Abstract Background: The increase in resistance and the shortage of new antibiotics has led to the reintroduction of old antimicrobials such as colistin. Aim: To evaluate the use of colistin during 2017 in a university hospital, through the characterization of patients and treatment, associated microbiology, response to treatment and adverse effects. Methods: Retrospective observational design. The data of all patients who received colistin for at least 48 hours during the year 2017 were reviewed. Results: 55 patients were included, equivalent to 144 treatments. The respiratory focus was the main one (57.9%). 64% of the treatments began in the ICU, while 7% in the ward. Most of the patients has a recent hospitalization (86.8%) and has previous use of antibiotics (90.4%). The two main pathogens identified were Pseudomonas aeruginosa and Klebsiella spp. In 87.1% of the cases with microbiological justifications for the use of colistin, a favorable response was obtained. The average consumption of colistin was 2.4 DDD/100 beds/day. The department that consumed the most colistin was the ICU, with 45,5 DDD/100 beds/day, generally using a dose of 3 MIU every 8 hours IV and with low use of loading doses. Conclusion: Colistin corresponds to an antibiotic whose use is restricted to infections suspected or confirmed by multi-resistant bacterial agents. Its initial use in this serie was mainly empirical, in patients with risk factors for antibiotics resistance, it was used in association with other antimicrobials, being the respiratory the main infectious focus.

Resumen Resumen: El aumento de la resistencia y la escasez de nuevos antibacterianos ha requerido la reintroducción de antiguos antimicrobianos entre ellos colistín. Objetivo: Caracterizar la utilización de colistín durante el año 2017 en un hospital universitario, mediante la descripción de los pacientes, los tratamientos, la microbiología asociada y efectos adversos. Pacientes y Métodos: Trabajo observacional retrospectivo. Se revisaron los datos de todos los pacientes que recibieron colistín intravenoso (IV) por al menos 48 horas, durante el año 2017. Resultados: Se incluyeron 53 pacientes, equivalentes a 91 tratamientos. El foco respiratorio fue el principal (46,2%). El 68,1% de los tratamientos fue iniciado en la UCI. La mayoría de los pacientes tenía una hospitalización reciente (83,5%), y presentaban uso previo de antibacterianos (89%). Los dos patógenos mayoritariamente identificados fueron Pseudomonas aeruginosa y Klebsiella spp. El consumo promedio de colistín fue de 2,4 DDD/100 camas/día. El servicio que más consumió colistín fue la UCI, con 45,5 DDD/100 camas/día, usando generalmente la dosis de 3 MUI cada 8 horas IV y con una baja utilización de dosis de carga. Conclusión: Colistín corresponde a un antimicrobiano de uso restringido a infecciones sospechadas o confirmadas por agentes bacterianos multi resistentes. En esta serie, su uso inicial fue principalmente empírico, en pacientes con factores de riesgo para resistencia antibacteriana; se usó en forma asociada a otros antimicrobianos, siendo el foco principal el respiratorio.

Objective: To determine the subjective experience of students and teachers on curriculum change.Methodology: Cross-sectional study in a sample of 169 Regular fourth-year students and 32 teachers. Information collected in the survey “Concerns and procedures to adopt educational innovations” (IPIE) validated and adapted to the study. Descriptive analysis with means, medians, ranges, percentages and averages compared with t-test and ANOVA. Study respected ethical and informed consent. Results: 26.0% of students accounted for Medical Technology, Nursing and Nutrition 22.5%, 29.0% respectively and Obstetrics. Mean age 21.3 ± 1.43 years. 68.1% women. In “Information”, students showed the highest average item “I want to know what others are doing in this area” (4.1 ± 0.9), and teachers in “I wonder if they have the resources to keep this innovation in the immediate future “(4.7 ± 0.4). In “Functionality” highest average corresponded to “I wonder what this innovation will be required to keep it in the future” (4.3 ± 0.8) and lowest in the scale “I am fully occupied / to other things, for innovation is not my priority “(2.4 ± 1.4). In teaching, in “Results” highest average “I am interested in evaluating my impact on students” and “I want other teachers to motivate teams with the achievements we have in this curricular innovation process” (4.6 ± 0, 4, 4.6 ± 0.4). Conclusions: students and teachers were satisfed with the experience of curriculum change. Still, there are doubts about how this will affect the student skills and sustainability over time. It is necessary to continue this line of research for the professional practice of graduates, to objectively assess the skills of the new student-centered curriculum.

