Editorial: A systemic model for scientific discussion in the health sciences
Discussion in scientific articles is essential to contextualize findings and promote the advancement of knowledge, especially in the health sciences. Despite its importance, the discussion often lacks a comprehensive approach that links the results with the existing body of knowledge and considers their impact on the latter and on society. Therefore, this editorial proposes the need to adopt a systemic model for scientific discussion and argues the relevance of structuring this section under such an approach to improve its quality and relevance. This model is based on principles such as interdisciplinary integration, coherence with existing scientific knowledge and consideration of the impact of findings on society. In this way, it seeks to strengthen the discussion of an article, preparing it to make a more significant contribution to knowledge and its practical application.
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Clinical Characteristics and Resistance/Sensitivity Profile in Bacteremia by Non-Fermenting Gram-Negative Bacilli in a Pediatric Intensive Care Unit
Objective: To determine the clinical characteristics and the resistance/sensitivity profile in bacteremia due to non-fermenting Gram-negative Bacillus, in patients treated in the Doña Pilar Pediatric Intensive Care Unit of the Hospital Napoleón Franco Pareja, in the city of Cartagena, during 2017 to 2021. Materials and methods: Retrospective descriptive cross-sectional study. Based on the blood culture report, retrospective follow-up was carried out on the cases to determine the resistance and sensitivity profile, as well as the clinical course, considering the hospital stay and clinical outcomes. Results: 55.5% belonged to the male sex and the average age was 3.1 ± 4.7 years (range 1 month – 17 years), Pseudomonas aeruginosa was the most frequently isolated non-fermenting gram-negative germ with 31.2%, the highest sensitivity was for levofloxacin with 96.1%. Patient mortality was 45.1%, regardless of the isolated germ. Conclusions: Pseudomonas aeruginosa was the most frequently isolated non-fermenting gram-negative germ sensitive to levofloxacin. It is important to know the local antibiotic sensitivity and resistance in order to reduce prolonged hospital stays and possible mortality outcome.
ARTICLE OF SCIENTIFIC AND TECHNOLOGICAL RESEARCH
Cutaneous Leishmaniasis with Unusual Presentation: Case Report
Leishmaniasis is a zoonotic disease, transmitted by vectors through the bite of female dipteran of the genus Phlebotomus, whose natural reservoirs are canines, rodents and humans. There are three forms of clinical presentation: cutaneous, mucocutaneous and visceral; The skin varies from painless papules and nodules to ulcers. It is a public health problem in America, Africa and Asia; It mainly affects young men, due to their activities in endemic rural areas. The diagnosis is based on the microscopic identification of amastigotes in the lesions. There are several treatment options. The case of a 72-year-old Venezuelan farmer is presented, who consulted for a periorbital ulcer that had been developing for several days; Due to origin and occupation, leishmaniasis was suspected, treatment with liposomal Amphotericin B was confirmed and ordered; The injury progressed until it was completely healed. Reporting this case is relevant due to the few existing descriptions of periorbital lesions caused by Leishmania.
Fetal Surgery in Monochorionic Diamniotic Twin Pregnancy. Clinical case
Introduction: Monochorionic diamniotic pregnancies (MCBA) represent around 15% of twin pregnancies, with feto-fetal transfusion syndrome (TTTS) and intrauterine growth restriction (IUGR) being some of the most serious gestational complications. Early detection of these complications requires strict echographical– ultraosound monitoring. This article reports on the case of a pregnancy at 21 weeks of gestation in which MCBA and FTTS were detected, whose treatment was successful. Case report: this is a pregnancy in a 29-year-old woman with a diagnosis of MCBA and STFF, which had IUGR grade IIA in one of the fetuses; Treatment was performed using laser photocoagulation to occlude the abnormal vascular anastomoses; The pregnancy continued until week 32, when a cesarean section was performed, with the delivery of two live neonates in good general condition, with no signs of fetal hypoxia. Conclusion: Based on evidence, strict ecological monitoring in patients with monochorionic twin pregnancies as an early detection tool that allows the timely identification of these pregnancies that present TTTS in early stages with association with selective IUGR and thus be able to make the right choice. of the treatment. fetal therapy vs. Expectation should always be individualized.
