Hospital Universitario de Neiva

Introducción: los síntomas de los trastornos de la interacción cerebro-intestino (TICI) tienen alta comorbilidad psiquiátrica. La personalidad, entendida como un patrón relativamente estable de cognición, emoción y conducta, podría modular la expresión y gravedad de los síntomas gastrointestinales. Objetivo: determinar la relación entre los dominios de personalidad y la presencia y gravedad de los síntomas relacionados con TICI en una muestra clínica de pacientes con trastornos mentales en Bogotá. Métodos: estudio observacional, analítico y transversal realizado en 131 pacientes mayores de 18 años atendidos en una clínica de salud mental. Para medir síntomas gastrointestinales se utilizó la escala Irritable Bowel Syndrome Severity Score (IBS-SSS) y el Personality Inventory for DSM-5 (PID-5) para medir rasgos de personalidad. Se realizaron análisis descriptivos, pruebas de correlación y comparaciones mediante Kruskal-Wallis. Resultados: el 91,2% de los participantes presentó algún síntoma de los TICI, según el puntaje obtenido en la escala IBS-SSS, con predominio de rangos moderados (42,6%) y leves (31,6%). Los dominios de afecto negativo (r = 0,176; p = 0,041), desapego (r = 0,250; p = 0,003) y psicoticismo (r = 0,177; p = 0,039) se correlacionaron significativamente con mayor gravedad de los síntomas. El dominio de desapego mostró una diferencia de mayor gravedad sintomática en IBS-SSS (χ² = 11,5; grados de libertad [gl] = 3; p = 0,009) con respecto a otros dominios de personalidad. Conclusiones: los rasgos de personalidad de desapego, afecto negativo y psicoticismo se relacionan con mayor presencia de síntomas de trastornos intestinales, lo que confirma la hipótesis de la interacción intestino-cerebro. Esto resalta la importancia de evaluar tanto los rasgos de personalidad en gastroenterología como los síntomas digestivos en salud mental.

Prostate cancer is the most common solid neoplasm in men, with an increasing incidence. This study describes clinical and sociodemographic features and PSA levels, and evaluate their associations with stage, risk categories, metastasis, and mortality in a public tertiary hospital in southern Colombia. The present retrospective cohort study included 590 patients diagnosed with prostate cancer between 2020 and 2023. Sociodemographic and clinical variables, PSA levels, pathological characteristics and risk scales were analyzed. Patients were categorized into two groups: living (n = 429) and deceased by prostate cancer (n = 109), and other causes (n = 44). Statistical analyses were performed to determine associations with mortality and presence of metastasis. PSA screening was more frequent among survivors (66.9%, n = 287) than among deceased (22.0%, n = 24; p < 0.001). Median PSA at diagnosis was higher in those who died (123 vs 16 ng/mL; p < 0.001). PSA > 100 ng/mL was associated with ~50% probability of metastatic disease, rising to >95% for PSA > 323 ng/mL. High-risk D'Amico classification was strongly associated with metastasis (RR 6.67) and mortality (OR 14.24, p < 0.001). Bone pain was the predominant presenting symptom in the deceased group (76.1%, n = 83) and showed a strong association with metastasis (RR 8.146). PSA screening was strongly associated with improved survival outcomes. Elevated PSA levels, high risk D'Amico classification and the presence of bone pain were important predictors of metastasis and mortality. The need to strengthen early detection in our population is evident, given the high percentage of patients presenting at advanced stages.

Intracranial complications in dengue fever are uncommon but have been increasingly reported in severe cases. Dengue fever is a mosquito-borne viral illness caused by the dengue virus, which usually presents mild symptoms such as fever, headache, and myalgia. In a minority of cases, the disease can progress to more severe forms characterized by plasma leakage, severe thrombocytopenia, and bleeding. Although neurological manifestations are not typical in dengue infections, factors such as severe thrombocytopenia and previous neurosurgical interventions may predispose patients to intracranial hemorrhagic events. This case report presents an 18-year-old female with a fatal intraparenchymal hemorrhage, occurring in the context of severe dengue and a history of prior post-traumatic craniectomy. This case illustrates how dengue-related thrombocytopenia and endothelial dysfunction can trigger catastrophic intracranial bleeding in areas of prior structural brain injury. Considering preexisting neurosurgical lesions as potential sites of secondary hemorrhage in dengue patients with severe thrombocytopenia.

