The CBS Journal is a quarterly publication in the field of basic health sciences and related disciplines, with a strong focus on the discussion and dissemination of results from theoretical works and practical research conducted at universities, healthcare institutions, and national and international research centers. Indexing: Latindex, Dialnet, Google Scholar, others. Frequency: Quarterly. ISSN (Online): 2981-5800
Body awareness and occupational adaptation in recyclers
This research was conducted at a recycling company in Pamplona, Norte de Santander. Its main objective was to determine the influence of body awareness on the occupational adaptation of recyclers in Pamplona through a quantitative study, promoting efficiency in the performance of occupational tasks. The theoretical framework was based on theories from the discipline of occupational therapy, recognizing that adaptation depends on the individual’s ability to adjust to environmental demands and that performance occurs as a result of the interaction between the person, their contexts, and the tasks they perform. A descriptive quantitative approach with a cross-sectional design was used. The instruments applied were a sociodemographic questionnaire, the MAIA-II for body awareness, and the OPHI-II for occupational adaptation. The data were processed using SPSS version 23. The results showed that high perceptual dimensions (Perception and Emotional Awareness at the ninetieth percentile) do not exert a protective influence on occupational adaptation. Conversely, low regulatory dimensions (Avoiding Distractions, Attention Regulation, and Body Listening at the fortieth percentile) exert a significant negative influence on occupational identity and competence. The Emotional Awareness subscale showed a significant association with problems in Occupational Identity, with an odds ratio equal to four point zero and a ninety-five percent confidence interval ranging from one point zero two to fifteen point nine three, and a p value lower than zero point zero five. For Occupational Competence, two subscales showed significant associations: Emotional Awareness, with an odds ratio of twenty-eight point seventy-five, and Avoiding Distractions, with an odds ratio of zero point one three four. In the Occupational Context scale, the pattern was identical to that observed in Occupational Competence, since the same contingencies underlie the work environment. Across the three scales, odds ratios greater than four point zero and statistical significance were observed in all cases. It is concluded that body awareness exerts a paradoxical influence on occupational adaptation. In contexts of extreme precarity, high interoceptive perception without self-care actions intensifies the conflict between bodily needs and work demands.
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Vaginocutaneous fistula secondary to gluteal abscess: a case report
A fistula is an abnormal connection between two epithelialized surfaces that are normally separated, most commonly occurring secondary to infectious, inflammatory, or traumatic processes. Vagino-cutaneous fistulas are exceedingly rare, as the most frequent fistulas in this anatomical region are vesicovaginal or rectovaginal, due to the close proximity of these structures. We present the clinical case of a 36-year-old woman with a history of obesity and sedentary lifestyle who initially presented to her primary healthcare unit with pain in the gluteal and perianal region, accompanied by urinary symptoms. She was treated empirically with antibiotics for a presumed urinary tract infection and analgesics, without clinical improvement. On day 15, she attended the emergency department due to purulent vaginal discharge. Physical examination revealed a necrotic lesion measuring 5 × 5 cm in the perianal region of the left buttock, and surgical debridement confirmed a vagino-cutaneous fistula. Initial management included debridement, eschar excision, and sterile dressing coverage, followed by a second procedure for partial closure. The patient remains hospitalized under multidisciplinary management, awaiting further evaluation for additional intervention. This case highlights the importance of timely medical diagnosis and thorough physical examination during the initial consultation, and documents the rarity and complexity of vagino-cutaneous fistulas.
Hemipelvectomy due to severe pelvic fracture secondary to a traffic accident: clinical case
Most pelvic injuries in young patients are due to high-energy blunt trauma, although frail and elderly patients may suffer these injuries from a low-energy mechanism (i.e., a fall from standing height). High-energy trauma increases the likelihood of concomitant injuries, which are likely to involve the abdominal and pelvic viscera. Pelvic fractures account for approximately 3 percent of all skeletal injuries. Overall mortality from pelvic fractures ranges from 5 to 16 percent, with unstable pelvic fractures accounting for about 8 percent. Open pelvic fractures, which make up 2 to 4 percent of all pelvic fractures, are associated with a mortality rate of up to 45–50 percent. The most common mechanisms of pelvic fractures include motor vehicle collisions and motorcycle accidents (43 to 58 percent), pedestrians struck by a motor vehicle (20 to 22 percent), and falls (5 to 30 percent). This clinical case presents a 25-year-old female who suffered pelvic trauma secondary to a traffic accident, resulting in an open type IIIC pelvic fracture with injury to the external iliac artery, as well as the left femoral artery and vein. Due to progression to non-viability of the limb, a left hemipelvectomy was performed.
