Development of a Second Primary Lung Cancer Following a Primary Breast Cancer: A Case Series.

Breast cancer (BC) accounts for 24.2% of all women's malignant tumors, with rising survival rates due to advancements in chemotherapy and targeted treatments. However, second primary cancers, particularly lung cancer (LC), have become more prevalent, often emerging approximately 10 years after BC treatment. This study presents a case series of 9 women diagnosed with second primary LC following BC, treated at a high-complexity hospital in Colombia between 2014 and 2019. All initial BCs were ductal carcinomas, 7 were triple negative, 1 was human epidermal growth factor receptor 2 positive, and 1 was estrogen and progesterone positive. Each patient had undergone radiation therapy, and 7 had received chemotherapy, increasing their LC risk. The second primary LCs, all adenocarcinomas, were confirmed using immunohistochemical stains for thyroid transcription factor-1 (TTF-1), Napsin A, and estrogen receptor (ER) status. The interval between treatments and LC detection ranged from 1 to 17 years, with 4 cases identified after 10 years and 3 within 1 to 3 years, underscoring the need for prolonged surveillance. Seven LCs were ipsilateral to the BC and radiation site, while 2 were contralateral, highlighting the necessity of monitoring both sides for potential LC development. This case series enhances the local epidemiological understanding, showing that prior radiotherapy for BC and histological analysis are key in characterizing second primary LC patients. The study emphasizes the critical role of accurate histological diagnosis in guiding treatment approaches for lung lesions in BC survivors.

Caracterización clínica y epidemiológica de la enfermedad pulmonar obstructiva crónica / Clinical and epidemiological characterization of chronic obstructive pulmonary disease

Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con enfermedad pulmonar obstructiva crónica. Métodos: estudio descriptivo retrospectivo trasversal, que incluyó pacientes adultos con diagnóstico de enfermedad pulmonar obstructiva crónica en un hospital universitario de Medellín. Material y métodos: la fuente de información fue secundaria a través de historias clínicas, el análisis se realizó en el programa Jamovi, empleando un análisis univariado. Resultados y discusión: se incluyeron 552 pacientes, la edad mediana fue 76 años con predominio del sexo femenino (56.7%). Respecto a la exposición a sustancias tóxicas respiratorias importantes en el desarrollo de la enfermedad, 24.1% consumían cigarrillo y 23% exposición a biomasa. Al momento del ingreso hospitalario 17.9% fueron clasificados con disnea grado IV; 74.1% recibió beta-agonistas de corta acción y antimuscarínicos de corta acción 60%; 11.6% requirió ingreso a las unidades de cuidados intensivos o especiales y 7.8% fallecieron durante la hospitalización. Conclusiones: se evidencia subdiagnóstico espirométrico de la enfermedad que puede estar relacionado con las limitaciones económicas, tecnológicas y de recurso humano capacitado, lo cual afecta el adecuado diagnóstico y manejo de la enfermedad, así como impacta la calidad de vida de los pacientes.

Objective: clinical and epidemiological characterization of patients with chronic obstructive pulmonary disease (COPD). Methods: a retrospective, cross-sectional, descriptive study, which included adult patients with a diagnosis of COPD in a university hospital in Medellín. Data sources were secondary, based on medical records. The Jamovi program was used to perform a univariate analysis. Results and discussion: 552 patients were included. Median age was 76 years with a female predominance (56.7%). Regarding exposure to major respiratory toxic substances implicated in the development of the disease, 24.1% were tobacco smokers and 23% were exposed to biomass smoke. At the time of hospital admission,17.9% were classified as having grade 4 dyspnea; 74.1% received short acting beta-agonists and 60% short-acting antimuscarinics,11.6% required intensive care unit or special care unit admission, and 7.8% died in hospital. Conclusions: under-diagnosis of COPD by spirometry may be related to economic, technological, and trained human resource limitations, which affect adequate diagnosis and management of the disease, as well as patient ́s quality of life.

