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En la carrera Estomatología, las relaciones interdisciplinarias entre las asignaturas clínicas y la Farmacología resultan necesarias para lograr en los estudiantes un mayor desarrollo de habilidades teóricas y prácticas dirigidas la prescripción racional de medicamentos de uso estomatológico. La presente investigación tuvo como objetivo describir dos vías para lograr lo antes expuesto. Las vías propuestas resultaron ser: la identificación de los nodos potenciales de articulación interdisciplinaria entre estas unidades curriculares y la interrelación de métodos de enseñanzas. Se concluye que ambas propuestas constituyen vías concretas para el establecimiento y desarrollo de las relaciones interdisciplinarias entre las asignaturas clínicas y la Farmacología en la carrera Estomatología.
In the Stomatology degree, interdisciplinary relationships between clinical subjects and Pharmacology are necessary to achieve in students a greater development of theoretical and practical skills aimed at the rational prescription of medications for stomatological use. The objective of this research was to describe two ways to achieve the above. The proposed paths turned out to be: the identification of potential nodes of interdisciplinary articulation between these curricular units and the interrelation of teaching methods. It is concluded that both proposals constitute concrete ways for the establishment and development of interdisciplinary relationships between clinical subjects and Pharmacology in the Stomatology career.
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Aim: This study aimed to assess the interest of dental students, clinicians and professors in a mobile app for calculating dosages of medicines for use in Pediatric Dentistry. Methods: The cross-sectional survey involved a random sample of undergraduate and postgraduate pediatric dental students, clinical pediatric dentists and professors. Initially, participants watched a video about an early version of the app. They then answered a questionnaire about their clinical experience, calculation routine, and interest in the app. Descriptive analyses were carried out. Results: Of the 41 participants (20 students, 10 clinicians and 11 professors), 87.8% recognized the need to adjust doses of medicines used in pediatric dentistry, but only 56.1% felt confident in doing so. Almost a fifth of participants (19.5%) admitted errors in prescribing medicines for pediatric dental patients. After seeing the app's functionalities, 92.7% considered it relevant, and 87.8% were interested in the full version. Conclusion: The app is deemed relevant, necessary, and of significant interest to the target audience, indicating potential for investment and full development.
Objetivo:Este estudo buscou avaliar o interesse de estudantes de odontologia, clínicos e professores em um aplicativo móvel para calcular dosagens de medicamentos para uso em Odontopediatria. Métodos: A pesquisa transversal envolveu uma amostra aleatória de estudantes de odontologia pediátrica de graduação e pós-graduação, odontopediatras clínicos e professores. Inicialmente, os participantes assistiram a um vídeo sobre uma versão inicial do aplicativo. Em seguida, eles responderam a um questionário sobre sua experiência clínica, rotina de cálculos e interesse no aplicativo. Análises descritivas foram realizadas. Resultados:Dos 41 participantes (20 estudantes, 10 clínicos e 11 professores), 87,8% reconheceram a necessidade de ajustar as doses de medicamentos usados em Odontopediatria, mas apenas 56,1% se sentiam confiantes para fazê-lo. Quase um quinto dos participantes (19,5%) admitiu erros na prescrição de medicamentos para pacientes odontopediátricos. Após verem as funcionalidades do aplicativo, 92,7% o consideraram relevante, e 87,8% demonstraram interesse na versão completa. Conclusão: A conclusão é que o aplicativo é relevante, necessário e de interesse para o público-alvo, indicando potencial para investimento e desenvolvimento completo.
Asunto(s)
Farmacología , Odontología Pediátrica , Quimioterapia , Aplicaciones MóvilesRESUMEN
Introducción: El estudio de los efectos farmacológicos preclínicos de la lecitina de soya sobre parámetros hematológicos y marcadores inflamatorios sistémicos, contribuirá a sustentar las bases de su posible empleo como medicamento natural. Objetivo: Determinar los efectos de la lecitina de soya sobre parámetros hematológicos y marcadores inflamatorios sistémicos de ratas Wistar. Métodos: Se realizó un estudio de farmacología preclínica experimental, en el que se administró lecitina de soya en dosis máximas y mínimas a dos grupos experimentales de ratas Wistar. Se estimaron variables hematológicas para ser comparadas con el grupo control, se determinó recuento diferencial y el conteo global de leucocitos según fórmula avanzada como indicativo indirecto de inmunocompetencia. Se calcularon como marcadores inflamatorios sistémicos la relación neutrófilos-linfocitos (N/LR) y la relación plaquetas-linfocitos (P/LR). La existencia de diferencias de medianas y rangos de las diferentes variables entre los grupos se reveló mediante la Prueba de Kruskal-Wallis de muestras independientes con nivel de significancia de p <0.05. Resultados: Se observó leucopenia, aumento del recuento plaquetario y alteraciones de índices relacionados con la inflamación y la inmunidad en ambos grupos experimentales, relacionado con la dosis. La N/LR y P/LR se incrementaron de manera proporcional con la dosis y el índice de inmunidad e inflamación sistémica se incrementa con dosis mínima y tiende a decrecer con dosis máxima. Conclusiones: El producto modifica parámetros hematológicos en ratas, pero se requieren otros estudios controlados que corroboren el estado de inmunocompetencia, tomando en consideración lo que expresan los marcadores inflamatorios sistémicos.
Introduction: The study of the preclinical pharmacological effects of soy lecithin on hematological parameters and systemic inflammatory markers, will contribute to support the foundations of its possible use as a natural medication. Objective: To determine the effects of soy lecithin on hematological parameters and systemic inflammatory markers of Wistar rats. Methods: An experimental preclinical pharmacology study was conducted, in which soy lecithin was administered in maximum and minimum doses of two experimental Wistar rats. Hematological variables were estimated to be compared to the control group, differential counting and global leukocyte count according to advanced formula as an indirect indicative of immunocompetence was determined. The neutrophil-linfocyte (N/LR) and the platelet-linfocyte ratio (P/LR) were calculated as systemic inflammatory markers. The existence of medium and ranges differences of the different variables between the groups was revealed by the Kruskal-Wallis test of independent samples with a level of significance of p<0.05. Results: Leukopenia, increased platelet count and alterations of inflammation related to inflammation and immunity dose-related were observed in both experimental groups. The N/LR and P/LR were proportionally increased with the dose and the system of systemic immunity and inflammation is increased with minimal dose and tends to decrease with maximum dose. Conclusions: The product modifies hematological parameters in rats, but other controlled studies are required that corroborate the state of immunocompetence, taking into consideration what systemic inflammatory markers express.