Bronchopleural fistula secondary to spontaneous pneumothorax due to bullous disease: case report
Bullous lung disease is a variant of emphysema characterized by the formation of air cavities larger than 1 cm, primarily associated with COPD and chronic smoking. Its complications include spontaneous pneumothorax, hemoptysis, bulla infection, and bronchopleural fistula, the latter of which is difficult to manage clinically and carries a high morbidity and mortality rate. Spontaneous pneumothorax secondary to bullous disease can be complicated by bronchopleural fistula, a rare condition outside of surgery. Persistent air leak limits conservative management and requires consideration of surgery. Video-assisted thoracoscopy and limited lung resections are effective and safe options, improving prognosis and respiratory function in selected patients. Furthermore, bronchopleural fistula secondary to spontaneous pneumothorax due to bullous disease is a rare but serious complication. Timely diagnosis and adequate surgical approach are crucial for clinical recovery and reduced morbidity and mortality in these patients. We present the case of a 63-year-old male patient with a history of COPD and chronic smoking who was admitted with a left pneumothorax initially managed with closed thoracostomy. He presented with a persistent air leak secondary to severe bullous emphysema. Due to the lack of resolution with conservative management, surgery was performed, revealing a ruptured apical bulla with a bronchopleural fistula, fibrinopurulent pleural effusion, and lung entrapment. A non-anatomical segmentectomy was performed with closure of the fistula. The postoperative outcome was favorable, and the patient was discharged on the fourth day without complications.
Introduction: Cecal volvulus is a rare cause of intestinal obstruction, characterized by the axial rotation of the cecum and ascending colon around the mesenteric vasculature. This torsion can lead to tissue necrosis and intestinal perforation. Timely diagnosis and appropriate management can reduce mortality. Case report: A 43-year-old woman presented to the emergency department with nonspecific abdominal symptoms. A computed tomography scan suggested intestinal torsion, prompting an exploratory laparotomy. A cecal volvulus with extensive necrosis was identified, necessitating a right hemicolectomy and detorsion as a damage control approach. Discussion: Cecal volvulus is a pathological condition with multiple predisposing factors, among which a history of abdominal surgery is particularly significant. Diagnosis relies on laboratory studies and imaging techniques, with abdominal computed tomography being the most sensitive and specific modality. Management is primarily surgical, ranging from detorsion to colectomy, depending on intestinal viability and the patient’s hemodynamic stability. In cases of irreversible intestinal ischemia, colectomy with or without ileostomy is necessary to mitigate damage and prevent complications. Conclusions: Cecal volvulus is a rare cause of intestinal obstruction, characterized by nonspecific symptoms and accelerated progression. Early diagnosis, as well as surgical treatment, are essential to reducing complications.
Social determinants and quality of life in breast cancer: evidence from a Mexican population
Introduction: Cancer is a public health problem being the second leading cause of mortality worldwide. In Mexico, the incidence was 195,499 in 2020, being breast cancer (BC) the one that most affects Mexican women. Objective: To analyze the social determinants that have the greatest impact on the quality of life (QoL) of patients with breast cancer treated in a Mexican hospital Material and methods: Analytical cross-sectional study, with patients aged 18 years and older diagnosed with BC in the last 36 months in stage I-III, who received medical care and chemotherapy at the Leon General Hospital. Three instruments were used: 1) the QLQ-30 (QLQ-30), 2) its complement for BC (QLQ-BR-23), both elaborated by the European Organisation for Research and Treatment of Cancer, and 3) questionnaire elaborated for social determinants. Results: 73 participants. Neoadjuvant chemotherapy caused more pain (p-value=0.021). Global CV score 77.62. Having a partner was associated with better sexual functioning (p=0.023), not owning a home increased breast cancer (p=0.030), lower family income increased nausea and vomiting, better body image and worse sexual functioning (p=0.020, 0.053, 0.007 respectively). Positive association with CV physical, emotional and social functioning; and concern for future (p=0.015, 0.006, 0.005 and 0.037 respectively), negatively: fatigue, pain, body image and side effects to treatment (p-value=0.004, 0.003,0.023 and 0.006 respectively). Conclusions: It was found that the factors that significantly influenced the participants' QoL were having a partner, not owning a home, and lower family income. The factors that had a negative association with participants' QoL were fatigue and pain, body image items, side effects of systemic therapy and worry about the future.
