Telerehabilitation in Colombia: A Country Report and Qualitative Analysis During the Covid-19 Pandemic - Perceptions of Healthcare Providers and Patients.

Given Colombia's status as a middle-income country with healthcare challenges, leveraging telemedicine could significantly benefit hard-to-reach regions, under-resourced and underserved communities. This study provides a comprehensive overview of the country's telerehabilitation landscape, exploring the clinicians' and patients' perspectives during the COVID-19 pandemic through systematic review and qualitative analysis. Sixteen therapists and three patients were identified via snowball sampling. The literature review was scarce and scattered across various topics in the country; some studies delved into specific aspects like legislative frameworks and patient outcomes from different medical specialties. The qualitative analysis demonstrates that despite the learning curve, telerehabilitation strengthens therapeutic support, enhances patient autonomy, fosters a positive patient-provider relationship, achieves treatment goals, promotes family involvement, reduces time and costs, and ensures continuity of therapy services. This study identified research gaps, challenges, and opportunities in telerehabilitation in a Latin American country. Adopting telemedicine technologies in low- and middle-income countries could significantly enhance their healthcare systems.

Dolor lumbar en el embarazo, aspectos fisiopatológicos y tratamiento / Low back pain in pregnancy, pathophysiological aspects and treatment

INTRODUCCIÓN: El dolor lumbar es una condición de alta prevalencia en la población general. La gestación genera cambios fisiológicos que favorecen la aparición de síntomas dolorosos que pueden comprometer la calidad de vida. MÉTODO: Revisión de la literatura con términos MeSH en inglés y español en las bases de datos Embase, PubMed, Lilacs, Sage, Google Academics y Scielo desde el año 1994 hasta el año 2021. Se encontraron 74 artículos y fueron seleccionados 50, basados en su impacto clínico. RESULTADOS: El dolor lumbar afecta a más del 50% de las mujeres embarazadas. Existen antecedentes gineco-obstétricos que pueden intervenirse para disminuir el riego o la intensidad de los síntomas. El diagnóstico es clínico, pero puede asociarse a imágenes diagnósticas cuando se sospechan condiciones de riesgo. El tratamiento se basa en intervenciones no farmacológicas como ejercicio y terapia física, pero pueden utilizarse algunos medicamentos e intervenciones en dolor según su riesgo-beneficio materno y fetal. CONCLUSIONES: El dolor lumbar en el embarazo es muy frecuente y debe ser conocido, diagnosticado y tratado por los profesionales de la salud que atienden esta población, dentro de un equipo multidisciplinario de tratamiento.

INTRODUCTION: Low back pain is a condition of high prevalence in the general population. Gestation generates physiological changes that favor the appearance of painful symptoms that can compromise the quality of life. METHOD: Review of the literature with MeSH terms in English and Spanish in the databases Embase, PubMed, Lilacs, Sage, Google Academics and Scielo from the year 1994 to the year 2021. Seventy-four articles were found and 50 were selected based on their clinical impact. RESULTS: Low back pain affects more than 50% of pregnant women. There are gyneco-obstetric antecedents that can be intervened to reduce the risk or intensity of symptoms. The diagnosis of this entity is clinical, but it can be associated with diagnostic imaging when risk conditions are suspected. Treatment is based on non-pharmacological interventions such as exercise and physical therapy, but some medications and pain interventions can be used according to their risk of maternal and fetal benefit. CONCLUSIONS: Low back pain in pregnancy is very frequent, it should be known, diagnosed, and treated by health professionals who care for this population, based on a multidisciplinary treatment team.

The Effects of Adding a Gel-Alike Curcuma longa L. Suspension as Color Agent on Some Quality and Sensory Properties of Yogurt.

Color is an important characteristic of food products. This characteristic is related to consumer acceptability. To use the entire rhizome of Curcuma longa (CL) as a food colorant, a novel gel alike stable suspension (CLS) was previously developed using cellulose nanofibers (CNFs). Therefore, the present study was conducted to evaluate the CLS as a color additive on a stirred yogurt. Three concentrations of CLS were studied (0.1, 0.125, and 0.15 wt. %) and compared to yogurt without CLS. The obtained yogurts were characterized through the determination of pH, titratable acidity, syneresis, color and curcumin content after 1, 7, 14, and 21 days of storage. Additionally, rheological and sensory measurements were performed on the samples after one day of storage. Results show that the addition of CLS does not affect the pH and titratable acidity of the samples, but all the yogurts showed an increase in their syneresis during the storage time, showing a breakdown of the gel structure. Furthermore, the CLS suspension has the ability to impart a yellow color to yogurts, a characteristic that was stable during storage. Finally, the addition of 1 wt. % or 1.25 wt. % of CLS allows the development of a yogurt with adequate sensory perception.

