BackgroundSubmaximal tests such as the Sit-to-Stand Test (STS) in its three modalities are used to evaluate strength and aerobic capacity in people with respiratory, cardiovascular, and metabolic diseases. However, international reference values do not account for the genetic and environmental particularities of the Colombian population, underscoring the need to establish local references. AimTo establish sex and age-specific reference values for the 5-repetition, 30-second, and 1-minute sit-to-stand tests in community-dwelling Colombian adults.Methods A cross-sectional study was conducted between 2023 and 2024 in Colombia, with the participation of healthy adults aged 18 to 80 years. Anthropometric characteristics and physical activity were assessed using the IPAQ questionnaire and the Sit-to-Stand Test (STS) at 1 minute, 30 seconds, and 5 repetitions. Normative percentiles were calculated by sex and age with a sample of 393 people.Results The study included 393 participants (208 women and 185 men), with an average age of 44 years and a BMI of 25.9 ± 4.1. Age was negatively correlated with repetitions (R= 0.493; 60 sec and R= -0.497; 30 sec), height showed a positive correlation (R= 0.262; 60 sec). High BMI was associated with worse performance (R= -0.119; 60 sec, R= -0.153; 30 sec).ConclusionsThis study establishes reference values for STS testing in healthy adults in Colombia, accounting for age, sex, BMI, and physical activity.
IntroductionIt is suggested that chronic obstructive pulmonary disease (COPD) patients have high death anxiety and the majority of them tend to search for COPD-related information on the internet. ObjectiveExplore the association between death anxiety and cyberchondria in patients with COPD MethodsThis descriptive, cross-sectional study included 143 patients diagnosed with COPD aged 45 years or older, who had no sensory impairments affecting communication, were cognitively intact, and actively used the internet ResultsA multiple regression analysis examining the Cyberchondria Scale (CS-12) total score in relation to sociodemographic and clinical characteristics found that marital status, regular use of medications, having a COPD exacerbation in the last 6 months, and daily internet use time together explained 35.8% of the variance in the Cyberchondria Scale (CS) score (Adj R2= 0.358, p <0.001). Additionally, it was discovered that doing regular breathing exercises, being hospitalized in the last 6 months, searching for information about the COPD on the internet and use any medication other than those prescribed (such as analgesic, antipyretics, anti-emetics, etc.) by their doctor in the last year explained 37.3% of the variance in the Death Anxiety Score (Adj R2= 0.373, p <0.001) ConclusionThe findings indicate that patients with COPD exhibited moderate levels of cyberchondria and high levels of death anxiety, highlighting the relevance of psychological factors in this patient group.
ObjetivoEste estudio examinó los factores determinantes de la aceptación de la vacuna contra la COVID-19 en Colombia, con especial énfasis en las respuestas de las personas tras experimentar posibles efectos secundarios.MétodosSe realizó un estudio transversal mediante un cuestionario anónimo en línea en Colombia entre enero y marzo de 2023. La encuesta ad hoc recopiló información sociodemográfica, antecedentes de COVID-19, estado de vacunación y efectos adversos. Se realizaron análisis descriptivos, pruebas de chi cuadrado y regresión logística multinomial (ORa, IC95%) (p <0.05).ResultadosEl 40.2% de los participantes expresó dudas o habría rechazado la vacunación si hubiera conocido previamente los posibles efectos secundarios. Las mujeres tuvieron una mayor probabilidad de presentar dudas o de rechazar la vacuna tras experimentar efectos adversos. Los participantes que presentaron efectos secundarios fueron más propensos a cuestionar su decisión de vacunarse. Las personas más jóvenes tuvieron menor probabilidad de desarrollar actitudes negativas tras experimentar efectos secundarios que los adultos mayores. Quienes habían recibido solo una dosis presentaron una mayor probabilidad de dudar o rechazar futuras vacunaciones, mientras que quienes habían recibido múltiples dosis presentaron una menor probabilidad de hacerlo. Los participantes que cursaron COVID-19 de manera asintomática tuvieron menor probabilidad de rechazar la vacunación tras conocer los posibles efectos secundarios, posiblemente porque confiaban más en su sistema inmunológico o tenían un mayor deseo de proteger a otros. ConclusionesLa vacilación hacia la vacunación se asoció con el sexo femenino, la presencia previa de efectos adversos y un menor número de dosis recibidas, mientras que la menor edad se asoció con una mayor aceptación. Estos hallazgos resaltan la necesidad de estrategias de comunicación del riesgo dirigidas a abordar las preocupaciones sobre la seguridad y a fortalecer la confianza en las vacunas.