Influence of Music on Preoperative Anxiety and Vital Signs of Patients Scheduled for Surgery
Introduction: Surgical procedures generate anxiety and affect patients' vital signs. Music therapy has also been used since ancient times to reduce preoperative stress, citing historical examples such as those of Nightingale and Billroth. The proposed study seeks to evaluate the positive, negative, or null influence of music therapy on preoperative anxiety and patients' vital signs. Methods: The Amsterdam Preoperative Anxiety Information Scale (APAIS) was administered, and information on the patient's vital signs was collected before music therapy was administered in a 20-minute session with traditional Chinese music at a moderate volume, using wireless headphones, while vital signs were monitored. Results: A decrease was demonstrated in all assessed parameters, highlighting an average reduction of 10.75 units in systolic blood pressure and 5.875 units in diastolic blood pressure. Oxygen saturation averaged 0.125 units and body temperature averaged 0.275 degrees. The heart rate showed the most notable changes, with an average decrease of 9.375 beats per minute. Conclusion: Music and its interventions are currently presented as a promising, non-pharmacological tool for mitigating preoperative anxiety, contributing to a positive and less stressful experience for individuals undergoing surgical procedures.
Environmental Risks Associated with the Generation of Biological Waste in the Healthcare Sector.
The generation of biological waste in the healthcare sector poses significant environmental risks, focusing on incorrect classification, improper handling, and poor management of these wastes. Studies indicate that the lack of training for personnel and the absence of adequate infrastructure for waste management exacerbate these risks. Furthermore, the importance of organizational policies that promote environmental responsibility and the rational use of supplies is highlighted. The COVID-19 pandemic has increased the urgency of adopting more sustainable waste management practices, especially in the handling of personal protective equipment. To mitigate environmental impacts, an integrated approach combining education, effective policies, and environmental management strategies is required. Collaboration among healthcare sector stakeholders and the implementation of innovative solutions are key to efficient and sustainable management of biological waste.
Citations and References: Key Tools for Scientific Validation and Reproducibility
Copyright (c) 2024 Biociencias https://creativecommons.org/licenses/by-nc-sa/4.0
The Role of the Social Network Instagram in the Development of Life Skills and Psychological Well-Being
Currently, society has recognized the importance of social networks as a digital communication strategy for the development of market strategies, education, and health promotion and prevention. A strategy was designed on the Instagram social network to develop life skills and promote psychological well-being and reduce risk behaviors. In the design, the choice of network, brand, and content was made and the community and metric management were taken into account. In the implementation of the network, the “Entrepanas” brand is established with a design and frequency of publications with interactions becoming a tool for personal development. It is concluded that creating a strategy on the social network Instagram allows the development of accessible content at all latitudes of time, contributing to the mental health of adolescents, young people and the population in general.
Uncovering Behçet's Syndrome. A Case Report of a Rare Disease in Colombia
Introduction: Behçet's syndrome is a multisystem disorder of unknown etiology classified as a variable-vessel vasculitis, it is characterized by oral and genital ulcers, skin lesions and ophthalmological, neurological or rheumatic manifestations, with oral and genital aphthae being the most frequent features; the presence of the HLA-B51 antigen is associated with up to 60% of cases. Clinical case: 35-year-old female patient, with history of recurrent aphthous stomatitis who presented with one month evolution clinical picture characterized by the appearance of painful ulcers in the oral cavity and genital associated with fever. Most likely infectious and inflammatory causes were ruled out and Behçet's syndrome diagnosis was considered by exclusion and application of international criteria; although the pathergy test was negative, the determination of the HLA-B51 allele was positive. The patient showed improvement after treatment with corticosteroids and colchicine. Discussion: Behçet's syndrome is a rare and underdiagnosed disorder in our environment with an approximate prevalence of 1.1 per 100,000 inhabitants. Diagnosis is often difficult and it must be made in an exclusion manner It is recommended to use the international criteria for Behçet's disease and, treatment is aimed at attenuating inflammatory exacerbations and preventing relapses to maintain a good quality of life. Conclusion: Behçet's syndrome is a multisystemic disorder that is probably underdiagnosed due to low prevalence, high diversity in clinical presentation and low diagnostic suspicion among healthcare professionals.