Historical review of peritoneal dialysis, its surgical approach and its relationship with Henry Tenckhoff
Introduction: Peritoneal dialysis is a procedure that allows the purification of fluids and electrolytes in patients suffering from chronic renal failure thanks to the physiological capacities of the parietal peritoneum, whose path to development as a treatment for said pathology was marked by milestones throughout history. The peritoneal catheter is a prosthesis similar to a round tube, usually made of silicone, that can be placed using open, laparoscopic and even percutaneous surgical techniques. Objective: To make a historical account of the development over time of peritoneal dialysis, as well as to describe the various techniques in the placement of Tenckhoff catheters by endoscopic, percutaneous or open surgery, with their respective indications and contraindications. Materials and methods: A literature review was conducted in the PubMed and Google Scholar databases, both in Spanish and English, using the sole search terms "peritoneal dialysis history" and "peritoneal catheter placement techniques," limiting the search to articles published since 2013, yielding 690 results. A manual search was performed without any software support, in which fourteen articles were included based on a review of the title, abstract, and keywords.
Series of biliary tract atresia cases in a Level III hospital in North Santander
Biliary atresia is a rare hepatobiliary disease characterised by an inflammatory and destructive process with progressive obliteration and sclerosis of the intra- and extrahepatic bile ducts, leading to obstruction of bile flow and damage to the parenchyma and intrahepatic bile ducts, with subsequent liver failure and cirrhosis. The surgical treatment of choice has been Kasai portoenterostomy; however, the vast majority of patients require liver transplantation (up to 80%) due to disease progression. To date, this pathology is not subject to mandatory reporting in Colombia, so we do not have epidemiological data despite it being one of the leading causes of TH in the first years of life in the paediatric population. We describe a series of cases including six patients diagnosed with biliary atresia at a tertiary care hospital in the department of Norte de Santander, Colombia. In our work, we highlight the critical importance of early detection strategies for timely diagnosis and treatment to reduce morbidity and mortality.
Post-cheiloplasty scars: efficacy of fractional CO2 laser and intense pulsed light (IPL) a narrative review
Introduction: Post-cheiloplasty scars pose a clinical challenge due to their aesthetic, functional, and psychosocial impact. Fractional CO2 laser and intense pulsed light (IPL) have been used to optimise scar quality, but the evidence remains heterogeneous and there is no consensus on the most effective modality. Methods: A narrative review of the literature was conducted in PubMed and Embase (2015–2025), including clinical trials, systematic reviews, and observational studies. Key clinical outcomes analysed were thickness, texture, pliability, pigmentation, and vascularity. Results: Fractional CO2 laser showed consistent benefits in reducing scar thickness and improving texture and pliability, with greater efficacy when applied in the early phases of healing. IPL was particularly useful for pigmentary and vascular alterations, with a favourable safety profile. Studies evaluating the combination of CO2 and IPL, such as those by Peng and Komisarek, suggest a possible synergistic effect, although methodological limitations persist. Heterogeneity of protocols, small sample sizes, and the limited number of direct head-to-head comparisons restrict the generalisability of the findings.Conclusions: Fractional CO2 laser has the strongest evidence for improving structural parameters of post-cheiloplasty scars, whereas IPL provides complementary benefits for pigmentation and vascularity. Combining both therapies may be a promising strategy, but well-designed, multicentre, controlled trials with standardised protocols and direct comparisons are needed, ideally incorporating quality-of-life outcomes.
Strangulation of the penis with a metal ring in pediatrics: case report
Introduction: The imprisonment of the genital organs by metallic elements is a rare clinical event, which requires finding the best method for metal ablation, allowing rapid decompression of the acute injury and in-depth urological study of the damage caused. Clinical case: An 11-year-old male patient who consulted the emergency department with strangulation of the base of the penis, with a self-inflicted object (steel ring), which generated grade II trauma, with decreased distal perfusion and three hours of evolution. evaluated by Pediatric Surgery-Urology. Results: Prior to regional blockade of the penis, ring cutting techniques were performed with a cold cutter, circular saw clamp and pincer clamp without achieving objective ablation, for which a lymph evacuation procedure was performed with direct pressure, achieving a reduction in distal edema and mobilization of the object, with satisfactory evolution and without urethral injury. Discussion: It is of vital importance for the efficient management of pediatric emergencies to be able to guarantee penile block and edema drainage techniques in a timely manner that reduce the risks of failed cutting procedures.
