Spanish validation of the short version of the racing and crowded thoughts questionnaire (RCTQ-13).

BACKGROUND: The Racing and Crowded Thoughts Questionnaire (RCTQ-13) is the most widely used specific scale for the measurement of racing thoughts, but there is currently no Spanish version that allow the evaluation in Spanish-speaking patients. The objective of this study is to translate, adapt, and validate the RCTQ-13 in a Colombian population with affective disorders. METHODS: The questionnaire was translated and back-translated, and corrections were implemented following a pilot test to improve comprehensibility. We included patients with Bipolar I Disorder and with Major depressive disorder seen in three centers in the city of Medellín, Colombia. We evaluate structural validity with confirmatory factor analysis, internal consistency, and test-retest reliability. Construct validity was also assessed with the comparison between euthymic, maniac, and depressive episodes and the correlation with worry, rumination, and mania scales. Responsiveness was measured 1 month after the first evaluation. Based on item response theory (IRT), we also estimated item difficulty, discrimination, and fit using a generalized partial credit model. RESULTS: Two hundred fifty subjects were included. Confirmatory factor analysis revealed that the three-factor structure of the scale was appropriate. Internal consistency was adequate for the entire scale (Cronbach's alpha = 0.95, 95% CI: 0.94-0.96) and for each factor. Test-retest reliability was good (intraclass correlation coefficient = 0.82, 95%IC: 0.70-0.88). For construct validity, we observed differences between patients with different types of affective episodes, a moderate positive correlation with the Penn State Worry Scale (r = 0.55) and the Ruminative Response Scale (r = 0.42), and a low negative correlation with the Young Mania Rating Scale (r = - 0.10). Responsiveness was proved to be adequate. Under IRT, the response thresholds for the response options are organized for all items. The infit was adequate for all items and the outfit was acceptable. CONCLUSIONS: The Spanish version of the RCTQ-13 is a reliable, valid, and responsive scale and can be used for the clinical assessment of the construct of racing and crowded thoughts in patients with the spectrum of affective disorders in whom this experience can be expressed with different nuances. Further research is needed to expand the relationship with rumination and worry.

Risk factors characterisation for CHD: a case-control study in Bogota and Cali, Colombia, 2002-2020.

OBJECTIVE: CHDs correspond to 28% of all congenital anomalies, being the leading cause of infant mortality in the first year of life. Thus, it is essential to explore risk factors for CHDs presentation, allowing the detection of probable cases within a population. METHODS: We identified newborns with CHDs within a cohort from the Program for the Prevention and Monitoring of Congenital Defects in Bogota and Cali, 2002-2020. Cases were classified as isolated, complex isolated, polymalformed, and syndromic. Variables were analysed by comparing case and control averages with Student's t test using a 95% confidence level. RESULTS: Prevalence obtained was 19.36 per 10 000 live births; non-specified CHD, ventricular septal defect, and atrial septal defect were the most prevalent. As risk factors were found: paternal and maternal age above 45 years, pregestational diabetes, mother's body mass index above 25, low educational level, and socio-economic status. As protective factors: folic acid consumption within the first trimester and pregestational period. CONCLUSION: Different risk and protective factors associated with the presentation of CHDs have been described. We consider that public health strategies should be aimed to reduce risk factors exposure. Also, improving diagnosis and prognosis by having a close monitoring on high-risk patients.

Device-associated infections in neonatal care units in a middle-income country, 2016-2018.

OBJECTIVE: Describe the device-associated infections in the NICUs in Cali - Colombia, a middle-income country, between August 2016 to December 2018. METHODS: Observational cross-sectional study evaluating reports of device-associated infections in 10 NICUs in Cali, Colombia, between August 2016 and December 2018. Socio-demographic and microbiological data were obtained from the National Public Health surveillance system, through a specialized notification sheet. The relationship of device-associated infections with several outcomes including birth weight, microorganisms, and mortality was evaluated using OR CI95%, using the logistic regression model. Data processing was performed using the statistical program STATA 16. RESULTS: 226 device-associated infections were reported. The rate of infection with central line-associated bloodstream infections was 2.62 per 1000 days of device use and 2.32 per 1000 days for ventilator-associated pneumonia. This was higher in neonates under 1000 g; 4.59 and 4.10, respectively. 43.4% of the infections were due to gram-negative bacteria and 42.3% were due to gram-positive bacteria. Time from hospitalization to diagnosis of all device-associated infections had a median of 14 days. When compared by weight, infants with a weight lower than 1000 g had a greater chance of death (OR 3.61; 95% CI 1.53-8.49, p = 0.03). Infection by gram-negative bacteria was associated with a greater chance of dying (OR 3.06 CI 95 1.33-7.06, p = 0.008). CONCLUSIONS: These results highlight the need to maintain epidemiological surveillance processes in neonatal intensive care units, especially when medical devices are used.

