RESUMEN
BACKGROUND: The role of nasopharyngeal bacteria in respiratory syncytial virus (RSV) disease has been underestimated. We measured the frequency and burden of respiratory bacteria in the upper respiratory tract of infants with RSV infection over 7 respiratory seasons, and their impact on clinical outcomes. METHODS: Children <2 years old with mild (outpatients, n=115) or severe (inpatients, n=566) RSV infection, and matched healthy controls (n=161) were enrolled. Nasopharyngeal samples were obtained for RSV, Streptococcus pneumoniae, Staphylococcus aureus, Moraxella catarrhalis, and Haemophilus influenzae detection and quantitation by PCR. Multivariable models were constructed to identify variables predictive of severe disease. RESULTS: S. pneumoniae, H. influenzae, and M. catarrhalis, but not S. aureus, were detected more frequently in RSV-infected children (84%) than healthy controls (46%; P<.001). Detection of S. pneumoniae and/or H. influenzae was associated with fever, more frequent antibiotic treatment, worse radiologic findings, and higher neutrophil counts (P<.01). In adjusted analyses, S. pneumoniae/H. influenzae codetection was independentlyassociated with greater odds of hospitalization, higher disease severity scores, need for supplemental oxygen, and longer hospitalization. CONCLUSIONS: Nasopharyngeal codetection of S. pneumoniae and H. influenzae in infants with RSV infection is associated with increased disease severity.
Asunto(s)
Enfermedades Transmisibles , Infecciones por Virus Sincitial Respiratorio , Bacterias , Niño , Preescolar , Haemophilus influenzae , Humanos , Lactante , Moraxella catarrhalis , Nasofaringe/microbiología , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Virus Sincitiales Respiratorios , Streptococcus pneumoniaeRESUMEN
Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory infections in children around the world. The post-pandemic era has resulted in a notable increase in reported cases of RSV infections, co-circulation of other respiratory viruses, shifts in epidemiology, altered respiratory season timing, and increased healthcare demand. Low- and middle-income countries are responsible for the highest burden of RSV disease, contributing significantly to health expenses during respiratory seasons and RSV-associated mortality in children. Until recently, supportive measures were the only intervention to treat or prevent RSV-infection, since preventive strategies like palivizumab are limited for high-risk populations. Advances in new available strategies, such as long-acting monoclonal antibodies during the neonatal period and vaccination of pregnant women, are now a reality. As the Regional Expert Group of the Latin American Pediatric Infectious Diseases Society (SLIPE), we sought to evaluate the burden of RSV infection in Latin America and the Caribbean (LAC) region, analyze current strategies to prevent RSV infection in children, and provide recommendations for implementing new strategies for preventing RSV infection in children in LAC region.
RESUMEN
Background: Staphylococcus aureus infections are a significant cause of morbidity and mortality in pediatric populations worldwide. The Staphylo Research Network conducted an extensive study on pediatric patients across Colombia from 2018 to 2021. The aim of this study was to describe the epidemiological and microbiological characteristics of S. aureus in this patient group. Methods: We analyzed S. aureus isolates from WHONET-reporting centers. An "event" was a positive culture isolation in a previously negative individual after 2 weeks. We studied center characteristics, age distribution, infection type, and antibiotic susceptibilities, comparing methicillin sensitive (MSSA) and resistant S. aureus (MRSA) isolates. Results: Isolates from 20 centers across 7 Colombian cities were included. Most centers (80%) served both adults and children, with 55% offering oncology services and 85% having a PICU. We registered 8,157 S. aureus culture isolations from 5,384 events (3,345 MSSA and 1,961 MRSA) in 4,821 patients, with a median age of 5 years. Blood (26.2%) and skin/soft tissue (18.6%) were the most common infection sources. Most isolates per event remained susceptible to oxacillin (63.2%), clindamycin (94.3%), and TMP-SMX (98.3%). MRSA prevalence varied by city (<0.001), with slightly higher rates observed in exclusively pediatric hospitals. In contrast, the MRSA rate was somewhat lower in centers with Antimicrobial Stewardship Program (ASP). MRSA was predominantly isolated from osteoarticular infections and multiple foci, while MSSA was more frequently associated with recurrent infections compared to MRSA. Conclusions: This is the largest study of pediatric S. aureus infections in Colombia. We found MSSA predominance, but resistance have important regional variations. S. aureus remains susceptible to other commonly used antibiotics such as TMP-SMX and clindamycin. Ongoing monitoring of S. aureus infections is vital for understanding their behavior in children. Prospective studies within the Staphylored LATAM are underway for a more comprehensive clinical and genetic characterization.
