Possible association between subclinical hypothyroidism and age at menopause in Colombian women.

OBJECTIVE: To evaluate the association between subclinical hypothyroidism with early menopause, premature menopause, and last menstrual bleeding before the natural age of menopause. METHODS: This was a cross-sectional study conducted in 643 postmenopausal women aged 40-69 years. Groups were formed according to last menstrual episode: ≥45 [Natural age at menopause], 40-44 and [Early menopause], <40 [Premature menopause], and <45 [last menstrual episode before the natural age of menopause]. The Zulewski scale was applied to identify manifestations related to hypothyroidism and subclinical hypothyroidism, diagnosed with a serum TSH > 4.5 µIU/mL plus T4-free between 0.7 and 1.9 ng/dL. RESULTS: It was found that 24.4% had the last menstrual episode before the natural age of menopause, 18.6% had early menopause, and 5.7% had premature menopause. Subclinical hypothyroidism was diagnosed in 4.5% of patients. Among women with subclinical hypothyroidism, there was a higher frequency of early menopause, premature menopause, and last menstrual episode before the natural age of menopause, than in women without subclinical hypothyroidism (p < 0.05). Paresthesia (50%) and dry skin (40.7%) were the most reported hypothyroidism-related manifestations. Early menopause, premature menopause, and last menstrual episode before the natural age of menopause were associated with subclinical hypothyroidism, OR: 3.37 [95% CI: 1.40-8.10], OR: 4.31 [95% CI: 1.24-14.97], and OR: 3.57 [95% CI: 1.57-8.10], respectively. CONCLUSIONS: The last menstrual episode before the natural age of menopause, early menopause, and premature menopause were significantly associated with a higher chance of subclinical hypothyroidism.

Knowledge and attitudes regarding contraceptive methods and sex education in students and parents of eight Colombian schools 2020-2021: a mixed methods study.

Background: In Colombia, the average age of first sexual intercourse is between 14 and 15, and it has one of the highest fertility rates among adolescents in Latin America, which reflects poor access to health services and a lack of knowledge about contraception. Some laws support comprehensive sex education as a learning process that families and schools should provide. The objective of this work was to assess the frequency of adequate knowledge and attitudes of acceptance towards contraception in students, their associated factors, sexual behaviours in sexually active students, and experiences with sex education. Methods: Mixed methods study consisting of an analytical cross-sectional study and a qualitative hermeneutic phenomenological study. The former included students who completed a questionnaire with sociodemographic variables, surveys on knowledge and attitudes toward contraception, and questions about sexual behaviour. Focus groups were used in the qualitative study to evaluate students' and parents' sex education experiences. Findings: 827 students were surveyed, of whom 52.3% had adequate knowledge about contraceptives and 80.1% had attitudes of acceptance. Talking with parents about sex education, receiving sex education, and being in the eleventh grade increased the likelihood of having adequate knowledge. Each year of age, being male, being a victim of forced displacement, and studying in a public school were associated with lower possibilities of attitudes of acceptance. Using condoms, compared to other contraceptives, was associated with less adequate knowledge and attitudes of acceptance (p < 0.05). Experiences with sex education, contraception, and sexual and reproductive rights were three emerging categories in the focus groups. Interpretation: In a group of Colombian high school students, half of them had adequate knowledge, eight out of 10 had attitudes of acceptance about contraception, and both were associated with having received sex education. Nevertheless, different types of barriers to sexual education were identified at home and in schools. The results will allow the generation of educational policies that modify the educational model as well as new strategies by health professionals to raise awareness about responsible sexuality. Funding: This project was financed by internal research of the Fundación Universitaria de Ciencias de la Salud-FUCS (DI-I-0392-20).

Clinical considerations for sarcopenia in older Colombian Afro-descendant and mestizo women.

OBJECTIVES: To identify the frequencies of clinical suspicion of sarcopenia (CSS) and probable sarcopenia (PS) and their association with ethnic groups. METHODS: This cross-sectional study categorized 700 women into Afro-descendant and mestizo ethnic groups. Calf circumference, muscle strength, and gait speed were measured. CSS was assessed using a sarcopenia risk scale and the measurement of calf circumference; the muscle strength of the dominant hand was used to establish PS. Unadjusted logistic regressions assessed associations between CSS/PS and ethnicity. Two adjusted logistic regression models included relevant covariates. RESULTS: CSS and PS were identified in 10.4% to 20.7% and 7.8% to 14.1% of study participants, respectively. Compared with mestizos, Afro-descendants had a more favorable sarcopenia risk score, greater calf circumference, and greater muscle strength and were associated with a lower risk for CSS (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06-0.28 and OR: 0.12, 95% CI: 0.07-0.21) and PS (OR: 0.12, 95% CI: 0.05-0.30 and OR: 0.11, 95% CI: 0.06-0.21). CONCLUSION: Compared with mestizos, CSS and PS were less frequent among Afro-descendants, who had 87% to 88% lower probability of CSS and 88% to 89% lower probability of PS.