Device-associated infections in neonatal care units in a middle-income country, 2016-2018

Abstract Objective: Describe the device-associated infections in the NICUs in Cali - Colombia, a middle-income country, between August 2016 to December 2018. Methods: Observational cross-sectional study evaluating reports of device-associated infections in 10 NICUs in Cali, Colombia, between August 2016 and December 2018. Socio-demographic and microbiological data were obtained from the National Public Health surveillance system, through a specialized notification sheet. The relationship of device-associated infections with several outcomes including birth weight, microorganisms, and mortality was evaluated using OR Cl95%, using the logistic regression model. Data processing was performed using the statistical program STATA 16. Results: 226 device-associated infections were reported. The rate of infection with central line-associated bloodstream infections was 2.62 per 1000 days of device use and 2.32 per 1000 days for ventilator-associated pneumonia. This was higher in neonates under 1000 g; 4.59 and 4.10, respectively. 43.4% of the infections were due to gram-negative bacteria and 42.3% were due to gram-positive bacteria. Time from hospitalization to diagnosis of all device-associated infections had a median of 14 days. When compared by weight, infants with a weight lower than 1000 g had a greater chance of death (OR 3.61; 95% CI 1.53-8.49, p = 0.03). Infection by gram-negative bacteria was associated with a greater chance of dying (OR 3.06 CI 95 1.33-7.06, p = 0.008). Conclusions: These results highlight the need to maintain epidemiological surveillance processes in neonatal intensive care units, especially when medical devices are used.

Trends in long-term cancer survival in Cali, Colombia: 1998-2017.

Background: Population-based cancer survival is an indicator of the effectiveness of cancer services that reflects the survival of all cancer patients in the population, regardless of socioeconomic status and disease characteristics. Aim: Provision of an up-to-date survival estimate of patients recorded within Cali Population Cancer Registry (RPCC) in 1998-2017. As a second objective, results will be compared with those reported by the CONCORD study for cancers prioritized by the current Ten-Year Cancer Control Plan of Colombia, 2012-2021. Methods: Adult cancer cases (aged 15 to 99 years) for nine cancer types diagnosed between 1998 and 2017, with follow-up to 2018, were obtained from the RPCC. The 5-year age-standardized net survival estimates (NS) were estimated using the Pohar-Perme. The results for the period 1995- 2014 were compared with those reported by the CONCORD study for the following locations: stomach (C16), breast (C50), cervix (C53), prostate (C61), and lung (C33-34). Results: Five-year survival estimates for breast and prostate cancers improved ten percentage points through 2007 (70.8 to 81.1 for breast and 79.9 to 90.2 for prostate) and remained stable during 2008-2017. For cervical cancer, survival estimates has remained stable for the last two decades at 53%. For stomach cancer and lung cancer, five-year NS was lower than 25% over the study period. For colorectal cancer, survival estimates increased from 37.9% in 1998-2002 to 54.8% in 2013-2017. Compared to previous 5-year survival estimates of cases diagnosed in 2010-2014, the estimates in this study are significantly higher than those obtained by CONCORD. Survival estimates of patients diagnosed in 1995-2009 showed no difference to CONCORD study. Conclusions: Periodic update of vital status and date of last contact reduces bias in survival estimates in population-based cancer registries with passive follow-up.

Antecedentes: La supervivencia del cáncer es un indicador de la eficacia de los servicios oncológicos que refleja la supervivencia de todos los pacientes con cáncer de la población, independientemente del nivel socioeconómico y las características de la enfermedad. Objetivo: Realizar una estimación actualizada de la supervivencia de los pacientes registrados en el Registro Poblacional de Cáncer de Cali durante 1998-2017. Como segundo objetivo, los resultados se compararán con los reportados por el estudio CONCORD para los cánceres priorizados por el actual Plan Decenal de Control del Cáncer de Colombia, 2012-2021. Métodos: Los casos de cáncer en adultos (15 a 99 años) para nueve tipos de cáncer diagnosticados entre 1998 y 2017, con seguimiento hasta 2018, se obtuvieron del RPCC. Las estimaciones de supervivencia neta (NS) estandarizada por edad a 5 años se estimaron utilizando el método de Pohar-Perme. Los resultados del periodo 1995-2014 se compararon con los obtenidas por el estudio CONCORD para las siguientes localizaciones: estómago (C16), mama (C50), cuello uterino (C53), próstata (C61) y pulmón (C33-34). Resultados: La SN-5a para los cánceres de mama y próstata mejoró diez puntos porcentuales hasta 2007 (SN=70.8 a 81.1 para mama y NS=79.9 a 90.2 para próstata) y se mantuvo estable durante 2008-2017. Para el cáncer de cuello uterino fue 53% y permaneció estable durante dos décadas. Para el cáncer de estómago y el cáncer de pulmón, la SN-5años fue inferior al 25%. Para cáncer colorrectal las estimaciones de supervivencia aumentaron de 37.9% en 1998-2002 a 54.8% en 2013-2017. En comparación con estimaciones anteriores de supervivencia a 5 años de casos diagnosticados en 2010-2014, las estimaciones de este estudio son significativamente más altas que las obtenidas por CONCORD-3. Para la década 1995-2009 no hubo diferencia. Conclusión: La actualización periódica del estado vital y la fecha de último contacto reduce el sesgo en las estimaciones de supervivencia en los registros de cáncer de base poblacional que hacen seguimiento pasivo.

