Unveiling Colombia's medicinal Cannabis sativa treasure trove: Phenotypic and Chemotypic diversity in legal cultivation.

INTRODUCTION: Cannabis sativa is a highly versatile plant with a long history of cultivation and domestication. It produces multiple compounds that exert distinct and valuable therapeutic effects by modulating diverse biological systems, including the endocannabinoid system (ECS). Access to standardized, metabolically diverse, and reproducible C. sativa chemotypes and chemovars is essential for physicians to optimize individualized patient treatment and for industries to conduct drug-discovery campaigns. OBJECTIVE: This study aimed to characterize and assess the phytochemical diversity of C. sativa chemotypes in diverse ecological regions of Colombia, South America. METHODOLOGY: Ten cannabinoids and 23 terpenes were measured using liquid and gas chromatography, in addition to other phenotypic traits, in 156 C. sativa plants that were grown in diverse ecological regions in Colombia, a hotspot for global biodiversity. RESULTS: Our results reveal significant phytochemical diversity in Colombian-grown C. sativa plants, with four distinct chemotypes based on cannabinoid profile. The significant amount of usually uncommon terpenes suggests that Colombia's environments may have unique capabilities that allow the plant to express these compounds. Colombia's diverse climates offer enormous cultivation potential, making it a key player in both domestic and international medicinal and recreational C. sativa trade. CONCLUSION: These findings underscore Colombia's capacity to pioneer global C. sativa production diversification, particularly in South America with new emerging markets.

Programa de actividades físicas adaptadas para la inclusión de estudiantes en estado de gestación, en la clase de Educación Física

El presente estudio investigativo abordó el tema de la inclusión de las gestantes adolescentes en las clases de Educación Física, enfocado al mejoramiento de la salud física y el bienestar de la madre y el feto durante el embarazo. El objetivo principal del trabajo fue proponer un programa de actividades físicas adaptadas para la inclusión de estudiantes en estado de gestación en la clase de Educación Física, en la Unidad educativa fiscal "Pichincha". Se planteó una metodología con enfoque cualitativo, se utilizaron como métodos empíricos la observación científica, la entrevista, la encuesta y la revisión documental que facilitaron la identificación del problema en la parte inicial hasta la realización de la propuesta de ejercicios físicos adaptados, en su etapa final. Se concluye con la aplicación y ejecución de actividades físicas adaptadas, y se obtienen mejoras en la salud cardiovascular, el fortalecimiento de los músculos y las articulaciones, el control del aumento de peso, la reducción del riesgo de complicaciones del embarazo y la mejora del bienestar emocional. Estos resultados fueron comparados con investigaciones de otros autores que corroboran que implementar actividades físicas adaptadas contribuye al mejoramiento de la salud, tanto de la madre como del feto.

A presente pesquisa abordou a questão da inclusão de adolescentes grávidas nas aulas de Educação Física, com foco na melhoria da saúde física e do bem-estar da mãe e do feto durante a gravidez. O objetivo principal do trabalho foi propor um programa de atividades físicas adaptado para a inclusão de estudantes grávidas na aula de Educação Física, na unidade educacional fiscal "Pichincha". Foi proposta uma metodologia com abordagem qualitativa, foram utilizados observação científica, entrevista, levantamento e revisão documental como métodos empíricos que facilitaram a identificação do problema na parte inicial até a realização da proposta de exercícios físicos adaptados, em sua etapa final. . Conclui com a aplicação e execução de atividades físicas adaptadas, obtendo-se melhorias na saúde cardiovascular, fortalecimento de músculos e articulações, controle do ganho de peso, redução do risco de complicações na gravidez e melhora do bem-estar emocional. Esses resultados foram comparados com pesquisas de outros autores que corroboram que a implementação de atividades físicas adaptadas contribui para melhorar a saúde da mãe e do feto.