Positive maternal mental health in pregnant women and its association with obstetric and psychosocial factors.

OBJECTIVE: To estimate the frequency of Positive Maternal Mental Health (PMMH) interpretation levels in pregnant women who attended prenatal consultation and to identify their association with obstetric and psychosocial factors. METHODS: A cross-sectional study that included pregnant women who attended prenatal care at 12 or more weeks of gestation. The following scales were applied: Positive Mental Health Questionnaire (PMHQ), Goldberg Anxiety and Depression Scale, and Jong Gierveld Loneliness Scale. RESULTS: 702 pregnant women were evaluated; 634 (90.3%) had flourishing PMMH, and 68 (9.7%) had non-flourishing PMMH. Among the latter, all were at an intermediate level, and none were languishing. Flourishing PMMH was more frequent in adults (91.2%) compared to adolescents (75.0%) and in women with higher education (93.0%) than in those with basic education (83.9%). The PMHQ factors and global score correlated positively with maternal age and negatively with anxiety, depression, emotional, social, and general loneliness. Associated with a higher frequency of non-flourishing PMMH were general loneliness OR:6.32[CI95%:3.38-11.82], social loneliness OR:5.98[CI95%:3.42-10.42], adolescence OR:3.47[CI95%:1.61-7.45], emotional loneliness OR:3.12[1.83-5.32], anxiety OR:2.14[CI95%:1.27-3.60], and depression OR:1.88[CI95%:1.09-3.25]. Less frequently: work occupation outside the home OR:0.41[CI95%:0.24-0.68], technical/technological studies OR:0.22[CI95%:0.08-0.60] and university OR:0.27[CI95%:0.10-0.71]. Preconception consultation, desired pregnancy, cesarean section, and fetal or neonatal death were not associated. In the adjusted model: general loneliness OR:3.02[CI95%:1.10-8.31], social loneliness OR:2.82[CI95%:1.38-5.79] and anxiety OR:1.93[CI95%:1.02-3.67], retained statistical significance. CONCLUSION: Nine out of ten pregnant women had flourishing PMMH, and none had languishing PMMH. None of the obstetric factors were associated with non-flourishing PMMH but with general loneliness, social loneliness, and anxiety.

Quality of life deterioration and associated factors in prenatal care pregnant women: assessment with the WHOQOL-BREF scale / Deterioro de la calidad de vida y factores asociados en gestantes en control prenatal: evaluación con la escala WHOQOL-BREF

Introduction: Quality of life is a set of situations that contribute to people's well-being. In pregnantwomen, it is necessary to explore the emotional, social and physical aspects. Few studies in the LatinAmerican population explore the quality of life of pregnant women. The objective was to establishthe frequency of deterioration of the physical, psychological, social and environmental quality of lifeand to identify the associated factors in pregnant women residing in cities of the ColombianCaribbean who attended prenatal consultation.Material and methods: A cross-sectional study was conducted on 509 pregnant women whoperformed daily activities and participated voluntarily and anonymously after signing informedconsent. They filled out a form that explored sociodemographic and clinical characteristics andapplied the WHOQOL-BREF scale, identifying the poor quality of life. Adjusted logistic regressionwas performed to estimate the association between quality of life (dependent variable) andbiopsychosocial factors (independent variables).Results: The age of the participants was 26.8 ± 6.2 years. In 250 (49.1%) physical or mentaldeterioration was identified, in 281 (55.2%) deterioration of the social relationship and in 270(53.0%) of the environmental relationship. Diabetes OR:6.01[95%CI:1.20-18.42], depressionOR:4.71[95%CI:1-20-18.42], living in a rural area OR:2.96[95%CI :1.78-4.91], anguish withpregnancy OR:2.87[95%CI:1.65-5.01], financial problems OR:2.61[95%CI:1.54-4.40 ] or coupleOR:2.60[95%CI:1.03-6.69], were associated with impaired quality of life (p<0.01). Beingcohabiting, compared to being alone, and being a student/employee versus a housewife, wereassociated with a lower possibility of deterioration in quality of life (p<0.01).Conclusions: Deterioration of each quality of life domain was identified in half of the pregnantwomen and several biopsychosocial factors were significantly associated. ... (AU)