Los cambios demográficos, sumado a la exposición a factores ambientales han ocasionado un incremento global de la prevalencia, la morbilidad y la mortalidad por enfermedades respiratorias crónicas como la enfermedad pulmonar obstructiva crónica (EPOC), el asma, la enfermedad intersticial, y el cáncer del pulmón.1 En EPOC, reportes muestran que la prevalencia en población general mayor de 35 años es del 8.9% siendo mayor en hombres fumadores2, respecto a asma, más de la mitad de los países reportan una prevalencia del 15% o más, destacando que la desigualdad social es un factor altamente relevante en la prevalencia.3 En condiciónes como enfermedades intersticiales, se han registrado 320,014 muertes entre 1990-2019, con mayor mortalidad en adultos mayores y la región andina. 4 Este aumento progresivo de la prevalencia de enfermedades crónicas ha generado la necesidad de un nuevo paradigma de atención para estos pacientes, y con ello, la necesidad de cambios profundos en los sistemas de salud. En el 2002, la OMS elaboró el documento “Atención innovadora para las condiciones crónicas: Elementos Fundamentales para la Acción”, 5con el fin de guiar los lineamientos necesarios para la adopción de políticas tendientes a reducir la amenaza que representan las enfermedades crónicas para la población en general, los sistemas de salud y sus economías. Este documento basó su estrategia en el concepto de la atención integrada, definida como “la acción coordinada de los sistemas de salud para ofrecer, entregar, gestionar y organizar los servicios relacionados con el diagnóstico, tratamiento, cuidado, rehabilitación y promoción de la salud”.
Objetivo: Identificar los factores demográficos, psicosociales y del ciclo de vida que aumentan el riesgo de suicidio en la zona cafetera de Colombia entre la segunda mitad de 2017 y finales de 2019.Métodos: Diseño de casos y controles emparejados. Se utilizó una muestra de 176 personas, de las cuales 101 eran muertes por suicidio (casos) y 75 eran muertes por accidentes de tránsito (controles); se utilizaron autopsias psicológicas con fines de investigación. Se realizaron análisis de regresión logística de máxima verosimilitud penalizada, que indicaban la oportunidad o ventaja relativa (OR) de suicidio, ajustando por sexo, grupo de edad, provincia de la autopsia médico-legal y fuente de los datos. Las regresiones logísticas se aplicaron en tres bloques: problemas de salud mental, consumo de sustancias psicoactivas y adversidades durante el curso de la vida. El análisis estadístico se realizó con Stata®.Resultados: El 78.2 % de los casos y el 84.0 % de los controles eran hombres. La edad media de los casos era de 39 años y la de los controles, de 43 años. Los factores de riesgo clave para el suicidio, con p< 0,05, fueron el trabajo forzoso durante la adolescencia (OR: 32,41), la dependencia económica (OR: 4,3), el maltrato verbal o físico por parte de la pareja (OR: 10,28), cualquier trastorno mental (OR: 26,14), un intento previo de suicidio (OR: 11,64; p= 0.061) y antecedentes de trastorno depresivo mayor (OR: 24.86). Un factor protector fue la muerte de un familiar cercano en algún momento de la vida (OR: 0.34; p= 0.073).Conclusiones: El trabajo forzado en la adolescencia, el abuso verbal y físico por parte de la pareja, la dependencia económica de otras personas, cualquier trastorno mental, el trastorno depresivo severo y los intentos de suicidio previos fueron factores de riesgo de suicidio; la muerte de cualquier familiar cercano en algún momento de la vida fue un factor de protección contra el suicidio.