The present research study addressed the issue of the inclusion of pregnant adolescents in Physical Education classes, focused on improving the physical health and well-being of the mother and fetus during pregnancy. The main objective of the work was to propose a program of physical activities adapted for the inclusion of pregnant students in the Physical Education class, in the "Pichincha" Fiscal Educational Unit. A methodology with a qualitative approach was proposed, scientific observation, interview, survey and documentary review were used as empirical methods that facilitated the identification of the problem in the initial part until the proposal of adapted physical exercises was carried out, in its final stage. It concludes with the application and execution of adapted physical activities, and improvements are obtained in cardiovascular health, strengthening of muscles and joints, control of weight gain, reduction of the risk of pregnancy complications and improvement of well-being. emotional. These results were compared with research by other authors that corroborate that implementing adapted physical activities contributes to improving the health of both the mother and the fetus.

Effects of exergames on rehabilitation outcomes in patients with osteoarthritis. A systematic review.

PURPOSE: To analyze the effects of exergames on rehabilitation outcomes in osteoarthritis (OA) patients. MATERIALS AND METHODS: A systematic review was reported according to the PRISMA statement. Randomized controlled trials (RCTs) were searched in Pubmed, Scopus, WoS, CINAHL, and PEDro (inception to November 2023). Studies that applied non-immersive exergames and assessed physical, functional, cognitive, pain, and psychosocial outcomes were included. Comparisons were other exercise modalities and non-intervention. Methodological quality was assessed with PEDro scale, and risk of bias (RoB) was assessed with Cochrane RoB-2 tool. RESULTS: Eight studies were included (total of participants = 401). The mean PEDro score was 6.1, and seven studies had high RoB. Seven studies involved knee OA and one cervical OA. The most frequent duration for interventions was four weeks. Exergames were more effective than controls in at least one outcome in all studies. The outcomes for which exergames were most effective were functional disability, postural balance, muscle strength, proprioception, gait, range of motion, pain, quality of life, depression, and kinesiophobia. CONCLUSION: Non-immersive exergames constitute an effective strategy for optimizing several relevant outcomes in rehabilitation. However, more RCTs with high methodological quality are required to deepen the knowledge about the multidimensional effects of exergames in OA patients.

Osteoarthritis (OA) is one of the leading causes of disability, involving high health costs and a public health problem.Physical exercise has recently been recognized as a first-line treatment in OA to reduce symptomatology and to improve or maintain physical functioning and quality of life.Non-immersive exergames are a safe therapeutic strategy to improve functional disability, postural balance, muscle strength, proprioception, gait performance, range of motion, and pain in OA patients.Similarly, non-immersive virtual reality strategies contribute to the improvement of depression, kinesiophobia, and quality of life in people with OA.

Manejo de la vía aérea ante un caso de paro respiratorio en un escenario clínico simulado. Experiencia en una residencia de pediatría / Airway management during a respiratory arrest in a clinical simulation scenario. Experience at a pediatric residency program

Introducción. La insuficiencia respiratoria es la causa más común de paro cardíaco en pediatría; su reconocimiento y el manejo adecuado son cruciales. La simulación se utiliza para mejorar las habilidades médicas. El objetivo del trabajo fue determinar la proporción de residentes de pediatría que reconocieron un paro respiratorio (PR) pediátrico en un centro de simulación. Métodos. Se realizó un estudio observacional con 77 médicos residentes. Se utilizó un caso simulado de un paciente con dificultad respiratoria que progresa a PR. Resultados. De los 77 participantes, 48 reconocieron el paro respiratorio (62,3 %). El tiempo medio para reconocer el PR fue de 34,43 segundos. Conclusión. El 62,3 % de los participantes logró reconocer el paro respiratorio. Entre aquellos que lo identificaron, el tiempo promedio fue de 34,43 segundos. Se observaron graves deficiencias en algunas de las intervenciones esperadas.

Introduction. Respiratory failure is the most common cause of cardiac arrest in pediatrics. Recognizing and managing it adequately is critical. Simulation is used to improve medical skills. The objective of this study was to establish the proportion of pediatric residents who recognized a respiratory arrest in a child at a simulation center. Methods. This was an observational study in 77 residents. A simulation of a patient with respiratory distress that progressed to respiratory arrest was used. Results. Among the 77 participants, 48 recognized respiratory arrest (62.3%). The mean time to recognize respiratory arrest was 34.43 seconds. Conclusion. Respiratory arrest was recognized by 62.3% of participants. Among those who did so, the average time was 34.43 seconds. Severe failures were noted in some of the expected interventions.