Introducción: La calidad de vida es un conjunto de situaciones que contribuyen al bienestar de laspersonas. En las mujeres embarazadas es necesario explorar los aspectos emocionales, sociales yfísicos. Son pocos los estudios en población latinoamericana que exploran la calidad de vida de lasgestantes. El objetivo fue establecer la frecuencia de deterioro de la calidad de vida física,psicológica, social y ambiental e identificar los factores asociados en gestantes residentes en ciudadesdel Caribe colombiano que acudieron a consulta prenatal.Material y métodos: Se realizó un estudio transversal en 509 gestantes que realizaban actividadescotidianas y participaban de forma voluntaria y anónima previa firma del consentimiento informado.Llenaron un formulario que exploró características sociodemográficas y clínicas y aplicaron la escalaWHOQOL-BREF, identificando la mala calidad de vida. Se realizó una regresión logística ajustadapara estimar la asociación entre calidad de vida (variable dependiente) y factores biopsicosociales(variables independientes).Resultados: La edad de los participantes fue de 26,8 ± 6,2 años. En 250 (49,1%) se identificódeterioro físico o mental, en 281 (55,2%) deterioro de la relación social y en 270 (53,0%) de larelación ambiental. Diabetes OR:6.01[IC95%:1.20-18.42], depresión OR:4.71[IC95%:1-20-18.42],vivir en zona rural OR:2.96[IC95% :1.78-4.91], angustia con embarazo OR:2,87[IC95%:1,65-5,01],problemas financieros OR:2,61[IC95%:1,54-4,40] o pareja OR:2,60[IC95%:1,03-6,69], se asociaroncon deterioro de la calidad de vida (p<0,01). Ser conviviente, comparado con estar solo, y serestudiante/empleado versus ama de casa, se asoció con una menor posibilidad de deterioro en lacalidad de vida (p<0,01).Conclusiones: Se identificó deterioro de cada dominio de la calidad de vida en la mitad de lasgestantes y varios factores biopsicosociales se asociaron significativamente. ... (AU)

Guía de práctica clínica para el tratamiento de la rinosinusitis crónica: versión completa / Clinical practice guideline for the treatment of chronic rhinosinusitis: full version

La rinosinusitis (RS) se define como la inflamación de la nariz y los senos paranasales con dos o más síntomas como bloqueo/obstrucción/congestión o secreción nasal (goteo nasal anterior/posterior) más dolor/presión facial y/o reducción o pérdida del sentido del olfato. Adicional, se tienen en cuenta los hallazgos objetivos como la presencia de pólipos nasales y/o descarga mucopurulenta en meato medio y/o edema u obstrucción de la mucosa en el meato medio en la endoscopia nasal. Se pueden considerar o no, los cambios tomográficos como cambios mucosos en el complejo osteomeatal y la mucosa de los senos paranasales. Se reconoce que los síntomas tienen alta sensibilidad, pero baja especificidad, de ahí la necesidad de hallazgos objetivos.

Rhinosinusitis (RS) is defined as inflammation of the nose and sinuses with two or more symptoms such as blockage/obstruction/congestion or nasal discharge. with two or more symptoms such as nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior runny nose) plus facial pain/pressure and/or reduction or loss of the sense of smell. sense of smell. In addition, objective findings such as the presence of nasal polyps and/or nasal presence of nasal polyps and/or mucopurulent discharge from the middle meatus and/or edema or mucosal obstruction or mucosal obstruction in the middle meatus on nasal endoscopy. Tomographic changes may or may not tomographic changes may or may not be considered as mucosal changes in the osteomeatal complex and mucosal osteomeatal complex and the mucosa of the paranasal sinuses. It is recognized that the symptoms symptoms have high sensitivity but low specificity, hence the need for objective findings. findings.

Guía de práctica clínica para el tratamiento de la rinosinusitis crónica: versión corta para profesionales de la salud. Colombia-2023 / Clinical practice guideline for the management of chronic rhinosinusitis: short version for health care professionals. Colombia-2023

La rinosinusitis (RS) se define como la inflamación de la nariz y los senos paranasales con dos o más síntomas como bloqueo/obstrucción/congestión o secreción nasal (goteo nasal anterior/posterior) más dolor/presión facial y/o reducción o pérdida del sentido del olfato. Adicional, se tienen en cuenta los hallazgos objetivos como la presencia de pólipos nasales y/o descarga mucopurulenta en meato medio y/o edema u obstrucción de la mucosa en el meato medio en la endoscopia nasal.

Rhinosinusitis (RS) is defined as inflammation of the nose and sinuses with two or more symptoms such as blockage/obstruction/congestion or nasal discharge with two or more symptoms such as nasal blockage/obstruction/congestion or nasal discharge (anterior/posterior runny nose) plus facial pain/pressure and/or reduced or lost sense of smell sense of smell. Additionally, objective findings such as the presence of nasal polyps and/or nasal presence of nasal polyps and/or mucopurulent discharge in the middle meatus and/or edema or mucous or mucosal obstruction in the middle meatus on nasal endoscopy.

Adherence to Subcutaneous Anti-Tumour Necrosis Factor Treatment in a Cohort of Patients with Rheumatoid Arthritis Before and After the Implementation of a Comprehensive Care Model.