ObjetivoDescribir los desenlaces obstétricos asociados al uso de dinoprostona y su efectividad en la maduración cervical en gestantes con trastornos hipertensivos asociados al embarazo frente a gestantes normotensas. MétodosEstudio de cohorte retrospectivo en hospital de tercer nivel en Medellín, Colombia (marzo 2020 - octubre 2024). Se incluyeron gestantes con embarazo único, mayores de 30 semanas, feto vivo en presentación cefálica y maduración cervical con óvulo de dinoprostona. Se excluyeron mujeres con uso de otros métodos de maduración, cérvix favorable al ingreso o trastorno hipertensivo no clasificado. Los desenlaces principales fueron maduración cervical exitosa, parto vaginal, tiempos hasta Bishop favorable y parto, e indicaciones de cesárea. Se consideraron eventos adversos como abrupcio placentario, estado fetal no tranquilizador, taquisistolia y empeoramiento hipertensivo Resultados Se incluyeron 400 pacientes (200 hipertensas, de éstas, 100 con preeclampsia grave). La tasa de éxito en la maduración cervical fue similar en pacientes con trastornos hipertensivos y mujeres sanas RR crudo 0.95, IC 95%: 0.88-1.03, RR ajustado por edad gestacional, edad materna y paridad 0.96, IC 95%: 0.88-1.04. La tasa de parto vaginal fue similar 44 y 55% (p: 0.16). La mediana de tiempo a Bishop favorable y al parto fue comparable entre normotensas e hipertensas, incluso en casos graves. La cesárea se debió principalmente a maduración fallida y decisión médica. Los eventos adversos, excepto la taquisistolia, fueron más frecuentes en hipertensas, sin significación estadística. ConclusiónLa dinoprostona es eficaz en pacientes hipertensas, incluso con uso de sulfato de magnesio, sin diferencias significativas frente a normotensas
As Editor-in-Chief of Colombia Médica, Professor Mauricio Palacios Gómez has led a sustained process of editorial, technical, and scientific strengthening for more than a decade in one of the most influential biomedical journals in Latin America. Through timely, strategically structured, and conceptually solid editorials, he has charted a path of critical reflection and global projection on the role of scientific journals in contexts of academic, technological, and political transition. One of his most recent contributions,”The Art of Validating Science: Four Centuries of Peer Review”, clearly and elegantly synthesizes the historical trajectory of peer review and analyzes current challenges regarding quality, transparency, and equity in scientific publishing. This editorial continues a line of thought initiated a decade earlier with”Agreement to Build Better Scientific Journals in Colombia”, which represented a clear institutional stance by endorsing the San Francisco Declaration on Research Assessment (DORA), advocating for a fairer and more qualitative way of evaluating scientific output. In”How to Organize Scientific and Technological Information in Latin America?”, published in 2016, Professor Palacios proposed an integrative regional vision that emphasizes collaborative networks and open science as pillars of a new knowledge infrastructure. In 2018, his editorial, “The Uncertainty of Colombian Scientific Journals with Publindex,” issued a critical warning about systemic weaknesses in the national indexing model and became a key text for understanding the sustainability challenges faced by Colombian scientific journals. A year later, in” Editorial Advances of the Journal Colombia Médica”, he documented the journal’s evolution, including its digital transformation, growing international visibility, and consolidation as a regional benchmark in public health, clinical medicine, and biomedical sciences. In” What does Colombia require to earn a Nobel Prize in Medicine?”, he offered a reflective critique of the excessive use of bibliometric indicators. He advocated for more balanced and contextualized scientific evaluations.
