Gadoxetic Acid in MRI: A Five-Year Experience at a High-Complexity Hospital in Colombia.

Objective The objective of the study was to evaluate the use of the hepatospecific contrast agent, gadoxetic acid, for MRI in patients at a high-complexity hospital in Medellin, Colombia, from 2016 to 2022. Materials and methods This was an observational, descriptive, and retrospective cross-sectional study involving patients who had undergone MRI with gadoxetic acid from February 2016 to January 2022. The MRI studies were interpreted by two radiologists specializing in body imaging, each with at least 10 years of experience. The medical records of the identified patients were reviewed. Quantitative variables were presented using either means and standard deviations or medians and interquartile ranges, depending on the distribution of the variables. Qualitative variables were represented through absolute and relative frequencies. Results A total of 100 pharmacy records were collected, leading to a final sample of 75 patients aged between three and 91 years. The primary reason for imaging was to assess focal liver lesions in 58 patients (77.3%), with bile duct injury being the second most common indication in 16 patients (21.3%). A diagnostic alteration was noted in 69.3% of cases (52 patients). Among the 58 focal liver lesions analyzed using a hepatospecific agent, 31 cases (53.4%) were diagnosed as focal nodular hyperplasia. Conclusion Our study reinforces the clinical value of gadoxetic acid-enhanced MRI in refining diagnostic assessments, particularly in cases involving bile duct and focal hepatic lesions.

Interventional Therapy for Upper Extremity Phlegmasia Cerulea Dolens in a Patient With Heparin-Induced Thrombocytopenia: A Case Report.

This article presents a case of a multimorbid 63-year-old woman with chronic kidney disease and heparin-induced thrombocytopenia (HIT). Following the insertion of a central venous catheter, she developed phlegmasia cerulea dolens (PCD) in her left arm, a rare and severe complication of deep vein thrombosis (DVT). Given the severity of the case, adapting to anticoagulant contraindications or unavailability, management with catheter-directed thrombolysis and mechanical thrombectomy was made. It is concluded that catheter-directed thrombolysis and mechanical thrombectomy are valuable therapeutic alternatives in critical situations where treatment options are limited.

Acute Idiopathic Scrotal Edema, an Underrecognized Cause of Scrotal Pain in Children: A Case Report and Literature Review.

Acute idiopathic scrotal edema is a clinical entity predominant in children under 10 years whose true incidence is unknown in our setting. Diagnosis is challenging and avoids unnecessary surgeries. We present the case of an idiopathic acute scrotal edema with ultrasound findings highly suggestive of the diagnosis, which was managed conservatively with complete signs and symptoms resolution after discharge. We aim to review the ultrasound characteristics and differential diagnosis of this disorder.

Magnetic Resonance Cholangiography Diagnosing Post-cholecystectomy Biliary Injuries.

OBJECTIVE: This study aimed to determine the diagnostic performance of contrasted magnetic resonance cholangiography for detecting bile duct lesions following cholecystectomy. MATERIALS AND METHODS: A retrospective case series study was conducted that included patients over 18 years of age with suspected bile duct injury after cholecystectomy, who underwent contrasted magnetic resonance cholangiography, and who also had endoscopic retrograde cholangiopancreatography, surgery, or subsequent clinical follow-up. The images were interpreted by two radiologists who assigned the type of lesion according to the Strasberg classification. Qualitative variables were represented by frequencies and proportions, while quantitative variables were described using measures of central tendency and dispersion. Sensitivity, specificity, and predictive values were assessed, along with interobserver variability, using the kappa index. RESULTS: We included 20 patients with a median age of 51.5 years (interquartile range: 35), and 14 (70%) were women. In all 20 patients, lesions were identified on magnetic resonance cholangiography, of which 19 were confirmed with the gold standard for a positive predictive value of 100% (hepatobiliary-specific contrast agents) and 92% (extracellular contrast). The most frequent lesions were Strasberg E2 and E4 in five patients each. The kappa index was 1 in determining the presence or absence of bile duct injury and 0.9 in the Strasberg classification. CONCLUSION: Contrasted magnetic resonance cholangiography is a method with high positive predictive value and almost perfect interobserver agreement for diagnosing bile duct lesions after cholecystectomy.

Multiple Aneurysms or Pseudoaneurysms of the Gastroepiploic Artery: An Anecdotal Cause of Hemoperitoneum.

