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Incidences and Causes of Surgery Cancellation in a University Hospital in Barranquilla, Colombia, in 2016t
No full textIntroducción: La cirugía es todo procedimiento realizado en quirófano que permite el tratamiento
oportuno a patologías y traumatismos; en Colombia un indicador de calidad para el Sistema de
Información de salud es la proporción de cancelación de cirugía programada.
Materiales y método: Diseñamos un estudio observacional retrospectivo, seleccionando todos los
pacientes programados en la Institución Hospitalaria en el periodo de 1 enero 2016 a 31 diciembre de
2016. Un total de 3207 pacientes programados. Se analizaron las cancelaciones en factores atribuibles
al paciente, institución y orden médica.
Resultados: De los 3207 procedimientos programados 1739 (54,2%) fueron hombres y 1468 (45,8%)
mujeres, se programaron procedimientos quirúrgicos entre 6 meses y 116 años de edad, con un
promedio de 38 años. Del total de programaciones 244 (7,6%) sufrieron cancelación de la cirugía, los
meses con el menor y mayor incidencia de cancelación fue de agosto y noviembre con 9 (3,7%) y 36
(14,8%) respectivamente. La tasa de cancelación por especialidades medico quirúrgicas de manera
independiente oscila entre 1 (0,4%) de las especialidades de ginecología oncológica, maxilofacial,
urología y 85 (34,8%) de ortopedia.
Las causas de cancelación se clasificaron en atribuibles a la institución 93 casos (38,1%), al usuario 99
(40,6) y por orden médica 52 (21,3%).
Conclusiones: El 41% de las cancelaciones podrían haber sido evitadas. Recomendamos seguimiento
continuo a los pacientes programados, además divulgación de estos estudios a profesionales para el
empoderamiento de las responsabilidades y la necesidad de educación a los usuarios que serán
intervenidos.Introduction: Surgery is any procedure performed in the operating room that allows timely treatment of
pathologies and injuries; in Colombia, an indicator of the quality of the information system is the
proportion of scheduled surgery cancellations.
Materials and method: We designed a retrospective observational study, selecting all patients
scheduled for surgery at the hospital institution from January 1, 2016 to December 31, 2016. A total of
3207 patients were included. We analyzed cases of surgery cancellations because of factors
attributable to the patient, institution, and medical order.
Results: Of the 3207 scheduled procedures, 1739 (54.2%) were men and 1468 (45.8%) were women.
Surgical procedures were scheduled for patients aged between 6 months and 116 years, with an
average age of 38 years. Of the scheduled procedures, 244 (7.6%) surgeries were cancelled. The
months with the lowest and highest incidences of surgery cancellation were August and November, with
9 (3.7%) and 36 (14.8%) cancellations, respectively. The cancellation rate for surgical specialties
independently ranged from 1 (0.4%) for gynecology specialties of oncology, maxillofacial, and urology
and 85 (34.8%) for orthopedics.
As the causes of cancellation, 93 (38.1%) were attributable to the institution, 99 (40.6) to patients, and
52 (21.3%) to medical orders.