Antecedentes: La terapia hormonal es clave para tratar el cáncer de mama, pero se reporta baja adherencia terapéutica y existe poca evidencia sobre los predictores que contribuyen a mejorar esta adherencia terapéutica en esta población. Objetivo: Identificar factores asociados a la adherencia a la terapia hormonal en mujeres con cáncer de mama, en una Clínica Oncológica de Medellín-Colombia. Métodos: Estudio transversal analítico. Se incluyeron mujeres >18 años con cáncer de mama con receptores hormonales positivos, en tratamiento con terapia hormonal. Se aplicó la escala MMAS-8 para medir y clasificar a las mujeres en baja, mediana y alta adherencia terapéutica. Los datos fueron analizados mediante regresión logística multinomial. Resultados: Se incluyeron 178 pacientes, con edad mediana de 64.0. El 50.0% estaba siendo tratado con tamoxifeno. La prevalencia de adherencia incompleta fue de 48.9%. El 70.2 % presentó efectos adversos por la terapia hormonal y el olvido fue el principal motivo por el que las pacientes dejaban de tomar el medicamento (76.2%). La edad se asoció con la adherencia terapéutica, siendo las mujeres mayores las más adherentes (83.5%). Las mujeres que presentaron efectos adversos, que pertenecían a estadios III-IV, a niveles socioeconómicos y educativos bajos y no contaban con red de apoyo mostraron tener menor adherencia terapéutica. Conclusión: Se evidencia elevada prevalencia de mediana y baja adherencia terapéutica en las mujeres más jóvenes, de estratos socioeconómicos y niveles educativos más bajos. Se requieren estrategias preventivas que mitiguen factores que impactan negativamente en la adherencia terapéutica.
Objectives: This study aimed to investigate whether serum Interleukin 36 gamma (IL-36γ) levels in pediatric allergic rhinitis patients correlate with disease severity (mild, moderate, severe) and duration (intermittent, persistent). Additionally, we assessed the potential of IL-36γ as a biomarker and its role in disease pathogenesis to inform future treatment strategies. Methods: In this cross-sectional observational study, pediatric allergic rhinitis patients from outpatient clinics were compared with healthy controls. Serum IL-36γ levels were measured from blood samples and analyzed across subgroups based on disease severity and duration. Results: Fifty patients with allergic rhinitis and forty controls were included. IL-36γ levels were higher in the patient group with borderline significance (p= 0.050). Female patients had significantly higher IL-36γ levels than male controls (p= 0.044). Conclusions:This is the first study to evaluate IL-36γ levels in pediatric allergic rhinitis. Although the difference between groups showed borderline significance, larger studies may confirm these findings. The observed gender-related difference suggests IL-36γ could be a potential biomarker. Additionally, a significant negative correlation with total IgE and a nonsignificant negative correlation with eosinophil counts were noted.
Antecedentes: Los niños, niñas y adolescentes (NNA) con maltrato infantil enfrentan consecuencias graves en su salud física, mental y desarrollo social (perpetuación de violencia, pobreza y desigualdad). La OMS lo reconoce como un problema de salud pública, destacando la necesidad de reparar el trauma complejo y garantizar la no repetición. En Colombia, aunque existe una ruta intersectorial que involucra salud, protección y justicia, la falta de centros especializados lleva a revictimización, reprocesos y fallas en la atención integral. Adicionalmente, las guías del Ministerio de Salud no incluyen protocolos ambulatorios para la reparación del trauma. MétodosFrente a esto, la Universidad del Valle y el Hospital Universitario del Valle Evaristo García (HUV) en Cali, Colombia desarrollaron un programa innovador basado en el modelo ecológico de la salud, la estrategia INSPIRE (OMS) y la Convención de los Derechos del Niño. ResultadosLa Unidad de Pediatría Social ofrece atención interprofesional centrada en la persona, integrando acciones clínicas, acciones del sector justicia y protección; evitando la revictimización, mejorando los procesos y garantizando la reparación del trauma. A través de la narrativa se describen los desafíos para la sostenibilidad del programa, las enseñanzas de la implementación del modelo y del trabajo intersectorial. Conclusiones Posterior a la atención de 3,602 NNA; 1,454 con maltrato infantil, se puede concluir que estos programas son esenciales para romper ciclos de violencia, demostrando que la atención integral, centrada en la persona y basada en evidencia puede mitigar el impacto del maltrato infantil en el individuo y el territorio.