Cancer epidemiology in Cali, 60 years of experience.

Background: The population-based Cancer Registry of Cali Colombia operates continuously since 1962, disseminating incidence information in the XI volumes of Cancer Incidence in Five Continents. Aim: To describe the incidence and mortality rates for the period 2011-2020 and the changes in the trend of incidence rates (1962-2017) and mortality rates from cancer (1986-2020). Methods: The Joinpoint model and the annual percentage change (APC) were used as summary measures of the changes in the trends of incidence rates (ASR-I) and mortality (ASR-M) standardized by age with the direct method. Results: Trough 1988-2017 the ASR-I for all locations increased 0.4% annually (95% CI: 0.2, 0.6) in men and decreased annually 0.2% (95% CI: -0.3; -0.1) in women. The ASR-Is of cancers related to opportunity screening activities (prostate and breast) increased until the early 21st century and then decreased. The ASR-I of cancers related to infectious agents continue to decrease (cervix, vulva, and stomach). There is evidence of control of cancer related to tobacco consumption (lung, oral cavity, bladder). In both sexes, the ASR-I of thyroid, colorectal and lymphoma cancers increased and those of ovarian cancer decreased. Between 1984-2020 the ASR-M for all locations decreased annually 0.7% (95% CI: -0.9, -0.5) in men and 1.1% (95% CI: -1.3, -0.9) in women. For both sexes, ASR-M decreased for cancers of the esophagus, stomach, lung, bladder, lymphomas, and leukemias; and increased in colorectal cancer. The ASR-M for cervical and prostate cancer decreased annually by 3.5% (95% CI: -3.9, -3.2) and 0.1% (95% CI: -0.5, -0.3), respectively. Comment: This information allows the construction of some indicators to monitor the City Cancer Challenge initiative and the current 10-year plan for cancer control in Colombia, 2011-2021.

Antecedentes: El registro poblacional de Cáncer de Cali-Colombia, opera desde 1962 divulgando continuamente la información de incidencia en los XI volúmenes de Cancer Incidence in Five Continents. Objetivo: Describir las tasas de incidencia y mortalidad del periodo 2011-2020 y los cambios en la tendencia de las tasas de incidencia (1962-2017) y mortalidad por cáncer (1986-2020). Métodos: Se utilizó el modelo de Joinpoint y el cambio porcentual anual (APC) como medidas de resumen de los cambios en las tendencias de las tasas de incidencia (ASR-I) y mortalidad (ASR-M) estandarizadas por edad con el método directo. Resultados: Durante el periodo 1988-2017 las ASR-I para todas las localizaciones aumentaron anualmente 0.4% (IC 95%: 0.2; 0.6) en los hombres y disminuyeron anualmente 0.2% (IC 95%: -0.3; -0.1) en las mujeres. Las ASR-I de los cánceres relacionados con actividades de tamización de oportunidad (próstata y mama) aumentaron hasta principios del siglo XXI y luego descendieron. Las ASR-I de los canceres relacionados con agentes infecciosos continúan disminuyendo (cérvix, vulva y estómago). Hay evidencias de control de los cánceres relacionados al consumo de tabaco (pulmón, cavidad oral, vejiga). En ambos sexos aumentaron las ASR-I de los cánceres de tiroides, colorrectal y linfomas y disminuyeron las de cáncer de ovario. Entre 1984-2020 las ASR-M para todas las localizaciones disminuyeron anualmente 0.7% (IC 95%: -0.9; -0.5) en los hombres y 1.1% (IC 95%: -1.3; -0.9) en las mujeres. Para ambos sexos, disminuyeron las ASR-M para los cánceres de esófago, estómago, pulmón, vejiga, linfomas y leucemias; y aumentaron en cáncer colorrectal. Las ASR-M por cáncer de cérvix y próstata disminuyeron anualmente 3.5% (IC 95%: -3.9; -3.2) y 0.1% (IC 95%: -0.5; -0.3), respectivamente. Comentario: Esta información permite construir algunos indicadores para monitorear la iniciativa City Cancer Challenge y el actual Plan Decenal para el Control del Cáncer en Colombia, 2011-2021.

Trends in long-term cancer survival in Cali, Colombia: 1998-2017 / Tendencias en la supervivencia al cáncer a largo plazo en Cali, Colombia: 1998-2017

