Search

El trastorno por déficit de atención e hiperactividad es una condición mental que afecta a niños y adolescentes con prevalencia estimada de 5.3% en la población mundial y en Colombia de 19-24% en hombres y 10-12% en mujeres. Su etiología es multifactorial entre ellos la hipoxia, como un factor del medio ambiente uterino; presentándose en entidades como la preeclampsia, donde se ha considerado determinante en el desarrollo del trastorno por déficit de atención e hiperactividad; por eso es importante evaluar su asociación. Objetivo: Determinar la asociación entre el diagnóstico trastorno por déficit de atención e hiperactividad y el antecedente perinatal de preeclampsia. Metodología: Estudio de casos y controles retrospectivos de 404 casos de trastorno por déficit de atención e hiperactividad y 411 controles no emparentados sin el trastorno ni otros trastornos disruptivos del comportamiento. La evaluación psiquiátrica se hizo entre los años 2005–2011, mediante entrevista estructurada que incluyó indagar acerca del antecedente de PE en el embarazo de cada paciente. Resultados: El antecedente de preeclampsia se dio en el 3.7% de los pacientes con trastorno por déficit de atención e hiperactividad y en el 5.5% de los controles (OR 0.66, IC95% 0.34 – 1.29; p=0.221). Esta falta de asociación se mantiene luego de ajustar por género, ser adoptado, haber nacido por cesárea y edad de inicio del trastorno que llevó a consultar al paciente (OR 0.51, IC95% 0.22 – 1.17; p=0.115).Conclusión: No hubo significancia estadística entre el antecedente de preeclampsia materna y el trastorno por déficit de atención e hiperactividad en la muestra de los pacientes seleccionados. [Castellanos-Castellanos YA, Escobar-Sánchez M, Páez-Leal MC, Díaz-Martínez LA, Arias-Duran CA, Espitia-Orejarena DM, Forero-Parada JL. Preeclampsia y trastorno por déficit de atención con hiperactividad. Estudio de casos y controles. MedUNAB 2014; 17(1): 23-29] Attention deficit hyperactivity disorder is a mental disorder that affects children and adolescents. Its prevalence is 5.3% in the global population, in Colombia is 19-24% in men and 10-12% in women. Its etiology is multifactorial and hypoxia as a factor of the uterine environment; performing in entities such as preeclampsia, has been considered in the development of attention deficit hyperactivity disorder, been important to evaluate the association. Objective: Determine the association between attention deficit hyperactivity disorder diagnosis and perinatal history of preeclampsia. Methodology: Retrospective case-control study. 404 cases with attention deficit hyperactivity disorder and 411 unrelated controls without psychiatric or other disruptive behavior disorders. The psychiatric evaluation was made between 2005–2011 by structured interview, which will assess the obstetric history of mothers in search of preeclampsia. Results: The history of preeclampsia occurred in 3.7% of patients with attention deficit hyperactivity disorder and 5.5% of controls (OR 0.66, 95% CI 0.34 – 1.29, P= 0.221). This lack of association remains after adjusting for patient sex, if adopted, would have been born by caesarean section and age of onset of the disorder that led to refer the patient (OR 0.51, 95% CI 0.22 – 1.17, P= 0.115). Conclusions: There was no statistical significance between maternal history of preeclampsia and attention deficit hyperactivity disorder in the sample of selected patients. [Castellanos-Castellanos YA, Escobar-Sánchez M, Páez-Leal MC, Díaz-Martínez LA, Arias-Duran CA, Espitia-Orejarena DM, Forero-Parada JL. Preeclampsia and attention deficit disorder with hyperactivity. Case-control study. MedUNAB 2014; 17(1): 23-29]

Antecedentes: El tratamiento de la apendicitis aguda implica su extirpación; es frecuente la solicitud de cicatrices postquirúrgicas del mejor tamaño posible. Una de las estrategias disponibles es el abordaje transumbilical. Objetivos: Descubrir las características clínicas y los desenlaces operatorios de los pacientes pediátricos en quienes se realiza apendicectomía vía transumbilical. Metodología: Estudio prospectivo de 424 pacientes sucesivos en cuanto a los desenlaces operatorios a corto plazo. Resultados: El tiempo promedio de intervención quirúrgica fue de 22 minutos; 95,8% de los pacientes presentó evolución satisfactoria del postquirúrgico; 1,4% de los pacientes se reintervino para drenar un absceso intracavitario residual y 0,2% presentó infencción de sitio operatorio sin mas complicaciones. Conclusión: El abordaje transumbilical de la apendicitis es una alternativa minimamente invasiva para todos los estados de apendicitis aguda e implica disminución del tiempo de realización, menor estancia del postquirúrgico, menor incidencia de complicaciones y mayor conformidad con los resultados estéticos.

