Alexandra Hurtado-Ortiz

Background/Objectives: The HER2-low classification has redefined therapeutic strategies, but its prognostic significance remains uncertain. We compared overall survival (OS) and progression-free survival (PFS) across HER2 categories (HER2-low, HER2-negative, HER2-positive) in a real-world cohort. Methods: This was a single-center retrospective cohort study conducted at a high-complexity cancer center in Colombia; it included 373 patients with invasive breast cancer classified as HER2-positive (IHC 3+ or ISH+), HER2-low (IHC 1+ or 2+/ISH−), or HER2-negative (IHC 0). Survival was estimated by Kaplan–Meier. Multivariable Cox models were adjusted for age, clinical stage, histological grade, and hormone receptor status, and PFS was additionally analyzed separately in stage I–III and stage IV disease. Results: The cohort included HER2-low (38.3%), HER2-negative (39.7%), and HER2-positive (22.0%) tumors. HER2-low tumors showed lower grade and higher hormone receptor expression (p < 0.001), without better survival. Three-year OS (81.8%, 76.5%, 62.8%; p = 0.178) and PFS (p = 0.227) did not differ. Advanced stage remained the main determinant of mortality, whereas the association with high grade was attenuated. HER2-low was not independently associated with OS (HR 0.67; 95% CI 0.31–1.45) or PFS (HR 0.77; 95% CI 0.40–1.49). Hormone receptor positivity was associated with lower mortality (HR 0.43; 95% CI 0.21–0.88). PFS did not differ across HER2 categories in stage I–III (p = 0.307) or stage IV disease (p = 0.068). Conclusions: HER2-low status was not independently associated with survival. Its more favorable clinicopathological profile was largely explained by higher hormone receptor expression, which was itself associated with survival once included in the models.

Background: Hospital‐associated deconditioning (HAD) affects up to 30% of older adults during acute hospitalization, leading to functional and cognitive decline and adverse long‐term outcomes. Purpose: To develop and pilot “Let's Move,” an implementation‐oriented early exercise program designed to support mobility in hospitalized patients. Methods: An action‐research study was conducted at a tertiary hospital in two stages: (i) program design based on an electronic health record (EHR) needs assessment and targeted protocol review; and (ii) pilot implementation among clinically stable adults aged ≥ 18 years, hospitalized for ≥ 48 h, without physiotherapy referral. Outcomes included Hopkins Highest Level of Mobility (JH‐HLM) functional status, adherence, and safety, complemented by qualitative interviews and a focus group. Results: In Stage 1, 1399 adult inpatients without rehabilitation referral were identified (median age, 65 years [IQR, 46–78]; length of stay, 3 days [IQR, 2–4]) with circulatory diseases predominating (57.18%). Among 26 participants enrolled in the pilot, 17 were evaluable for adherence, with 13 (76.5%) classified as adherent. Walking ≥ 75 m was the most frequent JH‐HLM assessment category, no adverse events or in‐hospital deaths occurred, and 25/26 participants (96.2%) achieved individualized goals. Qualitative findings supported relevance and feasibility and informed refinements, including sessions every 2 days and standardized educational materials. Discussion: “Let's Move” is a structured early‐mobilization program developed through action research that integrates brief patient education with low‐intensity exercise for routine inpatient care. It provides a practical workflow to support early mobility and warrants broader evaluation to assess its effectiveness and scalability.

