The COVID-19 pandemic has had significant impacts on healthcare systems around the world, including in Latin America. In Colombia, there have been over 23,000 confirmed cases and 100 deaths since 2022, with the highest number of cases occurring in females and the highest number of deaths in males. The elderly and those with comorbidities, such as arterial hypertension, diabetes mellitus, and respiratory diseases, have been particularly affected. Coinfections with other microorganisms, including dengue virus, Klebsiella pneumoniae, and Mycobacterium tuberculosis, have also been a significant factor in increasing morbidity and mortality rates in COVID-19 patients. It is important for surveillance systems to be improved and protocols to be established for the early detection and management of coinfections in COVID-19. In addition to traditional treatments, alternatives such as zinc supplementation and nanomedicine may have potential in the fight against COVID-19. It is also crucial to consider the social, labor, educational, psychological, and emotional costs of the pandemic and to address issues such as poverty and limited access to potable water in order to better prepare for future pandemics.

Purpose: The purpose of this study was to describe factors associated with prolonged ventilatory support in subjects undergoing coronary artery bypass graft. Patients and Methods: This was an analytical retrospective case–control study. Cases were defined as subjects requiring prolonged mechanical ventilation (> 48 hours) following isolated coronary artery bypass graft. Subjects older than 18 years who had undergone surgery were included, while subjects with missing clinical record data, subjects in coma or subjects with prior cardiac surgery were excluded. Variables were measured at the three time points surrounding surgery. Results: A total of 204 cases and 408 controls were included. The final logistic model showed an association between prolonged mechanical ventilation and the following presurgical variables: chronic obstructive pulmonary disease (OR 1.85; 95% CI: 1.06– 3.23, p = 0.03) and chronic kidney disease (OR 1.90; 95% CI: − 3.31; p = 0.02). The associated transurgical variable was the use of intra-aortic balloon pump (OR 3.63; 95% CI: 1.73– 7.61, p = 0.00), and associated postsurgical variables were venous oxygen saturation < 60% (OR 2.00; 95% CI: 1.18– 3.40, p = 0.01), mediastinitis (OR 18.51; 95% CI: 4.06– 84.40, p = 0.00), inotrope use (OR 2.82; 95% CI: 1.77– 4.48, p = 0.00), pleural effusion requiring drainage (OR 3.57; 95% CI: 2.02– 6.32, p = 0.00) and delirium (OR 3.45; 95% CI: 1.91– 6.25, p = 0.00). Conclusion: This study identifies factors associated with prolonged mechanical ventilation in subjects subject to coronary artery bypass graft over the presurgical, transurgical and postsurgical periods, identifying a new factor, delirium, for this type of population.

Las teorías plantean un ejercicio reflexivo de especulación y explicación, las cuales se someten a revisión y examinación a través de la práctica y la investigación. Estas pueden ser definidas con base en unos niveles, de acuerdo con su restricción, tentatividad y evaluabilidad. De acuerdo con esa estructura existen diferentes niveles de descripción, explicación y predicción de cada teoría, según su alcance puede haber metateorías, también grandes teorías como es el modelo de salud biopsicosocial, o las de rango medio como las teorías de compuerta de control del dolor, la de integración sensorial y aquellas teorías de aplicación más específica o práctica (1).

Purpose: To measure the effects of an exercise program on the physical capacities of older adults such as strength, flexibility, balance, and aerobic capacity. Patients and Methods: This was a quasi-experimental study on a population of 5550 older adults and a sample of 4830 participants in an active aging program designed by the Municipal Health Secretary. The exercise program lasted 12 months, and pre-and post-program intervention measures were recorded using the senior fitness test. Results: Most participants were women (92.4%) and their mean age was 70.7 years (standard deviation, 7.3 years; range, 60– 97 years). All areas showed significant differences before and after the program in terms of the participants’ physical capabilities (p < 0.05), muscular strength and flexibility had a more significant mean difference and a large effect (> 0.80), except for aerobic capacity, which had a small effect. Conclusion: The present study revealed that a supervised physical exercise program at the community level has positive effects on the physical capacities of coordination, balance, flexibility, strength, and aerobic capacity, which are essential components for a better functional capacity at this stage of life, with improvements that encompassed the improved self-perception of their health status, a reduction of overweight and obesity. The reinforcement of these programs is recommended, consequently, promoting pre-sport games and sports championships among the elderly population, as a public health strategy.

Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas cold antibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient with systemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology and hematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severe hematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinical suspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timely diagnosis and provide optimal therapy.

Background: Hematooncology patients admitted to intensive care units (ICUs) are at high risk for mortality due to the severity of their critical illness. Such complications can develop into complex clinical management, thus signaling an urgent need to identify mortality-related factors to improve interventions and outcomes for these patients. Methods: A systematic review of studies published between 2012 and 2023 in databases such as PubMed, Scopus, and Web of Science was conducted, following the PRISMA guidelines. A meta-analysis was carried out to determine the significance of mortality-related factors. Results: In a review of twenty-four studies, it was found that invasive mechanical ventilation (IMV) was associated with an odds ratio (OR) between 2.70 and 8.26 in 75% of the studies. The use of vasopressor support had an OR of 6.28 in 50% of the studies, while pulmonary involvement by tumor had an OR of 6.73 in 30% of the studies. Sepsis showed an OR of 5.06 in 60% of the studies, and neutropenia upon admission increased mortality in 40% of the studies. Severe respiratory failure (PaO₂/FiO₂ < 150) had an OR of 7.69 in 55% of the studies. Additionally, ICU readmission and late admission were identified as risk factors for increased mortality. Conclusions: Mortality among hematooncology ICU patients is associated with IMV, vasopressor support, pulmonary involvement, sepsis, neutropenia, severe respiratory failure, ICU readmission, and late admission. Identifying and managing these factors in a timely manner can improve survival and the quality of care.