High-risk HPV prevalence and vaccination coverage among Indigenous women in the Colombian Amazon: Implications for cervical cancer prevention. Cross-sectional study.

Cervical cancer, primarily caused by Human Papillomavirus (HPV) transmission through sexual contact, necessitates comprehensive strategies to combat its impact on women's health. Yet, certain underserved populations, such as low socioeconomic and ethnic minority groups, encounter barriers in accessing timely interventions and early diagnosis. This cross-sectional study was conducted with the aim of assessing HPV prevalence, genotype distribution, and co-infections among 280 adult women residing in a Colombian Indigenous Reserve within the Amazon region. The research adhered to a community-centric approach that respected cultural norms, native languages, and Indigenous authorities' permission. The study revealed an overall HPV infection prevalence of 31.1% (n = 87, 95% CI 25.7-36.8), with 22.5% (n = 63, 95% CI 17.7-27.8) of women infected by at least one high-risk HPV genotype and 15.0% (n = 42, 95% CI 11-19.7) infected by at least one LR genotype. These results align with the findings of other Colombian studies. Notable high-frequency genotypes included 16, 52, 66, 56, and 68, with the most common combinations being [66-52] and [66-58]. The study also assessed the prevalence of HPV vaccination, revealing a rate of 22.9%, lower than the national average. In vaccinated women, the prevalence of genotypes 16 and 18 was significantly reduced, as anticipated. Importantly, it was observed that 57.1% of all high-risk HPV infections could have been prevented with the use of the nonavalent vaccine. These findings underscore the critical need to enhance adherence to early cervical cancer detection and monitor positive cases to evaluate high-risk HPV persistence. Efforts should be directed toward continuing vaccination coverage against high-risk HPV 16 and 18 with the quadrivalent vaccine, while also striving to make the nonavalent vaccine accessible for inclusion in large-scale public health programs. Additionally, the study did not identify a specific pattern of co-infection. The study emphasizes the significance of adopting a locally tailored epidemiological approach to guide and promote cervical cancer prevention efforts in Indigenous communities.

Use of the ReSVinet Scale for parents and healthcare workers in a paediatric emergency service: a prospective study.

Introduction: Most scales for acute respiratory infection (ARI) are limited to healthcare worker (HCW) use for clinical decision-making. The Respiratory Syncytial Virus network (ReSVinet) Scale offers a version for parents that could potentially help as an early warning system. Objective: To determine whether or not the ReSVinet Scale for ARI in infants can be reliably used by HCWs and parents in an emergency service. Methods: A prospective study was done of infants with ARI who were admitted to a paediatric emergency room to assess the ReSVinet Scale when used by faculty (paediatric doctor-professors), residents (doctors doing their first specialty in paediatrics) and parents. Spearman's correlation and a weighted kappa coefficient were used to measure interobserver agreement. Internal consistency was also tested by Cronbach's alpha test. Results: Overall, 188 patients, 58% male, were enrolled. A Spearman's correlation of 0.92 for faculty and resident scoring and 0.64 for faculty or resident and parent scoring was found. The weighted kappa coefficients were 0.78 for faculty versus residents, 0.41 for faculty versus parents, and 0.41 for residents versus parents. Cronbach's alpha test was 0.67 for faculty, 0.62 for residents and 0.69 for parents. Conclusion: There was good correlation in the ReSVinet scores between health professionals when used in the paediatric emergency area. Agreement between parents and health professionals was found to be more variable. Future studies should focus on finding ways to improve its reliability when used by parents before the scale is used in the emergency room.

