Aesthetic Rib Cage Remodeling with Osteosynthesis: Body Structural High-Definition Reshaping (RIBOSS).

BACKGROUND: Rib cage remodeling has shown promising aesthetic results as a new technique for body contouring yet risks and complications associated with the procedure have not been well established. The aim of our study is to assess safety, efficacy and patient satisfaction rate associated with a new surgical technique for waistline definition. METHODS: We looked into our records for patients who underwent waist narrowing through a new rib remodeling procedure with osteosynthesis of the 11th and 12th ribs; from October 2022 to June 2023. Follow up was carried out at 1 and 3 months after surgery. Outcomes were evaluated based on waist and hip measures, body images, pain and a patient satisfaction survey. RESULTS: A total of 27 consecutive patients were included in the analysis. Our technique resulted in a significant reduction in waist circumference, as evidenced by a decrease of 12.1 cm and 13.0 cm at the first and third month respectively (p<0.005). A reduction of hip circumference of 6.2 cm and 8.7 cm was also reported. A high patient satisfaction rate was reported. Postoperative complications included only one case of wound dehiscence and one case of mild pain. Pain levels were also reduced, with a mean pain score of 2.4 at week 1 and 0.26 at month 1. CONCLUSION: Rib osteotomy with osteosynthesis emerges as an innovative, safe, and reliable approach for waist narrowing. Our results suggest that this technique can be applied to a wide variety of patients and presents might entail significant advantages compared to those from other techniques. TYPE OF STUDY: Retrospective cohort. Level of Evidence: III.

General Hospitalization and Intensive Care Unit-Related Factors of COVID-19 Patients in Northeastern Colombia: Baseline Characteristics of a Cohort Study.

Objective This study aims to describe demographic and clinical characteristics and the factors associated with the risk of COVID-19 general hospitalization and intensive care unit (ICU) care of patients who consulted in a third-level hospital in Santander, Colombia. Methods We used baseline data from an ambidirectional cohort study. We included all patients with positive real-time polymerase chain reaction (PCR) tests for COVID-19 who came to the emergency room (ER) for respiratory symptoms related to COVID-19. Information regarding patients' baseline characteristics and symptoms was collected through telephone interviews and review of medical records. Vital signs were extracted from medical records as well. Results We enrolled 3,030 patients, predominantly men, with a median age of 60 (interquartile range (IQR): 44-73). Symptoms of the acute phase varied between men and women. Men presented with more respiratory symptoms, and women had general symptoms. Hypertension, obesity, and diabetes were common risk factors for hospital admission. Antibiotic consumption may also play a role in hospital admission.  Conclusions Male sex, older age, hypertension, obesity, prior thrombotic events, and self-medicated antibiotics were associated with general hospitalization. Hypertension, obesity, diabetes, and cancer were associated with ICU admission. The Charlson comorbidity index (CCI) is a powerful tool for evaluate the impact of pre-existing health conditions on COVID-19 hospital admission. We highlight the importance of these findings as possible predictors in our region.

Dysautonomia in people with epilepsy: A scoping review.

BACKGROUND: Epilepsy is one of the most common neurological diseases and has high morbidity and mortality. Multiple methods for assessing dysautonomia have been reported; however, the patient characteristics and epilepsy features that drive any method selection are unclear. People with epilepsy (PWE) can experience sudden unexpected death in epilepsy (SUDEP) and one reason can be dysautonomia. If dysautonomia can be detected in PWE before a severe event, then it could complement and redirect patient treatment and monitoring. OBJECTIVE: To map the available literature on dysautonomia in PWE and describe patients' characteristics and methods used to evaluate dysautonomia. METHODS: We performed a scoping literature review. We searched PubMed, Scopus, Embase, and hand searched starting from the first registry in the literature until August 2019. Studies were independently assessed by three authors and two epileptologists. We present data in tables and summarize information according to the following structure: population, concepts, and context. RESULTS: Thirty-five studies were included in the analysis with epidemiological designs including case reports (23), cross-sectional studies (4), case‒controls (7), and cohort studies (1). A total of 618 patients were enrolled. Heart rate variability, arrhythmia, blood pressure, the tilt-table test, polysomnography, respiratory function, and magnetic resonance imaging were the methods most commonly used to assess dysautonomia in PWE. A detailed description of the heart rate variability assessment is presented. CONCLUSIONS: This review provides a broad description of the available literature identifying clinical findings, the most frequently reported assessment measurements of dysautonomia, in temporal lobe epilepsy and extratemporal epilepsies.

