Global research on centenarians: A historical and comprehensive bibliometric analysis from 1887 to 2023.

Background: Centenarians are considered the most successful human biological aging model. However, the characteristics and patterns of research among centenarians have not been described or analyzed. Thus, this study aimed to disclose the historical landscape of global research on centenarians. Methods: This bibliometric study investigated historical evidence on centenarian research published in the Scopus database. The bibliometrix package in R was used to perform visual and quantitative analyses of research metrics, trends, and patterns. Results: Of the 2061 documents included between 1887 and 2023, 84.2% (n = 1736) were published as articles with primary data. We identified international collaboration and annual growth rates of 21.4% and 3.15%, respectively. The United States published the highest number of papers on centenarians (n = 786), whereas the publications from Italy had the highest impact (h-index = 90). Based on the frequency of keywords, mortality, genetics, dementia, Alzheimer's disease, and immunosenescence are a few of the most studied topics among centenarians, with emerging research related to mitochondrial DNA and comparison of results between nonagenarians and centenarians. Italy, the United States, and China lead the global research collaboration network, collaborating most frequently with Japan and European countries. Conclusions: Global research on centenarians has grown over the last 20 years, primarily led by Italy, the United States, and China. Latin American and African countries have conducted little or no research on centenarians. The most widely studied topics include mortality, cognition, immunosenescence, and genetics.

Autoimmunity in centenarians. A paradox.

Autoimmune diseases (ADs) are one of the groups of chronic illnesses that impose a significant burden of disease and health costs worldwide. Age is a crucial risk factor for the onset of ADs. Theoretically, it is inferred that with organic and immune system aging, the loss of immune tolerance and specificity of immune activity becomes more intense, the probability of autoimmunity is increasing. However, there is a group of individuals whose prevalence of ADs is very low or non-existent, despite the biological aging. This paradox in autoimmunity raises questions. Centenarians, individuals who are over 100 years old, are possibly the most successful model of biological aging in humans. Most of these individuals exhibit a favorable health phenotype. To date, primary data evidence and potential hypotheses explaining this phenomenon are lacking globally, even though this paradox could provide valuable, original, and relevant information regarding the understanding of risk or protective factors, biological drivers, and biomarkers related to autoimmunity. Herein we discuss some hypothesis that may explain the absence of ADs in centenarians, including inflammaging, immunosenescence and immune resilience, immune system hyperstimulation, proteodynamics, and genetics.

Historical evolution of cancer genomics research in Latin America: a comprehensive visual and bibliometric analysis until 2023.

Background: Cancer genomics, as an interdisciplinary research area within the Global Cancer Research agenda, genomics and precision medicine, its important in research and clinical practice in Latin America. To date, there has been no study investigating evolution of this area in this region. The aim of this study was to evaluate for first time, the historical evolution of cancer genomics research in Latin America. Methods: Bibliometric cross-sectional study of documents on cancer genomics published by Latin American authors until 2023 in Scopus was performed. Statistical and visual analysis was performed with R programming language. Results: A total of 1534 documents were obtained. The first document of cancer genomics research was published in 1997, marking the inception of a 26-year evaluation period that extended until 2023. Among the documents, 74.3% (n = 1140) constituted original articles, followed by 22.7% (n = 349) classified as reviews. International collaboration was observed in 6.5% (n = 100) of the articles. Within the compilation of the ten most prolific authors in this region, 90% of them are from Brazil. This observed pattern extends to affiliations as well, wherein the Universidade de São Paulo emerges as the most active institution (n = 255 documents). This arrangement firmly establishes Brazil's prominence as the preeminent country in the region concerning cancer genomics research, showcasing robust collaboration networks both regionally and intercontinentally. An important transition in the studied hot topics over the last 20 years was identified, from the exploration of the human genome and the characterization of genomic and proteomic cancer profiles (1997-2010) to an in-depth investigation of cancer stem cells and personalized medicine (2011-2023). Among the array of cancer types under study, predominant attention has been directed towards breast, lung, prostate, and leukemia. Conclusion: Over the course of the past 26 years, a favorable and notable evolution has characterized cancer genomics research within Latin America, with Brazil leading the way, which possess a robust network of regional and intercontinental collaboration. Furthermore, the lines of research and hot topics have change in harmony with the region's objectives, strategies, and requisites.