Nodular Melanoma of the Acral Region with Distal Metastasis
Skin cancer is an entity that has a progressive increase in its incidence worldwide; In the spectrum of this disease, malignant melanoma is one of the most aggressive neoplasms; the literature describes 4 subtypes, among which we find superficial spreading melanoma, lentigo maligna melanoma, acral lentiginous melanoma and nodular melanoma. The latter is still in its early stages and can generate distal metastatic involvement; its etiology is multifactorial and among the main risk factors is exposure to ultraviolet (UV) radiation. The lesion initially presents as a nodule that grows progressively and its diagnosis is mainly through biopsy; timely treatment reduces the risk of aesthetic and systemic complications. We present a case of a 42-year-old male patient with clinical and histopathological symptoms corresponding to nodular melanoma in the acral region associated with lymph node and lung metastasis.
Euthanasia: Ethical-legal Implications of the Physicians Regarding Ministry of Health in Colombia. Resolution 971/202
Euthanasia is a topic that has been addressed since 1200 a. C. in Ancient Greece and Rome; Such has been its impact on society, that it has currently been debated in current legislation. In Colombia, Resolution 971 of 2021 was recently issued, which sets some parameters to carry out the procedure by doctors and the Medical Committee. In this sense and, under this context, assimilating that there is no law that properly regulates this matter in accordance with the ambiguities and some regulations, this article analyzes through documentary analysis, the ethical-legal implications of the doctor in the context of the issuance of resolution 971 of 2021 and suggests, among other things, the creation of an applicable legal framework (law), a structural change in the health system and as the doctor-patient relationship.
Polyconsumption of Psychoactive Substances in Young Health Sciences University Students in Bogotá. Ethnographic Study
Psychoactive substances (PAS) are compounds that produce alterations in the central nervous system and have effects and/or consequences at an economic, social, family and personal level. The purpose of the study was to identify the context of the patterns, factors and side effects of polydrug use of SPA in university students. Qualitative research was carried out with an ethnographic approach; The population was young people between 15 and 24 years old from a higher health education institution; The technique was participant observation, and the collection instrument was a field diary. From the findings, the categories emerge: university context, context of places of consumption, consumption patterns, motivational factors, side effects. The context in which SPA consumption develops is framed in the factors, patterns, language and places that are preferred according to youth culture, as well as the synergy between groups according to the academic program.
Fixed Prosthesis Reinforced with Fiberglass as a Restorative Option to Conventional Fixed Prosthetics
Introduction: For the replacement of missing teeth, conventional fixed dentures are a treatment option by restoring dental function and anatomy. However, the wear generated towards an abutment tooth to comply with the principles of preparation has led to the emergence of other alternatives to overcome this problem. Fiberglass-reinforced composites offer a new, minimally invasive treatment option capable of rehabilitating a tooth loss. The aim of this review is to describe the properties, advantages, disadvantages and limitations of glass fibre reinforced composites. Methods: A scientific literature search was conducted in 6 databases during December 2023, using the descriptors fiberglass reinforcing composite, fiber-reinforced composite, fixed dental prostheses, properties, combined with the Boolean operators AND and OR. Results: Fiberglass reinforced composites are offered as an alternative to rehabilitate missing teeth. These exhibit good flexible strength (297-426MPa), compressive strength (965MPa), tensile strength (18.9-43.4MPa), good elastic modulus (3-6GPa), viscoelastic performance and attractive aesthetics, through satisfactory biocompatibility. Conclusion: Interest in the use of fiberglass-reinforced composites in prosthodontics continues to increase. One of the perspectives of this work would be to carry out new research related to the failures presented by these compounds and their long-term performance.