Tromboprofilaxis entrauma / Thromboprophylaxis in Trauma Santiago Castañeda Palacio1

Introducción: Las lesiones traumáticas son una de las principales causas de morbilidad y mortalidad en todo el mundo. Los pacientes que sufren traumatismos tienen riesgo de estados de hipercoagulación y aumentan el riesgo de sufrir enfermedad tromboembólica venosa. La tromboprofilaxis hace referencia a cualquier intervención usada para prevenir el desarrollo del tromboembolismo venoso como son la trombosis venosa profunda y el tromboembolismo pulmonar. Objetivo: Realizar una revisión sobre los principales mecanismos de tromboprofilaxis y sus principales esquemas en relación con el trauma ortopédico. Métodos: Se realizó una búsqueda de artículos de investigaciones originales en las bases de datos MEDLINE, EMBASE, Lilacs y Science Direct. Se seleccionaron palabras claves y términos del MeSH relacionados con anticoagulantes, tromboembolismo venoso, y embolismo pulmonar entre otros. La mayoría de bibliografía utilizada tuvo un rango de publicación no mayor a 5 años. Conclusiones: Los pacientes que sufren traumas tienen riesgo de sufrir estados de hipercoagulación y aumentan el riesgo de una enfermedad tromboembólica venosa. Con el fin de prevenirla se utilizan en la tromboprofilaxis distintos medicamentos, como heparinas de bajo peso molecular, y dispositivos de compresión(AU)

Introduction: Traumatic injuries are one of the leading causes of morbidity and mortality worldwide. Up to six million people die due to this cause. Trauma patients are at risk for hypercoagulable states and are at increased risk for venous thromboembolic disease. Thromboprophylaxis refers to any intervention used to prevent the development of venous thromboembolism such as deep vein thrombosis and pulmonary thromboembolism. Objective: To carry out a practical review of the main mechanisms of thromboprophylaxis and its main schemes in relation to orthopedic trauma. Methods: A search for original research articles was conducted in MEDLINE, EMBASE, Lilacs, and Science Direct databases. The keywords and MeSH terms related to anticoagulants, venous thromboembolism, and pulmonary embolism were selected among others. Most of the bibliography used had a publication range of no more than 5 years. Conclusions: Patients who suffer trauma are at risk of hypercoagulable states and these increase the risk of venous thromboembolic disease. In order to prevent it, different drugs are used in thromboprophylaxis, such as low molecular weight heparins, among others, as well as other compression devices(AU)

Inulin as a Fat-Reduction Ingredient in Pork and Chicken Meatballs: Its Effects on Physicochemical Characteristics and Consumer Perceptions.

Fat reduction in meat products represents a technological challenge, as it affects the physicochemical and sensory properties of foods. The objective of the present investigation was to develop reduced-fat pork and chicken meatballs. In the initial stage, a survey was performed on 387 individuals, in order to determine the consumer perception of the meaning of a healthy meatball and the likelihood that they would consume such a product. In the second stage, four pork and chicken meatball formulations were developed: control meatballs (AC), meatballs with inulin (AI), meatballs with fructo-oligosaccharides (AF), and meatballs with inulin and fructo-oligosaccharides (AM). In the third stage, physicochemical properties were evaluated (water activity, humidity, fat, protein, ash, weight loss, pH, color, and texture) and a sensorial profile was created with semi-trained panelists for the four meatball formulations. In the fourth stage, AI was selected as the meatball with sensorial and physicochemical characteristics most similar to AC. An analysis of nutritional characteristics and a home test (84 consumers) were performed. The present study established that the inclusion of inulin as a fat substitute in the preparation of pork and chicken meatballs, in the amount of 3.5 g of fiber/100 g of the mixture, imitates the technological properties characteristic of fat and showed acceptance by consumers.

Adherence to Antidepressant Therapies in Patients with Depressive Disorders Attending an Outpatient Clinic in a Public Mental Health Hospital, Antioquia, Colombia in 2017.

To evaluate the level of adherence to antidepressant therapies and associated factors in patients with depressive disorders. a cross-sectional analytical study was conducted in patients diagnosed with depressive disorders. The sample was for convenience, and a survey including sociodemographic, clinical, and therapeutic variables was designed. The Morisky-Green test, Beliefs about Medicines Questionnaire, and Simplified Medication Adherence Questionnaire were also used, all of which have been validated for assessing adherence in patients with depression. The qualitative variables were evaluated with absolute and relative frequencies, and a bivariate analysis was performed. This study included 54 patients with an average age of 49.5 ± 13.7 years, and 83.3% were women. All patients were diagnosed with major depression, and 9.25% also had an anxiety disorder. According to the Morisky-Green test, only 37% of patients were compliant with the drug therapy, although this was not statistically significant. Women were less compliant than men (33.3% versus 55.6%; p = 0.21). The beliefs that patients have regarding medication do not have a great impact on adherence to antidepressant therapy. However, it was evidenced that adherent patients had less doubts about the medication administered in comparison to non-adherent patients.