Introducción: El síndrome metabólico (SM) es factor de riesgo para mortalidad por enfermedad coronaria y diabetes mellitus. Se han propuesto nuevos marcadores de riesgo cardiovascular (RCV), con mejor capacidad pronóstica en la toma de medidas preventivas para disminuir la aparición o severidad de sus consecuencias. Objetivos: Establecer la prevalencia de SM y determinar el comportamiento de los factores de riesgo cardiovascular tradicionales y no convencionales entre hombres y mujeres de Bucaramanga, Colombia. Metodología: GÉNESIS es un estudio de cohorte prospectivo con evaluación en 2005 y 2010. Para la segunda fase, todos los participantes contestaron una encuesta semiestructurada, recibieron evaluación clínica, de presión arterial (PA) y parámetros antropométricos, así como toma de sangre periférica en ayunas para medición de colesterol, HDL, triglicéridos, glicemia, PCR, IL- 6, Apo A-I y Apo B. Resultados: Para la segunda fase se evaluaron 66 empleados. Se encontró una prevalencia de SM del 18.2%. La población masculina presentó los mayores valores de PA, glucemia, triglicéridos, Apo B y relación Apo B/Apo A-I, comparado con las mujeres. En el estudio de seguimiento se evaluaron 44 personas en dos momentos (2005 y 2010), donde la población femenina evidenció un aumento significativo del PA, niveles de colesterol, HDL y glucemia, así como descenso en los de PCR comparado con los hombres. Conclusión: El reconocimiento de los factores de riesgo tradicionales y no convencionales, y las diferencias de los mismos entre los géneros ayudaría a optimizar la estratificación del RCV y a futuro una mayor prevención de las enfermedades cardiovasculares.______________________________________________________________________Background: The metabolic syndrome (MS) is a risk factor for coronary heart disease and diabetes mellitus mortality. New cardiovascular risk markers have been proposed with better prognostic ability for taking preventive measures to decrease the occurrence or severity of their consequences. Objectives: To establish the prevalence of MS and to determine the behavior of traditional and no traditional cardiovascular risk factors of men and women from Bucaramanga, Colombia. Methodology: GENESIS is a prospective cohort study in 2005 and 2010 assessment. For the second phase, all participants completed a semistructured questionnaire, received clinical evaluation forblood pressure and anthropometric parameters and peripheral blood sampling for measurement of fasting glucose, cholesterol, HDL, triglycerides, CRP, IL-6, Apo AI and Apo B. Results: 66 employees were evaluated for second phase. The prevalence of MS was 18.2%. Among them, the male population had the highest values of waist circumference, glucose, triglycerides, Apo B and Apo B/Apo AI, compared with women. In Follow-up study, 44 people were assessed on two occasions (2005 and 2010); female population showed a significant increase in waist circumference, cholesterol, HDL and blood glucose levels, and decrease in CRP compared with men. Conclusion: Therecognition of traditional and non-conventional risk factors, andthe differences between genders would help to optimize cardiovascular risk stratification and therefore better prevention of CVD in the future.