Gastroepiploic artery aneurysms and pseudoaneurysms pose diagnostic challenges due to their rarity and overlapping radiological features. This case report presents an 82-year-old woman with sudden-onset severe abdominal pain with computed tomography revealing hemoperitoneum and saccular dilations adjacent to the stomach's greater curvature, suggestive of vascular pathology. Selective abdominal arteriography confirmed three saccular dilatations in the gastroepiploic artery, which were managed successfully with coil embolization. The discussion emphasizes the importance of accurate diagnosis, distinguishing between aneurysms and pseudoaneurysms, and prompt intervention to mitigate the risk of hemorrhagic complications of either of them. The case underscores the significance of endovascular management in such rare and critical scenarios.

Preoperative Embolization of a Giant Solitary Fibrous Tumor of the Pleura: A Case Report.

Only 5% of pleural neoplasms are fibrous tumors of the pleura, which typically develop from sub-mesothelial mesenchymal tissue of the visceral pleura. These tumors often behave clinically benignly, and when they are larger than 15 cm or occupy more than 40% of the hemithorax, they are referred to as "giant" tumors. Surgical excision is the gold standard treatment, although intra-operative bleeding is one of the major complications. In this case report, we discuss a 39-year-old female patient with a large homogeneous enhancing mass of soft tissue density in the right lower hemithorax with systemic arterial supply from the right inferior phrenic artery. Angiography and embolization were valuable adjuncts in preoperative management. Via thoracotomy, the mass was successfully removed completely with minimal blood loss. Giant SFTP is a rare neoplasm of the pleura. Intraoperative bleeding is one of the main complications during surgical resection, which is the gold standard of its treatment. Angiography and embolization are valuable complements in the preoperative treatment of this type of tumors to reduce intraoperative blood loss and operative times.

Prevalencia de embolia pulmonar en pacientes con infección por COVID-19, abril-diciembre de 2020 / Prevalence of pulmonary embolism in patients with COVID-19, april - december 2020

ResumenIntroducción: Los fenómenos trombóticos asociados a COVID-19 contribuyen a una mayor morbimortalidad. El objetivo fue determinar las características clínicas e imagenológicas de pacientes con sospecha diagnóstica de embolia pulmonar (EP) y COVID-19, de abril a diciembre de 2020. Metodología: Estudio observacional transversal que incluyó pacientes con diagnóstico molecular de infección por SARS-CoV-2 y angiotomografía computarizada de tórax (Angio-TAC) realizada por sospecha de EP. Se dividieron los pacientes en dos grupos (EP vs. no EP). Se compararon entre sí variables cualitativas con la prueba Chi2 de Pearson o la prueba exacta de Fisher, y se realizó la misma exploración con variables cuantitativas empleando la prueba T de Student o U de Mann-Whitney. Resultados: Se incluyeron 127 pacientes con una mediana de edad de 60 años (RIC 45-69) ­68 (53,5 %) eran hombres­ y el 23,6 % (n = 30) presentó EP. Al comparar EP (n = 30) vs. no EP (n = 97), se observó que en el primer grupo la mayoría requirieron ventilación mecánica, más días de hospitalización y tuvieron una mortalidad mayor, así como niveles más altos de dímero D, todos con diferencia estadísticamente significativa (p < 0,05). Conclusión:Una cuarta parte de los pacientes con COVID-19 sufrieron EP como complicación, con altos niveles de dímero D, mayor frecuencia de asistencia ventilatoria, más días de estancia hospitalaria y mayor mortalidad.

Introduction:Thrombotic events associated with COVID-19 infection contribute to higher morbidity and mortality of patients. The objective was to review the clinical and imaging characteristics of patients with suspected diagnosis of pulmonary embolism (PE) and COVID-19 infection, from April to December 2020. Methodology:Cross-Sectional observational study that included patients with a molecular diagnosis of SARS CoV-2 infection and chest computed tomography angiography (CT angiography) performed for suspected PE.Patients were divided into two groups (PE vs No PE). Qualitative variables were compared with each other with Pearson's Chi2 test or Fisher's exact test, and quantitative variables were analized with the Student's T test or the Mann-Whitney U test.Results: 127 patients were included with a median age of 60 (IQR: 45-69) years, 68 (53.5%) were men and 23.6% (n = 30) presented PE. When comparing PE (n = 30) vs No PE (n = 97), the first group required more mechanical ventilation, extended days of hospitalization, higher mortality as well as higher levels of D-Dimer, all with statistically significant difference (p < 0.05). Conclusion:A quarter of patients with COVID-19 presented PE as a complication with high levels of D-dimer, a higher frequency of ventilatory assistance, more days of hospitalization and higher mortality