Knowledge and attitudes of health professionals in Chile towards people living with human immunodeficiency virus: A cross-national survey.

Introduction: People living with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) often experience discrimination from both other individuals and the health personnel who care for them. Chile has experienced a marked increase in the number of new HIV cases.Methods: Prospective cross-sectional study. The HIV/AIDS questionnaire for providers and health personnel was obtained from the International Planned Parenthood Federation, initially carrying out a pilot test and evaluating its validity.Results: A total of 784 health professionals answered the questionnaire correctly. Among them, 68.4% (n = 536) were women, and 36.2% (n = 284) were physicians. The study revealed that more than 90% of respondents had a positive attitude towards caring for people living with HIV, and more than 75% did not mind buying food from them or sharing services with them. Furthermore, more than 99% rejected the religiously endorsed labeling of people living with HIV/AIDS as immoral. Additionally, 95.5% (n = 749) mentioned that they did not feel anxious about knowing whether the next patient on their care list was living with HIV, and 76.9% (n = 603) of the respondents felt safe taking blood samples.Conclusions: Chilean health professionals have good knowledge about HIV infection and its mode transmission. Their attitudes towards people living with HIV are also generally positive.

Relationship between Duffy Genotype/Phenotype and Prevalence of Plasmodium vivax Infection: A Systematic Review.

The Duffy protein, a transmembrane molecule, functions as a receptor for various chemokines and facilitates attachment between the reticulocyte and the Plasmodium Duffy antigen-binding protein. Duffy expression correlates with the Duffy receptor gene for the chemokine, located on chromosome 1, and exhibits geographical variability worldwide. Traditionally, researchers have described the Duffy negative genotype as a protective factor against Plasmodium vivax infection. However, recent studies suggest that this microorganism's evolution could potentially diminish this protective effect. Nevertheless, there is currently insufficient global data to demonstrate this phenomenon. This study aimed to evaluate the relationship between the Duffy genotype/phenotype and the prevalence of P. vivax infection. The protocol for the systematic review was registered in PROSPERO as CRD42022353427 and involved reviewing published studies from 2012 to 2022. The Medline/PubMed, Web of Science, Scopus, and SciELO databases were consulted. Assessments of study quality were conducted using the STROBE and GRADE tools. A total of 34 studies were included, with Africa accounting for the majority of recorded studies. The results varied significantly regarding the relationship between the Duffy genotype/phenotype and P. vivax invasion. Some studies predominantly featured the negative Duffy genotype yet reported no malaria cases. Other studies identified minor percentages of infections. Conversely, certain studies observed a higher prevalence (99%) of Duffy-negative individuals infected with P. vivax. In conclusion, this systematic review found that the homozygous Duffy genotype positive for the A allele (FY*A/*A) is associated with a higher incidence of P. vivax infection. Furthermore, the negative Duffy genotype does not confer protection against vivax malaria.

Evolution of Plasmodium vivax and resistance patterns for infection based on Duffy genotype and phenotype.

The Duffy protein, a transmembrane molecule, acts as a receptor for various chemokines and facilitates binding between reticulocytes and the Plasmodium Duffy antigen binding protein. Duffy expression is associated with the Duffy chemokine receptor antigen genotype on chromosome 1 and exhibits variation across different geographic regions. Traditionally, the Duffy negative genotype and phenotype have been described to confer a certain level of protection against infection and symptom development. However, recent data suggest a shift in this behavior, with significantly higher prevalence observed in individuals with Duffy negative genotype or phenotype. Given that malaria is an endemic vector-borne disease in regions of Asia, Africa, and Latin America, posing a substantial global burden of disease and prioritizing public and global health, identifying evolutionary changes in infection and resistance patterns holds great importance for the design of strategies and reevaluation of conventional interventions. Hence, the aim of this review was to analyze the evolution of Plasmodium vivax and infection resistance patterns based on Duffy genotype and phenotype. The distribution of genotypes, phenotypes, and polymorphisms of P. vivax ligands and erythrocyte receptors varies geographically, notably resistance patterns of this microorganism in individuals with Duffy negative genotype and phenotype have significantly changed compared to studies conducted 30 years ago. The prevalence of vivax malaria in individuals with a Duffy negative status can reach up to 100%. Consequently, prioritizing research on this topic is essential for public health.

CEA-delta could be a biomarker of tumor phenotype, clinical stage, and chemotherapeutic response in rectal cancer with OCT4-positive cancer stem cells.

