Artículo retractado: Infección por Brucella melitensis con compromiso osteoarticular: primeros casos reportados en ColombiaCategoría: Presentación de casoRecibido: 29/11/2024Revisado: 09/06/2025Aceptado: 09/07/2025Publicación anticipada: 11/07/2025Publicado: 07/06/2026Retractado: 11/08/2026Citación: Díaz RA, Ramírez-Sánchez IC, Montoya D. Infección por Brucella melitensis con compromiso osteoarticular: primeros casos reportados en Colombia. Biomédica. 2026;46(Supl.1):8-15. https://doi.org/10.7705/biomedica.7780
La frecuencia de la tos ferina fue controlada en varios países con la vacunación, aunque ha reemergido en las últimas décadas. Poco se sabe de la historia de esta enfermedad en Colombia; este trabajo resume la historia de la tos ferina en el país desde un enfoque poblacional.Las evidencias sugieren que la tos ferina apareció hacia finales del siglo XV en Persia, y desde esa época ha sido endémica, especialmente entre los menores de edad. Al territorio colombiano debió llegar durante el siglo XVIII o a inicios del XIX. En Colombia, se han presentado importantes epidemias, en especial antes de que existiera la vacuna contra Bordetella pertussis. Las epidemias más importantes tuvieron lugar en Bogotá (1814) y en Cajicá (1922). La vacunación fue muy efectiva en la segunda mitad del siglo XX, aunque hubo brotes entre las poblaciones no vacunadas de las zonas rurales y entre los indígenas de diversos lugares del país. Actualmente, la tos ferina es una amenaza para Colombia por los casos traídos del exterior o en personas sin vacunar.
Introduction. Healthcare professionals, particularly midwives and nurses, have played a fundamental role in global immunization efforts by acting as the primary providers responsible for vaccine administration.Objective. This study aims to determine whether there is a statistically significant difference in Childhood Vaccination Advocacy Scale scores before and after vaccine advocacy awareness training.Materials and methods. Data were collected using a questionnaire on demographic characteristics and knowledge regarding vaccine administration, developed by the researcher in accordance with the literature, as well as the Vaccine Advocacy Scale for Childhood Vaccines. This research was designed as a single-group, pre-test and post-test quasi-experimental study. Pre-test and post-test scores were compared using the Wilcoxon signed-rank test. A significance level of p < 0.05 was considered statistically significant.Results. The study was conducted with 249 midwives and/or nurses. The mean age of the participants was 39.40 ± 7.43 years, with an average of 18.01 ± 7.99 years of profesional experience. The mean total score on the Vaccine Advocacy Scale for Childhood Vaccines was 45.19 ± 2.85 before the training and 46.95 ± 1.99 after the training. A Wilcoxon signed-rank test revealed that the increase in post-training scores was statistically significant (p = 0.000).Conclusion. The findings indicate that participants had relatively high levels of vaccine advocacy even prior to the training. However, the statistically significant improvement in scores post-training clearly demonstrates the effectiveness of the educational intervention.
Is avoidable childhood mortality in Colombia a type of violence? Childhood analysis mortality requires a broader approach than a purely biological one, as this situation reflects the confluence of social, environmental, economic, and political factors, among others, which portray the vulnerability of this population group. At the global level, efforts to control mortality have yielded significant achievements; however, low- and middle-income countries still show high and uneven figures across regions, related primarily to violence as a latent phenomenon. The objective of this essay was to reflect on childhood mortality as a form of indirect violence. In conclusion, avoidable childhood mortality needs to be analyzed from a political perspective that allows for the identification of the different forms of violence portrayed in this event. Consequently, it can be stated that avoidable childhood mortality as a form of violence requires analysis from an intersectoral and multidisciplinary approach that enables the prioritization of actions to control it.
Is avoidable childhood mortality in Colombia a type of violence? Childhood analysis mortality requires a broader approach than a purely biological one, as this situation reflects the confluence of social, environmental, economic, and political factors, among others, which portray the vulnerability of this population group. At the global level, efforts to control mortality have yielded significant achievements; however, low- and middle-income countries still show high and uneven figures across regions, related primanly to violence as a latent phenomenon. The objective of this essay wasip etectoa childhood mortality as a form of indirect -violence. In condusion, avoidable childhood mortality needs to be analyzed from a political perspective that allows for the identification of the different forms of violence portrayed in this event. Consequently, it can be stated that avoidable childhood mortality as a form of violence requires analysis from an intersectoral and multidisciplinary approach that enables the prioritization of actions to control it.