Descripción del caso:Se presenta el primer caso humano en un entorno urbano de infección por Rickettsia parkeri, cepa Atlantic Rainforest, en un paciente masculino de 8 años . Hallazgos clínicos:El paciente, quien refirió una picadura de garrapata, presentó fiebre (38 °C), mialgia, dolor abdominal, artralgia y linfadenopatía leve en la axila derecha. Se observó una lesión en el sitio de la picadura de la garrapata. Tratamiento y resultados:Se obtuvo una muestra de biopsia del área de la picadura para diagnóstico mediante PCR y secuenciación del fragmento de ADN, que mostró una homología del 100 % con Rickettsia parkeri, cepa Atlantic Rainforest, reportada en casos humanos en Brasil. El tratamiento consistió en 100 mg de doxiciclina durante 10 días, con desaparición de los síntomas a las 24 horas de iniciado el tratamiento. Relevancia clínica:Reportamos el primer caso de rickettsiosis por Rickettsia parkeri en un área urbana de México. La infección se considera de curso leve a moderado, aunque es inusual en ambientes urbanos. Los médicos deben estar atentos a las manifestaciones clínicas asociadas a las picaduras de garrapata, especialmente cuando se presenta linfadenopatía.
Background:Submaximal tests such as the Sit-to-Stand Test (STS) in its three modalities are used to evaluate strength and aerobic capacity in people with respiratory, cardiovascular, and metabolic diseases. However, international reference values do not account for the genetic and environmental particularities of the Colombian population, underscoring the need to establish local references. Aim:To establish sex and age specific reference values for the 5-repetition, 30-second, and 1-minute sit-to-stand tests in community-dwelling Colombian adults. Methods:A cross-sectional study was conducted between 2023 and 2024 in Colombia, with the participation of healthy adults aged 18 to 80 years. Anthropometric characteristics and physical activity were assessed using the IPAQ questionnaire and the Sit-to-Stand Test (STS) at 1 minute, 30 seconds, and 5 repetitions. Normative percentiles were calculated by sex and age with a sample of 393 people. Results:The study included 393 participants (208 women and 185 men), with an average age of 44 years and a BMI of 25.9 ± 4.1. Age was negatively correlated with repetitions (R= 0.493; 60 sec and R= -0.497; 30 sec), height showed a positive correlation (R= 0.262; 60 sec). High BMI was associated with worse performance (R= -0.119; 60 sec, R= -0.153; 30 sec). Conclusions:This study establishes reference values for STS testing in healthy adults in Colombia, accounting for age, sex, BMI, and physical activity.
Aim: To examine the determinants of COVID-19 vaccine acceptance in Colombia, with particular emphasis on individuals' responses to possible side effects. Methods: A cross-sectional study was conducted using an anonymous online questionnaire in Colombia between January and March 2023. The ad hoc survey collected sociodemographic data, COVID-19 history, vaccination status, and adverse effects. Descriptive analyses, chi-square tests, and multinomial logistic regression (aOR, 95% CI) were performed (p <0.05). Results: The 40.2% of respondents expressed doubts or would have rejected vaccination had they known about possible side effects beforehand. Women were more likely to hold doubts or reject the vaccine after experiencing adverse effects. Participants who experienced side effects were more likely to question their decision to vaccinate. Younger individuals were less likely than older adults to develop negative attitudes after experiencing side effects. Those who had received only one dose were more likely to doubt or reject further vaccination, whereas individuals with multiple doses were less likely to do so. Participants with asymptomatic COVID-19 were less likely to refuse vaccination after learning about potential side effects, possibly because they trusted their immune system more or had a stronger desire to protect others. Conclusions: Vaccination hesitancy was associated with female sex, prior adverse effects, and fewer doses, whereas younger age was associated with greater acceptance. These findings highlight the need for targeted risk communication to address safety concerns and strengthen vaccine confidence.
