Icesi University

Background To achieve optimal outcomes, adolescents with chronic or end-stage kidney disease must undergo healthcare transition (HCT) preparation from a pediatric- to an adult-focused setting. The pediatric nephrology group at the Fundación Valle del Líli in Cali, Colombia, collaborated with the University of North Carolina Chapel Hill STARx Program and Hospital Infantil de México Federico Gómez to start an HCT preparation program using their tools. The objective of this study was to evaluate the efficacy of the “ALL YOU NEED IS LOVE” syllabus (Spanish version) and its effects on HCT readiness in young patients with kidney failure, including renal transplants. Methods We conducted a pre-test/post-test quasi-experimental study without control group in 11- to 21-year-old consecutive patients with kidney failure followed at the Fundación Valle de Lili. Using the TRxANSITION Index, we measured HCT readiness skills before and after implementing the “ALL YOU NEED IS LOVE” syllabus, an educational curriculum delivered in three monthly 2-hour sessions. Analysis was performed using linear mixed models in R Studio software to evaluate intervention effects while accounting for participant characteristics. Results We enrolled 35 patients (57% female, median age 15.4 years [IQR: 12.6–17.1]). Most patients (77%) had received dialysis pre-transplant and 68% had congenital anomalies of the kidneys and urinary tract. Mothers were primary caregivers for 85% of patients. Linear mixed models showed that post-intervention scores increased significantly across all measures (β = 3.28, 95% CI 2.64–3.92, p < 0.001 for transition scores; β = 1.93, 95% CI 1.48–2.38, p < 0.001 for parent scores; β = 9.31, 95% CI 7.66–10.96, p < 0.001 for total scores). College education was associated with higher baseline scores (β = 2.38, 95% CI 0.42–4.35, p = 0.019 for transition scores; β = 7.58, 95% CI 1.23–13.93, p = 0.021 for total scores). Male participants showed slightly lower initial scores (β = − 0.88, 95% CI − 1.76 to 0.00, p = 0.051). Conclusion In this cohort of youth with kidney failure from Cali, Colombia, implementation of the Spanish version of the “ALL YOU NEED IS LOVE” syllabus was associated with significant improvements in HCT readiness. Linear mixed models demonstrated robust intervention effects across all domains, with educational level emerging as a significant moderator of intervention effectiveness. Further longitudinal studies are needed to evaluate the long-term impact and sustainability of these improvements in transition readiness scores. Trial Registration This study was retrospectively registered at ClinicalTrials.gov (NCT06836544, https://clinicaltrials.gov/ct2/show/NCT06836544) on February 10, 2025.

Enuresis is a common pathological condition in children aged 6–12 years and adolescents, with percentages varying from 10% to 12% and 1%, respectively. It is mainly associated with genetic causes because a family history of enuresis is one of the main risk factors for suffering from the disease. Its pathophysiological mechanisms are still under discussion. However, it is mainly associated with deficiency at the level of hormones, such as antidiuretics, which are altered with circadian cycles, parasympathetic system alterations and sphincter‐level problems. To determine the association between the development of enuresis as an early marker in children presenting neurological and behavioural problems. The review found 14 articles that support the strong association between enuresis and various behavioural alterations in children and adolescents, as well as neuropsychological, growth and learning problems. With the advancement of multidisciplinary health teams and a better understanding of conditions that were previously considered part of the expected growth process, it has been recognised that enuresis can be an early clinical sign of mental conditions that, if not addressed, can affect the quality of life and socialisation capacity of children in adulthood. The evidence provided so far shows a strong relationship between enuresis and problems of depression, anxiety, hyperactivity and issues such as obsessive–compulsive syndrome, among others, allowing paediatric urology an early approach to the identification of the issues at the mental health level, even before they are very evident, proposing an alternative for alerting and managing this type of patient.