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Objetivo:Identificar propriedades químicas e farmacológicas do gênero Copaifera no tratamento de lesões e feridas. Método: Revisão integrativa da literatura realizada nas bases de dados LILACS, MEDLINE, PubMed, Taylor & Francis e Scopus, em janeiro de 2022, por meio da estratégia de busca: "Chemical Properties" AND "Copaifera" AND "Wounds and Injuries" e "Pharmacology" AND "Copaifera" AND "Wounds and Injuries". Foram incluídos artigos originais, de texto completo, identificados de acordo nível de evidência, redigidos em português, inglês ou espanhol. Resultados: Na busca primária foram encontrados 261 artigos. Após a seleção sistematizada, 12 estudos foram selecionados para análise qualitativa. Espécies do gênero Copaifera apresentam propriedades farmacológicas favoráveis ao tratamento de feridas: controle da dor inflamatória, diminuição da reação inflamatória, reepitelização e reparo tecidual, angiogênese, retração da ferida e remodelagem de cicatrizes. Dentre as propriedades químicas associadas ao tratamento de lesões, destacam-se presença de compostos bioativos: diterpenos, 3-hidroxi-copálico, sesquiterpenos, éster kolavic-15-metílico. Entre os diterpenos testados, o caurenoico e os ácidos copálicos mostraram atividades hemolíticas significativas. Apenas o ácido copálico e o ácido hardwíckiico inibiram a produção de óxido nítrico em macrófagos ativados por lipopolissacarídeos. Conclusão: As plantas do gênero Copaifera apresentam propriedades químicas e farmacológicas favoráveis ao tratamento de lesões e feridas
Objective:To identify chemical and pharmacological properties of Copaifera in the treatment of injuries and wounds. Method: Integrative literature review conducted in the LILACS, MEDLINE, PubMed, Taylor & Francis and Scopus databases in January 2022, using the search strategy: "Chemical Properties" AND "Copaifera" AND "Wounds and Injuries" and "Pharmacology" AND "Copaifera" AND "Wounds and Injuries." Original articles, full text, identified according to level of evidence, written in Portuguese, English or Spanish, were included. Results: In the primary search 261 articles were found. After systematized selection, 12 studies were selected for qualitative analysis. Species of the genus Copaifera have pharmacological properties favorable for wound treatment: control of inflammatory pain, reduction of inflammatory reaction, tissue reepithelialization and repair, angiogenesis, wound retraction and scar remodeling. Among the chemical properties associated with the treatment of injuries, the presence of bioactive compounds stand out: diterpenes, 3-hydroxy-copalic, sesquiterpenes, kolavic-15-methyl ester. Among the tested diterpenes, kaurenoic and copalic acids showed significant hemolytic activities. Only copalic acid and hardwickiic acid inhibited nitric oxide production in lipopolysaccharide-activated macrophages. Conclusion: Plants of the genus Copaifera have chemical and pharmacological properties favorable for the treatment of injuries and wounds.
Objetivo:Identificar las propiedades químicas y farmacológicas del género Copaifera en el tratamiento de lesiones y heridas. Método: Revisión integradora de la literatura realizada en las bases de datos LILACS, MEDLINE, PubMed, Taylor & Francis y Scopus, en enero de 2022, mediante la estrategia de búsqueda: "Chemical Properties" AND "Copaifera" AND "Wounds and Injuries" e "Pharmacology" AND "Copaifera" AND "Wounds and Injuries". Se incluyeron artículos originales, a texto completo, identificados según el nivel de evidencia, escritos en portugués, inglés o español. Resultados: En la búsqueda primaria se encontraron 261 artículos. Tras una selección sistematizada, se seleccionaron 12 estudios para el análisis cualitativo. Las especies del género Copaifera presentan propiedades farmacológicas favorables para el tratamiento de las enfermedades: control del dolor inflamatorio, disminución de la reacción inflamatoria, reepitelización y reparación tecidual, angiogénesis, retracción de la piel y remodelación de las cicatrices. Entre las propiedades químicas asociadas al tratamiento de las lesiones, destaca la presencia de compuestos bioactivos: diterpenos, 3-hidroxicopálico, sesquiterpenos, éster kolavico-15-metilo. Entre los diterpenos probados, los ácidos kaurenoico y copálico mostraron actividades hemolíticas significativas. Sólo el ácido copálico y el ácido hardwickiico inhibieron la producción de óxido nítrico en macrófagos activados por lipopolisacáridos. Conclusión: Las plantas del género Copaifera presentan propiedades químicas y farmacológicas favorables para el tratamiento de lesiones y heridas.
Asunto(s)
Humanos , Animales , Heridas y Lesiones/tratamiento farmacológico , Preparaciones de Plantas/farmacología , Fabaceae/química , Fitoterapia , Cicatrización de Heridas/efectos de los fármacos , Aceites de Plantas/uso terapéutico , Extractos Vegetales/uso terapéutico , Antiinflamatorios/farmacologíaRESUMEN
Resumen El personal biomédico carece de plataformas informatizadas que resuman los principales mecanismos de colaboración entre los microbios intestinales y los seres humanos en cuanto a la absorción y transformación de los medicamentos o vacunas y sus respuestas homeostáticas. Por esta razón, el presente trabajo tiene como objetivo aportar evidencias y recomendaciones para el diseño de una plataforma de consulta biomédica, referente a esta relación, lo cual permitirá la valoración de la posible inclusión de la taxa y abundancia microbiana intestinal en los protocolos de evaluación de la efectividad de los mismos. La encuesta realizada a un grupo de profesionales, destinada a la verificación de las posibilidades de acceso y especificidad de este tipo de información posibilitó la identificación de los tópicos principales para la conexión entre grupos de medicamentos, estructura tridimensional, moduladores y mediadores de la respuesta homeostática, biomarcadores, relación inter-reinos y mecanismos patogénicos, de manera que se fusione toda la información "ómica" humanomicrobiota en una plataforma dentro de la página del NCBI, la cual se propone que se denomine Pharmacolobiomic o Pharmaco-metagenomic. La información existe en las bases de datos contenidas en NCBI-NIH, según la búsqueda realizada y el filtrado a partir de 28 628 referencias. A partir de la presente propuesta se demostró la necesidad de contar con una plataformafarma cometagenómica que resuma el papel de la microbiota intestinal en el metabolismo y la efectividad de los fármacos y vacunas; así como disponer de la actualización sistemática para los profesionales en cuanto a la microbiota como biomarcador, en los protocolos de ensayos clínicos.
