Update of Antibiotic Therapy of Brucellosis

Currently, the only option for treating brucellosis is antibiotics especially to prevent complications. In this chapter, we want to talk about the drug therapy in brucellosis and the update of these therapies in the last years. Also, we will expose the principal antibiotics in brucellosis such as doxycycline, rifampin, streptomycin, cotrimoxazole (TMP/SMX), and gentamicin by talking about each one of their mechanism of action, pharmacokinetics, administration, risk assessment, adverse effects, and principal drug interactions. Furthermore, we will add the evidence of efficacy therapy in monotherapy or combinate therapy based on the evidence

Colistin dose in multiresistance: case report

Given the high resistance to antibiotics due to multiresistant bacterial infections at the hospital level, therapeutic alternatives that require the use of more potent antibiotics and higher doses should be considered. We presented the case of a 56-year-old patient with multiple surgeries and several previous antibiotic treatments. After clinical deterioration, a blood culture yield Pseudomonas aeruginosa resistant to carbapenems, treated with intravenous colistin and doripenem. The patient then developed acute renal failure, which reverts when the colistin dose decreases. Finally, the patient finishes the treatment with 10-day antibiotic adjustment and favorable clinical response

Evidencia clínica de las fórmulas magistrales basadas en cannabis medicinal en tres indicaciones claves: una revisión panorámica de la literatura

21 páginasEl Cannabis ha sido usado ampliamente como planta medicinal durante milenios, sin embargo, los estudios relacionados con sus principales componentes comenzaron en 1960. A partir de este momento, los laboratorios comenzaron a producir nuevos componentes y estructuras relacionadas con propiedades biológicas activas. Los países que han aprobado su uso medicinal, cuentan con normatividades que rigen su uso clínico y científico. Adicionalmente, una de las formas de administrar el cannabis medicinal es mediante fórmulas magistrales que deben contar siempre con una prescripción médica, deben ser elaboradas en un establecimiento que cumpla con estándares de calidad que aseguren las cantidades de sus componentes principales como tetrahidrocannabinol (THC) y cannabidol (CBD); adicionalmente deben contar con una indicación clara de su uso en el paciente previo a la prescripción.Especialización en Farmacología ClínicaEspecialista en Farmacología Clínic

Instrument to assess the quality of the design of virtual learning environments for face-to-face courses in Medicine

La aparición del SARS-CoV-2 planteó un reto a nivel educativo ya que las asignaturas de educación médica migraron completa e inesperadamente a la virtualidad. Al retornar a la presencialidad se cuestionó la calidad de las actividades virtuales realizadas, dando importancia a los entornos virtuales de aprendizaje de alta calidad de las asignaturas presenciales como complemento de la enseñanza en Medicina. Ahora, dichos entornos requieren tener diseños robustos que garanticen su calidad como complemento de las asignaturas presenciales en Medicina. MÉTODOS: Se realizó un estudio cuantitativo de caso descriptivo con el objetivo de construir un instrumento para evaluar la calidad del diseño de los entornos virtuales de aprendizaje de las asignaturas presenciales en Medicina. Se realizaron las siguientes fases: revisión de literatura, síntesis de la revisión de la literatura y desarrollo de los ítems. RESULTADOS: Se construyó el instrumento donde se definieron 7 categorías clave con su respectiva definición: funcionamiento global del curso, gestión de recursos, diseño de materiales y didáctica, metodología, espacio virtual de aprendizaje del curso, sistema de evaluación y retroalimentación. Con un total de 37 ítems a evaluar y cada ítem con una escala de respuesta tipo Likert, los cuales pueden ser contestados desde la perspectiva del creador del entorno, docente y estudiante. CONCLUSIONES: Los entornos virtuales de aprendizaje en las asignaturas presenciales de medicina deben contar con diseños de calidad. Este instrumento plantea criterios que permiten evaluar la calidad del diseño de los entornos virtuales de aprendizaje desde la perspectiva del creador, docente y estudiante.The outbreak of the SARS-CoV-2 resulted in a challenge at the educational level since medical education subjects completely and unexpectedly migrated to virtuality. Upon returning to face-to-face, the quality of the virtual activities carried out was questioned, giving importance to high-quality virtual learning environments for face-to-face subjects as a complement to teaching in Medicine. Now, these environments require robust designs that guarantee their quality as a complement to face-to-face courses in Medicine. METHODS: a descriptive quantitative study was made with the objective of building an instrument to evaluate the quality of the design of the virtual learning environments of the face-to-face courses in medicine. The following faces were carried out: literature review, synthesis of the literature review and development of the items. RESULTS: A tool where 7 key categories were defined with their respective definition was built: global functioning of the course, management of resources, didactic and design materials, methodology, the course virtual learning space, evaluation system and feedback. With a total of 37 items to evaluate, each one with a type of Likert response scale, which can be answered from the environment creator’s perspective, the teacher and the student CONCLUSION: The virtual learning environments in the face-to-face medicine courses must contemplate quality designs. This tool proposes criteria to assess the design’s quality of the virtual learning environments that are evaluable from the creator, teacher, and student’s perspective.Magíster en Educación para Profesionales de la SaludMaestríahttps://orcid.org/0000-0003-2102-6413https://orcid.org/0000-0003-0142-4983https://orcid.org/0000-0001-9979-328X,https://scholar.google.com/citations?user=o3rGh1MAAAAJ&hl=eshttps://scholar.google.com.co/citations?user=ongdFVgAAAAJ&hl=es&citsig=AMD79oqgbwXHGOQwuWgPYN4MgKdrBcpI1