Competencias adquiridas con simuladores en programas de entrenamiento en cirugía laparoscópica ginecológica: una revisión de revisiones / Acquired skills with laparoscopic simulators in gynaecological laparoscopic surgery training programs: A review of reviews

INTRODUCCIÓN: La cirugía laparoscópica ginecológica demanda un entrenamiento en simuladores para desarrollar habilidades diferentes a la cirugía convencional. No hay un acuerdo sobre las competencias estándar que debe obtener un aprendiz en un simulador de laparoscopia. OBJETIVO: Identificar las competencias en cirugía laparoscópica ginecológica que se pueden adquirir con entrenamientos simulados y los tipos de simuladores que permiten hacerlo. MÉTODOS: Se realizó una revisión de revisiones en MEDLINE, EMBASE, ERIC y publicaciones oficiales de instituciones en cirugía endoscópica. Los criterios de inclusión fueron artículos relacionados con habilidades y simulación en laparoscopia realizada por ginecólogos graduados o en formación. RESULTADOS: Se seleccionaron 12 revisiones sistemáticas, donde se evidenciaron 11 tareas, 7 habilidades y 5 procedimientos que se pueden practicar en los simuladores. Los simuladores encontrados se dividieron en simuladores de realidad virtual, videosimuladores y cajas de entrenamiento. La heterogeneidad de los estudios no permitió agrupar estos hallazgos en un metaanálisis. Se listan los métodos para evaluar la transferencia de las habilidades adquiridas. CONCLUSIONES: El entrenamiento simulado en laparoscopia permite desarrollar varias competencias quirúrgicas. Su práctica en los simuladores es medible con parámetros objetivos para evaluar la transferencia de las competencias a la cirugía real, con posibles beneficios para el paciente

INTRODUCTION: Gynaecological laparoscopic surgery demands training in simulators to develop skills different from conventional surgery. There is no agreement on proficiency standards that a trainee must obtain in a laparoscopy simulator. OBJECTIVE: To identify the competences in gynaecological laparoscopic surgery that can be acquired with simulated training and the types of simulators that allow this to be done. METHODS: A review of reviews was carried out in MEDLINE, EMBASE, ERIC and official publications of institutions in endoscopic surgery. Inclusion criteria were articles related to laparoscopic skills and simulation made by graduate gynaecologists or in training. RESULTS: A total of 12 systematic reviews were selected in which there was evidence of 11 tasks, 7 skills, and 5 procedures that could be practiced on the simulators. The simulators found were divided in virtual reality simulators, video simulators, and box trainers. The heterogeneity of the studies did not allow these findings to be grouped in a meta-analysis. The methods for evaluating the transfer of acquired skills are listed. CONCLUSIONS: Simulated training in laparoscopy allows several surgical skills to be developed. Their practice in simulators is measurable with objective parameters to evaluate transfer of skills to real surgery, with possible benefits for the patient

Validación del handwashing assessment inventory en un hospital universitario de Bogotá / Validation of the handwashing assessment inventory scale at a university hospital in Bogota

El lavado de manos evita infecciones asociadas al cuidado; es necesaria una escala que mida la motivación y su cumplimiento. Objetivo: Validar el Handwashing AssessmentInventory (HAI) en enfermeras del Hospital de San José, Bogotá, Colombia. Métodos: Luego de la adaptación transcultural, se realizó el análisis factorial (AF). Para la validez concurrente se comparó el HAI con la escala Acttitudes Regarding Guidelines Practices (ARGP). Se evaluó consistencia interna (CI), confiabilidad prueba reprueba(CPR) y sensibilidad al cambio. Resultados: Se presentó una adecuada equivalencia lingüística. El AF indicó ocho dominios, similares a la escala original. La correlación entre escalas (ARGP- HAI) fue menor a 0,30. La CI indicó alfa de Cronbach de 0,82. La CPR presentó valores menores de 0,30. El ANOVA de medidas repetidas no presentó diferencias en siete dominios. Conclusión: La validación del HAI presenta satisfactoria equivalencia transcultural. La consistencia interna es adecuada; pero la confiabilidad es baja

Handwashing prevents infections associated to health care. A scale to measure motivational factors behind the fulfilment of handwashing protocols is necessary. Aims: To validate the Handwashing Assessment Inventory (HAI) in nurses of Hospital San José in Bogota, Colombia. Methods: After Cross-cultural adaptation, Factor analysis was used for validating the content. Concurrent validity was evaluated by comparing the HAIscale with the Attitudes Regarding Guidelines Practices (ARGP). Internal consistency, test-retest reliability and sensitivity to change were evaluated. Results: An adequate linguistic equivalency has been found. Factor analysis suggested eight domains, these were similar to the original scale. The correlation between ARGP and HAI scales was less than 0.30. Internal consistency showed a Cronbach’s alpha of 0.82. Test-retest coefficients were less than 0.30. ANOVA for repeated measures did not show any differences in seven domains. Conclusion: HAI validation presented a satisfactory cross-cultural equivalence. Internal consistency was adequate, but reliability was low