Abstract Biomedical staff lacks a computer platform that summarises the main mechanisms of collaboration between intestinal microbes and humans, related to the absorption and transformation of drugs and vaccines and their ho-meostatic responses. For this reason, the aim of this work is to provide some evidences and recommendations for the design of a biomedical consultation platform, about the relationship between the microbiota and the effect of drugs or vaccines. These evidences will support the assessment for inclu¬sion of taxa and gut microbial abundance, as a part of clinical protocols of effectiveness. The survey carried out on a group of biomedical professionals, aimed at verifying the possibilities of access and specificity of this type of information made it possible to identify the main topics for the connection between drug groups, three-dimensional structure, modulators and mediators of the homeostatic response, biomarkers, inter-kingdom relationship and pathogenic mechanismsin such a way that all the human-microbiota "omics" information will be shown into a sub-platform within NCBI-NIH, which could be called Pharmacolobiomic or Pharmaco-metagenomic. The information is present in the databases contained in the NCBI, taking into account this search and filtering, from 28 628 references. Based on this proposal, the need for a pharmacometagenomic platform that summarises the role of the intestinal microbiota in the metabolism and effectiveness of drugs and vaccines was demonstrated, as well as having the systematic update for professionals about the microbiota as a biomarker, in clinical trial protocols.
Resumo O pessoal biomédico carece de plataformas computadorizadas que resumam os principais mecanismosde colaboração entre micróbios intestinais e seres humanos, em termos de absorção e transformação demedicamentos e vacinas e suas respostas homeostáticas. Por essa razão, este trabalho visa fornecer evidênciase recomendações para o desenho de uma plataforma de consulta biomédica, referente a esta relação;o que permitirá avaliar a possível inclusão dos táxons e da abundância microbiana intestinal nosprotocolos de avaliação da sua eficácia. A pesquisa realizada em um grupo de profissionais, teve comoobjetivo verificar as possibilidades de acesso e especificidade desse tipo de informação; possibilitouidentificar os principais tópicos para a conexão entre grupos de medicamentos, estrutura tridimensional,moduladores e mediadores da resposta homeostática, biomarcadores, relação inter-reino, mecanismospatogênicos; de forma tal que toda a informação "ômica" humano-microbiota se funde em uma plataformadentro da página do NCBI, à qual se propõe ser chamada de Pharmacolobiomic ou Pharmacometagenomic. A informação existe nas bases de dados contidas em NCBI-NIH, tendo em conta a pesquisarealizada e a filtragem, a partir de 28 628 referências. Com base nessa proposta, foi demonstradaa necessidade de contar com uma plataforma farmacometagenômica que resuma o papel da microbiotaintestinal no metabolismo e eficácia de medicamentos e vacinas; além de ter a atualização sistemáticapara os profissionais quanto à microbiota como biomarcador, nos protocolos de ensaios clínicos.
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Fundamento: los estilos y enfoques de aprendizaje permiten conocer cómo el estudiante enfrenta este proceso y el modo en que procesa la información que debe ser asimilada. Objetivo: identificar los estilos y enfoques de aprendizaje que utilizan estudiantes de Estomatología y su relación con el rendimiento académico en la disciplina Farmacología. Métodos: estudio descriptivo-transversal, con enfoque cualicuantitativo, realizado de noviembre 2021 a enero 2022. La muestra, no probabilística, fue de 28 estudiantes (90,3 %) de segundo año de la carrera de Estomatología impartida en la Facultad de Estomatología de La Habana. A los participantes se les aplicaron dos instrumentos: cuestionario Honey y Alonso sobre estilos de aprendizaje y cuestionario Enfoques e Inventario de Habilidades de Estudio de los Estudiantes. Las dimensiones del rendimiento académico fueron excelente, bueno, y regular. Resultados: predominó la preferencia muy alta/alta en el estilo teórico (67,86 %) y la preferencia moderada en el reflexivo (67,86 %). Se encontró relación significativa entre la cantidad de estilos de aprendizaje de preferencia muy alta/alta y el rendimiento académico (p=0,044), y entre el estilo reflexivo y el rendimiento académico (p=0,024). También, se encontró relación significativa entre el rendimiento académico y el enfoque de aprendizaje estratégico (p=0,008) y la preferencia por la transmisión de la información (p=0,028). Conclusiones: en los estudiantes existen estilos y enfoques de aprendizaje que se relacionan con el rendimiento académico en Farmacología; se muestran aspectos que se deben considerar para el mejoramiento del proceso docente de esta disciplina en Estomatología.
Foundation: the learning styles and approaches allow us to know how the student faces this process and the way in which they process the information that must be assimilated. Objective: to identify the learning styles and approaches used by Dentistry students and their relationship with academic performance in the Pharmacology discipline. Methods: a descriptive-cross-sectional study, with a qualitative-quantitative approach, carried out from November 2021 to January 2022. The non-probabilistic sample consisted of 28 students (90.3%) in the second year of the Dentistry course taught at the Havana Dentistry Faculty. Two instruments were applied to the participants: the Honey and Alonso questionnaire on learning styles and the Approaches and Inventory of Student Study Skills questionnaire. The dimensions of academic performance were excellent, good, and regular. Results: the very high/high preference predominated in the theoretical style (67.86%) and the moderate preference in the reflective style (67.86%). A significant relationship was found between the number of very high/high preference learning styles and academic performance (p=0.044), and between the reflective style and academic performance (p=0.024). Also, a significant relationship was found between academic performance and the strategic learning approach (p=0.008) and the preference for the transmission of information (p=0.028). Conclusions: there are learning styles and approaches among students that are related to academic performance in Pharmacology; Aspects that should be considered for the improvement of the teaching process of this discipline in Dentistry are shown.