Factors associated with long COVID syndrome in a Colombian cohort.

Introduction: After acute phase of SARS-CoV-2 infection, some patients persist with clinical symptoms, a phenomenon known as Long COVID syndrome. It is necessary to understand the factors associated with the persistence of these symptoms to develop individualized preventive approaches and effectively address this challenge. Objective: To determine the factors associated with the persistence of symptoms six months after COVID-19 infection. Materials and methods: A ambidirectional cohort, single-center study, that included individuals previously diagnosed with COVID-19 by real-time polymerase chain reaction (PCR) positive test, who were followed for a period of six months. Univariate, bivariate and a multivariate binomial regression model were performed to determine risk factors associated with the persistence of COVID-19 symptoms at the six months of follow-up. Results: The prevalence of long COVID syndrome was 47%. Age demonstrated no significant association with Long COVID (RR 0.999 [95% CI 0.996-1.002]); however, female sex (RR 1.148 [95% CI 1.038-1.268]), requirement of mechanical ventilation (RR 1.278 [95% CI 1.050-1.555]), presence of Chronic Obstructive Pulmonary Disease (COPD) (RR 1.340 [95% CI 1.104-1.626]), Rheumatic Disease (RR 1.259 [95% CI 1.055-1.504]) and the Hospitalization Type: General Hospitalization (RR 1.247 [95% CI 1.090-1.427]) and ICU Hospitalization (RR 1.490 [95% CI 1.221-1.818]) were significantly associated with the persistence of symptoms at the six month of follow-up. Conclusion: Female sex, presence of COPD, rheumatic disease, hospitalization type and requirement of mechanical ventilation during index infection were identified as significant risk factors for the diagnosis of Long COVID. These findings emphasize the importance of addressing Long COVID syndrome in terms of prevention and management, taking these risk factors into consideration.

Assessment of sexual dysfunction in patients with multiple sclerosis: a perspective from neurologist.

BACKGROUND: Sexual dysfunction (SD) is a common comorbidity in people with multiple sclerosis (pwMS). It affects the quality of life and remains an overlooked condition. The objective of this study was to describe how Colombian neurologists assess and treat SD and explore the barriers during sexual function evaluation. METHODS: In this observational cross-sectional study we developed a questionnaire for neurologists with 4 sections (demographic data, evaluation and treatment of SD, and possible reasons for not discussing sexual dysfunction.) It was sent via email to 326 Colombian neurologists. We grouped the answers according to the type of consultation (neurologists from a MS program or no MS program). We described through absolute frequencies and proportions. RESULTS: Fifty neurologists answered the survey. 64% stated that they usually study sexual dysfunction in neurological disorders. The main methods employed were private reading (86%) and attending conferences (14%). 5/50 participants have never attend pwMS; the Sect. 2-4 was not answered by them. 29% work in a MS program, all of them asked their patients about sexual function, but 18.75% of physicians working outside an MS program have never asked about it. Main reasons for not talking about sexual dysfunction were lack of knowledge (65.1%), presence of a companion (65.1%) and lack of time (55.8%). 91% of the neurologists reported that their patients usually and frequently ask about sexual function. Neurologists use informal questions to assess sexual function (80%), although 64.4% said that they are aware of SD questionnaires. When sexual dysfunction is detected, 91% of neurologists refer patients to another specialist and 87% do not start any treatment. CONCLUSIONS: Colombian neurologists are concerned with sexual function in pwMS, however it remains an underdiagnosed an undertreated condition. It is necessary to strengthen knowledge about the diagnosis and treatment of sexual dysfunction in pwMS, for neurologists and patients. It is also imperative to eliminate barriers around the topic and include sexual function evaluation and treatment as the routine care of pwMS.

Interpretation of white blood cell counts in the cerebrospinal fluid of neonates with traumatic lumbar puncture: a retrospective cohort study.