Airway management during a respiratory arrest in a clinical simulation scenario. Experience at a pediatric residency program. / Manejo de la vía aérea ante un caso de paro respiratorio en un escenario clínico simulado. Experiencia en una residencia de pediatría.

Introduction. Respiratory failure is the most common cause of cardiac arrest in pediatrics. Recognizing and managing it adequately is critical. Simulation is used to improve medical skills. The objective of this study was to establish the proportion of pediatric residents who recognized a respiratory arrest in a child at a simulation center. Methods. This was an observational study in 77 residents. A simulation of a patient with respiratory distress that progressed to respiratory arrest was used. Results. Among the 77 participants, 48 recognized respiratory arrest (62.3%). The mean time to recognize respiratory arrest was 38.16 seconds. Conclusion. Respiratory arrest was recognized by 62.3% of participants. Among those who did so, the average time was 38.16 seconds. Severe failures were noted in some of the expected interventions.

Introducción. La insuficiencia respiratoria es la causa más común de paro cardíaco en pediatría; su reconocimiento y el manejo adecuado son cruciales. La simulación se utiliza para mejorar las habilidades médicas. El objetivo del trabajo fue determinar la proporción de residentes de pediatría que reconocieron un paro respiratorio (PR) pediátrico en un centro de simulación. Métodos. Se realizó un estudio observacional con 77 médicos residentes. Se utilizó un caso simulado de un paciente con dificultad respiratoria que progresa a PR. Resultados. De los 77 participantes, 48 reconocieron el paro respiratorio (62,3 %). El tiempo medio para reconocer el PR fue de 38,16 segundos. Conclusión. El 62,3 % de los participantes logró reconocer el paro respiratorio. Entre aquellos que lo identificaron, el tiempo promedio fue de 38,16 segundos. Se observaron graves deficiencias en algunas de las intervenciones esperadas.

Communication of medical errors in a simulated clinical scenario. Experience with a pediatric residency group.

OBJECTIVE: To determine the performance of groups of pediatric residents from a Buenos Aires hospital, in terms of correct recognition and communication of a medical error (ME), in a high-fidelity simulation scenario. To describe the reactions and communication attempts following the ME and the self-perception by the trainees before and after a debriefing. METHODS: Quasi-experimental uncontrolled study conducted in a simulation center. First- and third-year pediatric residents participated. We designed a simulation case in which an ME occurred and the patient deteriorated. During the simulation, participants had to provide information on communicating the ME to the patient's father. We assessed communication performance and, additionally, participants completed a self-perception survey about ME management before and after a debriefing. RESULTS: Eleven groups of residents participated. Ten (90.9%) identified the ME correctly, but only 27.3% (n=3) of them reported that a ME had occurred. None of the groups told the father they were going to give him important news concerning his son's health. All 18 residents who actively participated in this communication completed the self-perception survey, with an average score before and after debriefing of 5.00 and 5.05 (out of 10) (p=0.88). CONCLUSIONS: We observed a high number of groups that recognized the presence of a ME, but the communication action was substantially low. Communication skills were insufficient and residents' self-perception of error management was regular and not modified by the debriefing.