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Dexmedetomidine's α-adrenoreceptor agonism has been gaining popularity in the anesthetic room as a sedative-hypnotic and analgesic agent, and with extensive perioperative use rising concern about side effects is necessary. Bradycardia and hypotension are common adverse effects, but there are also several reports of excessive urine output, possibly due to vasopressin secretion and permeability of collecting ducts. Polyuria usually resolves with discontinuation of the drug, and significant morbidity has not been reported. Early identification, removal of the agent, and treatment are imperative to minimize complications - mainly natremia and neurological symptoms. This case report describes a dexmedetomidine-related polyuric syndrome during opioid-free general anesthesia for major head and neck surgery. A nephrogenic mechanism for the clinical effect is proposed and reinforced by analytical data obtained. An intra-operative polyuria approach is also delineated.
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O período gestacional é uma fase de cuidados em todos os aspectos da vida da gestante. São muitos os sais anestésicos utilizados em odontologia e as suas propriedades, que devem ser levadas em consideração na escolha da substância que será utilizada, de acordo com a condição sistêmica do paciente. As propriedades do Cloridrato de Bupivacaína podem ser consideradas interessantes e demonstrar aspectos positivos para o seu uso em pacientes grávidas durante os procedimentos odontológicos. O objetivo desse trabalho é apresentar as razões, pelas quais o Cloridrato de Bupivacaína deve ser o sal anestésico de escolha para uso em gestantes na odontologia. Uma revisão de literatura foi realizada para coletar dados pertinentes ao assunto. Esse sal anestésico é capaz de preservar tanto a saúde da mãe, como a do bebê, desde que aplicada corretamente.
The pregnancy in women is a phase of high expectations and care in all aspects of a pregnant woman's life. There are many anesthetic solutions used in dentistry and their properties must be considered when choosing the substance to be used according to the patient's systemic condition. The properties of Bupivacaine Hydrochloride can be considered interesting and demonstrate positive aspects for its use in pregnant patients during dental procedures. The objective of this review is to present the reasons why Bupivacaine Hydrochloride should be the anesthetic salt of choice for use in pregnant women in the dental clinic. A literature review was carried out to collect relevant data to the subject. This anesthetic salt can preserve the mother's and baby's health if it is correctly applied.
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Introducción: En Cuba han existido varias concepciones sobre planes de estudio. La necesidad de revisar y proponer cambios que aseguren los niveles de calidad deseados en el proceso de formación integral de los futuros profesionales motivó a investigar los elementos teóricos y metodológicos que regulan y orientan el proceso de enseñanza-aprendizaje en la asignatura Farmacología Clínica. Objetivo: Analizar el programa de Farmacología Clínica del plan de estudio E para la carrera de Medicina desde un enfoque crítico y sistematizado. Métodos: Se realizó un estudio cualitativo del programa de estudio de la asignatura Farmacología Clínica según el plan E, vigente en la Universidad de Ciencias Médicas de Santiago de Cuba, durante el 2022, para lo cual se utilizaron los métodos de revisión documental, los documentos rectores del proceso docente en la educación superior y la metodología propuesta por algunos autores. Resultados: Varios temas enunciaban un número excesivo de objetivos específicos sin tener en cuenta el nivel de asimilación; la forma de organización de la enseñanza más utilizada fue la conferencia. En las evaluaciones frecuentes no se tuvo en cuenta el trabajo investigativo independiente; en tanto, la bibliografía básica correspondió a una edición del 2002. Conclusiones: El programa no requirió trasformaciones temáticas, pero desde el punto de vista didáctico deben modificarse componentes del proceso de enseñanza-aprendizaje y, además, se debe actualizar la bibliografía básica pertinente.
Introduction: In Cuba several conceptions have existed on the study plans. The necessity to revise and propose changes that assure the levels of quality wanted in the process of integral formation of the future professionals motivated to investigate the theoretical and methodological elements that regulate and guide the teaching-learning process in the Clinical Pharmacology subject. Objective: To analyze the program of Clinical Pharmacology of the E plan study for the medicine career, from a critical and systematized approach. Methods: A qualitative study of the study program in the Clinical Pharmacology subject was carried out according to the E plan, effective in the University of Medical Sciences in Santiago de Cuba, during 2022, for which the methods of documental review, the rector documents of the teaching process in higher education and the methodology proposed by some authors were used. Results: Several topics enunciated an excessive number of specific objectives without taking into account the level of assimilation; the form of organization most used in teaching was the conference. Independent investigative work was not taken into account in frequent evaluations; meanwhile, the basic bibliography corresponded to an edition from 2002. Conclusions: The program did not require of thematic transformations, but from the didactic point of view components of the teaching-learning process should be modified, besides updating the pertinent basic literature.