Influence of a Non-Ionic Surfactant in the Microstructure and Rheology of a Pickering Emulsion Stabilized by Cellulose Nanofibrils.

Emulsion stabilization is a broad and relevant field with applications in oil, polymer and food industries. In recent years, the use of solid particles to stabilize emulsions or Pickering emulsions have been studied for their kinetic and physical properties. Nanomaterials derived from natural sources are an interesting alternative for this application. Cellulose nanofibrils (CNFs) have been widely explored as a Pickering emulsifier with potential food applications, however, in some cases the presence of surfactants is unavoidable, and the literature is devoid of an evaluation of the effect of a non-ionic food-grade surfactant, such as polysorbate 80, in the stabilization of a vegetable oil by CNFs. To better assess the possible interactions between CNFs and this surfactant emulsions containing coconut oil, an emerging and broadly used oil, were processed with and without polysorbate 80 and evaluated in their qualitative stability, morphological and physical properties. Fluorescence microscopy, dynamic light scattering and rheology were used for this assessment. Results indicate in absence of the surfactant, emulsion stability increased at higher CNFs content, creaming was observed at 0.15 and 0.3 wt.% of CNFs, while it was not evidenced when 0.7 wt.% was used. After the addition of surfactant, the droplets are covered by the surfactant, resulting in particles with a smaller diameter, entrapped in the cellulosic structure. Rheology indicates a lower network stiffness after adding polysorbate 80.

Oncological Follow-up with 2-[18F]-FDG PET/CT in Li-Fraumeni Syndrome

Li-Fraumeni syndrome is a rare disorder caused by abnormalities of the tumor-suppressor protein P53 gene. We present the case of a 26-years-old female diagnosed with bilateral ductal carcinoma. The genetic panel for breast cancer gene 1 (BRCA1) and BRCA2 mutations was negative and positive heterozygous germline tumor protein P53 gene mutations, considering Li-Fraumeni syndrome. A 2-[18F]-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was used for postsurgical staging to show the right lung hypermetabolic nodule. A lobectomy was accomplished, and histopathology reported pulmonary adenocarcinoma. A year later, oncological follow-up was conducted with 2-[18F]-FDG PET/CT without evidence of abnormalities.

Cultura contemporánea: ciencia y capitalismo, la cuestión de la subjetividad / Contemporary culture: science and capitalism, the question of subjectivity / Cultura contemporânea: ciência e capitalismo, a questão da subjetividade

Se abordará el mundo contemporáneo a través del discurso de la ciencia y el discurso del capitalismo para advertir las consecuencias sobre la subjetividad. El objetivo de este escrito es comprender cómo es forcluido el sujeto por el discurso de la ciencia, vía la ley universal científica y el capitalismo, vía la estandarización de los modos gozar a través de los mismos objetos de consumo. Ambos discursos suponen un "para todos", desconociendo la singularidad del sujeto. Se justifica pensar este asunto en tanto que implica una dimensión ética, ya que en el centro de la reflexión se encuentra el sujeto y su deseo. El tema se desarrolla en tres momentos: En el primero se conceptualizan las características de la ciencia y del sujeto moderno cartesiano, mostrando como desde el método de la ciencia se forcluye al sujeto, paradoja, porque el sujeto de la ciencias es condición de posibilidad para el sujeto del psicoanálisis; En un segundo momento se muestra cómo el discurso del capitalismo realiza un giro con respecto al discurso amo, que coloniza la subjetividad con los objetos de consumo, proponiendo a la diversidad de las satisfacciones humanas los mismos objetos, advirtiendo algunas consecuencias subjetivas. Concluyendo, el psicoanálisis, como reverso de los discursos contemporáneos, tiene como objetivo restituir la singularidad del sujeto, vía el dispositivo clínico, propuesto por Freud y formalizado por Lacan, que tiene como eje central de su experiencia el vínculo transferencial, como aquello que posibilita acoger lo más íntimo del sujeto.