Características clínicas y demográficas de los pacientes incidentes en diálisis crónica y su relación con el ingreso programado a diálisis / Clinical and demographic characteristics of incident patients on chronic dialysis and its relationship to the planned admission to dialysis

Resumen Objetivo: describir las características clínicas y demográficas de los pacientes incidentes en diálisis, y su relación con el inicio programado de diálisis en la Unidad Renal del Tolima en la ciudad de Ibagué. Contexto y tipo de estudio: estudio observacional de corte transversal. Población de referencia conformada por los pacientes de nefrología atendidos en 10 hospitales de la ciudad de Ibagué y por los pacientes que asisten a consulta externa de nefrología de la Unidad Renal del Tolima. Material y métodos: información recolectada por los investigadores mediante revisión de historias clínicas, variables sociodemográficas y clínicas que determinan las características del ingreso a diálisis. Resultados: se analizaron 74 pacientes con mediana de edad 65 años. En 82.4% la modalidad dialítica inicial fue hemodiálisis. El 93.5% de los pacientes incidentes a hemodiálisis inició en forma no programada. El 43.2% del total de incidentes a diálisis tuvo valoración previa por nefrología, y de éstos el 71.9% ingresó de forma no programada a diálisis. El 50% de los pacientes que vive fuera de Ibagué y el 43.7% de los que lo hace en zona rural seleccionan hemodiálisis como terapia definitiva. Se asocian en forma estadísticamente significativa al inicio programado de diálisis: cuidado previo por nefrología, régimen de salud contributivo, nefropatía diabética, condición ambulatoria al inicio de diálisis, y diálisis peritoneal como modalidad dialítica inicial. Conclusiones: los pacientes incidentes tuvieron una edad avanzada, y en su mayoría ingresaron estando hospitalizados y sin acceso dialítico definitivo inclusive dentro del grupo de pacientes con manejo previo por nefrología. (Acta Med Colomb 2013; 38: 138-142).

Abstract Objective: to describe the clinical and demographic characteristics of incident patients in dialysis, and its relation to the programmed start of dialysis in the Renal Unit of Tolima in Ibagué. Context and type of study: cross-sectional observational study. Reference population comprised nephrology patients treated at 10 hospitals in the city of Ibague and patients attending the outpatient nephrology Renal Unit of Tolima. Material and methods: information collected by researchers by reviewing medical records, demographic and clinical variables that determine the characteristics of admission to dialysis. Results: we analyzed 74 patients with a mean age of 65 years. In 82.4% the initial dialysis modality was hemodialysis. 93.5% of patients starting hemodialysis started in a nonprogrammed way. 43.2% of all incident patients to dialysis had prior nephrology assessment, and of these, 71.9% were admitted for dialysis in a nonprogrammed way. 50% of patients who live outside of Ibague and 43.7% of those in rural areas select hemodialysis as a definitive therapy. Factors associated in a statistically significant way to the programmed start of dialysis, are: prior nephrology care, contributory health scheme, diabetic nephropathy, ambulatory status at the start of dialysis, and peritoneal dialysis as initial dialysis modality. Conclusions: incident patients had an advanced age, and were mostly admitted being hospitalized without definitive dialysis access even within the group of patients with prior management by nephrology. (Acta Med Colomb 2013; 38: 138-142).

Depurando la Terminologia Anatomica: Apertura y Foramen, Dos Similitudes y Redundancia Terminológica / Refining the Anatomical Terminology: Opening and Foramen, Two Similarities and Redundancy

El uso redundante de términos en el campo de la morfología, además de dificultar el aprendizaje de los estudiantes, va en contra de los preceptos establecidos por el Programa Federativo Internacional para la Terminología Anatómica (FIPAT) sobre el uso de una terminología anatómica unificada, mediante la cual se pretende evitar la redundancia terminológica. Se propone suprimir el término apertura piriforme y reemplazarlo por el término foramen piriforme, con el fin de evitar la ambigüedad y la utilización de distintos nombres que describen a una estructura de similares características.

The redundant use of terms in morphology field, as well as hindering the learning of students, goes against the precepts established long ago by the Federative International Programme for Anatomical Terminology (FIPAT) on the use of unified anatomical terminology, which is meant to avoid the redundancy terms. It is proposed to delete the term piriform aperture and replace it for the term piriform foramen in order to avoid ambiguity and the use of different names that describe similar structure features.