Malignant pleural mesothelioma (MPM) constitutes less than 1% of total malignant neoplasms. It is characterized by aggressive tumorigenesis, exhibiting low incidence rates, poor prognostic outcomes, and diminished survival metrics. MPM is derived from pleural mesothelial cells, making it a primary neoplasm of the pleura. It manifests in the pleura (70-90%), with exposure to asbestos increasing its incidence to 80%. Diagnostic assessment necessitates imaging modalities, histopathological biopsy, and immunohistochemical analysis, rather than reliance solely on clinical symptomatology, particularly given past asbestos exposure which may obscure differential diagnoses that emulate these clinical presentations. We report a case involving a 51-year-old male patient exhibiting pleural effusion and coagulated hemothorax, who underwent diagnostic evaluations confirming epithelioid mesothelioma, which does not warrant surgical resection prioritization and has been referred for oncological management.
Intraoperative finding of Amyand’s hernia: case report and literature review
The presence of the cecal appendix whether, inflamed, perforated, or intact, within the hernia sac is known as an Amyand hernia, a rare condition first described by surgeon Claudius Amyand in 1735 (with a global prevalence of 0.13%), which can mimic a strangulated hernia; This report describes the case of an elderly patient who underwent scheduled surgery for a right inguinal hernia, with a clinical history of two years. During the surgical procedure, a direct sliding inguinal hernia measuring 3 × 2 cm was identified. Upon opening the hernia sac, the cecal appendix was found in a phlegmonous phase, adhered to the sac wall. A decision was made to perform an appendectomy, the hernia sac was reintroduced, and the posterior wall of the inguinal canal was repaired using the Lichtenstein technique. As no complications occurred, the patient was discharged two days after surgery with outpatient antibiotic management.
Adolescent with Guillain-Barré syndrome: cervico-pharyngeal-brachial variant at the Children's Hospital of Toluca. Case report
Introduction: Guillain Barré syndrome (SGB) is an acute demyelinating disease that causes the rapid development of weakness of the extremities and often of the facial, respiratory and swallowing muscles. It is the most common cause of flaccid paralysis, reported with an incidence of 0.6 cases in 100 000 people per year. Case report: an adolescent with acute and progressive decrease of upper and later lower limbs that additionally led to data of respiratory distress that required advanced management of the airway, later management with immunoglobulin was started and a conduction speed study was conducted with evidence of “SBG PCB” variant. Conclusion: Although SGB is a recurrent pathology secondary to infection processes, we consider that the previously described variant does not occur frequently, so it is prudent to present the case and evaluate the patient's follow-up.
Relationship between performance patterns and occupational behavior in overweight schoolchildren at the Guaimaral Technical Institute in Cúcuta
The overall objective of this research is to determine the impact of performance patterns on occupational behaviors in the population at risk of obesity at the Guaimaral Technical Institute, Cúcuta. The methodology employed is quantitative and descriptive, using data collection techniques such as the sociodemographic form, the Occupational Performance Historical Interview (OPHI-II), and the MOHOST assessment instrument. The target population includes overweight high school students selected through random, non-probability sampling. The instruments used include the sociodemographic form to characterize the population, the OPHI-II to assess performance patterns, and the MOHOST to assess occupational behavior. This study seeks to provide an understanding of how habits, routines, and roles affect overweight and offer a solid basis for designing occupational therapy interventions.
Depression and anxiety in Venezuelan migrants in the Atlantic Department, 2023
Introduction: The migration process brings with it different feelings such as anxiety and depression. Anxiety is an emotion that the individual experiences when they feel afraid or worried in everyday situations, while depression is considered a mental disorder in which sadness and loss of interest in everyday life persist, leading to affectation of the physical and mental state, expressed through thoughts and behaviors. Objective: To determine the levels of anxiety and depression in Venezuelan migrants who live in a municipality in the department of Atlántico. Methodology: The study is a cross-sectional descriptive observational study. The study population is made up of all Venezuelan migrants who are registered with the “Fundemar” foundation in a municipality in the department of Atlántico, and the sample was taken in its entirety. Two surveys were applied: Hamilton test for anxiety and the 17-item Hamilton test for depression. Results: A descriptive analysis of the data obtained from the application of the surveys was carried out, where it was found that 76% of the people surveyed had mild anxiety and only 6% had severe anxiety. 58% of the migrants who participated in the study do not present depression, 30% present mild minor depression, 8% moderate depression and 2% severe depression. Conclusion: The results revealed a significant picture, the majority of participants showed levels of anxiety classified as mild, while a minimal proportion experienced severe anxiety. This finding highlights that the majority of people studied experience mild anxiety.
