Postsurgical complications of aortic valve replacement in middle-aged people: an exploratory review of the literature / Complicaciones postquirúrgicas de reemplazo de válvula aórtica en personas de mediana edad: una revisión exploratoria de literatura

Introduction: Cardiovascular Disease (CVD) is the world's leading cause of death, claiming the lives of approximately 18 million people each year, 80% of them in low- and middle-income countries . We say that it is the most difficult intervention because of its cardiac and vascular anatomical composition. Its injury would be extremely dangerous because it would compromise the circulatory and respiratory system, which would generate an aggravation of the patient or his death. That is why the WHO in 2016 calculated the number of deaths attributed to cardiovascular diseases for Colombia at 83,987, added to the post-surgical complications derived from them. The causes that affect the heart and especially the aortic valve range from circulatory difficulty to mechanical failure, so we know that every year more people die from cardiovascular diseases (CVD) than from any other cause. This means the high need and demand for a surgical intervention; indispensable to safeguard the life of patients, for this reason we wonder what are the post-surgical complications of aortic valve replacement surgery in middle-aged people? Objective: To identify the types of post-surgical complications of aortic valve replacement in middle-aged people in the first six months after surgery. Methodology: PRISMA protocol for exploratory literature reviews and its extension for exploratory literature reviews. Methodological quality was assessed with PEDro, and study characteristics were extracted independently. Result: 28 studies included in the review, with scores between 6 and 9, of good and excellent methodological quality. The most frequent post-surgical complications were surgical reintervention, post-surgical bleeding, thrombosis or thromboembolism. Conclusion: Complications of aortic valve replacement are frequent in the middle-aged population.

Introducción: Las Enfermedades Cardiovasculares (ECV) son la principal causa mundial de muerte, y cobran la vida de aproximadamente 18 millones de personas cada año, el 80% de ellas en países de ingresos bajos y medios . Decimos que es la intervención con mayor dificultad por su compuesto anatómico cardiaco y vascular. Su lesión sería sumamente peligrosa porque comprometería el sistema circulatorio y respiratorio, lo cual generaría un agravamiento del paciente o su fallecimiento. Por eso la OMS en el 2016 calculó el número de muertes atribuidas a enfermedades cardiovasculares para Colombia en 83.987, sumado a las complicaciones postquirúrgicas derivadas de ellas. Las causas que afectan al corazón y especialmente la válvula aórtica van desde una dificultad circulatoria hasta una falla mecánica, por lo que sabemos que cada año mueren más personas por enfermedades cardiovasculares (ECV) que por cualquier otra causa. Lo que significa la alta necesidad y demanda de una intervención quirúrgica, la cual es indispensable para salvaguardar la vida de los pacientes, por esta razón nos preguntamos ¿cuáles son las complicaciones postquirúrgicas de una cirugía de reemplazo de válvula aórtica en personas de mediana edad en el primer semestre post cirugía? Objetivo: Identificar los tipos de complicaciones postquirúrgicas de reemplazo de válvula aórtica en personas de mediana edad en el primer semestre post cirugía Metodología: Protocolo PRISMA para revisiones exploratorias de literatura y su extensión para revisiones exploratorias de literatura. Se evaluó la calidad metodológica con PEDro, y se extrajeron de forma independiente las características de los estudios. Resultado: 28 estudios incluidos en la revisión, con puntuaciones entre 6 y 9, de calidad metodológica buena y excelente. Las complicaciones postquirúrgicas más frecuentes fueron: reintervención quirúrgica, hemorragias post cirugía, trombosis o tromboembolismo. Conclusión: Las complicaciones por reemplazo de válvula aortica son frecuentes entre la población de mediana edad.