Abstract Background: Population-based cancer survival is an indicator of the effectiveness of cancer services that reflects the survival of all cancer patients in the population, regardless of socioeconomic status and disease characteristics. Aim: Provision of an up-to-date survival estimate of patients recorded within Cali Population Cancer Registry (RPCC) in 1998-2017. As a second objective, results will be compared with those reported by the CONCORD study for cancers prioritized by the current Ten-Year Cancer Control Plan of Colombia, 2012-2021. Methods: Adult cancer cases (aged 15 to 99 years) for nine cancer types diagnosed between 1998 and 2017, with follow-up to 2018, were obtained from the RPCC. The 5-year age-standardized net survival estimates (NS) were estimated using the Pohar-Perme. The results for the period 1995- 2014 were compared with those reported by the CONCORD study for the following locations: stomach (C16), breast (C50), cervix (C53), prostate (C61), and lung (C33-34). Results: Five-year survival estimates for breast and prostate cancers improved ten percentage points through 2007 (70.8 to 81.1 for breast and 79.9 to 90.2 for prostate) and remained stable during 2008-2017. For cervical cancer, survival estimates has remained stable for the last two decades at 53%. For stomach cancer and lung cancer, five-year NS was lower than 25% over the study period. For colorectal cancer, survival estimates increased from 37.9% in 1998-2002 to 54.8% in 2013-2017. Compared to previous 5-year survival estimates of cases diagnosed in 2010-2014, the estimates in this study are significantly higher than those obtained by CONCORD. Survival estimates of patients diagnosed in 1995-2009 showed no difference to CONCORD study. Conclusions: Periodic update of vital status and date of last contact reduces bias in survival estimates in population-based cancer registries with passive follow-up.

Resumen Antecedentes: La supervivencia del cáncer es un indicador de la eficacia de los servicios oncológicos que refleja la supervivencia de todos los pacientes con cáncer de la población, independientemente del nivel socioeconómico y las características de la enfermedad. Objetivo: Realizar una estimación actualizada de la supervivencia de los pacientes registrados en el Registro Poblacional de Cáncer de Cali durante 1998-2017. Como segundo objetivo, los resultados se compararán con los reportados por el estudio CONCORD para los cánceres priorizados por el actual Plan Decenal de Control del Cáncer de Colombia, 2012-2021. Métodos: Los casos de cáncer en adultos (15 a 99 años) para nueve tipos de cáncer diagnosticados entre 1998 y 2017, con seguimiento hasta 2018, se obtuvieron del RPCC. Las estimaciones de supervivencia neta (NS) estandarizada por edad a 5 años se estimaron utilizando el método de Pohar-Perme. Los resultados del periodo 1995-2014 se compararon con los obtenidas por el estudio CONCORD para las siguientes localizaciones: estómago (C16), mama (C50), cuello uterino (C53), próstata (C61) y pulmón (C33-34). Resultados: La SN-5a para los cánceres de mama y próstata mejoró diez puntos porcentuales hasta 2007 (SN=70.8 a 81.1 para mama y NS=79.9 a 90.2 para próstata) y se mantuvo estable durante 2008-2017. Para el cáncer de cuello uterino fue 53% y permaneció estable durante dos décadas. Para el cáncer de estómago y el cáncer de pulmón, la SN-5años fue inferior al 25%. Para cáncer colorrectal las estimaciones de supervivencia aumentaron de 37.9% en 1998-2002 a 54.8% en 2013-2017. En comparación con estimaciones anteriores de supervivencia a 5 años de casos diagnosticados en 2010-2014, las estimaciones de este estudio son significativamente más altas que las obtenidas por CONCORD-3. Para la década 1995-2009 no hubo diferencia. Conclusión: La actualización periódica del estado vital y la fecha de último contacto reduce el sesgo en las estimaciones de supervivencia en los registros de cáncer de base poblacional que hacen seguimiento pasivo.

Association between maternal infections during pregnancy and congenital defects in their offspring: a population-based case-control study in Bogota and Cali, Colombia 2001-2018.

Infections are frequent during pregnancy and their teratogenic role is well documented in Toxoplasmosis, other infections, Rubella, Cytomegalovirus, and Herpes simplex (TORCH). However, the in-utero development effects of the rest of the infections that affect pregnant women are unknown. We described a cohort of patients with major Birth Defects (BD) and the exposure to infections during pregnancy from the information of Congenital Defects Surveillance Programs of two Colombian cities (Bogota and Cali) between 2001 and 2018. We evaluated associations between groups of maternal infections and BD among 3096 cases and 7446 controls that were registered. BD presentation was more frequent as isolated (64.3%), polymalformed (23.2%), and syndromic (12.4%). Infections during pregnancy were present in 52.5% of cases and 44.6% of controls. The most common single infection between cases and controls was vaginal infection. The most common polyinfection was vaginal and urinary tract infection. We found an association between BD and vaginal infections with an odds ratio (OR) 1.18 (CI 1.08-1.30), urinary tract infections OR 1.16 (CI 1.05-1.28), gastrointestinal infections OR 2.06 (IC 1.18-3.59), respiratory infections OR 1.56 (IC 1.28-1.9) and viral infections OR 1.88 (IC 1.18-3.0). Knowing the teratogenic effect of infections is important to extend prevention, screening, timely diagnosis, and appropriate treatment to pregnant women.

Head and neck cancer in Cali, Colombia: Population-based study.