Driven by their growing impact on countries’ economic development, research on management teams in new technology-based firms (NTBFs) has intensified in recent years, aiming to identify the success and failure factors of these companies, given their high mortality rates. This study investigates the influence of human capital, technological capability, and access to finance on the sustainability over time of new technology-based firms (NTBFs). We employed a PLS-SEM model and data from the Global Entrepreneurship Index (2018), the Digital Platform Economy Index (2020), and the Global Innovation Index (2023), integrating information from 106 countries. Our results show a significant and positive relationship between: (a) technological capability and access to finance, indicating that greater financial resources lead to more robust technological development; and (b) both technological capability and human capital, which directly influence the long-term growth and sustainability of NTBFs. Prior work and entrepreneurial experience within the management team emerged as the strongest predictor of firm survival. These findings suggest entrepreneurs should prioritize experienced teams and innovative models based on new technologies, while policymakers should focus on human capital development, technology-based innovation, and broader access to financing to promote sustainable growth over time of NTBFs.

The quality and magnitude of the immune and inflammatory responses determine the clinical outcome of Leishmania infection, and contribute to the efficacy of antileishmanial treatments. However, the precise immune mechanisms involved in healing or in the chronic immunopathology of human cutaneous leishmaniasis (CL) are not well understood. Through sequential transcriptomic profiling of blood monocytes, neutrophils, and eosinophils over the course of systemic treatment with meglumine antimoniate, we revealed that a heightened and sustained Type-I interferon response signature is a hallmark of treatment failure (TF) in CL patients infected with Leishmania (Viannia) panamensis and L.V. braziliensis. The transcriptomes of pre-treatment, mid-treatment and end-of-treatment samples were interrogated to identify predictive and prognostic biomarkers of TF. A composite score derived from the expression of 11 differentially expressed genes (common between monocytes, neutrophils and eosinophils) is predictive of TF. Similarly, machine learning models constructed using data from pre-treatment as well as post-treatment samples, accurately classify treatment outcome into cure and TF. Results from this study instigate the evaluation of Type-I interferon responses as immunological targets for host-directed therapies for the treatment of CL, and highlight the feasibility of using transcriptional signatures as predictive biomarkers of outcome for therapeutic decision making.

Background Static echocardiography-guided pericardiocentesis, the current standard of care, uses a phased-array probe to locate the largest fluid pocket, marking the safest entry site and needle trajectory. Nevertheless, real-time needle visualization throughout the procedure would potentially increase success and decrease complications. The aim of this study was to assess the complication rates of the real-time in-plane ultrasound-guided technique compared to the traditional static echocardiography-guided pericardiocentesis. Methods All adult patients who underwent pericardiocentesis in a tertiary care hospital from January 2011 to June 2024 were identified. The incidence of total complications of the real-time, in-plane, US-guided pericardiocentesis versus the static echocardiography-guided technique was compared using a regression model with overlap weighting, based on propensity scores, to adjust for confounding factors. Results A total of 220 pericardiocentesis were identified, 91 with real-time, in-plane US-guided technique and 129 with a static echo-guided approach. The overall rate of total complications was 5.5%, with no significant difference between both techniques (IRR 1.06 [95% CI 0.98 to 1.16, p = 0.163]). Only one major complication was reported with the in-plane technique (pulmonary edema) compared to four major complications in the echo-assisted approach (three cardiac injuries and one injury to thoracic vessels), all of which required emergency surgery. The success rate was higher in the real-time in-plane US-guided procedures (97%) compared to the static echo-guided approach (93%). Conclusions In this single-center retrospective cohort study, real-time in-plane, US-guided pericardiocentesis technique was safe, and the rate of total complications was not significantly different from a static echo-guided approach. The low rate of major complications and high success rate underscores the potential use of this technique in emergency situations by well-trained physicians. Future studies are warranted to thoroughly assess the potential benefits of the real-time approach.