Background: There is very limited evidence on biomarkers for evaluating the clinical behavior and therapeutic response in rectal cancer (RC) with positive expression of cancer stem cells (CSCs). Methods: An exploratory prospective study was conducted, which included fresh samples of tumor tissue from 109 patients diagnosed with primary RC. Sociodemographic, pathological and clinical characteristics were collected from medical records and survey. The OCT4 protein was isolated using the Western Blot technique. It was calculated the ΔCEA, ΔOCT4, and ΔOCT4/GUSB values by assessing the changes before and after chemotherapy, aiming to evaluate the therapeutic response. Results: Patients had an average age of 69.9 years, with 55% (n=60) being male. Approximately 63.3% of the tumors were undifferentiated, and the most frequent staging classification was pathological stage III (n=64; 58.7%). Initial positive expression was observed in 77.1% of the patients (n=84), and the median ΔCEA was -1.03 (-3.82 - 0.84) ng/ml, with elevated levels (< -0.94 ng/ml) found in 51.4% of the subjects (n=56). Being OCT4 positive and having an elevated ΔCEA value were significantly associated with undifferentiated tumor phenotype (p=0.002), advanced tumor progression stage (p <0.001), and negative values of ΔOCT4 (p <0.001) (suggestive of poor therapeutic response) compared to those without this status. Conclusion: This study identified a significant and directly proportional association among the values of ΔCEA, ΔOCT4, and ΔOCT4/GUSB. These findings suggest that ΔCEA holds potential as a clinical biomarker for determining the undifferentiated tumor phenotype, advanced clinical stage, and poor therapeutic response in RC with CSCs positive expression.

Use of hand-held ultrasound to perform E-FAST by general surgery residents in a trauma reference center: First experience in the Colombian Caribbean region / Uso de ecografía portátil para realizar E-FAST por residentes de cirugía general en un centro de referencia en trauma: primera experiencia en la región del Caribe colombiano

Introduction. Extended focused assessment with sonography for trauma (E-FAST) can be performed with minimal training and achieve ideal results. It allows easy transport and use in austere environments such as the Colombian Caribbean, where many centers do not have 24-hour radiology services. The objective of this study was to determine the performance of the use of E-FAST in the evaluation of trauma by second-year general surgery residents in the emergency department. Methods. Retrospective observational study that evaluated the diagnostic performance of E-FAST with Butterfly IQ, in patients with thoracoabdominal trauma, who attended a referral center in the Colombian Caribbean between November 2021 and July 2022. Sensitivity, specificity, and positive and negative predictive values were evaluated, compared with intraoperative findings or conventional imaging. Results. A total of 46 patients were included, with a mean age of 31.2 ± 13.8 years, 87.4% (n=39) were male. The main mechanism of trauma was penetrating (n=32; 69.5%). It was found that 80.4% (n=37) of the patients had a positive E-FAST result, and of these, 97% (n=35) had a positive intraoperative finding. Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 75%, 94.6%, and 66.6%, respectively. The positive likelihood ratio was 3.68, while the negative likelihood ratio was 0.10. Conclusion. General surgery residents have the competence to perform accurate E-FAST scans. The hand-held ultrasound device is an effective diagnostic tool for trauma and acute care surgery patients.

Introducción. La evaluación enfocada extendida con ecografía en trauma (E-FAST, extended focused assessment with sonography for trauma) puede realizarse con entrenamiento mínimo y lograr resultados ideales. Su fácil transporte permite usarla en entornos austeros, como el Caribe colombiano, donde muchos centros no disponen de servicio radiológico las 24 horas. El objetivo de este estudio fue determinar el rendimiento del uso de E-FAST por residentes de cirugía general de segundo año en la evaluación del paciente con trauma en urgencias. Métodos. Estudio observacional retrospectivo que evaluó el rendimiento diagnóstico de E-FAST con Butterfly IQ, en pacientes con trauma toracoabdominal que acudieron a un centro de referencia del Caribe colombiano, entre noviembre de 2021 y julio de 2022. Se evaluaron sensibilidad, especificidad, valores predictivos positivo y negativo, comparando la descripción de la ecografía con los hallazgos intraoperatorios o imagenología convencional. Resultados. Se incluyeron un total de 46 pacientes, con una media de edad de 31,2 ± 13,8 años, siendo el 87,4 % (n=39) hombres. El principal mecanismo de trauma fue penetrante (n=32; 69,5 %). Se encontró que el 80,4 % (n=37) de los pacientes tuvo resultado E-FAST positivo, y que, de estos, el 97 % (n=35) tuvo un hallazgo positivo intraoperatorio. Se calculó una sensibilidad de 92,1 %, especificidad de 75 %, valor predictivo positivo de 94,6 % y negativo de 66,6 %; la razón de verosimilitud positiva fue de 3,68 y la negativa de 0,10. Conclusión. Los residentes de cirugía general están capacitados para realizar exploraciones E-FAST precisas. El ecógrafo portátil es una herramienta de diagnóstico eficaz para pacientes traumatizados.