Purpose: To assess, in a cohort of patients with rheumatoid arthritis (RA) treated with subcutaneous antitumor necrosis factor drugs (anti-TNFs), the levels of treatment adherence before and after implementing a comprehensive care model (CCM). Patients and Methods: An observational study including RA patients under treatment with subcutaneous anti-TNFs (adalimumab, etanercept, and golimumab) selected at convenience was performed; a sample size of 125 patients was calculated. The outcome variable was adherence assessed with the Compliance Questionnaire on Rheumatology (CQR19), measured before and after implementing a CCM. Descriptive and bivariate analyses were performed comparing adherence before and after applying the model (Wilcoxon and McNemar's Chi2 test). For multivariate analysis, a generalized linear model adjusted for covariates was performed, where the difference in the proportion of adherence was the outcome measure. Results: A total of 131 RA patients were followed-up for 24 months; average age was 62 years, and 83.9% were women. The median of DAS28 at the beginning of the follow-up was 2.32, and the HAQ was 0.25. At baseline, 87.8% were adherent; after 24 months, 96.2% were adherent according to CQR19. At the end of follow-up, adherence increased with the three types of anti-TNFs treatment. In a matched model adjusted for clinical variables, the CCM was estimated to produce a 9.4% increase in the total percentage of adherent patients. Additionally, a statistically significant increase of 4.5% in the percentage of adherent patients treated with golimumab compared with etanercept and adalimumab was found. Conclusion: A CCM produced an important increase in the percentage of patients with rheumatoid arthritis adherent to treatment after 24 months of follow-up. It is noteworthy that Golimumab patients were more adherent when compared with other current anti-TNFs treatments.

Clinical suspicion of sarcopenic obesity and probable sarcopenic obesity in Colombian women with a history of surgical menopause: a cross-sectional study.

OBJECTIVES: To identify the frequency of clinical suspicion of sarcopenic obesity (CSSO) and probable sarcopenic obesity (PSO) and to estimate the association between them and surgical menopause. METHODS: A cross-sectional study carried out in women residing in Colombia, ages 60 to 75 years. Body mass index, the SARC-F scale, SARC-CalF < 31, and SARC-CalF <33 versions adding the calf circumference measurement in the last two were used to identify CSSO. Muscle strength measurement was added to the above measures to establish PSO. Surgical menopause was defined in women who underwent bilateral oophorectomy simultaneously with hysterectomy before natural menopause. Adjusted and unadjusted logistic regression were performed between CSSO or PSO with surgical menopause, bilateral oophorectomy after natural menopause, and abdominal hysterectomy with ovarian preservation. All participants provided informed consent. P < 0.05 was statistically significant. RESULTS: Seven hundred women 67.0 ±â€Š4.8 years old were included; 23.7% were obese, 68.1% had reduced muscle strength, and 4.2% had surgical menopause. CSSO was found in 3.0% with SARC-F and with SARC-CalF < 31; whereas 2.0% were found with SARC-CalF <33. PSO was found in 2.4%, 1.5%, and 2.2% with SARC-F, SARC-CalF <31, and SARC-CalF <33, respectively. Surgical menopause was associated with PSO but was not associated with CSSO. Bilateral oophorectomy after menopause and hysterectomy with ovarian preservation were not associated with CSSO or PSO. CONCLUSIONS: In a group of older adult women, the frequency of CSSO was up to 3.0% and PSO up to 2.4%. Surgical menopause was statistically significantly associated with PSO. On the contrary, CSSO was not associated.

Barriers and facilitators to provide multidisciplinary care for breast cancer patients in five Latin American countries: A descriptive-interpretative qualitative study.

Background: Multidisciplinary care (MDC) remains a cornerstone for breast cancer management as it is associated with improved quality of care and patient outcomes. However, the adoption of MDC practice is heterogeneous and has been poorly explored in Latin America. The objective was to describe barriers and possible facilitators for providing MDC to breast cancer patients in five Latin American countries. Methods: A panel of experts with an active clinical practice in Bolivia, Colombia, Ecuador, Mexico, and Uruguay was convened to identify barriers and facilitators to MDC. This study is a qualitative synthesis of a structured discussion regarding the state of MDC in the setting of breast cancer. Findings: Experts recognized that most oncology practices in Latin America do not apply a multidisciplinary approach for breast cancer patients. Predominant barriers for MDC are fragmentation of health services, being understaffed, inadequate infrastructure, and geographic disparities. Access to MDC varies widely in the region, with significant heterogeneity documented within countries. MDC practice was described as being more common in the private sector in Ecuador and Uruguay, while it is more widely implemented in public institutions of Colombia and Bolivia. Interpretation: Establishing quality MDC remains a challenge for oncology practices in Latin America. Addressing regional issues and identifying specific local needs is warranted to encourage the adoption of an effective multidisciplinary approach and, consequently, improve clinical outcomes. Active involvement of all stakeholders is required to build locally solutions and should involve institutions, health professionals, and patients. Funding: Research was funded by Productos Roche S.A.

Guía de práctica clínica para el tratamiento de la leucemia linfocítica crónica: guía para profesionales de la salud / Clinical practice guideline for the treatment of chronic lymphocytic leukemia: a guide for health care professionals

La leucemia linfocítica crónica (LLC) es una neoplasia caracterizada por la proliferación y acumulación clonal de células B maduras, que típicamente co-expresan los antígenos de superficie CD5 ­ CD23, dentro de la sangre, la médula ósea, los ganglios linfáticos, el bazo y otros tejidos . Esta patología es considerada el tipo de leucemia más común en personas adultas en países occidentales, y se considera una enfermedad de adultos mayores, con una mediana de edad al diagnóstico de 70 años .