INTRODUCTION: Head and neck cancer (HNC) is the seventh most common type of cancer in the world. In Latin America, data on HCN are limited by the scarcity of population-based cancer registries. OBJECTIVE: To describe survival and changes in the time trends of incidence and mortality rates of HCN with data from the Cali Cancer Population Registry (Colombia) during 1962-2018. METHOD: Males and females of any age residing in Cali were included. The trends in incidence rates (1962-2016) and mortality (1984-2018) were analysed by calculating the mean annual percentage change (APC). Five-year net survival was estimated for the four 5-year periods of 1996-2015 using the Pohar-Perme method. RESULTS: During 1962-2015, 5,110 new cases of HNC were recorded: 1,506 in the larynx, 1,377 in the oral cavity, 487 in the nose and paranasal sinuses, 643 in the oropharynx, 603 in the salivary glands and 360 in Naso-Hypopharynx region. The incidence rates of HNC decreased significantly at all subsites, except in those associated with the human papillomavirus. Between 1984 and 2018, there were 1,941 deaths attributed to HNC, and the mortality rate decreased significantly. The 5-year age-standardized net survival was 43.2% in 1996-2000, remained stable during the following decade, and for 2011-2015 it was 50.9%. CONCLUSION: The incidence and mortality of HNC in Cali decreased significantly during the study period in both sexes.

Prevalence of microcephaly: the Latin American Network of Congenital Malformations 2010-2017.

Objective: The Latin American Network of Congenital Malformations: ReLAMC was established in 2017 to provide accurate congenital anomaly surveillance. This study used data from ReLAMC registries to quantify the prevalence of microcephaly from 2010 to 2017 (before, during and after the Zika virus epidemic). Design: Nine ReLAMC congenital anomaly registries provided case-level data or aggregate data for any live births, still births or terminations of pregnancy with microcephaly. Births to pregnant women infected with Zika virus first occurred in Brazil in 2015, and in the remaining registry areas in 2016 with the exception of Chile that did not experience Zika virus. Therefore the prevalence of microcephaly for 2010-2014 and individual years 2015, 2016 and 2017 was estimated using multilevel random effect Poisson models. Clinical classification and characteristics of the cases were compared pre and post Zika for all centres providing individual case-level data. Results: The prevalence of microcephaly for all registries excluding Brazil was 2.3 per 10 000 (95% CI 2.0 to 2.6) for 2010-2014 rising to 5.4 (95% CI 4.8 to 6.0) in 2016 and 5.9 (95% CI 5.3 to 6.6) in 2017. Brazil had a prevalence of 0.6 per 10 000 (95% CI 0.5 to 0.6) in 2010-2014, rising to 5.8 (95% CI 5.6 to 6.1) in 2015, 8.0 (95% CI 7.6 to 8.3) in 2016 and then falling in 2017. Only 29 out of 687 cases of microcephaly were reported as congenital Zika syndrome in countries excluding Brazil. Conclusions: The prevalence of microcephaly was influenced both by Zika causing congenital Zika syndrome and by increased reporting awareness.

A case-control study of factors associated with SARS-CoV-2 infection among healthcare workers in Colombia.

BACKGROUND: Healthcare Workers (HCW) are repeatedly exposed to SARS-CoV-2 infection. The aim of this study was to identify factors associated with SARS-CoV-2 infection among HCW in one of the largest cities in Colombia. METHODS: We conducted a case-control study, where cases had a positive reverse transcription-polymerase chain reaction and controls had a negative result. Participants were randomly selected and interviewed by phone. Analyses were performed using logistic regression models. RESULTS: A total of 110 cases and 113 controls were included. Men (AdjOR 4.13 95% CI 1.70-10.05), Nurses (AdjOR 11.24 95% CI 1.05-119.63), not using a high-performance filtering mask (AdjOR 2.27 95% CI 1.02-5.05) and inadequate use of personal protective equipment (AdjOR 4.82 95% CI 1.18-19.65) were identified as risk factors. Conversely, graduate (AdjOR 0.06 95% CI 0.01-0.53) and postgraduate (AdjOR 0.05 95% CI 0.005-0.7) education, feeling scared or nervous (AdjOR 0.45 95% CI 0.22-0.91), not always wearing any gloves, caps and goggles/face shields (AdjOR 0.10 95% CI 0.02-0.41), and the use of high-performance filtering or a combination of fabric plus surgical mask (AdjOR 0.27 95% CI 0.09-0.80) outside the workplace were protective factors. CONCLUSION: This study highlights the protection provided by high-performance filtering masks or double masking among HCW. Modifiable and non-modifiable factors and the difficulty of wearing other protective equipment needs to be considered in designing, implementing and monitoring COVID-19 biosafety protocols for HCW.

Description and results of birth defects surveillance and follow-up programs in Bogotá and Cali, Colombia, 2002-2019.

Birth defects are structural or functional defects present at birth and are caused by different factors that affect intrauterine development. They are the second most common cause of death under five years of age in Latin America and the Caribbean. In Bogotá and Cali, Colombia, there are two surveillance programs established to evaluate the prevalence of them. The purpose of the following article is to describe the experience and results of the surveillance of the Birth Defects Surveillance Programs in Bogotá and Cali, Colombia, 2002-2019. The information was taken from the surveillance programs that have an active hospital system in some institutions of the city (ECLAMC modality), and use data from the passive national system (Sistema Nacional de Vigilancia en Salud Pública - SIVIGILA) to expand their coverage. From 2002 until 2019, 1,289.650 births have been monitored through one of the surveillance programs, including both methodologies. The importance of surveillance programs relies on the amount of data obtained that allows the development of research, the detection of potential changes throughout time, and the guidance of public policies to improve promotion and prevention strategies.