Prevalence of neonatal withdrawal syndrome in newborns of mothers who use psychoactive substances and were treated at the Erasmo Meoz University Hospital, 2010–2024
Neonatal Abstinence Syndrome (NAS) represents a complex clinical condition in newborns exposed to psychoactive substances (PS) during pregnancy. The main purpose of this research was to determine the prevalence of NAS and its association with the type of PS used by mothers attended at the Erasmo Meoz University Hospital (HUEM) between 2010 and 2024. This work is based on the understanding of placental substance transfer and its effects on fetal neurodevelopment. An observational, retrospective, and quantitative study was carried out, analyzing 119 medical records through a structured data collection tool and statistical processing using RStudio. Findings showed a prevalence rate of 25.2%, being most common in newborns exposed to cocaine, bazuco, and heroin. The main clinical features included irritability, feeding difficulties, and respiratory problems. Additionally, maternal polysubstance use and social vulnerability were linked to greater severity of NAS and a higher rate of neonatal institutionalization. These results highlight the need to strengthen preventive measures, early diagnosis, and comprehensive care programs in perinatal health services.
Incidence of thermal burns in pediatric patients at the Erasmo Meoz University Hospital June 2023 – February 2025
Introduction: Thermal burns in the pediatric population are one of the leading causes of childhood trauma worldwide, with serious physical and emotional consequences. The World Health Organization (WHO) identifies children as a highly vulnerable group, with the majority of cases being preventable. In Colombia, the National Institute of Health reports an increase in cases, especially in Norte de Santander. However, gaps in local knowledge about this problem persist. This study seeks to determine the incidence and characteristics of pediatric burns in Cúcuta to understand the epidemiological profile and guide preventive actions. Objective: To establish the incidence of thermal burns requiring surgical management and their eventual prognosis in the pediatric population. Methodology: A descriptive, observational, and retrospective study was conducted at the Erasmo Meoz University Hospital in San José de Cúcuta, Norte de Santander, Colombia, from June 2023 to February 2025. Medical records were selected from the database submitted by the IT department, based on inclusion and exclusion criteria, and data entry was performed using an-Excel spreadsheet. Results: Predominance in older male infants, scalds by hot liquids (75.3%) as the predominant causative agent, most injuries were second degree (85.7%) and mild (49.4%), percentage of surgical interventions (83.1%) with predominance of debridement and favorable prognosis with 100% survival. Conclusion: Pediatric thermal burns represent an important cause of morbidity in Cúcuta, with predominance of scalds in older infants, second-degree injuries, and surgical management. These findings, together with the high childhood vulnerability and risk conditions in the home environment, confirm the urgency of focused preventive strategies.
Laparoscopic gastrojejunostomy with palliative intent in duodenal adenocarcinoma. Case report
Introduction: Duodenal adenocarcinoma is a rare neoplasm, accounting for approximately 0.3% of gastrointestinal tumors. Its clinical presentation is often nonspecific, making its diagnosis a considerable clinical challenge. Case Report: The case of an-81 year old female patient with a history of multiple comorbidities is presented, who was recently diagnosed with intestinal-type duodenal adenocarcinoma. Due to the persistence of recurrent emetic episodes, oral intolerance, and diffuse abdominal pain, a laparoscopic gastrojejunostomy was performed with palliative intent. The procedure was successfully completed, resulting in favorable clinical progression and significant resolution of symptoms. Discussion: Duodenal adenocarcinoma requires timely surgical intervention, whether for curative or palliative intent, to optimize prognosis and improve patients' quality of life. Conclusions: Despite its low incidence, duodenal adenocarcinoma has significant clinical relevance. Early diagnosis is challenging; however, timely and appropriate intervention are key factors in improving prognosis, contributing to more favorable outcomes for patients.