Evaluation of Attitudes and Changes in Practice Among Non-specialized Mental Health Professionals
Introduction: the WHO launched its Health Gap Action Program in 2008, and the Intervention Guide in 2010, which provides evidence-based elements for the evaluation and management of priority mental health disorders in low- and middle-income countries. This review aims to describe the experience of the implementation of the Program in Colombia and highlight the approach of redistribution of tasks in primary care by professionals not specialized in mental health and the measurement of their knowledge and competencies and identify the applications of the mhGAP strategy in different geographic and social contexts. Methodology: review of the literature on mhGAP implementation experiences in the databases Pubmed, Scopus, Virtual Health Library and the virtual public health field of the Pan American Health Organization. Results: 36 studies were found, 3 of them developed in the Americas region. In Colombia, approximately 2,400 professionals not specialized in mental health have been trained, through agreements between PAHO, the Ministry of Health and universities. Conclusions: it has not been evaluated whether mhGAP training has improved clinical diagnostic skills, attitudes towards people with mental disorders and changes in the practice of non-specialist professionals and its impact on reducing the unmet need for treatment of people with mental disorders. mental disorders. It is important to conduct more research on mhGAP implementation in the social and cultural context.
Unilateral pectoralis agenesis is known as Poland's anomaly and is characterized by unilateral absence of the pectoralis minor muscle and partial absence of the pectoralis major muscle, and can be associated with nipple abnormalities, syndactyly, symbrachydactyly, amastia, subcutaneous cellular tissue hypoplasia, unilateral renal agenesis and dextrocardia. The accepted etiology is vascular alterations during subclavian differentiation. Our patient is a 16-year-old adolescent, who consulted for asymmetry of breast development, with no history of consanguinity and no exposure to teratogens. Physical examination showed normal facie, hypoplasia of the left hemithorax and breast, with nipple and areola displaced towards the axillary region (Tanner II) and brachydactyly of the left index finger; the right breast expressed Tanner V. Chest X-ray showed translucent left hemithorax, and the karyotype was reported as 46, XX. With the diagnosis of Poland syndrome, genetic and family psychological counseling was performed with referral for plastic surgery.
Neonatal Abstinence Syndrome in Infants Born to Substance-Dependent Mothers (Pereira, Colombia, 2019)
Introduction: Drug addiction is a global public health problem with widespread implications in society, significantly affecting lactating mothers with addictions and putting the health of newborns at risk. Objective: To determine the incidence of neonatal abstinence syndrome in children of mothers with substance dependence treated at a health institution in Pereira, Colombia in 2019. Methodology: Observational and descriptive study with a cross-sectional and prospective cohort design of 40 cases of babies born to drug-dependent mothers. The Finnegan scale was used to assess neonatal abstinence, applied every 4 hours during the first 12 to 24 hours after birth; a score greater than 8 indicated neonatal abstinence syndrome. Clinical data of the neonate, including the Apgar test, the method of delivery, and birth weight, among others, were recorded. Congenital anomalies, treatments, infections, complications, and the duration of hospital stay were also noted. Results: Among the neonates assessed with the Finnegan scale during the observation period, 70% of neonates who scored between 10 and 11 points were considered to have mild to moderate withdrawal symptoms. The most notable signs and symptoms in neonates who developed neonatal abstinence syndrome included unexplained continuous crying, mild tremors, myoclonus, sweating, fever, and diarrhea, specifically in 27 cases (67.5%). Conclusions: The incidence of neonatal abstinence syndrome has experienced significant growth in recent years. Therefore, it is imperative to emphasize public health policies aimed at preventing drug use during pregnancy in order to reduce the rising incidence of neonatal abstinence syndrome.