Characterization of Risk Factors for Neural Tube Defects: A Case-Control Study in Bogota and Cali, Colombia, 2001-2018.

Worldwide prevalence of neural tube defects is between 1.2 and 124.1 per 10 000 live births. This study analyzes risk factors linked with neural tube defects. The study focused on the Surveillance and Monitoring Programs of Congenital Anomalies databases in Bogota and Cali. Births were monitored between 2001 and 2018. Liveborn or stillborn with neural tube defects were defined as cases, using a case-control ratio of 1:4. Paternal age, folic acid supplementation, birth weight, urban or rural origin, maternal and paternal studies, and socioeconomic levels were analyzed. Across the 215 730 births monitored, 147 cases with a rate of 6.82/10 000 live births were found (6.79-6.85). In isolated cases, lower birth weight had a P <.01. Paternal age >45 years showed an odds ratio (OR) of 4.24 (1.54-11.65), socioeconomic status 1 and 2, OR of 2.49 (1.63-3.82), maternal primary schooling or lower OR 2.61 (1.28-5.31), and housing in urban areas OR 2.4 (1.4-4.09).

Mortality from respiratory infections and chronic non-communicable diseases before the COVID-19 pandemic in Cali, Colombia.

INTRODUCTION: The COVID-19 disease pandemic is a health emergency. Older people and those with chronic noncommunicable diseases are more likely to develop serious illnesses, require ventilatory support, and die from complications. OBJECTIVE: To establish deaths from respiratory infections and some chronic non-communicable diseases that occurred in Cali, before the SARS-CoV-2 disease pandemic. METHODS: During the 2003-2019 period, 207,261 deaths were registered according to the general mortality database of the Municipal Secretary of Health of Cali. Deaths were coded with the International Classification of Diseases and causes of death were grouped according to WHO guidelines. Rates were standardized by age and are expressed per 100,000 people-year. RESULTS: A direct relationship was observed between aging and mortality from respiratory infections and chronic non-communicable diseases. Age-specific mortality rates were highest in those older than 80 years for all diseases evaluated. Seasonal variation was evident in respiratory diseases in the elderly. COMMENTS: Estimates of mortality rates from respiratory infections and chronic non-communicable diseases in Cali provide the baseline that will serve as a comparison to estimate the excess mortality caused by the COVID-19 pandemic. Health authorities and decision makers should be guided by reliable estimates of mortality and of the proportion of infected people who die from SARS-CoV-2 virus infection.

INTRODUCCIÓN: La pandemia de la enfermedad COVID-19 es una emergencia sanitaria. Las personas mayores y aquellos con enfermedades crónicas no trasmisibles tienen más probabilidades de desarrollar enfermedades graves, requerir soporte ventilatorio y morir a causa de las complicaciones. OBJETIVO: Establecer las defunciones por infecciones respiratorias y por algunas enfermedades crónicas no trasmisibles ocurridas en Cali, antes de la pandemia de la enfermedad por el SARS-CoV-2. MÉTODOS: Durante el periodo 2003-2019, se registraron 207,261 defunciones información obtenida de la base de datos de mortalidad general de la Secretaria de Salud Municipal de Cali. Las defunciones se codificaron con la Clasificación Internacional de Enfermedades y las causas de muerte se agruparon según las guías de la OMS. Las tasas se estandarizaron por edad, son expresadas por 100,000 personas-año. RESULTADOS: Se observó una relación directa entre envejecimiento y la mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles. Las tasas de mortalidad específicas por edad fueron más altas en los mayores de 80 años para todas las enfermedades evaluadas. En las enfermedades respiratorias fue evidente una variación estacional en los ancianos. COMENTARIO: Las estimaciones de las tasas de mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles para Cali proporcionan la línea de base que servirá de comparación para estimar el exceso de mortalidad que ocasionará la pandemia de COVID-19. Las autoridades sanitarias y los tomadores de decisiones deben guiarse por estimaciones fiables de la mortalidad y de la proporción de infectados que mueren por la infección del virus SARS-CoV-2.

Mortality from respiratory infections and chronic non-communicable diseases before the COVID-19 pandemic in Cali, Colombia / Mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles antes de la pandemia por COVID-19 en Cali, Colombia

Abstract Introduction: The COVID-19 disease pandemic is a health emergency. Older people and those with chronic noncommunicable diseases are more likely to develop serious illnesses, require ventilatory support, and die from complications. Objective: To establish deaths from respiratory infections and some chronic non-communicable diseases that occurred in Cali, before the SARS-CoV-2 disease pandemic. Methods: During the 2003-2019 period, 207,261 deaths were registered according to the general mortality database of the Municipal Secretary of Health of Cali. Deaths were coded with the International Classification of Diseases and causes of death were grouped according to WHO guidelines. Rates were standardized by age and are expressed per 100,000 people-year. Results: A direct relationship was observed between aging and mortality from respiratory infections and chronic non-communicable diseases. Age-specific mortality rates were highest in those older than 80 years for all diseases evaluated. Seasonal variation was evident in respiratory diseases in the elderly. Comments: Estimates of mortality rates from respiratory infections and chronic non-communicable diseases in Cali provide the baseline that will serve as a comparison to estimate the excess mortality caused by the COVID-19 pandemic. Health authorities and decision makers should be guided by reliable estimates of mortality and of the proportion of infected people who die from SARS-CoV-2 virus infection.