Experiencia de embolización de la arteria renal previa a nefrectomía / Experience of Renal Artery Embolization Prior to Nephrectomy

Resumen Objetivo: Describir la evolución perioperatoria de pacientes sometidos a nefrectomía con y sin embolización de la arteria renal (EAR) prequirúrgica, en un hospital de alta complejidad de Medellín, Colombia. Materiales y Métodos: Observacional descriptivo retrospectivo; se incluyeron pacientes de 18-90 años con diagnóstico de tumor renal, sometidos a nefrectomía con y sin EAR prequirúrgica. Las variables cualitativas se expresaron por medio de frecuencias y proporciones, y las cuantitativas mediante medidas de tendencia central y dispersión. Resultados: Se incluyeron 71 pacientes con una media de edad de 58,1 (DE: 10,6) años, 41 eran mujeres y el 69% tenía diagnóstico de carcinoma de células claras. La media del volumen de sangrado intraoperatorio fue de 540,8 cc, y 19,7% requirió transfusión. El tiempo quirúrgico promedio fue de 2,6 horas y el 38% presentó alguna complicación, con una mortalidad total del 4,2%. Al observar comparativamente los pacientes con EAR (15 pacientes) versus aquellos sin ella (56 pacientes), se identificó un mayor volumen de sangrado intraoperatorio y la necesidad de transfusión en los primeros. Conclusión: Los pacientes sometidos a EAR presentaron un mayor volumen de sangrado, mayor frecuencia de transfusión y complicaciones postoperatorias, siendo necesario un consenso sobre su real pertinencia terapéutica.

Abstract Aim: To describe the perioperative outcomes of patients undergoing nephrectomy with and without preoperative Renal Artery Embolization (RAE) in a high-complexity hospital in Medellín, Colombia. Materials and Methods: Retrospective, descriptive and observational study; 18-90 years old patients with renal tumor diagnosis, submitted to nephrectomy with and without preoperative RAE were included. Qualitative variables were expressed by measures of frequencies and proportions, and quantitative variables were expressed by measures of central tendency and dispersion. Results: 71 patients with a media age of 58,1 (SD: 10,6) years were included, 41 were women and 69% were diagnosed with clear cell carcinoma. The blood loss volume media was 540.8 cc, and 19.7% required transfusion. The operative time media was 2.6 hours and 38% had any complication, with a total mortality of 4.2%. Comparatively observing patients with RAE (15 patients) versus patients without RAE (56 patients), a higher intraoperative blood loss and transfusion requirements were identified in the first ones. Conclusion: Patients submitted to RAE presented greater volume of bleeding, greater frequency of transfusion and post-operative complications, requiring a consensus on its real therapeutic relevance.

Aneurysmal bone cyst of the mandible with conservative surgical management: A case report.

The aneurysmal bone cyst is a nonneoplastic, osteolytic and locally destructive lesion that mainly affects the metaphyseal area of long bones and only 2% of it is diagnosed in the maxillofacial skeleton. Although surgical treatment is the most common option, it is associated to high morbidity rates. The case of an aneurysmal bone cyst of a considerable size in a 27-year-old male patient illustrating a conservative surgical approach with preservation of the dental structures in the mandible to limit aesthetic and functional side effects is presented. Two-year clinical follow-up was performed with no evidence of recurrence. Key words:Aneurysmal bone cyst; curettage, conservative treatment, mandibular osteotomy.

Colopericardial fistula presenting with massive rectal bleeding.

Colopericardial fistulae constitute a condition with a very low prevalence and a high morbidity and mortality rate. In this case report, we discuss an 80-year-old male patient who presented to emergency services for massive rectal bleeding and signs of hypovolemic shock. Abdominal arteriography and upper gastrointestinal endoscopy were negative for bleeding. Findings indicative of fistula between the left ventricle and the transverse colon were described in computed tomography angiogram and the diagnosis was confirmed endoscopically. The patient was stabilized and the bleeding was self-limited. Direct communication between the gastrointestinal tract and the pericardium, or even with the heart itself, is a rare disease and constitutes a diagnostic challenge.

