Special considerations for the use of AI tools by PEERs as a learning and communication aid.

There is no doubt that navigating academia is a formidable challenge, particularly for those from underrepresented backgrounds who face additional barriers at every turn. In such an environment, efforts to create learning and training environments that are diverse, equitable, and inclusive can feel like an uphill battle. We believe that harnessing the power of artificial intelligence (AI) tools can help in leveling the playing field. While AI cannot supplant the need for supportive mentorship, it can serve as a vital supplement, offering guidance and assistance to those who may lack access to adequate avenues of support. Embracing AI in this context should not be stigmatized, as it may represent a vital lifeline for underrepresented individuals who often face systemic biases while forging their own paths in pursuit of success and belonging in academia. AI tools should not be gatekept from these individuals, particularly by those in positions of power and privilege within the scientific community. Instead, we argue, institutions should make a strong commitment to educating their community members on how to ethically harness these tools.

Artificial intelligence, applications and challenges in simulation-based education

The rapid advancement of Artificial Intelligence (AI) has taken the world by "surprise" due to the lack of regulation over this technological innovation which, while promising application opportunities in different fields of knowledge, including education, simultaneously generates concern, rejection and even fear. In the field of Health Sciences Education, clinical simulation has transformed educational practice; however, its formal insertion is still heterogeneous, and we are now facing a new technological revolution where AI has the potential to transform the way we conceive its application.

El rápido avance de la inteligencia artificial (IA) ha tomado al mundo por "sorpresa" debido a la falta de regulación sobre esta innovación tecnológica, que si bien promete oportunidades de aplicación en diferentes campos del conocimiento, incluido el educativo, también genera preocupación e incluso miedo y rechazo. En el campo de la Educación en Ciencias de la Salud la Simulación Clínica ha transformado la práctica educativa; sin embargo, aún es heterogénea su inserción formal, y ahora nos enfrentamos a una nueva revolución tecnológica, en la que las IA tienen el potencial de transformar la manera en que concebimos su aplicación.

Manejo y resultados de pacientes con diverticulitis aguda: experiencia de cinco años en el Hospital San Vicente Fundación / Management and results of patients with acute diverticulitis. Five year-experience at the San Vicente Fundación Hospital

Introducción. Los datos epidemiológicos de la diverticulitis en Colombia son limitados. El objetivo de este artículo fue caracterizar una población que ingresó con diverticulitis aguda al Hospital Universitario San Vicente Fundación, un centro de referencia de la ciudad de Medellín, Colombia, para analizar la presentación y comportamiento de la enfermedad en la población local, con estadísticas propias y desenlaces de la enfermedad en los últimos años. Métodos. Estudio observacional retrospectivo, descriptivo, entre enero de 2015 y diciembre de 2019. Se hizo un estudio exploratorio uni-, bi- y multivariado de factores de riesgo para fallo en el tratamiento y la mortalidad. Resultados. Se incluyeron 103 pacientes. Se presentó principalmente en mujeres y la edad promedio fue de 65 años. La diverticulitis Hinchey Ia fue la más frecuente (41,7 %) y el manejo médico fue exitoso en todos los casos, mientras que en las tipo III y IV, todos se manejaron de forma quirúrgica, con tasas de éxito entre el 50 y el 64 %. La presencia de signos de irritación peritoneal al examen físico, el recuento de leucocitos y la PCR, el ingreso a la Unidad de Cuidados Intensivos y la mortalidad aumentaron de forma directamente proporcional con el estadio de Hinchey. Conclusiones. Existe una relación directamente proporcional entre la clasificación de Hinchey y los signos de respuesta inflamatoria clínicos y paraclínicos, la necesidad de manejo quirúrgico, la estancia en la Unidad de Cuidados Intensivos y la mortalidad.

Introduction. Epidemiological data on diverticulitis in Colombia are limited. The objective of this article was to characterize a population that was admitted with acute diverticulitis to the San Vicente Fundación University Hospital, a reference center in the city of Medellín, Colombia, to analyze the presentation and behavior of the disease in the local population, with its own statistics, and outcomes of the disease in recent years. Methods. Retrospective descriptive observational study between January 2015 and December 2019. An exploratory uni-, bi- and multivariate study of risk factors for treatment failure and mortality was performed. Results. A total of 103 patients were included. The most frequent Hinchey classification was Ia (41.7%). It occurs mainly in women, mean age 65 years. Hinchey Ia diverticulitis is the most frequent and medical management is successful in 100% of cases; while in III and IV, 100% were managed surgically with success rates between 50 and 64%. The presence of peritoneal signs on physical examination, leukocyte count and CRP, ICU admission and mortality increased directly proportional with Hinchey stage. Conclusions. There is a directly proportional relationship between Hinchey staging with clinical and paraclinical signs of inflammatory response, need for surgical management, ICU stay and mortality.

Craniofacial and dental features in children aged 3-5 years with congenital Zika syndrome.

OBJECTIVE: Zika virus infection has been associated to congenital zika syndrome (CZS) in newborns and is characterized by microcephaly, central/axial motor and sensory dysfunction, dysphagia among other previously described severe health complications. CZS is usually diagnosed postpartum by evident/apparent neural development problems. Although there are some reports of craniofacial/dentition development in CZS, several clinical oral aspects are still unknown. This study describes some structural and functional characteristics of facial and cranial growth and deciduous dentition in CZS-affected children. MATERIAL AND METHODS: Some cranial, facial and dental characteristics were determined in 14 children with CZS aged 3-5 years and compared them against 12 apparently healthy children paired by age and gender. RESULTS: Fourteen CZS cases presented microcephaly, maxillary prognathism, altered facial thirds, asymmetric pupillary line, bruxism (p = 0.006), deep and anterior open bite and distal step decidual molar relationship (p = 0.031). CZS children cannot feed by themselves and most cannot walk and have not develop coordinated and intelligible language according to their chronological age. In contrast, controls presented normal skull features, have autonomous locomotion skills, speak intelligible language, feed by themselves, presented a harmonic intermaxillary relationship and have symmetrical facial thirds. CONCLUSION: Microcephaly, dysphagia, bruxism, mandibular retrognathia, altered facial proportions and malocclusion are the main craniofacial and oral features at CZS. CLINICAL RELEVANCE: The complications of CZS including those related with the face and the oral cavity are still being identified. This study revealed some cranial, facial and oral features in children affected by CSZ. Interdisciplinary rehabilitation protocols must address these syndromic features that could improve children and parents living conditions.

