Introduction: Ventricular assist devices represent a treatment option for patients with advanced heart failure, offering control over various haemodynamic variables. Similarly, the prescription of exercise within a cardiac rehabilitation programme for heart failure patients is recommended to reduce symptoms, and hospitalisations, improve cardiorespiratory fitness, and increase exercise tolerance. Therefore, exercise prescription can impact those with ventricular assist devices. Given the limited evidence on exercise-based cardiac rehabilitation programmes for this population, this review aims to describe the most commonly used strategies and their health benefits when physical exercise is included in a cardiac rehabilitation programme for patients with ventricular assist devices. Materials and methods: An exploratory review was conducted through searches in the databases: PubMed, SCOPUS, PeDro, and ScienceDirect. The search was limited to studies published between 2013 and 2023. Filters were applied independently by title, abstract, and full text. The included articles were analysed based on the description of the types of cardiac rehabilitation strategies used in patients with ventricular assist devices. Results: Seven articles were included. Each programme employed a cardiopulmonary exercise test before prescribing physical exercise. The most commonly used strategy was aerobic exercise, predominantly high-intensity interval training (HIIT) with intensities close to 90% of peak VO₂, followed by continuous moderate-intensity exercise. Limb strength exercises were included in three programmes. Conclusions: The analysed literature suggests that cardiac rehabilitation in patients with ventricular assist devices is safe and can provide benefits in cardiorespiratory fitness and exercise tolerance. High-intensity interval training is identified as an appropriate strategy for achieving results, offering short-term improvements.

Point-of-care ultrasound (POCUS) is a valuable tool in the prehospital management of critically ill patients, particularly patients with trauma, dyspnea, or shock. This review aims to evaluate the diagnostic and therapeutic applications, limitations, and implementation challenges of POCUS in prehospital care. Key findings are that ultrasound, particularly the extended Focused Assessment with Sonography in Trauma (eFAST) protocol, offers high specificity in identifying severe hemorrhage in trauma cases, although its sensitivity varies depending on the clinical context and operator experience. In dyspnea, pulmonary ultrasound significantly enhances diagnostic accuracy, aiding early detection of heart failure and other respiratory conditions. For shock, focused echocardiography facilitates rapid diagnosis and timely therapeutic decisions, improving patient outcomes. However, the effectiveness of POCUS is highly dependent on the operator’s expertise, and challenges such as time, space, and resource limitations in prehospital settings may impact its use. Furthermore, local studies in Latin America assessing the impact of prehospital ultrasound on morbidity and mortality reduction are lacking. Based on our review, we recommend standardized training programs, increased availability of portable ultrasound devices, and prospective studies on cost-benefit analysis to optimize POCUS implementation in prehospital systems, particularly in resource-limited regions. Prehospital ultrasound has the potential to revolutionize patient care by improving diagnostic precision and reducing time to definitive treatment, but its successful implementation requires strategic integration of technology, education, and research.

Background: During cardiac or pulmonary rehabilitation exercises, the use of a surgical mask may not be well tolerated by patients, especially those experiencing dyspnea during certain activities due to their underlying health conditions. The purpose of this study was to describe the influence of a surgical mask on exertion perception and some physiological parameters during an incremental test in healthy subjects. Methods: A descriptive study involving 16 healthy adult individuals was conducted. The BRUCE incremental protocol was performed twice, with and without the use of a surgical mask. Results: No significant changes were found in vital signs, such as heart rate (p: 0.8684), mean arterial pressure (p: 0.2781), and peripheral oxygen saturation (p: 0.5314). However, the respiratory rate showed a significant difference (p: 0.023). Furthermore, significant differences were observed in the distance covered (p: 0.0005), duration (p: 0.0003), and measured intensity (METs) (p: 0.0117). Metabolic acidosis (p: 0.032), hypocapnia (p: 0.238), and hyperlactatemia (p: 0.024) were detected in the analysis of arterial gases. Oxygenation parameters, such as PaO2 (p: 0.038) and PaO2/FiO2 ratio (p: 0.038), were higher in the mask-off trial. Conclusion: Surgical masks induce negative changes in METs, distance covered, and duration during an incremental treadmill test. Although no significant impact on vital signs was observed, the use of a surgical mask resulted in statistically significant but not clinically relevant decreases in oxygenation parameters. The stages of the Bruce protocol were achieved differently when participants wore a surgical mask.

Introducción. La glándula salival más grande es la Parótida. A diferencia de las glándulas submandibulares y sublinguales, que secretan saliva hacia la cavidad oral propiamente dicha, la glándula parótida libera su contenido en el vestíbulo oral. La glándula parótida accesoria se define como un tejido glandular adyacente al conducto parotídeo, pero claramente separado de la glándula principal. Su relevancia clínica es significativa, ya que puede presentar tumores o alteraciones en el flujo salival. Objetivo. Describir el hallazgo de una glándula parótida accesoria en un cadáver de un adulto mayor en Colombia para fortalecer el conocimiento anatómico regional. Reporte de caso. Durante una disección académica en la Universidad Santiago de Cali, se identificó una glándula parótida accesoria en la hemicara derecha de un hombre de entre sesenta y setenta años. La estructura, de diez milímetros de ancho por treinta y dos milímetros de largo, se localizó anterior a la glándula parótida principal y sobre el músculo masetero. Presenta un conducto accesorio de cinco milímetros que desemboca en el conducto parotídeo principal. El análisis histológico confirmó la presencia de parénquima de glándula salival con acinos mixtos, tanto serosos como mucosos. Conclusión. El hallazgo coincide con la ubicación anatómica más frecuente reportada en la literatura. El registro de estas variantes es fundamental para la formación médica y la planificación de cirugías faciales, permitiendo minimizar riesgos de parálisis por la proximidad de los ramos del nervio facial.