Revista Médica de Risaralda

Adverse Effects of Calcium Hydroxylapatite as a Cosmetic Filler and Therapeutic Alternatives: A Systematic Review

Lina Bibiana Peña Cifuentes — Mon, 22 Sep 2025 00:00:00 +0000

Introduction: The use of calcium hydroxylapatite (CaHA) as a dermal filler has become a common procedure in facial aesthetic medicine due to its biostimulatory capacity and non-surgical lifting effect. However, its application may lead to adverse complications of varying severity, requiring proper management by healthcare professionals.

Objective: To conduct a systematic review of the adverse effects associated with the use of calcium hydroxylapatite as a cosmetic filler and the available therapeutic alternatives for their management.

Methods: A literature search was performed in PubMed, SciELO, Dialnet, and Google Scholar databases, following PRISMA methodology guidelines. Articles published in the last ten years, in Spanish and English, addressing adverse effects related to CaHA application and its treatment options were included. A total of 25 articles were selected after applying eligibility and exclusion criteria.

Results: The most frequently reported adverse effects include dermal nodules, erythema, ecchymosis, edema, and dysphonia, as well as major complications such as skin necrosis and vision loss. Therapeutic strategies described in the literature include the use of sodium thiosulfate (Na₂S₂O₃), dilutions with lidocaine and/or saline solution, combined techniques of collagenase ultraphonophoresis and thiosulfate diadynophoresis, as well as the application of vectorized patterns to optimize product distribution and minimize complications.

Conclusion: Calcium hydroxylapatite is a safe material when properly administered; however, its application requires a thorough knowledge of facial anatomy, proper injection techniques, and effective protocols for the prevention and management of complications. The dissemination of evidence-based therapeutic strategies is essential to improve the safety of these procedures in clinical practice.

Risk Factors Associated with Intrauterine Fetal Demise (IUFD) in Pregnant Women Managed at a Tertiary-Level Hospital in Neiva, Huila, from January 2018 to September 2023

Mon, 22 Sep 2025 00:00:00 +0000

Objective: Determine the risk factors associated with stillbirth at the Hospital Universitario Hernando Moncaleano Perdomo from January 1, 2018, to September 30, 2023.

Methodology: Retrospective, observational study conducted at a single center on the clinical characteristics of pregnant women who experienced stillbirth. A probabilistic sampling, by convenience, using simple randomization was performed. Consecutive records from patients diagnosed with stillbirth and admitted to the Hospital Universitario Hernando Moncaleano Perdomo in Neiva, Huila, Colombia, between January 2018 and September 2023.

Results: A total of 79 patients were included during the study period who met the inclusion criteria. The main findings related to fetal death in the studied population were that 49.4% of the mothers had attended fewer than three prenatal visits (21.5% had no prenatal visits), with the presence of pathologies such as diabetes (5.1%) or hypertension during pregnancy (3.8%), as well as excess weight during pregnancy.

Stillbirth occurred more frequently in the third trimester (82.3%), however, 74.7% of the deaths occurred before 37 weeks. Additionally, 3.8% of fetal deaths occurred in women with a history of ≥2 previous losses in 5.1% of the patients.

Conclusion: The most frequent findings in cases of fetal death were intrauterine abruptio placentae, followed by cord prolapse and fetal malformations, mainly congenital heart defects. None of these findings showed statistical significance.

Knowledge of Practices During and After Childbirth in the Tutunendo Indigenous Community, Chocó, Colombia

Mon, 22 Sep 2025 00:00:00 +0000

Objective: to evaluate the knowledge about the practices performed during and after childbirth in the indigenous community Tutunendo, Chocó - Colombia.

Methodology: descriptive observational study that included indigenous community leaders. The population was selected through the Asociación de Cabildos de Autoridades Tradicionales Indígenas Embera Dóbida, Katío, Chamí y Tule in conjunction with the Asociación de Pueblos Indígenas Dobida, Eyabida y Katio del Chocó. The information was collected from the primary source by means of an instrument adapted by the researchers. The analysis was carried out by means of relative and absolute frequencies for qualitative variables and median and interquartile ranges for quantitative variables according to their distribution.

Results: 23 indigenous community leaders were included, with a median age of 38 years and a predominance of males (69.6%, 16). Of the indigenous leaders, 47.8% (11) considered that midwives should have formal education and certification to perform this type of practice; however, 17.4% (4) thought that it was sufficient to have ancestral knowledge and experiential experience.

Conclusion: although Colombia already has clearer concepts about the importance of midwives in different parts of the country, it is essential to promote education and the sharing of knowledge in order to safeguard maternal and child health and improve maternal and child morbidity and mortality rates.