Use of Virtual Reality and Three-Dimensional Printing in the Surgical Planning of Slide Tracheoplasty.

Purpose: To describe our experience using virtual reality (VR) and three-dimensional (3D) printing as complements for the surgical planning process of slide tracheoplasty (ST) in patients with congenital tracheal stenosis (CTS). Description: VR and 3D printing are used for the surgical planning of ST as a therapeutic option in three female patients under five years of age with CTS. Evaluation: We assessed the planned surgical procedure, procedural time, postoperative complications, and outcomes, as well as the main surgeon's experience with the use of the applied technologies. Conclusions: The interaction within the VR environment allowed for collaboration of the surgical plan between surgical staff and enhancement of the radiologist-surgeon communication, while procedural simulation with 3D printing prototypes allowed for refining technical abilities for the surgical interventions. Based on our experience, the application of these technologies have added value to the surgical planning of ST and its outcomes in the treatment of CTS.

Vaccination against COVID-19 in Perú: Inequalities and associated factors. / LA VACUNACIÓN CONTRA COVID-19 EN EL PERÚ: Desigualdades y factores asociados.

Objective: to search for inequalities in vaccination with two doses, and its relationship with social and economic variables, cases and deaths. Methods: Exploratory ecological study of a secondary source from the Ministry of Health of Peru and the United Nations Program, from March 2020 to January 2022. Results: We found a high positive correlation (p < 0.05) with the Regional Competitiveness Index (r = 0.72), and the State Density Index (r = 0.81); moderate with the Human Development Index, doctors per 1,000 inhabitants, cases and deaths per 100 000. In the three waves of the pandemic, the most affected were older adults; the third wave was higher. Mortality decreased during vaccination compared to before it; there was inequality with two doses between the regions. The Lorenz curve expressed inequality with the number of doses (GINI: One dose: 0,05, Two doses: 0,06, Three doses: 0,18). The concentration curve was similar to that of Lorenz through the Regional Competitiveness Index, with higher doses, inequality increased (One dose: 0,05, two doses: 0,06, three doses: 0,16); The same happened with the State Density Index (One dose: 0,05, two doses: 0.06, three doses: 0,17). Conclusion: Inequality in vaccination between regions was found, associated with socioeconomic factors in Peru.

Objetivo: buscar desigualdades en la vacunación con dos dosis, y su relación con variables sociales, económicas, casos y fallecidos. Métodos: Estudio ecológico exploratorio de fuente secundaria del Ministerio de Salud de Perú y Programa de las Naciones Unidas, de marzo 2020 a enero 2022. Resultados: Encontramos correlación positiva alta (p < 0,05) con el Índice de Competitividad Regional (r = 0,72), y el Índice de Densidad del Estado (r = 0,81); moderada con el Índice de Desarrollo Humano, médicos por 1000 habitantes, casos y fallecidos por 100 000. En las tres olas de pandemia, los más afectados fueron adultos mayores; fue más alta la tercera ola. La mortalidad disminuyó durante la vacunación en comparación con antes de ella; existió desigualdad con dos dosis entre las regiones. La curva de Lorenz expresó desigualdad con el número de dosis (GINI: Una dosis: 0,05, Dos dosis: 0,06, Tres dosis: 0,18). La curva de concentración presentó semejanza con la de Lorenz mediante el Índice de Competitividad Regional, a mayor dosis se incrementó la desigualdad (Una dosis: 0,05, dos dosis: 0,06, tres dosis: 0,16); igual sucedió con el Índice de Densidad del Estado (Una dosis: 0,05, dos dosis: 0,06, tres dosis: 0,17). Conclusión: Se encontró desigualdad en la vacunación entre las regiones, asociada con factores socioeconómicos en Perú.

Uso de plasmaféresis en el manejo de colestasis intrahepática grave asociada a enfermedad de Graves: a propósito de un caso / Use of plasmapheresis in the treatment of severe intrahepatic cholestasis associated with Graves' disease: a case report

La tirotoxicosis es la manifestación clínica de una liberación excesiva de hormonas tiroideas, asociada o no a una función glandular autónoma; en este primer escenario, se denomina específicamente hipertiroidismo. Las principales etiologías son la enfermedad de Graves (EG), el adenoma tóxico, el bocio multinodular tóxico y el grupo de tiroiditis, predominando sus formas aguda y subaguda. La EG es la forma más común de hipertiroidismo, representando entre el 60 % y el 80 % de los casos, con una mayor incidencia en personas entre 40 y 60 años. Se ha descrito un compromiso hepático entre 45 % y el 90 % de pacientes con hipertiroidismo. Presentamos el caso de un hombre de 47 años con tirotoxicosis secundaria a enfermedad de Graves con compromiso bioquímico hepático manifestado como colestasis intrahepática refractaria al tratamiento médico en el corto plazo, tratado exitosamente con plasmaféresis como terapia puente a tiroidectomía total, proporcionando un análisis de la respuesta a la terapia a través de un cambio en los niveles de tiroxina libre (T4) y bilirrubina total a lo largo de su evolución.