Alternative and complementary therapies used in renal patients: review of the literature
Objective: To describe complementary and alternative therapies reported in patients with kidney disease and the effects found. Material and methods: A bibliographic search was performed in several databases: PubMed, Web of Science, RedAlyC, Scielo, Cochrane Library, and Scopus data, Medline, Embase, and EBSCO, using keywords to locate articles from the last 10 years in English and Spanish. Therapies were classified into 5 groups: complete medical systems, mind-body medicine, biological therapies, manipulative and body-based practices, and energy therapies, by means of matrices. Results: 13 articles were found in total of alternative or complementary therapies used in patients with kidney disease: 3 in medical systems, 2 in mind-body medicine, 4 in biological therapies, and 4 in manipulation-based practices and body and energy therapies. Conclusions: Of the 13 articles found 9 of them showed positive effects in the direct treatment of patients' kidney disease or symptoms, however, the groups of studies were too small to point out that these treatments really work. We found 4 articles focused not on the direct treatment of the disease or its symptoms but on the psychoemotional improvement of the patients, in which they found that the use of alternative therapies in conjunction with their treatments helped to reduce stress and anxiety.
Evaluation of adherence to established FDA and INVIMA regulations on the use of omeprazole in a high-complexity hospital in northeast Colombia
Introduction: In clinical practice worldwide, proton pump inhibitors (PPIs) are widely used due to their effectiveness in treating various gastrointestinal disorders. However, they are not without adverse reactions, and their use should be strictly guided by precise clinical indications. Indiscriminate or prolonged use can increase the risk of side effects such as nutritional deficiencies, alterations in the gut microbiota, and a higher risk of bone fractures, among others. Therefore, their prescription must be based on an individualized evaluation of the patient and aligned with the indications provided by the United States Food and Drug Administration (FDA) and the Colombian National Institute for Food and Drug Surveillance (INVIMA).Objective:To evaluate adherence to FDA and INVIMA regulations regarding the use of omeprazole in a high-complexity hospital in northeastern Colombia. Methodology:Retrospective, observational study with a quantitative approach was conducted. A total of 373 medical records were analyzed, selected through non- probabilistic convenience sampling, applying inclusion and exclusion criteria. Data collection was carried out via documentary analysis using Google Forms. Descriptive statistical methods (tables and frequency graphs) and analytical methods, including ANOVA tests and Pearson correlation, were applied to evaluate the relationship between variables such as dosage, pathologies, and prescription years, as well as adherence to FDA and INVIMA regulations.Results:A total of 373 medical records of patients admitted to the emergency department with omeprazole prescriptions between January 2020 and 2024 were analyzed. Only 1.07% of the prescriptions met the indications established by the FDA and INVIMA. The most frequent associated pathologies were COVID-19 (12%), acute myocardial infarction (9%), and community-acquired pneumonia (5.4%), all without clinical indications for omeprazole use. Prescriptions were mainly made by general practitioners and internists, with the most common dosage being 40 mg IV/day. No significant differences were found in treatment duration between different doses. There was no significant association between dosage and the treated pathology, although a significant relationship was found with gastrointestinal conditions, especially upper gastrointestinal bleeding, emesis, and abdominal pain.Conclusions:The study revealed low adherence (1.07%) to FDA and INVIMA-approved indications for IV omeprazole use in a high-complexity hospital in northeastern Colombia. Omeprazole was frequently used in conditions without regulatory support and was often prescribed inappropriately, particularly among older adults with comorbidities. Most prescriptions were made by general practitioners in emergency settings. In response, an institutional protocol was developed to optimize its use, promote patient safety, and strengthen adherence to international clinical guidelines.
Robotic surgery in Colombia: an analysis from experience and perspectives for its evolution
Introduction: Robotic surgery has transformed surgical practice worldwide due to its precision, reduced risk of complications, and shorter recovery times. However, its adoption in Colombia has been limited since the first intervention in 2010, performed by Clínica de Marly. Currently, only seven additional robots are available, all located in Bogotá, highlighting its low penetration in the country. Methods: A reflective analysis was conducted based on our experience and a review of data on the implementation of robotic surgery in Colombia. Economic, structural, and educational barriers were identified, and strategies were proposed by comparing them to successful international models. Results: The main barrier is the high cost, which is not covered by the healthcare system, restricting patient access and specialist training. Moreover, the centralization of this technology in Bogotá limits its reach in other regions. The lack of local research further perpetuates the absence of evidence supporting its broader adoption. Conclusions: Robotic surgery is a strategic tool for enhancing surgical standards in Colombia. Implementing policies to reduce costs, decentralize technology, and strengthen academic training is crucial. Overcoming these challenges could position Colombia as a regional leader in robotic surgery, benefiting both the healthcare system and patients alike.
