Predominio del subtipo molecular Luminal B en un grupo de mujeres con cáncer de mama infiltrante del Eje Cafetero de Colombia: Análisis por técnica de inmunohistoquímica / Predominance of the Luminal B molecular subtype in a group of women with infiltrating breast cancer from the Coffee Region of Colombia: Analysis by immunohistochemistry

Resumen El cáncer de mama es el cáncer más frecuente en las mujeres y constituye un problema de salud pública debido a sus altas tasas de morbimortalidad. El diagnóstico se hace a través de estudios rutinarios de histopatología que se complementan con estudios de expresión de receptores hormonales (Receptores de Estrógenos y Progesterona), del factor de crecimiento epidérmico humano 2 (HER2) e índice de proliferación celular (Ki67) para su subtipificación en grupos moleculares (Luminal A, Luminal B, Her2 y triple negativo), los cuales tienen implicaciones pronósticas y terapéuticas diferentes. Globalmente, se ha reportado una alta prevalencia del subtipo Luminal A, predominantemente en Norteamérica, Europa y algunos países latinoamericanos, sin embargo, los reportes en la población colombiana son heterogéneos. El objetivo de esta investigación es establecer un perfil de incidencia de dichos subtipos moleculares en una población del eje cafetero en Colombia. Retrospectivamente se analizaron muestras de 377 pacientes con diagnóstico de cáncer de mama infiltrante, entre los años 2015 a 2018. Los diagnósticos histológicos incluyeron: Carcinomas Ductal infiltrante NOS (339 casos; 89.9 %), lobulillar infiltrante (23 casos; 6.1 %), mucinoso infiltrante (6 casos; 1.5 %), papilar infiltrante (1 caso; 0.2 %) y patrones mixtos: ductal-lobulillar (3 casos; 0.7 %) y ductal con componente mucinoso (5 casos; 1.3 %), de los cuales 56.2 % (212 casos) corresponden a luminal B, 22.2 % (84 casos) a Luminal A, 14.8 % (56 casos) a triple negativo y 6.6 % (25 casos) a HER2. Estos hallazgos contrastan con la prevalencia reportada a nivel mundial. Por lo tanto, en la población del eje cafetero colombiano, se debe considerar este predominio del patrón luminal B al momento de establecer pronóstico y tratamiento por parte del personal médico tratante.

Abstract Breast cancer is the most common cancer in women and constitutes a public health problem due to its high rates of morbidity and mortality. Diagnosis is made through routine histopathology studies that are complemented by expression studies of hormone receptors (Estrogen and Progesterone Receptors), human epidermal growth factor 2 (HER2) and cell proliferation index (Ki67) for their subtyping into molecular groups (Luminal A, Luminal B, Her2 and triple negative), which have different prognostic and therapeutic implications. Globally, a high prevalence of the Luminal A subtype has been reported, predominantly in North America, Europe, and some Latin American countries; however, the reports in the Colombian population are heterogeneous. The objective of this research is to establish an incidence profile of these molecular subtypes in a population of the coffee region in Colombia. In retrospect, samples of 377 patients with a diagnosis of infiltrating breast cancer were analyzed, between the years 2015 and 2018. The histological diagnoses included: NOS infiltrating ductal carcinomas (339 cases; 89.9 %), infiltrating lobular (23 cases; 6.1%), infiltrating mucinous (6 cases; 1.5%), infiltrating papillary (1 case; 0.2%) and mixed patterns: ductal - lobular (3 cases; 0.7%) and ductal with mucinous component (5 cases; 1.3%), of which 56.2% (212 cases) correspond to luminal B, 22.2% (84 cases) to Luminal A, 14.8% (56 cases) to triple negative and 6.6% (25 cases) to HER2. These findings contrast with the prevalence reported worldwide. Therefore, in the population of the Colombian coffee region, this predominance of the luminal pattern B should be considered when establishing prognosis and treatment from medical staff.