Resumen Introducción: La pandemia de la enfermedad COVID-19 es una emergencia sanitaria. Las personas mayores y aquellos con enfermedades crónicas no trasmisibles tienen más probabilidades de desarrollar enfermedades graves, requerir soporte ventilatorio y morir a causa de las complicaciones. Objetivo: Establecer las defunciones por infecciones respiratorias y por algunas enfermedades crónicas no trasmisibles ocurridas en Cali, antes de la pandemia de la enfermedad por el SARS-CoV-2. Métodos: Durante el periodo 2003-2019, se registraron 207,261 defunciones información obtenida de la base de datos de mortalidad general de la Secretaria de Salud Municipal de Cali. Las defunciones se codificaron con la Clasificación Internacional de Enfermedades y las causas de muerte se agruparon según las guías de la OMS. Las tasas se estandarizaron por edad, son expresadas por 100,000 personas-año. Resultados: Se observó una relación directa entre envejecimiento y la mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles. Las tasas de mortalidad específicas por edad fueron más altas en los mayores de 80 años para todas las enfermedades evaluadas. En las enfermedades respiratorias fue evidente una variación estacional en los ancianos. Comentario: Las estimaciones de las tasas de mortalidad por infecciones respiratorias y enfermedades crónicas no trasmisibles para Cali proporcionan la línea de base que servirá de comparación para estimar el exceso de mortalidad que ocasionará la pandemia de COVID-19. Las autoridades sanitarias y los tomadores de decisiones deben guiarse por estimaciones fiables de la mortalidad y de la proporción de infectados que mueren por la infección del virus SARS-CoV-2.

Primeros dos años de notificación de las enfermedades huérfanas-raras en Cali e identificación de algunas variables asociadas con la mortalidad / First 2 years of municipal registry of orphan-rare diseases in Cali and identification of some sociodemographic and clinical variables associated with mortality

RESUMEN Introducción: en los últimos años Colombia reconoció las enfermedades huérfanas-raras como problema de interés en salud pública y ordenó su notificación obligatoria. Objetivo: describir la información sobre las enfermedades huérfanas-raras obtenida en Cali a través del SIVIGILA en los primeros 2 años de registro. Materiales y métodos: estudio observacional transversal analítico. Se calcularon frecuencias absolutas y relativas. Se realizó un análisis de normalidad con el Test Shapiro-Wilk. Se calcularon prevalencias. Se evaluó la relación de diferentes variables sociodemográficas y clínicas y el riesgo de mortalidad usando modelos lineales generalizados, la familia de distribución de Poisson con función de enlace logarítmica y modelos de varianza. Resultados: fueron notificados 635 casos: 78 en el 2016 (prevalencia 3,25/100.0009) y 557 en el 2017 (prevalencia 23,01/100.000). La mayoría de los casos pertenecen al régimen contributivo. Las comunas con mayor número de casos y mayor prevalencia fueron la 17 y la 22. Entre las primeras enfermedades huérfanas-raras más comunes está la drepanocitosis, fue la más notificada en Cali con 25 casos para el 2016 (prevalencia 1,04/100.000) y 77 casos para el 2017 (prevalencia 3,1/100.000). La tasa cruda de mortalidad estimada para el periodo de estudio fue 0,83/100.000, las enfermedades con mayor mortalidad fueron la drepanocitosis en mujeres (0,12/100.000) y la polineuropatía en hombres (0,13/100.000). Discusión: es necesario realizar y publicar en el futuro análisis más profundos a través de la revisión detallada de historias clínicas y la incorporación de otras fuentes disponibles, como el Registro Individual de la Prestación de Servicios (RIPS) y el Registro Único de Afiliados (RUAF), con el fin de disminuir el subregistro y suministrar a toda la comunidad información más precisa y detallada.

SUMMARY Introduction: In recent years, Colombia recognized orphan diseases as a problem of public health interest and ordered its mandatory notification. Objective: Describe the information on orphan-rare diseases obtained in Cali through SIVIGILA in the first 2 years of registration. Materials and methods: Analytical cross-sectional observational study. Absolute and relative frequencies were calculated. Normality analysis of Shapiro Wilk was performed. Prevalence was calculated. The relationship of different sociodemographic and clinical variables and mortality risk was evaluated, using Generalized Linear Models, the Poisson distribution family, Logarithmic link function and robust variance models. Results: 635 cases were notified, 78 in 2016 for a prevalence of 3,25 / 100.000 and 557 in 2017 for a pre-valence of 23,01 / 100.000. Most cases belong to the tax system. The communes with the highest number of cases and the highest prevalence were 17 and 22. Among the first most common orphan-rare diseases, sickle cell disease was the most reported in Cali with 25 cases in 2016 (prevalence 1,04/100.000) and 77 cases in 2017 (prevalence 3,1/100.000). The estimated crude mortality rate for the study period was 0,83 / 100.000, and the diseases with the highest mortality were sickle cell disease in women (0,12 / 100.000) and polyneuropathy in men (0,13 / 100.000). Discussion: It is necessary to carry out and publish in the future, deeper analyzes through the detailed review of medical records and the incorporation of other available sources such as the Individual Registry of Provision of Services (RIPS) and the Unique Registry of Affiliates (RUAF), with in order to reduce the sub-registry and provide the whole community with more precise and detailed information.