AimTo synthesize technical, clinical, and regulatory knowledge on transdermal patches and identify persistent gaps that impact their safe and effective use.MethodsData sources and selection criteria were defined as follows. Sources consulted included PubMed, Scopus, ScienceDirect, and Google Scholar; regulatory agency websites (FDA, EMA, ANVISA, INVIMA); and official pharmacopeial and methodological documents (USP-NF, European Pharmacopoeia, OECD). English, Spanish, and Portuguese sources were considered, with no predefined time limits. The last search update was performed on September 9, 2025. Regarding study selection, the narrative approach includes published reviews, relevant primary studies, official regulatory guidance’s/Q&A, and pharmacopeia standards related to design, release/permeation, bioavailability/bioequivalence, adhesion, and regulatory frameworks. Non-authoritative or commercial webpages and duplicates were excluded, with priority given to official and peer-reviewed sources. This review was appraised against the SANRA criteria, covering justification of the article's importance, statement of aims, description of the literature search, referencing, scientific reasoning, and appropriate presentation of data.ResultsTransdermal systems may offer sustained drug delivery and adherence advantages, but their real-world performance is constrained by biological variability, patient misuse, and fragmented regulatory requirements. Adhesion remains a critical quality attribute, yet test methods are heterogeneous and alignment between in vitro metrics and clinical outcomes is limited.ConclusionsStronger harmonization of adhesion and bioequivalence standards, together with improved patient education and testing under real-life stress conditions, is needed to ensure the quality, safety, and interchangeability of innovator and generic transdermal products.
Case Description: A 28-year-old postpartum woman presented with severe headache, fever, and decreased level of consciousness. Cerebrospinal fluid PCR detected 185,000 copies of Epstein-Barr virus DNA. Clinical Findings: Neuroimaging revealed diffuse cerebral edema consistent with intracranial hypertension in the absence of hemorrhagic lesions, confirming Epstein-Barr virus encephalitis complicated by objectively documented elevated intracranial pressure. Treatment and Outcomes: The patient received intravenous acyclovir, phenytoin, and hypertonic saline, achieving complete neurological recovery after 21 days of therapy. Clinical Relevance: To our knowledge, this is the first documented case of non-hemorrhagic Epstein-Barr virus encephalitis with objectively confirmed intracranial hypertension in the postpartum period. The most plausible mechanism is inflammation-induced diffuse cerebral edema leading to impaired cerebrovascular autoregulation and subsequent intracranial pressure elevation. Clinicians should include Epstein-Barr virus infection in the differential diagnosis of postpartum patients presenting with encephalitis and signs of increased intracranial pressure, even when neuroimaging does not reveal hemorrhagic findings.
All human endeavors -even the most noble and carefully crafted- are, at some point, destined for transformation or failure, whether total or partial. Global Health is no exception. Almost nothing we envision unfolds exactly as projected, and it falls to those of us who care about these causes to reorient them in order to keep their spirit alive; to treat them with a proper diagnosis, without allowing their enemies to let them die quietly in bed, and recognizing that saving them often requires transforming them.I once heard a Colombian poet say that he hoped his epitaph would read: “There is nothing and no one who has not disappointed me”. At this stage of a professional life in Public Health, while many colleagues still seem enthusiastic about the promises and possibilities of social movements, others of us drift toward skepticism, always striving to prevent it from turning into cynicism or indifference. Instead, we try to turn those doubts into a new kind of hope: to imagine other possible futures (1); perhaps new ways of being disappointed, but which, while they last and insofar as they are honest, move the needle of change.This is how I think about Global Health, which had already disappointed me even before it came under such open attack from nationalist movements. Many of us have long identified its contradictions and shortcomings, particularly within the mechanisms of international cooperation. Several of these are now being exploited by discourses such as Trumpism (understood here not only as a U.S. phenomenon, but as a broader expression of anti-institutional, anti-elite nationalism) to dismantle what should, in fact, be transformed.
Objectives: This study aimed to investigate whether serum Interleukin 36 gamma (IL-36 gamma) levels in pediatric allergic rhinitis patients correlate with disease severity (mild, moderate, severe) and duration (intermittent, persistent). Additionally, we assessed the potential of IL-36 gamma as a biomarker and its role in disease pathogenesis to inform future treatment strategies. Methods: In this cross-sectional observational study, pediatric allergic rhinitis patients from outpatient clinics were compared with healthy controls. Serum IL-36 gamma levels were measured from blood samples and analyzed across subgroups based on disease severity and duration. Results: Fifty patients with allergic rhinitis and forty controls were included. IL-36 gamma levels were higher in the patient group with borderline significance (p= 0.050). Female patients had significantly higher IL-36 gamma levels than male controls (p= 0.044). Conclusions: This is the first study to evaluate IL-36 gamma levels in pediatric allergic rhinitis. Although the difference between groups showed borderline significance, larger studies may confirm these findings. The observed gender-related difference suggests IL-36 gamma could be a potential biomarker. Additionally, a significant negative correlation with total IgE and a nonsignificant negative correlation with eosinophil counts were noted.