Introdução: A doença cardiovascular é a principal causa de morte no mundo, causando a morte de cerca de 18 milhões de pessoas a cada ano, 80% dos quais em países de baixa e média renda. Dizemos que é a intervenção mais difícil devido à sua composição anatômica cardíaca e vascular. Sua lesão seria extremamente perigosa porque comprometeria o sistema circulatório e respiratório, o que geraria um agravamento do paciente ou sua morte. É por isso que a OMS calculou em 2016 o número de mortes atribuídas a doenças cardiovasculares para a Colômbia em 83.987, acrescido das complicações pós-cirúrgicas derivadas delas. As causas que afetam o coração e especialmente a válvula aórtica variam de dificuldade circulatória a falha mecânica, por isso sabemos que a cada ano mais pessoas morrem de doenças cardiovasculares (CVD) do que de qualquer outra causa. Isto significa a alta necessidade e demanda de uma intervenção cirúrgica; indispensável para salvaguardar a vida dos pacientes, por esta razão nos perguntamos quais são as complicações pós-cirúrgicas da cirurgia de substituição da válvula aórtica em pessoas de meia-idade? Objectivo: Identificar os tipos de complicações pós-cirúrgicas da substituição da válvula aórtica em pessoas de meia-idade nos primeiros seis meses após a cirurgia. Metodologia: Protocolo PRISMA para a revisão da literatura exploratória e sua extensão para as revisões exploratórias da literatura. A qualidade metodológica foi avaliada com PEDro, e as características do estudo foram extraídas de forma independente. Resultado: 28 estudos incluídos na revisão, com pontuações entre 6 e 9, de boa e excelente qualidade metodológica. As complicações pós-cirúrgicas mais frequentes foram reintervenção cirúrgica, hemorragia pós - cirurgia, trombose ou tromboembolismo. Conclusão: As complicações da substituição da válvula aórtica são frequentes na população de meia-idade.

EXECUTIVE FUNCTIONS IN YOUNG ADULTS AGED 19 TO 24 YEARS WITH BREAST CANCER: AN EXPLORATORY REVIEW OF THE LITERATURE BETWEEN 2015 AND 2020 / FUNCIONES EJECUTIVAS EN ADULTOS JÓVENES DE 19 A 24 AÑOS CON CÁNCER DE MAMA: REVISIÓN EXPLORATORIA DE LITERATURA ENTRE 2015 Y 2020

With the growth and aging of the population, along with economic growth and changes in lifestyles associated with increased quality of life, the main burden of disease shifted from infectious diseases to noncommunicable and complex diseases. However, it is cancer that has increased its incidence in the world population, especially in low- and middle-income countries, where 70% of cancer deaths occur.  The research is articulated to sustainable development goal three, in particular on the effect of cancer on cognitive functioning, because cancer pain impairs cognitive functioning. A simple review for executive functions and breast cancer in PROSPERO indicated an absence of reviews on this topic. Reason why, our aim is to describe executive functions and treatment effect by chemotherapy/radiotherapy in young adult breast cancer patients between 2015 and 2020 in the scientific literature. Materials and methods: exploratory literature review according to PRISMA protocol for exploratory reviews. Articles published in Scopus, PubMed, ScienceDirect, scielo, google academic, in Spanish, English, French. With the keywords: ("Executive Function") AND ("Neoplasms") OR "breast cancer" OR "Drug Therapy," AND ("Young Adult"), searches were performed until February 4, 2020. Results: 16 articles included in the review. Clinical and methodological heterogeneity was found on patients' executive functions and treatment. However, we did find executive function impairment among patients assessed by both treatment and cancer. Conclusions: A systematic review on the subject and meta-analysis are suggested to identify the effect size, accompanied by the statistical evidence identified in the studies. Colombia could investigate this topic because there is no Colombian research.

Con el crecimiento y envejecimiento de la población, junto al crecimiento económico y los cambios en los estilos de vida asociados al incremento en la calidad de vida, la principal carga de morbilidad pasó de las enfermedades infecciosas a las no transmisibles y complejas. Sin embargo, es el cáncer incrementó su incidencia en la población mundial, especialmente en países de ingresos bajos y medios, dónde el 70% de las muertes por cáncer se presentan.  La investigación se articula al objetivo de desarrollo sostenible tres, en particular sobre el efecto del cáncer sobre el funcionamiento cognitivo, debido a que el dolor por cáncer deteriora el funcionamiento cognitivo. Una revisión sencilla por funciones ejecutivas y cáncer de mama en PROSPERO indicó una ausencia de revisiones en este tema. Razón por la cual, nuestro objetivo es describir las funciones ejecutivas y el efecto del tratamiento por quimioterapia/radioterapia en pacientes con cáncer de mama en adultos jóvenes entre 2015 y 2020 en la literatura científica. Materiales y métodos: Revisión exploratoria de literatura según protocolo PRISMA para revisiones exploratorias. Artículos publicados en Scopus, PubMed, ScienceDirect, scielo, google académico, en idioma español, inglés, francés. Con las palabras clave: ("Executive Function") AND ("Neoplasms") OR "breast cancer" OR "Drug Therapy," AND ("Young Adult"), las búsquedas se realizaron hasta el 4 de febrero de 2020. Resultados: 16 artículos incluidos en la revisión. Se encontró heterogeneidad clínica y metodológica sobre las funciones ejecutivas de los pacientes y el tratamiento. Sin embargo, sí se encontró afectación de funciones ejecutivas entre los pacientes evaluados tanto por el tratamiento cómo por el cáncer. Conclusiones: Se sugiere una revisión sistemática sobre el tema y meta-análisis para identificar el tamaño del efecto, acompañado de la evidencia estadística identificada en los estudios. Colombia podría investigar sobre esta temática debido a que no hay investigaciones colombianas.