Objetivo: Conocer la experiencia subjetiva de estudiantes y docentes respecto del cambio curricular. Metodología: Estudio transversal, muestra de 169 estudiantes de cuarto año curricular y 32 docentes. Información recogida en cuestionario “Inquietudes y procedimientos para adoptar Innovaciones Educativas” (IPIE) validado y adaptado al estudio. Análisis descriptivo. Estudio respetó normas éticas y consentimiento informado. Resultados: 26,0% de alumnos correspondió a Tecnología Médica; 22,5% Enfermería y Nutrición, respectivamente, y 29,0% Obstetricia. Edad media de 21,3±1,43 años. Mujeres 68,1%. En “Información”, los estudiantes mostraron el promedio más alto en el ítem “Quisiera saber lo que otros están haciendo en esta área” (4,1±0,9), y los docentes en “Me gustaría saber si se contará con los recursos para mantener esta innovación en un futuro inmediato” (4,7±0,4). En “Funcionalidad”, promedio más alto correspondió a “Me gustaría saber qué es lo que esta innovación va a requerir para mantenerla en el futuro” (4,3±0,8) y el más bajo en “Estoy totalmente ocupado/a en otras cosas, para mí la innovación no es prioridad” (2,4±1,4). En “Resultados”, los docentes presentaron el promedio más alto en “Me interesa evaluar mi impacto sobre los estudiantes” y “Quisiera que otros equipos de docentes se motiven con los logros que tenemos en este proceso de innovación curricular” (4,6±0,4; 4,6±0,4). Conclusiones: Estudiantes y docentes se mostraron conformes con la experiencia del cambio curricular. Aún existen dudas respecto de cómo este cambio afectará las competencias del estudiantado y la sustentabilidad en el tiempo. Es necesario continuar esta línea investigativa durante el ejercicio profesional de egresados.

Background: Depression is an important mental health problem. The Chilean Ministry of Health has considered depression in women as one of the health priorities for the country. Aim: To assess the prevalence of depressive and somatic symptoms and their risk factors in climacteric women. Material and methods: A special questionnaire was applied to 171 women (45 to 55 years of age), coming from a community organization (PRODEMU) and a private health institution (ISAPRE Banmedica). Risk factors for depression were determined using multiple logistic regression. Results: The prevalence of depressive symptoms was 43%. Women with primary education had an odds ratio for depression of 2.49, compared with women with high school or university education. Other risk factor for depression was the lack of a remunerated job (Odds ratio 1.9). The risk factors for somatic symptoms were the presence of depressive symptoms (OR 3.2), lack of secondary or university education (OR 2.4), low income (OR 1.9) and having a current partner (OR 3.6). Conclusions: There is a high prevalence of depressive symptoms in the studied population of climacteric women. Lack of education and of a remunerated job are important risk factors for the presence of such symptoms. Women with a low level of education and with depressive symptoms have also a high risk of presenting somatic symptoms (Rev Méd Chile 2002; 130: 885-91)

Sea anemones are a rich source of biologically active substances. In crayfish muscle fibers, Bunodosoma cangicum whole venom selectively blocks the I K(Ca) currents. In the present study, we report for the first time powerful hemolytic and neuroactive effects present in two different fractions obtained by gel-filtration chromatography from whole venom of B. cangicum. A cytolytic fraction (Bcg-2) with components of molecular mass ranging from 8 to 18 kDa elicited hemolysis of mouse erythrocytes with an EC50 = 14 µg/ml and a maximum dose of 22 µg/ml. The effects of the neuroactive fraction, Bcg-3 (2 to 5 kDa), were studied on isolated crab nerves. This fraction prolonged the compound action potentials by increasing their duration and rise time in a dose-dependent manner. This effect was evident after the washout of the preparation, suggesting the existence of a reversible substance that was initially masking the effects of an irreversible one. In order to elucidate the target of Bcg-3 action, the fraction was applied to a tetraethylammonium-pretreated preparation. An additional increase in action potential duration was observed, suggesting a blockade of a different population of K+ channels or of tetraethylammonium-insensitive channels. Also, tetrodotoxin could not block the action potentials in a Bcg-3-pretreated preparation, suggesting a possible interaction of Bcg-3 with Na+ channels. The present data suggest that B. cangicum venom contains at least two bioactive fractions whose activity on cell membranes seems to differ from the I K(Ca) blockade described previously.