Introduction The increasing prevalence of extrapulmonary nontuberculous mycobacterial (NTM) infections poses significant challenges in clinical management due to their inherent drug resistance, the need for prolonged antibiotic regimens and the complexities associated with surgical management. Although these infections are infrequent in daily clinical practice, detailed information on associated clinical outcomes is lacking in the local literature. Materials and methods This descriptive observational study examined 17 patients with extrapulmonary NTM infection from the General Mycobacteria Registry of Fundación Valle del Lili University Hospital (FVL), a leading reference care center located in Cali, a city in southwestern Colombia. Notably, Cali is classified as a high-risk area for tuberculosis. The study reviewed a total of 391 patients between 2007 and 2021. Results A predominance of women with a history of cosmetic surgery was observed, with the skin being the most common site of involvement, especially for M. fortuitum complex and M. abscessus complex. Clarithromycin based therapy was given to 14/18 (82.3%) of the patients. The mean duration of treatment was 4–6 months, for a cure rate of 15/17 (88.2%). Conclusion The treatment regimens implemented mostly align with the literature recommendations. However, it is essential to note that while the observed cure rate exceeds 80%, this assertion is tempered by the limitation imposed by the lack of confirmatory imaging in some cases. A contributing factor to the higher cure rate observed in this study may be the use of more extensive surgical interventions, with some patients undergoing more than one procedure. Given the limited number of case series on extrapulmonary nontuberculous mycobacterial infections, these findings emphasize the potential importance of surgical management in achieving higher cure rates. The observed cure rate suggests potentially better clinical management of these infections in our region and underscores the need for future research to understand the factors contributing to this comparative therapeutic success.

Background Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe cutaneous reactions induced by delayed drug hypersensitivity, characterized by their complexity and multisystemic nature. Their diagnosis and management are challenging and require a multidisciplinary approach. Identifying the culprit drug is crucial to ensure that the patient has access to safe therapeutic options in the future. To date, there are no specific Latin American guideline or consensus documents on SJS/TEN. Objective To develop a Latin American guideline on the clinical diagnosis, management, and treatment of SJS/TEN, based on available scientific evidence and the experience of experts from various medical specialties. Methods This guideline was developed by a group of Latin American allergists and dermatologists involved in the management of SJS/TEN. A search of scientific publications was conducted, and the expert group evaluated the available evidence in the literature, providing grades of recommendation. In cases where there was insufficient evidence, consensus was reached among the experts. Results The Latin American guidelines on SJS/TEN were developed, addressing relevant practical aspects of clinical diagnosis, and the identification of culprit drugs using the ALDEN (Algorithm of Drug Causality for Epidermal Necrolysis). It also offers recommendations on management, treatment, and prevention of complications, along with a specific algorithm for disease management. This guideline includes a therapeutic strategy, developed and agreed upon by expert specialists involved in the treatment of SJS/TEN.

Background Septic shock is commonly associated with reduction in vasomotor tone, mainly due to vascular hyporesponsiveness to norepinephrine (NE). Although the diastolic arterial pressure (DAP)/heart rate (HR) ratio reflects vasomotor tone, it cannot be a reliable index of vascular responsiveness to NE (VNERi). We hypothesized that adjusting DAP/HR for the NE dose could yield a VNERi value (VNERi = DAP/(NE dose x HR)), knowledge of which can help guiding therapeutic strategies in cases of persistent hypotension despite NE (e.g., increasing NE doses vs. introducing additional vasopressors). For our hypothesis be valid, at least VNERi should demonstrate a stronger association with patient outcome than DAP, DAP/HR or mean arterial pressure (MAP)/NE dose, a global marker of NE responsiveness. Methods We conducted a post-hoc analysis of the ANDROMEDA-SHOCK database. Hemodynamic variables and initial NE doses were recorded at the randomization time-point, within 4 h of septic shock diagnosis. NE doses were expressed in µg/kg/min (using the bitartrate NE formulation). A multivariate model was employed to compare the associations between these variables and key clinical outcomes, including in-hospital mortality, numbers of vasopressor-free days and of renal replacement therapy (RRT)-free days up to day 28. Results The ANDROMEDA-SHOCK database included 424 patients with septic shock receiving NE. The median DAP was 52 mmHg [IQR: 45–50] and the median NE dose at inclusion was 0.2 µg/kg/min [IQR: 01-0.4]. In-hospital mortality was 43%. VNERi demonstrated the strongest association with in-hospital mortality compared to DAP, DAP/HR, and MAP/NE dose, emerging as the most significant covariate in the multivariate model. Similar findings were found for the associations with numbers of vasopressor-free days and RRT-free days up to day 28. The model revealed an inverted J-shaped relationship between in-hospital mortality and VNERi, with a nadir point at 6.7, below which mortality increased. Conclusions In patients receiving NE during early septic shock, VNERi demonstrated the strongest association with outcome compared to DAP, DAP/HR, and MAP/NE dose. Due to its physiological basis and robust association with outcomes, VNERi may serve as a valuable bedside marker of the vascular responsiveness to NE. This index could potentially be integrated into decision-making of early septic shock.