Conclusions: In total, 41% of cancellations could have been avoided. We recommend continuous
monitoring of scheduled patients, as well as the dissemination of our findings to professionals for the
empowerment of responsibilities and the need for education for patients undergoing intervention
Mangrove forests evolution and threats in the caribbean sea of Colombia
No full textColombia has approximately 379,954 hectares of mangrove forests distributed along the
Pacific Ocean and the Caribbean Sea coasts. Such forests are experiencing the highest annual rate
of loss recorded in South America and, in the last three decades, approximately 40,000 hectares
have been greatly affected by natural and, especially, human impacts. This study determined, by
the use of Landsat multispectral satellite images, the evolution of three mangrove forests located
in the Colombian Caribbean Sea: Malloquín, Totumo, and La Virgen swamps. Mangrove forest at
Mallorquín Swamp recorded a loss of 15 ha in the period of 1985–2018, associated with alterations in
forest hydrology, illegal logging, urban growth, and coastal erosion. Totumo Swamp lost 301 ha in the
period 1985–2018 associated with changes in hydrological conditions, illegal logging, and increased
agricultural and livestock uses. La Virgen Swamp presented a loss of 31 ha in the period of 2013–2018
that was linked to the construction of a roadway, alterations of hydrological conditions, illegal logging,
and soil urbanization, mainly for tourist purposes. Although Colombian legislation has made efforts
to protect mangrove ecosystems, human activities are the main cause of mangrove degradation,
and thus it is mandatory for the local population to understand the value of the ecosystem services
provided by mangrove
Pioderma gangrenosa en un paciente diabético tipo 2: reporte de un caso
No full textWe are presenting a case of patient with type 2 diabetes mellitus that was diagnosed with a soft tissue infection in the lower extremity. This was initially treated as cellulitis and antibiotic treatment was initiated. Due to a poor clinical response, the diagnosis of pyoderma gangrenosum was proposed as part of the differential diagnosis. Skin biopsies and pathology confirmed the diagnosis of pyoderma gangrenosum that had a satisfactory response to steroid treatment.Se presenta el caso de una paciente diabética tipo 2 que inicialmente fue diagnosticada como una celulitis complicada del miembro inferior izquierdo, pero ante la pobre respuesta con el tratamiento antibiótico, se consideró el diagnóstico de pioderma gangrenosa, confirmado anatomopatológicamente, con respuesta satisfactoria al tratamiento esteroideo tópico
Case-Serie of 4 COVID-19 patients hospitalized in an intensive care unit in a hospital institution in Barranquilla, Colombia
No full textObjetivo: Presentar una serie de casos de COVID-19 con requerimiento
de ingreso a Unidad de Cuidados Intensivos. Métodos: La información fue tomada
de las historias clínicas, y su evaluación y diagnóstico fue realizado mediante
estudios paraclínicos en sangre, orina, PCR e imágenes diagnósticas en 4 pacientes
con diferentes comorbilidades y nexo epidemiológico presente para desarrollo de la
enfermedad. El caso 1 desarrolló falla orgánica múltiple, incluyendo injuria renal
aguda con una estancia en UCI de 4 dias antes de su fallecimiento, mientras los
casos 2, 3 y 4 tuvieron una evolución favorable y fueron dados de alta de UCI. Los
cuatro casos fueron manejados con cloroquina 300 mg via oral cada 12 horas y
azitromicina 1 gr via oral cada 24 horas durante 5 dias sin complicaciones ni
toxicidad asociada. Conclusiones: Se requieren estudios multicéntricos rápidos
que orienten científicamente hacia un mejor abordaje diagnóstico y manejo, en el
contexto de una enfermedad con un comportamiento clínico-epidemiologico que
debe estudiarse en profundidad y que probablemente cobrará muchas vidas,
ademas, debido a la ausencia de pruebas diagnósticas rápidas, la utilización de una
clasificación basada en la severidad de lesiones radiológicas llamada CO-RADS
(Covid-19 Imaging Reporting and Data System), podría ser de gran importancia para
instalar de manera temprana los tratamientos farmacológicos disponibles y la
asistencia respiratoria mecánica precoz.Objective: To present a COVID-19 case series with clinical admission
criteria to Intensive Care Unit. Methods: Patients information was obtained from
medical records, and daily clinical evaluation whereas diagnosis was carried out
through paraclinical studies in blood, urine, PCR and diagnostic images in 4 patients
with different comorbidities and epidemiological link for the development of COVID19. The case 1 developed multiple organ failure, including acute kidney injury with
an ICU stay of 4 days before his death, while cases 2, 3 and 4 had a favorable
evolution and were discharged from the ICU. All four cases were managed with
chloroquine 300 mg orally every 12 hours and azithromycin orally every 24 hours for
5 days without complications or associated toxicity. Conclusions: rapid multicenter
studies are required to scientifically guide a better diagnostic and management
approach, in the context of a disease with a clinical-epidemiological behavior that
must be studied in depth and will probably take many lives. In addition, due to the
absence of sufficiently rapid tests, the use of a classification based on the severity
of radiological lesions called CO-RADS (Covid-19 Imaging Reporting and Data
System), could be of great importance to install av
Impact on the bacterial resistance of the previous revision of the prescription of antibiotics by the pharmaceutical service in hospitals of Atlántico (Colombia)
No full textObjetivo: Determinar el impacto sobre la resistencia bacteriana de la revisión previa de la
prescripción de antibióticos por parte del servicio farmacéutico en hospitales de mediana y
alta complejidad del departamento del Atlántico (Colombia).
