Uso sem fórmula de modafinil em estudantes de medicina de uma universidade na cidade de Cartagena, Colômbia

Introduction: Modafinil is a drug approved for excessive sleepiness associated with narcolepsy, shift work disorder and obstructive sleep apnea; however, healthy people in different social settings also consume it, with university students among those most prone to non-medicated uses of this drug. Objective: To determine the prevalence and patterns of use, knowledge, perceptions and unwanted effects of mo- dafinil in students of a medicine program at a university in the city of Cartagena - Colombia. Methods: Prevalence study on a sample of 269 students from a medicine program. An instrument was designed, validated and applied to characterize the non-medicated use of modafinil. A descriptive analysis was performed and group comparison was performed using the chi-square test with a significance level of 0.05. Results: 6.7% (n=18; CI95%: 3.7 - 9.7) of the subjects have consumed modafinil without a medical prescription, presenting in most cases some unwanted effect. The beginning of use occurred mainly for exams during the third academic semester seeking to increase intellectual capacity and/or stay awake. There is little knowledge about the medical use of the drug. Conclusion: The prevalence of non-medicated modafinil use in medical students at this institution was low, consis- tent with other studies on similar populations.Introducción: Modafinilo es un fármaco aprobado para la somnolencia excesiva asociada con narcolepsia, trastorno del trabajo por turnos y apnea obstructiva del sueño; sin embargo, es consumido también por personas sanas en diferentes ámbitos sociales, siendo los estudiantes universitarios una de las poblaciones más propensas al uso no medicado de este fármaco. Objetivo. Determinar la prevalencia y patrones de uso, conocimientos, precepciones y efectos indeseados de este en estudiantes de un programa de medicina de una universidad de la ciudad de Cartagena - Colombia. Métodos. Estudio de prevalencia sobre una muestra de 269 estudiantes de un programa de medicina. Se diseñó, validó, aplicó un instrumento para caracterizar el uso no medicado de modafinilo en esta población y se llevó a cabo un análisis descriptivo. La comparación de grupos fue realizada usando la prueba de chi al cuadrado con un nivel de significación de 0,05. Resultados. El 6,7% (n=18; IC95%: 3,7 – 9,7) de los sujetos han consumido modafinilo sin prescripción médica, presentándose en gran parte de los casos algún efecto indeseado. El inicio de uso se dio mayormente en el tercer semestre académico de la carrera, en época de exámenes, buscando aumentar la capacidad intelectual y/o mante- nerse despierto. Existe poco conocimiento sobre el uso médico del fármaco. Conclusión. La prevalencia de uso no medicado de modafinilo en los estudiantes de medicina de esta institución fue baja, coherente con otros estudios sobre poblaciones similares.Introdução: O modafinil é um medicamento aprovado para sonolência excessiva associada à narcolepsia, transtorno do trabalho por turnos e apneia obstrutiva do sono; no entanto, também é consumido por pessoas saudáveis em diferentes contextos sociais, sendo os universitários uma das populações mais propensas ao seu uso sem fórmula. Objetivo: Determinar a prevalência e padrões de uso, conhecimento, percepções e efeitos indesejados do consumo de modafinil em estudantes de um programa de medicina de uma universidade na cidade de Cartagena - Colôm- bia. Métodos: Estudo de prevalência em uma amostra de 269 estudantes de um curso de medicina. Foi elaborado, validado e aplicado um instrumento para caracterizar o uso de modafinil nesta população e realizada uma análise descritiva. A comparação dos grupos foi realizada pelo teste do qui-quadrado com nível de significância de 0,05. Resultados: Do total estudado 6,7% (n=18; IC 95%: 3,7 – 9,7) dos sujeitos consumiram modafinil sem prescrição mé- dica, apresentando algum efeito indesejável na maioria dos casos. O início do uso ocorreu principalmente no tercei- ro semestre letivo da licenciatura, em época de exames, visando aumentar a capacidade intelectual e/ou manter-se acordado. Há pouco conhecimento sobre o uso médico da droga. Conclusão: A prevalência do uso não medicamentoso de modafinil em estudantes de medicina desta instituição foi baixa, consistente com outros estudos em populações semelhantes

Pertinencia de los programas de Medicina de la ciudad de Cartagena en el entorno socio-económico del departamento de Bolívar.