Thyrotoxicosis is the clinical manifestation of excessive thyroid hormone release, whether or not asso-ciated with autonomous glandular function; in this first scenario, it is specifically termed hyperthyroi-dism. The main etiologies are Graves' disease (GD), toxic adenoma, toxic multinodular goiter ant the group of thyroiditis, predominantly acute and subacute forms. GD is the most common form of hyperthyroidism, accounting for 60% to 80% of cases, with a higher incidence among people aged 40 to 60 years. Liver involvement has been reported in 45% to 90% of patients with hyperthyroi-dism. We present the case of a 47-year-old man with thyrotoxicosis secondary to Graves' disease with hepatic biochemical involvement manifested as intrahepatic cholestasis refractory to medical management in the short term, successfully treated with plasmapheresis as bridge therapy to total thyroidectomy, providing an analysis of the response to therapy through a change in free thyroxine (T4) and total bilirubin levels throughout his evolutio

Food insecurity profile according to habits and lifestyles in workers with subsistence jobs, Medellín-Colombia 2016.

Introduction: Although the informal economy absorbs a considerable portion of the population, there is still little evidence that contributes to identify the lifestyles and eating habits that outline food insecurity in workers with subsistence jobs. Objectives: To determine the profile of food insecurity according to habits and lifestyles in workers with subsistence jobs. Methods: Cross-sectional study with primary sources of information, obtained through an assisted survey, to a census of 686 workers in 2016. The results of the nutritional component of a doctoral thesis approved by the Institutional Ethics Committee of the CES University, Medellín, Colombia, are presented. Results: In this working population, 52.6% were 50 years or old; however, 86.1% reported being the main household provider, and 33.3% did not have a permit to work in public areas. Moreover, 56.8% reported being sedentary/little active, and the highest consumption of alcohol and tobacco was recorded in men, who also ate their food alone. Conversely, women considered that mood affected their appetite, and they consumed their food while serving customers and handling money. In general, less than 50.0% of workers had a set time to consume their food. Food insecurity in workers' households was explained by alcohol consumption (prevalence ratio = 1.62; confidence interval = 1.05;2.38) and having exclusive hours to consume food (prevalence ratio = 1.40; confidence interval = 1.00;1.96). Their food insecurity is defined by not consuming alcoholic beverages, considering that their mood affects their appetite, consuming one or two meals a day, without a defined schedule, not having permission to work, presenting moderate/severe food insecurity, and being a woman. Conclusions: The conditions that explain and outline food insecurity in this working population contribute to their socio-environmental and labor vulnerability, however, these conditions can be reversed.

Introducción: Aunque la economía informal ocupe una gran parte de la población, todavía existen pocas evidencias que ayuden a identificar los estilos de vida y hábitos alimentarios que definen la inseguridad alimentaria entre los trabajadores con empleos de subsistencia. Objetivos: Determinar el perfil de inseguridad alimentaria según hábitos y estilos de vida en trabajadores con empleos de subsistencia. Métodos: Estudio transversal con fuentes primarias de información, realizado a través de encuesta asistida, con un censo de 686 trabajadores en 2016. Los resultados del componente nutricional de una tesis doctoral aprobada por el Comité de Ética Institucional de la Universidad CES, en Medellín, Colombia, son presentados. Resultados: De esta población trabajadora, el 52,6% tenía más de 50 años, sin embargo, el 86,1% reportó ser la persona que más aportaba en el hogar y al 33,3% no se le permitía trabajar en los espacios públicos. El 56,8% refirió ser sedentario/poco activo, registrándose el mayor consumo de bebidas alcohólicas y cigarrillos en los hombres, quienes también comían solos. Por su parte, las mujeres consideraban que el estado de ánimo afectaba al apetito y, cuando comían, simultáneamente atendían a los clientes y manejaban dinero. En general, menos del 50,0% tenía un tiempo definido para consumir sus alimentos. Explicaron inseguridad alimentaria en sus hogares, consumo de bebidas alcohólicas (RP = 1,62. IC = 1,05;2,38) e horarios exclusivos para consumir alimentos (RP = 1,40. IC = 1,00;1,96). Perfilan su inseguridad alimentaria no consumir bebidas alcohólicas, considerar que el estado de ánimo afectaba al apetito, consumir una o dos comidas al día, sin horario definido, no tener permiso para trabajar, presentar inseguridad alimentaria moderada/grave y ser mujer. Conclusiones: Las condiciones que explican y perfilan la inseguridad alimentaria de esta población trabajadora contribuyen a configurar su vulnerabilidad socioambiental y laboral, sin embargo, pueden ser revertidas.

Condiciones ambientales, laborales, hábitos y estilos de vida relacionados con la hipertensión en trabajadores informales, Medellín / Environmental and working conditions, habits and lifestyles related to hypertension in informal workers, Medellín / Condições ambientais, laborais, hábitos e estilos de vida relacionados com a hipertensão em trabalhadores informais, Medellín

Resumen Introducción: la hipertensión arterial (HTA) en trabajadores informales, podría explicarse por sus condiciones laborales, ambientales, hábitos y estilos de vida. Objetivo: determinar condiciones laborales, ambientales, hábitos y estilos de vida, que aportan a la explicación de HTA en trabajadores informales del centro de Medellín, Colombia, 2016. Metodología: estudio descriptivo transversal con intención analítica. Fuentes primarias de información, a un censo de 686 trabajadores en 2016, previa toma de consentimiento informado. Se indagaron condiciones laborales, ambientales, hábitos, estilos de vida y autorreporte de HTA. Se realizó análisis univariado, bivariado y multivariado. Pruebas estadísticas con 95 % de confianza y error del 5 %. Un grupo de trabajadores participó en el diseño y ejecución del trabajo de campo. Proyecto aprobado por comité de Ética Institucional de la Universidad CES, Medellín (septiembre 2015). Resultados: el 20,26 % de los trabajadores tenía HTA. Edad 50(±11,76) años y 23,5 años como venteros, 81,5 % trabaja >8 horas diarias. El 17,2 % fumaba cigarrillo, 23,7 % utilizaba salero en la mesa y 28,9 % eran sedentarios. Mayor hipertensión a mayor edad (RP=12,35), mayor antigüedad en el oficio (RP=1,73) y considerarse obeso (RP=2,61), y menor para quienes no consumían licor (RP=0,48). Explica mayor HTA consumir alimentos fritos (PR=3,14. IC=1,64; 6.00), tener entre 30-44 (PR=10,71.CI: 5,00; 22,94) y 45-59 años (PR=2,69. CI: 1,66; 4,37), y menor HTA, considerarse con sobrepeso (PR=0.54. IC=0.34, 0.78). Conclusiones: las condiciones laborales, hábitos y estilos de vida, aportan a la explicación de HTA. Siendo estas, algunas características que aportan a configurar vulnerabilidad laboral, en esta población trabajadora.

