Introducción. El conjunto de estrategias de recuperación mejorada después de la cirugía (ERAS, por sus siglas en inglés) constituye un enfoque de atención multimodal y multidisciplinario, cuyo propósito es reducir el estrés perioperatorio de la cirugía, disminuir la morbilidad y acortar la estancia hospitalaria. Este estudio tuvo como objetivo describir los resultados clínicos de pacientes sometidos a cirugía por cáncer colorrectal, identificando las complicaciones principales y los factores perioperatorios relacionados con el alta temprana. Métodos. Se analizaron los pacientes consecutivos sometidos a cirugía colorrectal entre los años 2020 y 2023, todos los cuales siguieron el protocolo ERAS institucional. Se evaluaron las características clínicas, los factores perioperatorios, los desenlaces postoperatorios y la tasa global de adherencia al protocolo. Resultados. Un total de 456 pacientes fueron sometidos a cirugía colorrectal, 51% de sexo masculino, con edad media de 60 años. La mayoría de las intervenciones se realizaron por laparoscopia (78 %), con una tasa de conversión del 14,5 %. Las complicaciones postoperatorias incluyeron fuga anastomótica (4,6 %), sangrado, infección intraabdominal y obstrucción intestinal. La estancia hospitalaria promedio fue de 4 días y la mortalidad del 2,8 %. La tasa global de adherencia al protocolo ERAS fue del 84,7 %. Conclusiones. El enfoque combinado de cirugía laparoscópica y protocolo ERAS es factible, seguro y se asocia con una estancia hospitalaria más corta. La implementación y adherencia al protocolo ERAS no solo mejora los resultados postoperatorios, sino que también resalta la importancia de acceder a datos sólidos, permitiendo mejorar la atención perioperatoria local.

Background: Low birth weight in newborns is of multifactorial origin (fetal, maternal, placental, and environmental factors), and in one-third of cases, the cause is of unknown origin, with high infant morbidity and mortality. The main treatment for regaining weight and height in children with low birth weight is the application of growth hormones. However, their role as a protective factor to prevent an increase in body composition and the development of metabolic diseases is still poorly understood. Methodology: A case–control study was conducted in a cohort of patients consulted at the CES Pediatric Endocrinology Clinic, Medellín, Colombia, between 2008 and 2018. We evaluated sociodemographic and clinical variables. Additionally, the identification of differential patterns of genomic methylation between cases (treated with growth hormone) and controls (without growth hormone treatment) was performed. The groups were compared using Fisher’s exact test for qualitative variables and Student’s t-test for the difference in means in independent samples. The correlation was evaluated with the Pearson coefficient. Results: Regarding clinical manifestations, body mass index (BMI) was higher in children who did not receive growth hormone treatment, higher doses of growth hormone treatment helped reduce body mass index (R: −0.21, and p = 0.067), and the use of growth hormone was related to a decrease in triglyceride blood concentrations (p = 0.06); these results tended towards significance. Regarding genome-wide methylation patterns, the following genes were found to be hypermethylated: MDGA1, HOXA5, LINC01168, ZFYVE19, ASAH1, MYH15, DNAJC17, PAMR1, MROCKI, CNDP2, CBY2, ZADH2, HOOK2, C9orf129, NXPH2, OSCP1, ZMIZ2, RUNX1, PTPRS, TEX26, EIF2A4K, MYO1F, C2orf69, and ZSCAN1. Meanwhile, the following genes were found hypomethylated: C10orf71-AS1, ZDHHC13, RPL17, EMC4, RPRD2, OBSCN-AS1, ZNF714, MUC4, SUGT1P4, TRIM38, C3, SPON1, NGF-AS1, CCSER2, P2RX2, LOC284379, GGTA1, NLRP5, OR51A4, HLA-H, and TTLL8. Conclusions: Using growth hormone as a treatment in SGA newborns helps regain weight and height. Additionally, it could be a protective factor against the increase in adolescent body composition.

Introduction: Pseudomonas aeruginosa behaves as an opportunistic pathogen involved in hospital infections, with high capacity to generate resistance to antibiotic treatment. The interpretative reading of the antibiogram makes possible inferring these resistance mechanisms and establishing appropriate antibiotic treatment.Objective: The interpretative reading of the antibiogram seeks to infer the resistance phenotype of P. aeruginosa at Fundación Hospital de la Misericordia (HOMI, by its acronym in Spanish) between 2006 and 2014.Materials and methods: Descriptive cross-sectional study where a search of positive antibiogram reports for P. aeruginosa was performed. The resistance phenotype was deduced based on the interpretative reading of the antibiogram.Results: A sample of 463 positive antibiograms for P. aeruginosa was obtained; these samples were taken from children aged 0 to 17, showing a higher prevalence among infants and toddlers. The antibiograms mainly came from male subjects (62.2%). The most frequent hospitalization services were: PICU —pediatric intensive care unit— (30.2%) and general hospitalization (27.3%). The most common sources of isolation were: blood (24.4%) and urine (23.8%). 11 phenotypes were characterized, being the most common: natural phenotype (63.2%), loss of porin OprD (5.7%) and partial and full AmpC derepression (8.4% and 8.2%, respectively).Conclusion: Isolation of P. aeruginosa at HOMI predominantly shows a natural phenotype. The interpretative reading of the antibiogram allowed inferring 11 phenotypes.