Association of the Thyroid-Stimulating Hormone, Thyroxine and Triiodothyronine with the Heavy Metals Lead and Mercury in Patients with Suspected Hyperthyroidism
Introduction: Humans are exposed daily to various chemical elements through water, food and use of personal hygiene and cosmetic products that can cause alterations in the multiple systems of the human body, including the endocrine system. In this sense, the objective of the study was to associate the concentration of thyroid stimulating hormone (TSH), free thyroxine (T3F) and free triiodothyronine (T4F) with the levels of lead (Pb) and mercury (Hg) in patients with suspected hyperthyroidism. Materials and Methods: The study group (SG) consisted of 20 patients regardless of sex and a control group (CG) of 20 individuals with no history of underlying pathologies. Method atomic absorption, coupled to a hydride generator, were used for Pb and Hg analysis, the biological sample being whole blood (Pb) and partial urine (Hg). Hormones were analyzed in serum by chemiluminescence. Results: the concentration of TSH, T3F and T4F in the SG were 0.46 ± 0.08 µUI/L, 8.34 ± 0.45 pg/mL and 1.25 ± 0.23 ng/mL. Statistical analysis yielded significant difference for TSH and T3F with respect to CG (p=0.046 and 0.021). Pb and mercury levels for the SG were 11.54 ± 0.75 µg/dL and 8.43 ± 0.11 µg/g of creatinine, values above the permissible limits for these two metals and statistically significant with respect to the SG. Conclusions: This study suggests a potential association between Pb and Hg with THS and T3F alteration, together with other toxicological aspects to which the patients may be associated.
Parieto-occipital Encephalocele: Importance of Early Diagnosis
The clinical manifestations of occipital encephalocele are usually rare, reaching a probability of 1 case per 10,000 pregnancies or 1 live birth with OE per 5,000 to 10,000 pregnancies and whose causes may be related to environmental, congenital factors. or nutritional. Objective: to report the case of a pregnancy at 12.6 weeks of gestation in which a fetus with EO was detected with no chance of surviving conditions external to the uterus. Materials and Methods: an EO case is described in which a presumptive diagnosis was made with 2D and 3D ultrasound demonstrating incompatibility with extrauterine life and received medical treatment for IVE and subsequent obstetric curettage with medical and psychological supervision until the patient progressed satisfactorily. Conclusion: the case described above is an example of EO with incompatibility with the extrauterine environment whose management (IVE) culminates in favorable conditions for the patient.
Systematic Review of the Impact of a Healthy Culture on University Students
This article examines the impact of healthy lifestyle habits in the university environment on community health and well-being during the transition from adolescence to early adulthood. Through a comprehensive literature review from 2017, which included 34 articles, four main themes were identified: physical activity, diet, sedentary behavior, and technological recreation. Although most studies adopted a descriptive, cross-sectional, and qualitative approach, they highlighted internal and external factors influencing the promotion of healthy habits. However, despite acknowledging the need to mitigate risks associated with unhealthy practices, the emphasis is placed on the importance of integrating health promotion into university culture, institutional policies, and curricula.
Resistance Reversals in Candida spp. A Vision from Drugs, Plant Derivatives and Membrane Transporters
Worldwide infectious diseases, generated by filamentous fungi and yeasts, are becoming more frequent because they adapt to existing drugs and use different resistance mechanisms. Candida species that affect humans are around fifteen, some more frequent than others and with high morbidity and mortality rates. One of the most studied resistance mechanisms in Candida spp. is for drug efflux pump, which the ABC and MFS transporters are the most investigated. The ABC and MFS transporters energize the transport of substances by ATP and proton gradient, respectively. Therefore, the use of chemical compounds or plant derivatives, as possible resistance reversers, could be considered a study target instead of creating new antifungals. The efficacy of current antifungals can be increased by a combination adequate with natural substances. In this review, we address issues such as the classification of antifungal drugs, resistance to antifungal drugs, general mechanisms of antifungal resistance, ABC and MFS transporters, use of plant derivatives to reverse resistance processes, and laboratory evaluation of plant’s derivatives as possible reversers.
Dectin 1a Orchestrates Complex Responses in Immunocompetent Lineages: Towards β-Glucans of Fungal Origin
In fungi, β-Glucans (bG), composed of glucose, perform various functions, such as components of extracellular matrices and energy reserves. The interest in its study is due to its immunomodulatory and antitumor properties. The present review comprehensively presents the molecular interactions behind these effects that are still limitedly understood, so there is a knowledge gap related to their mechanisms and effects in humans. A relevant aspect found through the non-systematic exploration of the literature is the ligand-receptor dynamics between: β-Glucans (bG) and molecular pattern receptors (PRRs) key in their recognition, such as Dectin1 and the membrane-type complement receptor. 3 (CR3), separately and together. Thus, bG, Dectin1 and CR3 were shown to orchestrate a cellular immune response. It is essential to recognize the need for: a specific molecular weight monitoring standard and further research on β-glucan receptors, such as CR3.