Antecedentes: La dependencia a la nicotina (DN) es la dependencia más frecuente en la población general colombiana; sin embargo, a la fecha no se conocen los factores asociados.Objetivo: Determinar la prevalencia y los factores asociados a DN en adultos del área urbana de Bucaramanga, Colombia. Método: Se diseñó un estudio poblacional transversal para estudiar una muestra probabilística de personas entre 18 y 65 años. La DN se determinó en fumadores diarios durante el último mes con la escala de Etter para dependencia al cigarrillo (CDS), con un punto de corte de 30/60. Mediante regresión logística se ajustaron las variables asociadas.Resultados: Participaron 2.496 personas con edad promedio de 38,0 años (DE=13,5), 69,7% mujeres. Un total de 250 (10,0%) personas informaron consumo diario de cigarrillo; de este grupo, 154 (61,6%) presentaron DN. La prevalencia ajustada de DN en la población global fue 5,6%. La DN fue más frecuente en varones (3,0; IC95% 2,0-4,4), en personas con menor escolaridad (OR=1,1; (IC95% 1,0-1,1), en personas empleadas (OR=1,5; IC95% 1,0-2,2), en residentes en estrato bajo (OR=1,7; IC95% 1,2-2,4), en consumidores diarios de café (OR=2,8; IC95% 1,9-4,1), en presencia de consumo abusivo de alcohol (OR=4,1; IC95% 2,4-7,2) y quienes informaron trastornos mentales comunes (OR=3,5; IC95% 2,3-5,1).Conclusiones: La prevalencia de DN es alta en la población general de Bucaramanga, Colombia. Dos tercios de los fumadores diarios presentan DN. La DN se asocia a consumo diario de café, consumo abusivo de alcohol y la presencia de trastornos mentales comunes.Background: Nicotine dependence (ND) is the most common substance dependence in Colombian population. However, its factors associated are unknown. Objective: To establish the prevalence and factors associated with ND among adults in Bucaramanga, Colombia. Method: A cross-sectional study was done with adults aged between 18 and 65 years. Among current cigarette smokers, the ND was quantified with the Cigarette Dependence Scale (CDS), cut-off point of 30/60. Regression logistical was calculated for adjusting associated variables. Results: A total of 2,496 people participated in this research. The mean age was 38.0 (SD=13.5); and 9.7% were women. Two-hundred fifty persons reported current daily cigarette smoking (10.0%); 154 (61.6%) of them met criteria for ND. The general prevalence of ND was 5.6%. The ND was more common among men (3.0, 95%CI 2.0-4.4), less years of scholarship (OR=1.1, 95%CI95 1.0-1.1), employed persons (OR=1.5; 95%CI 1.0-2.2), low income neighbors (OR=1.7, 95%CI 1.2-2.4), daily coffee drinkers (OR=2.8; 95%CI 1.9-4.1), abusive alcohol users (OR=4.1, 95%CI 2.4-7.2), and people with common mental disorders (OR=3.5, 95%CI 2.3-5.1). Conclusions: The prevalence of ND is high among smokers from Bucaramanga, Colombia. Two thirds of smokers present ND. Abusive alcohol consumption, coffee consumption, and mental common disorders are associated with ND.

Preeclampsia presents itself inall of the world’s populations, with an incidence of 5 – 7%; howeverin developing countries it can be three times greater. In Colombiait is the primary cause of maternal morbidity and mortality, beinga problem of public health. Ethiology of PE is still unknown but it’saccepted that it is a complex disease where individual manifestationsdepends on the interaction of maternal and fetal geneticsand environmental factors. Recently the influence of each ofthese factors on predisposition to develop the disease has triedto be measured. Genetic factors, maternal and fetal, contribute50% towards susceptibility to the condition. General results bya study on Colombian candidate genes in PE, GenPE, supportthese findings, having found the having a familiar history of PE(i.e. mother, sister) are independent risk factors to develop thepathology with OR of 2.74 (IC 95% 1.96-3.83) and 2.37 (IC 95% 1.54-2.63), respectively.