Instrument to assess the quality of the design of virtual learning environments for courses in Medicine

INTRODUCCIÓN: La aparición del SARS-CoV-2 planteó un reto a nivel educativo ya que las asignaturas de educación médica migraron completa e inesperadamente a la virtualidad. Al retornar a la presencialidad se cuestionó la calidad de las actividades virtuales realizadas, dando importancia a los entornos virtuales de aprendizaje de alta calidad de las asignaturas presenciales como complemento de la enseñanza en Medicina. Ahora, dichos entornos requieren tener diseños robustos que garanticen su calidad como complemento de las asignaturas presenciales en Medicina. MÉTODOS: Se realizó un estudio cuantitativo de caso descriptivo con el objetivo de construir un instrumento para evaluar la calidad del diseño de los entornos virtuales de aprendizaje de las asignaturas presenciales en Medicina. Se realizaron las siguientes fases: revisión de literatura, síntesis de la revisión de la literatura y desarrollo de los ítems. RESULTADOS: Se construyó el instrumento donde se definieron 7 categorías clave con su respectiva definición: funcionamiento global del curso, gestión de recursos, diseño de materiales y didáctica, metodología, espacio virtual de aprendizaje del curso, sistema de evaluación y retroalimentación. Con un total de 37 ítems a evaluar y cada ítem con una escala de respuesta tipo Likert, los cuales pueden ser contestados desde la perspectiva del creador del entorno, docente y estudiante. CONCLUSIONES: Los entornos virtuales de aprendizaje en las asignaturas presenciales de medicina deben contar con diseños de calidad. Este instrumento plantea criterios que permiten evaluar la calidad del diseño de los entornos virtuales de aprendizaje desde la perspectiva del creador, docente y estudiante.INTRODUCTION: The appearance of SARS-CoV-2 posed a challenge at an educational level since medical education subjects completely and unexpectedly migrated to virtuality. When returning to face-to-face, the quality of the virtual activities carried out was questioned, giving importance to high-quality virtual learning environments for face-to-face subjects as a complement to teaching in Medicine. Now, these environments require robust designs that guarantee their quality as a complement to face-to-face courses in Medicine. METHODS: A quantitative descriptive case study was carried out with the aim of building an instrument to assess the quality of the design of virtual learning environments for face-to-face courses in Medicine. The following phases were carried out: literature review, synthesis of the literature review, and item development. RESULTS: The instrument was built where 7 key categories were defined with their respective definition: global operation of the course, resource management, design of materials and didactics, methodology, virtual learning space for the course, evaluation and feedback system. With a total of 37 items to be evaluated and each item with a Likert-type response scale, which can be answered from the perspective of the creator of the environment, teacher and student. CONCLUSIONS: Virtual learning environments in face-to-face medicine courses must have quality designs. This instrument proposes criteria that allow evaluating the quality of the design of virtual learning environments from the perspective of the creator, teacher and student

Acute liver failure complication of brucellosis infection: a case report and review of the literature

Abstract Background Brucellosis is one of the most widespread zoonoses worldwide. It can affect any organ system, particularly the gastrointestinal system, but there is no report of acute liver failure as a brucellosis complication. Case presentation We present a case of acute liver failure secondary to brucellosis infection. A 75-year-old Hispanic man presented to a University Hospital in Chía, Colombia, with a complaint of 15 days of fatigue, weakness, decreased appetite, epigastric abdominal pain, jaundice, and 10 kg weight loss. On examination in an emergency room, abdomen palpation was normal with hepatosplenomegaly and the results of a liver function test were elevated. The diagnosis of brucellosis was confirmed by epidemiological contact and positive Rose Bengal agglutination with negative enzyme-linked immunosorbent assay immunoglobulin M for Brucella. He was then treated with doxycycline plus trimethoprim/sulfamethoxazole, with a favorable clinical outcome. Conclusions The clinical presentation of brucellosis can be very imprecise because it can affect any organ system; however, there is no report of acute liver failure as a brucellosis complication. This is the first reported case in the Colombian literature of acute liver failure due to brucellosis. We found this case to be of interest because it could be taken into account for diagnosis in future appearances and we described adequate treatment and actions to be taken at presentation

