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INTRODUCTION: Heart failure (HF) is one of the leading causes of morbidity and mortality worldwide. This study aimed to assess the impact of sex on sociodemographic, clinical, and laboratory parameters in patients with HF who were included in the Colombian Heart Failure Registry (RECOLFACA). METHODS: This was a cross-sectional analytical research. All 2528 patients included in RECOLFACA were analysed. The Mann-Whitney U test was used to compare median values as well as first and third quartiles (Q1-Q3). The age-related trend of NT-proBNP levels for both men and women groups was statistically evaluated. RESULTS: The study included 2528 patients with HF (1072 women and 1456 men). The echocardiographic evidence showed that men presented reduced left ventricular ejection fraction (LVEF) (79.63 vs. 69.75%, respectively; p < 0.001) more often than women, which had a significantly higher proportion of preserved LVEF (20.46 vs.11.24%, respectively; p < 0.001). Women displayed a higher value of systolic blood pressure (p < 0.001) and heart rate (p = 0.014) compared to men. Haemoglobin, creatinine, and sodium levels were significantly higher in men. Men had a considerably lower glomerular filtration rate value, with the median reaching a G3a value for chronic renal failure. According to age, the levels of NT-proBNP in each sex increased equivalently with age. CONCLUSION: Sex differences presented in this study are comparable to those discovered in other nations. However, certain variations show that these sex differences may differ by geographical area, which should encourage further investigations to describe them.

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Background: The value of Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitor) therapy in individuals with heart failure with preserved EF (HFpEF) was unknown until the EMPEROR-Preserved trial. We aimed to assess the proportion of patients with HFpEF that are eligible for empagliflozin therapy within the Colombian Heart Failure Registry (RECOLFACA). Methods: RECOLFACA enrolled adult patients with a HF diagnosis during 2017-2019 from 60 medical centers in Colombia. Criteria of the EMPEROR-Preserved Trial were used to recruit participants. The main outcome was individual eligibility with N-terminal pro-B-type natriuretic peptide (NT-proBNP) criteria, while the secondary outcome was eligibility without NT-proBNP data. Results: RECOLFACA had 799 patients with HFpEF (mean age70.7 ± 13.5; 50.7 % males). According to the major selection criteria of the EMPEROR Preserved Trial, 73.7 % patients would be eligible for empagliflozin therapy initiation when considering the NT-proBNP threshold. The NT-proBNP threshold represented the main determinant of ineligibility in patients with this biomarker measure (13.6 %; n = 16). In patients without NT-proBNP data, the main reasons for exclusion were the diagnosis of symptomatic hypotension or a systolic blood pressure below 100 mmHg (7.5 %), having an eGFR < 20 ml/min/1.73 m2 (4.3 %), and haemoglobin < 9 g/dl (3.1 %). Excluding NT-proBNP criteria increased empagliflozin eligibility to 80.6 %. Conclusion: Most patients with HFpEF from RECOLFACA are potential candidates for empagliflozin therapy initiation according to the EMPEROR-Preserved trial criteria. These findings favor the utilization of SGLT-2 inhibitor medications in daily medical practice, which may further decrease morbidity and mortality in HF patients, regardless of their EF classification.

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Introduction: Transplantation with fresh cadaveric osteochondral allograft (FOCA) is frequently used in defects of the femoral condyle and tibial plateau to preserve the knee joint. However, the use of FOCA in bipolar lesions remains controversial in cases with bipolar defects and a history of infection. Case Report: We present a 21-year-old male patient with a massive post-traumatic osteochondral defect of the lateral compartment of the knee and a history of infection, treated by a two-stage approach. In stage 1, infection was eradicated, and joint function recovered with aggressive debridement, polymethyl methacrylate beads, bone cement spacers, and Judet's quadricepsplasty. In stage 2, transplantation was performed with a bipolar FOCA. All treatments were planned using 3D-printed models. Conclusion: The two-stage approach and 3D planning can increase the chances of transplant success by preparing the future allograft bed and obtaining an optimal match between the cadaveric allograft and the patient's defect in cases with potential contraindications, such as a bipolar lesion in the femoral condyle and tibial plateau and a history of infection. A combined approach may lead to a more beneficial outcome for the patient to preserve joint function and improve quality of life.