Patients on non-invasive ventilation (NIV) often require concomitant treatment with enteric tube placement and aerosol medication. We aimed to describe the creation and implementation of a novel tube and inhaler adaptor for NIV (TIA-NIV). The design of TIA-NIV, validation, intellectual property and sanitary registry, as well as ecodesign and commercial isolation processes, is described. TIA-NIV’s effectiveness was initially assessed in a non-randomised quasi-experimental study, which demonstrated increased comfort and reduced air leaks compared with conventional NIV (p<0.001). This novel adaptor shows promise in improving the care of patients receiving NIV and providing its availability in all clinical settings. Further studies are needed in order to evaluate the clinical impact of using TIA-NIV in patients undergoing NIV.

Due to the low frequency and nature of electric injuries, and the different implied mechanisms of trauma, which can manifest in different organs and systems depending on the time of exposure, voltage, amperage and intrinsic resistance of body tissue, the presentation and consequences of the trauma are heterogeneous, and difficult to characterize. We present the case of a previously healthy adult patient who had a high voltage electric injury, resulting in a diffuse brain leukoencephalopathy with delayed image presentation in MRI as an early complication, and a short review of the mechanisms of electric injury which will help us to understand this pathology and its manifestations in the central nervous system.

Insects use volatile organic compounds (VOCs) as environmental cues for resource-searching. Volatile cues provide information that can attract pollinators and natural enemies or repel crop pests. Naturally occurring VOCs are valuable tools for controlling and monitoring pests as part of integrative pest management strategies. However, their effectiveness as monitoring tools depends on the surrounding context, emphasizing the importance of evaluating their performance within the specific conditions in which they will be deployed. Delia platura (Meigen), or seedcorn maggot, is a globally distributed pest, often feeding on seeds of legumes, allium, and cereal grains. Adults of this pest rely on olfaction when searching for oviposition sites. To determine which cues are more attractive for D. platura, and if the attraction to certain cues depends on the surrounding crop context, a 2-factorial blocked experiment was conducted to test the individual and combined effects of previously reported attractants (silage alfalfa, fresh alfalfa, manure, fish meal, bone meal, soil, a commercially available attractant and control soils) and at-risk crop species (field corn, soybean, and snap bean) on adult response. There were differences between attractants and seed types but no interactions. Traps containing silage alfalfa attracted more flies than the controls and the commercially available attractant. Traps containing corn attracted more flies than those containing soybean. These results indicate that D. platura uses volatile cues to differentiate among attractant sources and seed types, and that future management practices could use the same attractant across the 3 crop systems.

