Colomb Medica
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We analyze the impact of the COVID-19 pandemic on oncology service demand in a middle-income country with universal health coverage. ⋯ Starting the confinement (April 2020), a general decrease in service demand was observed (R: -14.9% to -90.0%), with an additional but lower decrease in August 2020 coinciding with the first pandemic wave (R: -11.3% to -70.0%). Follow-up visits and ambulatory treatment showed no consistent reductions. New patients' consultations for cross-cutting services had a speedy recovery (1 month), but clinical oncology, specialized units, and in-hospital treatment resumed more slowly. Only breast and stomach cancer showed a sustained reduction in early-stage disease. Women and older patients had a more significant reductionin service demand. Conclusion: Despite no changes in service supply, the confinement induced a significant reduction in service demand. Variations by cancer type, service type, and population demographics deserve careful consideration for a suitable response to the emergency. The speedy recovery and the absence of a significant decrease during subsequent waves of the pandemic suggest patient resiliency and a lower impact than expected in middle-income settings in the presence of universal health insurance.
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To analyze the cervix cancer mortality in Colombia, based on age, period and cohort effects. ⋯ Demographic factors could explain the behavior of cervical cancer mortality in Colombia, as well as the establishment of public health measures in the last two decades.
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To describe cancer incidence and mortality trends in Manizales, Colombia, between 2008-2017. ⋯ In Manizales, population aging has contributed to an increased burden of cancer. In terms of incidence and mortality, progress in the fight against this disease is still discrete. It is a priority to reinforce cancer control strategies with a differential approach by sex.
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Patients with pulmonary hypertension present limited tolerance to exercise and aerobic capacity; which is reflected in the reduction in peak oxygen consumption and their functional performance. This intolerance to exercise has traditionally been attributed to cardiac and respiratory dysfunction. However, as it happens in other chronic diseases, lower-limb and respiratory muscle alterations are also involved in patients with pulmonary hypertension. ⋯ In diseases such as COPD, lower-limb muscle function, exercise tolerance and quality of life improve following exercise training. And just as with COPD, it is necessary to promote evidence-based interventions with pulmonary hypertension. This narrative review focuses on the evaluation, safety and efficacy of training the respiratory muscles and the muscles of upper and lower extremities in patients with pulmonary hypertension.
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qSOFA is a score to identify patients with suspected infection and risk of complications. Its criteria are like those evaluated in prognostic scores for pneumonia (CRB-65 - CURB-65), but it is not clear which is best for predicting mortality and admission to the ICU. ⋯ None of these scores proved to be an appropriate predictor for mortality and admission to the ICU. Furthermore, the CRB 65 exhibited the lowest discriminative ability.