vol. 3 núm. 1 (2025): enero - marzo

Carcinomatous lymphangitis is a rare form of pulmonary dissemination associated with metastasis of malignant neoplasms, primarily adenocarcinomas. Approximately 6-8% of patients with the malignant disease develop carcinomatous lymphangitis. This condition causes progressive invasion of the pulmonary lymphatic vessels, affecting lymphatic circulation and generating respiratory problems. This case details the experience of a patient with ovarian carcinoma and carcinomatous lymphangitis, highlighting the complexity of diagnosis due to nonspecific symptoms and its slow progression. The implications of carcinomatous lymphangitis and its association with different types of cancer are discussed, and the importance of advanced imaging techniques for early diagnosis is emphasized. An analysis of previous cases is presented, highlighting the rarity of the condition and its poor prognosis. Overall, the need for a comprehensive approach to the management of patients with paraneoplastic syndromes is highlighted, especially those associated with respiratory complications such as carcinomatous lymphangitis.

Introduction: Gestational syphilis is considered one of the main causes of maternal and perinatal complications, with economic, social and health consequences of significant impact on health systems worldwide. Objective: To determine the level of knowledge about syphilis in pregnant women diagnosed with gestational syphilis in a first level hospital in Cúcuta - Colombia during the first semester of the year 2023. Materials and Methods: Quantitative, descriptive, cross-sectional study, with a sample of forty pregnant women diagnosed with gestational syphilis; enrolled in the prenatal control program. A sociodemographic survey and the questionnaire: Degree of knowledge of gestational syphilis, based on the Nursing Outcomes Classification (NOC) criteria, were applied. Results: 23.5% had little knowledge in the infection control variable, determined by signs and symptoms (50.0%) and mode of transmission (75.0%). In the variable of prevention and treatment mechanisms, 36.8% reported poor knowledge, represented by the factors that contribute to infection (67.5%), practices that reduce infection (65.0%) and the importance of completing treatment (57.5%). Finally; 38.6% of the pregnant women presented poor knowledge in relation to the variable of control and follow-up. Conclusions: The level of knowledge about syphilis in pregnant women diagnosed with gestational syphilis was low; therefore, it becomes relevant to optimize the processes of information, education, and communication for maternal health.

Objective: To evaluate the psychosocial impact on the relatives of the case of orphan Creutzfeldt-Jakob disease (CJD). Methodology: Case report with a diagnosis of CJD and interview with family members about the psychosocial impacts and challenges. Result: Chronology of CJD was conducted and the operationalization was defined where psychological factors of emotion, psychological distress (including depression, anxiety, and stress) and social factors of social isolation, social support for family members were determined. Conclusions: CJD should be considered as a differential diagnosis in patients presenting with psychiatric symptoms, personality changes, and focal neurological symptoms; Likewise, at the time of diagnosis of people affected by a rare or orphan disease, family members who experienced this process of their relative with CJD not only showed a greater need for psychological care during the time spent searching for a diagnosis, but once this was obtained, they also more acutely felt the social implications.

Introduction: Spirituality is a vital component of being human. It is established that enhancing the meaning and purpose of life influences people's well-being and quality of life. Objective: To evaluate the effectiveness of an educational program to promote spiritual growth in informal caregivers of people with disabilities in the Pamplona Region. Methodology: Quasi-experimental study that had a descriptive phase in which the HPLP-II instrument was applied to a sample of 308 informal caregivers. Based on the results, the thirty-nine most affected caregivers were identified, twenty being assigned to the control group and nineteen to the intervention group. Subsequently, a protocol of interventions was designed, which were evaluated at the end of the study. Results: In the descriptive phase it was found that 87.7% of the caregivers were in the category “they sometimes carry out practices that promote spiritual growth” and 12.66% do not conduct healthy practices. In the intervention phase it was found that when descriptively analyzing the differences in means with the Student T test, statistically significant results were found in the post-intervention and the experimental group when compared with the control group. Conclusion: When evaluating the educational intervention program, better performance in spiritual practices was found in caregivers after the interventions developed.