Oleaginous yeasts have emerged as promising microbial cell factories for lipid production, offering sustainable alternatives to traditional sources of biodiesel and nutraceuticals. In this study, the lipid accumulation potential of yeast strains isolated from two freshwater aquatic ecosystems in Cali, Colombia, was evaluated to identify novel candidates for biotechnological applications. A total of 56 strains were tested for their oleaginous nature using a gravimetric lipid assay with glucose as a carbon source. Of the assessed strains, 46.15% exceeded 20% lipid yields relative to the dry biomass. Seven strains were selected using glycerol as a carbon source, but only five yeasts were further characterized for their lipid profiles. Molecular identification revealed diverse species, including Aureobasidium sp., Papiliotrema rajashtanensis, Rhodotorula spp., and Clavispora lusitaniae. The selected strains demonstrated unique lipid profiles, with high proportions of monounsaturated and polyunsaturated fatty acids, such as oleic acid (C18:1) and linoleic acid (C18:2). In particular, Aureobasidium sp. accumulated uncommon fatty acids such as petroselinic acid under conditions induced by glycerol. This fatty acid, which has a double bond in position 6,7 and a melting point of 33 °C, highlights its potential as an alternative to margarine production, as well as a precursor to sophorolipids, estolide esters, soaps, and plastics. Rhodotorula sp. exhibited very long-chain fatty acids such as docosadienoic and docosatrienoic acids in its lipid profile. These findings underscore the biotechnological value of yeasts from lentic aquatic systems as sustainable lipid producers, paving the way for innovations in biofuels, nutraceuticals, and oleochemicals. Supplementary Information The online version contains supplementary material available at 10.1007/s11274-025-04309-7.

Importance The use of hypertonic saline (HTS) vs mannitol in the control of elevated intracranial pressure (ICP) secondary to neurotrauma is debated. Objective To compare mortality and functional outcomes of treatment with 3% HTS vs 20% mannitol among children with moderate to severe traumatic brain injury (TBI) at risk of elevated ICP. Design, Setting, and Participants This prospective, multicenter cohort study was conducted between June 1, 2018, and December 31, 2022, at 28 participating pediatric intensive care units in the Pediatric Acute and Critical Care Medicine in Asia Network (PACCMAN) and the Red Colaborativa Pediátrica de Latinoamérica (LARed) in Asia, Latin America, and Europe. The study included children (aged <18 years) with moderate to severe TBI (Glasgow Coma Scale [GCS] score ≤13). Exposure Treatment with 3% HTS compared with 20% mannitol. Main Outcomes and Measures Multiple log-binomial regression analysis was performed for mortality, and multiple linear regression analysis was performed for discharge Pediatric Cerebral Performance Category (PCPC) scores and 3-month Glasgow Outcome Scale–Extended Pediatric Version (GOS-E-Peds) scores. Inverse probability of treatment weighting was also performed using the propensity score method to control for baseline imbalance between groups. Results This study included 445 children with a median age of 5.0 (IQR, 2.0-11.0) years. More than half of the patients (279 [62.7%]) were boys, and 344 (77.3%) had severe TBI. Overall, 184 children (41.3%) received 3% HTS, 82 (18.4%) received 20% mannitol, 69 (15.5%) received both agents, and 110 (24.7%) received neither agent. The mortality rate was 7.1% (13 of 184 patients) in the HTS group and 11.0% (9 of 82 patients) in the mannitol group ( P = .34). After adjusting for age, sex, presence of child abuse, time between injury and hospital arrival, lowest GCS score in the first 24 hours, and presence of extradural hemorrhage, no between-group differences in mortality, hospital discharge PCPC scores, or 3-month GOS-E-Peds scores were observed. Conclusions and Relevance In this cohort study of children with moderate to severe TBI, the use of HTS was not associated with increased survival or improved functional outcomes compared with mannitol. Future large multicenter randomized clinical trials are required to validate these findings.

Introduction Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, emphasizing the critical role of optimal medical therapy (OMT) in improving patient outcomes. Despite extensive research, most scientific evidence regarding HF is gathered and studied in developed countries, leaving substantial knowledge gaps regarding HF in Latin America and the Caribbean. Objective To characterize the sociodemographic and clinical profiles of HF patients and to assess their adherence to OMT in the Americas. Methods The AMERICCAASS Registry is a prospective, observational, multicenter study, including patients aged 18 and older, both hospitalized and ambulatory, and diagnosed with HF. Sociodemographic and clinical data were collected from the first 2,500 patients to characterize the study population. Adherence to OMT was subsequently evaluated according to left ventricular ejection fraction (LVEF). Results Among the 2,500 patients in the study, 36% were hospitalized and 64% were ambulatory. The median ages of the patients were 66.9 (hospitalized) and 66.3 years (ambulatory). Males made up 60.8% of hospitalized and 59.3% of ambulatory patients. The majority had HF with reduced LVEF (≤40%): 60.7% for hospitalized and 58.5% for ambulatory. The New York Heart Association (NYHA) functional class II predominated among ambulatory patients (67.9%), while NYHA functional class III predominated among hospitalized patients (46.6%). Only 21% of patients with reduced LVEF were receiving quadruple therapy, whereas 12.3% of patients with mildly reduced LVEF (41–49%) were on this treatment. Conclusion The findings demonstrate that the sociodemographic and clinical profiles of HF patients in the Americas are broadly consistent with international reports. However, the low use of OMT observed in this population underscores gaps in adherence to current guidelines. These results highlight the need for targeted strategies to improve pharmacological treatment adherence to optimize health outcomes in this region.