Factors associated with suicide in physicians: a silent stigma and public health problem that has not been studied in depth.

Suicide is a complex and multifaceted public health issue that affects individuals from all walks of life, including healthcare professionals such as physicians. According to research, physicians have a higher risk of suicide compared to the general population, with an estimated suicide rate that is two to three times greater than that of the general population. Suicide in physicians can have devastating consequences, not only for the individual but also for their patients and colleagues. The factors contributing to suicide in physicians are numerous and often interrelated. Physicians are exposed to numerous stressors in their daily lives, including long work hours, high workload, burnout, and exposure to traumatic events. These stressors can lead to mental health problems such as depression, anxiety, and substance use disorders, which in turn can increase the risk of suicide. In addition to work-related stressors, personal factors such as relationship problems, financial stress, and a history of mental health problems can also contribute to suicide risk in physicians. Stigma and shame around seeking help for mental health issues may also prevent physicians from seeking treatment, exacerbating the problem. Understanding the complex factors that contribute to suicide in physicians is crucial for developing effective prevention strategies. For this reason, it is necessary to know the behavior of this phenomenon and the factors associated with a higher risk of suicide in this population. However, taking into account that different regions of the world vary in socioeconomic, cultural, professional, occupational, and health attributes, it is to be expected that the behavior of these risk factors will also be heterogeneous. At present, it is presumed that there is a significant gap in the evidence, due to a predominance of evidence on this topic from high-income countries. Considering the importance of having a comprehensive understanding of the risk factors for suicide in the medical population and possible strategies to mitigate this condition, the aim of this review is to analyze the most recent evidence on these factors, and to assess the quality of the evidence and gaps that need to be studied further.

Participation of Latino Authors in TOP Dermatology Journals During 2021: a Brief Bibliometric Analysis / Participación de autores latinos en revistas TOP de dermatología durante el 2021: un corto análisis bibliométrico / Participação de autores latinos nas revistas TOP de dermatologia durante 2021: uma breve análise bibliométrica / Participation of Latino Authors in TOP Dermatology Journals During 2021: a Brief Bibliometric Analysis

A key global health objective is to promote the advancement of scientific production in disciplines with low publication volume, as opposed to specialties addressing pathologies that represent the greatest global disease burden (1). Dermatology is one such discipline, which has experienced substantial growth in research on immunopathogenic, pathophysiological, diagnostic, and therapeutic aspects (2-4). The extent to which Latin American authors and institutions have been involved in publishing scientific articles in the dermatology journals with highest impact worldwide remains unknown.

Un objetivo clave de salud mundial es promover el avance de la producción científica en disciplinas con bajo volumen de publicación, a diferencia de especialidades que abordan las patologías que representan la mayor carga de enfermedad a nivel mundial (1). La Dermatología es una de esas disciplinas que ha experimentado un crecimiento sustancial en investigación en aspectos inmunopatogénicos, fisiopatológicos, diagnósticos y terapéuticos (2-4). El alcance en el cual los autores e instituciones latinoamericanas han participado en la publicación de artículos científicos en revistas de dermatología con mayor impacto mundial permanece incierto.

Um objetivo fundamental da saúde global é promover o avanço da produção científica em disciplinas com baixo volume de publicações, em oposição às especialidades que abordam patologias que representam a maior carga de doenças em todo o mundo (1). A Dermatologia é uma das disciplinas que tem experimentado um crescimento substancial nas pesquisas em aspectos imunopatogênicos, fisiopatológicos, diagnósticos e terapêuticos (2-4). A extensão da participação de autores e instituições latino-americanas na publicação de artigos científicos em revistas de dermatologia de maior impacto global permanece incerta.