Human immune response to SARS-CoV-2: What is known? A scoping review

Purpose: Patients with obesity and a large pannus may benefit from the simultaneous performance of panniculectomy and ventral hernia repair. However, the literature reports conflicting results regarding an increased risk of surgical site events when both procedures are performed concurrently. This study aimed to describe the outcomes of patients undergoing simultaneous ventral hernia repair and panniculectomy. Methods: A retrospective single-arm cohort study was conducted, including consecutive patients who underwent abdominal wall reconstruction and panniculectomy during the same surgical procedure at a high-complexity center in Bogotá, Colombia, between 2014 and 2024. Demographic data, intraoperative variables, and postoperative outcomes were collected and analyzed. Results: A total of 171 patients underwent combined abdominal wall reconstruction and panniculectomy in a single surgical session. The mean age was 54 ± 12.8 years, and the average body mass index (BMI) was 27.77 ± 4.7. Male patients accounted for 26.3% of the cohort. The most common complications were seroma, hematoma, and skin dehiscence. The median hospital stay was 2 days (± 3.3). Early discharge with continued recovery through a home hospitalization program was achieved in 11.1% of the patients. Conclusion: Abdominal wall reconstruction combined with panniculectomy is a feasible surgical strategy that not only restores the dynamic functionality of the abdominal wall but also improves the patient’s aesthetic appearance. This study represents the first published experience in Latin America aiming to evaluate the safety, feasibility, and clinical benefits of this combined approach in real-world medical practice.

ResumenObjetivoCaracterizar factores de riesgo asociados a complicaciones en los pacientes con tosferina en 2009-2013.Materiales y métodosEstudio de casos y controles. Identificación de factores de riesgo asociados a complicaciones en pacientes con Bordetella pertussis, confirmados con reacción en cadena de la polimerasa.ResultadosSe caracterizó a 96 pacientes. Un total de 76% eran menores de 6 meses, media de 4,56±6,8meses. El 58,3% eran niños y el 41,5%, niñas. Un 51% tuvo alguna complicación. Al 58% se les hospitalizó en cuidado crítico. Un 9,4% tuvo sepsis y el 14,6% requirió ventilación asistida. Un 4,2% fallecieron. La media de estancia en cuidado crítico fue de 8,75 días (± 85) y hospitalaria de 13,92 días (± 12,81). Se identificaron los siguientes factores de riesgo asociados a complicación: noción de contagio (OR: 2,20), ausencia de vacunación (OR: 3,31). Clínica: cianosis (OR: 4,07), deshidratación (OR: 2,72), taquicardia (OR: 2,64), taquipnea (OR: 3,94), desaturación (OR: 3,34). Paraclínica: coinfección bacteriana (OR: 7,66), linfocitosis (OR: 3,18), trombocitosis (OR: 3,038).ConclusiónLos antecedentes, clínica y paraclínicos pueden definir pacientes con infección por Bordetella pertussis en riesgo de complicaciones e ingreso en cuidado crítico.AbstractObjectiveTo characterize the risk factors associated with complications in patients infected with Bordetella pertussis, 2009-2013.Material and methodsCase-control study. Identification of risk factors associated with complications in patients with Bordetella pertussis, confirmed by polymerase chain reaction.ResultsA total of 96 patients were characterized. 76% were younger than 6 months, mean 4.56±6.8 months; there were 58.3% boys and 41.5% girls. A total of 51% had complications. Some 58% were hospitalized in critical care. Sepsis occurred in 9.4% patients, and 14.6% required assisted ventilation. A total of 4.2% died. The mean critical care stay was 8.75 days (± 85) and the mean hospital stay was 13.92±12.81 days. The following risk factors associated with complications were identified: notion of contagion (OR: 2.20), no vaccination (OR: 3.31). Clinical: (OR: 4.07) cyanosis, dehydration (OR: 2.72), tachycardia (OR: 2.64), tachypnea (OR: 3.94), desaturation (OR: 3.34). Paraclinical: Bacterial co-infection (OR: 7.66), lymphocytosis (OR: 3.18), thrombocytosis (OR: 3.038).ConclusionBackground, clinical and paraclinical factors can identify patients with B. pertussis infection at risk for complications and admission to the critical care unit