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Introduction Cocaine and ethanol (EtOH) co-consumption is a risk factor for physiologically and clinically negative outcomes. We describe the occurrence of cocaine consumption alone or co-consumption with EtOH and others psychotropics. Patients and methods The descriptive research used data on medical records of patients positive to cocaine test who attended an emergency room between 2016 and 2017. We determined the frequency of cocaine consumption alone and co-consumption with EtOH, cannabis or benzodiazepines (BZDs). Results Over one year period, 88 patients (13.3%) were positive to cocaine test, mainly attended on weekends, in holiday months, young adults or men. Among those positive for cocaine, 72% were also positive for EtOH, cannabis or BZD. Cocaine co-consumption with one or two out of three substance was 55.2% (CI95%; 44.7-65.8%) and 16.4% (CI95%;8.58-24.3%), respectively. Co-consumption was more frecuently wih EtOH, followed by cannabis or BZD. Conclusion Co-consumption of cocaine with EtOH is very common and could be associated with acute or chronic consumption of cannabis or acute exposure to BZDs. It is important that emergency physicians use a systematic approach to diagnose and treat more than one psychotropic substance in cocaine positive patients.

IntroductionAsymptomatic carriers (AC) of the new SARS-CoV-2 represent an important source of spread for COVID-19. Early diagnosis of these cases is a powerful tool to control the pandemic. Our objective was to characterise patients with AC status and identify associated sociodemographic factors.MethodsUsing a cross-sectional design and the national database of daily occurrence of COVID-19, we characterised both socially and demographically all ACs. Additional correspondence analysis and logistic regression model were performed to identify characteristics associated with AC state (OR, 95% CI).Results76.162 ACs (12.1%; 95% CI 12.0% to 12.2%) were identified, mainly before epidemiological week 35. Age≤26 years (1.18; 1.09 to 1.28), male sex (1.51; 1.40 to 1.62), cases imported from Venezuela, Argentina, Brazil, Germany, Puerto Rico, Spain, USA or Mexico (12.6; 3.03 to 52.5) and autochthonous cases (22.6; 5.62 to 91.4) increased the risk of identifying ACs. We also identified groups of departments with moderate (1.23; 1.13 to 1.34) and strong (19.8; 18.6 to 21.0) association with ACs.ConclusionSociodemographic characteristics strongly associated with AC were identified, which may explain its epidemiological relevance and usefulness to optimise mass screening strategies and prevent person-to-person transmission.