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This work analyzed exhaustion markers in CD8+ T-cell subpopulations in 21 samples of peripheral blood mononuclear cells (PBMCs) from individuals with ocular toxoplasmosis (n = 9), chronic asymptomatic toxoplasmosis (n = 7), and non-infected people (n = 5) by using RT-qPCR and flow cytometry techniques. The study found that gene expression of PD-1 and CD244, but not LAG-3, was higher in individuals with ocular toxoplasmosis versus individuals with asymptomatic infection or uninfected. Expression of PD1 in CD8+ central memory (CM) cells was higher in nine individuals with toxoplasmosis versus five uninfected individuals (p = .003). After ex vivo stimulation, an inverse correlation was found between the exhaustion markers and quantitative clinical characteristics (lesion size, recurrence index, and number of lesions). A total exhaustion phenotype was found in 55.5% (5/9) of individuals with ocular toxoplasmosis. Our results suggest that the CD8+ exhaustion phenotype is involved in the pathogenesis of ocular toxoplasmosis.

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INTRODUCTION: Chronic kidney disease (CKD) represents one of the most frequent comorbidities observed in heart failure (HF) patients and has been observed to increase this population's risk of adverse outcomes. Nevertheless, evidence analyzing kidney dysfunction in HF is scarce in Latin American populations. We aimed to analyze the prevalence of kidney dysfunction and assess its association with mortality in patients diagnosed with HF enrolled in the Colombian Heart Failure Registry (RECOLFACA). METHODS: RECOLFACA enrolled adult patients with HF diagnosis from 60 centers in Colombia during the period 2017-2019. The primary outcome was all-cause mortality. A Cox proportional-hazards regression model was used to assess the impact of the different categories of eGFR in mortality risk. A p value of <0.05 was considered significant. All statistical tests were two-tailed. RESULTS: From the total 2,514 evaluated patients, 1,501 (59.7%) patients had moderate kidney dysfunction (eGFR <60 mL/min/1.73 m2), while 221 (8.8%) patients were classified as having a severe kidney dysfunction (eGFR <30 mL/min/1.73 m2). Patients with lower kidney function were most commonly males, had higher median age, and reported a higher prevalence of cardiovascular comorbidities. Moreover, different patterns of medications prescription were observed when comparing CKD versus non-CKD patients. Finally, eGFR <30 mL/min/1.73 m2 was significantly associated with a higher mortality risk compared to eGFR >90 mL/min/1.73 m2 status (HR: 1.87; 95% CI, 1.10-3.18), even after an extensive adjustment by relevant covariates. CONCLUSION: CKD represents a prevalent condition in the setting of HF. Patients with CKD and HF present with multiple sociodemographic, clinical, and laboratory differences compared with those only diagnosed with HF and present a significantly higher risk of mortality. A timely diagnosis and optimal treatment and follow-up of CKD in the setting of HF may improve the prognosis of these patients and prevent adverse outcomes.

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OBJECTIVE: To determine the frequency of sleep problems in low-income, urban pediatric populations in cities at different altitudes in Colombia. METHODS: A descriptive, cross-sectional population-based observational study was conducted in children aged between 2 and 12 years in the low income, urban areas of three cities in Colombia (Santa Marta, Bucaramanga, and Bogotá) located at 15, 959, and 2640 m above sea level, respectively. Sociodemographic data were collected, and the Spanish version of the Pediatric Sleep Questionnaire was used. RESULTS: 1989 children were surveyed, distributed as follows: Santa Marta (32.0%), Bucaramanga (33.4%), and Bogotá (34.6%). The overall prevalence of sleep problems was 39.0%. Children from Santa Marta had the highest frequency of parasomnias (58.0%); those from Bucaramanga had the highest frequency of attention deficit symptoms (4.0%) and apneic pauses witnessed by parents or caregivers (5.7%). Finally, Bogotá, the only high-altitude location, had the highest frequency of sleep disordered breathing (17.2%). CONCLUSIONS: The study found a high frequency of sleep problems in the pediatric population, especially at higher altitudes when compared to lower altitude settings. Sleep disorders warrant early detection and timely therapeutic intervention.