BACKGROUND: Difficulty in interpreting white blood cell (WBC) counts in cerebrospinal fluid (CSF) complicates the diagnosis of neonatal meningitis in traumatic lumbar punctures (LP). The aim of our study was to determine the correction factor for WBC counts in traumatic LP that offers the greatest diagnostic efficacy in meningitis. METHODS: We conducted a retrospective observational study of LP in neonates between January 2014 and December 2020. Traumatic LP was defined as a red blood cell (RBC) count ≥ 1,000 cells/mm3 CSF and pleocytosis as WBCs ≥ 20 cells/mm3 CSF. The CSF RBC:WBC ratio was analyzed by linear regression to determine a new correction factor. Cell count adjustments were also studied using the 500:1, the 1,000:1 ratio method, and the peripheral blood RBC:WBC ratio, using ROC curves and studies of accuracy (sensitivity and specificity). RESULTS: Overall, 41.0% of the 1,053 LPs included in the study were traumatic. The best results for effective WBC correction were the method based on the peripheral blood ratio (sensitivity = 1.0 and specificity = 0.9 for bacterial meningitis and sensitivity = 0.8 and specificity = 0.9 for viral meningitis) and the 400:1 ratio (sensitivity = 1.0 and specificity = 0.8 for bacterial meningitis and sensitivity = 0.8 and specificity = 0.8 for viral meningitis) obtained from linear regression (95% CI 381.7-427.4; R2 = 0.7). CONCLUSION: Both the peripheral blood correction and the 400:1 correction reduce the number of neonates classified with pleocytosis who were not eventually diagnosed with meningitis. Both methods might be a useful tool to clarify the neonatal meningitis diagnosis, offering neonatologists the possibility to assess the WBC count in traumatic LP.

Polycystic ovary syndrome and the new antiepileptic drugs: A systematic review.

OBJECTIVE: To evaluate the presence of polycystic ovary syndrome (PCOS) in women of reproductive age with the use of antiepileptic drugs. METHODS: A systematic literature review of observational analytical studies (cohort, cross-sectional and case-control), from January 1966 to January 2021 on PCOS in women of reproductive age with the use of the antiepileptics. The search covered the Cochrane, MEDLINE, Embase and LILACS databases. INCLUSION CRITERIA: Studies reporting the frequency of PCOS with the antiepileptic drugs in women of reproductive age. EXCLUSION CRITERIA: studies that did not have categorically relevant measurements, those published as abstracts only, and studies of investigational treatment. Data extraction was performed based on the PECOT strategy, considering the method of intervention, methodological quality, and presence of PCOS with the antiepileptic drugs. RESULTS: A total of 2043 references were obtained from which 22 articles were selected by title and abstract. Four articles met the inclusion criteria. No articles were found describing the risk of PCOS upon exposure to levetiracetam, felbamate, gabapentin, lacosamide, pregabalin, rufinamide, tiagabine, topiramate, vigabatrin, or zonisamide. Only articles related to oxcarbazepine and lamotrigine were found, in which the frequency of PCOS was like that found in women without epilepsy. CONCLUSIONS: The anticonvulsants are probably safer, but the risk of developing PCOS associated with the antiepileptics cannot be established, since there are insufficient studies.

Diagnostic definition of malattia leventinese in a family from Colombia / Definición diagnóstica en una familia con malattia leventinese en Colombia.

The malattia leventinese is an autosomal dominant inherited disease whose symptoms appear between the second and fourth decades of life. It is characterized by the appearance of drusen located between the retinal pigment epithelium and the Bruch membrane. It is usually associated with low vision and may progress to blindness. The pathogenic variant p.Arg345Trp in the EFEMP1 gene has been associated with this disease. We characterized clinically and molecularly a family with malattia leventinese using a comprehensive approach that involved ophthalmologists, pediatricians, and geneticists. This approach is of great importance since the phenotype of this disease is often confused with acular degeneration. All family members underwent ophthalmological evaluation and DNA extraction from a peripheral blood sample. All exons of the EFEMP1 gene were amplified and sequenced. The pathogenic variant p.Arg345Trp was identified in affected individuals in this family. This is the first report of malattia leventinese in a family with the p.Arg345Trp pathogenic variant in Colombia. The molecular diagnosis of retinal dystrophies is essential to differentiate this type of pathology.

La malattia leventinese es una enfermedad hereditaria autosómica dominante, cuyos síntomas se inician entre la segunda y la cuarta décadas de la vida. Se caracteriza por la aparición de drusas localizadas entre el epitelio pigmentario de la retina y la membrana de Bruch; suele reducir la visión drásticamente y progresar a ceguera. La variante patogénica p.Arg345Trp en el gen EFEMP1 se ha asociado con esta enfermedad. Se presenta aquí la caracterización clínica y molecular de una familia con malattia leventinese mediante un manejo integral que involucró a oftalmólogos, pediatras y genetistas, lo que es de gran importancia, ya que el fenotipo de esta enfermedad suele confundirse con la degeneración macular. A todos los individuos de la familia se les hizo la evaluación oftalmológica con imágenes diagnósticas de retina y extracción de ADN a partir de una muestra de sangre periférica. Todos los exones del gen EFEMP1 se amplificaron y secuenciaron. La variante patogénica p.Arg345Trp se identificó en los individuos afectados. Este es el primer reporte de malattia leventinese en una familia con la variante patogénica p.Arg345Trp en Colombia. El diagnóstico molecular de las distrofias retinianas es fundamental para diferenciar este tipo de enfermedades.