Introducción: El tamizaje metabólico neonatal básico (TMNB) es una estrategia esencial de salud pública para la detección temprana de trastornos que pueden afectar el desarrollo del recién nacido si no son tratados oportunamente. Este estudio evaluó el programa de TMNB en el Hospital Universitario Hernando Moncaleano Perdomo de Neiva durante 2022-2023. Materiales y Métodos: Estudio observacional y descriptivo en neonatos sometidos a TMNB. Se realizó un análisis univariado de los datos, obtenidos de historias clínicas y registros de laboratorio. Se incluyeron recién nacidos con menos de un mes de vida y se excluyeron aquellos fallecidos o nacidos fuera de la institución. Resultados: Se analizaron 980 pacientes lo que representó el 20.12% de los nacimientos en la institución. La mediana de edad en la toma de muestra fue de 2.7 días (RIC: 1-2 días), con el 62.45% de las muestras recolectadas antes de los dos días de vida. No se detectaron casos positivos para fenilcetonuria, galactosemia, hiperplasia suprarrenal congénita ni déficit de biotinidasa, pero se identificaron tres casos de fibrosis quística (1 por cada 1623 nacimientos) y un caso de rasgo falciforme (1 por cada 4878 nacimientos). Conclusión: La baja cobertura del TMNB resalta la necesidad de abordar barreras que limitan su acceso. Es esencial fortalecer la educación del personal de salud y las familias para garantizar una toma de muestras oportuna y reducir falsos resultados. Además, se requiere un seguimiento clínico eficaz para confirmar diagnósticos y asegurar el acceso a tratamientos especializados.

Interest in near-death experiences (NDEs) has grown across disciplines such as medicine, psychology, and literature, yet no consensus exists on their origin or nature. This study presents a bibliometric and systematic review of 775 articles published between 1977 and April 2025, using PRISMA guidelines. Data was extracted from the Scopus database and analyzed with the Bibliometrix package in R. Additionally, the Tree of Science method was used to map citation networks and identify core contributions and research fronts. The United States, the United Kingdom, and Belgium lead in NDE research. Methodologies vary widely, encompassing medical analyses of brain activity, psychological outcomes like reduced suicidal ideation, and narrative approaches identifying common language patterns. Findings reveal a fragmented theoretical landscape, emphasizing the need for integrative frameworks. Future studies should deepen the medical and psychological understanding of NDEs and explore their long-term impact on individuals' mental health and spiritual development.

Identifying immune markers driving early and effective antibody response in patients with severe coronavirus disease 2019 (COVID-19) is critical due to the threat of future coronavirus pandemics, incomplete global vaccination, and suboptimal booster coverage. Patients with life-threatening severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are characterized by dysregulated thromboinflammation and cytokine storm that could influence the isotype virus-specific antibody response and the subsequent clinical outcome. We investigated the association between COVID-19-related mortality with the dynamics, magnitude, and relative avidity of nucleoprotein (N), spike (S), and receptor-binding domain (RBD)-specific IgM, IgA, and IgG in circulation. We also assessed the relationship between the virus-specific antibody responses and cytokine patterns, as well as systemic and pulmonary thromboinflammation markers. This multicenter study included COVID-19 patients hospitalized early in the pandemic, classified as survivors (n=62) and non-survivors (n=17). We developed indirect enzyme-linked immunosorbent assays (ELISAs) to evaluate each virus-specific isotype using well-characterized outpatient COVID-19 (n=180) and pre-pandemic cohorts (n=111). The pro-inflammatory interleukin (IL)-6 and tumor necrosis factor (TNF)-α, as well as the regulatory IL-10, transforming growth factor (TGF)-β1, and soluble tumor necrosis factor receptor I (sTNFRI) levels were evaluated. The ELISAs performed highly for all virus-specific isotypes, although modest for IgM-N. Non-survivors increased N-specific, but no S-specific, IgM and IgA responses throughout the disease course and, more notably, a delayed class switching to IgG-S and IgG-RBD compared to survivors. No differences were observed in the virus-specific IgG relative avidity. Survivors exhibited an antibody response proportional to the degree of systemic and pulmonary thromboinflammation, whereas non-survivors showed those dissociated because of their uncontrolled severe thromboinflammation. Only the survivors showed a dominant regulatory cytokine pattern in the early phase of infection (<10 days after symptoms onset), which strongly correlated with developing IgG-S and IgG-RBD protective antibodies. We developed easy-to-use immune assays that enable patient monitoring and identify at-risk populations in low- to middle-income regions. Non-survivors displayed an ineffective N-mediated antibody response, marked by an inability to control inflammation and a compromised time-dependent class switching toward S and RBD-specific IgG. The regulatory cytokine axis, including TGF-β1, maybe a critical immune correlate of effective antibody-mediated immunity in COVID-19.

Systemic sclerosis is an orphan disease characterized by tissue fibrosis and organ dysfunction, mainly lung and heart. Its pathogenesis is still not clearly determined, although indications of genetic predisposition and alteration of immune function have been found. This pathology represents a challenge for the anesthesiologist from the approach of airway as well as the anesthetic technique, and other key aspects (venous access, monitoring of vital signs, protective pulmonary ventilation). A clinical case of a 12-year-old female with a history of diffuse systemic sclerosis and a history of 3 previous surgical procedures is presented; she arrives for a scheduled cosmetic procedure. Difficult airway predictors, without presurgical tests.