Communication of medical errors in a simulated clinical scenario. Experience with a pediatric residency group / Comunicação de erros médicos em cenário clínico simulado. Experiência com residentes em Pediatria

ABSTRACT Objective: To determine the performance of groups of pediatric residents from a Buenos Aires hospital, in terms of correct recognition and communication of a medical error (ME), in a high-fidelity simulation scenario. To describe the reactions and communication attempts following the ME and the self-perception by the trainees before and after a debriefing. Methods: Quasi-experimental uncontrolled study conducted in a simulation center. First- and third-year pediatric residents participated. We designed a simulation case in which an ME occurred and the patient deteriorated. During the simulation, participants had to provide information on communicating the ME to the patient's father. We assessed communication performance and, additionally, participants completed a self-perception survey about ME management before and after a debriefing. Results: Eleven groups of residents participated. Ten (90.9%) identified the ME correctly, but only 27.3% (n=3) of them reported that a ME had occurred. None of the groups told the father they were going to give him important news concerning his son's health. All 18 residents who actively participated in this communication completed the self-perception survey, with an average score before and after debriefing of 5.00 and 5.05 (out of 10) (p=0.88). Conclusions: We observed a high number of groups that recognized the presence of a ME, but the communication action was substantially low. Communication skills were insufficient and residents' self-perception of error management was regular and not modified by the debriefing.

RESUMO Objetivo: Determinar o desempenho de grupos de residentes pediátricos de um hospital de Buenos Aires, em termos de reconhecimento e comunicação correta de um erro médico (EM),em cenário de simulação. Descrever as reações e tentativas de comunicação após o EM e a autopercepção pelos estagiários antes e depois de um questionário. Métodos: Estudo quase experimental não controlado realizado em centro de simulação. Participaram residentes pediátricos do primeiro e terceiro anos. Concebeu-se um caso de simulação em que ocorreu um EM com deterioração de um paciente. Durante a simulação, os participantes tiveram que fornecer informações relacionadas à comunicação do EM ao pai do paciente. Avaliou-se o desempenho da comunicação e, adicionalmente, os participantes completaram um inquérito de autopercepção sobre a gestão da EM, antes e depois de um questionário. Resultados: Onze grupos de residentes participaram. Dez (90,9%) identificaram corretamente o EM, mas apenas 27,3% (n=3) deles comunicaram que havia ocorrido o EM. Nenhum dos grupos disse ao pai que iria dar notícias importantes sobre a saúde do seu filho. Todos os 18 residentes que participaram ativamente da comunicação completaram o questionário de autopercepção com uma pontuação média antes e depois do questionário de 5,00 e 5,05 (máximo: 10 pontos) (p=0,88). Conclusões: Observamos elevado número de grupos que reconheceram a presença de um EM, mas a ação de comunicação foi rara. A capacidade de comunicação foi insuficiente e a autopercepção da gestão de erros por parte dos residentes foi regular, não sendo modificada pelo debriefing.

Self-directed video versus instructor-based neonatal resuscitation training: a randomized controlled blinded non-inferiority multicenter international study.

OBJECTIVE: To compare the efficacy of video-assisted self-directed neonatal resuscitation skills course with video-assisted facilitator-led course. METHODS: This multicenter, randomized, blinded, non-inferiority-controlled trial compared two methods of teaching basic neonatal resuscitation skills using mask ventilation. Groups of novice providers watched an instructional video. One group received instructor facilitation (Ins-Video). The other group did not (Self-Video). An Objective Structured Clinical Exam (OSCE) measured skills performance, and a written test gauged knowledge. RESULTS: One hundred and thirty-four students completed the study. Sixty-three of 68 in the Self-Video Group (92.6%) and 59 of 66 in the Ins-Video Group (89.4%) achieved post-training competency in positive pressure ventilation (primary outcome). OSCE passing rates were low in both groups. Knowledge survey scores were comparable between groups and non-inferior. CONCLUSIONS: Video self-instruction taught novice providers positive pressure ventilation skills and theoretical knowledge, but it was insufficient for mastery of basic neonatal resuscitation in simulation environment.