Abstract Introduction: High blood pressure (HBP) in informal workers could be explained, by their working and environmental conditions, habits and lifestyles. Objective: To determine working and environmental conditions, habits and lifestyles, which contribute to the explanation of HBP in informal workers in the downtown area in Medellin, Colombia, 2016. Methodology: Cross-sectional descriptive study with analytical intent. Primary source of information: a census of 686 workers in 2016, after obtaining informed consent. Working and environmental conditions, habits, lifestyles and self-report of HBP were investigated. Univariate, bivariate and multivariate analyzes were performed. Statistical tests show 95% confidence and 5% error. A group of workers participated in the design and execution of the fieldwork. Project approved by the Institutional Ethics Committee of Universidad CES, Medellín September 2015. Results: 20,26% of the workers had HBP. Age 50 (±11,76) years old, and 23,5 years as street vendors, 81,5% work>8 hours a day; 17,2% smoked cigarettes, 23,7% used saltshakers at the table and 28,9% were sedentary. Greater hypertension at older age (PR=12.35), greater seniority in the job (PR=1,73) and considered themselves obese (PR=2,61), and lower HBP for those who did not consume liquor (PR=0,48). Greater HBP is explained in people consuming fried foods (PR=3.14.IC=1,64; 6.00), being between 30-44 (PR=10,71. CI:5,00;22,94) and 45 to 59 years old (PR=2,69.CI: 1.66; 4.37), and a lower HBP for those considered as overweight (PR=0,54. IC=0.34; 0.78). Conclusion: working conditions, habits and lifestyles contribute to the explanation of HBP. These are some characteristics that contribute to configure labor vulnerability in this working population.

Resumo Introdução: a hipertensão arterial (HTA) em trabalhadores informais, poderia explicar-se por suas condições laborais, ambientais, hábitos e estilos de vida. Objetivo: determinar condições laborais, ambientais, hábitos e estilos de vida, que aportam à explicação de HTA em trabalhadores informais do centro de Medellín, Colômbia, 2016. Metodologia: estudo descritivo transversal com intenção analítica. Fontes primarias de informação, a um censo de 686 trabalhadores em 2016, previa toma de consentimento informado. Indagaram-se condições laborais, ambientais, hábitos, estilos de vida e auto reporte de HTA. Realizou-se análise uni variado, bivariado e multivariado. Provas estadísticas com 95 % de confiança e erro do 5 %. Um grupo de trabalhadores participou no desenho e execução do trabalho de campo. Projeto aprovado por comité de Ética Institucional da Universidade CES, Medellín (setembro 2015). Resultados: o 20,26 % dos trabalhadores tinha HTA. Idade 50(±11,76) anos e 23,5 anos como camelôs, 81,5 % trabalha >8 horas diárias. O 17,2 % fumava cigarro, 23,7 % utilizava saleiro na mesa e 28,9 % eram sedentários. Maior hipertensão a maior idade (RP=12,35), maior antiguidade no ofício (RP=1,73) e considerar-se obeso (RP=2,61), e menor para quem não consumiam licor (RP=0,48). Explica maior HTA consumir alimentos fritos (PR=3,14. IC=1,64;6.00), ter entre 30-44 (PR=10,71.CI:5,00;22,94) e 45-59 anos (PR=2,69. CI:1,66;4,37), e menor HTA, considerar-se com sobrepeso (PR=0.54. IC=0.34, 0.78). Conclusões: as condições laborais, hábitos e estilos de vida, aportam à explicação de HTA. Sendo estas, algumas características que aportam a configurar vulnerabilidade laboral, nesta população trabalhadora.

Factores de riesgo asociados a la pérdida insuficiente o ganancia significativa de peso en pacientes sometidos a cirugía bariátrica / Risk factors associated with insufficient weight loss or significant weight gain in patients undergone bariatric surgery

Introducción. La cirugía bariátrica es efectiva para inducir una rápida pérdida del exceso de peso, pero existen dudas sobre la duración de este efecto a largo plazo. Este estudio buscaba identificar la proporción de pacientes operados que presentaron una pérdida insuficiente o una ganancia significativa de peso y los posibles factores relacionados. Métodos. Estudio de cohorte retrospectivo en pacientes adultos sometidos a cirugía bariátrica. Se describieron variables demográficas y clínicas. Se realizó un análisis multivariado para identificar factores relacionados con un peso fuera de metas posterior a la cirugía. Resultados. Se incluyeron 187 pacientes, 117 con baipás gástrico y 70 con manga gástrica. La mediana de índice de masa corporal preoperatorio fue 41,3 kg/m2 y postoperatorio de 28,8 kg/m2. El 94,7 % de los pacientes en ambos grupos logró una adecuada pérdida del exceso de peso. La ganancia de peso mayor del 20 % se presentó en el 43,5 % de los pacientes, siendo mayor en el grupo de manga gástrica (p<0,004). Los factores independientes para ganancia de peso fueron el sexo masculino (OR 5,5), cirugía tipo manga gástrica (OR 3,4), síndrome de apnea del sueño (OR 2,9) y enfermedad mental medicada (OR 2,8). Conclusión. La cirugía bariátrica produce una pérdida del exceso de peso suficiente en casi la totalidad de los pacientes, pero un buen número recuperan peso luego de 3 años. Los principales factores asociados a ganancia de peso son el sexo masculino y la cirugía tipo manga gástrica