Chronic lymphocytic leukemia (CLL) is a neoplasm characterized by the proliferation and clonal accumulation of mature B cells, which typically co-express the CD5 - CD23 surface antigens, within the blood, bone marrow, lymph nodes, spleen and other tissues. This pathology is considered the most common type of leukemia in adults in Western countries, and is considered a disease of older adults, with a median age at diagnosis of 70 years.

Guía de práctica clínica para el tratamiento de la leucemia linfocítica crónica / Clinical practice guideline for the treatment of chronic lymphocytic leukemia

La guía está dirigida al personal clínico asistencial especializado que brinda tratamiento a los pacientes con diagnóstico de LLC, en el contexto del SGSSS colombiano. Incluye a los siguientes profesionales potenciales: Hematólogos y Hematólogos-oncólogos. También está dirigida a los centros asistenciales que brindan cuidado a los pacientes con diagnóstico de LLC y a quienes toman decisiones administrativas, tanto en el medio hospitalario como en las aseguradoras, pagadores del gasto en la salud y en la generación de políticas de salud. Finalmente, las recomendaciones pueden ser de interés para pacientes con LLC, sus familiares y cuidadores. Se considera pertinente aclarar que la guía ofrecerá recomendaciones específicas frente a las preguntas definidas, y excede el alcance de esta, definir las competencias profesionales del equipo involucrado en el manejo de esta patología.

The guide is aimed at specialized clinical care personnel who provide treatment to patients diagnosed with CLL, in the context of the Colombian SGSSS. It includes the following potential professionals: hematologists and hematologist-oncologists. It is also addressed to health care centers that provide care to patients diagnosed with CLL and to administrative decision makers, both in the hospital environment and in the insurance companies, health care payers and health policy makers. Finally, the recommendations may be of interest to CLL patients, their families and caregivers. It is considered pertinent to clarify that the guide will offer specific recommendations in response to the questions defined, and it is beyond the scope of this guide to define the professional competencies of the team involved in the management of this pathology.

Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19 / Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19

Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.

Objetivo: elaborar una aproximación a la prevalencia de los problemas de sueño (PDS) en mujeres climatéricas colombianas durante la pandemia COVID-19. Materiales y Métodos: estudio transversal que pertenece al proyecto de investigación Calidad de Vida en la Menopausia y Etnias Colombianas bajo condiciones de pandemia [CAVIMEC+COVID STUDY]. Se incluyeron mujeres naturales y residentes en Colombia entre 40 y 59 años, quienes en los primeros cinco días de junio del 2020 participaron de forma anónima y voluntaria, previo consentimiento informado en el diligenciamiento de un formulario alojado en una plataforma virtual. Los PDS fueron identificados con el tercer ítem de Menopause Rating Scale. Se exploraron características sociodemográficas, la presencia y severidad de los PDS y el estado menopáusico. Se hace estadística descriptiva. Resultados: participaron 984 mujeres, la mediana de edad fue 47,0 [RIC: 42,0-53,5] años. El 84,5% de las participantes eran mestizas, el 13,7% afrodescendientes y 1,7% indígenas. El 39,3% posmenopáusicas. El 70% residían en la región caribe colombiana. Informaron PDS 637 (64,7%) de las participantes y 112 (11,3%) tenían PDS severos. Las posmenopáusicas informaron un 65,1% de PDS, en forma severa el 10,1%, y las premenopáusicas informaron 64,5%, en forma severa el 12,2%. Conclusiones: los PDS podrían ser un problema frecuente en las mujeres en estado premenopáusico y postmenopáusico. Se debe explorar este problema en la consulta ginecológica para ofrecer soluciones. Se requieren estudios poblacionales que confirmen estas observaciones.

Streptococcus agalactiae and genital ulcers in a heterosexual male / Streptoccoccus agalactiae y úlceras genitales en un varón heterosexual

Streptococcus agalactiae (S. agalactiae) is a microorganism that asymptomatically colonizes the female genital and gastrointestinal tracts of humans. It produces infections in extreme ages of life and in pregnant women. The case of an adult male is presented, with frequent heterosexual intercourse with different partners. He consulted for itching and burning in the penis' glans. His partner had marked vaginal dryness as a result of early ovarian failure. The patient had ulcerative, non-painful, erythematous lesions with raised edges and little yellow-green discharge. No Donovan bodies were found in the discharge smear and the culture was positive for S. agalactiae. His asymptomatic partner had negative microbiological tests. Both with negative serologies for Chlamydia, HIV and syphilis. No information was obtained from other sexual contacts. It cannot be ascertained that it was a venereal event, it is more likely that the injuries are related to repeated coital trauma.(AU)