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Introdução: A literatura tem apontado uma possível relação entre diversas condições sistêmicas e as doenças periodontais. Dentro das doenças sistêmicas que podem gerar o uso crônico de medicamentos, com potencial associação com as doenças periodontais, destacam-se a hipercolesterolemia e o uso de estatinas; e as doenças do metabolismo ósseo e o uso de bisfosfonatos. Objetivo: Dessa maneira, o presente estudo objetivou revisar a literatura sobre o efeito das estatinas e dos bisfosfonatos nos parâmetros clínicos e radiográficos periodontais de indivíduos adultos. Resultados: Apenas estudos observacionais em humanos foram incluídos. Um estudo mostrou que, em pacientes que apresentam doença periodontal e usam estatina, houve 37% menos bolsas periodontais (profundidade de sondagem ≥4mm) quando comparadas aos que não utilizam a medicação, além de apresentarem menor índice de carga inflamatória e menor perda de inserção clínica. Em relação aos bisfosfonatos em indivíduos com doenças que envolvem o metabolismo ósseo, sugere-se que a utilização do fármaco tem obtido resultados positivos nos parâmetros periodontais, como menores sinais clínicos de inflamação gengival, menor profundidade de sondagem, menor perda de inserção clínica e maior nível de osso alveolar, quando comparados aos que nunca realizam essa terapia. Conclusão: Dessa forma, as estatinas e os bisfosfonatos apresentam efeitos promissores, em pacientes sob tratamento para suas respectivas condições sistêmicas, na melhoria dos parâmetros periodontais, porém é importante salientar que são necessários mais estudos sobre o assunto para melhor entender os reais efeitos a longo prazo do uso desses fármacos.(AU)
Introduction: The literature showed a possible relationship between several systemic conditions and periodontal diseases. Within the systemic diseases that can generate the chronic use of these drugs, potentially related with periodontal diseases, it may be cited the hypercholesterolemia and the use of statins; and bone metabolism diseases and the use of bisphosphonates. Objective: In this sense, the present study aimed to review the literature about the effect of statins and bisphosphonates in the periodontal parameters of adults individuals. Results: Only observational studies in humans were included. A study showed that, in patients with periodontal disease and users of statins, there 37% fewer periodontal pockets (probing depth ≥4mm) when compared to those who do not use the medication, as well as having a lower rate of inflammatory burden and less loss of clinical insertion. Regarding the bisphosphonates in individuals diagnosed with diseases involving bone metabolism, it was suggested that the use of the drug has obtained positive results in periodontal parameters, such as a greater absence of plaque, less clinical signs of gingival inflammation, less probing depth, lower level of clinical insertion and higher level of alveolar bone when compared to those who never undergo this therapy. Conclusion: Thus, statins and bisphosphonates have promising effects in patients under treatment for their respective systemic condition in improving periodontal parameters, but it is important to emphasize that further studies on the subject are needed to better understand the long-term effects of the use of these drugs.(AU)
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Humanos , Enfermedades Periodontales/inducido químicamente , Periodoncio/efectos de los fármacos , Inhibidores de Hidroximetilglutaril-CoA Reductasas/efectos adversos , Difosfonatos/efectos adversos , Enfermedades Óseas Metabólicas/complicaciones , Enfermedades Óseas Metabólicas/tratamiento farmacológico , Factores de Riesgo , Hipercolesterolemia/complicaciones , Hipercolesterolemia/tratamiento farmacológicoRESUMEN
Introducción: La validación de estrategias didácticas para favorecer las relaciones interdisciplinarias en el proceso enseñanza aprendizaje, resulta necesaria para su posterior aplicación en la práctica pedagógica y posible generalización. Objetivo: Validar una estrategia didáctica para las relaciones interdisciplinarias en el proceso enseñanza aprendizaje de las asignaturas clínicas, con la Farmacología en la carrera Estomatología. Métodos: Se realizó una investigación educativa entre enero y junio de 2022. Se asumieron métodos teóricos (analítico-sintético, inductivo-deductivo y sistematización), empíricos (consulta a expertos) y matemáticos-estadísticos (estadística descriptiva). Se seleccionó a los expertos según el nivel de competencia. Se elaboró y aplicó un cuestionario para valorar 16 aspectos de la estrategia en términos de: muy adecuado, bastante adecuado, adecuado, poco adecuado y no adecuado. Los criterios valorativos emitidos por los expertos se procesaron mediante el modelo matemático de Torgerson y se determinó el nivel de consenso de los expertos mediante el cálculo del coeficiente de concordancia de Kendall. Resultados: El coeficiente de competencia promedio de los expertos fue alto. De los 16 aspectos valorados, uno resultó "bastante adecuado" y el resto, "muy adecuado". Se estimó concordancia significativa entre los expertos consultados. Conclusiones: Los resultados de la consulta a expertos apuntan al reconocimiento del valor científico, teórico y práctico, de la estrategia didáctica diseñada para favorecer las relaciones interdisciplinarias en el proceso enseñanza aprendizaje de las asignaturas clínicas, con la Farmacología en la carrera Estomatología y le otorgan validez.
Introduction: The validation of didactic strategies to favor interdisciplinary relationships in the teaching-learning process is necessary for their subsequent application in pedagogical practice and possible generalization. Objective: To validate a didactic strategy for interdisciplinary relationships in the teaching-learning process of clinical subjects, with Pharmacology in the Stomatology career. Methods: Educational research was carried out, between January and June, 2022. Theoretical methods (analytical-synthetic, inductive-deductive and systematization), empirical (consultation to experts) and mathematical-statisticians (descriptive statistics). The experts were selected according to the level of competence. A questionnaire was developed and applied to assess 16 aspects of the strategy, in terms of: very suitable, quite suitable, suitable, not very suitable and not suitable. The evaluative criteria issued by the experts were processed using the Torgerson mathematical model and the level of consensus of the experts was determined by calculating the Kendall concordance coefficient. Results: The average competence coefficient of the experts turned out to be high. Of the 16 aspects assessed, one was "fairly adequate" and the rest, "very adequate". Significant agreement was estimated between the experts consulted Conclusions: The results of the expert consultation point to the recognition of the scientific, theoretical and practical value of the didactic strategy designed to favor interdisciplinary relationships in the teaching-learning process of clinical subjects with Pharmacology in the Stomatology career, and give validity to the same.
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Introdução: A alta prevalência do uso de medicamentos na população brasileira pode interferir na prescrição odontológica. Objetivos: Identificar os medicamentos em uso por pacientes atendidos em uma clínica de cirurgia oral menor e estimar os riscos de interações medicamentosas (IM) potenciais com fármacos comumente prescritos em procedimentos cirúrgicos. Materiais e Métodos: Realizou-se um estudo piloto analítico e transversal, sendo incluídos 24 pacientes atendidos na Clínica de Cirurgia Oral da Faculdade de Odontologia de uma universidade pública brasileira. Os dados foram coletados por meio de um questionário exploratório. Todos os medicamentos foram classificados no sistema Anatomical Therapeutic Chemical (ATC). As IM potenciais foram analisadas no banco de dados do Drugs® após correlação entre os medicamentos em uso pelo paciente e os medicamentos comumente prescritos em cirurgia oral.Resultados: Observou-se prevalência de 66,7% (n= 16) no uso de pelo menos 1 medicamento dentre os pacientes atendidos na clínica de cirurgia oral, com média de 3,5 (±2,2) medicamentos, sendo a polifarmácia identificada em 16,6% pacientes (n= 4). A média de idade dos usuários de medicamentos foi de 52 (±16) anos e totalizou-se 56 medicamentos. Os fármacos mais prevalentes foram aqueles atuantes nos sistemas nervoso e cardiovascular. Quando simuladas as adições dos fármacos comumente prescritos em cirurgia oral (anti-inflamatórios, analgésicos e antimicrobianos) aos medicamentos em uso pelos 16 pacientes, identificou-se 75 IM potenciais diferentes, sendo 61 (81%) de gravidade moderada e 14 (19%) de gravidade alta. As IM potenciais mais frequentes foram de anti-hipertensivos com anti-inflamatórios, enquanto as de importância clínica grave envolveram fármacos de ação central e analgésicos opioides. Conclusão: Observou-se alta prevalência na utilização de medicamentos pelos pacientes atendidos na clínica de cirurgia oral, com importante risco de interações com medicamentos prescritos em procedimentos cirúrgicos.