Introduction. The factors affecting genetic diversity and antiretroviral therapy resistance mutations in human immunodeficiency virus (HIV) type 1 in military personnel are unknown. Objective. To describe the factors affecting genetic variability and resistance to HIV antiretrovirals in the military population during one year of follow-up. Materials and methods. Fifty-two Peruvian military personnel living with HIV and receiving antiretroviral therapy were recruited. Genetic diversity, genetic subtypes, recombination events, and resistance profile occurring in protease and reverse transcriptase genes were compared at 12 and 18 month follow-up, taking into account the socio-epidemiological characteristics of the participants. Results. Intermittent condom use (37%), contact with sex workers (17%) and a history of sexually transmitted infections (56%) were observed. The genetic diversity index (π) increased from 0.30 to 0.45, while genetic subtypes and recombinant forms did not change significantly. Of eleven samples with significant nucleotide changes, five showed resistance mutations. Finally, bivariate analysis showed that increasing subject age was significantly associated with a difference in resistance profile after an interval of 12 months or more. Conclusions. We show that, after at 12 and 18 month of follow-up, HIV-infecting a population of Peruvian military subjects underwent changes in its genetic diversity and resistance profile, which were associated with the chronological age of the participants.
This article offers a vision of the mental health situation in Colombia, highlighting its growing relevance in the public sphere and the specific challenges facing the country. It analyzes the impact of the armed conflict and the COVID-19 pandemic on the mental health of the Colombian population, focusing on how these situations have exacerbated pre-existing problems. Additionally, the existence of significant barriers to accessing specialized services is highlighted, such as stigma, lack of trained personnel, and high costs associated with the treatment of mental disorders. Therefore, the need to address inequalities in mental health care is raised, both nationally and internationally. Finally, recommendations are proposed to improve prevention, community care and access to mental health services in Colombia.
Introduction. Recombination is a mechanism that prevents the accumulation of noxious mutations. Recombination occurs between different sublineages of the same virus that are co-circulating and co-infecting the same host. Next-generation sequencing technologies have allowed the identification of recombinant sublineages of omicron. Objective. To describe how viral recombination in new omicron lineages has conferred important characteristics to this variant and allowed its prevalence. Materials and methods. A total of 338 genomes of recombinant lineages from positive samples of SARS-CoV-2 analyzed by the Laboratorio Departamental de Salud Pública de Antioquia were characterized, between November 9, 2022, and November 5, 2023. The genomes were obtained using Oxford Nanopore™ sequencing technology. Phylogenetic analysis identified different recombinant sublineages of omicron and predictors allowed the identification of regions in the SARS-CoV-2 genome that were the product of recombination events. Results. Twenty-six recombinant lineages of omicron were identified, and important amino acid changes were found involved in evasion of the immune response, infectivity and increased viral replication, N501Y, D614G and P681H. The F456L variant was also identified and was present in 55% of the XBB.1.5.72 genomes and is a biomarker for recognition of this sublineage. The analysis with recombination predictors allowed the identification of the potential parents of some recombinant genomes such as XBB.1.5 and XBB.1.5.77. Conclusion. The circulation of omicron sublineage recombinants shows important changes that impact their biology and have altered infection and virulence factors.
Introduction. Despite the obligation to provide priority and timely care to people with orphan diseases, they continue to find barriers to health services. Objective. To determine access to health services barriers for people diagnosed with orphan or rare diseases. Materials and methods. We carried out a cross-sectional analytical study based on secondary data of 134 people reported with orphan or rare diseases in the department of Huila. Sociodemographic and clinical characterization and identification of barriers to access to health services at the geographic, economic, social, knowledge, cultural and health care levels were carried out. Statistical analysis was performed in Stata 15 (TM)(TM) usin measures of central tendency and association. Results. The median age was 15 years, 51.5% were male, 61.9% lived in urban areas, low income predominated, the most prevalent diagnosis was Guillain-Barr & eacute; syndrome and 32.8% required hospitalization for complications of the disease. Living in rural areas presents a greater probability of having limited access to the center of care ( OR = 10.7 ; 95% CI: 4.3-27) and lack of money for transportation ( OR = 2.84 ; 95% CI: 1.26-6.52). Statistical association between subsidized regime and of medicines (OR-4.59; 95% CI: 1.44-19.17) was found. Conclusion. Participants face significant barriers to accessing health services associate with living in rural areas and their affiliation status.