RESUMEN
Background: Children with cancer are at risk of critical disease and mortality from COVID-19 infection. In this study, we describe the clinical characteristics of pediatric patients with cancer and COVID-19 from multiple Latin American centers and risk factors associated with mortality in this population. Methods: This study is a multicenter, prospective cohort study conducted at 12 hospitals from 6 Latin American countries (Argentina, Bolivia, Colombia, Ecuador, Honduras and Peru) from April to November 2021. Patients younger than 14 years of age that had an oncological diagnosis and COVID-19 or multisystemic inflammatory syndrome in children (MIS-C) who were treated in the inpatient setting were included. The primary exposure was the diagnosis and treatment status, and the primary outcome was mortality. We defined "new diagnosis" as patients with no previous diagnosis of cancer, "established diagnosis" as patients with cancer and ongoing treatment and "relapse" as patients with cancer and ongoing treatment that had a prior cancer-free period. A frequentist analysis was performed including a multivariate logistic regression for mortality. Results: Two hundred and ten patients were included in the study; 30 (14%) died during the study period and 67% of patients who died were admitted to critical care. Demographics were similar in survivors and non-survivors. Patients with low weight for age (<-2SD) had higher mortality (28 vs. 3%, p = 0.019). There was statistically significant difference of mortality between patients with new diagnosis (36.7%), established diagnosis (1.4%) and relapse (60%), (p <0.001). Most patients had hematological cancers (69%) and they had higher mortality (18%) compared to solid tumors (6%, p= 0.032). Patients with concomitant bacterial infections had higher mortality (40%, p = 0.001). MIS-C, respiratory distress, cardiovascular symptoms, altered mental status and acute kidney injury on admission were associated with higher mortality. Acidosis, hypoxemia, lymphocytosis, severe neutropenia, anemia and thrombocytopenia on admission were also associated with mortality. A multivariate logistic regression showed risk factors associated with mortality: concomitant bacterial infection OR 3 95%CI (1.1-8.5), respiratory symptoms OR 5.7 95%CI (1.7-19.4), cardiovascular OR 5.2 95%CI (1.2-14.2), new cancer diagnosis OR 12 95%CI (1.3-102) and relapse OR 25 95%CI (2.9-214). Conclusion: Our study shows that pediatric patients with new onset diagnosis of cancer and patients with relapse have higher odds of all-cause mortality in the setting of COVID-19. This information would help develop an early identification of patients with cancer and COVID-19 with higher risk of mortality.
RESUMEN
Respiratory viral infections are associated with significant morbidity and mortality in children < 5 years of age worldwide. Among all respiratory viruses, respiratory syncytial virus (RSV) is the world's leading cause of bronchiolitis and pneumonia in young children. There are known populations at risk for severe disease but the majority of children who require hospitalization for RSV infection are previously healthy. Viral and host factors have been associated with the pathogenesis of RSV disease; however, the mechanisms that explain the wide variability in the clinical presentation are not completely understood. Recent studies suggest that the complex interaction between the respiratory microbiome, the host's immune response and the virus may have an impact on the pathogenesis and severity of RSV infection. In this review, we summarize the current evidence regarding the epidemiologic link, the mechanisms of viral-bacterial interactions, and the associations between the upper respiratory tract microbiome and RSV disease severity.
Asunto(s)
Interacciones Microbianas , Microbiota , Infecciones del Sistema Respiratorio/microbiología , Infecciones del Sistema Respiratorio/virología , Preescolar , Humanos , Lactante , Infecciones por Virus Sincitial Respiratorio/microbiología , Infecciones por Virus Sincitial Respiratorio/virología , Virus Sincitial Respiratorio Humano/patogenicidad , Sistema Respiratorio/microbiología , Sistema Respiratorio/virología , Índice de Severidad de la EnfermedadRESUMEN
Introducción: La evaluación del desempeño profesional pedagógico del tutor es vital para elevar la calidad del proceso educativo. Objetivo: Diagnosticar el estado actual de la evaluación del desempeño profesional pedagógico del tutor de Medicina General Integral. Materiales y métodos: Se realizó una investigación descriptiva de corte transversal, con enfoque mixto, entre marzo y septiembre de 2022, en la Filial de Ciencias Médicas Dr. Eusebio Hernández Pérez, de Colón, en la provincia de Matanzas. Variable: el desempeño profesional pedagógico del tutor de Medicina General Integral. Unidades de estudio: 78 tutores, 275 residentes y 44 directivos. Dimensiones: cognoscitiva, procedimental y comportamental. Métodos: teóricos: análisis-síntesis e inducción-deducción; empíricos: análisis documental, encuesta, entrevista, observación; estadísticos: medidas de resumen para variables cualitativas y cuantitativas: frecuencias absolutas y relativas. Procedimientos: parametrización, triangulación metodológica. Resultados: Se identificaron problemas según las dimensiones cognoscitiva (poco dominio de las modalidades de educación en el trabajo y en la didáctica en la tutoría; poca preparación en metodología de la investigación y en buscadores de información científica en salud), procedimental (no correspondencia entre actividades presenciales y las de tutoría, poco nivel para planificar, ejecutar y controlar actividades), y comportamental (poca participación en superación relacionada con la tutoría, en eventos y poca producción científica). Las potencialidades se identificaron según las dimensiones procedimental (nivel de integración de conocimientos; promoción de cooperación y trabajo en equipo; relación entre temas de investigación y el banco de problemas del policlínico), y comportamental (nivel en que estimula el reforzamiento de valores y la ética médica; promoción de empatía y comunicación efectiva con el residente). Conclusiones: El diagnóstico permitió identificar problemas y potencialidades del objeto estudiado. Se propone una alternativa propia de las ciencias de la educación médica para resolver el problema científico, que es la elaboración de una metodología.