Introduction: The high prevalence of drug use in the Brazilian population can interfere with dental prescriptions.Objective: To identify drugs being used by patients seen at a minor oral surgery clinic and to estimate the risks of potential drug interactions (DI) with drugs commonly prescribed in surgical procedures. Materials and Methods: An analytical and cross-sectional pilot study was carried out, including 24 patients treated at the Oral Surgery Clinic of the Dental School of a Brazilian Federal University. Data were collected through an exploratory questionnaire. All drugs were classified in the Anatomical Therapeutic Chemical (ATC) system. Potential DI were analyzed in the Drugs® database after correlation between the drugs used by the patient and the drugs commonly prescribed in oral surgery.Results: There was a prevalence of 66.7% (n= 16) in the use of at least 1 medication among patients seen at the oral surgery clinic, with a mean of 3.5 (±2.2) medications, with polypharmacy identified in 16.6% patients (n= 4). Mean age of medication users was 52 (±16) years, totaling 56 medications. The most prevalent drugs were those acting on the nervous and cardiovascular systems. When the additions of drugs commonly prescribed in oral surgery (anti-inflammatory drugs, analgesics and antimicrobials) to the drugs used by the 16 patients were simulated, 75 different potential DI were identified, 61 (81%) of moderate severity and 14 (19%) of high gravity. The most frequent potential DIs were antihypertensives with anti-inflammatory drugs, while those of serious clinical importance involved centrally acting drugs and opioid analgesics. Conclusion: There was a high prevalence of medication use by patients seen at the oral surgery clinic, with a significant risk of interactions with prescribed medications in surgical procedures.
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Procedimientos Quirúrgicos Orales , Interacciones Farmacológicas , Prescripciones de Medicamentos , Cirugía Bucal , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos , Utilización de Medicamentos , Medicamentos bajo PrescripciónRESUMEN
La homeopatía emplea el denominado 'principio de similares' como método terapéutico el cual consiste en administrar medicamentos que provocan ciertos síntomas en individuos sanos para tratar síntomas similares en individuos enfermos (similia similibus curantur) - para inducir una reacción curativa secundaria del cuerpo en contra de sus propios trastornos. Esta reacción secundaria (vital, homeostática o paradójica) del cuerpo se basa en el 'efecto de rebote' de los fármacos modernos, un tipo de evento adverso que se produce después de interrumpir varias clases de fármacos prescritos según el 'principio de los contrarios' (contraria contrariis curantur). Objetivo: La presente revisión ha buscado justificar científicamente el principio de curación homeopática frente a la farmacología clínica y experimental a través de un estudio sistemático del efecto de rebote de los fármacos modernos o reacción paradójica del cuerpo. Métodos: Empleando como referencia estudios y revisiones sobre el tema publicados a partir de 1998, actualizamos los datos añadiendo estudios recientes incluidos en la base de datos PubMed. Resultados: El efecto de rebote se produce después de interrumpir varias clases de fármacos con acción contraria a los síntomas de las enfermedades, exacerbándolos a niveles superiores a aquellos previos al tratamiento. Independientemente de la enfermedad, fármaco, dosis y duración del tratamiento, el fenómeno del rebote se manifiesta en una pequeña proporción de los individuos susceptibles. Siguiendo las premisas homeopáticas, los fármacos modernos también podrían usarse según el principio de la similitud terapéutica, empleando entonces el efecto de rebote (reacción paradójica) con propósito curativo. Conclusiones: Evidenciado por cientos de estudios que constatan la similitud de conceptos y manifestaciones, el efecto de rebote de los fármacos modernos justifica científicamente el principio de la cura homeopática. Aunque el fenómeno de rebote es un evento adverso estudiado por la farmacología moderna, no es conocido por los profesionales de la atención médica, lo cual priva a los médicos de un conocimiento indispensable para el manejo seguro de los fármacos.
Homeopathy employs the so-called 'principle of similars' as therapeutic method - which consists in administering medicines that cause certain symptoms in healthy individuals to treat similar symptoms in sick individuals (similia similibus curantur) - to induce a secondary and healing reaction by the body against its own disorders. This secondary (vital, homeostatic or paradoxical) reaction of the body is based on the 'rebound effect' of modern drugs, a type of adverse event that occurs following discontinuation of several classes of drugs prescribed according to the 'principle of contraries' (contraria contrariis curantur). Aim: The present review sought to scientifically substantiate the homeopathic healing principle vis-à-vis experimental and clinical pharmacology through a systematic study of the rebound effect of modern drugs or paradoxical reaction of the body. Methods: Employing as reference studies and revisions on the subject published since 1998, we updated the data adding recent studies included in database PubMed. Results: The rebound effect occurs after discontinuation of several classes of drugs with action contrary to the symptoms of diseases, exacerbating them to levels above the ones before treatment. Regardless of disease, drug, dose and duration of treatment, the rebound phenomenon manifests in a small proportion of susceptible individuals. Following the homeopathic premises, modern drugs might also be used according to the principle of therapeutic similitude, thus employing the rebound effect (paradoxical reaction) with curative intent. Conclusions: Evidenced by hundreds of studies that attest to the similarity of concepts and manifestations, the rebound effect of modern drugs scientifically substantiates the principle of homeopathic cure. Although the rebound phenomenon is an adverse event studied by modern pharmacology, it is not known by health care professionals, thus depriving doctors of knowledge indispensable for safe management of drugs.