Characterization of Eating Habits in University Students. Descriptive Study
Introduction: eating habits are a set of behaviors related to the preparation and consumption of food, due to their characteristics they can be healthy or unhealthy. University students face situations that predispose them to acquire eating habits that are harmful to their health, characterized by little time to eat, disproportionate consumption of food and preference for fast foods. The increase in the prevalence of overweight and obesity in this population could be related to the bad habits acquired during their transit through the university. Objective: to characterize the eating habits of university students in the city of Barranquilla, Colombia. Materials and methods: it is a descriptive-analytical cross-sectional study, with a convenience sample of students enrolled in a Barranquilla District University who agreed to participate in the study. A characterization of sociodemographic, anthropometric and lifestyle variables was made, which were evaluated with the questionnaire “Lifestyle in Young University Students (CEVJU-R)”. Results: unhealthy habits occurred in 13.28% of the participants. It can be affirmed that the eating habits in the studied population are associated with the socioeconomic stratum, in the same way lifestyle is associated with eating habits (P-value <0.05 and a confidence level of 95%). Conclusion: university life can become a risk factor for the development of non-communicable diseases associated with eating habits, so it is important to work on promoting healthy eating habits.
Cardioprotective Potential of ACE2, Angiotensin-(1-9), and Angiotensin-(1-7) against Acute Myocardial Infarction
Cardiovascular diseases have a significant global impact as the leading cause of death. The renin-angiotensin system (RAS) plays a crucial role in the pathophysiology of these diseases, regulating renal, cardiac, and vascular physiology. Its activation has been linked to chronic conditions such as hypertension, heart failure, and kidney disease, primarily due to the activation of angiotensin-converting enzyme (ACE), whose metabolic products elicit an inflammatory and hypertrophic response. In recent years, the involvement of a counterregulatory RAS has been discovered, opposing the effects of the classic RAS. Of particular importance is ACE2, which generates Angiotensin-(1-7) and Angiotensin-(1-9), countering the pathological effects of the classic RAS. These peptides are active in myocardial ischemic events such as acute myocardial infarction (AMI), but little is known about their involvement in this pathology. The aim of this article is to review the cardioprotective potential of ACE2 and its products, Angiotensin-(1-7) and Angiotensin-(1-9), against Acute Myocardial Infarction.
Self-medication with Antibiotics in Patients Diagnosed with COVID-19 and its Consequences for Public Health
Self-medication is a practice that has spread throughout the world; people who carry it out seek relief or cure from an illness without the supervision or management of a health professional. Often, using all types of medications such as antibiotics and pharmacological preparations to mitigate the symptoms of the pathologies they are suffering from. The main interest in carrying out this research lies in the above, since the phenomenon must be described, and potential solutions proposed. In this way, it will be possible to have a clear mechanism of action to mitigate this problem, and this can be achieved by making known the causes of self-medication with antibiotics, its consequences on public health and the recommendations that must be considered with clear objective of promoting education regarding the rational use of medications, within the context of treatment against COVID-19 in infected patients. In addition, it is necessary to reform the structure of health professionals, along with the necessary government actions to reflect a significant improvement in the way information is transmitted to the general population, therefore, an updated educational model and legislation Adequate training in community training in self-medication can generate positive effects on people's behavior and habits regarding the use of medicines. Conclusion: self-medication with antibiotics has been the main factor causing an increase in antibiotic resistance, which is a serious public health problem. The COVID-19 pandemic was the key scenario to study this behavior and its possible strategies to mitigate this problem. It is recommended to prioritize the implementation of strategies such as the rational use of medicines, support for education and scientific research, as well as legislative reforms that the authorities consider necessary.