Perioperative optimization in patients with chronic pain: a reflective review
Chronic pain is an intersectional condition whose impact has gained more attention following the COVID-19 pandemic. Preoperative optimization in these patients presents logistical, social, and economic challenges. This study explores the implementation of Perioperative Optimization Programs (POP) as an integrated approach to improve care and outcomes for these patients. A reflective review of various articles available in scientific databases, action plans, and protocols in both Spanish and English was conducted to assess the importance of perioperative optimization and identify existing evidence for optimizing the preoperative state in chronic pain patients. The implementation of an integrated perioperative approach improves recovery and reduces risks in chronic pain patients. These programs are essential to optimizing surgical care and promoting a faster, safer recovery.
Use of social networks and its influence on self-image and nutrition in adolescents in schools of the municipality of San Gil
Introduction: Digital platforms facilitate various aspects of life, the lack of responsibility with these media leads adolescents to spend several hours a day browsing the internet regardless of the quality of the programs they visit, impacting their self-image and their relationship with their diet. Objective: To determine the influence of social networks on the self-image and eating behavior of adolescents between 12 and 19 years old from schools in the municipality of San Gil. Method: Quantitative cross-sectional, descriptive, correlational research with a sample of 188 adolescents, chosen at random, 4 instruments were implemented: sociodemographic characteristics, a social media addiction test, a body image scale test, and a scoff test. Results: A statistically significant association was evidenced between TCA and sex (p = 0.001), with women being the most affected, as well as between self-image and eating disorders (p = 0.000), and also between the sex of the participants and self-image (p = 0.001). Conclusions: The influence of social networks on self-image and eating behavior in adolescents was determined, finding a correlation in most of the variables.
Impact of pulmonary vein isolation on left atrial contractile function in patients with paroxysmal atrial fibrillation: a prospective cohort analysis using strain echocardiography
Objetive Assess left atrial (LA) contractile function in patients with paroxysmal (AF) using strain echocardiography before and after pulmonary vein isolation (PVI) and compare them with matched controls. Methods A prospective cohort study was conducted at the National Institute of Cardiology Ignacio Chavez from May 2021 to November 2022. Patients with paroxysmal AF underwent transthoracic echocardiography (TTE) assessing LA global strain and strain in the LA reservoir, conduit, and contraction phases strains before and after PVI. Echocardiographic parameters were compared prior to and after PVI, and against matched controls. Results 15 subjects with paroxysmal AF and 15 matched controls were analyzed. Post-PVI, subjects showed significant improvements in LA global and reservoir phase strains. Compared to controls, significant echocardiographic differences were noted pre-PVI, but not post-PVI. Conclusion PVI may enhance LA strain parameters in paroxysmal AF patients, aligning them with matched controls. This suggests PVI's potential restorative effect on atrial function. Further research is warranted to validate these observations.
Morel–Lavallée syndrome secondary to high energy trauma
Morel-Lavallée syndrome is a clinical condition not frequently seen in medical practice, with a prevalence of approximately 8.3% in acetabular fractures. It has a male predominance, with an approximate male-to-female ratio of 2:1, which could be due to the male predominance observed in multiple traumas. However, these injuries often go undiagnosed or are sometimes diagnosed later, thus underestimating their true prevalence. This article presents the clinical case of a young adult patient diagnosed with Morel-Lavallée syndrome in the left lower limb secondary to trauma to the thigh and left hip from a traffic accident. This required surgical treatment due to the functional limitation it generated and the high risk of the hematoma abscessing, leading to septic arthritis of the hip, sepsis, or irreversible functional limitations.
Impact of trauma on the development of septic arthritis: a case report
Post-traumatic septic arthritis, a rare but serious complication of joint injuries, is characterized by the invasion of microorganisms, frequently methicillin-sensitive Staphylococcus aureus, through disruption of the skin and joint capsular barrier, triggering a severe inflammatory response that can progress to systemic complications such as acute kidney injury, septic shock, hematogenous dissemination bacteremia, and encephalopathies, among others. This case study describes a patient who, after suffering joint trauma, developed severe septic arthritis of the left knee, requiring multiple surgical interventions, long-term antibiotic therapy, and presenting with complications such as acute kidney failure and spondylodiscitis secondary to hematogenous seeding. This highlights the importance of early recognition and multidisciplinary management of this condition to minimize associated morbidity and mortality.