Introduction. Bariatric surgery is highly effective in inducing rapid excess body weight loss but there are doubts about its effect on long-term. This study seeks to identify the number of patients that underwent bariatric surgery who present insufficient weight loss or significant weight gain and the possible related factors. Methods. Retrospective cohort study of adult patients who underwent bariatric surgery. Demographic and clinical variables are described. A multivariate analysis was performed to identify factors related to patient weight outside the set goals postoperatively. Results. 187 patients were included (117 gastric bypass, 70 gastric sleeve). The median preoperative body mass index was 41m/kg2 and 28.8m/kg2 postoperatively. 94.7% of the patients in both groups achieved adequate excess body weight loss. Weight gain (>20%) occurred in 43.5% of the patients, with the probability being higher in the gastric sleeve group (p<0.004). Independent factors for weight gain were male gender (OR 5.5), gastric sleeve surgery (OR 3.4), sleep apnea syndrome (OR 2.9), and mental illness under treatment (OR 2.8). Conclusions. Bariatric surgery produces sufficient loss of excess weight in almost all patients, but a good number of them regain weight after 3 years. The main factors associated with weight gain are male gender and gastric sleeve surgery

Accidente Lonómico: Reporte de dos casos / Lonomic accident: Report of two cases

Resumen Introducción: dentro de los insectos del orden lepidóptero, la familia Saturniidae tiene más de 2.400 especies, allí se encuentran Hylesia y Lonomia. Objetivo: presentar dos casos de pacientes con accidente lonómico, el manejo y desenlace para reconocer la importancia de estos eventos en las regiones silvestres de la Orinoquia colombiana. Casos clínicos: paciente de 8 años proveniente de área rural quien refería contacto en región palmar de mano derecha con gusanos quién 48 horas después de dicho contacto presentó equimosis en extremidades, flictena sangrante en talón derecho, cefalea, escalofríos y artralgias, además se evidenciaron tiempos de coagulación prolongados. Paciente de 13 años de características similares a las del caso previamente descrito sin presentar manifestaciones clínicas, pero que presentaba tiempos de coagulación prolongados. Se consideró que cursaba con accidente lonómico por lo que se aplicaron 5 ampollas de suero antilonómico polivalente a cada una sin registrar reacciones adversas. En ambos casos cursaron con evolución clínica adecuada con disminución a rangos de seguridad de tiempos de coagulación. Conclusiones: el veneno lonómico actúa en la cascada de coagulación produciendo manifestaciones hemorrágicas de gravedad variable. El suero antilonómico es el único tratamiento eficaz, a pesar de estar disponible desde hace más de 20 años en Brasil hay un 5% de progresión a síndromes hemorrágicos severos y un 1.5 a 2% de mortalidad. A pesar de tener gran relevancia clínica en las Américas existe subregistro, es importante conocer sus manifestaciones y el manejo para así poder evitar complicaciones mortales.

Abstract Background: among the insects of the order Lepidoptera, the family Saturniidae has more than 2,400 species, there are Hylesia and Lonomia. Objective: to present two cases of patients with lonomic accident, the management and outcome to recognize the importance of these events in the wild regions of the Colombian orinoquia. Clinical case: an 8-year-old patient from a rural area who refers to contact in the palmar region of the right hand with worms for more than 48 hours, presents ecchymosis in the extremities, bleeding flictena in the right heel, headache, chills and arthralgias. Clotting times are performed which are prolonged. A 13-year-old patient who also referred contact without presenting clinical manifestations but presenting prolonged clotting times. They are considered to occur due to a lonomic accident, so 5 ampoules of polyvalent antilonomic serum are administered to each one without registering adverse reactions. They have an adequate clinical evolution with a decrease in the safe ranges of clotting times. Conclusions: the lonomic venom acts in the coagulation cascade producing hemorrhagic manifestations of variable severity. Antilonomic serum is the only effective treatment, despite being available for more than 20 years in Brazil, there is a 5% progression to severe hemorrhagic syndromes and 1.5 to 2% mortality. Despite being of great clinical relevance in the Americas, there is an underreporting, it is important to know its manifestations and management in order to avoid fatal complications.

Riesgo biomecánico por sobrecarga estática y presencia de trastornos musculoesqueléticos en odontólogos durante su práctica clínica asistencial. Una revisión narrativa / Ergonomic risk by static overload and musculoskeletal disorders in dental practice: a review / Risco biomecânico devido a sobrecarga estática e presença de distúrbios musculosqueléticos em dentistas durante sua prática clínica de assistência. Uma revisão narrativa

Resumen Los trastornos musculoesqueléticos son lesiones que afectan el movimiento corporal, incluyendo músculos, tendones, ligamentos, entre otros. Estos trastornos son unos de los problemas más importantes en la práctica clínica odontológica, ocasionados en su mayoría por sobrecarga física tanto dinámica como estática, en particular para esta última, toma relevancia la postura mantenida en posición bípeda o sedente durante la realización de procedimientos extremadamente precisos en un espacio de trabajo tan pequeño como lo es la cavidad oral; por esto, se pretende con base en la literatura existente, describir el riesgo biomecánico por sobrecarga estática y los trastornos musculoesqueléticos en odontólogos. Con esta intención se realizó una revisión narrativa de la literatura científica al respecto en español e inglés de productos de investigación de los últimos diez años, utilizando descriptores DeCS y MeSH, en fuentes académicas y científicas de Pubmed, Medline, Scopus y Google académico en donde se seleccionaron 50 artículos teniendo como resultado principal que si existe una relación entre riesgo biomecánico y sobrecarga estática con la aparición de trastornos musculoesqueléticos.

