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Razonamiento clínico en medicina I: un recorrido histórico 医学临床推理I:历史之旅
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-01 DOI: 10.17533/UDEA.IATREIA.102
J. P. Zapata-Ospina, Mario Andrés Zamudio-Burbano
1 Médico y cirujano. Especialista en psiquiatría, magíster en epidemiología clínica. Estudiante del doctorado en Medicina Clínica. Profesor. Facultad de Medicina. Universidad de Antioquia. Medellín, Colombia. 2 Médico y cirujano. Especialista en anestesiología y reanimación. Estudiante de la maestría en Epidemiología Clínica. Profesor. Facultad de Medicina. Universidad de Antioquia. Medellín, Colombia.
1名医生和外科医生。精神病学专家,临床流行病学硕士。临床医学博士生。教授。医学院。安蒂奥基亚大学。哥伦比亚麦德林。2名医生和外科医生。麻醉学和复苏专家。临床流行病学硕士生。教授。医学院。安蒂奥基亚大学。哥伦比亚麦德林。
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引用次数: 0
Breve historia de las lágrimas y el llanto 眼泪和哭泣的简史
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-01 DOI: 10.17533/UDEA.IATREIA.95
Ximena Palacios-Espinosa, Mariano Sánchez-Martínez, Leonardo Palacios-Sánchez, Juan Camilo Zuluaga-González
the introduction of dissection and physio-logical experimentation.
解剖和生理实验的介绍。
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引用次数: 0
Aula invertida a distancia vs. aula invertida convencional: un estudio comparativo 远程倒置教室与传统倒置教室:比较研究
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-01 DOI: 10.17533/UDEA.IATREIA.104
Luis Carlos Domínguez-Torres, Neil Valentín Vega-Peña, D. Sierra-Barbosa, Juan José Pepín-Rubio
Introduction: In this study were compared the effects of the Conventional Flipped Classroom (virtual component for independent study + face-to-face component for the interactive discussion of clinical cases) and the Remote Flipped Classroom (FRFC) (virtual component for independent study + “online” component for the interactive discussion of clinical cases), as a teaching / learning strategy in the face of the COVID-19 pande-mic, on the self-directed learning of surgical students. Methods: Self-directed learning levels, as a result indicator of the change in methodological strategy, were compared in a group of undergraduate students participating in a conventional flipped classroom in 2017 to those of a group of students participating in a remote flipped classroom in 2020, during the surgery course at the Universidad de La Sabana, in Chia-Co-lombia. For this purpose, the Preparedness Scale for Self-Directed Learning (EPAD), validated to the Spa-nish language, was used. Results: In both groups, the levels of self-directed learning were acceptable. No significant effect (posi-tive or negative) of either of the two models of flipped classroom was identified on the self-directed learning (d Cohen =-0.08;IC95%-0.42 – 0.24). Conclusions: The remote flipped classroom is an alternative to the conventional inverted classroom that does not compromise the self-directed learning of surgery students.