Com o crescimento e o envelhecimento da população, juntamente com o desenvolvimento económico e as mudanças nos estilos de vida associadas ao aumento da qualidade de vida, o principal fardo da doença mudou de doenças infecciosas para doenças não transmissíveis e complexas. No entanto, é o câncer que aumentou a sua incidência na população mundial, especialmente nos países de baixa e média renda, onde 70% das mortes por câncer ocorrem. A pesquisa está articulada com o Objectivo de Desenvolvimento Sustentável 3, em particular sobre o efeito do câncer sobre o funcionamento cognitivo, porque a dor do cancro prejudica a função cognitiva. Uma simples revisão para funções executivas e câncer de mama em PROSPERO indicou uma ausência de comentários sobre este tópico. A razão pela qual, nosso objetivo é descrever as funções executivas e o efeito do tratamento por quimioterapia/radioterapia em pacientes jovens adultos com câncer de mama entre 2015 e 2020 na literatura científica. Materiais e métodos: revisão da literatura exploratória de acordo com o protocolo PRISMA para revisões exploratórias. Artigos publicados em Scopus, PubMed, ScienceDirect, scielo, google academic, em espanhol, inglês, francês. Com as palavras-chave: ("Função Executiva") E ("Neoplasmas") OU "câncer de mama" OU" Terapia de drogas," E ("Jovem Adulto"), as pesquisas foram realizadas até 4 de fevereiro de 2020. Resultados: 16 artigos incluídos na revisão. Foi encontrada heterogeneidade clínica e metodológica nas funções executivas e no tratamento dos pacientes. No entanto, descobrimos que a função executiva foi prejudicada entre os pacientes avaliados tanto pelo tratamento como pelo câncer. Conclusões: Sugere-se uma revisão sistemática do assunto e meta-análise para identificar o tamanho do efeito, acompanhada das provas estatísticas identificadas nos estudos. A Colômbia poderia investigar este assunto porque não há pesquisa colombiana.

Effects of internet-based, psychosocial, and early medical interventions on professional burnout in health care workers: Systematic literature review and meta-analysis.

Background: The prevalence of professional burnout increased among healthcare workers during the coronavirus 2019 (COVID-19) pandemic, with negative effects on their mental health. Consequently, research interest in methods to decrease the prevalence of burnout and reduce the effects of burnout on healthcare workers has increased. Objective: This study was designed to evaluate the effects of Internet-based, psychosocial, and early medical interventions on professional burnout among healthcare workers. Methodology: This systematic review and meta-analysis involved 8004 articles identified from four databases: Cochrane, Web of Science, PubMed/Medline, and clinical trials. Results: Four articles were included in the systematic review, of which two could be meta-analyzed. The pooled effect of the group of interventions compared to control conditions was not statistically significant. Discussion: Evaluating therapeutic effectiveness requires more clinical trials that allow its evaluation. Although we did not find improvements in the three intervention categories, the methodological heterogeneity in each intervention and the need for a standardized intervention guide for managing and decreasing professional burnout, subject to the evaluation of its impact, are highlighted.