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Toxoplasma gondii, as other apicomplexa, employs adhesins transmembrane proteins for binding and invasion to host cells. Search and characterization of adhesins is pivotal in understanding Apicomplexa invasion mechanisms and targeting new druggable candidates. This work developed a machine learning software called ApiPredictor UniQE V2.0, based on two approaches: support vector machines and multilayer perceptron, to predict adhesins proteins from amino acid sequences. By using ApiPredictor UniQE V2.0, five SAG-Related Sequences (SRSs) were identified within the Toxoplasma gondii proteome. One of those candidates, TgSRS12B, was cloned in plasmid pEXP5-CT/TOPO and expressed in E. coli BL21 DE3. The resulting recombinant protein was purified via affinity chromatography. Co-precipitation assays in CaCo and Muller cells showed interactions between TgSRS12B-His-tagged and the membrane fractions from both human cell lines. In conclusion, we demonstrated that ApiPredictor UniQE V2.0, a bioinformatic free software, was able to identify TgSRS12B as a new adhesin protein.

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Introducción: la faringoamigdalitis aguda, independientemente de su origen, es de los diagnósticos más frecuentes en los servicios de urgencias. Aunque se ha establecido que en la mayoría de casos su origen es viral, ante la dificultad de identificar su agente etiológico con hallazgos clínicos se ha aumentado la formulación indiscriminada de antibióticos, principalmente en los servicios de urgencias, lo que contribuye con la emergencia de resistencias bacterianas y la aparición de efectos secundarios. Se propone evaluar la adherencia a la guía de práctica clínica para el manejo de faringoamigdalitis aguda en urgencias en el Hospital Universitario San Ignacio en Bogotá, Colombia. Materiales y métodos: se realizó un estudio de tipo descriptivo retrospectivo. Se revisaron 7762 historias clínicas de pacientes que consultaron por urgencias entre 2016 y 2019 por dolor de garganta. Se analizaron los datos de formulación de analgésicos, antibióticos, solicitud de la prueba rápida de detección de Estreptococo betahemolítico del grupo A (SBHGA) y el registro de la presencia de exudados al examen físico. Resultados: se incluyeron 7762 pacientes. Del total, 74,2 % recibieron antibiótico y 98 % analgesia. Se solicitó la prueba rápida de detección de SBHGA al 11,53 % de los pacientes. La presencia de exudados es el principal factor asociado a la formulación de antibióticos, y la solicitud de una prueba rápida de detección disminuye significativamente su formulación, dado que 21 % de dichos estudios fueron positivos

Objective: Sore throat is one of the most frequent complaints in the ER, both in children and adults. Although it has been established that most cases of acute tonsillitis are caused by viruses, given the difficulty in identifying its etiology based exclusively upon clinical signs, the indiscriminate prescription of antibiotics in the emergency setting has become very frequent. This practice may lead to the emergence of antibiotic resistance and secondary effects. We evaluated the adherence of ER physicians to clinical practice guidelines for the management of acute tonsillitis at Hospital Universitario San Ignacio in Bogotá, Colombia. Methods: A retrospective descriptive study was carried out. Clinical records for emergency visits between the years of 2016 and 2019 were reviewed. Data regarding rapid antigen detection test for GABHS (RAD), antibiotic and analgesic prescription and tonsillar exudates on physical exam, were recorded. Results: 7.762 patients with acute tonsillitis were included in the study. 74,2% were prescribed antibiotics and 98% received pain medication. For 11,53% of cases the rapid antigen test for GABHS was requested. Although tonsillar exudates are the main factor associated with the formulation of antibiotics, only 21% of rapid antigen detection tests were positive. As such, the systemic use of rapid diagnostic tests may help reduce unnecessary antibiotic prescription, bacterial resistance and drug side effects