Regenerative Effects of Ozonized Oils REGEN(PJ)FACEZONE® and REGEN(PJ)BODYOZONE® on Skin Lesions

Peeter Francisco Cazco — Mon, 22 Sep 2025 00:00:00 +0000

Introduction: The aim of this study was to analyze the effects of ozonized oils REGEN(PJ)FACEZONE® and REGEN(PJ)BODYOZONE® on skin regeneration in patients with cutaneous lesions, through microbiological testing and dermal analysis.

Materials and Methods: An experimental, quantitative, cross-sectional study was conducted. Inductive–deductive methods, data triangulation, and comparative analysis were employed. The applied techniques included direct observation, data tabulation, medical history, dermal analysis, and microbiological evaluation. The sample was divided into two groups: Group A (control), treated with conventional management (n=5), and Group B (experimental), treated with REGEN(PJ)FACEZONE® and REGEN(PJ)BODYOZONE® (n=5).

Results: Group A showed high levels of bacterial resistance to tetracycline, minocycline, and clindamycin, which limited their effectiveness against Cutibacterium acnes and Staphylococcus aureus. In contrast, Group B demonstrated that REGEN(PJ)FACEZONE® achieved significant inhibition of C. acnes and S. aureus bacterial growth. Furthermore, REGEN(PJ)BODYOZONE® showed notable improvements in skin hydration and regeneration.

Conclusions: Ozonized oils REGEN(PJ)FACEZONE® and REGEN(PJ)BODYOZONE® represent an effective alternative for the treatment of resistant bacterial infections, particularly in acne, pressure ulcers, and dermatitis. They are also effective in improving facial elasticity and reducing solar lentigines.

Study of Cardiovascular Risk Characterization Using the Globorisk Model in Patients from Northwestern Colombia

Mon, 22 Sep 2025 00:00:00 +0000

Introduction: Cardiovascular diseases represent the leading cause of morbidity and mortality worldwide. Identifying cardiovascular risk in specific populations allows for the timely implementation of intervention strategies. The Globorisk model is a validated tool that estimates the 10-year risk of cardiovascular events, considering clinical and demographic variables.

Objective: To characterize cardiovascular risk using the Globorisk model in patients from northwestern Colombia.

Materials and Methods: A descriptive, cross-sectional study with a quantitative approach was conducted. The population included patients over 40 years of age who attended a healthcare institution in northwestern Colombia. The Globorisk model was applied, estimating cardiovascular risk based on age, sex, blood pressure, total cholesterol, diabetes, and smoking status.

Results: 68.8% of participants were women, with a mean age of 65.67 years. The main comorbidities were arterial hypertension (81.4%), non-insulin-dependent diabetes mellitus (28.2%), and hypercholesterolemia (24.3%). Treatment adherence was 91%, while adequate control of risk factors reached 70.2%. According to Globorisk-based cardiovascular risk estimation, 35.2% of the population had low risk, 46.1% moderate risk, and 18.7% high risk. Patients with higher cardiovascular risk showed lower treatment adherence levels.

Conclusions: The prediction equations applied using the Globorisk model demonstrated good performance in terms of discrimination and calibration, surpassing limitations observed in other models previously used in similar contexts. Furthermore, there is a need to strengthen access for high-risk populations to specialized cardiovascular care, as well as to improve continuity in monitoring and control of risk factors. Based on these findings, the implementation of an institutional improvement plan aimed at strengthening comprehensive cardiovascular risk management is recommended, along with multicenter studies to validate and optimize the application of the Globorisk model and other stratification tools across different regions of Colombia, contributing to improved national cardiovascular prevention strategies.

Situational Analysis of Pharmacovigilance in a Secondary-Level Hospital in Puebla, Mexico

Angélica, Diana Salazar Flores, Irvin Sánchez Rodríguez — Mon, 22 Sep 2025 00:00:00 +0000

Introduction: In Mexico, pharmacovigilance has been around for a very short time, it began in 1995, only 68 events of Adverse Drug Reactions were reported, 10 years later the figure increases to 7960, however, with the increase in the reporting rate, there is a need to continue evaluating the level of knowledge and attitude of the staff, which gives the opportunity for improvements for quality certification.

Objective: To determine the situational analysis based on the knowledge, attitudes, and perceptions of the health personnel of the third-level hospital in the interior of the state of Puebla, regarding the pharmacovigilance process, within 2023.

Methodology: This research was performed through an observational and cross-sectional study, with descriptive, prolective and analytical characteristics, through a validated survey based on guidelines and the Mexican standard NOM-220-SSA1-2016.

Results: It was found that female medical staff corresponds to 9% and male medical staff represents 31%. The position of the staff surveyed was female staff (50%), Medical Staff (45%), and Clinical laboratory staff (5%). The working shift of the hospital, Morning (44%), Evening (16%), Night (17%), Cumulative Day (23%). In the same point of view, the comparision between sex, workshift, and professions, showed interesting results, like women have more knowledge in pharcovigilance than men (*p<0.05), the working shift nocturne (***p<0.001) have more knowledge than the others, and the nurses have more knowledge than doctors(*p<0.05).

