Revista Médica Sanitas

From clinical cases to collective knowledge

Iván Pradilla — 2025-08-22

How Do Monoclonal Antibodies Work in HIV Treatment?

Danna Gabriela Jiménez — 2025-08-22

Introduction: Human Immunodeficiency Virus (HIV) remains one of the major global health challenges. Although significant progress has been made in treatment over recent decades, the search for new therapeutic strategies has led to the exploration of monoclonal antibodies (mAbs)—engineered proteins designed to recognize specific antigenic epitopes—with potential to enhance the immune response against HIV. Methods: A systematic search was conducted in the PubMed database, including articles in English and Spanish using the MeSH terms: “HIV”, “Monoclonal Antibodies”, and “CD4 Lymphocyte”. After screening titles and abstracts, 21 studies were selected for qualitative synthesis. Results: The selected studies report significant efficacy of neutralizing mAbs against various HIV strains, particularly those derived from CD4 T cell membrane fragments. These antibodies not only block viral entry but also promote macrophage activation, aiding in the elimination of infected cells. Additionally, the role of CCR5 coreceptor inhibitors is highlighted as key biomarkers in disease progression. Various mechanisms of action of mAbs are described, targeting viral entry and replication in host target cells. Conclusions: Monoclonal antibodies represent a promising therapeutic alternative in the treatment of HIV, offering potential advantages in specificity, efficacy, and safety. However, further high-quality, low-bias studies are required to validate these benefits and assess their impact on clinically relevant outcomes.

Recent advances and findings in the diagnosis of Helicobacter Pylori

Sofía Forero-Giraldo — 2025-08-22

Helicobacter pylori (H. pylori) is a gram-negative bacterium that colonizes the human gastric mucosa and is closely linked to conditions such as chronic gastritis, peptic ulcer disease, and gastric cancer. Since its isolation in 1982 by Marshall and Warren, its pathogenic role has been extensively studied. This state-of-the-art review analyzes recent advances in its morphology, epidemiology, diagnosis, antimicrobial resistance, and immune interaction. A systematic search in databases such as PubMed and BVS yielded 32 studies published since 2000. High prevalence rates are reported in low-resource regions, with genetic variability among strains influencing virulence and antibiotic resistance. Mixed infections are common, and transmission occurs mainly via oral routes. Significant limitations are identified in current diagnostic methods, along with rising resistance to antibiotics such as metronidazole and levofloxacin. Additionally, immune and virulence factors are explored to explain its persistence and oncogenic potential. The evidence underscores the need for more accurate diagnostic tools and personalized treatments based on the genomic profile of circulating strains.

Literature review: Analysis of 9 types of reviews and their methodological approaches

Johana Benavides-Cruz — 2025-08-22

A literature review is a systematic analysis of previous studies on a specific topic. Its purpose is to synthesize existing evidence, identify gaps in knowledge, and provide a theoretical framework to guide future research, clinical decisions, and policy formulation. However, the lack of standardization in methodologies hinders the comparability and replicability of these studies. Although they can synthesize large amounts of evidence and draw robust conclusions, they face challenges such as bias in the selection of studies and the lack of clear criteria for assessing the quality of evidence. This research became increasingly important with the rise of evidence-based practice, particularly in the field of health and health research. However, the diversity of approaches and terminologies can lead to confusion. This article aims to provide a comprehensive overview of ten different types of literature reviews, focusing on their methodological characteristics, the questions they can address, their strengths and limitations, and the types of analyses that can be performed.

Tuberculosis as an ANCA-positive vasculitis mimicker

Valentina Pedreros-Cleves — 2025-08-22

ANCA-associated small vessel vasculitis and tuberculosis are medical conditions that share similar symptoms and diagnostic challenges, primarily affecting the pulmonary and renal systems. We present the case of a 56-year-old man who was initially treated for tuberculosis due to pulmonary nodules and caseating granulomas. Subsequently, positive ANCA antibodies and necrotizing glomerulonephritis were detected, leading to the diagnosis of granulomatosis with polyangiitis (GPA). Immunosuppressive treatment with cyclophosphamide was initiated, resulting in clinical improvement. A thorough evaluation, including medical history, laboratory tests, imaging studies, and sometimes biopsies, is essential for accurate diagnosis and appropriate treatment. Early and accurate identification of these conditions is essential to reduce the morbidity and mortality associated with delays in diagnosis.

How might toilet paper orientation be a behavioral marker of anxiety?

Ana María Torres-Arias — 2025-08-22

Background: Anxiety is characterized by a persistent state of excessive worry, often resulting in compulsive behaviors. This study explores the relationship between preferred toilet paper position and anxiety symptoms in medical students. Objective: To determine whether toilet paper end position preference is associated with anxiety symptoms in medical students at the Fundación Universitaria Sanitas. Methodology: A cross-sectional observational study was conducted using a virtual survey. Sociodemographic characteristics, presence of compulsive behavior, and anxiety symptoms were assessed using the GAD-7 scale validated in Spanish. A bivariate analysis was performed to explore differences in GAD-7 scores in relation to toilet paper position preference. Results: The final analysis included 147 students (69.86% female; median age: 19 years). Sixty-six percent (n=97) showed a toilet paper position preference, predominantly outward. Anxiety symptoms were present in 83.56% of the participants; 17 were classified as having severe anxiety. Females placed more importance on the toilet paper position (p = 0.017). Those with this preference had higher GAD-7 scores (median 9 vs. 7 points; p = 0.004). Conclusions: There is a significant association between toilet paper position preference and anxiety symptoms. These compulsive behaviors may be related to other personality factors.

Current approach to solid organ donation in Colombia, its bioethical considerations and regulation

Nicolás Campos-Espitia — 2025-08-22

La donación de órganos sólidos constituye una de las intervenciones médicas más complejas y éticamente sensibles de la medicina contemporánea. Este acto voluntario, orientado al beneficio de un tercero, está cimentado sobre principios éticos fundamentales como la autonomía, la beneficencia y la justicia distributiva. En Colombia, la regulación de la donación y trasplante de órganos ha evolucionado significativamente, adaptándose a nuevos desafíos sociales, médicos y bioéticos, particularmente desde la implementación de la Ley 1805 de 2016.

Si bien los antecedentes históricos del trasplante de órganos pueden rastrearse en la literatura y en relatos antiguos, los avances reales son recientes y responden al desarrollo de técnicas quirúrgicas, la comprensión de la inmunología y la consolidación de marcos regulatorios (1,2). El primer trasplante renal exitoso ocurrió en 1954 y el de pulmón en 1968 (3,4). Estos hitos abrieron el debate ético sobre los criterios de selección, consentimiento y equidad en el acceso, temas aún vigentes.