By means of the discourse of science and capitalism the article will address the contemporary world in order to warn of its consequences on subjectivity. The objective of this text is to understand how the discourse of science forcludes the subject by means of the universal, scientific law, capitalism, the standardization of the modes of jouissance through consumer objects. Both discourses suppose a "for all", ignoring the subject's singularity. It is necessary to analyze this topic as it implies an ethical dimension, given that at its heart there is a reflection on the subject and its desire. The article will elaborate the thesis in three moments: in the first moment, the characteristics of science and the Cartesian, modern subject are conceptualized in order to show how the subject is forcluded in the scientific method, which is paradoxical considering that the sceintific subject is the condition that makes possible the psychoanalytic subject; the second moment demonstrates how the discourse of capitalism twists the master discourse, that colonizes the subjectivity with consumer objects as the solution to the diversity of human needs with concomitant subjective consequences; finally, psychoanalysis, the reverse of the contemporary discourses, has as its objective restituting the singularity of the subject by means of the clinical apparatus, proposed by Freud and formalized by Lacan, that has as its central axis of its experience the transferential bond, that permits accommodate the intimacy of the subject.

Vai ser abordado o mundo contemporâneo através do discurso da ciência e o do captilalismo para perceber as consequências sobre a subjetividade. O objetivo deste escrito é compreender como é forcluído o sujeito pelo discurso da ciência por meio da lei universal e do capitalismo, por meio da estandardização dos modos de gozar através dos objetos de consumo. Ambos os discursos supõem um "para todos", desconhecendo a singularidade do sujeito. Pensar esse assunto é justificado na medida em que implica uma dimensão ética, já que no centro da reflexão se encontram o sujeito e seu desejo. O tema é desenvolvido em três momentos. No primeiro, são conceituadas as características da ciência e do sujeito moderno cartesiano, mostrando como a partir do método da ciência se foraclui o sujeito, paradoxo, porque o sujeito da ciência é condição de possibilidade para o sujeito da psicanálise. Em um segundo momento, mostra-se como o discurso do capitalismo faz um giro em relação ao discurso do mestre, que coloniza a subjetividade com os objetos de consumo, propondo à diversidade das satisfações humanas os mesmos objetos, informando algumas consequências subjetivas. Concluindo, a psicanálise, como avesso dos discursos contemporâneos, tem como objetivo restituir a singularidade do sujeito, por meio do dispositivo clínico, proposto por Freud e formalizado por Lacan, que tem como eixo central de sua experiência o vínculo transferencial como aquilo que possibilita acolher o mais íntimo do sujeito.

In-situ glyoxalization during biosynthesis of bacterial cellulose.

A novel method to synthesize highly crosslinked bacterial cellulose (BC) is reported. The glyoxalization is started in-situ, in the culture medium during biosynthesis of cellulose by Gluconacetobacter medellensis bacteria. Strong crosslinked networks were formed in the contact areas between extruded cellulose ribbons by reaction with the glyoxal precursors. The crystalline structure of cellulose was preserved while the acidic component of the surface energy was reduced. As a consequence, its predominant acidic character and the relative contribution of the dispersive component increased, endowing the BC network with a higher hydrophobicity. This route for in-situ crosslinking is expected to facilitate other modifications upon biosynthesis of cellulose ribbons by microorganisms and to engineer the strength and surface energy of their networks.

A cladistic re-analysis of the Gadiformes (Teleostei, Paracanthopterygii) using three-item analysis.

In the present paper, we describe LisBeth, a newly published phylogenetic program. LisBeth implements the cladistic three-item analysis for systematics and biogeography. We show how LisBeth handles character representation, character analysis, exact search functions, reconstruction of the intersection tree and other features, such as retention index, completeness index, character history and link with other programs such as PAUP*, version 4.0b10, TNT and Xper2. Using LisBeth, we reanalyze the phylogeny based on morphological characters of the order Gadiformes (Teleostei, Paracanthopterygii) published by Endo (2002) and compare our results. We also describe the generation of hypotheses of homology following Endo's guidelines versus 3ia representation schemes. We compare the topologies of all results and show the implications of the interpretation of character history.

Estudio etiológico y epidemiológico de las micosis cutáneas en un laboratorio de referencia - Antioquia - Colombia / Etiological and epidemiological study on superficial mycoses performed in a referral laboratory center - Antioquia -Colombia