Emotional Symptomatology of Emergency Healthcare Personnel in a Health Institution in Medellín, Colombia: A Cross-Sectional Study

Mon, 22 Sep 2025 00:00:00 +0000

Introduction: Nowadays, Depression, Anxiety and Stress are common diseases at the occupational level. It is not common for health institutions to screen staff for emotional symptoms, which motivated us to delve deeper into this topic.

Objective: To determine the emotional symptoms (symptoms of anxiety, depression and/or stress) of healthcare personnel in the emergency area (general physicians, emergency physicians, head nurses and nursing assistants) in a health institution in the city of Medellín, 2023.

Material and methods: Observational, descriptive, cross-sectional study. 22 nursing assistants, 10 physicians, 10 professional nurses and 1 emergency physician from the emergency area of the health institution were surveyed. A validated DASS 21 survey was applied to determine the presence of Depression, Anxiety and Stress in health professionals.

Results: The surveyed personnel were 77% women and 23% men. The largest number of participants was between the ages of 22-29 years (53%), followed by the 30-45 age group (47%). There were more single participants (51.2%), followed by participants in free union (34.9%), married (9.3%) and divorced (4.7%). The frequencies found were depression at 30.2%, anxiety and stress at 32.6%. The age group with the highest frequency of these emotional symptoms was that of less than or equal to 29 years. However, in the group of those over 29 years of age, extremely severe stress and anxiety were identified with a frequency of 1 participant.

Conclusions: Of the three disorders, the one that occurred in the highest percentage was depression, followed by anxiety and stress. Higher percentages of depression and stress were observed in physicians. Nurses presented higher anxiety symptoms. The degree of depression, anxiety and stress that they presented the most was moderate, followed by mild.

Prevalence and Associated Factors of Adverse Reactions to Vancomycin in Hospitalized Patients in the Internal Medicine Department of a High-Complexity Hospital in Colombia: A Cross-Sectional Study

Giovanni Caviedes Pérez, Allison Daniela Dussan Quintero, David Rivera Sterling — Mon, 22 Sep 2025 00:00:00 +0000

Objective: Identify the prevalence of adverse reactions associated with the use of vancomycin, as well as the factors related to their severity.

Materials and Methods: A descriptive cross-sectional study was conducted on patients admitted to a high-complexity hospital in the city of Neiva who were prescribed vancomycin. A probabilistic sampling was carried out, with a review of clinical histories and a survey, the dependent variable was the presence of adverse reactions. The data obtained were recorded in Excel and analyzed using statistical software, obtaining descriptive statistics with central tendency and dispersion measures. A bivariate analysis was performed, and the Chi-square test was used to analyze two qualitative variables.

Results: A total of 104 patients, of whom 51.9% were men; skin and soft tissues were the most commonly affected sites with 39.4%. Polypharmacy, hypertension, and advanced age were the most related comorbidities. 14% of the patients presented adverse drug reactions (ADR), nephrotoxicity being the most frequent at 53.3%. 85.6% of the patients had plasma level monitoring. 38.4% of the formulations had drug interactions, Piperacillin-tazobactam being the most commonly involved (45%). The pharmacological immunosuppression had a higher probability of presenting an adverse reaction.

Conclusions: The prevalence of adverse drug reactions to vancomycin is 14%, with nephrotoxicity and hypersensitivity reactions being the most common. Severe reactions were the most frequently found, and pharmacological immunosuppression was the most related factor with the occurrence of reactions.

Characterization of Fragility Hip Fracture, Causes of Surgical Delay, and Mortality in a Tertiary Center in Palmira, Colombia

Mon, 22 Sep 2025 00:00:00 +0000

Introduction: Fragility hip fractures in older adults are associated with high morbidity, mortality, and disability, with a detrimental impact on quality of life in the older adult population.

Methods: A retrospective cohort study was conducted in a tertiary clinic in Colombia from January 2021 to December 2023. The objective of the study was to describe the clinical characteristics of older adult patients hospitalized with fragility hip fractures and to establish the factors associated with mortality and early versus late surgery.

Results: A total of 191 patients were analyzed. The median age was 84 years. The cumulative mortality rate at 12 months of follow-up was 13% (n=25/191). 48.7% of surgeries were performed in less than 48 hours. Factors associated with cumulative mortality at 12 months were a Charlson score greater than 5 and surgery performed more than 48 hours later. Factors associated with surgical delay were sarcopenia, CKD with a GFR < 45 ml/min, and hemoglobin levels on admission < 9 g/dL.