The present comment considers the relevance of the Medicine study programs offered in the city of Cartagena, in relation to the social, economic and health conditions of the state of Bolívar. It analyzes the curricular characteristics of these programs and relates them to the realities of the state, in order to reflect on the aspects that respond or not to the needs of the social environment.El siguiente texto reflexiona acerca de la pertinencia de los programas de Medicina ofertados en la ciudad de Cartagena, con relación a las condiciones sociales, económicas y de salud del departamento de Bolívar. Se analizan las características curriculares de estos programas y se enfrentan a las realidades del departamento, con el fin de reflexionar sobre los aspectos que dan o no respuesta a las necesidades del entorno

Educación humanizada en medicina, un desafío para la universidad.

The present writing invites to the reflection of the educative task; regarding humanized education in the field of medical education; for its relevance and importance for the training of medical professionals according to the needs of current citizens.El presente escrito invita a la reflexión del quehacer educativo; en cuanto a la educación humanizada en el campo de la enseñanza médica; por su pertinencia e importancia para la formación de profesionales médicos acordes a las necesidades de los ciudadanos actuales.Keysword: education, Humanism, University, Medicine, Attention

Dinámica de la adquisición de sustancias estimulantes sexuales en droguerías y tiendas naturistas por parte de la población masculina entre 15 y 60 años de la ciudad de Cartagena de Indias.

Introducción: En la actualidad el uso indiscriminado de  fármacos estimuladores sexuales se considera  una problemática que padecen  la gran mayoría de los jóvenes y adultos, según el último reporte  del Ministerio de Salud Nacional; llegando a causar problemas cardiovasculares y nerviosos, que deterioran el estado físico y mental. Objetivo: Determinar los estimulantes sexuales de mayor consumo en  diferentes droguerías y tiendas naturistas  de Cartagena, estableciendo la edad poblacional  asociado a factores demográficos, durante un año. Metodología: Estudio de utilización de medicamentos tipo consumo, descriptivo de corte transversal, realizado en  diferentes droguerías , con la finalidad de determinar la frecuencia y otros factores demográficos relacionados con el consumo de estimulantes sexuales, mediante encuestas realizadas a la población previa sensibilización y consentimiento informado de las droguerías y pacientes. Resultados: Se demostró que los estimulantes sexuales de mayor consumo fueron los comerciales, destacándose el sildenafil; mostrando una diferencia significativa con relación a los naturistas. Se estableció que la población que presento mayor consumo fueron hombres entre los 26 y 35 años de edad. Conclusión: De acuerdo a la revisión bibliográfica y a los datos obtenidos en el estudio, se llegó a la conclusión que la población juvenil fue la que presento el mayor consumo de estimulantes sexuales, debido a factores como la experimentación, el deseo de una mayor prolongación en el acto sexual, y satisfacción plena con la pareja. Reflejando una problemática tanto de salud como económica que se traducen en una disminución de la calidad de vida de la población estudiada

Prevalência e padrões de consumo de bebidas energéticas em estudantes, estudo de caso com uma universidade colombiana

