Diagnosis and outcomes of pregnant women with Zika virus infection in two municipalities of Risaralda, Colombia: Second report of the ZIKERNCOL study.

BACKGROUND: Zika virus (ZIKV) infection has emerged as a significant threat for pregnant women and newborns in populations living in or visiting Latin America. We previously reported a preliminary analysis in Sucre, Colombia, as the first group of pregnant women with RT-PCR-confirmed ZIKV (ZIKa enEmbarazadas yReciénNacidos enCOLombia, ZIKERNCOL). METHODS: In this second report, findings of the first 86 pregnant women from La Virginia and Dosquebradas (municipalities), Risaralda, Colombia, with RT-PCR-confirmed ZIKV infection are reported. Clinical, demographical and obstetrical findings are described. RESULTS: All women reported ZIKV symptoms during pregnancy: 79.1% rash, 55.8% fever, among others. In addition to ZIKV, RT-PCR was positive for dengue in 18.6%; 45.3% Dengue IgM+; 5.8% RT-PCR positive for chikungunya; 3.6% Chikungunya IgM+. STORCH screening in mother: 11.6% IgG + anti-Toxoplasma gondii, 6% IgG + anti-rubella, 4.7% IgG + CMV. The rest of STORCH tests were negative. Microcephaly was observed in 2.4% of the newborns. No calcifications or other CNS alterations were detected. One newborn had cleft palate and one had bilateral renal ectopy. CONCLUSIONS: The rate of microcephaly in our cohort was consistent with other studies. Pregnant women in endemic areas should be followed and tested according to standard protocols, and asymptomatic ZIKV infection should be considered. Long-term follow-up of children is required in the congenital Zika syndrome (CZS) assessment.

Clínica y tratamiento de la diabetes tipo 2 en adultos jóvenes en un hospital colombiano / Clinical presentation and treatment of type 2 diabetes in young adults in a Colombian hospital

Resumen Introducción: la diabetes mellitus tipo 2 (DM2) es el tipo más común de diabetes la cual ocurre generalmente en adultos, sin embargo, hay reportes que la describen en adolescentes y adultos jóvenes. Objetivo: describir las características clínicas y el tratamiento de la diabetes tipo 2 en adultos jóvenes en un hospital colombiano. Material y métodos: estudio de corte transversal entre el 2017 y 2019, que incluyó pacientes adultos jóvenes entre 18 y 40 años con DM2, que fueron atendidos en el Hospital Santa Mónica de Dosquebradas, Colombia. La unidad de análisis fueron las historias clínicas. Se incluyeron variables sociodemográficas, clínicas, farmacológicas y control metabólico (HbAlc < 7.0%). Se realizaron análisis descriptivos y se aplicó una regresión logística binaria (p< 0.05). Resultados: se identificaron 124 pacientes de los cuales 83 (70.0%) cumplieron criterios de inclusión, con una edad media de 33.7 ± 5.3 años. Unos 28 pacientes eran obesos (33.7%). Además, 21 pacientes (25.3%) presentaron control metabólico. Los fármacos más usados fueron metformina en 64 pacientes (77.1%), seguido de las insulinas en 46 pacientes (55.4%). Se estableció que 51 de estos (61.4%) presentaron adherencia al tratamiento. No hubo pacientes con terapia triple como estrategia terapéutica. Los pacientes con retinopatía diabética presentaban una probable asociación con tener control de la enfermedad en el momento del estudio (P=0.048, OR:0.130; IC95%:0.017-0.987). Conclusiones: los pacientes adultos jóvenes presentan pobre control metabólico y uso frecuente de insulinas. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1902).