Condiciones de vida, violencia sexual y sintomatología psiquiátrica de mujeres afrocolombianas víctimas del conflicto armado colombiano: estudio de corte transversal en Cartagena, Colombia

Objetivo: Evaluar el fenómeno de violencia sexual y condición de vida de mujeres afrocolombianas víctimas del conflicto armado, asentadas en la ciudad de Cartagena, Colombia. Materiales y métodos: Estudio prospectivo de corte transversal, tipo encuesta poblacional, realizado entre septiembre de 2019 y marzo del 2020, en la ciudad de Cartagena, Colombia. Se evaluaron variables sociodemográficas, tipo de delitos sufridos en el conflicto armado y factores relacionados, además de antecedentes o presencia de sintomatología psiquiátrica asociada a los eventos traumáticos. A través de análisis descriptivo, se caracterizó las condiciones de vida actuales de las participantes y se exploraron asociaciones entre la condición de violencia sexual y sintomatología psiquiátrica, por medio de Odds Ratio (OR). Resultados: Participaron 215 mujeres, con una mediana de edad de 40 años y desplazadas principalmente del departamento de Bolívar (55%). El 85% eran amas de casa y solo el 60% tiene vivienda propia, encontrándose más del 65% del total de las viviendas en zonas de riesgo por inundación. Por lo menos el 35% habían sufrido discriminación de género, racial o habían sido víctima de violencia sexual. Aproximadamente la mitad de la muestra declaró padecer insomnio, ansiedad y depresión. El 40% mencionó haber tenido pensamientos suicidas y solo 1 de cada 5 mujeres recibió apoyo psicológico. Haber sido secuestrada (OR 4,71; IC 95%, 1,05-21,07), perseguida (OR 3,33; IC 95%, 1,61-6,89) y abusada sexualmente (OR 3,09; IC 95%, 1,60-5,96), son hechos que se asociaron de forma sostenida y significativa con sintomatología psiquiátrica. Conclusión: Las mujeres afrocolombianas víctimas del conflicto armado colombiano asentadas en Cartagena, presentan condiciones de vida inestables, no han recibido la ayuda adecuada de redes de apoyo, han sido discriminadas por su etnia, género y condición de víctima, y tienen una prevalencia elevada de sintomatología psiquiátrica asociada a los hechos traumáticos vividos.

Objective: To evaluate the phenomenon of sexual violence and the living conditions of Afro-Colombian women victims of the armed conflict, who lives in city of Cartagena, Colombia. Materials and methods: Prospective cross-sectional study, population-based survey type, conducted between September 2019 and March 2020, in the city of Cartagena, Colombia. Sociodemographic variables, type of crimes suffered in the armed conflict and related factors were evaluated, as well as history or presence of psychiatric symptoms associated with traumatic events. Through descriptive analysis, it was characterized the current living conditions of the participants; and also explored associations between the condition of sexual violence and psychiatric symptomatology, through Odds Ratio (OR). Results: 215 women participated, with a median age of 40 years and displaced mainly from the department of Bolívar (55%). 85% percent were housewives and only 60% have their own house, with more than 65% of the total number of houses located in flood risk areas. 35% had suffered gender or racial discrimination or had been victims of sexual violence. Approximately half of the sample reported suffering from insomnia, anxiety and depression. 40% mentioned having had suicidal thoughts and only 1 in 5 women received psychological support. Having been kidnapped (OR 4.71; 95% CI, 1.05-21.07), persecuted (OR 3.33; 95% CI, 1.61-6.89) and sexually abused (OR 3.09; 95% CI, 1.60-5.96), are events that were consistently and significantly associated with psychiatric symptomatology. Conclusion: The Afro-Colombian women victims of the Colombian armed conflict who lives in Cartagena, present unstable living conditions, have not received adequate help from support networks, have been discriminated against because of their ethnicity, gender and victim status, and have a high prevalence of psychiatric symptoms associated with the traumatic events experienced.

Research and Publication Trends in Pediatric Surgery in Latin America: A Bibliometric and Visual Analysis from 2012 to 2021.