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Objetivo: la parotiditis recurrente benigna de la infancia (PRBI) es una enfermedad de importancia clínica. Sin embargo, su diagnóstico puede no realizarse correctamente debido al desconocimiento de esta entidad. El propósito de este estudio es describir los aspectos clínicos fundamentales de esta condición y proponer un enfoque terapéutico simple. Materiales y métodos: se realizó un análisis descriptivo de pacientes pediátricos con diagnóstico de parotiditis viral y PRBI entre los años 2008 y 2018, en el Hospital Universitario San Ignacio de Bogotá, Colombia. Resultados: se encontraron 41 pacientes con diagnóstico de PRBI; de estos, el 51,2 % fueron de sexo femenino, con una edad media de 7,1 años. A 32 pacientes (78 %) con diagnóstico de PRBI se les realizaron imágenes diagnósticas, a pesar de que la tasa de complicaciones fue baja (19,5 %). El diagnóstico fue hecho por los servicios de pediatría y otorrinolaringología en el 80 % de los casos. Conclusiones: hasta donde sabemos, este es el estudio con mayor número de pacientes con diagnóstico de PRBI en Latinoamérica. Es indispensable conocer esta enfermedad y tener en cuenta su curso benigno y pocas complicaciones, con el fin de destinar menos recursos en el uso de imágenes innecesarias y evitar el sobrediagnóstico de parotiditis por paramixovirus.

SUMMARY Objectives: Benign recurrent parotitis of childhood (BRPC) is a clinically relevant disease in childhood. Its diagnosis, however, is usually not made due to the lack of knowledge regarding such a condition. The aim of this study is to describe the most relevant aspects of this condition and propose a simple therapeutic approach. Materials and Methods: We did a descriptive analysis of pediatric patients diagnosed with viral parotitis and BRPC between 2008 and 2018, at the Hospital Universitario San Ignacio in Bogotá, Colombia. Results: 41 patients with BRPC where included; 51.2% were female, with a mean age of 7.1 years. Thirty-two patients (78%) with diagnosis of BRPC underwent diagnostic imaging, despite the low rate of complications (19,5%). The diagnosis was made by otolaryngologists or pediatricians in 80% of the cases. Conclusions: To our knowledge, this is the study with the largest number of BRPC cases in Latin America. It is essential to know about this disease and take into account its benign course and few complication rates, in order to avoid both wasting of resources in the use of unnecessary imaging and the overdiagnosis of mumps.

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Resumen Objetivo. Determinar los valores leucocitarios, proteínas totales, fibrinógeno, albúmina y globulina en mulares sanos jóvenes pertenecientes a la Policía Nacional de Colombia. Materiales y métodos. Se muestrearon 50 mulares sanos entre machos y hembras. Se obtuvieron muestras de sangre por venopunción yugular para el análisis de recuento total y diferencial de leucocitos, albúmina, globulina, y proteínas plasmáticas totales por medio de conteo en cámara de Neubauer, frotis sanguíneo y espectrofotometría. Los datos fueron analizados por estadística descriptiva, y se realizó un análisis comparativo con la media reportada para otros équidos utilizando la prueba de T-student (P<0,05) y la prueba de Wilcoxon. Se estableció una confiabilidad del 95% y un margen de error del 5%. Resultados. Los valores de leucocitos fueron: 11,32 ± 2,99 x 10⁹ células/μl Diferencial: Neutrófilos 5038,6 ± 2228,9 células/µl, Linfocitos: 5758 ± 1975,9 células/µl; monocitos 109,95 ± 156,9 células/µl, Relación N/L: 1,03 ± 0,66, Proteínas totales 7 ± 0,39 gr/dl, Albúmina 4,48 ± 0,18 gr/dl, globulina 2,51 ± 0,43 gr/dl, relación A/G 1,7 ± 0,71, fibrinógeno 206 ± 107,6. Conclusiones. Se encontraron diferencias de la media en el recuento de leucocitos totales, diferenciales y fibrinógeno, comparando con otros équidos; estos valores fueron más cercanos a los encontrados en burros catalanes jóvenes. Con otros mulares jóvenes no hubo diferencias en los valores de leucocitos, neutrófilos y linfocitos. Los valores medios de proteínas totales, albúmina y globulina, se encontraron muy cercanos a los valores reportados en equinos. Los resultados obtenidos muestran la importancia de investigar los parámetros hematológicos en mulares de acuerdo con la raza, la edad y el manejo.