Reseña bibliográfica: glosario ilustrado de dermatología y dermatopatología, segunda edición / Bibliographic review: Illustrated Glossary of Dermatology and Dermatopathology, Second Edition

Resumen La segunda edición del Glosario ilustrado de dermatología y dermatopatología es un texto escrito por el médico especialista en Dermatopatología, Gerzaín Rodriguez Toro. El doctor Rodríguez fue docente de la Universidad Nacional de Colombia, en Bogotá, donde llegó a ser profesor titular y maestro universitario. Actualmente es profesor destacado de la Facultad de Medicina de la Universidad de La Sabana. Este texto constituye una sucesión de la labor que ha realizado el doctor Gerzaín durante décadas en el campo de la docencia médica, mediante sus múltiples publicaciones en el ámbito de la Dermatopatología.

Abstract The second edition of the Illustrated Glossary of Dermatology and Dermatopathology is a text written by the specialist in Dermatopathology, Gerzaín Rodriguez Toro. Dr. Rodríguez was a professor at the National University of Colombia, in Bogotá, where he became a full professor and university teacher. He is currently a prominent professor at the Faculty of Medicine of the University of La Sabana. This text constitutes a succession of the work that Dr. Gerzaín has carried out for decades in the field of medical teaching, through his multiple publications in the field of Dermatopathology.

Zika virus-induced neurological critical illness in Latin America: Severe Guillain-Barre Syndrome and encephalitis.

Zika virus (ZIKAV) is classically described as causing minor symptoms in adult patients, however neurologic complications have been recognized. The recent outbreak in Central and South America has resulted in serious illness in some adult patients. We report adult patients in Latin America diagnosed with ZIKAV infection admitted to Intensive Care Units (ICUs). METHODS: Multicenter, prospective case series of adult patients with laboratory diagnosis of ZIKAV in 16 ICUs in 8 countries. RESULTS: Between December 1st 2015 and April 2nd 2016, 16 ICUs in 8 countries enrolled 49 critically ill patients with diagnosis of ZIKAV infection. We included 10 critically ill patients with ZIKAV infection, as diagnosed with RT-PCR, admitted to the ICU. Neurologic manifestations concordant with Guillain-Barre Syndrome (GBS) were present in all patients, although 2 evolved into an encephalitis-like picture. 2 cases died, one due to encephalitis, the other septic shock. CONCLUSIONS: Differing from what was usually reported, ZIKAV infection can result in life-threatening neurologic illness in adults, including GBS and encephalitis. Collaborative reporting to identify severe illness from an emerging pathogen can provide valuable insights into disease epidemiology and clinical presentation, and inform public health authorities about acute care priorities.

Metodología para la elaboración de canales endémicos y tendencia de la notificación del dengue, Valle del Cauca, Colombia, 2009-2013 / Methodology to develop endemic channels and notification trends for dengue in Valle del Cauca, Colombia, 2009-2013

Introducción. El dengue es la enfermedad de más rápida propagación en el mundo y una permanente amenaza para la salud pública mundial, con aproximadamente 2,5 millones de personas en alto riesgo de infección. Ante la gravedad del cuadro de la enfermedad a nivel nacional y mundial, es necesario generar nuevas metodologías de predicción útiles para la adopción de decisiones en salud pública. Objetivo. Caracterizar los casos notificados de dengue entre el 2009 y el 2013 en el departamento del Valle del Cauca y presentar la metodología para elaborar canales endémicos en el caso del dengue. Materiales y métodos. Se hizo un estudio descriptivo retrospectivo, utilizando la base de datos secundaria de las fichas de notificación, y se caracterizaron los casos de dengue entre el 2009 y el 2013. Se elaboraron dos canales endémicos, uno mediante promedios móviles y el otro con suavización exponencial. Resultados. Se evidenció que la tendencia del dengue en el departamento del Valle del Cauca es positiva, lo que indica que en los últimos cinco años se ha incrementado el número de casos, aunque se observa una variación importante que podría explicarse por el ciclo de tres años que se inicia a partir del primer periodo epidemiológico del año. Conclusión. La elaboración del canal endémico del dengue en el Valle del Cauca evidenció la importancia de aplicar estas metodologías de vigilancia en las situaciones de interés en salud pública. Como se observó en los resultados, hubo años en los que el número de casos fue muy bajo y otros en los que la epidemia alcanzó cifras muy elevadas.