Overview: Energy drinks have amongst their ingredients stimulatingsubstances. Nowadays the prevalence of these drinksamongst teens and young adults have been increasing. Objective: To estimate prevalence and consumption patterns of energy drinks in university students from Cartagena, Colombia Methods: This is an observational, descriptive, cross-section study. A tool previously validated and piloted, aimed at characterizing frequency and consumption patterns of energy drinks was administered to 558 students from 10 academic programs from the said university in Cartagena, Colombia. Results: The prevalence of consumption of energy drinks was 35%, being Bacteriology and Surgical Instrumentation the academic programs with higher prevalence. Statistically significant difference was found between a regular consumer of energy drinks and academic program (p<0.001) and, sex (p<0.001). The beverage brand most consumed was Vive 100 and according to this study, the main reason for consumption was study. The most common undesirable effect amongst consumers was increased heart rate. 100% of the participants of this study are unaware of the regulations and currently in place in Colombia regarding the production of these drinks. Conclusions: There is a moderate prevalence of consumption of energy drinks, compared to other similar studies conducted on the subject. The general population is not knowledgeable about the ingredients or the effects of these drinks. It is recommended that university managers implement strategies aimed at decreasing the risks entailed in consumption patterns of energy drinks associated to potentially adverse effects.Introducción. Las bebidas energizantes son preparaciones con contenido de sustancias estimulantes. En los últimos tiempos, la prevalencia de uso de estas bebidas entre adolescentes y adultos jóvenes ha ido en aumento. Objetivo. Describir la prevalencia y los patrones de consumo de bebidas energizantes entre estudiantes universitarios de la Corporación Universitaria Rafael Núñez de Cartagena. Métodos. Se llevó a cabo un estudio observacional, descriptivo y de corte transversal. Se utilizó un instrumento previamente validado y sometido a una prueba piloto, para caracterizar la frecuencia y los patrones de consumo debebidas energizantes en 558 estudiantes de 10 programas profesionales de la Corporación Universitaria Rafael Núñez. Resultados. La prevalencia del consumo de bebidas energizantes fue de 35 %. En los programas de Bacteriología e Instrumentación Quirúrgica se encontró la mayor prevalencia de consumo. Se encontró una diferencia estadísticamentesignificativa entre ser consumidor de bebidas energizantes y programa académico (p<0,001) y sexo (p<0,001). La marca de bebida más consumida fue Vive 100® y la principal motivación para el consumo fue el estudio, principalmenteen tiempos de exámenes. El efecto indeseable más presentado entre los consumidores fue el aumento de la frecuencia cardiaca. El 100% de la población desconoce el marco legal en Colombia que cubre la producción de estas bebidas. Conclusiones. Existe una prevalencia moderada de consumo de bebidas energizantes con respecto a otros estudios en la población universitaria, con baja frecuencia en la ingestión. Hay poco conocimiento sobre los componentes yefectos que estas bebidas producen. Se presentan prácticas de consumo que aumentan los potenciales riesgos para la salud. Se recomienda a las autoridades universitarias la implementación de estrategias que permitan disminuir losriesgos derivados de los patrones de consumo que aumentan los potenciales efectos adversos de las bebidas energizantes.Introducao. As bebidas energéticas são preparações com conteúdos de substâncias estimulantes, a prevalência do uso destas bebidas entre adolescentes e jovens tem aumentado.Objetivo. O artigo visa descrever a prevalência e padrões de consumo de bebidas energéticas em estudantes universitários em Cartagena.Materiais e métodos. O estudo é observacional descritivo e de corte transversal. Foi aplicado um instrumento validado e sometido a prova piloto, para caracterizar frequência e padrões de consumo de bebidas energéticas em 558 estudantes de 10programas de graduação de uma Universidade.Resultados. A prevalência de consumo de bebidas energéticas foi de 35%, apresentando maior prevalência Bacteriologia e Instrumentação Quirurgica. Foi achada uma diferencia estatisticamente significativa entre consumir estas bebidas e o programa acadêmico e sexo. A marca mais consumida foi Vive 100, sendo usada para favorecimento dos estudos na época dos testes. O efeito indesejável mais mencionado foi aumento de frequência cardíaca, todos desconheciam o marco legal associado a estas bebidas na Colômbia.Conclusoes. Existe uma prevalência de consumo de bebidas energéticas moderada e pouco conhecimento dos componentes e efeitos que produzem estas bebidas. Apresentam-sepraticas de consumo que aumentam potenciais riscos para a saúde e recomenda-se às autoridades universitárias desenvolver estratégias para diminuir riscos associados ao alto consumo destas bebidas