Neumomediastino espontáneo: una serie de casos / Spontaneous Pneumomediastinum: Case Series

El neumomediastino espontáneo es una condición clínica de baja incidencia. Se caracteriza por tener aire libre en el mediastino sin trauma asociado, y se considera un trastorno benigno y autolimitado. El diagnóstico se realiza por sospecha clínica y se confirma con imágenes diagnósticas. Esta entidad ha sido poco informada en la literatura nacional, y se considera que el probable subdiagnóstico se debe al poco conocimiento de sus características clínicas y epidemiológicas en nuestro medio. Se presenta una serie de 11 casos de neumomediastino espontáneo estudiados en dos instituciones de alta complejidad de Medellín, Colombia.

Spontaneous pneumomediastinum, a clinical condition with low incidence, is characterized by the presence of free air in the mediastinum without associated trauma, and it is considered a benign and self-limiting disorder. The diagnosis is made by clinical suspicion and is confirmed with diagnostic images. This entity has been little reported in the national literature, considering that the probable underdiagnosis is due to lack of knowledge of its clinical and epidemiological characteristics in our environment. A series of 11 cases of spontaneous pneumomediastinum in patients admitted to two institutions of high complexity in Medellin-Colombia are presented.

Calidad de vida en la menopausia, un reto en la práctica clínica / Quality of life in menopause, a challenge in clinical practice

Introducción: la menopausia constituye una etapa significativa en la vida de la mujer y por ende requiere de un estudio integral. La medición de la calidad de vida en estas mujeres representa un desafío y los instrumentos para su valoración complementan de forma indispensable la evaluación médica. Objetivo: explorar la información existente en la literatura que aborda la calidad de vida en la menopausia, para contextualizar al lector en los aspectos relacionados con este periodo en la vida de la mujer; finalmente se plantea una revisión de los datos actuales que enfocan la terapia hormonal como un posible tratamiento de la gran variedad de síntomas que se presentan en este periodo. Métodos: búsqueda de la literatura de artículos de investigaciones originales en MEDLINE, EMBASE, Lilacs y ScienceDirect durante julio de 2014 y marzo del 2015, con el uso de combinación de palabras clave y términos MeSH relacionados, climaterio, calidad de vida, atención integral de salud, salud de la mujer. Se restringió el idioma a inglés y español. Conclusiones: es de vital importancia que el médico tratante cuente con herramientas y opciones terapéuticas que le permitan brindar soluciones a la paciente con menopausia frente a los síntomas que afectan su calidad de vida, no obstante, en la actualidad no se cuenta con evidencia suficiente para apoyar completamente una terapia adecuada que logre dar una respuesta casi completa a las pacientes y que a la vez considere un equilibrio en riesgo-beneficio(AU)

Introduction: Menopause is an important stage in a women's life, therefore it requires a comprehensive study in daily clinical practice. Measuring the quality of life of menopausal women represents a challenge, that´s why the tools available in order to perform this comprehensive evaluation are indispensable in the medical evaluation; they allow us to correctly consider the patient´s point of view regarding their state of health. Objective: Explore the existing information in the literature about the quality of life in menopause to contextualize the reader in the most common topics related with alterations during this period in the life of women; finally a review of current data that focus on hormonal therapy as a possible treatment for a variety of symptoms that occur in this period. Methods: A search of the literature of original research articles in MEDLINE , EMBASE , Lilacs and ScienceDirect was conducted between July 2014 and March 2015, using combinations of keywords and MeSH terms related to menopause, , quality of life , comprehensive health care , women's health. For this review, we restricted the languages to Spanish and English. Conclusion: The instruments for assessing quality of life are an indispensable complement to the comprehensive clinical evaluation of these women, being that they correctly consider the patient's view of their state of health(AU)

Infecciones vaginales en pacientes gestantes de una clínica de alta complejidad de Medellín-Colombia / Vaginal infections in pregnant patients of a high complexity clinic from Medellín-Colombia