This study examines the relationships between critical thinking, metacognition, psychological well-being, and empathy using structural equation modeling. The study sample consists of 155 university students from a higher education institution in Spain, who completed the PENCRISAL, the metacognitive abilities inventory, the Ryff psychological well-being scale, and the empathy quotient, which assess these psychological constructs. The results indicate that critical thinking has a direct positive effect on metacognition, which, in turn, is significantly associated with higher levels of psychological well-being and empathy. These findings reinforce the essential role of critical thinking in fostering cognitive self-regulation and socioemotional competencies. Furthermore, this study provides empirical evidence supporting the integration of critical thinking into educational programs, emphasizing its potential to enhance reflective thinking, emotional awareness, and interpersonal understanding.

Degradation is a technical and market hurdle in the development of novel photovoltaics and other energy devices. Understanding and addressing degradation requires complex, time-consuming measurements on multiple samples. To address this challenge, we present \textit{DeepDeg}, a machine learning model that combines deep learning, explainable machine learning, and physical modeling to: 1) forecast hundreds of hours of degradation, and 2) explain degradation in novel photovoltaics. Using a large and diverse dataset of over 785 stability tests of organic solar cells, totaling 230,000 measurement hours, DeepDeg is able to accurately predict degradation dynamics and explain the physiochemical factors driving them using few initial hours of degradation. We use cross-validation and a held-out dataset of over 9,000 hours of degradation of PCE10:OIDTBR to evaluate our model. We demonstrate that by using DeepDeg, degradation characterization and screening can be accelerated by 5-20x.

Patients with Alzheimer’s disease (AD) have two types of abnormal protein buildups: amyloid plaques and neurofibrillary tangles, in addition to the early synaptic dysfunction associated with the enzymes acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE). Impairment of the glutamatergic system is also crucial for neuronal survival, as it can cause synaptic dysfunction that overstimulates glutamate receptors, especially N-methyl-d-aspartate receptors (NMDARs). Another protein affecting neuronal health is glycogen synthase kinase-3 (GSK3), a widely preserved serine/threonine protein kinase linked to neuronal disorders, including AD. In recent years, alkaloids from the Amaryllidaceae have received great attention for their known anticholinergic activity, as well as their antioxidant, antigenotoxic, and neuroprotective properties. In this context, the identification of compounds capable of interacting with different targets involved in AD provides a possible new therapeutic strategy. In this study, we conducted a combination of in vitro and in silico approaches to identify the potential of C. subedentata in regulating key proteins involved in AD. Viability and neuroprotection assays were performed to evaluate the neuroprotection exerted by C. subedentata extract against neurotoxicity induced by Aβ (1–42) peptide and Okadaic acid in SH-SY5Y cells. Computational methods such as docking and molecular dynamic and viability therapeutic analysis were conducted to explore the interaction of alkaloids from C. subedentata with target proteins (AChE, BuChE, NMDA, and GSK-3) involved in AD. Our findings show that C. subedentata extract exerts neuroprotective effects against neurotoxic stimuli induced by Aβ (1–42) peptide and Okadaic acid. In addition, in silico approaches provide insight into how C. subedentata extract alkaloids interact with key proteins involved in AD. These findings provide insights into the potential therapeutic effects and action mechanisms of these alkaloids. We hope these rapid findings can contribute as a bridge to the identification of new molecules with the potential to counteract the effects of AD.