Introduction: Diagnoses of diseases associated with COVID-19 become relevant considering their incidence and prevalence in central Mexico. Objective: The objective of this work was to compare a neural network model with the findings reported in the literature. Methodology: A documentary, cross-sectional, correlational, and retrospective work was conducted with a sample of 6,500 cases selected by centralized entity in Mexico. Results: The results demonstrate the learning sequence that goes from diagnoses to application entities, which reveals a collaborative network guided by tomography. Discussion: In relation to the state of the art where findings focused on decisions, collaborative strategies and knowledge management prevail, this work suggests including these dimensions to anticipate the responses of public health institutions in future health contingencies.

Shoulder dislocations have a high incidence in medical emergencies, with an annual incidence rate that varies between 23.1 and 23.9 per 100,000 people, which represents 1.7% of the general population, with young adults and older women being at higher risk; Among the complications associated with traumatic shoulder dislocation due to reduction, vascular and neurological injuries are included, the former being more common in elderly patients, since their blood vessels tend to be more rigid and fragile, which can affect the axillary artery or vein and its branches. This article presents the clinical case of a 59-year-old male patient with a clinical diagnosis of right shoulder dislocation secondary to a fall from his own height with subsequent reduction causing injury to the axillary artery and brachial plexus, a situation that required surgical treatment due to the extension of the mixed injury and joint involvement leading to disarticulation of the affected upper limb.

Objective: To review the onset of schizophrenia as a psychiatric complication of chronic methamphetamine and cannabis use. Material and methods: PubMed, EBSCO and GOOGLE ACADEMICA databases were searched using the terms: cannabis and methamphetamine use, its relationship with the onset of schizophrenia, identifying its effects on the social, family, psychological and personal environment, as a complication.  Articles published in the last 20 years in English and Spanish were considered. A total of 4383 articles were found and after filtering, 16 remained. The most commonly used instrument was the DSM V criteria. Results: Chronic cannabis use occurs at an early age among adolescents, which accelerates psychiatric disease and therefore schizophrenia, although this fact is also known with prolonged methamphetamine use, this occurs in older users. As a whole, there are several factors that predispose the clinical manifestation of schizophrenia such as the vulnerability of the consumer, genetic defects, social and associated risks that are present at the time of combining them. Conclusions: Chronic cannabis use unlike methamphetamines at early ages on a timeline will sometimes manifest clinically as a precursor to many illnesses, mental disorders and schizophrenia itself. Therefore, cannabis use in adolescent users will also perpetuate as a trigger for schizophrenia especially in people with genetic vulnerability, developing a very marked modification between individuals with schizophrenia who have been cannabis users, and individuals with this disease, but without a history of use and abuse of this drug.

Grade IV hiatal hernia is a rare condition characterized by the intrathoracic migration of the stomach along with other abdominal viscera, such as the colon, spleen, or pancreas, through the esophageal hiatus. We present the case of a patient with long-standing symptoms of very severe epigastric pain who presented to the emergency department with exacerbation of the clinical condition. Imaging studies confirmed the presence of a giant hiatal hernia with multivisceral involvement. Surgical correction was performed laparoscopically, with reduction of the herniated contents and Hill-type gastroesophageal reflux disease (GERD). The postoperative course was favorable, with resolution of symptoms and adequate oral tolerance. This case highlights the importance of clinical suspicion, early diagnosis, and timely surgical treatment to prevent serious complications such as strangulation or perforation of herniated organs, as well as improving patient quality of life.