Pelayo Correa, born in Sonsón, Antioquia, in 1927, was one of the most influential figures in cancer epidemiology and pathology in Latin America and worldwide. His work transformed the understanding of gastric carcinogenesis and gave rise to one of the most solid and longstanding population-based registries on the continent. His scientific life - defined by rigor, curiosity, and public service - leaves an enduring legacy for generations of researchers. Professor Correa graduated as a physician from the University of Antioquia in 1949, where he completed his thesis on cancer statistics in the department —pioneering work that sparked his lifelong interest in differences in cancer risk across populations. This early study took him to Emory University in the United States, where he trained as a pathologist and solidified his etiologic vocation: to understand the causes of disease, not only its morphological expression. After completing his training, he returned to Colombia and joined the Universidad del Valle. During a 1961 congress, his presentation on cancer patterns in Cali drew the attention of Dr. Harold Stewart of the National Cancer Institute (NCI), who shared the data with Dr. William Haenszel. From that exchange, Dr. Haenszel traveled to Cali and, together with Professor Correa, helped establish the Cali Population-Based Cancer Registry (RPCC), the first in Latin America and today one of the oldest in the world. Dr. Haenszel also served as his mentor in epidemiology, contributing to the design and conduct of the investigations that followed in subsequent decades, aimed at clarifying the determinants of gastric cancer. The strength of the Cali Registry became evident early on. The RPCC publication in the Journal of the National Cancer Institute in April 1966 coincided with the release of the first volume of Cancer Incidence in Five Continents(January 1966), which included RPCC data. This convergence placed the Cali registry within the foundational landmarks of global cancer surveillance. At a time when the world was beginning to standardize comparative incidence measurement, Professor Correa’s work provided rigorous data from Latin America, demonstrating that his epidemiological vision was not only aligned with global developments but contributed to them from the outset.
Case description:The first human case in urban ambient of infection by Rickettsia parkeri Atlantic Rainforest strain in an 8-year-old male patient is presented. Clinical findings:The patient reporting a tick bite presented with fever (38 °C), myalgia, abdominal pain, arthralgia, and mild lymphadenopathy in the right axilla. A lesion was observed at the tick-bite site. Treatment and results:A biopsy sample was obtained from the tick bite area for diagnosis by PCR and sequencing of the DNA fragment, resulting in 100% homology towards Rickettsia parkeri Atlantic Rainforest strain reported in human cases in Brazil. Treatment consisted of 100 mg of doxycycline for 10 days, with symptoms ceasing 24 hours after the start of treatment. Clinical relevance:We report the first case of rickettsiosis by Rickettsia parkeri in an urban area in Mexico. Infection is considered mild to moderate, but it is unusual in urban environments. Medics should be concerned about the clinical manifestations associated with tick bites, particularly when lymphadenopathy is present.
Cutaneous leishmaniasis is a neglected tropical disease caused by Leishmania species and transmitted through the bite of infected female sandflies. It primarily affects the skin and mucous membranes, with a broad spectrum of clinical manifestations that depend mainly on the host's immune response. The immune balance between Th1, Th17, and Th2 pathways plays a pivotal role in disease progression and outcome. Hyperergic responses (Th1/Th17) are associated with localized and mucosal forms, while anergic responses (Th2/Treg) underline disseminated and diffuse cutaneous forms. Despite its global prevalence, particularly in tropical and subtropical regions, cutaneous leishmaniasis remains underdiagnosed and mismanaged due to a lack of awareness of its immunopathogenesis, clinical diversity, and diagnostic limitations. Treatment continues to rely primarily on pentavalent antimonial compounds, which have significant toxicity, underscoring the urgent need for safer and more effective therapeutic alternatives. This narrative review aims to examine the immune response, clinical manifestations, diagnostic methods, and medical management strategies for cutaneous leishmaniasis. Understanding the complex interplay between immune responses and clinical manifestations is essential for improving diagnosis and treatment.