Definición diagnóstica en una familia con malattia leventinese en Colombia / Diagnostic definition of malattia leventinese in a family from Colombia

Resumen La malattia leventinese es una enfermedad hereditaria autosómica dominante, cuyos síntomas se inician entre la segunda y la cuarta décadas de la vida. Se caracteriza por la aparición de drusas localizadas entre el epitelio pigmentario de la retina y la membrana de Bruch; suele reducir la visión drásticamente y progresar a ceguera. La variante patogénica p.Arg345Trp en el gen EFEMP1 se ha asociado con esta enfermedad. Se presenta aquí la caracterización clínica y molecular de una familia con malattia leventinese mediante un manejo integral que involucró a oftalmólogos, pediatras y genetistas, lo que es de gran importancia, ya que el fenotipo de esta enfermedad suele confundirse con la degeneración macular. A todos los individuos de la familia se les hizo la evaluación oftalmológica con imágenes diagnósticas de retina y extracción de ADN a partir de una muestra de sangre periférica. Todos los exones del gen EFEMP1 se amplificaron y secuenciaron. La variante patogénica p.Arg345Trp se identificó en los individuos afectados. Este es el primer reporte de malattia leventinese en una familia con la variante patogénica p.Arg345Trp en Colombia. El diagnóstico molecular de las distrofias retinianas es fundamental para diferenciar este tipo de enfermedades.

Abstract The malattia leventinese is an autosomal dominant inherited disease whose symptoms appear between the second and fourth decades of life. It is characterized by the appearance of drusen located between the retinal pigment epithelium and the Bruch membrane. It is usually associated with low vision and may progress to blindness. The pathogenic variant p.Arg345Trp in the EFEMP1 gene has been associated with this disease. We characterized clinically and molecularly a family with malattia leventinese using a comprehensive approach that involved ophthalmologists, pediatricians, and geneticists. This approach is of great importance since the phenotype of this disease is often confused with macular degeneration. All family members underwent ophthalmological evaluation and DNA extraction from a peripheral blood sample. All exons of the EFEMP1 gene were amplified and sequenced. The pathogenic variant p.Arg345Trp was identified in affected individuals in this family. This is the first report of malattia leventinese in a family with the p.Arg345Trp pathogenic variant in Colombia. The molecular diagnosis of retinal dystrophies is essential to differentiate this type of pathology.

Evaluation of Kappa Index as a Tool in the Diagnosis of Multiple Sclerosis: Implementation in Routine Screening Procedure.

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. Previous studies have shown that cerebrospinal fluid (CSF) kappa free light chains (K-FLCs) may have a role in MS diagnosis. In this regard, the kappa index (K-Index) has demonstrated higher sensitivity, and slightly lower specificity than oligoclonal bands (OCBs), the gold standard for the detection of intrathecal immunoglobulin synthesis, a feature of MS. Here, we evaluated the performance of the K-Index (K-Index = CSF/serum K-FLC divided by CSF/serum albumin) for the differential diagnosis of MS in a cohort of patients with suspected MS. K-FLCs were quantitatively measured in parallel serum and CSF samples by turbidimetry (Freelite Mx reagent on an Optilite system, The Binding Site Group Ltd). From 160 (63.4%) of a total of 252 patients who had K-FLC in CSF <0.03 mg/dl, below the sensitivity limit of the technique, only one had a diagnosis of MS. However, the absence of OCB in this same patient suggested no synthesis of intrathecal immunoglobulin. Globally, MS patients presented significantly higher K-Index levels than patients without an MS diagnosis (66.96 vs. 0.025, respectively; p < 0.0001). In agreement, patients with positive OCB testing also exhibited higher K-Index levels than patients negative for OCB (65.02 vs. 0.024, respectively; p < 0.0001). An optimal K-Index cutoff of 3.045 was defined by receiver operating characteristic (ROC) analysis for screening suspected MS, achieving a higher diagnostic sensitivity and slightly lower specificity than OCB (Sens. 0.9778 and Spec. 0.8629 vs. Sens. 0.8889 and Spec. 0.9086, respectively). A previously reported K-Index cutoff of 6.6 also showed good diagnostic performance (Sens. 0.9333; Spec. 0.8731), validating its power as a diagnostic biomarker for MS. Finally, a time- and cost-effective algorithm for MS screening is proposed that would offer an initial rapid evaluation of the intrathecal immunoglobulin synthesis through the K-FLC in CSF and K-Index analysis, followed by reflexing OCB testing that may be ordered more selectively.