Abstract Introduction: type 2 diabetes mellitus (T2DM) is the most common type of diabetes, generally occurring in adults. However, there are reports which describe it in adolescents and young adults. Objective: to describe the clinical characteristics and treatment of type 2 diabetes in young adults in a Colombian hospital. Materials and methods: a cross-sectional study from 2017 to 2019 which included young adult patients between 18 and 40 years old with T2DM who were seen at Hospital Santa Mónica in Dosquebradas, Colombia. The unit of analysis was the medical charts. Sociodemographic, clinical, pharmacological and metabolic control (HbA1c < 7.0%) variables were included. Descriptive analyses were performed, and binary logistic regression was applied (p<0.05). Results: 124 patients were identified, 83 (70.0%) of whom met the inclusion criteria, with a mean age of 33.7 ± 5.3 years. Some 28 patients were obese (33.7%). In addition, 21 patients (25.3%) had metabolic control. The most frequently used medications were metformin in 64 patients (77.1%), followed by insulin in 46 patients (55.4%). It was determined that 51 of these patients (61.4%) were compliant with treatment. No patients received triple therapy as a therapeutic strategy. Patients with diabetic retinopathy had a probable association with having the disease controlled at the time of the study (P=0.048, OR:0.130; 95%CI:0.017-0.987). Conclusions: young adult patients have poor metabolic control and frequent use of insulins. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1902).

Caracterización de los pacientes en una consulta de hipertensión arterial de Dosquebradas: Risaralda-Colombia: 2008-2012 / Patients characterization in one high blood pressure consultation from Dosquebradas: Risaralda-Colombia: 2008-2012

El objetivo fue describir las características de los pacientes evaluados en la consulta de hipertensión arterial del Hospital Santa Mónica de Dosquebradas, Risaralda, Colombia, atendidos en el período 2008-2012. Estudio observacional descriptivo realizado en el Hospital Santa Mónica de Dosquebradas, Risaralda, Colombia. Los pacientes corresponden a la población atendida en el programa de detección de hipertensión arterial con sospecha de la enfermedad que fueron ingresados a la consulta de hipertensión arterial del Hospital. Se evaluaron variables demográficas y clínicas, incluyendo presión arterial sistólica y diastólica, entre otras. De un total de 8900 pacientes con evaluación de la presión arterial en el período, se atendieron en promedio 1780 por año (±934), el promedio por mes durante el período fue de 148 pacientes (intervalo 93-286). De los pacientes 73,3% correspondió al sexo femenino y 26,7% al masculino. La edad promedio de los mismos fue de 62,91 años (±13,09). Del total de pacientes, 92,57% (IC95% 92,02-93,12) presentaban valores de prehipertensión/hipertensión arterial, siendo mayor en las mujeres de > igual 70 años (93,7%) que en las mujeres < 70 años (92,1%) (OR=1,269; IC95% 1,026-1,569). No se observaron diferencias significativas por edad en los pacientes del sexo masculino. El presente estudio permitió caracterizar una población de casi 9000 pacientes que acudieron a la consulta de hipertensión arterial del hospital de referencia del municipio durante 5 años, del cual no existen estudios previos y que muestra una considerable proporción de población con alteraciones de la presión arterial, especialmente en mujeres de más de 70 años.

The objetive was to describe the characteristics of patients evaluated at the high blood pressure consultation of the Hospital Santa Monica, Dosquebradas, Risaralda, Colombia, attended between 2008-2012. Observational, descriptive study realized in the Hospital Santa Monica,Dosquebradas, Risaralda, Colombia. The patients comes from the population attended at the hypertension screening program with disease who were admitted to the Hospital with high blood pressure diagnosis. We evaluated demographic and clinical variables, including systolic and diastolic blood pressure, among others. Results: from a total of 8900 patients with blood pressure assessment in the period, were attended on average 1780 per year(±934), the average per month during the period was 148 patients (range 93-286). Of the patients 73.3% were female and 26.7% male. The average age of them was 62.91 years (±13.09). Of the patients, 92.57% (95%CI 92.02-93.12) had values of prehypertension/hypertension, being higher in women < igual 70 years (93.7%) that in woman < 70 years (92.1%) (OR=1.269;95% CI 1.026-1.569). There were no significant differences by age in male patients. This study allowed us to characterize a population of nearly 9000 patients who were attended at the reference hospital of municipality for five years, of which there are no previous studies that show a considerable proportion of the population with blood pressure changes, especially in women over 70 years.