Abstract Musculoskeletal disorders are injuries that affect body movement, including muscles, tendons, ligaments, among others. These disorders are one of the most important problems in dental clinical practice, caused mostly by static overload due to prolonged posture in a standing or sitting position when performing extremely precise procedures in a workspace as small as the oral cavity; For this reason, based on the existing literature, it is intended to describe the biomechanical risk due to static overload and musculoskeletal disorders in dentists. With this intention, a narrative review of the scientific literature on the matter in Spanish and English of research products of the last ten years was carried out using DeCS and MeSH descriptors, in academic and scientific sources of PubMed, Medline, Scopus and academic Google in where 50 articles were selected, the main result being that there is a relationship between biomechanics factors and static overload with the use appearance of musculoskeletal disorders.

Resumo As desordens musculoesqueléticas são lesões que afetam os movimentos do corpo, incluindo músculos, tendões, ligamentos, entre outros. Esses distúrbios constituem um dos problemas mais importantes na prática clínica odontológica, ocasionados principalmente pela sobrecarga física, tanto dinâmica quanto estática, em particular para esta última, torna-se relevante a postura mantida na posição bípede ou sentada durante procedimentos extremamente precisos. tão pequeno quanto a cavidade oral; Portanto, pretende-se, com base na literatura existente, descrever o risco biomecânico devido à sobrecarga estática e distúrbios musculoesqueléticos em dentistas. Com esse intuito, foi realizada uma revisão narrativa da produção científica sobre o assunto, em espanhol e inglês, de produtos de pesquisa dos últimos dez anos, utilizando os descritores DeCS e MeSH, em fontes acadêmicas e científicas do Pubmed, Medline, Scopus e Google acadêmico onde foram selecionados 50 artigos, sendo que o principal resultado é que existe uma relação entre o risco biomecânico e a sobrecarga estática com o aparecimento de distúrbios musculoesqueléticos.

Tendencias temporales del cáncer de cuello uterino invasivo en mujeres entre 20 y 39 años en Manizales, Colombia. 2003-2018 / Temporary trends of invasive uterine cancer in women between 20 and 39 years. Manizales, Colombia. 2003-2018

Resumen Objetivo: Analizar la tendencia de la incidencia de cáncer de cuello uterino invasivo en mujeres entre 20 y 39 años en Manizales, Colombia, 2003-2018. Materiales y métodos: Estudio observacional, descriptivo, retrospectivo, de base poblacional. Se evaluaron las tendencias temporales en la incidencia (con referencia a Población Segi, por 100.000 mujeres/año) utilizando la regresión de Joinpoint (Joint Point Regression Program v. 4.7.0.0 del National Cancer Institute de los EEUU) para estimar los cambios porcentuales anuales y años de variación significativa en las tendencias. Resultados: Se realizó el estudio con un total de 116 pacientes, cuya edad promedio al momento del diagnóstico fue 33.7 años. Sólo se hallaron 3 casos de cáncer invasivo en mujeres entre 20 y 25 años. El mayor número de casos se presentó en el grupo de mujeres de 35 a 39 años. El tipo histológico más frecuente fue el carcinoma escamocelular. El 45.6% de los casos se diagnosticaron en etapas tempranas. El Cambio Porcentual Anual Promedio calculado mediante el modelo de regresión Joinpoint mostró un descenso de 7,9% en la tasa de incidencia entre 2003 y 2018, con un punto de quiebre en el año 2010. Conclusiones: El cáncer de cuello uterino en Manizales tiene escasa frecuencia en mujeres menores de 25 años y para edades entre 20 y 39 años muestra una tendencia a la disminución en el tiempo, en particular desde el año 2010 en adelante.

Abstract Objective: This article analyzes the invasive uterine cancer occurrences in women between 20 and 39 years old in Manizales, Colombia, 2003-2018. Materials and methods: Observational, descriptive, retrospective, population-based study. Temporary trends of occurrences were evaluated (as referring to Population Segi, per 100,000 women / year) by using the Joinpoint regression (Joint Point Regression Program v. 4.7.0.0 of the National Cancer Institute of the USA), in order to estimate annual percentage changes and number of years of significant variation in trends. Results: The study was carried out with a total of 116 patients, whose average age at the time of diagnosis was 33.7 years. Only 3 invasive cancer cases were found in women between the ages of 20 and 25. The greatest number of cases occurred in the group of women between 35 and 39 years old. The most frequent histological type was squamous cell carcinoma. 45.6% of cases were diagnosed in early stages. The Average Annual Percentage Change calculated using the Joinpoint regression model showed a 7.9% decrease in the incidence rate between 2003 and 2018, with a breaking point in 2010. Conclusions: Cervical cancer in Manizales is infrequent in women under the age of 25; and, for ages between 20 and 39, it has shown a tendency to decrease over time, particularly from 2010 onwards.

Factores relacionados con osteoartritis en trabajadores informales del centro de Medellín, Colombia / Related factors with Osteoarthritis in informal workers in Medellin downtown, Colombia

Resumen Introducción: Se hace una correlación entre la osteoatrosis y las condiciones laborales, hábitos y estilos de vida de los trabajadores informales del centro de Medellín, Colombia. Objetivo: Identificar la relación de la osteoartritis y la prevalencia de enfermedades crónicas y degenerativas con las condiciones sociodemográficas, laborales, hábitos y estilos de vida en un grupo de trabajadores informales de Medellín, Colombia. Materiales y métodos: Estudio transversal, con fuente primaria de información de 686 trabajadores informales. Se realizó una encuesta asistida, previa toma de consentimiento. Se seleccionaron 289 trabajadores con diagnóstico de enfermedad crónica o degenerativa, ≥18 años, con ≥5 años en su oficio. Se realizaron análisis exploratorios y de asociación con prueba Chi2, y cálculo de RP con IC del 95%. Resultados: el 79,9% de la población padecía alguna enfermedad crónica. El 3,46% presentaba diagnóstico de osteoartritis, siendo significativamente mayor (p<0,05) en quienes tenían entre 21 y 30 años en su oficio (RP=5,62. IC:1,20;26,34). También fue mayor la prevalencia de osteoartritis en; >45 años (RP=2,26), mujeres (RP:4,44), trabajadores sedentarios (RP=1,71), obesos (RP=3,40), así como en quienes habían sido obreros (RP=1,30), en aquellos que tenían puestos de venta semiestacionaria (RP=2,21), vendían productos de cosecha y perecederos (RP=1,78), en quienes trabajaban >8 horas diarias (RP:2,77), ≤5días a la semana (RP=3,10), no tenían espacio suficiente para moverse (RP=2,08), y en quienes tenían posturas o movimientos forzados (RP=2,72). Conclusión: En la población de vendedores informales del centro de Medellín, los factores sociodemográficos, laborales, hábitos y estilos de vida modificables se relacionan con una mayor prevalencia de osteoartritis.