Simulación clínica: una estrategia de aprendizaje y enseñanza en el pregrado / Clinical simulation: A strategy of learning and teaching in the undergraduate

No disponible

Xantomatosis cerebrotendinosa: el desafío diagnóstico / Cerebrotendinous xanthomatosis: The diagnostic challenge

No disponible

Modificación de la profundidad de las compresiones cardíacas durante la reanimación cardiopulmonar en un simulador pediátrico / Changes in the depth of chest compressions during cardiopulmonary resuscitation in a pediatric simulator

Introducción. Las compresiones cardíacas (CC) de alta calidad son el principal componente de la reanimación cardiopulmonar (RCP). Objetivos: Evaluar la profundidad de las CC durante las maniobras de RCP realizadas sobre un simulador pediátrico. Secundariamente, explorar la asociación entre la profundidad de las CC con respecto al género, nivel de formación, índice de masa corporal y entrenamiento físico periódico. Material y métodos. Trabajo prospectivo de observación experimental. Se incluyeron médicos residentes de Pediatría, pediatras, enfermeros y otros profesionales capacitados en RCP que asistían a niños. Se registró, mediante un software, la profundidad de las CC mientras realizaban maniobras de RCP durante 2 minutos. Se definió como equivalente a cansancio el deterioro en el número de CC adecuadas en profundidad (> 50 mm) mayor de 3 entre el primero y el último ciclo. Resultados. Participaron 137 sujetos (85,4 % de mujeres). Solamente 48 (35,8 %) presentaron un desempeño adecuado en cuanto a la profundidad. Se observaron diferencias significativas en favor del género masculino (p < 0,0001) y de los pediatras formados por sobre el resto (p 0,038). El 36,5 % de los participantes empeoraron su desempeño en cuanto a la profundidad a los dos minutos. No se observaron diferencias significativas en cuanto al índice de masa corporal y actividad física. Conclusiones. Las CC disminuyeron en profundidad al cabo de dos minutos. No hubo asociación con el índice de masa corporal ni la actividad física habitual de los reanimadores, pero sí en cuanto a género y nivel de formación.

Introduction. High-quality chest compressions (CCs) are the main component of cardiopulmonary resuscitation (CPR). Objectives. T o assess the depth of CCs during CPR using a pediatric patient manikin. A secondary objective was to explore the association between CC depth and sex, level of training, body mass index, and periodic physical training. Material and methods. Prospective study with experimental observation. Pediatric residents, pediatricians, nurses, and other health care providers trained in CPR and who attended children were included. A software program was used to record the depth of CCs while performing CPR during 2 minutes. Tiredness was defined as a deterioration in the number of adequately deep CCs (> 50 mm) by more than 3 CCs between the first and the last cycles. Results. A total of 137 subjects participated (85.4 % were women). Only 48 participants (35.8 %) showed an adequate performance in terms of depth. Significant differences were observed for men (p < 0.0001) and trained pediatricians compared to the rest (p = 0.038). A worsening was observed in performance in terms of depth after 2 minutes in 36.5 % of participants. No significant differences were observed in relation to body mass index and physical activity. Conclusions. Depth rate reduced after 2 minutes. No association was observed with the body mass index or regular physical activity of resuscitators but with their sex and level of training.

Changes in the depth of chest compressions during cardiopulmonary resuscitation in a pediatric simulator. / Modificación de la profundidad de las compresiones cardíacas durante la reanimación cardiopulmonar en un simulador pediátrico.

INTRODUCTION: High-quality chest compressions (CCs) are the main component of cardiopulmonary resuscitation (CPR). Objectives. T o assess the depth of CCs during CPR using a pediatric patient manikin. A secondary objective was to explore the association between CC depth and sex, level of training, body mass index, and periodic physical training. MATERIAL AND METHODS: Prospective study with experimental observation. Pediatric residents, pediatricians, nurses, and other health care providers trained in CPR and who attended children were included. A software program was used to record the depth of CCs while performing CPR during 2 minutes. Tiredness was defined as a deterioration in the number of adequately deep CCs (> 50 mm) by more than 3 CCs between the first and the last cycles. RESULTS: A total of 137 subjects participated (85.4 % were women). Only 48 participants (35.8 %) showed an adequate performance in terms of depth. Significant differences were observed for men (p < 0.0001) and trained pediatricians compared to the rest (p = 0.038). A worsening was observed in performance in terms of depth after 2 minutes in 36.5 % of participants. No significant differences were observed in relation to body mass index and physical activity. CONCLUSIONS: Depth rate reduced after 2 minutes. No association was observed with the body mass index or regular physical activity of resuscitators but with their sex and level of training.