Abstract Objective. To determine leukocyte, total protein, fibrinogen, albumin and globulin values in young mules belonging to the Colombian National Police. Matherials and Methods. 50 healthy male and female mules were sampled. Blood samples were obtained by jugular venipuncture for total and differential count analisis od leukocytes, albumin, globulin, and total plasma proteins by Neubauer counting chamber, blood smear and spectrophotometry. The data were analyzed by descriptive statistics, and a comparative analisis was performed with the mean reported for other equids using the T-student test (P<0.05) and the Wilcoxon test. A reliability of 95% with a margin of error 0f 5% were stablished. Results. Total White cell count: 11.32 ± 2.99 x 10⁹/L, differential count: neutrophils 5038.6 ± 2228 cells/µl, lymphocytes: 5758 ± 1975.9 cells/µl, monocytes: 109.95 ± 156.9 cells/µl, N/L ratio: 1.03 ± 0.66, total proteins 7 ± 0.39 gr/dl, albumin 4.48 ± 0.18 gr/dl, globulin 2.51 ± 0.43 gr/dl, A/G ratio 1.7 ± 0.71, fibrinogen 206 ± 107.6 gr /dl. Conclusions. Significant differences were established in the mean of total leukocytes, differentials and fibrinogen compared to other equids; these values were closer to those found in Catalans donkeys. In contrast, there were no differences in the values of leukocytes, neutrophils and lymphocytes with other young mules. The mean values of total proteins, albumin and globulin, were found to be closer to the values reported in horses. The results obtained show the importance of research on haematological parameters in mules according to breed, age, and management.

Resumo Objetivo. Determinar os valores de leucócitos, proteínas totais, fibrinogênio, albumina e globulina em mulas jovens saudáveis pertencentes à Policia Nacional da Colômbia. Materiais e métodos. Foram amostrados 50 machos e fêmeas. Amostras de sangue foram obtidas por punção venosa jugular para análise da contagem total e diferencial de leucócitos, albumina, globulina e proteínas plasmáticas totais por meio de contagem em câmara de Neubauer, esfregaço de sangue e espectrofotometria. Os dados foram analisados por estatística descritiva, e foi realizada uma análise comparativa com a média relatada para outros equídeos utilizando o teste T de Student (P<0,05) e o teste de Wilcoxon. Foi establecida uma confiabilidade de 95% e uma margem de erro de 5%. Resultados. Os valores de leucócitos foram: 11,32± 2,99 x 10 células/µl, Diferencial: Neutrófilos 5038.6 ± 2228.9 células/µl, Linfócitos: 5758 ± 1975,9 células/µl; monócitos 109,95 ± 156,9 células/µl, razão N/L: 1,03 ± 0,66, Proteins totais 7 ± 0,39 gr/dl, Albumina 4,48 ± 0,18 gr/dl, Globulina 2,51 ± 0,43 gr/dl, razão A/G: 1,7 ± 0,71, fibrinogênio 206 ± 107,6. Conclusões. Diferenças nas mëdias foram encontradas na contagem de leucócitos total, diferencial e fibrinogênio, quando comparados a outros equídeos; esses valores eram mais próximos dos encontrados em jovens burros catalães. Com outras mulas jovens não hove diferenças nos valores de leucócitos, neutrófilos e linfócitos. Os valores médios das proteínas totais, albumina e globulina, foram encontrados muito próximos aos valores relatados em cavalos. Os resultados obtidos mostram a importância da investigação dos parâmetros hematológicos em muares de acordo com a raça, idade e manejo.