INTRODUCTION: Pediatric surgery is a developing specialty with increasing volume in Latin America. However, the research and scientific activity trends carried out in this region in recent years are unknown. This study aimed to analyze and visualize Latin American research in pediatric surgery from 2012 to 2021. MATERIAL AND METHODS: Bibliometric cross-sectional study of scientific articles on pediatric surgery published by Latin American authors from 2012 to 2021 in Scopus was performed. Statistical and visual analysis was performed with R programming language and VOS viewer. RESULTS: 449 articles were found. Observational studies (44.7%; n = 201), case reports (20.4%; n = 92) and narrative reviews (11.4%; n = 51) were found to be the most common study designs. The published articles were predominantly monocentric (73.1%; n = 328), only 17% (n = 76) involved authors from 2 or more countries, and mostly there was no collaboration with high-income countries (80.6%; n = 362). The Journal of Pediatric Surgery was the journal with the highest volume of articles published (n = 37). The most used terms were Laparoscopy, Complications, and Liver Transplantation, and the countries with the highest number of articles published were Brazil and Argentina. CONCLUSIONS: This study found a progressive increase in the scientific activity of Latin authors in pediatric surgery from 2012 to 2021. The evidence produced was mainly from observational studies and case reports, predominantly conducted in Brazil. Multinational and international collaboration was low; the most frequent topics of interest were laparoscopy and minimally invasive surgery. LEVELS OF EVIDENCE: IV.

Surgical research in Colombia part 3: Authorship and publications of Colombian medical students in surgery in Colombian medical journals-cross-sectional study.

Research training, scientific activity and publications are cornerstones of academic surgery. Knowing the activity and trends of medical students aspiring to become surgeons it allows to identify gaps and skills to be strengthened. Currently, there is no data on the authorship and scientific activity of medical students in surgery in Latin America and Colombia. Methods: A bibliometric cross-sectional study was carried out, in which the Colombian medical journals were reviewed from 2010 to 2020. The articles with topics in general surgery and subspecialties where the authorship of medical students could be identified, were selected. Data on the sociodemographic and scientific characteristics of the authors and their publications were extracted and analyzed. Results: A total of 14 383 articles from 34 Colombian medical journals were reviewed. From 2010 to 2020, 807 articles related to surgery were published in Colombia. The most frequent typology of these articles was original articles (n=298; 37%), followed by case reports (n=222; 28.2%) and reviews (n=137; 17.3%). A total of 132 medical students and 141 authorships and were found, specifically in 9.9% (n=80/807) of these publications, with a higher frequency in original articles (n=32; 40%) and case reports (n=29; 36.2%). Collaboration of students with professors or surgeons was evidenced in 97.5% of the publications. Conclusions: The authorship of Colombian medical students in scientific publications in surgery in Colombian medical journals was low. From 2010 to 2020, student authors were found in 1 out of every 10 publications, mainly in original articles and clinical cases.

De una idea a una publicación original en cirugía: Una guía para futuros cirujanos académicos. Capítulo Futuros Cirujanos, Asociación Colombiana de Cirugía / From an idea to an original publication in surgery: A guide for future academic surgeons. Future Surgeons Chapter, Colombian Surgical Association

Introducción. Recientemente, se ha evidenciado un crecimiento exponencial de artículos de estudiantes y autores jóvenes; sin embargo, la mayoría de esos artículos no han sido citados. El objetivo de este artículo fue presentar un manual de fácil interpretación, aplicable durante el proceso de construcción de un manuscrito académico original en cirugía. Métodos. Se realizó una revisión sistemática de la literatura en las bases de datos académicas, utilizando las palabras clave "manuscrito académico", "cirugía", "investigación" y "how to do it", así como sinónimos. Se incluyeron estudios originales, revisiones y las directrices STROCSS 2021, publicadas hasta marzo de 2023. Resultados. Se logró recopilar una guía empírica, con recomendaciones y directrices útiles para la creación de un manuscrito académico en cirugía, óptima para uso en todos los niveles académicos. Conclusión. Se deben brindar herramientas que sean aplicables en todos los niveles educativos, desde un estudiante hasta cirujano graduado. Con este artículo se buscan dar a conocer un camino para transformar una idea en una publicación científica original de alto impacto, de forma metódica y fácil de entender, actuando como un incentivo y facilitador para la producción científica y académica en cirugía para Colombia y Latinoamérica