Prevalencia y factores asociados al consumo de marihuana en adolescentes escolarizados de Colombia, en el 2016 / Prevalence and factors associated with marijuana use in school adolescents in Colombia, in 2016

Resumen Introducción: La marihuana es concebida como una droga de bajo riesgo, considerada ilegal en Colombia, si bien es la más consumida por los adolescentes. Objetivo: Describir la prevalencia y examinar los factores asociados al consumo de marihuana durante los últimos 30 días por adolescentes escolarizados de Colombia. Método: Estudio transversal analítico. Muestra constituida por 80.018 adolescentes escolarizados entre 12 y 18 años. Se considera "adolescente consumidor de marihuana", a aquél que declaró haberla consumido durante los últimos treinta días. Se tuvieron en cuenta variables de interés, el sexo, la edad, el tipo de colegio, los episodios de ideación suicida y autolesión deliberada, la existencia de problemas de rendimiento académico y disciplinarios. Se realizó una descripción de la prevalencia de marihuana por cada una de las variables de interés. Se estimaron asociaciones por medio de modelos lineales generalizados, todos los análisis fueron ajustados por el factor de expansión. Resultados: La prevalencia de consumo de marihuana en los últimos 30 días fue del 4,3 % (IC 95 % 4,1 %- 4,6 %). Las mayores prevalencias de consumo se registraron en adolescentes que habían reportado 3 o más veces de ideación suicida en los últimos 12 meses, y en aquellos que acusaron 3 o más veces de autolesión deliberada en los últimos 12 meses (10,4 % y 10,0 %, respectivamente). Se encontró una asociación con todas las variables estudiadas. Conclusiones: Se evidenció una fuerte asociación entre el consumo de marihuana y presencia de episodios de autolesiones deliberadas y episodios de ideación suicida en adolescentes escolarizados.

Summary Introduction: Marijuana is conceived as a low-risk drug, considered illegal in Colombia, and the most consumed by adolescents. Objective: To describe the prevalence and examine the factors associated with marijuana use during the last 30 days by adolescents in school in Colombia. Method: Cross-sectional analytical study. Sample is 80,018 adolescents in school between 12 and 18 years of age. An "adolescent user of marijuana" is one who declared having used it during the last thirty days. Variables of interest were considered: sex, age, type of school, episodes of suicidal ideation and deliberate self-harm, the existence of academic and disciplinary performance problems. A description of the prevalence of marijuana was made for each of the variables of interest. Associations were estimated using generalized linear models, all analyzes were adjusted for the expansion factor. Results: The prevalence of marijuana use in the last 30 days was 4.3% (95% CI 4.1%-4.6%). The highest prevalence of consumption was recorded in adolescents who had reported 3 or more times of suicidal ideation in the last 12 months, and in those who accused 3 or more times of deliberate self-harm in the last 12 months (10.4% and 10. 0%, respectively). An association was found with all the variables studied. Conclusions: A strong association was found between marijuana use and the presence of episodes of deliberate self-harm and episodes of suicidal ideation in school adolescents.

Prevalencia y factores asociados al consumo de marihuana en universitarios de Colombia en el año 2016

Introducción: El consumo de marihuana toma un singular interés en el contexto de la universidad y en los universitarios, pues su uso podría ser parte de las relaciones sociales con sus pares. Objetivo: Describir la prevalencia y examinar los factores asociados al consumo de marihuana durante los últimos treinta días en estudiantes universitarios de Colombia durante 2016. Método: Estudio transversal analítico. Se realizó un análisis con 9555 universitarios colombianos. Fue considerado como consumidor de marihuana el universitario que manifestó haberla consumido durante los últimos treinta días. Se tomaron como variables de interés el sexo, la edad, la percepción de la situación económica, los problemas académicos y disciplinarios en la secundaria y las características de control parental. Para el análisis se reportó la prevalencia de la marihuana por cada una de las características estudiadas. Las asociaciones fueron estimadas a través de modelos lineales generalizados, tales análisis se ajustaron por el factor de expansión. Resultados: Se halló que el 9,7 % (IC 95 % 9,1 %- 10,4 %) había consumido marihuana en los últimos treinta días; los hombres (OR 2,23 IC95 % 1,92 - 2,59), aquellos que acusaron no tener control parental sobre los amigos (OR 2,32 IC95 % 1,58- 3,41) y que confesaron haber tenido problemas disciplinarios en la secundaria (OR 3,35 IC95 % 2,67-4,19), mostraron asociación con el consumo de marihuana. Conclusiones: La prevalencia de consumo de marihuana en estudiantes universitarios es elevada con respecto a otros países de la región. Destacan características como la presencia de problemas académicos o disciplinarios en la secundaria, así como un pobre control parental; ellas mostraron que tenían mayor relación con el consumo de marihuana entre los universitarios indagados.