Gender and Polysomnographic Profiles Findings in Obstructive Sleep Apnea Syndrome Patients Living in High Altitude.

PURPOSE: Obstructive sleep apnea (OSA) is a common sleep disorder which prevalence is 22% in men and 17% in women. It is well described that females presented different clinical and polysomnographic characteristics compared with men. Those studies were performed in plain areas. We described the analysis by gender and clinical profiles of a sample of patients with diagnostic of OSA and living at high altitude. PATIENTS AND METHODS: It is an observational study that describes differences between clinical and polysomnographic characteristics by gender in patients with OSA. Additionally, an unsupervised cluster algorithm was used to find groups of patients with similar clinical and polysomnographic characteristics. RESULTS: We included 709 patients, 51.6% were females and 48.3% were males with mean age of 64 and 62 years old, respectively, in which 90.97% presented OSA. Men presented a higher apnea and hypopnea index than women (p=0.002), besides presented more sleep polysomnographic alterations. Meanwhile, women evidenced better sleep quality based on parameters. Additionally, in the sample of patients, we found four separated clinical profiles characterized mainly by differences in the severity of polysomnographic parameters. CONCLUSION: The patients were more obese, older, and had lower SpO2 values than most of those previously reported. Men had greater severity in most of the parameters measured by polysomnography. Polysomnographic variables were different both in the OSA patient profiles and in the gender comparison. However, the REM sleep apnea hypopnea index did not differ between sexes, indicating the importance of this variable in the evaluation of OSA severity in women. In contrast to previous reports, clinical and demographic characteristics showed few differences in both analyses. This result suggests that the behavior of OSA at high altitudes may have particularities with respect to low altitudes.

Asociación entre polifarmacia y prescripción inapropiada según la clase social en adultos mayores de Bucaramanga / Association between polypharmacy and inappropriate prescription according to social class in older adults in Bucaramanga

Resumen Introducción: La polifarmacia y la prescripción inapropiada (PI) se han visto relacionadas con múltiples variables, incluidas las de aspecto socioeconómico, sin embargo, la evidencia en esta asociación es escasa y heterogénea. Objetivo: Evaluar la asociación entre la polifarmacia y la prescripción inapropiada de medicamentos en adultos mayores de 60 años según su clase social. Material y métodos: Estudio piloto de diseño descriptivo, corte transversal realizada en la ciudad de Bucaramanga-Colombia, con una muestra de 135 adultos mayores de 60 años. Se realizó una encuesta donde se registraron datos sociodemográficos, estado de salud en el último mes, comorbilidades, medicamentos de uso crónico y escalas de funcionalidad. Resultados: No se encontró asociación estadísticamente significativa entre prescripción inapropiada y polifarmacia con la clase social y el nivel educativo (P=0,639). Sin embargo, el tener una filiación al sistema de seguridad social de tipo subsidiado estuvo significativamente asociada a la infra prescripción (P<0,029). La presencia de ingresos mensuales estuvo asociada con la presencia de polifarmacia (P<0,029) y prescripción inadecuada (P<0,033). Conclusiones: Existe una asociación entre algunas variables socioeconómicas, el número de médicos tratantes y algunas especialidades médicas con presentar polifarmacia y prescripción inapropiada de medicamentos.

Abstract Introduction: Polypharmacy and inappropriate prescribing have been related to multiple variables, including sociodemographic, however the evidence is limited and heterogeneous. Objective: To evaluate the association between polypharmacy and inappropriate prescribing in adults over 60 years old according to their social class. Material and methods: A pilot cross-sectional population-based study in the city of Bucaramanga, Colombia, with a sample of 135 adults over 60 years old. A survey was conducted where sociodemographics, health status in the last month, comorbidities, drugs of chronic use and functionality according to scales were registered. Results: No statistical association was found between inappropriate prescribing and Polypharmacy amongst social class and education level (P=0.639). Nevertheless, having an affiliation with a subsidized social security system was significantly associated with infra prescription (P <0.029). The existence of monthly income was associated with the presence of polypharmacy (P <0.029) and inadequate prescribing (P <0.033). Conclusions: There exists an association between some socioeconomic variables, the number of practicing physicians and some medical specialties with polypharmacy and inadequate prescription of drugs.