Conclusions: Elderly patients with hip fractures often have multimorbidity, which makes them more clinically complex. Medical evaluation should aim to identify and stabilize comorbidities to achieve early surgery. In Colombia, there may be gaps in achieving the goal of early surgery related to the type of health insurance. It is important to strengthen guidelines for the prevention of osteoporotic fractures and curb therapeutic inertia.

Syphilis Reactivity in Blood Donors: Analysis in Blood Banks from Two Cities in the Colombian Caribbean

Mon, 22 Sep 2025 00:00:00 +0000

Introduction: Syphilis, caused by Treponema pallidum, is a sexually transmitted infection considered a global public health problem due to its silent course and potential severe complications if not treated promptly.

Objective: To describe serological reactivity to syphilis among blood donors from two cities in the Colombian Caribbean between 2021 and 2023.

Materials and Methods: A descriptive, cross-sectional, and retrospective study was conducted using secondary data from participating blood banks. Donors with reactive syphilis tests were included, and sociodemographic variables as well as coinfections with other infectious markers were analyzed. Descriptive and comparative statistical analyses were performed using GraphPad Prism 8.

Results: A total of 904 donors with reactive syphilis tests were identified: 42% in Cartagena and 58% in Sincelejo. Of these, 77.6% were male, a statistically significant difference (p = 0.008). The median age was 38 years, with the 29–39 age group being the most prevalent. Annual positivity rates exceeded the national average throughout the study period. Coinfection with other markers was found in 9.6% of cases, with hepatitis B virus being the most frequent.

Conclusion: Syphilis reactivity among blood donors in the Colombian Caribbean was higher in men and consistently above the national average. Although it was not possible to differentiate between active and past infection, the findings help identify key populations and guide prevention strategies for syphilis and other sexually transmitted infections.

Human Metapneumovirus: An Emerging Challenge for Public Health

Cristihian Gabriel Marin Ortega — Mon, 22 Sep 2025 00:00:00 +0000

Human metapneumovirus (hMPV) is a negative-sense single-stranded RNA virus, discovered in 2001, that belongs to the Paramyxoviridae family. This respiratory pathogen causes acute infections in individuals of all ages, being potentially severe in children, the elderly, and immunocompromised individuals. The epidemiology of hMPV shows seasonal prevalence, distributed globally, often coexisting with other respiratory viruses. The pathogenesis of hMPV involves the infection of epithelial cells in the lower respiratory tract, leading to symptoms ranging from mild colds to severe bronchiolitis and pneumonia. Clinical manifestations include fever, cough, wheezing, and dyspnea. Diagnosis is made using methods such as polymerase chain reaction (PCR) and rapid antigen tests. As for treatment, there is no specific antiviral; symptoms are managed with respiratory support and fluids. Prevention relies on hygiene measures, such as handwashing and avoiding close contact with infected individuals, with no vaccines currently available.

Glucose Transporter Type 1 (GLUT1) Deficiency Syndrome: A Case Report

Mon, 22 Sep 2025 00:00:00 +0000

The human brain represents only 2% of an adult individual's body weight. However, it requires 25% of the energy consumed by the body. This energy, primarily delivered to the brain in the form of the nutrient glucose, must cross the blood-brain barrier (BBB) through glucose transporter 1 (GLUT1), the main cerebral hexose transporter. Therefore, the levels of this transporter could affect brain function.

It is now recognized that Glut1 Deficiency Syndrome is significantly underreported. It follows an autosomal dominant inheritance pattern, with 90% of cases resulting from de novo mutations, while a small percentage are inherited in an autosomal recessive manner.

This report reviews the case of an adult patient with refractory epilepsy and progressive deterioration, whose clinical characteristics and genetic study confirmed the SLC2A1 mutation, establishing the diagnosis and highlighting the importance of considering this condition in differential diagnoses.

Therapeutic Value of Antivenoms in the Treatment of Snakebite Envenoming in Latin America: A Scoping Review

Mon, 22 Sep 2025 00:00:00 +0000

Introduction: Snakebites are an underestimated public health problem in rural areas of tropical and subtropical regions, with impoverished rural populations being the most affected due to their limited access to health services.

Objective: Realize a scoping review to synthesize the available evidence and identify knowledge gaps in therapeutic management and the efficacy of antivenoms for the treatment of snakebites in Latin America.

Results: Eleven selected studies showed that both monovalent and polyvalent antivenoms were effective in the treatment of snakebite envenoming.

Conclusions: All antivenoms evaluated in the studies were effective and safe for treating snakebite envenoming. It is important that hospitals and health centers have effective, affordable, and safe antivenoms to reduce patient care times.

Specialization in Health Systems Management at UTP: Three Decades Shaping the Future of Healthcare in Colombia

Alberth Cristian — Mon, 22 Sep 2025 00:00:00 +0000