Objetivo: describir características de las infecciones vaginales en pacientes gestantes.La gestación constituye un factor predisponente para infecciones vaginales, las cuales pueden generar consecuencias deletéreas para la madre y el feto. Materiales y métodos: estudio transversal, descriptivo. Población compuesta por gestantes condiagnóstico de infección vaginal en una clínica de alta complejidad durante enero de 2011 a junio de 2012. Se recolectó información sociodemográfica, clínica, microbiológica y terapéutica de las historias clínicas de las pacientes. Resultados: se incluyeron 67 pacientes, con una mediana de edad de 23 (RIQ 21-29) años; el 40% era primigestante y el 66% nulípara. Únicamente el 15% de las infecciones vaginales se presentaron en el primer trimestre gestacional. Los síntomas más frecuentemente referidos fueron: flujo vaginal (59.7%), síntomas urinarios bajos (26.9%) y prurito vulvar (23.9%); los principales hallazgos al examen físico fueron flujo (79.1%) y fetidez (16.4%) vaginal. En el 67,2% de los casos fue ordenada la realización del directo y gram de flujo vaginal, de los cuales, el 64,4% se realizó intrahospitalariamente. La reacción leucocitaria estuvo presente en la totalidad de las pacientes y en el 90% fue de moderada a abundante.Ocho de cada 10 pacientes presentó blastoconidias y pseudomicelios. El diagnóstico microbiológico más frecuente fue Candidiasis vulvovaginal (41.4%), seguido por Vaginosis bacteriana (24.1%). Conclusión: las infecciones vaginales constituyen una patología con sintomatología frecuente, la cual se presenta generalmente en la segunda mitad del embarazo, siendo Candida spp. el agente etiológico más común.

Objective: to describe the characteristics of vaginal infections in pregnant patients. Pregnancy is a predisposing factor for vaginal infections, which can lead to deleterious consequences for mother and fetus. Materials and methods: a cross-sectional study. Population consists in pregnant patients diagnosed with vaginal infection in a high complexity clinic, January 2011 to June 2012. Sociodemographic, clinical, microbiologicaland therapeutic information were collected from the clinical histories of the patients. Results: 67 patients were included, with a median age of 23 (IQR 21-29) years; 40%were in their first pregnancy and 66% were nulliparous. Only 15% of vaginal infectionsoccurred in the first trimester of pregnancy. The most frequently reported symptomswere vaginal discharge (59.7 %), lower urinary tract symptoms (26.9 %) and vulvarpruritus (23.9 %); the main physical findings were vaginal discharge (79.1 %) and vaginalstench (16.4 %). In 67.2% of cases were ordered the direct and gram of vaginaldischarge, of which 64.4% were performed during hospitalization. Leukocyte reactionwas present in all patients and in 90 % was moderate to abundant. 8 out of 10 patientshad blastoconidia and pseudomycelia. The most common microbiological diagnose was vulvovaginal candidiasis (41.4 %), followed by bacterial vaginosis (24.1 %). Conclusion: vaginal infections are a condition with frequent symptoms, which usually occursin the second half of pregnancy, being the Candida spp. the most common etiology.

La importancia de la adherencia terapéutica / The importance of medication adherence

La adherencia terapéutica es un componente importante de la atención en salud y para los pacientes con Diabetes Mellitus tipo 2 es un factor determinante en el control metabólico. Debido a que existen múltiples factores implicados, es un tema de difícil manejo que plantea retos para el personal de la salud y se ha convertido en foco de interés para numerosos investigadores, quienes han formulado modelos teóricos de cumplimiento, explorando las causas asociadas y diseñando estrategias que ayuden a mejorar el cumplimiento terapéutico.

Medication adherence is an important health care component and a determining factor in the metabolic control of type 2 diabetes mellitus patients. Due to the multiple factors involved, this issue has become a challenge for the medical staff and a focus of interest for many researchers, who have developed theoretical models of compliance, exploring the causes and associating strategies designed to help improve compliance.

CONSUMO DE NUTRACÉUTICOS, UNA ALTERNATIVA EN LA PREVENCIÓN DE LAS ENFERMEDADES CRÓNICAS NO TRANSMISIBLES / NUTRACEUTICAL CONSUMPTION, AN ALTERNATIVE IN THE PREVENTION OF NON TRANSMISSIBLE CHRONIC DISEASES

El conocimiento de la fisiopatología de enfermedades crónicas no transmisibles ha hecho que la dieta, los estilos de vida saludables y el autocuidado hagan parte de las estrategias para su prevención, esto se debe a que la terapéutica farmacológica tradicional puede traer consigo efectos adversos no deseados, por lo que se prefieren nuevas alternativas menos lesivas, más seguras y con la misma efectividad. Con base en lo anterior, se hace uso de diferentes estrategias para dar a conocer los efectos benéficos que los nutracéuticos le pueden brindar a la salud de sus consumidores, sus funciones fisiológicas y el tratamiento de enfermedades; pero sin duda alguna el aumento progresivo del consumo de estos suplementos ha generado preguntas sin resolver en la comunidad y el gremio médico sobre la real composición, los efectos fisiológicos y adversos que estos productos puedan tener para la población en general.