Background: Daily dietary calcium intake below the requirements has been related to low levels of vitamin D (Vit-D) and osteoarticular diseases. Objective: To determine the prevalence of Vit-D deficiency in the general population living in Bogotá, its relationship to dietary calcium intake, and the influence of socio-demographic factors and sunlight exposure. Materials and methods: In a pro-spective cohort of the general population (randomly selected), excluding individuals with conditions affecting calcium absorption or adequate Vit-D action, the prevalence of hypovitaminosis D (95 % ci) and regular consumption of calcium (RCI, mg/day) is measured according to socio-demographic, anthropometric, biochemical, and sunlight exposure variables. A multiple regression model is implemented (no intercept) to predict Vit-D concentration based on the factors described. Results: Ninety-seven patients are included, 61 % of which are women, with a median age of 23 years, a weight of 65 kg (IQR: 55.2-70.5), a height of 165 cm ± 8.9, and BMI of 22.8 kg/m2 (IQR: 21.2-25.2). The RCI was 393.7 mg/day, less than the benchmark for Colombian adults (p < 0.001); serum calcium concentration was 9.7 mg/dL. The mean Vit-D concentration (95 % ci) was 23.7 ng/mL (22.6-24.7); hypovitaminosis D was identified in 87 % of the sample (80.6-94.7 %), 24.7 % were classified as poor (15.6-33.8 %) and 62.9% as insufficient (52.8-73%). Vit-D concentration was predicted in a quadratic function by the interaction between sex, sunlight exposure, and RCI (R2 > 90 %). Conclusion: The suspected high prevalence of Vit-D deficiency is confirmed in the general Colombian adult population as a result of low dietary calcium intake, demographic factors, and sunlight exposure. Resumen: El consumo diario de calcio en la dieta por debajo de los requerimientos se ha relacionado con bajos niveles de Vitamina D (Vit-D) y con enfermedades osteoarticulares. Objetivo: Determinar la prevalencia de la deficiencia de Vit-D en la población general que vive en Bogotá, su relación con la ingesta de calcio en la dieta y la influencia de factores sociodemográficos y de la exposición a la luz solar. Materiales y métodos: En una cohorte prospectiva seleccionada aleatoriamente de la población general, excluyendo individuos con condiciones que afectaran la absorción de calcio o la acción de la Vit-D, se midió la prevalencia de hipovitaminosis D (IC 95 %) y el consumo habitual de calcio (CHC, mg/día), según variables sociodemográficas, antropométricas, bioquímicas y de exposición solar; se implementó un modelo de regresión múltiple (sin el intercepto) para predecir la concentración de Vit-D en función de los factores descritos. Resultados: Se incluyeron 97 pacientes, edad mediana 23 años, 61 % mujeres; con peso mediano 65 kg (RIC; 55,2-70,5), estatura 165 cm ± 8,9 e IMC 22,8 kg/m2 (RIC; 21,2-25,2). El CHC fue 393,7 mg/día, menor que el recomendado para adultos colombianos (p < 0,001); la concentración de calcio sérico fue 9,7 mg/dL. La concentración media (IC 95 %) de Vit-D fue 23,7 ng/mL (22,6-24,7), se identificó hipovitaminosis D en 87% (80,6-94,7%); 24,7% se clasificaron como deficientes (15,6-33,8 %) y 62,9 % como insuficientes (52,8-73 %). La concentración de Vit-D se logró predecir, en función cuadrática, por la interacción entre el sexo, la exposición solar y el CHC (R2 > 90 %). Conclusiones: Teniendo en cuenta los resultados obtenidos, se confirma la sospecha de alta prevalencia de hipovitaminosis D en población general colombiana adulta, relacionada con un bajo consumo de calcio en la dieta habitual, factores demográficos y de exposición solar. Resumo: Introdução: O consumo diário de cálcio na dieta abaixo dos requerimentos necessários tem sido relacionado com baixos níveis de vitamina D (Vit-D) e com doenças osteoarticulares. Objetivo: Determinar a prevalência da deficiência de Vit-D na população geral que vive em Bogotá, Colômbia, sua relação com a ingestão de cálcio na dieta, a influência de fatores sociodemográficos e a exposição à luz solar. Materiais e métodos: em uma coorte prospectiva selecionada aleatoriamente da população geral, excluindo indivíduos com condições que afetassem a absorção de cálcio ou a ação de Vit-D, foi medida a prevalência de hipovitaminose D (IC 95 %) e o consumo habitual de cálcio (CHC, mg/dia), segundo variáveis sociodemográficas, antropométricas, bioquímicas e exposição solar; foi implementado um modelo de regressão múltipla (sem o intercepto) para predizer a concentração de Vit-D em função dos fatores descritos. Resultados: Foram incluídos 97 pacientes, com idade média 23 anos, 61 % mulheres; com peso médio de 65 kg (RIC; 55,2-70,5), estatura 165 cm ± 8,9 e IMC 22,8 kg/ m2 (RIC; 21,2-25,2). O CHC foi 393,7 mg/dia, menor do que o recomendado para adultos colombianos (p < 0,001); a concentração sérica de cálcio foi 9,7 mg/dL. A concentração média (IC 95 %) de Vit-D foi 23,7 ng/mL (22,6-24,7), foi identificada hipovitaminose D em 87 % (80,6-94,7 %), foram classificados deficientes 24,7% (15,6-33,8%) e insuficientes 62,9% (52,8-73%). A concentração de Vit-D foi possível predizer, em função quadrática, pela interação entre sexo, exposição solar e CHC (R2 > 90%). Conclusões: A partir dos resultados obtidos, é confirmada a suspeita de alta prevalência de hipovita-minose D em população geral colombiana adulta, relacionada com um baixo consumo de cálcio na dieta habitual, fatores demográficos e exposição solar.