Introduction. Recently, there has been an exponential growth of articles by students and young authors; however, most of the articles have not been cited. This review presents an easy-to-interpret manual, applicable during the process of writing an original academic manuscript in surgery. Methods. A systematic literature review was performed in academic databases using the keywords "Academic Manuscript", "Surgery", "Research" and "How to do it", as well as synonyms; the search date was performed until March 2023, where original studies, reviews and STROCSS 2021 guidelines were included. Results. It was possible to compile an empirical guide, with useful recommendations and guidelines for the creation of an academic manuscript in surgery, optimal for use at all academic levels. Conclusion. Tools should be provided that are applicable at all educational levels, from a student to a graduate surgeon. The authors seek to show a way to transform an idea into an original scientific publication of high impact, in a methodical and easy to understand way, so this article acts as an incentive and facilitator for scientific and academic production in surgery in Colombia and Latin America

GRINCIRCAR: una iniciativa para promover la cirugía académica e investigación quirúrgica en el caribe colombiano / GRINCIRCAR: an initiative to promote academic surgery and surgical research in the Colombian Caribbean

Introducción. La investigación quirúrgica es uno de los pilares de la cirugía académica, que integra el microambiente para lograr una adecuada práctica basada en la evidencia, realizar planteamientos y conseguir eventuales soluciones a necesidades quirúrgicas de una población. En el caribe colombiano existen brechas significativas en cuanto al aporte en investigación quirúrgica, comparado con otras regiones del país. Por ende, es necesaria una iniciativa que haga frente a estos retos. Métodos. El Grupo Colaborativo de Investigación en Cirugía General y Subespecialidades del Caribe Colombiano (GRINCIRCAR), es una iniciativa fundada por una colectividad de estudiantes de medicina, médicos residentes de cirugía y cirujanos académicos de universidades del caribe colombiano, que buscan impulsar la investigación quirúrgica y aportar a la resolución de problemas de salud en cirugía de la región. Discusión. De acuerdo al programa de investigación con políticas y prioridades en salud establecidos por el Instituto Nacional de Salud, existen por lo menos dos dimensiones donde se involucra directamente la cirugía. A pesar de esto, no existen datos sobre la distribución de recursos para la investigación quirúrgica en la región del Caribe colombiano, pese a que el acceso al cuidado quirúrgico básico y las enfermedades quirúrgicas, hace parte de las prioridades en salud y cirugía global. Conclusiones. Se necesita promover la cirugía académica y la investigación quirúrgica en la región del caribe colombiano. La investigación colaborativa podría ser una solución al integrar la participación de múltiples centros y participantes

Introduction. Surgical research is one of the cornerstones of academic surgery, which integrates the microenvironment to achieve an adequate evidence-based practice, asking the right questions to achieve eventual solutions to the surgical needs of a population. In the Colombian Caribbean, there are significant gaps in the contribution in surgical research, compared to other regions of the country. Therefore, an initiative is needed to address these challenges. Methods. The Collaborative Group for Research in General Surgery and Subspecialties of the Colombian Caribbean (GRINCIRCAR) is an initiative founded by a group of medical students, surgical residents and academic surgeons from Colombian Caribbean universities, who seek to promote surgical research and contribute to solutions of health problems in surgery in the region. Discussion. According to the research program, health policies and priorities established by the National Institute of Health, there are at least two dimensions where surgery is directly involved. Despite this, there are no data on the distribution of resources for surgical research in the Colombian Caribbean region, despite the fact that access to basic surgical care and surgical diseases are part of the priorities in global health and surgery. Conclusions. There is a need to promote academic surgery and surgical research in the Colombian Caribbean region. Collaborative research in the region could be a solution by integrating the participation of multiple centers and participants

Diaphragmatic Dynamics and Thickness Parameters Assessed by Ultrasonography Predict Extubation Success in Critically Ill Patients.