Streptococcus agalactiae (S. agalactiae) es un microorganismo que coloniza asintomáticamente el tracto genital y gastrointestinal femenino de los seres humanos. Produce infecciones en edades extremas de la vida y en mujeres embarazadas. Se presenta el caso de un varón adulto, con frecuentes relaciones heterosexuales con diferentes parejas. Consultó por picazón y ardor en el glande del pene. Su pareja tenía una sequedad vaginal marcada como resultado de una insuficiencia ovárica precoz. El paciente presentaba lesiones ulcerosas, eritematosas, indoloras, con bordes elevados y escasa secreción de color amarillo verdoso. No se encontraron cuerpos de Donovan en el frotis de descarga y el cultivo fue positivo para S. agalactiae. Su pareja asintomática tuvo pruebas microbiológicas negativas. Ambos con serologías negativas para clamidia, VIH y sífilis. No se obtuvo información de otros contactos sexuales. No se puede determinar que fue un evento venéreo, es más probable que las lesiones estén relacionadas con traumatismos coitales repetidos. (AU)

Online assessment of the perception of loneliness and associated factors in Colombian climacteric women during the COVID-19 pandemic: A cross-sectional study.

Background: The coronavirus disease 2019 (COVID-19) pandemic has generated changes due to confinement, this measure can increase the perception of loneliness. The objective was to estimate the frequencies of emotional, social and general loneliness and their association with fear and anxiety with COVID-19, religiosity and severe deterioration of quality of life in middle-aged women. Methods: A cross-sectional study in Colombian women (40-59 y, n=984) surveyed with an electronic form that included sociodemographic characteristics and validated measures (Menopause Rating Scale, de Jong Gierveld Loneliness Scale, fear of COVID-19 scale, Coronavirus Anxiety Scale and Francis Scale for Religiosity). Associations of emotional, social and general loneliness (dependent variables) with severe somatic, psychological, urogenital and quality of life deterioration, as well as with high religiosity, anxiety and high fear of COVID-19 (independent variables), were estimated. Results: The median age was 47 years old, and 39.2% [95% CI: 36.2-42.3] postmenopausal. Severe deterioration in somatic, psychological, urogenital domains and quality of life in women with emotional, social and general loneliness was found (P <0.001). In adjusted models, high fear of COVID-19, severe deterioration of psychological and urogenital domains and quality of life were associated with emotional, social and general loneliness. Anxiety with COVID-19, somatic domain and high religiosity were not associated with loneliness. Conclusion: Emotional, social and general loneliness were identified in 4/10 middle-aged Colombian women surveyed, and the associated factors were high fear of COVID-19, severe deterioration of quality of life and psychological and urogenital domains. Professionals who care for climacteric women should explore the perception of loneliness when assessing menopausal symptoms.

Perceived Loneliness and Severe Sleep Disorders in Adult Women during the Covid-19 Quarantine: A Cross-Sectional Study in Colombia.

BACKGROUND: Quarantine is a measure to control COVID-19 spread, resulting in an increased perception of loneliness. In turn, sleep disorders (SD) may be more frequently reported in uncertain circumstances. OBJECTIVES: To identify the association between loneliness and severe SD, in women quarantined due to the COVID-19 pandemic. METHODS: A cross-sectional study carried out in women, between 40 and 79 years and living in Colombia. The women were invited through social network to complete 5 digital instruments: de Jong Gierveld Loneliness Scale, Menopause Rating Scale, Fear of COVID-19 Five-item Version, Coronavirus Anxiety Scale, and Francis Religion Scale. Bivariate analysis and adjusted logistic regression between loneliness and SD were performed. RESULTS: 1133 women participated, half of them under 50 years old. 43.1% had emotional loneliness, 39.9% social loneliness and 43.3% general loneliness. SD were identified in 6 out of 10 women, those with mild SD presented an OR of 1.84, 1.85, and 1.64, for emotional, social and general loneliness, respectively. Loneliness was associated twice with moderate SD, and more than twice with severe SD. Very severe SD reached OR:5.81 for emotional loneliness, OR:4.38 social loneliness and OR:4.02 general loneliness. In the presence of religiosity, fear and anxiety due to COVID-19, statistical significance was retained for associations, except intense SD with general loneliness. CONCLUSIONS: SD were significantly associated with loneliness in our study population. It is important to assess sleep quality and perception of loneliness in middle-aged women, especially during periods of quarantine due to a pandemic to avoid health implications.

Somnolencia diurna excesiva identificada con la escala de Epworth en gestantes que acuden a consulta prenatal ambulatoria / Excessive daytime sleepiness identified with the Epworth scale in pregnant women attending an outpatient prenatal consultation