Introduction: The evaluation of the professional pedagogical performance of the tutor is vital to raise the quality of the educative process. Objective: To diagnose the current status of the professional pedagogical performance of the tutor of Comprehensive General Medicine. Materials and methods: A descriptive, cross-sectional research, with mixed approach, was carried out between March and September 2022, in the Campus of Medical Sciences Dr. Eusebio Hernández Pérez, from Colon, in the province of Matanzas. Variable: professional pedagogical performance of the tutor of Comprehensive General Medicine. Units of study: 78 tutors, 275 residents and 44 members of the management staff. Dimensions: cognitive, procedural, and behavioral. Methods: theoretical methods: analysis-synthesis and induction-deduction; empirical methods: documentary analysis; surveys; interviews; observation. Statistical methods: summary measures for qualitative and quantitative variables; absolute and relative frequencies. Procedures: parameterization, methodological triangulation. Results: Problems were identified according to the cognitive dimensions (little mastery of the modalities of education at work and tutorship didactics; little training in research methodology and in search engines for scientific information in health); procedural dimension: no correspondence between face-to-face and tutoring activities, low level of planning, executing and controlling activities); and behavioral dimension (little participation in upgrading activities related to tutorship, in events, and little scientific production). Potentialities were identified according to procedural dimensions (level of knowledge integration; promotion of cooperation and teamwork promotion; relationship between research topics and policlinic's problem bank), and behavioral (level at which it stimulates the reinforcement values and medical ethics; promotion of empathy and effective communication with the resident). Conclusions: The diagnosis allowed the authors to identify problems and potentialities of the object studied. An alternative specific of the medical education sciences is proposed to solve the scientific problem, which is the elaboration of a methodology.
RESUMEN
Use of Intrathecal colistin has increased in recent years and has become an alternative for the management of infections of the central nervous system caused by multidrug resistant (MDR) bacteria. Evidence of therapeutic success and safety profile is increasing, particularly in MDR Acinetobacter baumanii infections in adults. Conversely, evidence in children is limited. We present a case of an 11-year-old female with postsurgical meningitis caused by an extensively resistant Pseudomonas aeruginosa strain and treated with venous and intrathecal colistin. The evidence of its use in children with nosocomial meningitis by MDR Gram negative bacteria is reviewed.
Asunto(s)
Antibacterianos/administración & dosificación , Ventriculitis Cerebral/tratamiento farmacológico , Colistina/administración & dosificación , Infecciones por Pseudomonas/tratamiento farmacológico , Neoplasias Encefálicas/cirugía , Ventriculitis Cerebral/microbiología , Niño , Femenino , Humanos , Inyecciones Espinales , Complicaciones Posoperatorias , Pseudomonas aeruginosa/aislamiento & purificaciónRESUMEN
Introducción: Para evaluar resulta imprescindible la construcción de herramientas en función de establecer resultados medibles. Objetivo: Construir y validar un instrumento para evaluar el desempeño profesional pedagógico del tutor de la especialidad de Medicina General Integral. Materiales y métodos: Enfoque mixto, diseño transversal analítico. Métodos: teóricos: análisis y síntesis, inducción-deducción, enfoque sistémico; empíricos: análisis documental, encuesta a tutores y residentes, observación y criterio de expertos; estadísticos: estadística descriptiva (valores absolutos y porcentuales), coeficiente alfa de Cronbach, coeficiente W de Kendall. Procedimientos: parametrización y triangulación metodológica. Fases: revisión bibliográfica, parametrización, análisis de validez de contenido, confiabilidad y aplicabilidad. Resultados: Se elaboró un instrumento con tres dimensiones (cognoscitiva, procedimental y comportamental) y 19 indicadores. Se seleccionaron 15 expertos. Más del 70 % evaluaron los ítems según los criterios de Moriyama en la categoría Mucho. El cálculo del coeficiente W de Kendall sugirió una alta concordancia entre los jueces. El instrumento final contó con 18 ítems. El coeficiente alfa de Cronbach resultó en 0,83 (alta confiabilidad). Con su aplicación se identificaron siete problemas y seis potencialidades, lo cual demostró su validez en la práctica para el diagnóstico. Conclusiones: El instrumento construido evidenció buenas condiciones de validez teórica y práctica, lo cual permitirá direccionar las acciones de superación para los tutores de la especialidad de Medicina General Integral. También puede complementar la evaluación profesoral, al particularizar en el cumplimiento de las funciones del tutor.