Abstract Introduction: A correlation is made regarding osteoarthrosis and working conditions and lifestyles of informal workers in Medellin downtown. Objective: To identify the prevalence of chronic and degenerative diseases, and the relationship of osteoarthritis with sociodemographic and work conditions, habits and lifestyles, in a group of informal workers from Medellín, Colombia. Materials and methods: Cross-sectional study, with a primary source of information, with 686 workers. An assisted survey was applied, after obtaining consent. 289 workers with a diagnosis of chronic or degenerative disease, ≥18 years old, with ≥5 years in their profession were included. Exploratory and association analysis with Chi2 test, and calculation of PR with 95% CI. Results: 79.9% of them suffered from a chronic disease. 3.46% had a diagnosis of osteoarthrosis, being significantly higher (p <0.05) in those who had spent between 21 and 30 years performing their profession (PR=5,62.CI:1,20;26,34). The prevalence of osteoarthrosis was also higher in; >45 years (PR=2.26), women (PR=4,44), sedentary workers (PR=1,71), obese (PR=3,40), as well as those who had been brick-layers (PR=1,30), in those who had semi-stationary sales positions (PR=2,21), they sold harvest and perishable products (PR=1,78), in those who worked> 8 hours a day (PR:2,77), ≤ 5 days a week (PR=3,10), they did not have enough space to move (PR = 2.08), and in those who had forced postures or movements (PR=2,72). Conclusion: sociodemographic and work factors, habits and modifiable lifestyles are related to a higher prevalence of osteoarthrosis in this working population.

In-Operando Study of Shape Retention and Microstructure Development in a Hydrolyzing Sol-Gel Ink during 3D-Printing.

3D printing of amorphous and crystalline ceramics is of paramount importance for the fabrication of a wide range of devices with applications across different technology fields. Printed ceramics are remarkably enabled by the sol-gel synthesis method in conjunction with continuous filament direct ink writing. During printing, multiple processes contribute to the evolution of inks including shape retention, chemical conversion, solidification, and microstructure formation. Traditionally, depending on the ink composition and printing environment, several mechanisms have been associated with the shape retention and solidification of 3D printed structures: gelation, rapid solvent evaporation, energy-driven phase transformation, and chemical-driven phase transformation. Understanding the fundamental differences between these mechanisms becomes key since they strongly influence the spatiotemporal evolution of the materials, as the out-of-equilibrium processes inherent to the extrusion, relaxation, and solidification of printed materials have significant effects on the materials properties. In this work, we investigate the shape retention mechanism and the hydrolysis-induced material conversion and microstructure formation during the 3D printing of a water reactive sol-gel ink that transforms into titanium dioxide-based ceramic. This study aims at identifying characteristic mechanisms associated with the material transformation, establishing connections between the microstructure development and the timescales associated with solidification under operando 3D-printing conditions. The investigation of this material's out-of-equilibrium pathways under processing conditions is enabled by time-resolved coherent X-ray scattering, providing simultaneous access to temporospatially resolved microstructural and dynamics information. Furthermore, we explore X-ray speckle tracking as a tool to resolve deformations of the microstructure in a printed filament associated with the deposition of consecutive filaments. Through this work, we aim at providing a fundamental understanding of the relationships behind these transformative processes in 3D printing and their timescales as the basis for achieving unprecedented control over printed materials microstructure.

Correspondencia entre el índice de placa y el recuento de Streptococcus mutans y Lactobacillus sp. en una población infantil: Un estudio transversal / Correspondence between plaque index and Streptococcus mutans and Lactabacillus spp. counts in a child population: A cross-sectional study

Antecedentes: La identificación de microorganismos como Streptococcus mutans(SM) y Lactobacillus sp. (LB) es un predictor del desarrollo de caries, sin embargo los métodos de identificación son de acceso limitado por su alto costo. Objetivo:determinar la correlación entre la biopelícula dental medida por el índice de placa bacteriana de (IPB) Silness y Löe modificado y el recuento de SM y LB en niños colombianos en edad preescolar. Este es un estudio descriptivo de corte transversal y correlacional. Materiales y métodos: Se tomaron 202 muestras de niños entre los 3 y 4 años de edad de tres jardines Infantiles de Cali, Colombia, pertenecientes al estrato socioeconómico 1 y 2, evaluados en cuatro tiempos (0, 3, 6 y 9 meses). Resultados: Hubo una correlación entre el IPB más alto y el mayor recuento de unidades formadoras de colonia de SMsólo a los 3 meses (p = 0,003*). Los recuentos de LB fueron homogéneos en todos los niños y no presentaron correlación con el IPB. Conclusión: Se observaron resultados mixtos sobre la relación entre IPB y los recuentos de SM presentes en la saliva, por lo cual se requiere un análisis de múltiples factores.