INTRODUCCIÓN: Durante el embarazo se reportan a menudo trastornos del sueño, pero son poco explorados en el control prenatal. El objetivo fue estimar la frecuencia e identificar los factores asociados a somnolencia diurna excesiva (SDE) en gestantes de bajo riesgo obstétrico que acudieron a consulta prenatal. MÉTODO: Estudio transversal dentro del proyecto «Salud biopsicosocial en gestantes», aprobado por el comité de ética de la Clínica Santa Cruz de Bocagrande, Cartagena, Colombia. Se estudiaron mujeres con 12 o más semanas de gestación. Se aplicó un formulario que incluía las escalas de somnolencia diurna de Epworth (ESE), de estrés percibido de 10 ítems (EPP-10) y revisada de depresión del Centro de Estudios Epidemiológicos (CESD-R10). Se realizó regresión logística ajustada y no ajustada de SDE con las otras escalas y variables cualitativas. Se buscó correlación entre variables cuantitativas y la escala de Epworth. Se consideró significativo p < 0,05. RESULTADOS: Se estudiaron 683 mujeres de 28,3 ± 6,3 años y 31,5 ± 6,9 semanas de gestación. Puntuación en la escala de Epworth: 3,82 ± 3,45. En el 4,9% se identificó SDE: 50% leve, 32,2% moderada y 17,6% importante. No se observó en el primer trimestre de gestación y la frecuencia fue similar en los otros; la SDE importante solo se observó en el tercer trimestre. Depresión: odds ratio [OR]: 3,69, intervalo de confianza del 95% [IC95%]:1,83-7,43. Anemia: OR 3,10, IC95%:1,50-6,38. Fatiga: OR 3,22, IC95%:1,23-8,44. Nerviosismo: OR 2,49, IC95%:1,22-5,12. Estrés: OR: 2,38, IC95%:1,12-5,05. Gran paridad: OR: 2,64, IC95%: 1,01-6,89. Trabajar fuera de casa: OR: 2,33, IC95%: 1,05-5,15. Todas estas variables se asociaron con SDE. En el modelo ajustado, la anemia (OR: 3,05, IC95%: 1,44-6,45) y la depresión (OR: 2,72, IC95%: 1,26-5,85) conservaron la asociación. Se observó correlación positiva, despreciable y estadísticamente significativa, de la ESE con la CESD-R10 y con la EPP-10; y ausencia de correlación con la edad materna, la edad gestacional, el número de abortos y el número de cesáreas. CONCLUSIONES: En una de cada 20 gestantes de bajo riesgo obstétrico se identificó SDE, y varias situaciones biopsicosociales se asociaron con mayor presencia.

INTRODUCTION: Sleep disturbances are constantly reported during pregnancy, although they are not often taken care of in prenatal care. The aim was to estimate the regularity and identify factors associated with excessive daytime sleepiness (EDS) in pregnant women at low obstetric risk who attended prenatal consultation. METHOD: Cross-sectional study belonging to the project “Biopsychosocial health in pregnant women”, approved by the ethics committee of the Santa Cruz de Bocagrande Clinic, Cartagena, Colombia. Pregnant women with 12 or more weeks of gestation were studied. A form including: Epworth Daytime Sleepiness Scale, 10-item Perceived Stress and the Revised Depression Scale of the Centre for Epidemiological Studies was applied. Adjusted and unadjusted logistic regression was performed between EDS with the other scales and qualitative variables. In addition, correlation between quantitative variables and the Epworth scale. P<0.05 was significant. RESULTS: 683 pregnant women were studied, maternal age 28.3 ± 6.3 years and gestational age 31.5±6.9 weeks. Epworth Scale score: 3.82 ± 3.45. EDS was identified in 4.9%, 50% mild, 32.2% moderate and 17.6% severe. It was not observed in the first gestational trimester and the frequency was similar in the others, severe EDS only in the third trimester. Depression OR: 3.69 [95% CI: 1.83-7.43], anemia OR: 3.10 [95% CI: 1.50-6.38], fatigue OR: 3.22 [95% CI: 1.23-8.44], nervousness OR: 2.49 [95% CI: 1.22-5.12, stress OR: 2.38 [95% CI: 1.12-5.05], high parity OR: 2.64 [95% CI: 1.01-6.89] and working outside the home OR: 2.33 [95% CI: 1.05-5.15, were associated with EDS. In the adjusted model, anemia OR: 3.05 [95% CI: 1.44-6.45] and depression OR: 2.72 [95% CI: 1.26-5.85] retained the association. CONCLUSIONS: In one out of every twenty low obstetric risk pregnant women EDS was identified and several biopsychosocial situations were associated with more presence.

Prevalencia de Sífilis, Hepatitis B y Virus de Inmunodeficiencia Humana en población masculina privada de la libertad de un establecimiento carcelario en Bogotá-Colombia. Año 2019 / Prevalence of Syphilis, Hepatitis B and Human Immunodeficiency Virus in the male prison population in Bogotá, Colombia in 2019

Resumen Objetivo: Determinar la prevalencia de sífilis, hepatitis B y virus de la inmunodeficiencia humana en una población privada de la libertad de un establecimiento carcelario masculino de Bogotá D.C.-Colombia en 2019. Materiales y métodos: Se realizó un estudio de corte transversal en un establecimiento carcelario masculino de Bogotá, se incluyeron personas privadas de la libertad, mayores de 18 años. Los sujetos fueron sometidos a pruebas de detección de anticuerpos contra el Treponema pallidum, Antígenos de Superficie contra hepatitis B (HBsAg) y Virus de Inmunodeficiencia Humana (VIH) y respondieron un cuestionario estructurado para la descripción de conductas de riesgo. Resultados: Participaron 447 sujetos, ubicados en 7 pabellones del establecimiento carcelario. La prevalencia de sífilis fue del 5.8% (IC95% 3.8 - 8.4), del 1.1% para VIH (IC95% 0.4 - 2.6), y del 0.45% para hepatitis B crónica (IC95% 0.05 - 1.6). Discusión: A pesar de que la prevalencia documentada para estas patologías es más alta que en la población general, los resultados son más bajos que los reporta dos en instituciones de condiciones similares en otras latitudes. Se recomienda que el establecimiento continúe desarrollando políticas de promoción y prevención de estas patologías dentro de su población.