Introduction: Grip strength has been established as a key indicator of general functionality in older adults and has been linked to mobility, independence, and overall health. The Short Physical Performance Battery (SPPB) is a widely used tool to assess balance, gait, and lower extremity strength in this population. This research is based on the theory of sarcopenia and active aging, where the loss of strength and physical function affects the quality of life of older adults. The present study aims to analyze the relationship between grip strength and functional capacity measured through the Short Physical Performance Battery (SPPB) in non-institutionalized older adults attending the E.S.E. Hospital San Juan de Dios in Pamplona. Materials and methods: This quantitative, descriptive, and correlational study uses dynamometry to measure grip strength and the SPPB to assess the functional capacity of the participants. A sample of fifty non-institutionalized older adults from Pamplona was selected, and the data were analyzed using Pearson's correlation coefficient to determine the relationship between both variables. Results: The average grip strength was 18 kg in the dominant hand, which was primarily the right. Good scores were found regarding the functional capacity of the older adults evaluated, specifically related to static and dynamic balance, postural control, and gait speed. There is a significant correlation between grip strength and Short Physical Performance Battery scores. Conclusion: The results obtained highlight the importance of hand strength as a predictor of functional status in older adults.

Acute respiratory infections are disorders of the upper or lower respiratory tract that can cause a variety of illnesses, ranging from asymptomatic or mild infections to severe and fatal diseases. Therefore, a mechanism is required to identify the care needs to provide better care in the clinical stages that require it. Objective: To determine the utility of the outcome measure "Respiratory Status" as a prognostic tool in identifying the need for care in individuals with acute respiratory infection. Materials and methods: This was a quantitative, observational, and analytical study conducted retrospectively through the analysis of medical records from the emergency department to the end of hospitalization of patients with acute respiratory infection. Results: It was observed that the Respiratory Status outcome measure allows for the prediction of patient admission to the Intensive Care Unit (ICU) from the emergency department, with a range of 49% to 70% according to the Cox and Snell and Nagelkerke R-squared values. It was determined that patients with scores ranging from 5 to 10 predict their admission to the ICU with a P-value <0.05. No statistical significance was observed in the model for predicting admission to hospitalization and outpatient care (P-value >0.05). Conclusions: The Respiratory Status outcome measure, through its evaluated indicators, improves the identification of patients who will be admitted to the ICU and require higher levels of care from the emergency department by nursing professionals. However, a prospective study is recommended in the future to specify the indicators and avoid confounding variables such as data quality, among others.

A healthy patient produces approximately two liters of chylous fluid from the gastrointestinal tract in 24 hours, which is transported through the thoracic duct to the vascular system. When an injury occurs to this duct by any mechanism, a rapid accumulation of chyle in the pleural space follows. We present the case of a 41-year-old man who was admitted to the emergency department with a gunshot wound at the thoracoabdominal level, which required management with closed thoracostomy and diaphragmatic lesion repair. During his postoperative period, chylous fluid was observed in the drainage systems. A cytochemical test confirmed the presence of chylothorax with a triglyceride level of 166.03. A multidisciplinary approach was initiated by the thoracic surgery and nutrition teams. After two weeks, the patient developed peristalsis with clinical symptoms, and surgical management with pleurodesis was performed due to the lack of changes in the patient's condition. As a final measure, thoracic duct management was decided upon, and the patient showed improvement and was subsequently discharged from the institution.

Introduction: Gender-based violence is a social issue affecting women of all cultures from a young age. In Colombia, the number of cases of violence against women has increased in recent years. The lifting of lockdown measures facilitated women reporting these cases, with most women being victims of domestic violence, primarily at the hands of current or former partners. Objective: To describe the association between attitudes towards gender-based violence and age, sex, and academic year among undergraduate nursing students in Colombia. Methodology: A quantitative, descriptive, and cross-sectional study was conducted involving 120 nursing students from the first to eighth semesters at a Colombian university. Attitudes towards gender-based violence were measured through three components: cognitive, affective, and behavioral, using the Attitudes towards Gender-Based Violence Scale. Results: 84.2% were women, 15.8% were men, and 55% were Catholic. The predominant percentage (40%) had a negative attitude, indicating a mostly rejecting attitude towards gender-based violence. Despite this, more than half have a neutral or accepting position towards gender-based violence as a whole. Conclusions: Attitudes towards gender-based violence among students show a majority trend towards the negative, with notable differences in the cognitive, behavioral, and affective components. In the cognitive component, a negative attitude predominates; in the behavioral component, a positive attitude is predominant; and in the affective component, indifference prevails.