Background Rockall score is the most widely used prognostic scale for assessing risk of complications from non-varicose upper gastrointestinal bleeding (UGIB). Several studies have been conducted in adult populations with non-varicose UGIB in different parts of the world, with conflicting findings regarding the extent of association between the score and some morbidity and mortality outcomes. Also, there is controversy regarding the best cut-off point for the score. Moreover, no studies validating this score in Colombia have been carried out. Objective To assess the diagnostic performance of the Rockall score in predicting rebleeding and mortality in patients with non-varicose UGIB. Methods A prospective cohort study was conducted in patients requiring upper gastrointestinal endoscopy (UGIE) for non-varicose bleeding. The pre-and post-endoscopy Rockall scores were calculated and outcomes, including mortality, UGIB-associated mortality and in hospital rebleeding were determined at the 1 and 3-month time points. The association between the scores and these outcomes was assessed using the chi2 or the Fisher test, whereas the discrimination ability of the score was determined using the areas under the ROC curve (AUC). High discrimination ability was considered to exist in cases in which an AUC ≤0.7 with α=0.05 could be rejected. Results Overall, 177 patients were analyzed. In-hospital outcomes at 1 and 3 months were 12%, 17% and 23% for general mortality, 6%, 12% and 15% for UGIB mortality, and 19%, 30% and 37% for rebleeding. The post-endoscopy Rockall score was associated with the three outcomes at the three time points assessed, while the pre-endoscopy score was only associated with general mortality at the three time points, and rebleeding at 1 and 3 months. Regarding discrimination ability, although the AUC was greater than expected by randomness (0.5) in all cases, only one AUC ≤0.7 was rejected in the post-endoscopy score for in-hospital UGIB mortality (AUC=0.901; 95%CI: 0.845—0.958), at 1 month (AUC=0.836; 95%CI: 0.717—0.954) and at 3 months (AUC=0.869; 95%CI: 0.771—0.967), and for rebleeding at 1 month (AUC=0.793; 95%CI: 0.725—0.861) and at 3 months (AUC=0.806; 95%CI: 0.741—0.871). Conclusion An association was found between the Rockall score and rebleeding and mortality in patients with non-varicose UGIB. Only the post-endoscopy score had a high predictive ability for rebleeding and UGIB mortality.

Transient CD4 lymphocytopenia is defined as the transitory presence of CD4+ T lymphocyte fewer than 300 cells/mm³ or less than 20% of T cells without HIV infection. It can occur due to multiple causes; however, it is rare for it to occur due to opportunistic infections. Few cases have been described in the literature where antimicrobial treatment normalizes the CD4 count, being more frequent in Mycobacterium tuberculosis infections. To date, this phenomenon has not been described in Cryptococcus neoformans infections. This would be the first reported case according to our knowledge, of a patient who normalizes CD4 count after antifungal treatment, later developing alveolar proteinosis due to M. Tuberculosis.

Objective: To determine the diagnostic yields of the different types of cell indices alone or in combination with C-reactive-protein(CRP) to distinguish between Pulmonary-tuberculosis(PT) and community-acquired-pneumonia(CAP). Methods: A retrospective cohort study was conducted in a high-complexity care center in Colombia, evaluating different types of cell indices in PT and CAP patients. A-receiver-operating-characteristic (ROC)-curve was plotted, and the area-under ROC-curve was calculated for each of these indices, as well as for CRP and procalcitonin values.Results: A total of 544 subjects were included in the final analysis. Of these, 270(49,6%) were diagnosed with PT and 274(50,4%) with CAP. Patients with CAP had significantly higher levels of leukocytes, neutrophils, monocytes, hemoglobin, hematocrit, and platelets than patients with PT (p < 0,05for-all-comparisons). Procal-citonin did not show significant differences between the groups (p=0,061). CRP has the highest ROC-curve for differentiating between PT and CAP, with ROC-curve of 0,76 (95%CI:0,71-0,88) and 0,75 (95%CI:0,71-0,80), respectively. Procalcitonin did not show discriminatory power for these two diseases, with an ROC-curve of 0,60 (95%CI:0,50-0,71). Conclusion: CRP and blood-cell-markers were the best markers to differentiate between patients with PT and CAP. The performance of these markers was acceptable, suggesting that they could be useful in clinical setting for suspected tuberculosis or CAP.