INTRODUCTION: A frequent cause of weaning and extubation failure in critically ill mechanically ventilated patients is diaphragm muscle dysfunction. Ultrasound (US) evaluation of the diaphragm yields important data regarding its thickness (diaphragm thickening fraction [TFdi]) and its movement or excursion (diaphragmatic dynamics) that reveal the presence of diaphragmatic dysfunction. METHODS: Cross-sectional study, which included patients older than 18 years with invasive mechanical ventilation with an expected duration of more than 48 h, in a tertiary referral center in Colombia. The excursion of the diaphragm, inspiratory and expiratory thickness, and TFdi were evaluated by US. Prevalence and use of medications were evaluated, and the association with failure in ventilatory weaning and extubation was analyzed. RESULTS: Sixty-one patients were included. The median age and APACHE IV score were 62.42 years and 78.23, respectively. The prevalence of diaphragmatic dysfunction (assessed by excursion and TFdi) was 40.98%. The sensibility, specificity, positive predictive value, and negative predictive value for TFdi < 20% was 86%, 24%, 75%, and 40%, respectively, with an area under the receiver operating characteristic (ROC) curve of 0.6. The ultrasonographic analysis of excursion of the diaphragm, inspiratory and expiratory thickness, and TFdi (>20%) allow in its set and with normal values, predict success or failure for the extubation with an area under the ROC curve of 0.87. CONCLUSION: Diaphragmatic dynamics and thickness parameters together assessed by ultrasonography could predict the success of extubation in critically ill patients in Colombia, based on the finding of diaphragmatic dysfunction.

Translation, adaptation, and validation of the MeNTS score in colombian population: The MeNTS Col score.

Objective: To evaluate and validate the medically necessary and time sensitive score by testing the variables, in order to create a surgical preoperative score for procedure prioritization in COVID-19 pandemic in Colombia. Methods: A multicenter retrospective cross-sectional study of instrument validation with a cultural adaptation and translation into the Spanish language was carried out in Bogota, Colombia. Patients over 18 years of age who had undergone elective procedures of general surgery and subspecialties were included. The translation of the medically necessary and time sensitive score into Spanish was performed independently by two bilingual surgeons fluent in both English and Spanish. A final version of the Spanish questionnaire (MeNTS Col) for testing was then produced by an expert committee. After translation and cultural adaptation, it was submitted to evaluate the psychometric properties of the medically necessary and time sensitive score. Cronbach's α was used to represent and evaluate the internal consistency and assess reliability. Results: A total of 172 patients were included, with a median age of 54 years; of which 96 (55.8%) patients were females. The vast majority of patients were treated for general surgery (n = 60) and colon and rectal surgery (n = 31). The evaluation of the internal consistency of the scale items in Spanish version was measured, and values of 0.5 for 0.8 were obtained. In the reliability and validation process, Cronbach's α values in all items remained higher than 0.7. The new MeNTS Col model was analyzed, and a result of 0.91 was obtained. Conclusions: The Spanish version of the medically necessary and time sensitive, the MeNTS Col score, and its respective Spanish translation perform similarly to the original version. Therefore, they can be useful and reproducible in Latin American countries.

Single incision laparoscopic appendectomy with surgical-glove port is cost-effective and reliable in complicated acute appendicitis: A casecontrol multicenter study in Colombia.

Background: The single-port (SPL) and multi-port (MPL) laparoscopic approach are the gold standard of management of acute appendicitis, due to its multiple advantages over open surgery, mainly because of its direct effects on recovery, esthetics and costs of the procedure. However, in third-world countries, the laparoscopic approach is not yet fully reproducible due to the costs of the technique. The surgical-glove port single incision laparoscopic appendectomy (SGP-SILA) has been proposed as a viable option. However, it has never been studied in Colombia. Objective: To evaluate the cost-effectiveness and reliability of SGP-SILA in the management of complicated acute appendicitis, compared to traditional MPL approach. Materials and methods: A retrospective case control study was carried out comparing patients undergoing laparoscopic appendectomy by SGP-SILA vs. MPL, evaluating operating costs associated with intraoperative and postoperative variables in two tertiary centers in Bogota, Colombia. The data were analyzed and expressed according to their nature and distribution. Results: 116 patients were included (SGP-SILA: 62 and MPL: 54). The median surgical time for SGP-SILA was 60 min vs. 39 min for MPL. SGP-SILA was shown to cause lower frequency of surgical site infection (4 vs. 8 patients; p = 0.047). It was found a significant correlation between Grade III surgical site infection and surgery time (p = 0.047) in the MPL group; also, with hospital stay (p < 0.001). Also, a lower risk of surgical site infection was found with the SGP-SILA technique (22% vs. 31%). SGP-SILA generated a reduction in both direct and indirect operating costs of approximately 10% (616 USD vs. 683 USD). Conclusion: SGP-SILA and MPL are feasible and comparable procedures in the resolution of complicated acute appendicitis. SGP-SILA turns out to be more cost-effective compared to MPL, due to the use of more easily accessible instruments. This may be a reproducible technique in low- and middle-income countries.