Introducción. Las compresiones cardíacas (CC) de alta calidad son el principal componente de la reanimación cardiopulmonar (RCP). Objetivos: Evaluar la profundidad de las CC durante las maniobras de RCP realizadas sobre un simulador pediátrico. Secundariamente, explorar la asociación entre la profundidad de las CC con respecto al género, nivel de formación, índice de masa corporal y entrenamiento físico periódico. Material y métodos. Trabajo prospectivo de observación experimental. Se incluyeron médicos residentes de Pediatría, pediatras, enfermeros y otros profesionales capacitados en RCP que asistían a niños. Se registró, mediante un software, la profundidad de las CC mientras realizaban maniobras de RCP durante 2 minutos. Se definió como equivalente a cansancio el deterioro en el número de CC adecuadas en profundidad (> 50 mm) mayor de 3 entre el primero y el último ciclo. Resultados. Participaron 137 sujetos (85,4 % de mujeres). Solamente 48 (35,8 %) presentaron un desempeño adecuado en cuanto a la profundidad. Se observaron diferencias significativas en favor del género masculino (p < 0,0001) y de los pediatras formados por sobre el resto (p 0,038). El 36,5 % de los participantes empeoraron su desempeño en cuanto a la profundidad a los dos minutos. No se observaron diferencias significativas en cuanto al índice de masa corporal y actividad física. Conclusiones. Las CC disminuyeron en profundidad al cabo de dos minutos. No hubo asociación con el índice de masa corporal ni la actividad física habitual de los reanimadores, pero sí en cuanto a género y nivel de formación.

[Role of students of medicine in the progress of public health in Latin America.] / Rol de los estudiantes de medicina en el avance de la salud pública en Latinoamérica.

Sr. Editor Según la OPS, la Salud Pública es el esfuerzo organizado de la sociedad, principalmente a través de sus instituciones de carácter público, para mejorar, promover, proteger y restaurar la salud de las poblaciones por medio de actuaciones de alcance colectivo (1). Siguiendo esta definición la educación y práctica médica necesitan salir de las aulas y los hospitales y llegar a donde la realidad social, cultural y económica no lo permite. En Latinoamérica el desarrollo de estas actuaciones colectivas se han convertido en iniciativas netamente estudiantiles sin quitarle valor a los estamentos gubernamentales, pero entendiendo que cada día toman más fuerza y credibilidad (2). Estudiantes que se ven reflejados en un órgano creado en 1986 en Valparaíso, Chile denominado Federación Latinoamericana de Sociedades Científicas de Estudiantes de Medicina FELSOCEM, organización no gubernamental, de carácter científico, no partidista y sin fines de lucro cuyo objetivo general es elevar el nivel científico de los estudiantes de pregrado, promoviendo la investigación cientifica y la educación médica continuada, con proyección a la comunidad (3). Los objetivos de salud pública y la misión de esta organización son similares, y son aún más las actividades que la respaldan como las intervenciones comunitarias denominadas Intervención Rural de Investigación y Saneamiento (IRIS), Campamento Interdisciplinar Regional de Investigación y Servicio (CIRIS) y el Campamento Universitario Multidisciplinar de Investigacion y Servicio (CUMIS), entre otras (4). En Colombia se realizan alrededor de 5 a 10 intervenciones a comunidades vulnerables tanto regionales como nacionales las cuales son administradas por medio de la Asociacion de Sociedades Científicas de Estudiantes de Medicina de Colombia ASCEMCOL que hace parte de FELSOCEM, la cual con ayuda de organizaciones oficiales como el ejército nacional y el ministerio de Salud le dan importancia a los estudiantes que se ven beneficiados de los conocimientos y prácticas que realizan en dichos eventos. El impacto es inconmensurable y los beneficios tanto para los estudiantes como para las organizaciones que los patrocinan son ineludibles. Involucrados en estos procesos, podemos también nombrar el trabajo de investigación cientifica que se desarrolla con la población vulnerable encontrando información muy valiosa para generar política públicas futuras que mejoren la calidad de vida de la población y la salud a largo plazo.