Farmacoterapia da anticoagulação. Revisão da literatura

17 páginasAnticoagulant therapy has multiple indications in diverse contexts; it goes beyond preventing the formation and propagation of thrombi and has as its final objective improving the quality of life of patients. In effect, anticoagulation becomes relevant in diverse clinical situ-ations, ranging from chronic diseases to surgical pathologies and special situations (obesity, chronic kidney disease, trauma, cancer), in order to avoid adverse outcomes such as venous thromboem-bolism, hypercoagulable states, acute coronary syndrome, atrial flutter and fibrillation, among others. In this sense, adequate under-standing and formulation of optimum doses of anticoagulants gain particular importance.The objective of this work was to review the evidence from clinical studies on the role of the main oral and parenteral anticoagulants in the context of patients with indication for anticoagulation for pathological, surgical and special situations like the aforementioned. Although there are several concepts and recommendations in prophylaxis and anticoagulant treatment in habitual indications, in special situations that are presented in daily clinical practice with patients, and for which there is still no consensus about medications and dosages optimal, indications of anticoagulation should be established.La terapia anticoagulante tiene múltiples indicaciones en diversos contextos; va más allá de la prevención de la formación de trombos o su propagación y tiene como objetivo final mejorar la calidad de vida de los pacientes. En efecto, la anticoagulación se hace relevante en diversas situaciones clínicas que abarcan desde enfermedades crónicas hasta patologías quirúrgicas y situaciones especiales (obesidad, enfermedad renal crónica, trauma, cáncer) para evitar desenlaces adversos, tales como el tromboembolismo venoso, los estados hipercoagulables, el síndrome coronario agudo, la fibrilación y el aleteo (flutter) auricular, entre otros. En este sentido, la comprensión adecuada y la formulación de dosis óptimas de anticoagulantes recobran especial importancia. El objetivo de este trabajo fue revisar la evidencia proveniente de estudios clínicos sobre el papel de los principales anticoagulantes orales y parenterales en el contexto de los pacientes con indicación de anticoagulación por antecedentes patológicos, quirúrgicos y en situaciones especiales como las mencionadas. Existen diversos conceptos y recomendaciones sobre la profilaxis y el tratamiento anticoagulante en indicaciones habituales; sin embargo, se debe establecer un consenso de anticoagulación en situaciones especiales que se presentan en la práctica clínica diaria.A terapia anticoagulante tem múltiplas indicações em diversos contextos. Além da prevenção da formação de trombos ou sua propagação, ela tem como objetivo final melhorar a qualidade de vida dos pacientes. De fato, a anticoagulação é relevante em diversas situações clínicas que abrangem desde doenças crônicas até patologias cirúrgicas e situações especiais (obesidade, doença renal crônica, trauma, câncer) para evitar resultados adversos, tais como tromboembolismo venoso, estados hipercoaguláveis, síndrome coronária aguda, fibri-lação e flutter atrial, entre outros. Deste modo, a compreensão adequada e a formulação de doses ótimas de anticoagulantes são particularmente importantes. O objetivo deste trabalho foi revisar a evidência proveniente de estudos clínicos sobre o papel dos principais anticoagulantes orais e parentais no contexto dos pacientes com indicação de anticoagulação por antecedentes patológicos, cirúrgicos e em situações especiais, como as mencionadas. Existem diversos conceitos e reco-mendações sobre a profilaxia e o tratamento anticoagulante em indicações habituais. Entretanto, deve-se estabelecer um consenso de anticoagulação em situações especiais que são apresentadas na prática clínica diária

STOPP-START criteria used to characterize the elderly population prone topotentially inadequate prescribing

15 páginasThe elderly has multiple comorbidities that often require treatment with multiple medications, so having strategies to lessen risks associated with pharmacological interactions and potentially inadequate prescribing (PIP) is of main importance. STOPP-START criteria are useful in identifying PIP along with other tools like LASA (Look-alike/Sound-alike) drugs and High risk medications (HRM). Objectives To characterize clinically and sociodemographically the population with PIP according to STOPP-START criteria, in hospitalized elderly patients during 6 months in a third-level hospital in Colombia, South America. Besides, to calculate the prevalence of PIP, LASA drugs and HRM and to identify other problems related with medication. Finally, to propose an algorithm for the identification of PIP in this population. Materials and methods: This was a descriptive, cross-sectional study in hospitalized patients older than 60 years during the first semester of 2021, to identify PIP according to STOPP-START criteria. An analysis of clinical and sociodemographic variables was conducted, as well as the construction of an algorithm to identify PIP in the elderly in an semiautomated way. Statistical analysis: Data was collected and analyzed using the software SPSS 2021, using descriptive statistics and measures of central tendency. Results Prevalence of PIP in the study population was 25%. 60% of patients had one problem related with medication and 27% used at least one LASA drug or HRM. Conclusions: This study allows to characterize, for the first time, the Colombian population prone to PIP, as well as the construction of an algorithm that identifies PIP in a semiautomated way.Especialización en Farmacología ClínicaEspecialista en Farmacología Clínic