Metodología: Se analizaron los valores de resistencia de bacterias Gram positivas, Enterobacterias y Gram negativos no fermentadores reportados en cinco institutos prestadores
de salud (IPS) del departamento del Atlántico, en dos periodos (preintervención e intervención), de 12 meses cada uno, entre junio de 2015 y mayo de 2017.
Resultados: Durante los dos periodos de estudio se identificaron 68 microorganismos en
8590 aislamientos microbiológicos provenientes de muestras de orina (40,3 %), sangre
(21,7 %), tejidos (8,5 %) y otras (29,5 %). Los microorganismos aislados más frecuentemente fueron Escherichia coli (28,9 %), Staphylococcus coagulasa negativo (12,1%), Klebsiella
pneumoniae (12,0 %), Pseudomonas aeruginosa (11,1 %) y Staphylococcus aureus (7,2 %). Durante los dos periodos la resistencia global osciló entre 27 y 40 %. Durante la Preintervención
la resistencia osciló entre el 33 y el 39 %, mientras que durante la Intervención estuvo entre
el 27 y 40 %. Al comparar los periodos de estudio solo hubo disminución significativa de la
resistencia en los primeros nueve meses del periodo de intervención (p < 0.05).
Conclusiones: Los valores de resistencia bacteriana reportados en el periodo de intervención fueron menores que en el periodo de preintervención. Se evidenció que la revisión previa de la prescripción por parte del servicio farmacéutico en las instituciones participantes
influye en una disminución significativa de la resistencia bacteriana, pero que esta debe ser
tanto continua como incremental.Objective: To determine the impact on bacterial resistance of the previous review of the
prescription of antibiotics by the pharmaceutical service in medium and high complexity
hospitals of the Department of Atlántico (Colombia).
Methodology: Resistance values were analyzed for Gram-positive bacteria, Enterobacterial and non-fermenting Gram-negative bacteria reported in five health care institutions
(IPS) of the Atlántico Department, in two periods (pre-intervention and intervention), of
12 months each between the months of June 2015 and May 2017.
Results: During the two study periods, 68 microorganisms were identified in 8,590 microbiological isolates from urine samples (40.3 %), blood samples (21.7 %), tissues (8.5%) and
others (29.5 %). The most frequently isolated microorganisms were Escherichia coli (28.9
%), Coagulase Negative Staphylococcus (12.1 %), Klebsiella pneumoniae (12.0 %), Pseudomonas
aeruginosa (11.1 %) and S. aureus (7.2 %). During both periods the global resistance ranged
between 27 and 40 %. During the Pre-intervention the resistance ranged between 33 and
39 %, while during the Intervention it was between 27 and 40 %. When comparing study
periods, there was only significant decrease in resistance in the first nine months of the
intervention period (p <0.05).
Conclusions: the bacterial resistance values reported during the intervention period were
lower than in the pre-intervention period. It was evidenced that the previous revision of
the prescription by the pharmaceutical service in the participating institutions influences a
significant decrease of the bacterial resistance; but that this must be both continuous and
incremental
Self-efficacy towards physical activity in Colombian schoolchildren
No full textObjetivo: El presente estudio tuvo como objetivo determinar la autoeficacia para la práctica de actividad física en escolares
colombianos y establecer su relación con los niveles de actividad física identificados de acuerdo al sexo. Método: Estudio de corte
transversal analítico en 2102 niñas y 2054 niños entre los 10 a 14 años estudiantes de 27 escuelas públicas. Se aplicó la Escala de
Autoeficacia hacia la Actividad Física y el Cuestionario de Actividad Física para Escolares (PAQ-C) para medir el comportamiento activo.