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Farmacocinética del Medicamento Homeopático , /estadística & datos numéricos , Efecto Rebote , Efecto ReboteRESUMEN
OBJECTIVE: To describe the marginal cost and survival of patients treated with tocilizumab in a university hospital under real-life conditions and to evaluate factors that could influence costs and health outcomes will be evaluated. METHODS: Observational, single-center, retrospective study of a cohort of adult patients infected with SARS-COV2 treated with tocilizumab. The 1â¯year restricted mean survival time was analyzed in life-years gained (LYG). The influence of sex, age and severity on patient survival was evaluated. The marginal cost/LYG and marginal cost/survivor ratios were calculated. RESULTS: 508 patients (66⯱â¯13â¯years; 32% women) were included. Seventeen percent were admitted to the ICU. Overall survival was 77%. Age older than 71.5â¯years (HRâ¯=â¯1.08; 95% CI 1.07-1.10; pâ¯<â¯0.001) and ICU admission at initiation of treatment (HRâ¯=â¯2.01; 95% CI 1.30-3.09; pâ¯=â¯0.002) were identified as risk factors. The total budgetary impact of tocilizumab in the period analyzed was 206,466 euros. The patients with the highest cost per unit of health outcome were those admitted to the ICU and those over 71.5â¯years, with a marginal cost/LYG of 966 and a marginal cost/survivor of 1136. CONCLUSION: The efficiency of treatment with tocilizumab is associated with the age and severity of the patients. The figures are lower in all subgroups than the thresholds usually used in cost-effectiveness evaluations. The results of the present study suggest that early first dose of tocilizumab is an efficient strategy.
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COVID-19 , Adulto , Humanos , Femenino , Anciano , Masculino , SARS-CoV-2 , Estudios Retrospectivos , ARN Viral , Resultado del Tratamiento , Tratamiento Farmacológico de COVID-19RESUMEN
OBJECTIVE: To describe the marginal cost and survival of patients treated with tocilizumab in a university hospital under real-life conditions and to evaluate factors that could influence costs and health outcomes will be evaluated. METHODS: Observational, single-center, retrospective study of a cohort of adult patients infected with SARS-CoV-2 treated with tocilizumab. The one-year restricted mean survival time was analyzed in life-years gained (LYG). The influence of sex, age and severity on patient survival was evaluated. The marginal cost/LYG and marginal cost/survivor ratios were calculated. RESULTS: 508 patients (66 ± 13 years; 32% women) were included. Seventeen percent were admitted to the ICU. Overall survival was 77%. Age older than 71.5 years (HR = 1.08; 95% CI 1.07-1.10; p < 0.001) and ICU admission at initiation of treatment (HR = 2.01; 95% CI 1.30-3.09; p = 0.002) were identified as risk factors. The total budgetary impact of tocilizumab in the period analyzed was 206,466 euros. The patients with the highest cost per unit of health outcome were those admitted to the ICU and those over 71.5 years, with a marginal cost/LYG of 966 and a marginal cost/survivor of 1,136. CONCLUSION: The efficiency of treatment with tocilizumab is associated with the age and severity of the patients. The figures are lower in all subgroups than the thresholds usually used in cost-effectiveness evaluations. The results of the present study suggest that early first dose of tocilizumab is an efficient strategy.
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COVID-19 , Adulto , Humanos , Femenino , Anciano , Masculino , SARS-CoV-2 , Estudios Retrospectivos , Tratamiento Farmacológico de COVID-19 , Resultado del TratamientoRESUMEN
ABSTRACT BACKGROUND AND OBJECTIVES: Pharmaceutical preparations of cannabis have been used by mankind since long time ago, and recently they have been the pharmaceutical industry's focus. However, for proper therapeutic application, in-depth knowledge of the endocannabinoid system, which is made mainly by lipid signaling, is needed. The purpose of this study was to explore the current understanding of the players in this system, paying special attention to the molecular machinery required to process it. CONTENTS: This is a narrative review of the current literature regarding major components of the endocannabinoid system, in particular: the receptors, main endogenous ligands, and the enzymes responsible for its components processing. The pharmacological and preclinical aspects were emphasized. CONCLUSION: The better comprehension of the molecular structure of receptors and enzymes will be crucial to developing new pharmacological strategies. A detailed description of the machinery responsible for endocannabinoid lipid metabolization will pave the way for the discovery of new drugs that act on the endogenous system and that can be applied effectively in clinical practice.
RESUMO JUSTIFICATIVA E OBJETIVOS: Os preparados medicinais canabinoides são há muito utilizados pela humanidade e têm sido objeto de interesse da indústria farmacológica recente. Para a aplicação terapêutica adequada é necessário, no entanto, o conhecimento aprofundado do sistema canabinoide endógeno, o qual em sua grande parte é constituído por mensageiros lipídicos. O objetivo deste estudo foi explorar o conhecimento vigente a respeito dos constituintes desse sistema, com especial atenção à maquinaria molecular necessária para processá-los. CONTEÚDO: Trata-se de uma revisão narrativa da literatura atual acerca dos integrantes do sistema canabinoide endógeno, notadamente: seus receptores, os principais ligantes endógenos e as enzimas responsáveis pelo processamento de seus componentes. Os aspectos farmacológicos e pré-clínicos foram enfatizados. CONCLUSÃO: O melhor entendimento da ultraestrutura de receptores e enzimas contribuirá de forma decisiva para o desenvolvimento de novas estratégias farmacológicas. A partir da descrição pormenorizada da maquinaria responsável pela metabolização lipídica endocanabinoide é que se pavimentará o caminho para a descoberta de novos fármacos que atuem no sistema endógeno e que possam ser aplicados de forma eficaz na prática clínica.
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Introducción: los sistemas de conocimientos y habilidades de cada profesión deben responder a los cambios sociales; esto implica el análisis constante para perfeccionarlos permanentemente. Objetivo: comparar los elementos fundamentales de los planes de estudio C, D y E de la asignatura Farmacología General para contribuir a la preparación de los docentes y mejorar el proceso enseñanza aprendizaje. Métodos: se realizó una revisión bibliográfica sistemática y documental que incluyó varias fuentes, entre ellas: resoluciones, programas de la asignatura Farmacología General, libros, artículos originales y de revisión. Se seleccionaron 24 fuentes teniendo en cuenta su pertinencia y actualización según el objetivo del trabajo. La búsqueda digital se realizó en las bases de datos Scopus, SciELO y Medline de los últimos cinco años. Las palabras claves utilizadas fueron: proceso docente educativo, farmacología general, plan de estudio, programa y educación médica. Desarrollo: se constató coherencia sistémica en los temas básicos de los programas, ajuste en sus objetivos, contenidos y evaluación de acuerdo con el modelo del profesional que se aspira a formar, con transformaciones en las horas clase, contenidos y formas organizativas de la enseñanza, responde al modelo del profesional que se aspira a formar; sin embargo, es susceptible de ser perfeccionado. Conclusiones: el programa de la asignatura Farmacología General ha experimentado un constante proceso de transformación según los cambios experimentados en el sistema de salud cubano, en busca de un mejor desarrollo del proceso docente educativo y de elevar su calidad y pertinencia.