HuertAula Comunitaria de Agroecología “Cantarranas” UCM 2010-2017: Hacia una educación transformadora y emancipadora

Depto. de Química AnalíticaFac. de Ciencias QuímicasFALSEsubmitte

Chiapas : entre el autoritarismo y la transición democrática, desde Acteal hasta el diálogo EZLN y sociedad civil

Obra cuya intención es dar cuenta de los diversos actores sociales involucrados en el conflicto de Chiapas, a nivel político, económico y sociocultural. El texto recupera un taller de análisis de coyuntura sobre el tema, realizado en agosto de 1998.ITESO, A.C

Clathrin regulates lymphocyte migration by driving actin accumulation at the cellular leading edge

Lymphocyte migration, which is essential for effective immune responses, belongs to the so-called amoeboid migration. The lymphocyte migration is up to 100 times faster than between mesenchymal and epithelial cell types. Migrating lymphocytes are highly polarized in three well-defined structural and functional zones: uropod, medial zone, and leading edge (LE). The actiomyosin-dependent driving force moves forward the uropod, whereas massive actin rearrangements protruding the cell membrane are observed at the LE. These actin rearrangements resemble those observed at the immunological synapse driven by clathrin, a protein normally involved in endocytic processes. Here, we used cell lines as well as primary lymphocytes to demonstrate that clathrin and clathrin adaptors colocalize with actin at the LE of migrating lymphocytes, but not in other cellular zones that accumulate both clathrin and actin. Moreover, clathrin and clathrin adaptors, including Hrs, the clathrin adaptor for multivesicular bodies, drive local actin accumulation at the LE. Clathrin recruitment at the LE resulted necessary for a complete cell polarization and further lymphocyte migration in both 2D and 3D migration models. Therefore, clathrin, including the clathrin population associated to internal vesicles, controls lymphocyte migration by regulating actin rearrangements occurring at the LE.This work was supported by the grants from the Spanish Ministry of Science and Technology (MICINN; BFU2011-29450 to E.V.) and Ministry of Economy and Competitiveness (MINECO; SAF2014-56716-REDT and BFU2014-59585-R to E.V., SAF2011-25834 to F.S.M., SAF2014-58895-JIN to A.C.A and BFU2014-54181-P to J.L.C.), the Madrid regional government (INDISNET-S2011/BMD-2332 to F.S.M.) and the European Research Council (ERC-2011-AdG 294340-GENTRIS to F.S.M.). We are grateful to the “Centro de Transfusión” of the “Comunidad Autónoma de Madrid” for providing the Buffy Coats

Correlation of Serotype-Specific Dengue Virus Infection with Clinical Manifestations

Dengue virus (DENV) causes disease in millions of people annually and disproportionately affects those in the developing world. DENVs may be divided into four serotypes (DENV-1, DENV-2, DENV-3, and DENV-4) and a geographical region may be affected by one or more DENV serotypes simultaneously. Infection with DENV may cause life-threatening disease such as dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS), but more often causes less severe manifestations affecting a wide range of organs. Although many previous reports have explored the role of the different DENV serotypes in the development of severe manifestations, little attention has focused on the relative role of each DENV serotype in the development of cutaneous, respiratory, gastrointestinal, musculoskeletal, and neurological manifestations. We recruited a large group of participants from four countries in South America to compare the prevalence of more than 30 manifestations among the four different DENV serotypes. We found that certain DENV serotypes were often associated with a higher prevalence of a certain manifestation (e.g., DENV-3 and diarrhea) or manifestation group (e.g., DENV-4 and cutaneous manifestations)

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London