Background/Objectives: Early risk stratification in acute myocardial infarction (AMI) requires accessible and cost-effective tools. Complete blood count-derived inflammatory indices may provide readily available markers of immunothrombotic activity. The objective of this study was to evaluate the association between inflammatory indices derived from the complete blood count at admission and in-hospital mortality among patients with acute myocardial infarction treated at a high-complexity cardiovascular center. Methods: We conducted a retrospective cohort analysis of prospectively collected data from adults with type 1 AMI treated at a high-complexity cardiovascular center in Colombia between 2021 and 2025. Complete blood count parameters at admission were used to calculate hematological inflammatory indices. The primary outcome was all-cause in-hospital mortality. Associations were evaluated using logistic regression models. Discrimination was assessed using ROC curves, and restricted cubic splines and sensitivity analyses were used to evaluate nonlinearity and robustness. Results: Among 3768 patients, 143 (3.8%) died during hospitalization. Non-survivors had higher NLR, SIRI, SII, and AISI values (all p < 0.001). After adjustment, SIRI (OR 1.94, 95% CI 1.62–2.32), NLR (OR 1.89, 95% CI 1.57–2.27), NPR (OR 1.86, 95% CI 1.56–2.22), and AISI (OR 1.83, 95% CI 1.53–2.19) showed the numerically largest adjusted associations with mortality. Discriminatory performance was modest, with the numerically highest AUROC observed for NPR (0.723), followed by SIRI (0.716) and NLR (0.706). Conclusions: Inflammatory indices were associated with in-hospital mortality in type 1 AMI, but their discriminatory ability was modest. These indices may serve as complementary markers of inflammatory risk.

Introduction. Robotic orthopedic surgery was introduced in Colombia in late 2023, representing a major technological advancement in joint replacement surgery. This study aimed to describe the sociodemographic characteristics, perioperative variables, and clinical outcomes of the first 100 patients undergoing robot-assisted total hip and knee arthroplasty using the Mako® robotic arm system in a high-complexity institution in Colombia. Methodology. A cross-sectional study was conducted between December 2023 and July 2024, including the first 100 patients undergoing robot-assisted total hip and knee arthroplasty. Clinical and demographic variables were obtained from electronic medical records. Continuous variables were summarized using descriptive statistics, while categorical variables were reported as frequencies and percentages. Results. Among the 100 patients, 69% were women, with a median age of 72 years (IQR 66–78). Most procedures corresponded to primary tricompartmental total knee arthroplasty. Regional anesthesia was administered in 96% of patients, and 94% received postoperative opioids. Hemoglobin levels decreased from 13.2 g/dL to 11.7 g/dL (p<0.001). Discussion. The initial implementation of robot-assisted arthroplasty demonstrated favorable perioperative and postoperative outcomes, supporting the feasibility and safety of robotic orthopedic surgery in a middle-income country context. Conclusions. Robotic orthopedic surgery showed positive early clinical outcomes and may contribute to optimizing surgical precision and postoperative recovery in joint replacement procedures.

Introduction. Statins are essential for cardiovascular prevention, but their use in individuals over 75 is debated due to potential adverse effects, limited trial data, and guidelines primarily support their use up to said age. With an aging population and a rising burden of cardiovascular disease, optimizing lipid-lowering strategies in older adults is increasingly important. Objective. To review the current evidence on the risks and benefits of statin therapy in adults over 70 years of age. Methods. A search was conducted in PubMed, Embase, Scopus, and Google Scholar, including articles published between January 2020 and February 2025, with no language restrictions. Observational studies, clinical trials, systematic reviews, and case reports on statin use in individuals over 70 years old were analyzed. Two independent reviewers selected the articles, with a third resolving discrepancies. Results. This review included 18 studies (1,015,142 participants), with varying designs and geographic representation. Atorvastatin and rosuvastatin were the most commonly used statins. Myalgias were the most frequent adverse event (38.89%), followed by rare severe liver disease, sarcopenia, and new-onset diabetes (5.56% each). Ten studies (55.56%) supported statin use, emphasizing cardiovascular benefits. Conclusion. This review supports the use of statins in older adults for primary cardiovascular prevention, while emphasizing the need for individualized risk-benefit assessment. Statin prescriptions should be tailored to age and comorbidities to optimize safety and efficacy.

Frailty has recognized prognostic value in cardiovascular disease, but its relationship with health-related quality of life (HRQoL) after heart transplanta