Aligning outcomes: DLBCL prognosis at a 4th Level University Hospital in Bogotá is comparable to high-income nations, identification of additional prognostic markers for overall survival and relapse.

Introduction: Diffuse large B-cell lymphoma (DLBCL), a prevalent non-Hodgkin lymphoma subtype, displays diverse clinical outcomes with persistently high mortality and relapse rates, despite treatment advancements. Notably, the Hispanic demographic lacks consideration in existing prognostic indices for DLBCL. Methods: A retrospective cohort study encompassing 112 DLBCL patients diagnosed between 2010 and 2020 was conducted at our institution. Patient data, including overall survival (OS), treatment response, and relapse, were analysed. Results: With a median age of 65 years and a predominant male population (60.7%), both the International Prognostic Index (IPI) and revised IPI correlated with OS. In multivariate analysis, patients with ki-67 ≥ 60% exhibited higher mortality risk (Hazard Ratio: 2.35, 95% confidence intervals (CI) 1.05-5.27, p = 0.039), even when controlled by IPI category and B2-microglobulin levels. The absence of B symptoms served as a protective factor for relapse (p < 0.01, OR: 0.147, 95% CI 0.058-0.376) when controlling for ki-67, CD5, and IPI. Conclusion: Our cohort demonstrated a 5-year OS rate comparable to high-income countries, highlighting the need for tailored prognostic models for Hispanic DLBCL patients. This study identifies easily accessible parameters aligning with regional resource constraints, providing insights into additional prognostic factors for DLBCL in the Hispanic population.

A Novel Digital Educational Strategy Improves Treatment Adherence and Quality of Life in Patients with Multiple Myeloma.

Multiple myeloma, the second most common hematologic malignancy worldwide, is an aggressive disease with high morbidity and mortality rates. Although myeloma remains incurable, new treatments have improved patients' life expectancy and quality of life. However, as these therapies are administered for prolonged and often indefinite periods, their success depends on high treatment adherence and significant patient engagement. This study aimed to evaluate the impact of a novel digital educational strategy on treatment adherence, quality of life, and the development of complications in patients with newly diagnosed myeloma. To this end, a two-arm, randomized, prospective, double-blind study was conducted to compare the conventional educational approach alone or combined with the novel digital strategy. This strategy was based on some principles of the Persuasive Systems Design model and incorporated the educational recommendations of patients and caregivers. Compared to the control group that only received information through the conventional educational approach, patients randomized to the digital strategy showed significantly higher treatment adherence and quality of life, associated with increased functionality and rapid reincorporation into daily routines. The digital strategy empowered patients and caregivers to understand the disease and therapeutic options and helped patients recall treatment information and implement healthy lifestyle habits. These results support that patient-targeted educational strategies can positively influence treatment adherence and thus improve their quality of life.

A Patient With Human Herpesvirus 8-Positive Multicentric Castleman's Disease Who Met Criteria for TAFRO Syndrome: Controversy in Practice?

Multicentric Castleman's disease (MCD) is a known entity with characteristics of lymphoproliferative syndrome, characterized by cytokine activation. Its association with human immunodeficiency virus (HIV) is frequently described, as well as its positivity for human herpesvirus 8 (HHV-8). However, some negative patients for the latter (called idiopathic MCD), may have an aggressive spectrum of the disease (characterized by the presence of cytopenia, renal failure, anasarca and organomegaly), known as TAFRO syndrome (thrombocytopenia, anasarca, myelofibrosis, renal dysfunction, and organomegaly). We present the case of a young patient recently diagnosed with HIV infection, in whom MCD was found, and with an aggressive course despite treatment, who met criteria for TAFRO syndrome despite HHV-8 positivity.

Edema pulmonar inducido por las alturas / High altitude pulmonary edema

El edema pulmonar inducido por las alturas hace parte del grupo de enfermedades inducidas por la altitud. En la actualidad existen numerosas inquietudes en su fisiopatología, manifestaciones clínicas y tratamiento. En el presente artículo se revisa la literatura disponible hasta el momento de esta enfermedad, pretendiendo aclarar estos aspectos. Además, se hace referencia a los resultados de estudios realizados en Colombia, con el fin de orientar un manejo adecuado de estos pacientes en nuestro medio.

Interpretación clínica de anticuerpos anti-estreptococo en fiebre reumática / Streptococcal antibody test clinical interpretation in rheumatic fever

La Fiebre Reumática es una complicación no supurativa de la infección por Streptocococus pyogenes. Es una enfermedad prevalente con una tasa importante de morbilidad y mortalidad en países en desarrollo. El diagnóstico de Fiebre Reumática tanto en el episodio agudo como en la recurrencia se apoya en criterios clínicos sumado a la evidencia serológica de infección previa por estreptococo beta hemolítico del grupo A. Los anticuerpos anti-estreptococo disponibles comercialmente son los anticuerpos anti-estreptolisina O (ASTO) y los anticuerpos anti- DNAasa B (anti-DNAasa B). Estos deben ser analizados teniendo en cuenta la edad del paciente, el tipo de infección, las comorbilidades asociadas, los títulos de anticuerpos, el tratamiento antibiótico previo y el momento en el cual se toman las muestras para la medición de estos. En este artículo se realiza una revisión de la literatura disponible con el objetivo de determinar la utilidad e interpretación de las pruebas de anti-estreptolisina O y anti-DNAsa B.

Interpretación de la PPD, fundamentos fisiopatologicos y enfoque práctico / PPD interpretation: physiopathology background and practice assessment

La Tuberculosis (TB) es un problema de salud pública, y la PPD (Tuberculina) se constituye en una herramienta para la detección de la TB latente. La interpretación de la PPD a través de un modelo que involucre el componente fisiopatológico, el sistema inmune del paciente y sus factores de riesgo permite una decisión correcta sobre tratar o no una TB latente de alta prevalencia de TB. En esta revisión se introduce un modelo racional de interpretación de la Tuberculina.