Introduction: To evaluate, the construction of tools able to establish measurable results is essential. Objective: To build and validate an instrument to evaluate the professional pedagogical performance of the tutor of the Comprehensive General Medicine specialist. Materials and methods: Mixed approach, cross-sectional, analytical design. Theoretical methods: analysis and synthesis; induction-deduction; systemic approach. Empirical methods: documentary analysis; survey to tutors and residents; observation, and experts' judgment. Statistical methods: descriptive statistics (absolute and percentage value), Cronbach Alpha coefficient; Kendall's W coefficient. Procedures: parametrization and methodological triangulation. Phases: bibliographic review; parametrization; analysis of content validity; reliability, and applicability. Results: An instrument was developed with three dimensions (cognitive, procedural and behavioral) and 19 indicators. 15 experts were chosen. More than 70% evaluated the items according to Moriyama criteria in the category A lot. The calculation of the Kendall's W coefficient suggested a high concordance between judges. The final instrument had 18 items. Cronbach Alpha coefficient resulted in 0.83 (high reliability). With its application, seven problems and six potentialities were identified, which demonstrated its validity in practice for diagnostic. Conclusions: The built document showed good conditions of theoretical and practical validity, which will allow directing the training actions for the tutors in the specialty of Comprehensive General Medicine. It can also complement the professorial evaluation, by particularizing in the fulfillment of the tutor's functions.
RESUMEN
Introducción: la figura del tutor es de vital importancia en la formación del especialista en medicina general integral. Objetivo: fundamentar la importancia del desempeño profesional pedagógico del tutor en la formación del especialista en medicina general integral en la sociedad cubana. Materiales y métodos: se realizó un análisis documental a partir de una búsqueda sobre el tema, de enero de 2020 a agosto de 2022, en las bases de datos PubMed y SciELO, y en el motor de búsqueda Google Académico. Se evaluaron artículos de revisión, de investigación y páginas web -en español, portugués e inglés- que hicieran referencia al tema a través del título. Fueron excluidos los artículos que no cumplieron con estas condiciones. Conclusiones: la medicina familiar es eminentemente social, por su objeto y misión en la comunidad, de ahí que garantizar la formación de profesionales integrales que involucren en su desarrollo los contenidos y habilidades de la especialidad, junto a valores y formas de actuación acorde con los principios de la sociedad socialista, supondrá una mayor resolutividad de los problemas de salud de la población y, por ende, una mayor calidad de vida.
Introduction: the figure of the tutor is of vital importance in the training of the specialist in comprehensive general medicine. Objective: to base the importance of the professional pedagogical performance in the training of the specialist in comprehensive general medicine in Cuban society. Materials and methods: a documental analysis was carried out froma search on the subject, from January 2020 to August in PubMed and SciELO databases and in the Google Scholar search engine. Review and research articles and web pages-in Spanish, Portuguese and English-that referred to the subject in the title were evaluated. Articles that did not meet this condition were excluded. Conclusions: family medicine is eminently social, due to its objective and mission in the community, hence guaranteeing the training of comprehensive professionals who involve the contents and skills of the specialty in their development, along with values and forms of action in accordance with the principles of the socialist society, will suppose a better resolution of the health problems of the population, and therefore, a better quality of life.