Se determinó la frecuencia de las variables categóricas y se realizó una Regresión Logística Multivariante, en la cual la variable dependiente
fue la actividad física general realizada durante la última semana, considerando en el modelo como variables independientes los componentes
de la autoeficacia hacia la actividad física. Se determinaron los Odds Ratio (OR) en población general y su intervalo de confianza (IC) del
95 % asumiendo un valor de significancia estadística menor de 0,05. Resultados: 64,3% de los escolares se categorizaron como inactivos
físicamente, donde 66,9% de niñas resultaron inactivas y 38,4% de niños activos. Es mayor la probabilidad de ser inactivos físicamente
en los escolares que consideran no poder correr al menos 8 minutos seguidos [OR 1,7 (IC95% 1,4-1,9)], realizar actividad física después
de la escuela [OR 1,5 (IC95% 1,2-1,7)] o cuando hace mucho frio o calor [OR 1,4 (IC95% 1,2-1,6)]. Conclusiones: Los escolares con baja
autoeficacia para la práctica de actividad física tienen mayor probabilidad de ser inactivos físicamente.Objective: The objective of this study was to determine the self-efficacy for the practice of physical activity in Colombian
schoolchildren and establish their relationship with the levels of physical activity identified according to sex. Method: Analytical crosssectional
study in 2102 girls and 2054 boys between 10 to 14 years old students of 27 public schools. The Self-Efficacy Scale was
applied to Physical Activity and the Physical Activity Questionnaire for Schoolchildren (PAQ-C) to measure active behavior. The
frequency of the categorical variables was determined and a Multivariate Logistic Regression was carried out, in which the dependent
variable was the general physical activity carried out during the last week, considering in the model as independent variables the
components of self-efficacy towards physical activity. The Odds Ratio (OR) in the general population and its 95% confidence interval
(CI) were determined assuming a value of statistical significance of less than 0.05. Results: 64.3% of the students were categorized as
physically inactive, where 66.9% of the girls were inactive and 38.4% of the boys were active. The probability of being physically
inactive is greater in schoolchildren who consider that they can not run at least 8 minutes in a row [OR 1.7 (95% CI 1.4-1.9)], perform
physical activity after school [OR 1, 5 (IC95% 1.2-1.7)] or when it is very cold or hot [OR 1.4 (IC95% 1.2-1.6)]. Conclusions: Students
with low self-efficacy for physical activity are more likely to be physically inactive
Behavioral aspects of phlebotomine sand flies associated with a case of cutaneous leishmaniasis in Atlántico, northern Colombia
No full textAfter the first autochthonous case of cutaneous leishmaniasis was reported in the Atlántico department in the Caribbean region of Colombia, entomological sampling was conducted in the specific areas where the infection might have occurred. CDC traps were installed inside and outside dwellings in the peri-urban and rural areas of a settlement in the municipality of Luruaco. Sampling was performed during the night with protected human bait, and phlebotomine sand flies were actively sampled from potential diurnal resting sites within dwellings. Ten species of the genus Lutzomyia were identified; Lutzomyia evansi was the dominant species (78%) in the rural and peri-urban areas as well as in the different sampled habitats, followed by Lutzomyia panamensis and Lutzomyia gomezi. There was a 100% household infestation by Lu. evansi, and its indoor mean abundance was 13.3 sand flies/CDC trap/night. The indoor mean abundance of Lu. panamensis and Lu. gomezi was only 0.9 and 0.8 sand flies/CDC trap/night, respectively. Female Lu. evansi were collected with protected human bait, mostly in the peridomestic area, with sustained activity during the night and a slight increase in the activity from 19:00 to 23:00 hours. Of the total sand flies captured in the diurnal resting sites, 73.1% were collected from the walls of bedrooms and corresponded to Lu. evansi, Lutzomyia cayennensis cayennensis, and Lutzomyia trinidadensis. Owing to their vectorial importance, the species on which entomological surveillance should be focused are Lu. evansi, Lu. panamensis, and Lu. gomezi. The biting and resting behavior reported in this study will help guide vector prevention and the control of leishmaniasis within the study area
Time series decomposition using automatic learning techniques for predictive models
No full textThis paper proposes an innovative way to address real cases of production prediction. This approach consists in the decomposition of original time series into time sub-series according to a group of factors in order to generate a predictive model from the partial predictive models
of the sub-series. The adjustment of the models is carried out by means of a set of statistic techniques and Automatic Learning. This method was compared to an intuitive method consisting of a direct prediction of time series. The results show that this approach achieves
better predictive performance than the direct way, so applying a decomposition method is more
appropriate for this problem than non-decomposition. The agricultural sector will be used as the
study subject
Pseudoxanthoma Elasticum: An Interesting Model to Evaluate Chronic Kidney Disease-Like Vascular Damage without Renal Disease
No full textBackground: Pseudoxanthoma elasticum (PXE; OMIM
264800) is an inherited multisystem disorder associated with
accumulation of mineralized and fragmented elastic fibers
in the skin, vascular walls, and brush membrane in the eye.