Programa de entrenamiento vacacional en investigación: una propuesta de estudiantes de medicina colombianos / Vacational research training program: a proposal of Colombian medical students

INTRODUCCIÓN: La investigación es una prioridad en la formación académica en el pregrado de medicina; se asocia a positivismo, motivación y pensamiento crítico. Las asociaciones científicas formas un papel fundamental en el fomento de la investigación en el pregrado. El objetivo de este estudio fue describir los resultados del programa vacacional en investigación propuesto por estudiantes de medicina colombianos y evaluar la importancia de fomentarlos en América Latina. MATERIALES Y MÉTODOS: La población de estudio incluyó a los estudiantes de la Universidad Tecnológica de Pereira (Risaralda, Colombia) participantes, quienes resolvieron un cuestionario sobre aspectos asociados a la investigación y publicación científica; además, se utilizó el cuestionario de actitudes hacia la investigación. Se realizó una segunda encuesta a un grupo de estudiantes latinoamericanos que incluyó la importancia de realizar programas vacacionales de investigación. Los análisis estadísticos se hicieron en STATA. RESULTADOS: Ser parte de una asociación aumenta las posibilidades de ganar un premio en un congreso (86%), presentar un trabajo de investigación en un congreso (68%) y tener una publicación científica (59%). El 82,2% dedicaría al menos 5h diarias de forma ininterrumpida a la investigación durante su periodo vacacional. En vacaciones tienen en promedio 5,5 h frente a 2,2 h durante jornada académica para investigar. CONCLUSIONES: La investigación es de gran importancia en la formación del médico; los estudiantes de medicina desean que en sus universidades se realicen cursos o programas vacacionales en investigación científica porque es cuando más tiempo disponen para actividades complementarias

INTRODUCTION: Research has become a priority in academic training among medical undergraduate students, and it has been associated with positivism, motivation, and critical thinking. Scientific associations also play a role in the research training for undergraduate students. The objective of this study was to describe the results of a research program during holiday periods proposed by Colombian medical students and to evaluate the importance of promoting them in Latin America. MATERIALS AND METHODS: The study population included students from the Universidad Tecnológica de Pereira (Risaralda, Colombia) who had completed a questionnaire on aspects associated with scientific research and publications. Furthermore, a questionnaire of attitudes towards research was also completed. A second survey was conducted by a group of Latin America students, which included the importance of conducting research-based programs. The statistical analysis was performed using the STATA program. RESULTS: To be a member of an association increased the chances of winning an award at a congress (89%), as well as presenting a research paper at congress (68%), and to have a scientific publication (59%). The large majority of them (82,2%) would spend at least 5hours a day continuously on research during their vacation time. During their vacation, they spend a mean of 5.5hours per day, and 2.2hours in an academic day. CONCLUSIONS: Research is important in medical training. Medical students would like to receive courses or programs during holiday periods about scientific research, as they have more free time for these complementary activities

[Diagnosis of pediatric arrhythmias in the emergency department: an academic challenge] / Diagnóstico de Arritmias Pediátricas en el Servicio de Urgencias: Un desafío Académico.