Sialolitiasis submandibular gigante, extracción quirúrgica y reparación ductal: reporte de caso / Giant submandibular sialolithiasis, surgical removal and ductal repair: case report

Introducción: la patología litiásica de las glándulas salivales forma parte de un grupo de afecciones que perjudica el sistema de drenaje normal de la saliva hacia la cavidad oral, ocasionando lesiones múltiples sobre la glándula afectada. Se realizó el reporte de un caso clínico con esta patología que, por el tamaño del lito, se considera extremadamente rara en nuestro medio. Método: se realizó el reporte de caso y revisión de la literatura (estudios radiológicos, historia clínica y hallazgos clínicos); además, el paciente firmó el consentimiento para esta publicación. Resultados: un paciente masculino de 38 años remitido de consulta externa con un cuadro clínico de 1 semana de dolor, edema y tumefacción en la región submandibular izquierda asociado con una secreción sialopurulenta por la cavidad oral. En la radiografía (Rx) oclusal estricta y en la tomografía axial computarizada (TAC) de cuello contrastado se evidenció una lesión litiásica de más o menos 4,5 x 1,8 cm de diámetro, de característica radiolúcida, a nivel del conducto de wharton. Se dio un manejo quirúrgico por otorrinolaringología maxilofacial, consistente en sialolitotomía y antibioticote- rapia por 10 días, con las cuales se obtuvieron buenos resultados. Conclusiones: la litiasis gigante a nivel del sistema salival (glándula, conductos) es una patología poco común en nuestro medio y está involucrada en el desarrollo de múltiples patología de tipo inflamatorio recurrente de la glándula involucrada, lo cual afecta la calidad de vida de los pacientes. Por esta razón, el diagnóstico y manejo debe ser oportuno para evitar complicaciones, como una infección profunda del cuello; en nuestro caso, el manejo fue oportuno con una extracción quirúrgica por la vía oral del cálculo y la reparación del conducto de wharton del lado izquierdo.

Introduction: the lithiasic pathology of the salivary glands is part of a group of conditions that harms the normal drainage system of the saliva towards the oral cavity, causing multiple lesions on the affected gland, a report of a clinical case with this pathology was made. Due to the size of the stone it is considered extremely rare in our environment. Method: case report and review of the literature (radiological studies, clinical history, clinical findings) patient consent was signed for this publication. Results: a 38-year-old male patient referred from the outpatient clinic with a 1-week clinical picture of pain, swelling and edema in the left submandibular region associated with sialopurulent secretion from the oral cavity in the strict occlusal Rx and a contrast-enhanced neck CT revealed a lithiasic lesion with more or less 4.5 x 1.8 cm in diameter of radiolucent features at the level of the wharton duct, surgical management was given by maxillofacial ENT, consisting of sialolitotomy and antibiotic therapy for 10 days with good results. Conclusions: the giant lithiasis at the level of the salivary system (gland, ducts) is a rare pathology in our environment, is involved in the development of multiple pathologies of recurrent inflammatory type of the affected gland, affecting the quality of life of patients, so the diagnosis and management should be timely and avoid complications, such as deep neck infection; in our case, the management was timely with oral surgical removal of the calculus and repair of the wharton duct on the left side.

Birth defects surveillance: experiences in Argentina and Colombia.

Birth defects (BDs) are structural or functional anomalies, sporadic or hereditary, of prenatal origin. Public health surveillance is defined as the ongoing systematic collection, analysis, and interpretation of outcome-specific data for use in the planning, implementation, and evaluation of public health practice. BD surveillance systems may have different characteristics according to design, coverage, type of surveillance, case ascertainment, case definition, BD description, maximum age of diagnosis, pregnancy outcomes, coding systems, and the location of the coding process (central or local). The aim of this article is to describe and compare methodology, applications, and results of birth defect surveillance systems in two South-American countries: Colombia and Argentina. In both countries, the surveillance systems developed activities in relation to the Zika virus emergency. For most BDs, a statistically significant higher prevalence is observed in Argentina-RENAC than in Colombian registries. This may be due to methodological reasons or real differences in prevalence. The strengths, weaknesses, and the future perspectives of the Argentine and Colombian systems are presented. When developing a surveillance system, the objectives, the available resources, and previous experiences in similar contexts must be taken into account. In that sense, the experience of Argentina and Colombia can be useful for others when developing a birth defect surveillance system.