Caracterización del modelo pedagógico desarrollado por los docentes de la facultad de instrumentación quirúrgica de la FUCS / Description of the pedagogical model developed by teachers of the FUCS surgical instrument technology program

La ley 784 del 23 de diciembre de 2002 reglamentó el ejercicio de la instrumentación quirúrgica profesional, lo cual exigió que la educación en este programa asegurara una sólida formación del estudiante siguiendo los lineamientos pedagógicos establecidos en el proyecto educativo institucional de la FUCS. Objetivo: caracterizar el modelo pedagógico aplicado por los docentes de la facultad entre 2006 y 2008. Métodos: estudio observacional descriptivo de corte transversal. Se construyó un instrumento de recolección de datos y se aplicó a 42 docentes de la facultad, recolectando la información correspondiente a la metodología de enseñanza desarrollada durante la clase. Resultados: la metodología más frecuente es la clase magistral con apoyo audiovisual 43% y los talleres de reconocimiento basados en los temas de la asignatura 38%. Conclusiones: la orientación del proceso de enseñanza aprendizaje desarrollada por los docentes de la facultad corresponde al modelo pedagógico establecido en el PEI de la institución, pero es importante revisar la metodología didáctica desarrollada durante la clase...

Law 784 of December 23 2002 regulated professional surgical instrument technology practice requiring this program to guarantee a sound training of the student following the pedagogical guidelines established by the FUCS Institutional Education Program (IEP). Objective: to describe the pedagogical model used by teachers of this program between 2006 and 2008. Methods: an observational descriptive cross-sectional study was performed. A data collection instrument was designed and used to survey 42 teachers of the program. Information on the teaching methodology developed during a class was gathered. Results: the most frequent methodologies used are lectures with audio visual aids (43%) and hands-on workshops based on course topics (38%). Conclusions: the teaching-learning process developed by faculty members of the program corresponds to the pedagogical framework established by the FUCS´s IEP, however, it is important to review the didactic methodology developed during a class...

Uso de hierbas medicinales en mujeres gestantes y en lactancia en un hospital universitario de Bogotá (Colombia) / The use of herbal medicine among pregnant and lactating women attending a university hospital in Bogota, Colombia

Las mujeres durante la gestación y lactancia utilizan diferentes hierbas y es escasa la información en el ámbito clínico en Colombia. Objetivo: Describir las prácticas relacionadas con el uso de hierbas en mujeres gestantes y en lactancia del Hospital de San José, Bogotá (Colombia). Metodología: Estudio de corte transversal. Con un cuestionario estructurado se indagó el uso, la frecuencia, el modo y razones de uso, de las hierbas medicinales y de quién se aprendió la práctica. Resultados: El uso de hierbas en mujeres gestantes y en lactancia fue de 33.6% (IC95%: 29.2% - 38%) y 36.6% (IC95%: 30.8% - 42.3%), respectivamente. En el grupo de gestantes la hierba más usada fue la manzanilla (36.7%) y en las mujeres en lactancia fue el hinojo (65%). Conclusión: Las mujeres gestantes y en lactancia, utilizan hierbas para las molestias del embarazo, acelerar el parto, disminuir el frío y promover la producción de leche (AU)

The use of herbal supplements is a common practice about pregnant and lactating women, however in Colombia there is limited data regarding the extent of women's use of herbal medicines during pregnancy and breastfeeding. The aim of this study was to describe the patterns of herbal medication use among pregnant and lactating women at the Hospital San Jose in Bogota, Colombia. Methods: Cross-sectional study. A questionnaire was designed to measure the frequency of herbal supplementation, why women took the herbal medicine, form of supplements, and who recommended the supplements or how did they learn about the herbal supplements. Results: The use of herbal supplements among pregnant and lactating women is 33.6% (CI 95%: 29.2%-38%) and 36.6 (CI 95%: 30.8%-42.3%), respectively. The most common supplement used by pregnant women is Chamomile (36,7%), and among lactating women is Fennel (Foeniculum vulgare) (65%). Conclusion: Pregnant and breastfeeding women use herbal supplements for specific pregnancy-related problems, to induce labor, to boost breast milk production and to improve extreme body temperature variations (AU)

