camillis, Monique Buttignol, Fernanda Machado Kutchak, Eder Chaves Pacheco, Louise Helena Rodrigues Gonçalves, Leonardo Miguel Correa Garcia, Karina Tavares Timenetsky, Luiz Alberto Forgiarini","doi":"10.25100/cm.v54i3.5580","DOIUrl":"https://doi.org/10.25100/cm.v54i3.5580","url":null,"abstract":"<p><strong>Background: </strong>The use of instruments in clinical practice with measurement properties tested is highly recommended, in order to provide adequate assessment and measurement of outcomes.</p><p><strong>Objective: </strong>To calculate the minimum clinically important difference (MCID) and responsiveness of the Perme Intensive Care Unit Mobility Score (Perme Score).</p><p><strong>Methods: </strong>This retrospective, multicentric study investigated the clinimetric properties of MCID, estimated by constructing the Receiver Operating Characteristic (ROC). Maximizing sensitivity and specificity by Youden's, the ROC curve calibration was performed by the Hosmer and Lemeshow goodness-of-fit test. Additionally, we established the responsiveness, floor and ceiling effects, internal consistency, and predictive validity of the Perme Score.</p><p><strong>Results: </strong>A total of 1.200 adult patients records from four mixed general intensive care units (ICUs) were included. To analyze which difference clinically reflects a relevant evolution we calculated the area under the curve (AUC) of 0.96 (95% CI: 0.95-0.98), and the optimal cut-off value of 7.0 points was established. No substantial floor (8.8%) or ceiling effects (4.9%) were observed at ICU discharge. However, a moderate floor effect was observed at ICU admission (19.3%), in contrast to a very low incidence of ceiling effect (0.6%). The Perme Score at ICU admission was associated with hospital mortality, OR 0.86 (95% CI: 0.82-0.91), and the predictive validity for ICU stay presented a mean ratio of 0.97 (95% CI: 0.96-0.98).</p><p><strong>Conclusion: </strong>Our findings support the establishment of the minimum clinically important difference and responsiveness of the Perme Score as a measure of mobility status in the ICU.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 3","pages":"e2005580"},"PeriodicalIF":1.1,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10714681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138813028","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":"Main results and public health implications of the National School Health Survey (ENSE), Colombia 2017.","authors":"Fabian Méndez Paz,&nbsp;Stefanie Tonguino,&nbsp;Delia Ortega-Lenis","doi":"10.25100/cm.v54i2.5402","DOIUrl":"https://doi.org/10.25100/cm.v54i2.5402","url":null,"abstract":"<p><strong>Introduction: </strong>The school population represents a fundamental group for health promotion actions, given that the foundations of healthy behaviors in adult life are established in children and adolescents, who can be greatly influenced by the school.</p><p><strong>Objective: </strong>To describe the health-related behavioral factors of schoolchildren between 13 and 17 years of age in secondary and middle school in Colombia.</p><p><strong>Methods: </strong>A national cross-sectional study was conducted (i.e., School Health Survey -ENSE-) that recorded information on dietary practices, physical activity, alcohol and drug consumption, injuries and bullying, and oral, visual and hearing health. Sampling was probabilistic, cluster and multistage.</p><p><strong>Results: </strong>Schoolchildren have low consumption of fruits, vegetables (13.1%) and dairy (76.5 %), high consumption of ultra-processed foods (82.4 %), sugary drinks (74.0 %) and fast foods (14.8 %), frequent addition of salt at the table (43.3 %), low compliance with physical activity recommendations (15.0 %) and high sedentary lifestyle (46.3 %), frequent consumption of alcohol (44.7 %) and psychoactive substances (14.7 %), in addition to prevalent situations of bullying (15.4 %), rejection (8.2 %) and verbal aggression (42.7 %).</p><p><strong>Conclusions: </strong>The ENSE shows critical inequalities by gender, ethnicity and social class, throughout the country. The indicators observed in schoolchildren are precursors of various chronic and degenerative diseases and mental illness, which requires the urgent attention of the different social actors in the country.</p>","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 2","pages":"e2015402"},"PeriodicalIF":1.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/ce/1657-9534-cm-54-02-e2015402.PMC10512797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156224","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":"Scientific perspective of emotional management in health professionals.","authors":"Lourdes Zevallos","doi":"10.25100/cm.v54i2.5686","DOIUrl":"10.25100/cm.v54i2.5686","url":null,"abstract":"This letter focuses on the interesting article entitled “Melancholy as a Healthy Strategy in Times of Great Human Crisis” 1 , where a series of very respectful observations and reflections are made: First, we raise the convenience of reorienting the worldview presented in the article since it establishes a tragic image of life (death). Not only because it implies the idea of the end of the world as the basis of the population’s anxieties and obsessions but also because it presupposes that the modernly conceived world is unlivable due to the level of stress endured because of uncertainty and change. Moreover, it presents melancholy and bitterness as strategies to be applied as a remedy to the living crisis and to achieve mental health. Certainly, behaviors that do not have a profile of harmony or internal coherence in the subject but of disorganization and a healthy lack of response to life. The second observation is a theoretical proposal of a materialistic and systemic, i.e., scientific nature. While it is true that the conditions we live in today are complex, uncertain and changing. It is also true that theoretical proposals such as resilience come from social psychology, which proposes assertive, proactive behaviors that look more positively to the health of citizens without reaching romantic explanations such as the possible exercise of freedom (subjectivism and idealism) or the ideal of the self (patent presence of psychoanalysis). These terms are not only insubstantial but have no known therapeutic correlation. Therefore, the population demands a clear and realistic vision of mental health to structure concrete ways out of their stress, depression, or anxiety.","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"54 2","pages":"e7005686"},"PeriodicalIF":1.1,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/48/dc/1657-9534-cm-54-02-e7005686.PMC10557474.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41150886","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":"Response to a critical reader of my essay on melancholy","authors":"Eduardo Botero Toro","doi":"10.25100/cm.v54i2.5749","DOIUrl":"https://doi.org/10.25100/cm.v54i2.5749","url":null,"abstract":"With the title “Scientific perspective of emotional management in health professionals,” the reader presents a series of considerations based on “very respectful observations and reflections”, five in total, to which I wish to respond after thanking the Journal and the reader because with its publication it contributes to stimulating the healthy debate that must exist in the field of knowledge that defines human behavior as an object. But first I want to state that, with the publication of my essay, I move away from any mood aimed at managing emotions in health professionals, whatever this means. Like everyone who publishes, I am encouraged by the desire to be read and the critical reader testifies to this, but, following the line of argument of his criticism of my essay, I depart from considering that the readers of this magazine are waiting for healthy recommendations for their ways of life. With Foucault, I share the radical criticism he makes of this type of psychoanalysis - and other so-called behavioral sciences - that tend to become preaching. I suppose (and desire) an adult reader and able to discern with my writing, in favor or not of this content. As in any essay, I use a vital experience that continues to be nourished by conceptual references produced from various areas of knowledge to fulfill one of the essential objectives of any essay: to investigate a topic and involve the reader and, finally, does not require exhaustiveness and declares mandatory the subjectivity of the essayist with total freedom in the structure, the tone and style of the text.","PeriodicalId":50667,"journal":{"name":"Colombia Medica","volume":"29 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135359547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}