RESUMEN
Introducción: La formación con calidad del capital humano en el sector salud constituye un reto para la educación médica cubana contemporánea. La formación académica, en particular la especialidad, tiene el cometido de formar un profesional con alta competencia y avanzadas capacidades para el desempeño especializado, solidez de los principios ético-morales y elevada calificación científico-técnica, por lo que el desarrollo de competencias profesionales resulta una prioridad para la formación de los especialistas biomédicos. Objetivo: Elaborar una propuesta de competencias profesionales específicas para la formación de los especialistas en gastroenterología. Métodos: Se realizó un estudio educacional, de investigación aplicativa, bajo el enfoque general dialéctico-materialista, con fundamento en teorías y enfoques filosóficos, psicológicos y legales de las leyes de la educación, y de la educación médica en particular. Asimismo, se utilizaron métodos teóricos, empíricos y estadístico-matemáticos. Resultados: Se elaboró una definición operativa de competencias profesionales específicas en gastroenterología, a partir del estudio del sistema de competencias y de la sistematización de los documentos rectores en dicha formación. También se identificaron y definieron las competencias profesionales específicas en las áreas asistencial, docente, investigativa y de dirección, que posibilitaron la mejora en el desempeño profesional de los futuros especialistas. Conclusiones: La formación basada en el desarrollo de competencias profesionales específicas constituye una prioridad para la educación médica y la salud pública cubana contemporánea, en aras de elevar la calidad del proceso formativo en la especialidad de gastroenterología y la atención médica que brindan estos galenos en los niveles de atención en salud(AU)
Introduction: The quality training of human capital in the health sector is a challenge for contemporary Cuban medical education. Academic training, particularly the residence, has the task of training a professional with high competence and advanced capabilities for specialized performance, solid ethical-moral principles and high scientific-technical qualification; therefore, the development of professional competences is a priority for the training of biomedical specialists. Objective: To elaborate a proposal of specific professional competences for the training of gastroenterology specialists. Methods: An educational study of applicative research was carried out under the general dialectical-materialistic approach and based on philosophical, psychological and legal theories and approaches of the laws of education and, particularly, of medical education. Theoretical, empirical and statistical-mathematical methods were also used. Results: An operational definition of specific professional competences in gastroenterology was elaborated, based on the study of the system of competences and the systematization of the guiding documents for such training. Specific professional competences were also identified and defined in the care, teaching, research and management areas, which allowed to improve the professional performance of future specialists. Conclusions: Training based on the development of specific professional competences is a priority for contemporary Cuban public health and medical education, in view of raising the quality of the training process in the specialty of gastroenterology and the medical care provided by these physicians at the levels of healthcare(AU)
Asunto(s)
Humanos , Competencia Profesional , Capacitación ProfesionalRESUMEN
Children with perinatal human immunodeficiency virus (HIV) infection can present early or late clinical disease. HIV-associated lymphoma is a later manifestation that is associated with advanced immunosuppression (acquired immunodeficiency syndrome -AIDS). This is a case of a 9-year-old boy with recent diagnosis of HIV with Burkitt's lymphoma as first clinical manifestation. In children, the frequency of this association is very low and there are few cases reported.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/congénito , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Linfoma de Burkitt/virología , Linfoma Relacionado con SIDA/virología , Terapia Antirretroviral Altamente Activa , Linfoma de Burkitt/diagnóstico , Linfoma de Burkitt/tratamiento farmacológico , Niño , Progresión de la Enfermedad , Humanos , Transmisión Vertical de Enfermedad Infecciosa , Linfoma Relacionado con SIDA/diagnóstico , Linfoma Relacionado con SIDA/tratamiento farmacológico , Imagen por Resonancia Magnética , Masculino , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Introducción: La formación académica en Cuba se propone una formación con alta competencia profesional y avanzadas capacidades para el desempeño profesional especializado, por lo que constituye una prioridad para la Educación Médica cubana dar respuesta a dicha exigencia. Resulta esencial un modelo de competencias profesionales para la formación de los especialistas médicos, que permita el mejoramiento del desempeño profesional en respuesta a las exigencias del modelo del egresado. Objetivo: Diseñar un modelo de competencias profesionales específicas para la formación de los especialistas en Gastroenterología. Material y Métodos: Se realizó un estudio educacional, prospectivo, de investigación aplicativa bajo el enfoque general dialéctico-materialista, con fundamento en teorías y enfoques filosóficos, psicológicos, legales, de las leyes de la Educación y la Educación Médica. Se utilizaron métodos teóricos, empíricos y estadístico-matemáticos. Se desarrolla en la Universidad de Ciencias Médicas de Matanzas en el período 2019-2021. Resultados: El modelo de competencias profesionales específicas se estructura en el marco epistemológico, objetivos, contexto social, representación gráfica, forma de implementación, así como se identifican y definen las competencias profesionales específicas en las áreas: asistencial, docente, investigativa y de dirección que posibilitan la mejora en el desempeño profesional de los futuros especialistas. Se corrobora la viabilidad del modelo, a partir de los resultados obtenidos de la triangulación efectuada. Conclusiones: El modelo de competencias profesionales específicas diseñado es pertinente, en correspondencia con el perfil profesional y ocupacional de la especialidad, lo que enriquece las Ciencias de la Educación Médica en lo referido a la formación permanente y continuada(AU)
Introduction: Academic training in Cuba proposes training with high professional competence and advanced skills for specialized professional performance, which is why it is a priority for Cuban medical education to respond to this requirement. A model of professional skills is essential for the training of medical specialists, which allows the improvement of professional performance in response to the demands of the graduate model. Objective: To design a model of specific professional competencies for the training of specialists in Gastroenterology. Material and Methods: An educational, prospective, applicative research study was carried out under the general materialist dialectical approach, based on philosophical, psychological, legal theories and approaches of the laws of Education and Medical Education. Theoretical, empirical and statistical-mathematical methods were used. It is developed at the University of Medical Sciences of Matanzas in the period 2019-2021. Results: The model of specific professional competencies is structured in the epistemological framework, objectives, social context, graphic representation, and form of implementation; additionally, specific professional competencies in the areas of care, teaching, research and management that enable improvement in the professional performance of future specialists are identified and defined. The viability of the model is corroborated, based on the results obtained from the triangulation carried out. Conclusions: The model of specific professional competencies designed is pertinent, in correspondence with the professional and occupational profile of the specialty, which enriches the Sciences of Medical Education in terms of permanent and continuing education(AU)
Asunto(s)
Humanos , Masculino , FemeninoRESUMEN
A case of a girl with chronic posttraumatic osteomyelitis of the right tibia with microbiological isolation of Bacillus spp. by conventional methods and confirmation by mass spectrometry MALDI-TOF (matrix-assisted laser desorption/ionization time-of-flight mass) of Corynebacterium striatum is presented. Diagnostic methods, clinical manifestations, and resistance pattern of these infections are described.