Estudio piloto de la prueba de percepción musical camp en implantados y normoyentes / Clinical assesment of the music perception test camp in implant users and normal- hearing subjects: a pilot study

En la búsqueda de una prueba de percepción musical estandarizada y aplicable en español, se evaluó el CAMP test creado en inglés por la Universidad de Washington para implantados y normoyentes. Objetivo: determinar las dificultades de su aplicación cuando el idioma nativo es español. Método: estudio de corte transversal con tres pruebas de percepción musical: umbral de tonos, percepción de melodías y timbre musical. Para correr el programa se tradujeron al español los comandos. Conclusión: la prueba CAMP de percepción musical resulta útil fácil de aplicar en normoyentes y usuarios de implante coclear cuyo idioma nativo sea español, cuando se dispone de cartillas con traducción de los comandos.

The CAMP test, created by the University of Washington for English-speaking implant users and normal-hearing subjects was evaluated in the search to provide a standardized music perception assessment for Spanish-speaking subjects. Objective: to determine administration difficulties when Spanish is the native language. Method: a cross-sectional study developed to examine three aspects of music perception: pitch discrimination threshold, melody recognition responand timbre recognition. Commands were translated into Spanish in order to run the program. Conclusions: The CAMP test for music perception is easily applied in Spanish-speaking normal-hearing individuals and cochlear implant users when instructions translated into Spanish are available.

Manejo médico de pacientes con hemofilia a, b y enfermedad de von Willebrand llevado a cirugía Hospital de San José, Bogotá: 16 años de experiencia / Medical management of patients with hemophilia a, b and von Willebrand disease who underwent surgery a sixteen year experience at Hospital de San José, Bogotá

Describir el manejo médico de tipo hemostático durante el pre, trans y posoperatorio de pacientes con hemoflia y enfermedad de von Willebrand. Materiales y métodos: serie de casos de pacientes diagnosticados con hemoflia A, B, enfermedad de von Willebrand y défcit de factor VII de enero 1993 a junio 2009 en el Hospital de San José, Bogotá DC. Resultados: 35 cirugías programadas de diferentes especialidades en 28 pacientes (4 mujeres y 24 hombres). Para aquellos con hemoflia A y B el objetivo en término de nivel hemostático para procedimientos ortopédicos fue: el día uno 100%, del dos al cinco 80% y de seis hasta el quince 58%; en cirugía general para el día uno 100%, del dos al cinco 74% y del seis en adelante 60%; en procedimientos odontológicos el día uno el factor se corrigió en promedio al 85% y del dos al cinco al 65%. Los pacientes con enfermedad de von Willebrand se manejaron con dosis de 50 UI/k cada 8 a 24 horas. Se presentaron tres infecciones y no hubo ningún fallecimiento. Conclusiones: el Hospital de San José tiene gran experiencia en la realización de procedimientos quirúrgicos programados en pacientes con hemoflia A y B y enfermedad de von Willebrand, los cuales a lo largo de estos 16 años han sido realizados con éxito y baja tasa de complicaciones.

To describe haemostatic management of patients with hemophilia and von Willebrand disease before, during and after surgery. Materials and Methods: case series of patients diagnosed with hemophilia A, B, von Willebrand disease and factor VII defciency, from January 1993 to June 2009 at Hospital de San José, Bogotá DC. Results: 35 scheduled surgeries of various specialties in 28 patients (4 females, 24 males). For those with hemophilia A and B the objective in terms of level of haemostasis in orthopedic procedures was: on day one 100%, from day two to fve: 74% and day 6 and so on: 60%; in dental procedures, on day one the factor was corrected an average of 85% and from day two to fve: 65%. Patients with Von Willebrand disease were managed with a 50 IU/k dose every 8 to 24 hours. There were 3 cases of infection and no deaths occurred. Conclusions: Hospital de San José has gained a vast experience in conducting scheduled surgical procedures in patients with hemophilia A, B and von Willebrand disease. These patients have been managed successfully during these 16 years with a low complication rate.