Carriers exhibit characteristic lesions in the cardiovascular
system, and peripheral and coronary arterial disease as well
as mitral valvulopathy often present as a cardiovascular feature of this disease. PXE and chronic kidney disease (CKD)
share some common patterns in the vascular damage and in
therapeutic approaches as well. Summary: To date, treating
PXE has focused more on careful follow-up examinations
with retinal specialists and cardiologist, avoiding long-term
anticoagulation. Like CKD, maintaining a low-calcium diet,
increasing dietary magnesium, and administering phosphate binders such as aluminum hydroxide or sevelamer
may yield a modest benefit. Recently, 4-phenylbutyrate acid
(4-PBA) has demonstrated a maturation of ABCC6 mutant effects into the plasma membrane. Moreover, in a humanized
mouse model of PXE, 4-PBA administration restored the physiological function of ABCC6 mutants, resulting in enhanced calcification inhibition and thus a promising strategy
for allele-specific therapy of ABCC6-associated calcification
disorders. Key Message: Vascular compromise in PXE patients share some components similar to CKD
Knowledge on prevention of sexual transmission infections in inmigrant adolescents in Soledad Atlantico 2018-2019
No full textDurante los últimos años ha incrementado el interés en el estudio de la adolescencia y el debut de las relaciones sexuales y de
pareja que presentan con frecuencia malestares de la salud sexual y reproductiva, que se manifiesta en el incremento de las
infecciones de transmisión sexual y embarazos no deseados. A su vez la problemática por el fenómeno de migración hace que
en la mayoría de casos esta población tenga difícil acceso a una institución de salud, lo que no permite tener un diagnóstico
precoz y tratamiento oportuno este trabajo tiene como objetivo evaluar el conocimiento sobre prevención de infecciones de
transmisión sexual en adolescentes inmigrantes habitantes en Soledad-Atlántico 2018-2019. Se utilizó una metodología
cuantitativa con enfoque descriptivo cuantitativo, la población objeto de estudio fueron 234 adolescentes inmigrantes que en
el rango de 10-19 años y que accedían a los servicios en salud en institución pública de Soledad-Atlántico. Se logró deducir a
través de la encuesta el conocimiento que tienen las adolescentes sobre infecciones de transmisión sexual, el resultado indica
que el nivel de conocimiento es medio, y afirman que es de gran importancia que los jóvenes adquieran conocimiento sobre las
ITS. Es apremiante la educación a la población vulnerable como método de prevención y aporte a la salud con énfasis en el
fortalecimiento de la Educación Integral de la Sexualidad a través de la promoción de conductas sexuales saludables.In recent years, interest in the study of adolescence and the debut of sexual and couple relationships that frequently present
sexual and reproductive health discomforts, which is manifested in the increase in sexually transmitted infections and
pregnancies, have increased not wanted. At the same time, the problem caused by the phenomenon of migration means that in
most cases this population has difficult access to a health institution, which does not allow for early diagnosis and timely
treatment. This work aims to assess the knowledge about prevention of sexually transmitted infections in immigrant
adolescents living in Soledad-Atlántico 2018-2019. A quantitative methodology with a quantitative descriptive approach was
used, the population under study were 234 immigrant adolescents in the range of 10-19 years and accessing health services at
a public institution in Soledad-Atlántico. It was possible to deduce through the survey the knowledge that adolescents have
about sexually transmitted infections, the result indicates that the level of knowledge is medium, and they affirm that it is of
great importance that young people acquire knowledge about STIs. Education to the vulnerable population is urgent as a
method of prevention and contribution to health with emphasis on strengthening the Integral Education of Sexuality through
the promotion of healthy sexual behaviors