HighlightsSSR is mainly caused by one of three conditions: hematological malignancies, infectious diseases, and other inflammatory or neoplastic disorders.CML is one of the main causes of SSR along with Hodgkin lymphoma.Three mechanisms are believed to cause SSR: parenchymal congestion and concomitant coagulopathy, leadingto splenic hemorrhage and infarction.In only 19 % of reported cases, SSR was diagnosed correctly; most common differential diagnoses include hepatic and biliary pathologies.Timely diagnosis and treatment improves survival rate and reduces complications.

Background Integrated Management of Childhood Illnesses (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF in 1992. It was deployed as an integrated approach to improve children’s health in the world. This strategy is divided into three components: organizational, clinical, and communitarian. If the Integrated Management of Childhood Illnesses implementation-related factors in low- and middle-income countries are known, the likelihood of decreasing infant morbidity and mortality rates could be increased. This work aimed to identify, from the clinical component of the strategy, the implementation-related factors to Integrated Management of Childhood Illnesses at 18 Colombian cities. Methods A quantitative cross-sectional study was performed with a secondary analysis of databases of a study conducted in Colombia by the Public Health group of Universidad de Los Andes in 2016. An Integrated Care Index was calculated as a dependent variable and descriptive bivariate and multivariate analyses to find the relationship between this index and the relevant variables from literature. Results Information was obtained from 165 medical appointments made by nurses, general practitioners, and pediatricians. Health access is given mainly in the urban area, in the first level care and outpatient context. Essential medicines availability, necessary supplies, second-level care, medical appointment periods longer than 30 min, and care to the child under 30 months are often related to higher rates of Integrated Care Index. Conclusion Health care provided to children under five remains incomplete because it does not present the basic minimums for the adequate IMCI’s implementation in the country. It is necessary to provide integrated care that provides medicine availability and essential supplies that reduce access barriers and improve the system’s fragmentation.

Background: Integrated Management of Childhood Illnesses (IMCI) is a strategy developed by the World Health Organization (WHO) and UNICEF in 1992. It was deployed as an integrated approach to improve children's health in the world. This strategy is divided into three components: organizational, clinical, and communitarian. If the related factors to Integrated Management of Childhood Illnesses in low- and middle-income countries are known, the likelihood of decreasing infant morbidity and mortality rates could be increased. Objective: To identify, from the clinical component of the strategy, the related factors to Integrated Management of Childhood Illnesses at 18 Colombian cities. Methods: A quantitative cross-sectional study was performed with a secondary analysis of databases of a study conducted at Colombia by the Public Health group of Universidad de Los Andes in 2016. An Integrated Care Index was calculated as a dependent variable and descriptive bivariate and multivariate analyses to find the relationship between this index and the relevant variables from literature. Results: Information was obtained from 165 medical appointments made by nurses, general practitioners, and pediatricians. Health access is given mainly in the urban area, in the first level care and outpatient context. Essential medicines availability, necessary supplies, second level care, medical appointment periods longer than 30 minutes and care to child under 30 months are often related to higher rates of Integrated Care Index Conclusion: Health care provided to children under five remains incomplete because it does not present the basic minimums for the adequate IMCI´s implementation in the country. It is necessary to provide integrated care that provides medicine availability and essential supplies that reduce access barriers and improve the system's fragmentation. Keywords Health care, infant mortality, IMCI, Primary health care.

Background In Colombia, official statistics indicate that infant mortality by 2020 would reach 7.22 per thousand live births. Prevalent and preventable diseases represent 70% of total infant mortality, so strategies such as Integrated Management of Childhood Illnesses (IMCI) are still relevant for the country. This research seeks to establish whether the professionals trained in IMCI between 2011 and 2015 apply the strategy in the prevention and care of children under 5 years of age. Methods A cross-sectional study was carried out in general practitioners, nurses and pediatricians who had some level of training in the IMCI strategy between 2012 and 2015. A survey based on the basic competences established in the framework of the IMCI strategy was used: evaluate, classify, and treat and, in addition, the basic care registry component was incorporated. Results Skills in the IMCI Strategy were observed in 259 consultations for children. 229 children were between 2 months and 5 years old, 30 children were between 0 and 2 months old (84.4% vs 11.6%, respectively). 51.4% of the evaluations were carried out in the Public Health Service Provider Institutions (HPIs) compared to 48.6% (126/259) in the private HPI. In children from 0 to 2 months, 92% of general practitioners, 82.58% of nurses, and 59.39% of pediatricians correctly assessed danger signs. In children from 2 months to 5 years, the health professional who best evaluated the danger signs was the pediatrician with a 70% correct evaluation, followed by nurses and general practitioners with a 65% correct evaluation. Conclusions Pediatricians were shown to perform better on the IMCI strategy in children 2 to 5 years of age. However, in the 0–2-month age group, general practitioners and nurses outperformed pediatricians on the IMCI strategy