Guía de manejo para el tratamiento de la leucemia linfoide aguda: Hospital de San José, Bogotá D. C / Treatment guidelines for acute lymphoblastic leukemia at Hospital de San José, Bogotá DC

Los esquemas para el tratamiento de leucemia linfoblástica aguda, muestran tasas de remisión completa entre 70 y 90%, pero con pobres resultados a largo plazo y supervivencia libre de enfermedad a cinco años de 30 a 40%. Ante los múltiples protocolos a nivel mundial, las diferentes respuestas clínicas, la controversia en las opciones terapéuticas y la dificultad de adaptar las estrategias de tratamiento en nuestro país, se justifica la realización de una guía para nuestra institución. Se realizó una búsqueda de literatura sobre el tratamiento de LLA en adultos. Se excluyeron los de LLA en pediatría y LLA de precursores T. Se encontraron 335 artículos y se seleccionaron 48 que cumplieron los criterios de inclusión. Objetivo: establecer estrategias terapéuticas en adultos con LLA basadas en la evidencia disponible y adaptándolas a los recursos institucionales. Materiales y métodos: la revisión ampliada se basó en la evaluación de estudios secundarios como guías de práctica clínica, metaanálisis, revisiones sistemáticas publicadas entre enero 2005 y febrero 2009, o bien se recurrió a ensayos clínicos. Las bases de datos analizadas incluyeron PubMed a través de Medline, Clinical Evidence, la colaboración Cochrane, así como treinta y cuatro entidades compiladoras. Conclusiones: 1) Para adultos con LLA las series más grandes concluyen que el tratamiento de inducción debe incluir corticoides, antracíclicos, vincristina y L asparaginasa, con profilaxis del sistema nervioso central. 2) Los adolescentes y adultos jóvenes deben recibir protocolos pediátricos pero no hay evidencia suficiente para aceptar uno estándar. 3) El imatinib está indicado para todos los pacientes con LLA Ph+ con dosis entre 400 y 800 mg/día desde la inducción hasta el final del tratamiento. El beneficio es mayor cuando se incorpora desde la inducción y se administra en forma concurrente, con la quimioterapia, más que de forma secuencial...

Treatment regimes for acute lymphoblastic leukemia (ALL) show complete remission rates of 70 and 90 percent but poor long-term results and 5-year disease-free survival rates of 30 to 40 percent. Designing treatment guidelines for our institution is justified by the existence of multiple protocols worldwide, various clinical responses, controversy on therapeutic options and difficulty to adapt treatment strategies in our country. We conducted a systematic literature search on adult ALL treatment. Childhood and progenitor T-cell ALL were excluded. We found 335 articles and selected 48 which met the inclusion criteria. Objective: to establish therapeutic strategies for adult ALL based on available evidence and adapting them to our institutional resources. Materials and Methods: the broaden review was based on the assessment of secondary trials such as clinical practice guides, meta-analyses and systematic reviews published between January 2005 and February 2009, or the review of clinical trials. The analyzed databases included PubMed, Medline, Clinical Evidence, Cochrane, as well as 34 compilation bases. Conclusions: 1) The largest series conclude that induction phase treatment for adult ALL must include corticosteroid, antracyclines, vincristine and Lasparaginase, including central nervous system prophylaxis. 2) Treatment of adolescents and young adults must be based on pediatric protocols but there is not enough evidence as to accept one standard protocol. 3) 400 and 800 mg/day imatinib is indicated for all Ph-positive ALL patients from the treatment induction phase up to treatment completion. Benefit is greater when it is given from the induction phase combined with chemotherapy than when administered sequentially. 4) Regimes consistent with high-intensity chemotherapy plus imatinib and consolidated with allogenic transplantation during the first complete remission have shown the best long-term results and constitute the standard therapy...