Introduction: the knowledge and skills systems of each profession must respond to social changes; this implies constant analysis to improve them permanently. Objective: to compare the fundamental elements of the C, D and E study plans of the General Pharmacology subject to contribute to the preparation of teachers and improve the teaching-learning process. Methods: a systematic and documentary bibliographic review was carried out that included several sources, among them: resolutions, General Pharmacology subject programs, books, original and review articles. 24 sources were selected taking into account their relevance and updating according to the objective of the work. The digital search was carried out in the Scopus, SciELO and Medline databases of the last five years. The keywords used were educational teaching process, general pharmacology, study plan, program and medical education. Development: systemic coherence was verified in the basic topics of the programs, adjustment in their objectives, contents, and evaluation in accordance with the model of the professional desired to train, with transformations in class hours, contents, and organizational forms of teaching, responds to the model of the professional to train; however, it is capable of being perfected. Conclusions: the program of the General Pharmacology subject has undergone a constant transformation process according to the changes experienced in the Cuban health system, in search of a better development of the teaching-learning process and to raise its quality and relevance.
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Farmacología , Educación Médica , Capacitación Profesional , AprendizajeRESUMEN
O uso indiscriminado dos antimicrobianos tem gerado um problema significativo na saúde pública, acarretando impactos negativos como fracasso na farmacoterapia frente as infecções bacterianas e aumentos nos custos assistenciais. Esta revisão narrativa tem como objetivo descrever as propriedades farmacocinéticas e farmacodinâmicas e aplicações clínicas dos principais antibióticos pertencentes a classe dos glicopeptídeos. A busca de artigos foi realizada nas seguintes bases de dados: Literatura Latino Americana e do Caribe em Ciências da Saúde (LILACS/PUBMED), SciELO (Scientific Electronic Library Online) e Biblioteca Virtual em Saúde (BVS). A vancomicina e a teicoplanina são fármacos de primeira linha no tratamento de infecções por bactérias gram-positivas com resistência a outros antibióticos. Ambos apresentam estruturas cíclicas complexas, contendo aminoácidos ligados a grupos de carboidratos que lhe conferem propriedades únicas. A administração dos glicopetídeos deve ponderar fatores relacionados ao paciente como faixa etária, função renal, desnutrição e obesidade devido a sua heterogeneidade farmacocinética, por isso o monitoramento sérico é recomendado para assegurar concentrações plasmáticas efetivas. Diante do exposto, o uso adequado e baseado em evidência científica dessa importante classe de antibióticos visa otimizar o tratamento farmacoterapêutico e diminuir o avanço da resistência bacteriana.
The indiscriminate use of antimicrobials has generated a significant problem in public health, causing negative impacts such as failure in pharmacotherapy against bacterial infections and increases in healthcare costs. This narrative review aims to describe the pharmacokinetic and pharmacodynamic properties and clinical applications of the main antibiotics belonging to the class of glycopeptides. The search for articles was carried out in the following databases: Latin American and Caribbean Literature in Health Sciences (LILACS/PUBMED), SciELO (Scientific Electronic Library Online), and Virtual Health Library (BVS). Vancomycin and teicoplanin are first- line drugs in infections caused by gram-positive bacteria it resistant to other antibiotics. Both have complex cyclic structures containing amino acids linked to carbohydrate groups that give them unique properties. The administration of glycopeptides must consider patient-related factors such as age group, renal function, malnutrition, and obesity due to its pharmacokinetic heterogeneity. Therefore, serum monitoring is recommended to ensure effective plasma concentrations. Thus, the proper use based on scientific evidence of this important class of antibiotics aims to optimize pharmacotherapeutic treatment and reduce the progress of bacterial resistance.
El uso indiscriminado de antimicrobianos ha generado un problema impor- tante en la salud pública, provocando impactos negativos como el fracaso en la farmaco- terapia contra las infecciones bacterianas y el aumento de los costos sanitarios. Esta revi- sión narrativa tiene como objetivo describir las propiedades farmacocinéticas, farmaco- dinámicas y aplicaciones clínicas de los principales antibióticos pertenecientes a la clase de los glicopéptidos. La búsqueda de artículos se realizó en las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS/PUBMED), SciELO (Scientific Electronic Library Online) y Biblioteca Virtual en Salud (BVS). La vancomicina y la teicoplanina son fármacos de primera línea en el tratamiento de infec- ciones causadas por bacterias grampositivas resistentes a otros antibióticos. Ambos tienen estructuras cíclicas complejas, que contienen aminoácidos unidos a grupos de carbohi- dratos que les otorgan propiedades únicas. La administración de glicopéptidos debe con- siderar factores relacionados con el paciente, como el grupo de edad, la función renal, la desnutrición y la obesidad debido a su heterogeneidad farmacocinética, por lo que se re- comienda el monitoreo sérico para asegurar concentraciones plasmáticas efectivas. En vista de lo anterior, el uso adecuado basado en la evidencia científica de esta importante clase de antibióticos tiene como objetivo optimizar el tratamiento farmacoterapéutico y reducir la propagación de resistencias bacterianas.
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El trabajo educativo consiste en transmitir un mensaje coherente desde la propia ciencia y estimula la motivación del aprendizaje de los estudiantes y su propia actividad cognoscitiva. El propósito de la educación médica superior es egresar un profesional integral; por tanto, se trata de instruir y educar a los estudiantes en los más altos valores patrióticos, morales y éticos en cada uno de los escenarios docentes, desde la propia ciencia. El objetivo de esta comunicación es ejemplificar algunos contenidos sobre la temática referente a medicamentos antiulcerosos en los que se puede intencionar el trabajo educativo desde la propia ciencia.
The educational work consists of transmitting a coherent educational message from science itself and stimulates the students' learning motivation and their own cognitive activity. The purpose of higher medical education is to graduate a comprehensive professional; therefore, it is about instructing and educating students in the highest patriotic, moral and ethical values in each of the teaching scenarios, from science itself. The objective of this research paper is to exemplify some content on the subject related to antiulcer drugs from which educational work can be intentioned from science itself.