Background:The identification of microorganisms such as Streptococcus mutans(SM) and Lactobacillusspp. (LB) is a predictor of the development of caries, however the identification methods are of limited access due to their high cost. Aim:To determine the correlation between the dental biofilm measured by the modified Silness and Löe dental plaque index (DPI)) and the SM and LB count, in preschool children from Colombia. Materials and methods: This is a descriptive cross-sectional and correlational study. We took202 samples from children between 3 and 4 years of age from three kindergartens in Cali, Colombia, belonging to socioeconomic stratum 1 and 2, evaluated at four times (0, 3, 6 and 9 months). Results: We found a correlation between the highest IPB and thehighest count of SM colony forming units only at 3 months (p = 0.003*). LB counts were homogeneous in all children and there was no correlation with IPB. Conclusion: We observed mixed results on the relationship between IPB and the counts of SM present in the saliva, therefore an analysis of multiple factors is required.KEY WORDSDental plaque;Streptococcus mutans;Lactobacillus spp;dental caries.1

Niveles de referencia de dosis de radiación para la toma de imágenes en pediatría / Reference Levels of Radiation Dose for Imaging in Pediatrics

Introducción: El uso de dosis adecuadas de radiación en pacientes pediátricos es un deber de los centros de diagnóstico médico debido a las características y retos que implica esta población. Por lo anterior, se han establecido unos niveles internacionales de referencia de dosis (DRL, del inglés dose reference level) para optimizar y comparar los protocolos de cada institución. En Colombia no se cuenta con estudios al respecto. Objetivo: Mostrar los DRL utilizados en un hospital universitario de alta complejidad en las modalidades de tomografía computarizada (TC), radiografía y fluoroscopia y compararlos con los estándares internacionales. Metodología: Estudio descriptivo retrospectivo realizado entre 2018 y 2019. Se analizaron datos de producto dosis longitud (DLP) para TC de cráneo, tórax, abdomen y TC de tórax de alta resolución (TACAR); y producto dosis área (DAP) para radiografía de tórax, abdomen, huesos y fluoroscopia por grupos etarios. Resultados: Se obtuvieron los datos de 780 pacientes: 360 radiografías, 100 de fluoroscopia y 320 tomografías. Se encontró que los niveles de referencia de dosis de radiación usados en el hospital son bajos, comparados con guías europeas de 2018 de niveles de referencia. Se describen DRL para cada estudio y grupo etario. Conclusión: Se demostró que en el hospital donde hizo el estudio los niveles de referencia de radiación en la población pediátrica son bajos. El presente trabajo puede servir como referente nacional.

Introduction: Due to the characteristics and challenges of the pediatric population regarding radiation, the use of adequate doses of radiation is a duty of medical diagnostic centers. For this reason, the Dose Reference Levels (DRL) have been established in many countries to optimize and monitor the protocols of each institution. In Colombia there are no studies in this subject. Objective: To show the DRLs used in a university hospital of high complexity in the modalities of computed tomography (CT), radiography and fluoroscopy and to compare them with international standards. Methodology: Retrospective descriptive trial between 2018 and 2019. We analyzed dose length product (DLP) data for skull, chest, abdomen, and high-resolution chest CT (HRCT); and dose area product (DAP) for chest, abdomen, bone, and fluoroscopy radiography by age groups. Results: Data were collected for a total of 780 patients. 360 x-rays, 100 fluoroscopy and 320 tomography scans. Reference levels of radiation dose used in the hospital were found to be low compared to European guidelines of 2018 reference levels. DRLs are described for each study and age group. Conclusion: It was demonstrated that at the hospital where the study was conducted, reference levels of radiation in the pediatric population are low. This work can serve as a national reference.

On the unusual amber coloration of nanoporous sol-gel processed Al-doped silica glass: An experimental study.

Silica is the most abundant component on the earth's surface. It plays an important role in many natural processes. Silica is also a critical material for a wide range of technical applications such as in optics and electronics. In this work, we discuss our recent experimental observation of the unusual amber coloration of aluminum doped sol-gel glass that has not been reported in the past. We characterized Al-doped sol-gel glasses, prepared at different sintering temperature, using a plethora of techniques to investigate the origin of this unusual coloration and to understand their structural and chemical properties. We used these experimental results to test a number of possible coloring mechanisms. The results suggested this coloring is likely caused by temperature-dependent aluminum-associated defect centers associated with different amorphous-to-crystalline ratios of the annealed sol-gel silica glass structures.

Revisión sistemática de "miocinas y regulación metabólica" / A systematic review of "myokines and metabolic regulation"

Malos hábitos como el sedentarismo, obesidad o sobrealimentación, se relacionan a la evolución de estados pro-inflamatorios crónicos, principal factor de riesgo para el desarrollo de enfermedades crónicas no transmisibles (ECNT). Sin embargo, modificar únicamente el peso corporal no reduce el riesgo, es necesario también aumentar la masa muscular, dando a entender que existe una relación benéfica asociada a este tejido que no está totalmente dilucidada. Durante los últimos años, las explicaciones celulares más interesantes se han enfocado en la producción de citokinas musculares denominadas miokinas, dentro de las que se destacan la interleucina 6, el factor inhibidor de la leucemia, entre otras recientemente estudiadas como lo son la mionectina y la musclina. Debido a los múltiples avances, se realiza una revisión que pretende: presentar los hallazgos más recientes y representativos acerca de las miokinas, corregir conceptos y demostrar su aplicabilidad en la prescripción del ejercicio físico para la salud

Bad habits such as sedentary lifestyle, obesity or overfeeding, are related to the production of chronic pro-inflammatory states, the main risk factor for the development of chronic noncommunicable diseases (CNCD). However, modifying only the body weight does not reduce the risk, it is necessary to increase muscle mass, this implies there is a beneficial relationship associated with the muscle tissue that is not fully elucidated. During the last years, the most interesting cellular explanations have focused on the production of muscle cytokines called myokines, among which stand out interleukin 6, the inhibitory factor of leukemia, with others recently studied such as mionectine and muscline. Due to the multiple advances, this intends to present the most recent and representative findings about myokines, correct concepts and demonstrate their applicability in the prescription of physical exercise for health