Introduction: Dengue is the fastest spreading disease in the world and a permanent threat to global public health. It is a viral illness for which approximately 2.5 million people are at high risk of infection. Given the severity of the disease at national and global levels, new predictive methodologies need to be generated to facilitate decision-making in public health. Objective: To characterize cases of dengue reported from 2009 to 2013 in Valle del Cauca department, Colombia, and to establish a methodology to develop endemic channels that can be applied to this event. Materials and methods: This was a retrospective descriptive study. Notification forms were used as a secondary database to characterize dengue cases from 2009 to 2013. Two endemic channels were developed, one using running means and the other through exponential smoothing. Results: Dengue in the department of Valle del Cauca showed a positive tendency, indicating that the number of cases had increased in the last five years. An important variation was observed that could be explained by a three-year cycle beginning in the first epidemiological period of the year. Conclusion: The development of the dengue endemic channel for Valle del Cauca illustrates the importance of applying these monitoring methodologies to events of public health interest. As can be seen from the results, there were some years in which the number of cases was very low and others in which the epidemic reached very high levels.

Methodology to develop endemic channels and notification trends for dengue in Valle del Cauca, Colombia, 2009-2013.

INTRODUCTION: Dengue is the fastest spreading disease in the world and a permanent threat to global public health. It is a viral illness for which approximately 2.5 million people are at high risk of infection. Given the severity of the disease at national and global levels, new predictive methodologies need to be generated to facilitate decision-making in public health.  OBJECTIVE: To characterize cases of dengue reported from 2009 to 2013 in Valle del Cauca department, Colombia, and to establish a methodology to develop endemic channels that can be applied to this event.  MATERIALS AND METHODS: This was a retrospective descriptive study. Notification forms were used as a secondary database to characterize dengue cases from 2009 to 2013. Two endemic channels were developed, one using running means and the other through exponential smoothing.  RESULTS: Dengue in the department of Valle del Cauca showed a positive tendency, indicating that the number of cases had increased in the last five years. An important variation was observed that could be explained by a three-year cycle beginning in the first epidemiological period of the year.  CONCLUSION: The development of the dengue endemic channel for Valle del Cauca illustrates the importance of applying these monitoring methodologies to events of public health interest. As can be seen from the results, there were some years in which the number of cases was very low and others in which the epidemic reached very high levels.

Alcohol y trauma: Un problema prioritario de salud pública / Alcohol and trauma: A priority public health problem

No hay duda de que existe una relación compleja entre el trauma y el consumo de alcohol que convierte a este binomio en un problema prioritario de salud pública. El trauma es una de las causas principales de la carga de la enfermedad; por su parte, el alcohol es uno de los mayores factores de riesgo para la salud global, y genera una variedad de efectos adversos en la vida de las personas, la productividad y los sistemas de salud. En el contexto del trauma, los consumidores de alcohol tienen más probabilidad de sufrir lesiones y que estas sean más severas. En los servicios de urgencias es posible reconocer problemas relacionados con el alcohol en pacientes a través de pruebas toxicológicas y cuestionarios de autorreporte. Los pacientes con altos niveles séricos de alcohol o que resultan positivos en cuestionarios de tamizaje están en alto riesgo de trauma recurrente y hospitalizaciones. Además, el uso de alcohol afecta el manejo inicial del paciente traumatizado de diversas maneras. Por lo tanto, la identificación y tratamiento apropiado de pacientes traumatizados que tengan problemas con alcohol es el método de prevención secundaria más eficaz para disminuir la incidencia de lesiones traumáticas relacionadas con este.

No doubt there is a complex relationship between trauma and alcohol consumption that makes this pairing a priority public health problem. Trauma is a major cause of disease burden. Alcohol is one of the major risk factors for global health by generating a variety of adverse effects on the people's lives, productivity and health systems. In the context of trauma, alcohol users are more likely to suffer injuries and make them more severe. In the emergency department is possible to recognize alcohol-related problems in patients through toxicological tests and self-report questionnaires. Patients with high blood alcohol levels or positive screening questionnaires are at high risk of recurrent trauma and hospitalizations. Moreover, alcohol use affects the initial management of trauma patients in different ways. Therefore the identification and treatment of trauma patients who have alcohol problems is the best method of secondary prevention in reducing the incidence of alcohol related traumatic injuries.