Introduction Gastrointestinal infections represent a worldwide public health problem. In Colombia, the incidence reaches 21.4 cases per 1,000 inhabitants. Given the limitations of traditional diagnostic methods in terms of sensitivity and specificity, the gastrointestinal panel (GIP) has emerged as a promising tool, allowing rapid detection of 22 pathogens. This study aimed to describe the clinical and microbiological characteristics of immunosuppressed and immunocompetent adult patients with diarrhea and the influence of the gastrointestinal panel in their treatment in a high-complexity hospital in Colombia. Materials and methods A cross-sectional observational study was carried out including 350 adult patients treated at the Fundación Valle del Lili hospital between 2021 and 2022. Demographic and clinical variables, GIP findings and treatment were analyzed by univariate and bivariate analysis. We compare immunocompromised and immunocompetent adult patients using Chi-square tests, Fisher’s F test for qualitative variables, Student’s t-test, and the Mann-Whitney U test for quantitative variables. A significance level of 5% was applied to demonstrate the significance of the variables in all the tests used. Results The results showed that 52% were men, with an average age of 52 years. 72.0% presented acute diarrhea, being inflammatory in 60.1%. 39.1% of the patients were immunosuppressed, mainly transplant recipients (31.3%). 53% of the GIPs were positive, with up to 5 pathogens per sample. Bacteria were detected in 80%, viruses in 14.4%, and parasites in 5.5%. The most frequent bacteria were enteropathogenic E. coli (43.0%), enteroaggregative E. coli (18.6%), and C. difficile (17.4%). Norovirus was the predominant virus (67.7%) and Cryptosporidium the most common parasite (41.7%). A higher frequency of Vibrio spp. was observed in non-immunosuppressed patients (p = 0.004) and of enterotoxigenic E. coli in immunosuppressed patients. 41.0% of patients received antibiotic/antiviral therapy, 83% empirically. GIP influenced the treatment of 56.7% of patients, with a 90.0% recovery rate. Conclusion This study confirms that GIP is a valuable diagnostic tool in the management of adult patients with diarrheal disease, particularly in immunocompromised patients. In our setting it is still a costly and difficult to access test, which makes it necessary to standardize the indications for its application. Future studies could evaluate its cost-effectiveness in our context.

Background The inflammatory response associated with COVID-19 varies with sex, potentially affecting disease outcomes. Males have a higher risk of complications compared to females, requiring an evaluation of differences in inflammatory response severity based on sex. Objective To compare clinical data, biochemical biomarkers, and outcomes among hospitalized COVID-19 patients in Latin America and the Caribbean (LA&C) based on sex and to perform a cluster analysis of biomarker profiles for both sexes. Methods This prospective, multicenter observational registry made by the Inter-American Council of Heart Failure and Pulmonary Hypertension of the Inter-American Society of Cardiology included hospitalized COVID-19 patients from 44 hospitals in 14 countries in LA&C between May 1, 2020, and June 30, 2021. Results Of 3,260 patients (1,201 females and 2,059 males), males had higher C-reactive protein and ferritin levels, while females had higher natriuretic peptides and d-dimer levels. Males had more cardiovascular complications (acute coronary syndrome [3.3% vs. 2.2%], decompensated heart failure [8.9% vs. 7.8%], pulmonary embolism [4.4% vs. 2.9%]), intensive care unit (ICU) admissions (56.9% vs. 47.7%), and overall mortality (27.5% vs. 22.1%). Cluster analysis identified three groups: one with normal-range biomarkers but elevated ferritin, one with coagulation abnormalities, and one with an inflammatory profile linked to renal injury and increased non-cardiovascular mortality. Conclusions In the LA&C population hospitalized with COVID-19, males had higher inflammatory biomarker levels, correlating with increased cardiovascular complications and mortality. The cluster with an inflammatory profile showed higher non-cardiovascular mortality, while clusters with elevated ferritin levels were associated with increased ICU admissions.