Nursing students imaginaries in the face of the uncertainty of human immunodeficiency virus (HIV) diagnosis: a narrative
HIV infection attacks the immune system, and acquired immunodeficiency syndrome (AIDS) is the most advanced stage of the disease. HIV attacks the white blood cells, weakening the immune system, and this makes it easier to contract diseases such as tuberculosis, other infections, and some cancers. The intention of this narrative is to learn from nursing students what a patient goes through before, during and after receiving the diagnosis of the infection, for this purpose four meetings were planned and executed with different groups of students and different topics of conversation such as; knowledge, pre-diagnosis feelings, post-diagnosis feelings and uncertainty in the diagnosis of HIV, in order to obtain solid and varied information on the central theme. The students state that knowledge before talking about this topic is crucial to be able to imagine the feelings such as fear, anguish and uncertainty that they present in their different stages in order to reach the diagnosis. Likewise, the accompaniment of social and family support networks is essential in the patient's process, as stigma can invade the infected patient and this can lead to unfavorable decisions.
Usefulness of the Respiratory Status Scale as a Prognostic Tool to Identify the Need for Care in People With Acute Respiratory Infection
Acute respiratory infections are disorders of the upper or lower respiratory tract that can cause a variety of illnesses, ranging from asymptomatic or mild infections to severe and fatal diseases. Therefore, a mechanism is required to identify the care needs to provide better care in the clinical stages that require it. Objective: To determine the utility of the outcome measure "Respiratory Status" as a prognostic tool in identifying the need for care in individuals with acute respiratory infection. Materials and methods: This was a quantitative, observational, and analytical study conducted retrospectively through the analysis of medical records from the emergency department to the end of hospitalization of patients with acute respiratory infection. Results: It was observed that the Respiratory Status outcome measure allows for the prediction of patient admission to the Intensive Care Unit (ICU) from the emergency department, with a range of 49% to 70% according to the Cox and Snell and Nagelkerke R-squared values. It was determined that patients with scores ranging from 5 to 10 predict their admission to the ICU with a P-value <0.05. No statistical significance was observed in the model for predicting admission to hospitalization and outpatient care (P-value >0.05). Conclusions: The Respiratory Status outcome measure, through its evaluated indicators, improves the identification of patients who will be admitted to the ICU and require higher levels of care from the emergency department by nursing professionals. However, a prospective study is recommended in the future to specify the indicators and avoid confounding variables such as data quality, among others.
Relationship Between Grip Strength and Physical Capacity in Older Adults
Introduction: Grip strength has been established as a key indicator of general functionality in older adults and has been linked to mobility, independence, and overall health. The Short Physical Performance Battery (SPPB) is a widely used tool to assess balance, gait, and lower extremity strength in this population. This research is based on the theory of sarcopenia and active aging, where the loss of strength and physical function affects the quality of life of older adults. The present study aims to analyze the relationship between grip strength and functional capacity measured through the Short Physical Performance Battery (SPPB) in non-institutionalized older adults attending the E.S.E. Hospital San Juan de Dios in Pamplona. Materials and methods: This quantitative, descriptive, and correlational study uses dynamometry to measure grip strength and the SPPB to assess the functional capacity of the participants. A sample of fifty non-institutionalized older adults from Pamplona was selected, and the data were analyzed using Pearson's correlation coefficient to determine the relationship between both variables. Results: The average grip strength was 18 kg in the dominant hand, which was primarily the right. Good scores were found regarding the functional capacity of the older adults evaluated, specifically related to static and dynamic balance, postural control, and gait speed. There is a significant correlation between grip strength and Short Physical Performance Battery scores. Conclusion: The results obtained highlight the importance of hand strength as a predictor of functional status in older adults.
Chylothorax in a Patient With a Thoracoabdominal Wound: Case Report
A healthy patient produces approximately two liters of chylous fluid from the gastrointestinal tract in 24 hours, which is transported through the thoracic duct to the vascular system. When an injury occurs to this duct by any mechanism, a rapid accumulation of chyle in the pleural space follows. We present the case of a 41-year-old man who was admitted to the emergency department with a gunshot wound at the thoracoabdominal level, which required management with closed thoracostomy and diaphragmatic lesion repair. During his postoperative period, chylous fluid was observed in the drainage systems. A cytochemical test confirmed the presence of chylothorax with a triglyceride level of 166.03. A multidisciplinary approach was initiated by the thoracic surgery and nutrition teams. After two weeks, the patient developed peristalsis with clinical symptoms, and surgical management with pleurodesis was performed due to the lack of changes in the patient's condition. As a final measure, thoracic duct management was decided upon, and the patient showed improvement and was subsequently discharged from the institution.