Asunto(s)
Infecciones por Corynebacterium/diagnóstico por imagen , Corynebacterium/aislamiento & purificación , Osteomielitis/diagnóstico por imagen , Infección de la Herida Quirúrgica/diagnóstico por imagen , Tibia/lesiones , Adolescente , Femenino , Humanos , Imagen por Resonancia Magnética , Osteomielitis/microbiología , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Infección de la Herida Quirúrgica/microbiología , Tibia/microbiología , Tibia/cirugíaRESUMEN
RESUMEN En Cuba, la transformación de la realidad por medio de la introducción de resultados científicos -en aras del desarrollo sostenible-, es una alta prioridad por parte de las primeras instancias de dirección desde 1959. La introducción de resultados investigativos ha sido abordada por prestigiosos autores desde diferentes aristas y contextos, pero existen escasas referencias relacionadas con el tema en el ámbito de las ciencias de la educación médica. En consecuencia, este artículo presenta un análisis sobre las tendencias del proceso de introducción de resultados científicos en el ámbito académico, para luego delinear cuáles pudieran ser las bases teórico-metodológicas para la mejora del proceso en el ámbito de la educación médica (AU).
ABSTRACT In Cuba, the transformation of reality through the introduction of scientific results -for the sake of the sustainable development- is a high priority for the first instances of direction since 1959. The introduction of research results has been approached by prestigious authors from different edges and in different contexts, but there are few references related to the theme in the field of the medical education sciences. Consequently, this article presents an analysis on the tendencies of the process of introducing scientific results in the academic sphere, and then outlines the possible theoretic-methodological bases for improving the process in the field of medical education (AU).
Asunto(s)
Humanos , Masculino , Femenino , Dominios Científicos , Estudios de Evaluación como Asunto , Enseñanza/educación , Formación de Concepto , Informe de Investigación/historiaRESUMEN
RESUMEN Introducción: el desarrollo de competencias investigativas e innovativas en los profesionales, es esencial para la aplicación de resultados generados por la investigación y por la innovación. Objetivos: evaluar la validez y fiabilidad de un cuestionario destinado a cuantificar el nivel de desarrollo de competencias investigativas e innovativas de profesores de la Universidad de Ciencias Médicas de Matanzas. Materiales y métodos: se realizó un estudio de tipo evaluativo, de enero a mayo del 2019. La validación del contenido se realizó aplicando los postulados de Moriyama. Su consistencia interna por el coeficiente alfa de Cronbach y la validez de construcción lógica por análisis factorial de los componentes principales. Resultados: el Alfa de Cronbach obtenido fue de ,930. La validación de contenido permitió considerar que la formulación de los ítems, es razonable, justifican su presencia en el cuestionario. Las categorías propuestas para ser incluidas en la construcción del instrumento son adecuadas. Los resultados sugirieron la presencia de cuatro factores que explicaron el 71,16 % de la varianza acumulada por todos los factores. Conclusiones: los resultados de validez fueron favorables. Está disponible un instrumento con condiciones adecuadas y criterios válidos que justifican su uso y aplicación en el terreno investigativo (AU).
ABSTRACT Introduction: the development of research and innovative competences in the professionals is essential for the application of results generated by research and innovation. Objective: to assess the validity and reliability of a questionnaire designed to quantify the development level of research and innovative competences of professors of the University Of Medical Sciences Of Matanzas. Materials and methods: an evaluative-kind study was carried out from January to May 2019; the content validation was made applying Moriyama´s postulates, its internal consistence applying Chronbach´s alpha coefficient, and its logical construction validity applying the factorial analysis of the main components. Results: the obtained Chronbach´s alpha was ,930. The content validation allowed considering that items formulation is reasonable, justifying their presence in the questionnaire. The categories proposed to be included in the instrument construction are adequate. The results suggest the presence of four factors explaining 71.16 % of the variance accumulated by all the factors. Conclusions: the validity results are favorable. An instrument is available with adequate conditions and valid criteria justifying its use and application in the research field (AU).