IgG4-related disease: a case report.

IgG4-related disease (IgG4-RD) is a condition that was first described recently, and is capable of affecting any organ of the body. Diagnosis is based on the correlation of clinical findings with histopathological findings and elevated serum IgG4. Treatment involves corticosteroids and rituximab for the most severe cases. We report the case of a symptomatic patient diagnosed of IgG4-RD whose diagnosed was guided by elevated serum IgG4 levels.

Estudio bibliométrico: 45 años de literatura biomédica en trasplante de células madre hematopoyéticas / A Bibliometric Study: 45 Years of Biomedical Literature in Hematopoietic Stem Cell Transplantation / Estudo bibliométrico: 45 anos de literatura biomédica em transplante de células-tronco hematopoiéticas

Introducción: La bibliometría mide variables de la literatura científica que se describen de forma cuantitativa por medio de análisis estadístico; con esta herramienta se busca evidenciar el impacto de los trasplantes de células madre hematopoyéticas en la literatura de los últimos 45 años. Objetivo: Descripción de la literatura médica indexada en MEDLINE desde 1970 hasta 2015 sobre trasplantes de células madre hematopoyéticas. Metodología: Se realizó una búsqueda en la base de datos MEDLINE a través de GoPubMed y Fabumed. La estrategia de búsqueda fue: "Hematopoietic Stem Cell Transplantation" [Majr] AND "1970:2015"[dp]. Las variables analizadas fueron el número de publicaciones por año, revistas, países y porcentaje de publicaciones sobre trasplantes de células madre hematopoyéticas. Resultados: Se recuperaron 23,295 referencias sobre trasplantes de células madre hematopoyéticas. Se identificaron 1,844 revistas diferentes, el mayor número de publicaciones se encontró en Bone Marrow Transplantation con 2,443 publicaciones, seguida de Blood con 1,375 y Biology of Bone Marrow Transplantation con 1,319 referencias. Estados Unidos fue el país con mayor número de publicaciones con 7,491 (32.15%); en Latinoamérica fueron publicados 324 (1.39%). Los descriptores de la literatura más investigados relacionados con el tema fueron: Trasplante de células madre hematopoyéticas con 23,345 publicaciones, humanos con 22,019 y células madre con 17,564. Conclusiones: Las publicaciones sobre trasplantes de células madre hematopoyéticas han incrementado de forma progresiva durante los 45 años estudiados. Los países desarrollados son los que han realizado mayor investigación del tema, en contraste con el número de publicaciones en total. [Ríos-Moreno JV, Bueno-Flórez SJ, Conde-Hurtado DI, Tarazona N, Sossa-Melo Claudia Lucía. Estudio bibliométrico: 45 años de literatura biomédica en trasplante de células madre hematopoyéticas. MedUNAB 2017-2018; 20(3): 319-326].

Introduction: Bibliometric measures variables from the scientific literature that are described quantitatively by means of statistical analysis; this tool seeks to demonstrate the impact of hematopoietic stem cell transplants in the literature throughout the last 45 years. Objective: To describe the indexed medical literature in MEDLINE from 1970 to 2015 on hematopoietic stem cell transplants. Methodology: A search of the MEDLINE database through GoPubMed and Fabumed was performed. The search strategy was: Hematopoietic Stem Cell Transplantation [Majr] and 1970:2015 [dp]. The variables analyzed were the number of publications per year, journals, countries and percentage of publications on hematopoietic stem cell transplants. Results: 23,295 references were recovered on hematopoietic stem cell transplants. 1,844 different journals were identified, the largest number of publications was found in Bone Marrow Transplantation with 2,443 publications, followed by Blood with 1,375 and Biology of Bone Marrow Transplantation with 1,319 references. The United States was the country with the highest number of publications with 7,491 (32.15%), in Latin America 324 (1.39%) were published. The most researched descriptors of literature related to the topic were: Transplantation of hematopoietic stem cells with 23,345 publications, humans with 22,019 and stem cells with 17,564. Conclusions: The publications on hematopoietic stem cell transplants have increased progressively during the 45 years studied. The developed countries are the ones that have done more research on the subject, in contrast to the number of publications in total. [Ríos-Moreno JV, Bueno-Flórez SJ, Conde-Hurtado DI, Tarazona N, Sossa-Melo Claudia Lucía. A Bibliometric Study: 45 Years of Biomedical Literature in Hematopoietic Stem Cell Transplantation. MedUNAB 2017-2018; 20(3): 319-326].