The knowledge of the physiopathology of most of chronic non transmissible diseases has made diet, healthy lifestyles, and self-care become part of the strategies for their prevention because the traditional pharmacologic therapy can bring unwanted side effects, so new less harmful, safer and equally effective alternatives are preferred. Based on the above, different strategies are used to publicize the beneficial effects nutraceuticals can have on the health of their consumers, their physiological functions and disease treatment; but without a doubt, the progressive increase in consumption of these supplements has raised unresolved questions in the community and the medical professionals about the actual composition, and the physiological and adverse effects these products can have for the general population.

Colitis eosinofílica en niños causada por alergia a la proteína de leche de vaca / Eosinophilic colitis in children caused by allergy to cow's milk protein

La proteína de leche de vaca es considerada el principal alergeno alimentario en los lactantes. La colitis eosinofílica por alergia a esta proteína es de carácter benigno, se presenta también en niños con lactancia materna exclusiva, y una cantidad importante de pacientes no son diagnosticados o permanecen sin ser reportados. La falta de búsqueda y sospecha de esta condición contribuye a una gran morbilidad y consumo de recursos de salud en el grupo de edad afectado. A continuación se realiza el reporte de dos casos y revisión de la literatura, se da a conocer la presentación de esta entidad en nuestro medio, y se insiste en la necesidad constante de considerar su diagnóstico, lo cual permitirá realizar una mayor búsqueda activa e impactar a largo plazo su subdiagnóstico.

Cow's milk protein is considered to be the main food allergen in infants. Eosinophilic colitis due to allergy to the milk protein is benign; it also occurs in exclusively breastfed infants and a significant number of these patients are undiagnosed or remain unreported. Failure to search for and to suspect of this condition will contribute to high morbidity rate and to health resource consumption in the affected age group. This is the report of two cases and on literature review where the presentation of this entity is made known in our conditions and the constant need of considering its diagnosis is underlined, all of which will allow to make active search and to have a long term impact.

Prevalencia y características del consumo de nutracéuticos en estudiantes universitarios de pregrado, Medellín-Colombia, 2013

Objetivo: Determinar la prevalencia y características del consumo de nutracéuticos en estudiantes de pregrado de una Universidad privada de la ciudad de Medellín (Colombia). Materiales y métodos: Estudio descriptivo de corte transversal. La población estuvo constituida por estudiantes matriculados en pregrado durante 2013 y se realizó un muestreo aleatorio simple. Para el análisis se empleó el programa SPSS Vr 17, se estimaron proporciones de consumo de nutracéuticos por sexo y grupo de edad; para las variables de tipo nominal y ordinal se estimaron porcentajes, y para las de razón, la media y la desviación estándar. A las proporciones de prevalencia de consumo se les calcularon los intervalos de confianza del 95%. La significancia estadística se apreció con el valor de probabilidad de la prueba de c2. Resultados: Participaron 427 estudiantes, con una edad promedio de 20.8 años (DE: 3.1), el 56.1% fueron mujeres. La prevalencia de vida de consumo de nutracéuticos fue de 66.3% y la anual de 51.8%. Los principales motivos para su consumo fueron complementar alimentación (32.8%) y prevenir enfermedades (20.1%). Conclusión: La alta prevalencia de consumo de nutracéuticos observada en el estudio, es comparable con lo reportado en la literatura en poblaciones similares, lo cual sugiere una tendencia al alza en el hábito de consumo de suplementos dietarios.

Objective: Determine the prevalence and characteristics of nutraceutical consumption in undergraduate students at a private university in Medellín, Colombia. Materials: A descriptive cross-sectional study was performed. The population constituted of undergraduate students enrolled during the 2013 academic year and a simple random sampling was performed. SPSS program version 17 was used to analyze the data. Nutraceutical consumption ratios were estimated by sex and age group. Percentages were estimated for nominal and ordinal variables, and for the reason type variables the media and standard deviation were estimated. Confidence intervals of 95% were calculated for the proportions of prevalence consumption. Statistical significance was evaluated with the probability value c2 test. Results: 427 students participated, the average age was 20.8 years (SD: 3.1), 56.1% were women. The prevalence of lifetime consumption of nutraceuticals was 66.3% and 51.8% were consumed annually. The main reasons for consumption were food complement (32.8%) and disease prevention (20.1%). Conclusion: The high prevalence of nutraceutical intake observed in the study is comparable to studies performed with similar populations reported in the literature, suggesting an upward trend in the habit of consuming dietary supplements.