Hereditary spastic paraplegias are genetic disorders characterized by spasticity in the lower limbs, weakness, and sensory disturbances. Global prevalence ranges from 1.27 to 9.6 per 100 000 individuals. Mutations in the PLP1 gene cause various X-linked hereditary spastic paraplegias phenotypes, including Pelizaeus-Merzbacher disease and spastic paraplegia type 2. A 53-year-old male presented with chronic lower limb weakness since childhood, requiring a wheelchair at age 47 and exhibiting zero strength in the lower limbs. Magnetic resonance imaging revealed periventricular leukodystrophy; similar symptoms were found in maternal uncles and a nephew. The 32-year-old nephew had gait difficulties. A genetic sequencing panel identified a hemizygous variant of uncertain significance in the PLP1 gene [c.197A>T (p.His66Leu)] in both, not reported in population genetic databases. X-linked spastic paraplegia 2 is a disease primarily affecting gait and causing lower limb weakness. Reports indicate that it may also include cognitive impairment, nystagmus, and ataxia, although in the studied family, weakness predominated without cerebellar symptoms. Thirty-six families with this condition have been documented worldwide, with cases of asymptomatic carrier females. The c.197A>T (p.His66Leu) variant in the PLP1 gene, identified in this case, is novel and, despite being classified as “of uncertain significance”, could be pathogenic according to bioinformatic predictors, explaining the spastic paraplegia 2 presentation in this family.
HIV infection is a risk factor for the development of cardiovascular diseases including ischemic strokes, for which there are different multiple etiologies in these patients.We present the case of a 27-year-old man with AIDS, with an ischemic stroke in the left middle cerebral artery territory. Laboratory studies confirmed the diagnosis of neurosyphilis but also the existence of antiphospholipid antibodies. Seven months after the treatment of neurosyphilis, anticoagulation and antiretroviral therapy, the persistence of antiphospholipid antibodies was confirmed. The diagnostic approach to a vascular stroke in people with HIV is a challenge since there may be multiple etiologies. The relevance of antiphospholipid antibodies in these patients is a matter of debate and should be considered depending on the clinical scenario
Introducción. A pesar de la obligatoriedad de brindar atención prioritaria y oportuna a las personas con enfermedades huérfanas o raras, esta población continúa encontrando barreras al acceso de los servicios de salud. Objetivo. Identificar las barreras al acceso de los servicios de salud para las personas con diagnóstico de enfermedades huérfanas o raras en el departamento del Huila, 2022. Materiales y métodos. Se trata de un estudio transversal analítico a partir de datos secundarios de 134 personas con diagnóstico de una enfermedad huérfana o rara en el departamento del Huila. Se hizo caracterización sociodemográfica y clínica; además, se identificaron las barreras para el acceso a los servicios de salud a nivel geográfico, económico, social, de conocimiento y cultura, y aquellas propias de la atención en salud. El análisis estadístico con medidas de tendencia central y de asociación en Stata 15™. Resultados. La mediana de edad fue de 15 años, el 51,5 % era de sexo masculino y el 61,9 % vivía en el área urbana y de ingresos económicos bajos. El diagnóstico más prevalente fue el de síndrome de Guillain-Barré y el 32,8 % requirió hospitalización por complicaciones de la enfermedad. El vivir en el área rural implicó mayores probabilidades de presentar limitaciones para llegar al centro de atención (OR = 10,7; IC95%: 4,3-27) y escasez de dinero para transportarse (OR = 2,84; IC95%: 1,26-6,52). Hubo asociación estadística entre el régimen subsidiado y la falta de entrega de los medicamentos (OR = 4,59; IC95%: 1,44-19,17). Conclusión. Los participantes enfrentan barreras significativas de acceso a los servicios de salud asociados con vivir en el área rural y el régimen de afiliación.
Dengue is the most common arboviral infection worldwide, and up to 5% of patients may develop severe forms with multiorgan involvement and an increased risk of death. We present the case of a 39-year-old woman from an endemic area, living in an urban setting, who presented with five days of fever associated with myalgias and vaginal bleeding. On admission, severe thrombocytopenia and acute hepatic and renal dysfunction were documented. Despite initial treatment with crystalloids, her condition progressively worsened, leading to acute liver failure and worsening acute kidney injury, requiring invasive mechanical ventilation, vasopressor support, and single-pass albumin dialysis plus continuous veno-venous hemodiafiltration. The patient showed clinical improvement with progressive recovery of liver and kidney function and was transferred to general hospitalization after 12 days in intensive care. This case highlights the potential usefulness of this therapy in patients with acute liver failure in settings without access to advanced liver support systems or when liver transplantation is contraindicated.