Introducción: las micosis superficiales son infecciones frecuentes de los tejidos queratinizados, causadas por levaduras, dermatofitos, mohos ambientales. Su etiología varía de acuerdo a la población de estudio. Objetivo: determinar la frecuencia etiológica y algunas características poblacionales y clínicas de los pacientes con diagnóstico presuntivo de micosis superficiales, que consultaron al Instituto Colombiano de Medicina Tropical (I.C.M.T.) durante el período 2008 al 2011. Materiales y métodos: se realizó un estudio descriptivo de corte retrospectivo en el que se analizaron los datos poblacionales y los resultados micológicos de 2 282 muestras provenientes de 1 645 pacientes con diagnóstico presuntivo de micosis superficiales. Resultados: el 71,8 % de los pacientes fueron de género femenino y la edad promedio fue 44,3 años. De las 2 282 muestras se reportó identificación micológica en 82,6 %, siendo los microorganismos más frecuentemente aislados Candida spp (25 %), Fusarium spp, Trichophyton mentagrophytes y Candida krusei (10 % cada uno) y Rhodotorula spp en 8 %. La onicomicosis, tanto de manos como de pies, fue la infección fúngica superficial encontrada con mayor frecuencia. Conclusiones: las micosis superficiales son enfermedades comunes, con variaciones en su frecuencia según la edad, el sexo y la región de donde provienen los pacientes. Su diagnóstico oportuno constituye una de las principales herramientas para un tratamiento adecuado y bien dirigido, evitando así fallas terapéuticas y aparición de cepas de hongos resistentes.

Introduction: Superficial mycoses are frequent infections caused by yeasts, dermatophytes and environmental molds on keratinized tissue. Objectives: To characterize the species of dermatophytes, yeasts and environmental molds that cause superficial mycoses and to analyze their relationship to sex, age and localization in patients evaluated at the Tropical Medical Institute in Valle de Aburrá Antioquia during the time period 2008-2011. Materials and methods: A descriptive retrospective cross-sectional study was performed, and 2282 samples from 1645 patients were included. Patients of all ages were included with a presumptive diagnosis of a superficial mycosis. A KOH was performed with culture of material from the lesions. The characterization of the fungi was done according to morphology and biochemical studies. Results: Out of 1645 patients 1182 (71.8 %) were women and the average age was 44.3 years. From the 2282 samples taken the mycological identification could be done in 82,6 % of them and the microorganisms most frequently isolated were Candida spp (25 %); Fusarium spp, Trichophyton mentagrophytes and Candida Krusei each represented 10 % and Rhodotorula was isolated in 8 % of samples. Hand and feet onychomycosis was the most frequent superficial fungal infection. Conclusions: Superficial mycoses are frequent pathologies that vary according to age, sex and the diagnostic methods used. The pertinent diagnosis constitutes one of the main tools for a timely and efficacious treatment, avoiding therapeutic failures and the appearance of resistant strains.

Resultados de la vigilancia de laboratorio en meningitis bacteriana: ocho años de seguimiento

Objetivos. Conocer el comportamiento de la meningitis bacteriana (MB) en cuanto a etiología, los grupos de edad más afectados y la sensibilidad de los principales gérmenes a los antibióticos de elección para su tratamiento. Materiales y métodos: Se trata de un estudio descriptivo ambipespectivo para el cual se tuvieron en cuenta los registros de laboratorio desde el año 1990 hasta 1997 y en un formulario se registraron los datos de edad de los pacientes, los gérmenes aislados y la sensibilidad de algunos de ellos a los antimicrobianos más utilizados para su tratamiento. El líquido cefalorraquídeo (LCR) se procesó siguiendo un protocolo estandarizado de laboratorio. A las cepas de Streptococcus pneumoniae se les probó la sensibilidad a la penicilina con discos de oxacilina y la sensibilidad por la técnica de Kirby-Bauer (KB). Al Haemophilus influenza se le detectó la presencia de B lactamasa por la técnica de la cefalosporina cromógena y adicinalmente se le determinó la sensibilidad por la técnica de KB. Resultados. En total se diagnosticaron 451 MB. El principal agente fue la Neisseria meningitidis en 197 pacientes, luego el H. influenza en 147, el neumococo en 62 y en el resto, otros gérmenes. El grupo más afectado fue el de menores de un año, en 29.2 por ciento de los casos. Veinte por ciento de los neumococos presentó sensibilidad intemedia a la penicilina G, 7.5 por ciento resistencia al cloranfenicol, 12.5 por ciento resistencia al trimetoprim sulfa (TMS) y 5 por ciento a la eritromicina. Respecto al H. influenzae, se detectó B lactamasa (+) en 2.27 por ciento, en 5.58 por ciento resistencia a la ampicilina, en 3.4 por ciento al cloranfenicol y en 9.09 por ciento al TMS. Conclusiones. el meningococo fue la principal causa de MB. La enfermedad predominó en los menores de un año. La resistencia a los antimicrobianos se presentó en forma importante, tanto en las infecciones por neumococo como por H. influenzae.