Abstract Objective: To determine the prevalence of syphilis, hepatitis B and the human immunodeficiency virus (HIV) in the male prison population in Bogotá, Colombia in 2019. Materials and methods: A cross-sectional study was carried out in a male prison center in Bogotá, in which sequential sampling, stratified by ward, included people deprived of liberty, over 18 years of age and who voluntarily agreed to participate in the investigation. Subjects underwent tests for antibodies to Treponema pallidum, Surface Antigens against hepatitis B (HBsAg) and Human Immunodeficiency Virus (HIV) and they answered a structured questionnaire for the description of risk behaviors. Results: A total of 447 subjects were included, belonging to 7 prison wards. The prevalence of syphilis was 5.8% (95% CI 3.8 - 8.4), 0.5% for chronic hepatitis B (95% CI 0.05 - 1.6) and 1.1% for HIV (95% CI 0.4 - 2.6). Discussion: Although the documented prevalence for these pathologies is higher than in the general population, the results are lower than those reported in other institutions with similar conditions in other latitudes. It is recommended that the institution continue to strengthen its policies for the promotion and prevention of these pathologies within its population.

Prevalencia de problemas de sueño en mujeres climatéricas colombianas durante la pandemia COVID-19 / Prevalence of sleep disorders in menopausal women during the COVID-19 pandemic in Colombia

RESUMEN Objetivo: Elaborar una aproximación a la prevalencia de los problemas de sueño (PDS) en mujeres climatéricas colombianas durante la pandemia COVID-19. Materiales y Métodos: Estudio transversal que pertenece al proyecto de investigación Calidad de Vida en la Menopausia y Etnias Colombianas bajo condiciones de pandemia [CAVIMEC+COVID STUDY]. Se incluyeron mujeres naturales y residentes en Colombia entre 40 y 59 años, quienes en los primeros cinco días de junio del 2020 participaron de forma anónima y voluntaria, previo consentimiento informado en el diligenciamiento de un formulario alojado en una plataforma virtual. Los PDS fueron identificados con el tercer ítem de Menopause Rating Scale. Se exploraron características sociodemográficas, la presencia y severidad de los PDS y el estado menopáusico. Se hace estadística descriptiva. Resultados: Participaron 984 mujeres, la mediana de edad fue 47,0 [RIC: 42,0-53,5] años. El 84,5% de las participantes eran mestizas, el 13,7% afrodescendientes y 1,7% indígenas. El 39,3% posmenopáusicas. El 70% residían en la región caribe colombiana. Informaron PDS 637 (64,7%) de las participantes y 112 (11,3%) tenían PDS severos. Las posmenopáusicas informaron un 65,1% de PDS, en forma severa el 10,1%, y las premenopáusicas informaron 64,5%, en forma severa el 12,2%. Conclusiones: Los PDS podrían ser un problema frecuente en las mujeres en estado premenopáusico y postmenopáusico. Se debe explorar este problema en la consulta ginecológica para ofrecer soluciones. Se requieren estudios poblacionales que confirmen estas observaciones.

ABSTRACT Objective: To make an approximation to the prevalence of sleep disorders in Colombian menopausal women during the COVID-19 pandemic. Materials and Methods: Cross-sectional study as part of the Quality of Life in Menopause and Colombian Ethnic Groups research project [CAVIMEC+COVID STUDY]. The population consisted of women born and residing in Colombia, 40 to 59 years of age, who signed an informed consent and agreed to participate by completing an online form, freely and anonymously, in the first five days of June 2020. Sleep disorders were identified using the third item on the Menopause Rating Scale. Sociodemographic characteristics, presence and severity of sleep disorders and menopause status were explored. Descriptive statistics are provided. Results: Overall, 984 women aged 47.0 [IQR: 42.0-53.5] years were included: 84.5% mestizo, 13.7% Afro-Colombian, 1.7% indigenous; 39.3% were postmenopausal; 70% lived in the Caribbean region of Colombia. Sleep disorders were reported by 637 women (64.7%), and 112 (11.3%) had severe sleep disorders. Among postmenopausal women, 65.1% reported sleep disorders with 10.1% reporting severe disorders, while 64.5% of premenopausal reported sleep disorders, and 12.2% severe disorders. Conclusions: Sleep disorders could be a frequent problem among premenopausal as well as postmenopausal women in the pandemic time. This issue should be explored during gynecological visits in order to offer solutions. Population studies that confirm these observations are required.