RESUMEN
Even though the general public opinion towards nanotechnology applications to health has been studied, medical residents' opinions remain unknown. The purpose of this study was to evaluate the perception, knowledge, and attitude of medical residents towards nanomedicine using a 35-item questionnaire. Correlations between intrinsic factors, heuristics, and attitude towards nanomedicine were analyzed using the χ 2 test. Seventy medical residents participated. Nanomedicine was perceived as a developing field in its clinical trial stages. Responsibility for nanomedicine was attributed to scientists, whereas its ethical responsibility to physicians. The majority reported not having adequate access to information. A positive attitude towards nanomedicine was correlated with higher willingness to use nanomedicine to diagnose and treat patients (p < 0.05). Medical residents had a positive attitude towards nanomedicine. However, they lacked accurate knowledge in the field. Participants might have relied on availability heuristics to form their opinion. Formal education for the "handlers" of nanomedicine seems to be needed.
RESUMEN
Our understanding of the role of antibiotics in the management of patients with pancreatic necrosis has changed over the past 5 years. Initial studies suggested that antibiotics were useful in preventing infection of necrosis, septic complications, and mortality in patients with acute pancreatitis; however, more recent, better-designed studies established that prophylactic antibiotics are not helpful. In the absence of infection, sterile necrosis is treated conservatively. With insufficient evidence to recommend antibiotics, these agents should be reserved to treat established infection of pancreatic necrosis. Infected necrosis is treated by targeting microbes with pancreatic-penetrating antibiotics (eg, carbapenems, quinolones in combination with metronidazole, or high-dose cephalosporins). If the patient with infected necrosis remains septic or deteriorates, surgical intervention should be performed urgently. Stable patients with infected necrosis can be managed more conservatively in a closely monitored environment. Recent studies suggest that many patients can clear the infection with antibiotics, but even if they do not clear the infection, delay in surgery decreases the mortality rate. Delaying surgery by using antibiotics may allow use of less invasive procedures if drainage is needed. The timing and method of interventions must be individualized based on the patient's condition, anatomic complications, patient's preference after informed consent, and expertise available at the institution.