ObjectiveAsymptomatic carriers (AC) of the new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) represent an important source of spread for Coronavirus Disease 2019 (COVID-19). Early diagnosis of these cases is a powerful tool to control the pandemic. Our objective was to characterize patients with AC status and identify associated sociodemographic factors.MethodsUsing a cross-sectional design and the national database of daily occurrence of COVID-19, we characterized both socially and demographically all ACs. Additional Correspondence Analysis and Logistic Regression Model were performed to identify characteristics associated with AC state (OR, 95% CI).Results2338 ACs (11.8%; 95% CI, 11.3-12.2%) were identified, mainly in epidemiological week 18 [EW] (3.98; 3.24-4.90). Age ≤ 39 years (1.56; 1.42-1.72). Male sex (1.39; 1.26-1.53), cases imported from Argentina, Spain, Peru, Brazil, Costa Rica or Mexico (3.37; 1.47-7.71) and autochthonous cases (4.35; 2.12-8.93) increased the risk of identifying AC. We also identified groups of departments with moderate (3.68; 3.13-4.33) and strong (8.31; 6.10-7.46) association with AC.DiscussionSociodemographic characteristics strongly associated with AC were identified, which may explain its epidemiological relevance and usefulness to optimize mass screening strategies and prevent person-to-person transmission.

BACKGROUND: Low back pain due to discopathy has become one of the most expensive and highest impact problems of global public health at present.AIM: To evaluate the effectiveness of alternative therapies (AT) and related factors in lumbar disk disease (LDD).METHODS: Information was collected by using a retrospective descriptive design from medical records of patients treated from January to December 2013 with LDD who were attended in a clinic specialized in AT. Sociodemographic and clinical variables included clinical diagnostic time, Visual Analog Scale at admission (V.A.S.) and post-treatment pain (0-100 points) were identifi ed. General and specifi c infl uence of the AT was measured.RESULTS: 453 medical records were identifi ed, at admission V.A.S. was 8.2 (CI95%, 7,9 to 8,3) and showed pain relief (scale 0-100) of 54,5 points (CI95%, 52.2 to 56.8). In overall, 13 types of ATs were implemented with LDD patients. The median of pain relief (p25-p75) in the general population was 60 (40-70); 8 of 13 interventions provided an estimated median of pain relief lower than the one evidenced in the general population .CONCLUSION: The AT treatment in our study showed a reduction in pain of 50-60 points and an absolute reduction of 35 points after two months of treatment, which remained over 6 or more months of follow-up. Our results suggest that the use of AT has signifi cant effect on chronic pain in patients with LDD with no response to conventional treatment

Background: Vitamin D (25OHD) has immunomodulatory properties that can play a major role in patients with active lupus or lupus nephritis. His immunomodulatory function could be influenced by demographic factors, comorbidities (Charlson score), bone supplements, and other features. Objectives: We explored the association between the best 25OHD cut-off points and specific clinical features that were present in patients with active lupus or lupus nephritis. Methods: A retrospective descriptive research using clinical registers of patients diagnosed with systemic erythematosus lupus, attended in two rheumatology clinics was performed. A decisions tree model was used to identify the best cut-off points of 25OHD [ng/mL] and clinical features associated with active lupus (SLEDAI-2k >6) or lupus nephritis. Results: We identified 81 patients, median age 41 years, women 91.3%. Active lupus and lupus nephritis were present in 69.1% and 29.6%, respectively. Median 25OHD was 26.49, without a difference at comparing with active lupus patients 24.85, but lower in lupus nephritis patients 21.50 (p: 0.015). Lupus nephritis was absent in patients with 25OHD cut-off points >38.8 (alone) or ≤38.8 if they were older than >57 years. Active lupus was always present in patients ≤44 years with 1. High comorbidity or 2. Low comorbidity plus cut-off point 25OHD >35; in >44 years, both a euthyroid state and the absence of bone supplements were present in patients with active lupus. Conclusion: Exist a strong relationship between vitamin D levels and LES activity. References [1] American College of Rheumatology. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999 Sep;42(9):1785-96 [2] Simioni J, Heimovski F, Skare T. On lupus, vitamin D and leukopenia. 2016;56(3):206-211. [3] Guzman R.A, Pineros L.G, Theran A, Flechas J, Mejia M. AB0795 Hypovitaminosis D and Calcium Intake of Adult Population in Bogota (DICAVITD). Ann Rheum Dis 2016;75:1175-. 1176. Acknowledgement: To Fundacion Universitaria Juan N. Corpas Disclosure of Interests: None declared