Introdução: A bibliometria mede variáveis da literatura científica que são descritas quantitativamente por meio de análise estatística; esta ferramenta procura demonstrar o impacto dos transplantes de células estaminais hematopoiéticas na literatura dos últimos 45 anos. Objetivo: Descrição da literatura médica indexada em MEDLINE de 1970 a 2015 em transplantes de células-tronco hematopoiéticas. Metodologia: uma pesquisa do banco de dados MEDLINE foi realizada através do GoPubMed e Fabumed. Aestratégia de busca foi: "Transplante de células estaminais hematopoiéticas" [Majr] AND "1970: 2015" [dp]. As variáveis analisadas foram o número de publicações por ano, periódicos, países e porcentagem de publicações sobre transplantes de células estaminais hematopoiéticas. Resultados: Foram recuperadas 23,295 referências, em transplantes de células estaminais hematopoiéticas. Identificamos 1,844 periódicos diferentes; o maior número de publicações foi encontrado no Transplante de medula óssea com 2,443 publicações, seguido de sangue com 1,375 e Biologia do transplante de medula óssea com 1,319 referências. Os Estados Unidos foi o país com maior número de publicações com 7,491 (32.15%); na América Latina, foram publicados 324 (1.39%). Os textos mais pesquisados da literatura relacionados com o tema foram: Transplante de células-tronco hematopoiéticas com 23,345 publicações, humanos com 22,019 e células-tronco com 17,564. Conclusões: As publicações sobre transplantes de células estaminais hematopoiéticas aumentaram progressivamente durante os 45 anos estudados. Os países desenvolvidos são os que fizeram mais pesquisas sobre o assunto, em contraste com o número de publicações no total. [Ríos-Moreno JV, Bueno-Flórez SJ, Conde-Hurtado DI, Tarazona N, Sossa-Melo Claudia Lucía. Estudo bibliométrico: 45 anos de literatura biomédica em transplante de células-tronco hematopoiéticas. MedUNAB 2017-2018; 20(3): 319-326].

The importance of fundus eye testing in rubella-induced deafness.

OBJECTIVE: The purpose of this study was to establish a new approach to improve detection of deafness due to rubella. METHODS: Colombian institutes for the deaf were visited by a medical team to perform in all enrolled individuals an ophthalmological examination with emphasis in fundus eye by a retina specialist. In cases where ocular alterations compatible with CRS were found, a medical interview by a clinical geneticist analyzing pre-and postnatal history and a thorough medical examination was done. RESULTS: A total of 1383 deaf institutionalized individuals were evaluated in 9 Colombian cities in the period of 2005 to 2006, finding a total of 463 positive cases for salt-and-pepper retinopathy (33.5%), in which rubella could be the etiology of deafness. Medellin, Cartagena, Bucaramanga and Barranquilla were the cities with the highest percentage of Congenital rubella, corresponding to 22.8% of analyzed population. The analysis performed on cases in which reliable prenatal history was obtained in a second appointment (n=88) showed association between positive viral symptoms during pregnancy and salt-and-pepper retinopathy in 62.5% of cases, while both (retinopathy and viral symptoms) were absent in 29.5% of cases; showing a correlation in 92% of cases. CONCLUSIONS: The frequency of deafness by rubella obtained by this study is significantly high compared with previous Colombian studies and with international reports. It was possible to correlate the antecedent of symptoms during pregnancy with the presence of salt-and-pepper retinopathy in this deaf population when reliable prenatal history was available, therefore eye testing with emphasis in fundus examination is a good indicator of rubella induced deafness. We propose a new approach in the search of deafness causes, based on a thorough ophthalmologic examination in all deaf people.

Validez y confiabilidad de dos escalas de siluetas para valorar la imagen corporal en estudiantes adolescentes / Validity and reliability of two silhouette scales to asses the body image in adolescent students

Objetivo: Determinar la validez y confiabilidad de la escala de los trece dibujos del contorno de la figura (13-CS) y del Standard Figural Stimuli (SFS) para la evaluación de la imagen corporal en estudiantes adolescentes de Bucaramanga. Métodos: Se evaluó una muestra probabilística de 189 estudiantes con las dos escalas. Dos semanas después se repitió la valoración junto con la talla, el peso, el porcentaje de grasa corporal, el cuestionario SCOFF y la escala de autoestima de Rosenberg. Resultados: La edad promedio fue 14,1 años; 67,2% fueron mujeres. La correlación de la 13-CS y SFS con el índice de masa corporal, peso y porcentaje de grasa corporal fue 0,61, 0,74, 0,40 y 0,72, 0,55, 0,46, respectivamente. La correlación de la insatisfacción de la imagen corporal con el SCOFF y la Rosemberg fue 0,43 y -0,26 con la 13-CS y 0,50 y -0,23 con la SFS. La reproducibilidad prueba-reprueba de la figura percibida e ideal fue de 0,93 y 0,90 con la 13-CS y de 0,85 y 0,78 con la SFS. Conclusión: La validez concurrente de ambas escalas fue buena. La reproducibilidad de la 13-CS fue excelente, y la de la SFS fue buena…