前言:本研究比较了传统翻转课堂(虚拟自主学习+面对面临床病例互动讨论)和远程翻转课堂(虚拟自主学习+“在线”临床病例互动讨论)作为面对COVID-19大流行的教/学策略对外科学生自主学习的影响。方法:将2017年参加传统翻转课堂的一组本科生与2020年参加远程翻转课堂的一组学生的自主学习水平作为方法学策略变化的结果指标进行比较,该研究是在中国-哥伦比亚萨巴纳大学的外科课程中进行的。本研究采用经西班牙语验证的自我指导学习准备量表(EPAD)。结果:两组学生的自主学习水平均为可接受水平。两种翻转课堂模式对自主学习均无显著影响(正、负)(d Cohen =-0.08;IC95%-0.42 - 0.24)。结论:远程翻转课堂是传统翻转课堂的一种替代,不影响外科学生的自主学习。
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引用次数: 4
Calidad de vida en adultos con hemofilia afiliados a un programa de salud en Medellín, Colombia 哥伦比亚麦德林卫生计划所附血友病成年人的生活质量
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-01 DOI: 10.17533/UDEA.IATREIA.82
Breitner Arteaga-Rubiano, Jenny García-Valencia
Objective: To determine the quality of life related to health in adults with hemophilia affiliated with a coagulopathic disorders program and to explore its association with clinical and demographic factors. Design: A cross sectional and descriptive study was performed. The hemophilia-specific quality of life questionnaire in Latin America (Hemolatin-QoL) was applied to all hemophilia patients at a specialized clinic in Medellin (Colombia). Descriptive statistical measures were used, and the factors associated with the different dimensions of quality of life were evaluated using the Kruskall-Wallis test and the Spearman correlation coefficient. Results: Forty-eight adults were included, with a median age of 32 years old (RI: 23.2-40.7). The populationvaried in the severity of hemophilia (16.7% mild, 12.5% moderate, and 70.8% severe) and in treatment(75% prophylaxis, 22.9% demand and 2.1% immunotolerance.), 37.5% had reduced mobility, while 16.7% suffered from comorbidity. The total Hemolatin-Qol score was 81.5. The factors associated with lower qualityof life were: older age, number of comorbidities, low socioeconomic level, presence of arthropathy and reduced mobility. Conclusions: The quality of life scores obtained by the study were close to the maximum possible score of the questionnaire. The factors associated with quality of life are similar to those found in other populations and are related to economic difficulties, other diseases and disability. Further longitudinal studies with a larger sample are necessary to establish causal associations.
目的:确定与凝血障碍相关的成人血友病患者的生活质量,并探讨其与临床和人口统计学因素的关系。设计:进行横断面和描述性研究。在麦德林(哥伦比亚)的一家专门诊所,将拉丁美洲血友病特异性生活质量问卷(Hemolatin QoL)应用于所有血友病患者。使用描述性统计测量,并使用Kruskall-Wallis检验和Spearman相关系数评估与生活质量不同维度相关的因素。结果:48名成年人被纳入研究,中位年龄为32岁(RI:23.2-40.7)。人群的血友病严重程度各不相同(16.7%为轻度,12.5%为中度,70.8%为重度),在治疗中(75%为预防性,22.9%为需求性,2.1%为免疫耐受性),37.5%的人行动能力下降,16.7%的人患有合并症。Hemolatin Qol总分为81.5。与生活质量较低相关的因素有:年龄较大、合并症数量、社会经济水平低、关节病和行动不便。结论:研究获得的生活质量分数接近问卷的最大可能分数。与生活质量相关的因素与其他人群的因素相似,与经济困难、其他疾病和残疾有关。为了建立因果关系,有必要对更大样本进行进一步的纵向研究。
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引用次数: 2
Factores sociales y clínicos asociados con el diagnóstico temprano de hipotiroidismo en el síndrome de Down 唐氏综合征甲状腺功能减退症早期诊断的社会和临床因素
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-01 DOI: 10.17533/UDEA.IATREIA.75
David Josué Machado-Velásquez, Ó. A. Villada-Ochoa
Metodología: se realizó un estudio observacional, transversal y analítico en pacientes con hipotiroidismo y síndrome de Down de tres años o menos, atendidos entre los años 2017 y 2018. Se tuvo como fuente secundaria la información de las historias clínicas. La fuente primaria fue una encuesta telefónica realizada al cuidador del paciente, se evaluaron variables demográficas, sociales y clínicas.