Asunto(s)
Humanos , Masculino , Femenino , Encuestas y Cuestionarios/estadística & datos numéricos , Indicadores de Ciencia, Tecnología e Innovación , Universidades/normas , Gestión de Ciencia, Tecnología e Innovación en Salud , Evaluación de la Investigación en Salud , Docentes/educaciónRESUMEN
While leprosy is not considered a public health problem in Colombia, affected children are an important warning sign, demonstrating the challenge of controlling the disease. Herein, we report 12 cases of leprosy in patients 5-17 years of age, summarizing our clinical, micro biological and treatment findings.
Asunto(s)
Lepra , Adolescente , Niño , Colombia , Femenino , Humanos , Lepra/diagnóstico , Lepra/microbiología , Lepra/transmisión , MasculinoRESUMEN
RESUMEN Para lograr un cambio en la formación permanente de los profesionales de la salud, en cuanto a la obtención del grado de doctor, la Universidad de Ciencias Médicas de Cienfuegos, comprometida con esta exigencia, ha organizado una estrategia de formación doctoral, en convenio con los centros autorizados. Su concepción científica y metodológica se define como el sistema de ideas acerca del proceso de formación doctoral, que fundamenta las etapas y acciones de formación, caracterizadas por los principios de carácter sistémico, contextual y la sistematización e integración de las acciones declaradas en la estrategia. Como principales resultados se espera contribuir a promover el trabajo conducente a la obtención de grados científicos, incrementar el protagonismo del departamento docente y/o asistencial en el seguimiento al proceso de formación doctoral, promover redes de colaboración para la superación doctoral y posdoctoral, desarrollar la gestión de la innovación e incorporar en la estrategia a los grupos científicos estudiantiles vinculados a los proyectos y temas de doctorados que se desarrollan en la institución.
ABSTRACT Aimed at achieving a change in the health professionals continuous development, regarding the obtaining of a Doctor Degree, and committed with this demand, the University of Medical Sciences has designed a Strategy of Doctoral Training in agreement with the certified institutions. Its scientific and methodological conception is defined as the system of ideas about the process of doctoral training which sets the stages and actions characterized by the principles of systemic, contextual character and their systematization and integration . As the main results it is expected to contribute promoting the work which leads to obtaining scientific degree, increase the protagonist action of the teaching and /or assisting department in following the process of doctoral training, to promote networks of collaboration for doctoral and post-doctoral development, to develop management of on innovation and incorporating to the strategy the scientific groups of students linked to doctoral projects and topics developed at the institution.
RESUMEN
Resumen El uso de colistina por vía intratecal se ha consolidado como una opción terapéutica para el manejo de infecciones del sistema nervioso central causadas por bacilos gramnegativos multi-resistentes. La evidencia del éxito terapéutico y del perfil de seguridad es creciente, particularmente en infecciones por Acinetobacter baumanii multi-resistente en adultos. La evidencia en niños es escasa. Se presenta el caso clínico de una niña de 11 años de edad, con una ventriculitis post-quirúrgica por Pseudomonas aeruginosa extensamente resistente tratada con colistina intravenosa e intratecal. Se revisa su uso en niños con meningitis nosocomial causada por bacilos gramnegativos multi-resistentes.
Use of Intrathecal colistin has increased in recent years and has become an alternative for the management of infections of the central nervous system caused by multidrug resistant (MDR) bacteria. Evidence of therapeutic success and safety profile is increasing, particularly in MDR Acinetobacter baumanii infections in adults. Conversely, evidence in children is limited. We present a case of an 11-year-old female with postsurgical meningitis caused by an extensively resistant Pseudomonas aeruginosa strain and treated with venous and intrathecal colistin. The evidence of its use in children with nosocomial meningitis by MDR Gram negative bacteria is reviewed.