Objective: To determine the validity and reliability of the 13-figure images scale (13-CS) and Standard Figural Stimuli (SFS) for the evaluation of body images in adolescent students from Bucaramanga. Methods: A probabilistic sample with 189 students was evaluated with the two scales. Two weeks later, the valuation together with the size, weight, percentage of body fat, SCOFF questionnaire and Rosenberg self-esteem valuation was repeated. Results:The average age was 14.1 years; 62.7% were women. The correlation of the 13-CS and SFS with body fat index, weight and body fat percentage was 0.61, 0.74, 0.40 and 0.72, 0.55, 0.45 respectively. The correlation of dissatisfaction with body image according to the SCOFF and the Rosenberg scales was 0.43 and 0.26 with the 13-CS; 0.50 and -0.23 with the SFS. The reproducibility shows that perceived and ideal figure was 0.93 and 0.90 with the 13-CS; and 0.85 and 0.78 with the SFS. Conclusion: the concurrent validity of both scales was good. The reproducibility of the 13-CS was excellent while the SFS was good…

[Validity and Reliability of Two Silhouette Scales to Asses the Body Image in Adolescent Students]. / Validez y confiabilidad de dos escalas de siluetas para valorar la imagen corporal en estudiantes adolescentes.

OBJECTIVE: To determine the validity and reliability of the 13-figure images scale (13-CS) and Standard Figural Stimuli (SFS) for the evaluation of body images in adolescent students from Bucaramanga. METHODS: A probabilistic sample with 189 students was evaluated with the two scales. Two weeks later, the valuation together with the size, weight, percentage of body fat, SCOFF questionnaire and Rosenberg self-esteem valuation was repeated. RESULTS: The average age was 14.1 years; 62.7% were women. The correlation of the 13-CS and SFS with body fat index, weight and body fat percentage was 0.61, 0.74, 0.40 and 0.72, 0.55, 0.45 respectively. The correlation of dissatisfaction with body image according to the SCOFF and the Rosenberg scales was 0.43 and 0.26 with the 13-CS; 0.50 and -0.23 with the SFS. The reproducibility shows that perceived and ideal figure was 0.93 and 0.90 with the 13-CS; and 0.85 and 0.78 with the SFS. CONCLUSION: the concurrent validity of both scales was good. The reproducibility of the 13-CS was excellent while the SFS was good.

Screening program for Waardenburg syndrome in Colombia: clinical definition and phenotypic variability.

A screening program to detect Waardenburg syndrome (WS) conducted between 2002 and 2005, among 1,763 deaf individuals throughout Columbia identified 95 affected individuals belonging to 95 families, giving a frequency of 5.38% of WS among the institutionalized deaf population. We confirmed the clinical diagnosis of WS in the 95 propositi and, through the family evaluation, we also identified 45 non-institutionalized affected relatives. Audiologic, ophthalmologic, and genetic studies were performed to confirm the diagnosis. Following the classification of the WS consortium, based on the Waardenburg Index (WI), to define the type of WS. We classified 62.1% of the propositi as WS2 and 37.9% as WS1. We present here the results of the study of clinical manifestations, analyzing the presence, severity, and symmetry of clinical findings among this affected population. Overall, among the 95 propositi, in addition to sensorineural deafness in all, the most frequent features were broad nasal root (58.9%), a first degree relative affected (37.9%), heterochromia irides (36.8%), skin hypopigmentation (31.6%), white forelock (28.0%), intense blue iris (27.4%), synophrys (12.6%), premature graying (10.5%), ptosis of the eyelids (9.5%), and hypoplasia alae nasi (1.1%). The majority of individuals had normal psychomotor development (87%), while the remaining 13% had developmental delay. Among the latter, 9.4% corresponded to WS2 and 3.6% to WS1. Our data confirm an interesting inter- and intrafamilial variability in the phenotypic manifestations as well as extremely variable expression.