Introduction:Congenital syphilis is a preventable disease with high morbidity and mortality, whose persistence reflects failures within the healthcare system. Objective:To characterize reports of congenital syphilis in Antioquia in the years 2021 and 2022 and to analyze their relationship with gestational age at the time of birth and diagnosis. Materials and methods:A descriptive, retrospective, cross-sectional study was conducted. All reported cases of congenital syphilis in Antioquia during 2021 and 2022 were analyzed using data from the Instituto Nacional de Salud. Sociodemographic, clinical, and healthcare-related variables from the epidemiological surveillance form were described. Frequencies, summary measures and statistical tests were applied to explore associations. Results:A total of 375 cases of congenital syphilis were reported, with incidences of 2.9 and 2.3 per 1000 live births in 2021 and 2022, respectively. A total of 54.4% (204/375) of the mothers were of low socioeconomic status, and 86.7% (325/375) of diagnoses occurred in the third trimester. Additionally, 46.4% (174/375) of mothers did not receive prenatal care, and 17.6% (66/375) did not receive penicillin before delivery. Gestational age at delivery was significantly associated with the neonate’s final condition (p < 0.001), prenatal care (p < 0.001), treatment (p < 0.05), and maternal-infant serological outcomes (p < 0.05). Conclusions:Congenital syphilis remains a public health concern in Antioquia, reflecting deficiencies in timely diagnosis and comprehensive treatment, as well as the influence of social determinants such as low socioeconomic status. Consequently, it is essential to strengthen primary healthcare services, ensure early and continuous prenatal screening, and implement territory-specific strategies aimed at reducing vertical transmission and advancing toward the elimination of the disease.
Introducción. La estrongiloidiasis puede convertirse en una enfermedad grave en grupos de alto riesgo, como los alcohólicos. Sin embargo, pocos estudios evalúan el efecto de esta comorbilidad en la salud de los individuos.Objetivo. Evaluar biomarcadores hematológicos, bioquímicos y hepáticos y la producción de inmunoglobulina E total en pacientes alcohólicos infectados con S. stercoralis. Materiales y métodos. Se trata de un estudio de casos y controles con 240 pacientes alcohólicos, 60 infectados y 180 no infectados con S. stercoralis. Los biomarcadores sanguíneos se evaluaron mediante métodos automatizados, kits comerciales o nefelometría. Resultados. Se observó una alta frecuencia de alcohólicos con anemia, sin diferencia entre los grupos infectados y los no infectados, 65,0 % (39/60) y 62,8 % (113/180), respectivamente. La frecuencia de eosinofilia, 58,3 (35/60) y 26,1 % (47/180) y la concentración total de inmunoglobulina E, 2882 y 1400 UI/ml, fueron significativamente mayores (p < 0,05) en los individuos infectados con S. stercoralis en comparación con los no infectados. Los niveles de ALT y AST estuvieron elevados en ambos grupos. Sin embargo, en el grupo infectado se encontraron niveles más bajos de AST, 61,5 ± 38,4 comparado con 84,3 ± 84,6 U/L en no infectados y una menor frecuencia de individuos con niveles elevados de ALT, 26,7 % (16/60) comparado con 40,5 % (73/180) en pacientes infectados. Además, los niveles de AST fueron mayores en individuos con una carga parasitaria superior a 100 larvas/g de heces, en comparación con aquellos con una menor carga parasitaria (90,80 ± 39,9 y 56,42 ± 31,9 U/L (p < 0,05), respectivamente).Conclusiones: Este estudio demuestra una menor alteración de las enzimas hepáticas en alcohólicos infectados con S. stercoralis, lo cual podría depender de la carga parasitaria.
The neuroblastoma-like schwannoma is considered a very rare variant of schwannoma, and represents a diagnostic challenge given its low incidence and few reports. We present the case of a 40-year-old woman with a painful nodule with progressive growth in the anterior thoracic wall. After histopathological and immunophenotypic analysis, and a literature case review, with emphasis in the differential diagnosis and immunohistochemical analysis, the diagnosis of neuroblastoma-like schwannoma was made.
Introduction. The EDAR (ectodysplasin A receptor) gene is associated with the development of ectodermal structures. The rs3827760 variant is highly frequent in East Asian and Native American populations, and this study analyzes its relationship with genetic ancestry proportions in a Latin American population sample. Objective. To analyze how genetic ancestry proportions influence the distribution of single nucleotide polymorphism (SNP) rs3827760 genotypes of the EDAR gene in Latin American populations. Materials and methods. Genetic ancestry proportions were estimated using a panel of 446 ancestry-informative SNPs, applying the STRUCTURE program and univariate and multivariate logistic regression models. Results. Native American ancestry proportions showed a significant positive association with the prevalence of rs3827760 GG genotypes, while European ancestry showed a negative association. Conclusion. Native American and European genetic ancestry proportions influence the distribution of SNP rs3827760 genotypes of the EDAR gene in Latin American populations.