Introduction: The consumption of marijuana takes on a singular interest in the context of the university and university students, because its use could be a part of relationships with their peers. Objective: To describe the prevalence and examine the factors associated with marijuana use during the last thirty days, in university students in Colombia, during the year 2016. Method: Cross-sectional analytical study. An analysis was carried out with 9555 Colombian university students. The university student who stated that he had used it during the last thirty (30) days was considered a marijuana user. The studied variables were sex, age, perception of the economic situation, academic and disciplinary problems in high school, and the characteristics of parental control. For analysis, the prevalence of marijuana was reported for each of the characteristics studied. The associations were estimated through generalized linear models; all analyzes were adjusted by the expansion factor. Results: It was found that 9.7% (95% CI 9.1%-10.4%) had used marijuana in the last thirty days; men (OR 2.23 CI95% 1.92 - 2.59), those who reported not having parental control over friends (OR 2.32 CI95% 1.58-3.41) and who confessed to having had disciplinary problems in high school (OR 3.35 CI95% 2.67-4.19) were associated with marijuana use. Conclusions: The prevalence of marijuana use in university students is high, compared to other countries in the region. They highlight characteristics such as the presence of academic or disciplinary problems in high school, as well as poor parental control; they showed that they had a greater relationship with the use of marijuana among the university students surveyed.

Autolesiones deliberadas y consumo de sustancias psicoactivas en adolescentes escolarizados de Colombia 2016 / Deliberate self-harm and psychoactive substance use in colombian school adolescents

BACKGROUND: Deliberate self-harm and the consumption of psy- choactive substances are important public health problems among adolescents. AIM: To determine the association of deliberate self-harm with the consumption of psychoactive substances, in school adolescents in Colombia. MATERIAL AND METHODS: A survey about deliberate self harm and psychoactive substance use during the last 12 months was answered by 80 018 adolescents aged between 12 and 18 years. RESULTS: The prevalence of deliberate self-harm in the last 12 months was 14.1%. The use of psychoactive drugs was associated with deliberate self-harm. The greatest association was observed with the use of non-prescription tranquilizers (Odds ratio 4.05 95% confidence intervals 3.42-4.81). CONCLUSIONS: We observed an association between deliberate self-harm and the consumption of different psychoactive substances.

Evaluación de anquiloglosia y lactancia materna en lactantes de 0 a 24 meses / Evaluation of ankyloglossia and breastfeeding in 0-24-month infants / Avaliação da anquiloglossia e da amamentação em lactentes de 0 a 24 meses

Introducción. La anquiloglosia es una condición limitante que en algunos casos no interfiere en la lactancia y genera adaptaciones anatomofisiológicas del frenillo al seno materno, el cual se presenta más elástico y menos fibroso. El objetivo fue establecer si existe relación entre las alteraciones del frenillo lingual y la lactancia materna. Materiales y métodos. Investigación descriptiva correlacional de corte transversal. La población objeto de estudio fue evaluada mediante el Protocolo de evaluación del frenillo de la lengua con puntuación para bebés. Resultados. Se identificó un 29% de prevalencia en las alteraciones del frenillo lingual. La anatomofisiología del frenillo y la succión son dependientes y estadísticamente significantes. Conclusiones. La lactancia materna y la anatomofisiología del frenillo lingual alterado, conocido como anquiloglosia, guardan una fuerte relación de dependencia, ya que ante la presencia de anquiloglosia no se produce un agarre adecuado del pezón en la cavidad oral. No obstante, en algunos casos se ha comprobado que los lactantes realizan procesos de adaptación para suplir las dificultades en la movilidad lingual y alimentarse.

Introduction. Ankyloglossia appears as a limiting condition, in some cases it does not interfere with lactation, presenting anatomophysiological adaptations of the frenulum to the mother's breast; it is more elastic and less fibrous. The objective was to establish whether there is a relationship between lingual frenulum alterations and breastfeeding. Methods. Cross-sectional correlational descriptive research. The population under study was evaluated through the "Protocol for evaluating the frenulum of the tongue with scores for babies". Results. A 29% prevalence of alterations in the lingual frenulum was identified, the anatomophysiology of the frenulum and suction are dependent and statistically significant. Conclusions. Breastfeeding and the anatomophysiology of the altered lingual frenulum known as ankyloglossia are strongly dependent, since in the presence of ankyloglossia there is not an adequate grip of the nipple in the oral cavity; however, in some cases it has been It has been proven that infants carry out adaptation processes in order to compensate for difficulties in tongue mobility and feeding.