方法:对2017年至2018年期间接受治疗的三岁或三岁以下甲状腺功能减退症和唐氏综合征患者进行了观察、横断面和分析性研究。第二个来源是病史信息。主要来源是对患者护理人员进行的电话调查,评估了人口、社会和临床变量。
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引用次数: 1
Deserción, rezago estudiantil y egreso exitoso en 40 cohortes del Programa de Medicina de la Universidad Tecnológica de Pereira. Colombia 佩雷拉理工大学医学项目40个队列的辍学、学生落后和成功毕业。哥伦比亚
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-08-09 DOI: 10.17533/10.17533/UDEA.IATREIA.133
R. Cabrales, G. Moreno, S. E. Trujillo, Jairo Franco Londoño, V. Patiño
Introduction: Dropout rates are a constant concern for schools of medicine. Its study and solution are complex, it compromises the future of the student and affects the academic reputation of the program.  Objective: Determine the dropout, graduation, and student lag rates of 40 cohorts of the Medicine Program of the Universidad Tecnologica de Pereira. Materials and methods: Descriptive observational study. Results: The average for inter-semester dropout rates for the Program (TDIP) and institution (TDI) were very similar: 4,1% and 4 %, respectively. The cumulative dropout rates of the Program (TDAP) and dropout per cohort (TDC) were similar (27%), with a tendency to decrease in the last decade and significantly less than that of some medicine programs in the country. The graduation rate (TGP) without delay was 66%. In the group of dropouts, men predominated (35,4% vs 29,5%, p = 0.001), without differences by social stratification or type of high school education institution. Conclusion: The data presented allows to establish comparisons with other programs in Colombia and around the world. It proposes adjusted definitions of cumulative dropout and successful graduation, providing more accurate information and becoming an important input for academic planning and the design of policies and strategies towards early detection, comprehensive support for vulnerable students, and successful graduation.
引言:辍学率一直是医学院关注的问题。它的研究和解决方案是复杂的,它损害了学生的未来,并影响了该项目的学术声誉。目的:确定佩雷拉科技大学医学项目40个队列的辍学率、毕业率和学生落后率。材料和方法:描述性观察研究。结果:该项目(TDIP)和机构(TDI)的学期间辍学率平均值非常相似:分别为4.1%和4%。该项目的累计辍学率(TDAP)和每个队列的辍学率(TDC)相似(27%),在过去十年中有下降的趋势,明显低于该国一些医学项目的辍学率。无延迟毕业率(TGP)为66%。在辍学群体中,男性占主导地位(35.4%对29.5%,p=0.001),没有社会分层或高中教育机构类型的差异。结论:所提供的数据可以与哥伦比亚和世界各地的其他项目进行比较。它提出了对累积辍学和成功毕业的定义进行调整,提供了更准确的信息,并成为学术规划和政策和战略设计的重要投入,以实现早期发现、全面支持弱势学生和成功毕业。
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引用次数: 0
Cancelación de procedimientos quirúrgicos electivos: una agenda para la investigación en Colombia 取消选择性外科手术:哥伦比亚研究议程
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-08-09 DOI: 10.17533/10.17533/UDEA.IATREIA.135
Franco Jesús Segnini, Luis Carlos Domínguez-Torres, Neil Valentín Vega-Peña
Cancellation of scheduled surgeries is a latent problem in Colombia, which encompasses negative consequences for the patient (physically and psychologically), the health care personnel (well-being, satisfaction, performance) and the institution (cost-effectiveness). The rate of cancellation varies between 2,7 - 7,6 %. Most cancellations are preventable and occur due to administrative or programming issues. In this document, we performed a review on the gaps of knowledge on this problem in Colombia, and we highlighted some points for the research agenda.
取消预定的手术是哥伦比亚的一个潜在问题,对病人(身体和心理)、保健人员(福利、满意度、绩效)和机构(成本效益)都有负面影响。消去率在2.7 - 7.6%之间变化。大多数取消都是可以预防的,并且由于管理或编程问题而发生。在本文件中,我们对哥伦比亚在这一问题上的知识差距进行了审查,并强调了研究议程的一些要点。
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引用次数: 0
Enfermedad renal crónica de las comunidades agrícolas, una revisión de la literatura 农业社区慢性肾脏病,文献回顾
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-08-09 DOI: 10.17533/10.17533/UDEA.IATREIA.136
J. F. Nieto-Ríos, Camilo Andrés García-Prada, Daniel Vesga-Martín, Manuela Obregón-Giraldo, L. M. Serna-Higuita
La enfermedad renal crónica (ERC) se define como la alteración funcional o estructural progresiva de los riñones que persiste por 3 meses o más. Esta enfermedad afecta el 10 al 15 % de la población mundial, siendo la diabetes mellitus, la hipertensión arterial, las glomerulopatías primarias y las enfermedades genéticas las etiologías más frecuentemente asociadas. Sin embargo, en los países pobres se reportan otras enfermedades  ausantes de la ERC; entre ellas la nefropatía mesoamericana (NM). La NM se presenta principalmente en la población masculina joven, lo cual lleva a pérdida de la vida laboral productiva. En Colombia hay una alta prevalencia de ERC con etiología no estudiada (mal llamada desconocida) y hay pocas investigaciones de la ERC en las comunidades agrícolas. Teniendo en cuenta que la población campesina de Colombia se expone a noxas climáticas y laborales similares a Mesoamérica, es posible que esta nefropatía también sea una causa de ERC en nuestra población. El presente artículo hace una revisión de la ERC de las comunidades agrícolas, con el fin de sensibilizar el personal de salud en la importancia de la búsqueda de esta enfermedad en la población vulnerable, lo cual podría impactar de una forma positiva en la salud de los agricultores y campesinos.