Asunto(s)
Humanos , Femenino , Niño , Infecciones por Pseudomonas/tratamiento farmacológico , Colistina/administración & dosificación , Ventriculitis Cerebral/tratamiento farmacológico , Antibacterianos/administración & dosificación , Complicaciones Posoperatorias , Pseudomonas aeruginosa/aislamiento & purificación , Inyecciones Espinales , Neoplasias Encefálicas/cirugía , Ventriculitis Cerebral/microbiologíaRESUMEN
Introducción: la formación de profesionales integrales en la educación superior es uno de los retos que enfrentan los gestores de los procesos de este nivel educacional. La formación basada en competencias constituye uno de los caminos para acercarse al logro de la calidad deseada en los egresados universitarios. Conocer las competencias profesionales específicas a desarrollar en la formación del especialista como médico general integral es muy importante por su relación con la calidad del desempeño profesional y la atención médica que brinda a la población. Objetivos: identificar y definir las competencias profesionales específicas para la formación de los especialistas en Medicina General Integral. Métodos: se realizó una investigación de desarrollo tecnológico, mediante métodos teóricos, sistematizándose la obra de varios autores acerca del tema, se determinaron diferentes posiciones en relación a la formación por competencias, el desempeño profesional y los modos de actuación profesional. Resultados: se identifican y definen las competencias profesionales específicas: comunicativa; clínica; epidemiológica; en educación en salud; docente; investigativa y gerencial y los modos de actuación profesional mediante los cuales se expresan en el desempeño profesional. Conclusiones: la formación basada en el desarrollo y adquisición de las competencias profesionales específicas constituye una alternativa para mejorar la calidad de la formación dentro de la especialidad de Medicina General Integral y de la atención médica que se brinda en la atención primaria de salud(AU)
Introduction: The training of integral professionals in higher education is one of the challenges faced by the managers of the processes at this educational level. Training based on competences is one of the ways to approach the achievement of the desired quality in university graduates. Knowing the specific professional competences to be developed in the training of the family medicine specialists is very important because of its relationship with the quality of professional performance and the medical attention they provide to the population. Objective: To identify and define the specific professional competences for the training of family medicine specialists. Methods: A technological development research was carried out, by means of theoretical methods, systematizing the work on the subject by several authors, different positions were determined in relation to competence-based training, professional performance and ways of professional performance. Result: Specific professional competences are identified and defined: communicative, clinical, epidemiological in health education, teaching; investigative and managerial, and the modes of professional action through which they express themselves in professional performance. Conclusions: Training based on the development and acquisition of specific professional skills is an alternative to improve the quality of training within the specialty of family medicine and medical care provided in primary health care(AU)
Asunto(s)
Humanos , Competencia Profesional , Educación Profesional , Medicina Familiar y ComunitariaRESUMEN
RESUMEN Fundamento en el informe del año 2016, la Organización Mundial de la Salud reportó que 55 000 personas fallecen por rabia en África y Asia y la vacuna no es la mejor manera de prevenir la enfermedad por su elevado costo, en este análisis realizado por la Organización Mundial de la Salud, declara que el 95 % de los pacientes son menores de 15 años. Objetivo: describir la sistematización de los fundamentos teóricos que sustentan la preparación para el desempeño de médico y enfermero de la familia en el manejo de la rabia. Métodos: se realizó un estudio descriptivo en el período 2012 a noviembre de 2017, la investigación se sustenta desde la concepción dialéctico-materialista, para la obtención de los datos y el procesamiento de la información se emplearon como métodos teóricos (análisis documental, sistematización e histórico-lógico), médicos y enfermeros de la familia del municipio Boyeros. Resultados: la sistematización realizada permitió encontrar regularidades que se convierten en antecedentes a la definición operativa que se propone sobre desempeño del médico y enfermero de la familia en el manejo de la rabia a partir de los fundamentos de la educación médica como teoría educativa. Conclusiones: la sistematización realizada sobre el mejoramiento del desempeño del médico y enfermero de la familia, permitió establecer un acercamiento centrado en los referentes teóricos que sustentan el mejoramiento del desempeño del médico y enfermero de la familia, al identificar los principios de la Educación en el Trabajo para el desempeño de este personal en el manejo de la rabia.
ABSTRACT Background in the report of 2016, the World Health Organization (WHO) reported that 55 000 people died of rabies in Africa and Asia and the vaccine is not the best way to prevent the illness because of the high cost, in this analysis carried out by the WHO, declares 95 % of patients are younger than 15 years old. Objective to describe the systematization the theoretical foundations that support the preparation for exert of doctor and nurse of family in the management of the Rabies. Methods: it was conducted a descriptive study in the period 2012-2017, the investigation is supported from the dialectic-materialist conception, for the obtaining of data and the processing the information was employed as theoretical methods (documentary analysis, systematization and historical-logical), doctors and nurses of family in the municipality Boyeros. Results: the carried out systematization allowed to find regularities that turn into antecedents for operative definition that proposes on exert of the doctor and nurse of family in the management of rabies from foundations of the medical education as educational theory. Conclusions: the carried out systematization on the improvement of the exert of the doctor and nurse of family, allowed to establish an approach centered in theoretical referents that support the improvement of exert of the doctor and nurse of family, identifying the principles of education in the work for the exert of these personnel in the management of rabies.