Infección por COVID-19 previo al inicio de la epidemia en Colombia / COVID-19 infection prior to the beginning of the epidemic in Colombia

Resumen La identificación del nuevo Coronavirus tipo 2 en marzo de 2020 en Colombia ha generado paradigmas e incógnitas en la epidemiología nacional con respecto a la llegada aproximada del virus y sus mecanismos de diseminación local en los departamentos y ciudades principales. Presentamos el caso de un paciente con COVID-19 que tuvo su inicio de síntomas dos semanas antes de la declaración del primer caso en Colombia, lo que sugiere circulación del virus y transmisión local en Colombia previo a la declaración de la epidemia.

Abstract The identification of Coronavirus type 2 in March 2020 in Colombia has generated paradigms and unknows in the national epidemiology regarding the approxi mate arrival of the virus and its mechanisms of local dissemination in the main departments and cities. We present the case of a patient with COVID-19 that had its onset of symptoms two weeks before the declaration of the first case in Colombia, wich moves the circulation of the virus and local transmission in Colombia prior the declaration of the epidemic.

A man with weight loss and cardiac tamponade: Pericardial tuberculosis.

We herein described a case of pericardial tuberculosis presenting as a cardiac tamponade in a HIV-negative man with restrictive pericarditis initially, but during treatment with antituberculous drugs and without the addition of corticosteroids, he developed constrictive pericarditis that required surgery. We raise the discussion of the indication of corticosteroids in these cases.

Hospitalization causes and outcomes in HIV patients in the late antiretroviral era in Colombia.

BACKGROUND: Antiretroviral therapy (ART) has modified the natural history of HIV-infection: the incidence of opportunistic infections (OIs) has decreased and mortality associated to HIV has improved dramatically. The reasons for hospitalization have changed; OIs are no longer the most common reason for admission. This study describes the patient population, admission diagnosis and hospital course of HIV patients in Colombia in the ART era. METHODS: Patients admitted with HIV/AIDS at six hospitals in Medellin, Colombia between August 1, 2014 and July 31, 2015 were included. Demographic, laboratory, and clinical data were prospectively collected. RESULTS: 551 HIV-infected patients were admitted: 76.0% were male, the median age was 37 (30-49). A new diagnosis of HIV was made in 22.0% of patients during the index admission. 56.0% of patients of the entire cohort had been diagnosed with HIV for more than 1 year and 68.9% were diagnosed in an advanced stage of the disease. More than 50.0% of patients had CD4 counts less than 200 CD4 cells/µL and viral loads greater than 100,000 copies. The main reasons for hospital admissions were OIs, tuberculosis, esophageal candidiasis and Toxoplasma encephalitis. The median hospital stay was 14 days (IQR 8-23). Admission to the intensive care unit (ICU) was required in 10.3% of patients and 14.3% were readmitted to the hospital; mortality was 5.4%. CONCLUSIONS: Similar to other countries in the developing world, in Colombia, the leading cause of hospitalization among HIV-infected patients remain opportunistic infections. However, in-hospital mortality was low, similar to those described for high-income countries. Strategies to monitor and optimize the adherence and retention in HIV programs are fundamental to maximize the benefit of ART.

Valores normales de presión arterial en niños menores de 1 año, Medellín – Colombia 1997 / Normal values of blood pressure in children under 1 year of age. Medellín, Colombia, 1997

Aunque en nuestro medio existen varios trabajos de medición de la presión arterial tanto en niños como en los neonatos, estos presentan varios inconvenientes como son el número de la muestra y las tablas de difícil interpretación. Por lo tanto, las curvas que se siguen como patrón de normalidad pertenecen a otros países. Teniendo en cuenta lo anterior, se decidió realizar este trabajo para crear tablas de distribución normal de la presión arterial en la población pediátrica de la ciudad de Medellín con el fin de que fueran aplicables a esta población específica. Para estos propósitos, se tomo una muestra representativa de 717 niños sanos menores de un año de un universo compuesto por los 34.391 niños de la ciudad de Medellín en el año de 1997. Como resultados se encontró que la muestra de estudio no presenta variaciones significativas en el intervalo de lo normal de las cifras tensiónales de niños del mismo grupo etáreo en otras poblaciones del mucho. Por lo tanto, estas pueden ser consideradas representativas y aplicables a esta población específica.