Depression is the main cause of disability-adjustedlost years around the world; hormonal changes which happen duringmenopause seem to increase susceptibility to develop depression.Aim: To establish depressive symptoms prevalence among femaleteachers aged 45 to 55 living at the Metropolitan Area of the Cityof Bucaramanga. Method: Cross-sectional survey with CES-D.Multivariated analysis was made to adjust confounding caused bydemographic and sexual/reproductive history variables with clinicallysignificant depressive symptoms (CSDS). Results: 581 womenparticipated (age average 50.3 years), 19.2% took hormonal therapy(HT); 50.2% (95%CI 45.3-55.2) were at their menopause. CES-Dscore oscillated between 0 and 39 points (average 13.6), beingsuperior among women with more time of amenorrhea, but not accordingto age, marital status, HT or sexual life. CSDS prevalencewas 32.4% (95%CI 28.6-36.3), but adjusted by predictive valuesallows to estimate a depression prevalence in 11.5%. The associatedfactors with CSDS were age (prevalence rate –PR– 0.948,95%CI 0.912-0.986), to have active sexual life (PR 0.492, 95%CI0.384-0.632), amenorrhea time (PR 1.57, 95%IC 1.057, IC 95%1.035-1.080), being divorced (PR 0.604, 95%CI 0.371-0.983), beingsingle (PR 0.590, 95%CI 0.381-0.914) and living out of wedlock.(PR 1.707, 95%CI 1.352-2.155). Conclusions: The depressionprevalence among perimenopauseal female teachers is similar to thegeneral population, being their risk factors similar to ones alreadyinformed in the medical literature.

Basocellular carcinomais maligne skin neoplasia more common. Its growing is slow,low mortality but sometime is very destructive and producehigh social and laboral disability. Sunlight is principal knownrisk factor. The objective of this study was to describedemographical, clinical, histopathologic and treatmentcharacteristics of a patient series from a privatedermatological consult in Bucaramanga, Colombia. FromJune 1996 to may 2002, a total of 305 BCC cases succeedwith histopathologic confirmation were studied. We identified391 lesions in 305 patients, your age was from to 27 to 100year old (22% under 50 year old); 57.7% was female. Menshowed more lesions than women (1.38 ± 0,79 vs 1,22 ±0,64, p = 0.013). Patients presenting more lesions were older.Ninety percent of lesions was in head and neck (22.4%,nose). Clinical presentation more frequent was nodular(65%). 13.2% of lesions had more than one histologicalclassification. Superficial BCC were more usual out headand neck. We conclude that BCC in this case series presentclinical features similar to others geographic regions, withexception the high number of superficial lesions.

Nosocomial infection (NI) is a adverse eventthat cause a negative impact over inpatient evoluation. NIcontrol strategies are based in institutional knowledge aboutits incidence rates by specific NI class and services.Aim: To stablish kind, distribution and tendence of NI ratesby service in Hospital Ramón González Valencia,Bucaramanga (Colombia), a 475-beds third level teachinghospital with 475 beds.Methodology: Active non selective NI surveillance systemin hospitalizes patients between 1995 and 2000.Results: IN rate in 1995 was 5.62 cases per 100 egresses,4,78 in 1996, 4,68 in 1997, 3,98 in 1998, 3,68 in 1999, and3,80 in 2000. Surgical site infection have higher rate, followedby skin and subcutaneous tussies infection, and phlebitis.SSI was significatively reduce in these six years, and senseorgans infection, gastrointestinal tract, and sepsis, too; butphlebitis and female reproductive organs infection rate wasup. Units with higher rate was burn unit, preterm neonatesunit and intensive care units; child infectology, orthopedicsand term neonates unit improves their rates, but unitsdedicated to care critical and chronically ill patients had growup rates (intern medicine and critical care units, both childrenand adults).Conclusion: Theses figures permit us orient to made specificinfection control strategies based by specific infection orhospitalization service. This activity must improve nosocomialinfection rates and in-patient attention.

Aim: To establish the frequency, mechanisms and circumstancesof biological accidents occurred among medicine students.Methodology: Retrospective, anonymous, and voluntary survey.Results: 31.6% (IC 95% 26.5-36.7%) of interview studentsinformed to have suffered at least one biological accident anacademic semester, with 0.64 /±/ 1.61 accidents during theacademic semester; the students of surgical levels presented 1.09/±/ 1.69 accidents, those of clinical level 0.96 ± 1.96 and those inbasic sciences 0.30 /±/ 0.73 accidents (P = 0.000001). The surgicalclinics students inform more frequently accidents of high risk fortransmission of infections that medical clinical area students (18.8%vs 3.4%) or basic sciences students (4.8%); the accidents of highrisk and means are more frequent in surgical and delivery roomsthan other places.Conclusion: It is necessary development strategies to teachbiosecurity to medical students, which include to educate them atthe beginning of their courses about biological risk during theiracademic duties and to use appropriate protection elements; alsomust implement procedures to assist biological accidents victimsin all the places where they are carried out.