Introdução. A anquiloglossia é uma condição limitante que em alguns casos não interfere na lactação e gera adaptações anatomofisiológicas do frênulo à mama da mãe, que é mais elástica e menos fibrosa. O objetivo foi estabelecer se existe relação entre as alterações do frênulo lingual e a amamentação. Materiais e métodos. Pesquisa descritiva e correlacional de corte transversal. A população em estudo foi avaliada por meio do protocolo de avaliação do frênulo da língua com pontuação para bebês. Resultados. Identificou-se prevalência de 29% nas alterações do frênulo lingual. A anatomofisiologia do frênulo e da sucção são dependentes e estatisticamente significativas. Conclusões. A amamentação e a anatomofisiologia do frênulo lingual alterado, conhecido como anquiloglossia, apresentam forte relação de dependência, visto que na presença de anquiloglossia não há pega adequada do mamilo na cavidade oral. No entanto, em alguns casos, descobriu-se que os bebês realizam processos de adaptação para superar as dificuldades de mobilidade da língua e alimentação.

Análisis fenoménico de la técnica neuromuscular funcional como tratamiento para el SAOS / Phenomenical Analysis of the Functional Neuromuscular Technique as a Treatment for OSA

Introducción: el objetivo de este estudio es develar si la técnica Neuromuscular Funcional (NMF) puede ser considerada como opción de tratamiento en el Síndrome de Apnea Obstructiva de Sueño (SAOS) y si se complementa con la Terapia Miofun-cional Orofacial o hace parte de ella.Métodos: la fenomenología trascendental de Husserl es el enfoque metodoló-gico que se adoptó para este estudio, siguiendo la ruta para su desarrollo: epojé, reducción trascendental fenomenológica y síntesis. El contenido real se obtuvo mediante dos entrevistas semiestructuradas, aplicadas a un informante clave que contó con los criterios de inclusión presupuestados. Resultados: en la primera etapa se identificaron 10 noesis y 266 noemas, que fue-ron relacionados entre sí; en la fase de reducción trascendental las noesis se redujeron a 5 y los noemas a 14. Análisis y discusión: el Método Chiavaro como fenómeno se decanta en las di-mensiones: (a) Enfoque Sistémico, (b) Técnica Neuromuscular Funcional y (c) Téc-nica Respiratoria. La prioridad del fenómeno NMF es la explicación de la alteración dentro del enfoque sistémico a partir de la lógica Función-Estructura-Función, de esta manera el SAOS se considera una manifestación de esas relaciones y como tal se le cataloga como adaptación o como función en disfunción.Conclusiones: la Técnica NMF hace parte de la neurorrehabilitación mientras que la TMO para intervenir el SAOS se inscribe en la fisiología del ejercicio

Introduction: the objective of this study is to reveal if the Functional Neuromuscu-lar technique (In Spanish: NMF) can be considered as a treatment option for OSA. Additionally, this paper seeks to assess if the aforementioned is derived from, a por-tion of or if it is complemented by Orofacial Myofunctional Therapy (OMT). Methods: Husserl's transcendental phenomenology is the methodological approach that was adopted for this study, following the path to its development: epoché, phenomenologi-cal transcendental reduction and synthesis. The actual content was obtained through two semi-structured interviews applied to a key informant who met the preconceived inclusion criteria.Results: in the first stage 10 noesis and 266 noems , which were related to each other, were identified; in the phase of transcendental reduction, the noesis were reduced to 5 and the noems to 14. Analysis and discussion: the Chiavaro Method as a phenomenon is composed of three dimensions: (a) Systemic Approach, (b) Functional Neuromuscular Technique and (c) Respi-ratory Technique. The priority of the NMF phenomenon is the explanation of the alteration within the systemic approach based on the Function-Structure-Function logic, ergo the OSA is considered a manifestation of these relationships and as such it is classified as adaptation or as a function in dysfunction.Conclusions: the NMF technique is a part of neurorehabilitation whilst OMT for the in-tervention of OSA is subscribed to the physiology of exercise.

Prevalencia de vida y factores asociados al consumo de marihuana en estudiantes escolarizados de Pamplona-Colombia, durante el primer período de 2015: estudio Emtamplona / Marijuana consumption among Colombian adolescents

Background: Marijuana consumption is a public health problem. Aim: To determine the life time prevalence of marijuana use among Colombian adolescents and the factors associated with its consumption. Material and Methods: Secondary analysis of data from a study aimed to determine the prevalence of smoking. A self-administered and anonymous questionnaire was answered by 814 adolescents aged 14 ± 2 years (439 women). Results: Ten percent of respondents consumed marijuana at least once in their life. A logistic regression analysis showed that professing a non-christian religion, being smoker and having an age over 12 years, was associated with marijuana consumption. Conclusions: There is a high frequency of marijuana use among these adolescents.