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Introducción: Las aplicaciones móviles (Apps) están transformando las perspectivas de aprendizaje en entornos de salud. Objetivo: Evaluar la efectividad y usabilidad de EpiApp como herramienta de apoyo en la consulta y resolución de problemas de epidemiología comparada con métodos tradicionales (MT). Materiales y métodos: Se diseñó EpiApp usando una estructura metodológica. Se realizó un estudio experimental controlado y aleatorizado con dos grupos: EpiApp y MT. La fectividad se evaluó con un cuestionario estandarizado y la usabilida con la escala MARS. Resultados: Se aleatorizaron 176 estudiantes: EpiApp (n=88) y MT (n=88). El tiempo de respuesta fue menor para los usuarios de EpiApp (23,99 min [± DE 8,38] vs. 29,16 min [± DE 11,61], p = 0,005). No hubo diferencias en el número de respuestas correctas (p = 0,635), ni en la oportunidad de aprobar el cuestionario (p = 0,054). La usabilidad fue buena (MARS > 4). Discusión: Las Apps móviles tienen un gran potencial para ser útiles en la educación en salud y en la toma de decisiones en epidemiología, así como en la atención médica en general. No obstante, es esencial realizar estudios rigurosos para garantizar que estas aplicaciones sean efectivas, útiles, fáciles de usar y comprender. Conclusiones: EpiApp redujo el tiempo de respuesta en la resolución de problemas de epidemiología sin afectar el número de respuestas correctas. La usabilidad fue buena, aunque hay oportunidad de mejora en diversión, interés, adaptabilidad individual e interactividad. La efectividad y usabilidad de EpiApp requiere ser validada con estudios más rigurosos y en diferentes contextos.
Introduction: Mobile applications (Apps) are transforming learning perspectives in healthcare settings. Objective: To evaluate the effectiveness and usability of EpiApp as a support tool in the consultation and resolution of epidemiology problems, compared to traditional methods (TM). Methodology: EpiApp was designed using a methodological structure. A randomized controlled experimental study was conducted with two groups: EpiApp and TM. A standardized questionnaire and the MARS scale were used to evaluate effectiveness and usability, respectively. Results: A total of 176 students were randomized: EpiApp (n=88) and TM (n=88). Response time was shorter for EpiApp users (23.99 min [±SD 8.38] vs. 29.16 min [±SD 11.61], p=0.005). There were no differences in the number of correct responses (p=0.635) or the opportunity to pass the questionnaire (p=0.054). Usability was good (MARS>4). Discussion: Mobile Apps have great potential to be useful in healthcare education and decision-making in epidemiology, as well as in general medical care. However, it is essential to conduct rigorous studies to ensure that these applications are effective, useful, and easy to use and understand. Conclusions: EpiApp reduced response time in solving epidemiology problems without affecting the number of correct answers. The usability was good, although there is room for improvement in terms of enjoyment, interest, individual adaptability, and interactivity. The effectiveness and usability of EpiApp need to be validated through more rigorous studies in different contexts.
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In this study, IL-6 levels were assessed as inflammatory biomarker of bacterial sepsis in patients hospitalized at the ICU of the hospital of Colombia. Materials and methods: Prospective study on 62 patients diagnosed with sepsis and septic shock. An ELISA assay was used to test serum levels of IL-6 at admission and 48 h after admission. Variables were analyzed by χ2 test (alfa <0.05). Multivariable Cox regression was used to determine the survival with the statistical program SPSS v23.00. Results: Patient's median age was 53 years old and 59.7% were male. Lung was the most common primary site of infection (43.5%), and hypertension comorbidity with higher prevalence (40%). Infection by Gram negative bacteria were significantly more frequent among patients than Gram positive (P = 0.037). Overall, survival analysis showed that 10 (16.1%) patients died with a survival median of 7.00 +4.874 (2-3) days. In patients with sepsis we detected a significant decline in the average of IL-6 serum levels after 48 h of admission [7.50 (SD: 7.00-68.00) pg/mL vs. 68.00 [SD: 7.00-300.00] pg/mL (P = 0.000). Only 25% of patients with septic shock who presented high levels of IL-6 at the time of admission and at 48 h had a survival up to 15 days (P = 0.005). Conclusion: We found significant differences between the plasma levels of IL-6 during the first 48 h after admission to the ICU among patients with sepsis and septic shock. Patients with sepsis had a significant decline in IL-6 levels, whereas in patients who developed septic shock, levels of this cytokine remained high and have a lower survival compared to those who maintained low levels of IL-6.
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Background. Interleukin-10 (IL-10) is a multifunctional cytokine which has been seen to play a relevant role in the pathogenesis of sepsis. We examined the association between a single nucleotide polymorphism (SNP) in IL-10-1082G/A in patients with sepsis in Cali city.Methods. A total of 100 patients with sepsis and 50 control subjects were enrolled in this study. Blood samples were collected from all patients in EDTA containing tubes. IL-10-1082G/A gene promoter polymorphism was analyzed by Sequence Specific Polymerase Chain Reaction (SS-PCR), while levels of serum IL-10 were measured by Enzyme Linked Immunoassay Assay (ELISA) in patients with sepsis and healthy controls.Results. AA homozygous genotype was found more frequently in patients (32%), compared with controls (18%). AA homozygous patients showed an increased risk of developing infection by Gram-negative bacteria (OR = 2,875; 95% CI = 1.162-7.113; p = 0.020), and significantly high plasma levels of IL-10 (OR = 4.800, 95% CI 1.652-13.944; p = 0.002). AA homozygous patients high plasma IL-10 levels have greater risk of developing sepsis (63.6%; OR = 4,894; 95% CI: 1,337-17,909; p = 0.002). In this group, Afro-Colombian individuals were overrepresented among the sepsis patients with high plasma IL-10 levels (OR = 1.661; 95% CI: 1.408-1.959; p = 0.036).Conclusion. Our study concluded that AA genotype of IL-10-1082G/A polymorphism is a risk factor for high IL-10 production and development of sepsis by Gram negative bacteria, especially in Afro-Colombian patients.