Señor Editor: Los eventos arritmogénicos en la población pediátrica, ha presentado variaciones en sus registros durante las últimas décadas con una incidencia de 5% en niños hasta de 7 años[1]. Teniendo en cuenta que ésta patología constituye un grupo complejo e infrecuente, la comunidad médica en general se ha preocupado por tener un mayor conocimiento acerca de esta entidad clínica, lo cual ha contribuido a un mayor reconocimiento de cuadros clínicos congénitos asociados a muerte súbita infantil de origen cardiaco dentro de la población pediátrica [2, 3]. En pediatría, la prevalencia de este tipo de alteraciones es menos frecuente en comparación con la población adulta. En niños, la taquicardia supraventricular, es la arritmia más frecuente, siendo la principal causa de emergencia cardiovascular en niños con un 90% de los casos [1]. La utilización de herramientas diagnósticas, como el electrocardiograma de doce derivaciones, permite valorar éste tipo de situaciones dentro del servicio de urgencias, lo cual ha disminuido el número de muertes de origen cardíaco dentro de la población infantil, sin embargo, la utilización de estas ayudas diagnósticas, no presenta un grado de utilidad superior, cuando no se tiene el grado de pericia necesario para la interpretación de los hallazgos, equipos especializados y la posibilidad de proporcionar un tratamiento oportuno [4]. Estas condiciones, conlleva a que los procesos que se llevan a cabo dentro servicio de urgencias sean limitados y que su resolución tenga que ser manejada por personal diferente al de cardiología pediátrica [2, 5]. El reconocimiento de alteraciones del ritmo cardíaco en la población pediátrica, se ha convertido en un reto para el médico del siglo XXI, circunstancias especiales, tales como la edad del paciente y los fenómenos fisiológicos cardíacos que trae consigo el crecimiento en ésta población, genera dificultades para la interpretación de los resultados [6]. Un estudio realizado en 12 países, con más de 900 médicos de diferentes servicios, incluyendo especialistas de las diferentes áreas de medicina interna y médicos generales, concluyo que pese a tener una muestra considerable y no ser suficiente para describir toda la población médica, se encontró que menos del 50% podía reconocer plenamente las alteraciones del ritmo dentro del electrocardiograma de doce derivaciones [2]. El uso del electrocardiograma como herramienta diagnóstica de arritmias dentro del servicio de urgencias, ha permitido que sea ampliamente valorada su utilidad en los últimos quince años, con la finalidad de ser aplicada en grupos especiales de pacientes, diferentes a los que se encuentran propiamente en este servicio, justificándose ventajas, tales como, el reconocimiento de patologías como el síndrome de QT largo, lo que podría prevenir el desarrollo de arritmias letales dentro de la edad pediátrica, y la detección de patologías cardíacas de presentación asintomática que conducen a muerte súbita infantil [5, 6]. Consideramos fundamental que la formación médica actual, siga profundizando y proporcionando las herramientas suficientes al médico general para poder detectar y abordar de manera integral las arritmias en pediatría. Además de la necesidad de tener una mayor evidencia científica que justifique la implementación del uso del electrocardiograma en pacientes con una historia clínica personal y familiar compatible con patologías que tienen relación con el síndrome de muerte súbita infantil, teniendo en cuenta que en nuestro país la evidencia sobre la utilidad y el uso del mismo, como mecanismo de prevención es escasa.

Importancia de los intercambios internacionales en la formación científica de estudiantes de medicina / Importance of international exchanges in the scientific training of medical students

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Fatigue during Chest Compression Using a Neonatal Patient Simulator.

OBJECTIVE: The objective of this study was to evaluate chest compression (CC) quality and operator fatigue during CC, with coordinated ventilation, on a neonatal simulator and to explore its association with provider aerobic activity and body mass index. METHODS: This was a prospective observational experimental study on pediatricians, neonatologists, and neonatal nurses who frequently deliver newborns and who have signed the informed consent. Subjects performed CC coordinated with ventilations at a ratio of 3:1 for 10 minutes on a neonatal mannequin. Proxy of fatigue was defined as four consecutive CC below target. RESULTS: Forty subjects participated; 62% were women. Twenty one (52%) evidenced weariness, as they performed. No gender-based differences were found in weariness. No subject abandoned the procedure due to fatigue. Subjects who participated in aerobic exercise had a significantly better performance than those who did not participate. Early fatigue was significantly associated with higher BMI. The reduction in effectiveness occurred at a mean time of 7.7 minutes (range 3.5-9 minutes). CONCLUSION: CC performance quality decreased and fatigue was frequent before 10 minutes had elapsed on a neonatal simulator. Provider fatigue was associated with both lack of aerobic activity and BMI ≥ 25. Our findings support the need for guidelines requiring frequent rotation of CC providers during prolonged neonatal resuscitation.