Background Vitamin D is a steroid hormone with pleiotropic effects on physiological processes. Among others, immune system regulation and their analogues prevent symptom development of autoimmune diseases such as SLE. A previous research in a colombian clinic found a prevalence of hipovitaminosis D of 87% in healthy population, but hypovitaminosis D is higher in SLE patients than healthy controls. Objectives To establish the prevalence of hypovitaminosis D in patients with SLE and relationship with SLEDAI – 2K. Methods A cross sectional study was carried out. 80 medical records with a diagnoses of SLE o CIE-10 M30-M36 were identified and we included patients>18 years of age who meet at least 4 of the 11 criteria to diagnoses of SLE for medical record. The analysis included means, DS and Kruskall Wallis with p-value Results The majority of patients are women (94%), with an average age of 39.9 years, married (41%), with secondary education (56.7%) and different occupations. It was found that the patients with higher activity, had lower vitamin D levels. Additionally, if the patient had lupus nephritis, vitamin D levels decreased even more. Conclusions Patients with active systemic lupus Erythematosus, (SLE) have hypovitaminosis D more frequently and we noticed that patients with renal involvement have the lowest levels of vitamin D, which justifies a later analysis. References [1] American College of Rheumatology. Guidelines for referral and management of systemic lupus erythematosus in adults. Arthritis Rheum. 1999Sep;42(9):1785–96. [2] Simioni J, Heimovski F, Skare T. On lupus, vitamin D and leukopenia. 2016;56(3):206–211. [3] Guzman R.A, Pineros L.G, Theran A, Flechas J, Mejia M. AB0795 Hypovitaminosis D and Calcium Intake of Adult Population in Bogota (DICAVITD). Ann Rheum Dis2016;75:1175–1176. [4] Alele J., et al. Autoimmun Rev2010;9:137–39. [5] Dall, era M., et al. in KelleyF Philadelphia 2017; 1368–89. Disclosure of Interest None declared

Background Several treatment alternatives are available for primary breast cancer, although those for metastatic disease or inflammation associated with tumor progression are ineffective. Therefore, there is a great need for new therapeutic alternatives capable of generating an immune response against residual tumor cells, thus contributing to eradication of micrometastases and cancer stem cells. The use of complex natural products is an excellent therapeutic alternative widely used by Chinese, Hindu, Egyptian, and ancestral Latin-American Indian populations. Methods The present study evaluated cytotoxic, antitumor, and tumor progression activities of a gallotannin-rich fraction derived from Caesalpinia spinosa (P2Et). The parameters evaluated in vitro were mitochondrial membrane depolarization, phosphatidylserine externalization, caspase 3 activation, DNA fragmentation, and clonogenic activity. The parameters evaluated in vivo were tumor growth, leukocyte number, metastatic cell number, and cytokine production by flow cytometry. Results The in vitro results showed that the P2Et fraction induced apoptosis with mitochondrial membrane potential loss, phosphatidylserine externalization, caspase 3 activation, DNA fragmentation, and decreased clonogenic capacity of 4T1 cells. In vivo, the P2Et fraction induced primary tumor reduction in terms of diameter and weight in BALB/c mice transplanted with 4T1 cells and decreased numbers of metastatic cells, mainly in the spleen. Furthermore, decreases in the number of peripheral blood leukocytes (leukemoid reaction) and interleukin 6 (IL-6) serum levels were found, which are events associated with a poor prognosis. The P2Et fraction exerts its activity on the primary tumor, reduces cell migration to distant organs, and decreases IL-6 serum levels, implying tumor microenvironment mechanisms. Conclusions Overall, the P2Et fraction lessens risk factors associated with tumor progression and diminishes primary tumor size, showing good potential for use as an adjuvant in breast cancer ER(+) treatment.