Objetivo: Determinar a prevalência e as características do consumo de nutracéuticos por estudantes de graduação da Universidade privada de Medellín (Colômbia). Materiais: Estudo descritivo de corte transversal. A população foi formada por estudantes de graduação em 2013, com amostragem aleatória simples. Para a análise empregou-se o programa SPSS Vr 17, e se estimaram proporções de consumo de nutracéuticos por sexo e grupos etários; para as variáveis de tipo nominal e ordinal se estimaram percentuais e, para as de razão a, media e o desvio padrão. Às proporções de prevalência de consumo se lhes calcularam os intervalos de confiança de 95%. A significância estatística se considerou com o valor de probabilidade da prova de c2. Resultados: Participaram 427 estudantes, com idade média de 20.8 anos (DE: 3.1), e 56.1% foram mulheres. A prevalência de vida de consumo de nutracéuticos foi de 66.3% e a anual de 51.8%. Os principais motivos para seu consumo foram complementação alimentar (32.8%) e prevenção de enfermidades (20.1%). Conclusão: A alta prevalência de consumo de nutracéuticos observada no estudo é comparável ao reportado na literatura em populações similares, o que sugere uma tendência de alta no hábito de consumo de suplementos dietéticos.

Síndrome de Ondina, hipoventilación central congénita idiopática / Ondine´s curse or idiopathic congenital central hyperventilation syndrome

El síndrome de hipoventilación central congénito idiopático, también conocido como síndrome de Ondina, es una enfermedad poco común, caracterizada por la ausencia congénita del control central de la respiración y disfunción del sistema nervioso autónomo. Su incidencia se estima en aproximadamente 1 de cada 200 000 nacimientos al año. Es una enfermedad de transmisión autosómica dominante, derivada de una mutación heterocigótica del gen PHOX2B, presente en 90 % de los pacientes, pero su causa fisiopatológica aún no está claramente dilucidada. Presenta una elevada tasa de mortalidad, y una dependencia a la ventilación mecánica durante el sueño de por vida; sin embargo, gracias a una atención multidisciplinar y coordinada, con estrecha vigilancia y apoyo, podría esperarse que los pacientes con ella puedan llevar una vida relativamente normal. Se realiza el reporte de un caso diagnosticado en el departamento de Antioquia (Colombia), lugar con importantes barreras socioeconómicas que limitan el estudio complejo de este tipo de enfermedades de baja prevalencia global.

Idiopathic congenital central hypoventilation syndrome, also known as Ondine´s curse, is a rare disease characterized by congenital absence of the central control of breathing and autonomic nervous system dysfunction. Its incidence is estimated to be one per 200,000 births a year. It is an autosomal dominant disease derived from a heterozygous PHOX2B gene mutation, present in 90 % of patients, but its pathophysiological cause has not been elucidated yet. It has a high mortality rate and a lifelong dependency on a life-support device during sleep. However, it could be expected that a coordinated multidisciplinary care, with close monitoring and support, could help this kind of patients to have a relatively normal life. This is the report of a case diagnosed with this disease in Antioquia, Colombia, a place with significant socio-economic limitations that hinder a complete study of this type of low overall prevalence disease.

Prevalencia y características del consumo de nutracéuticos en estudiantes universitarios de pregrado, Medellín-Colombia, 2013 / Prevalence and characteristics of nutraceutical consumption in undergraduate university students, Medellín-Colombia, 2013 / Prevalencia y características del consumo de nutracéuticos en estudiantes universitarios de pre-grado, Medellín-Colombia, 2013