Biociencias Journal: A commitment to contribute to the scientific dissemination of the country
Background: Caudal Regression Syndrome is an infrequent congenital malformation of the vertebral spine’s lower segments characterized by a truncated medullar cone and aplasia or hypoplasia of the sacrum. Specifically, sacral agenesis represents an incidence of 0.01 to 0.05 of every newborn. Among the main risk factors are elevated glycosylated hemoglobin, hormonal imbalance, and lipid protein metabolic disorder. A correlation has been established between anomalous pregnancies and congenital malformations in newborns, with a prevalence of 5 to 10% in children of diabetic mothers, with an incidence of 1 per 350 cases, representing a 200% rise over the general population. Objective: To report an extremely uncommon epidemiologically rare case of Caudal Regression Syndrome, characterized by caudal musculoskeletal involvement. Clinical case: a 27-year-old female in her 34th week of gestation during her second pregnancy presented to the high specialty, high-risk pregnancy consultation with a background of glycemia of 205mg/dl, glycosylated hemoglobin percentage (%HbA1c) of 10.1%, and estimated average glucose levels of 243mg/dl. The patient arrived at the emergency room during active labor with premature membrane rupture, both deciding factors for pregnancy termination. The outcome was a sole female live product with a vertebral spine interrupted approximately by T10, non-palpable iliac crests, sacrum, and coccyx, and shortening of hypotrophied inferior extremities. Conclusion: successful prevention in the early diagnosis of malformations during pregnancy requires strict prenatal control for any pregnant woman with metabolic risk factors. The first prenatal consultation presents an opportunity to perform diabetic screening. If diagnosed, follow-up procedures such as ultrasounds at a second level of medical care should be performed for the timely detection of congenital malformations associated with high levels of glycemia.
Biociencias y su compromiso con el desarrollo del conocimiento en salud
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Systemic Amyloidosis and Multiple Myeloma in a Patient with von Willebrand
Monoclonal gammopathies encompass a group of disorders that involve the plasmacyte and consequently affect the production of immunoglobulins. Among these gammopathies are systemic amyloidosis and multiple myeloma. These two diseases can coexist in the same patient with a frequency that varies from 13 to 26%, making this association more complex both for the diagnosis and the management of the patients who suffer from them. We report the case of an elderly male patient with systemic amyloidosis and multiple myeloma in the context of von Willebrand's disease with the aim of encouraging the physician to perform a directed anamnesis identifying the defining symptoms such as bone pain, pathological fractures, renal alteration and bone lesions, defining factors to reach the diagnosis in most cases. In our case the diagnosis was reached based on imaging and immunohistochemical findings of amyloid deposit and presence of plasmacytes with neoplastic phenotype in the bone marrow aspirate. With initiation of antineoplastic protocol (Bortezomib, Lenalidomide, Dexamethasone) and von willebrand factor supplementation with satisfactory evolution to medical discharge with periodic outpatient follow-up.
We present the case of a 26-year-old male patient, with symptoms of abdominal pain, absence of bowel movements, intolerance to the oral route and feverish spikes, who, given the bizarre clinical picture on admission, was poorly addressed in the emergency services as constipation and urinary tract infection, ending in surgical resolution of his atypical hernia picture.
Cardiovascular Risk Factors: From the Classics to the Emerging in the Light of New Evidence
Cardiovascular diseases (CVD) are the main cause of morbidity and mortality worldwide, especially affecting the population over 60 years of age, they can manifest depending on their origin in coronary disease (acute myocardial infarction, angina pectoris, sudden cardiac arrest, heart failure and sudden death) and cerebrovascular disease (strokes and transient ischemic events). Several risk factors associated with the development of CVD have been described, the classic factors (modifiable and non-modifiable), and others that have been added to the list as a result of new evidence, such as inflammation, thrombosis, stress, alterations in the levels of natriuretic peptides, heavy metals/environmental pollutants, renal insufficiency, and some infectious agents. The objective of this article is to present the state of the art associated with classic cardiovascular risk factors (CRFs) and the evidence that supports emerging CRFs.