慢性肾脏疾病(CKD)的定义是肾脏持续3个月或更长时间的渐进性功能或结构改变。这种疾病影响到世界人口的10%至15%,糖尿病、高血压、原发性肾小球疾病和遗传疾病是最常见的相关病因。然而,在贫穷国家,报告了其他导致慢性病的疾病;其中包括中美洲肾病。NM主要发生在年轻男性人群中,导致生产性工作生活的丧失。在哥伦比亚,病因未经研究(错误称为未知)的慢性肾脏病患病率很高,农业社区对慢性肾脏病的研究很少。考虑到哥伦比亚的农民人口接触到与中美洲相似的气候和工作noxas,这种肾病也可能是我国人口中CKD的原因。本文回顾了农业社区的慢性病,以提高卫生人员对在弱势群体中寻找这种疾病的重要性的认识,这可能对农民和农民的健康产生积极影响。
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引用次数: 0
Pericarditis Aguda asociada a infección por COVID-19: Resumen 与新型冠状病毒感染相关的急性心包炎:摘要
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-07-30 DOI: 10.17533/10.17533/UDEA.IATREIA.130
Jhon Edwar García-Rueda, Ana María Caicedo-Bolaños, Luz Adriana Gómez-Ramírez, Jorge Ricardo Sánchez-Madrid
Infection by coronavirus type 2 that causes severe acute respiratory syndrome (SARS-CoV-2) has been associated with multiple cardiovascular manifestations. The mechanism by which the virus affects the heart is under discussion; however, it has been proposed that the angiotensin-converting enzyme 2 (ACE2) serves as a direct entry point for the virus; likewise, the state of inflammation mediated by cytokine storm can generate multiorgan failure, explaining some cardiac manifestations. The main associations to the cardiovascular system reported in COVID-19 infection are acute coronary syndrome, acute heart failure, cardiogenic shock and arrhythmias. Acute pericarditis is an inflammatory syndrome of mainly viral etiology, and its relationship to SARS-CoV-2 infection seems infrequent, with few reports in the literature. We present the case of a patient who developed pericarditis, concomitant with SARS-CoV-2 infection.
导致严重急性呼吸综合征(严重急性呼吸系统综合征冠状病毒2型)的2型冠状病毒感染与多种心血管表现有关。病毒影响心脏的机制正在讨论中;然而,有人提出血管紧张素转换酶2(ACE2)是病毒的直接进入点;同样,细胞因子风暴介导的炎症状态可以产生多器官衰竭,解释了一些心脏表现。据报道,新冠肺炎感染与心血管系统的主要关联是急性冠状动脉综合征、急性心力衰竭、心源性休克和心律失常。急性心包炎是一种主要由病毒引起的炎症综合征,其与严重急性呼吸系统综合征冠状病毒2型感染的关系似乎很少,文献中很少报道。我们报告了一例患者并发严重急性呼吸系统综合征冠状病毒2型感染的心包炎。
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引用次数: 0
Cerrando las brechas entre profesores y estudiantes en la evaluación formativa 缩小形成性评价中的师生差距
IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-07-12 DOI: 10.17533/10.17533/UDEA.IATREIA.127
Luis Carlos Domínguez
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引用次数: 0
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