Objetivo: determinar la prevalencia y características del consumo de nutracéuticos en estudiantes de pregrado de una Universidad privada de la ciudad de Medellín (Colombia) Materiales y métodos: estudio descriptivo de corte transversal. La población estuvo constituida por estudiantes matriculados en pregrado durante 2013 y se realizó un muestreo aleatorio simple. Para el análisis se empleó el programa SPSS Vr 17, se estimaron proporciones de consumo de nutracéuticos por sexo y grupo de edad; para las variables de tipo nominal y ordinal se estimaron porcentajes, y para las de razón, la media y la desviación estándar. A las proporciones de prevalencia de consumo se les calcularon los intervalos de confianza del 95%. La significancia estadística se apreció con el valor de probabilidad de la prueba de c2 . Resultados: participaron 427 estudiantes, con una edad promedio de 20.8 años (DE: 3.1), el 56.1% fueron mujeres. La prevalencia de vida de consumo de nutracéuticos fue de 66.3% y la anual de 51.8%. Los principales motivos para su consumo fueron complementar alimentación (32.8%) y prevenir enfermedades (20.1%) Conclusión: la alta prevalencia de consumo de nutracéuticos observada en el estudio, es comparable con lo reportado en la literatura en poblaciones similares, lo cual sugiere una tendencia al alza en el hábito de consumo de suplementos dietarios.

Objective: to determine the prevalence and characteristics of the consumption of nutraceuticals in undergraduate students of a private university in the city of Medellín (Colombia) Materials and methods: descriptive cross-sectional study. The population consisted of students enrolled in undergraduate courses during 2013 and a simple random sampling was performed. For the analysis, the SPSS Vr 17 program was used, proportions of consumption of nutraceuticals by sex and age group were estimated; for the nominal and ordinal type variables, percentages were estimated, and for the ratio, mean and standard deviation. The prevalence ratios of consumption were calculated at 95% confidence intervals. Statistical significance was assessed with the probability value of the c2 test. Results: 427 students participated, with an average age of 20.8 years (SD: 3.1), 56.1% were women. Lifetime prevalence of nutraceuticals was 66.3% and annual prevalence was 51.8%. The main reasons for its consumption were to supplement food (32.8%) and prevent diseases (20.1%) Conclusion: the high prevalence of nutraceutical consumption observed in the study is comparable to what was reported in the literature in similar populations, which suggests an upward trend in the habit of consuming dietary supplements.

Cannabinoides: un obstáculo cognitivo para conducir con seguridad / Cannabinoids: a cognitive obstacle to drive safely

Las altas pérdidas económicas y humanas que traen consigo los accidentes de tránsito, además de sus implicaciones sociales y políticas, hacen evidente la necesidad de una comprensión clara de todos los factores que modifican su incidencia y severidad, entre los cuales se enuncia el consumo de psicotrópicos como el cannabis. Tras dos décadas de reducciones sustanciales en la magnitud del problema de la ingesta de alcohol y accidentes de tránsito, el uso extendido de cannabis en todo el mundo es lo que la hace, después del alcohol, la sustancia psicotrópica más frecuentemente hallada en la sangre de los conductores implicados en este tipo de accidentes; la presencia de cannabis se asocia con el doble de riesgo de ser herido fatalmente en el tráfico. Contrario a la creencia general, la marihuana no debe ser considerada una droga benigna; su consumo se asocia con trastornos cardiovasculares, pulmonares, reproductivos, inmunológicos y sobretodo sobre el sistema locomotor y cognitivo; concentraciones de tetrahidrocannabinol en sangre de 2 a 5 ng/mL, se asocian con deterioro sustancial en las habilidades necesarias para operar un vehículo motorizado. Por esta razón, se requieren aún más investigaciones que establezcan nexos claros de causalidad, y que permitan generar a largo plazo políticas públicas de responsabilidad vial que divulguen las devastadoras repercusiones humanas, sociales y económicas que genera el hecho de consumir cannabis y operar un vehículo motorizado en la vía.

The high economic and human losses that bring traffic accidents, as well as their social and political implications, make evident the need of a clear understanding of all the factors that influence its incidence and severity, between which states the use of psychotropic drugs as cannabis. After two decades of substantial reductions in the magnitude of the problem of alcohol consumption and traffic accidents, the widespread use of cannabis in the world is what makes it, after alcohol, the psychoactive substance most commonly found in the blood of drivers involved in such accidents; the presence of cannabis is associated with twice the risk of being fatally injured in traffic. Contrary to popular belief, marijuana should not be considered a benign drug, its use is associated with cardiovascular, pulmonary, reproductive, immunological, and especially with locomotor and cognitive disorders; blood tetrahydrocannabinol concentrations of 2-5 ng/mL are associated with substantial deterioration in the skills needed to operate a motor vehicle. Therefore, further investigations are required to establish clear causal links, to favor the generation of long-term public policy of vial responsibility, to divulge the devastating human, social and economic impacts that are generated because of the act of consuming cannabis while operating a motor vehicle on the track.