Resumen Objetivo: Recopilar y analizar información referente a la situación de la Política Nacional de Medicamentos de Panamá en los años 2018-2019. Métodos: Se trata de un estudio descriptivo relacionado con el diagnóstico situacional y cumplimiento de los objetivos y principios en que se basa la Política Nacional de Medicamentos (PNM) de acuerdo a sus fundamentos legales. Se confeccionó una encuesta en base a los componentes, lineamientos y estrategias plasmados en la PNM relacionada con el sector farmacéutico tanto público como privado. De una lista de contactos de correos se escogieron destinatarios relacionados con el tema y se les aplicó la encuesta a través de la plataforma Survey Monkey. Resultados: Contestaron 230 personas donde el 65% eran mujeres, el grupo etario que más participó fue el de 51 a 55 años, el 54,3% fueron farmacéuticos. El 84% de los entrevistados contestó que sí se había creado la Comisión Nacional de Medicamentos de Panamá. El 90% indicó que existía marco regulatorio dirigido a la vigilancia de la calidad de medicamentos. El 78% informaron que hay un intercambio de información y alertas tempranas con el uso de medicamentos a nivel nacional. Conclusiones: Este diagnóstico situacional no estuvo orientado a examinar, corregir o calificar los esfuerzos que se hayan podido realizar para el desarrollo de la Política Nacional de Medicamentos, dándonos la concepción general que tuvieron los encuestados sobre la misma, considerando que este ejercicio fue realizado en los años 2018-2019. Le corresponde al ente rector proponer una evaluación propia de la PNM.

Summary Objective: Collect and analyze information regarding the situation of the National Drug Policy of Panama in 2018-2019. Methods: It´s a descriptive study related to the situational diagnosis and fulfillment of the objectives and principles on which the National Drug Policy (PNM) is based according to its legal foundations. A survey was prepared based on the components, guidelines and strategies set out in the PNM related to the pharmaceutical sector, both public and private. From a list of email contacts, recipients related to the topic were chosen and the survey was applied to them through the Survey Monkey platform. Results: 230 people answered where 65% were women, the age group that most participated was 51 to 55 years old, 54.3% were pharmacists. 84% of those interviewed answered that the National Drug Commission of Panama had been created. 90% indicated that there was a regulatory framework aimed at monitoring the quality of drugs. 78% reported that there is an exchange of information and early warnings with the use of drugs at the national level. Conclusions: This situational diagnosis was not aimed at examining, correcting or qualifying the efforts that could have been made for the development of the National Drug Policy, giving us the general conception that the respondents had about it, considering that this exercise was carried out in the years 2018-2019. It is up to the governing body to propose its own evaluation of the PNM.

Abstract Background: In the last decades, the prevalence of infections by carbapenem resistant gram-negative bacilli has been increased. Objective: To determine types and frequency of the different carbapenemases in Klebsiella spp. and Pseudomonas aeruginosa, in six hospitals in Bogotá-Colombia. Methods: Descriptive and observational study, in six hospitals in the city of Bogotá, in the period ftom January 2017 to August 2018. PCR were performed for KPC, GES, VIM, NDM, IMP and OXA-48 genes, in carbapenem resistant Klebsiella spp. and P aeruginosa. Results: 52 P aeruginosa isolates amplified a carbapenemase gene, of which 39 (75%) were positive for KPC, 11 (21%) for VIM and two co-productions of KPC and VIM. Regarding Klebsiella spp. 165 strains amplified at least one carbapenemase gene, 98% expressed KPC and four isolates had co-productions of metallo-P-lactamases and KPC. Discussion: This study provides valuable information, such as the increased production of KPC in P. aeruginosa información valiosa, como el incremento de producción de KPC en P. aeruginosa and the co-production of KPC plus metallobetalactamases, which has an implication both in treatment selection, isolation precautions and patient prognosisy.

Resumen Introducción: En las últimas décadas, se ha incrementado la prevalencia de infecciones por bacilos gramnegativos resistentes a carbapenémicos. Objetivo: Determinar los tipos y la frecuencia de las distintas carbapenemasas en aislados de Klebsiella spp. y Pseudomonas aeruginosa, en seis hospitales de alta complejidad de Bogotá-Colombia. Métodos: Estudio observacional descriptivo en seis hospitales de la ciudad de Bogotá, en el período de enero de 2017 a agosto de 2018. Se realizaron RPC para genes de KPC, GES, VIM, NDM, IMP y OXA-48 en cepas de Klebsiella spp y P aeruginosa resistentes a carbapenémicos. Resultados: 52 aislados de P aeruginosa amplificaron para una carbapenemasa, de los cuales 39 (75%) fueron positivos para KPC, 11 (21%) para VIM y 2 co-producciones de KPC y VIM. En cuanto a Klebsiella spp., 165 cepas amplificaron al menos para una carbapenemasa, 98% expresaron KPC y 4 aislados tuvieron co-producciones de metalo-β-lactamasas y KPC. Discusión: Este estudio aporta información valiosa, como el incremento de producción de KPC en P. aeruginosa y la co-producción de KPC y metalo-β-lactamasas, locual tiene una implicancia tanto en la selección del tratamiento, las medidas de aislamiento de contacto y el pronóstico de los pacientes.

OBJETIVO: determinar la frecuencia de exposición a cuatro factores de riesgo cardiovascular en los pacientes adscritos a un programa de control de hipertensión arterial en un hospital de segundo nivel del departamento de Risaralda. METODOLOGÍA: se evaluaron 133 pacientes que asistían al programa de control de la hipertensión. Como instrumento se utilizó la prueba de adhesión Martin-Bayarre-Grau (test MBG), el índice de masa corporal y la medida de la presión arterial. RESULTADOS: 80% de los pacientes eran mujeres; las cifras de presión arterial promedio fueron de 141 y 86 mm Hg, sistólica y diastólica respectivamente. El 74% presentó sobrepeso y obesidad. Solo el 42,1% de los pacientes presentó adherencia total al tratamiento antihipertensivo. El 100% de los pacientes presentó al menos uno de los riesgos cardiovasculares evaluados. Conclusiones: la alta frecuencia de exposición de riesgos cardiovasculares es un indicador de la falta de adherencia terapéutica. Es necesario un grupo interdisciplinario que garantice el entendimiento de la enfermedad por parte del paciente y elabore estrategias para mejorar la adherencia.

OBJECTIVE: to determine the frequency of exposure to four cardiovascular risk factors in patients from a hypertension control program. This program belongs to a second level hospital located in Risaralda, Colombia. METHODOLOGY: a total of 133 patients from a hypertension control program were assessed. The Martin-Bayarre-Grau test (MBG test), the body mass index, and the blood pressure measurements were used as instruments for measuring adherence to treatment. RESULTS: 80% of the patients were female. The average systolic and diastolic arterial pressure values were 141 and 86 mm Hg respectively. 74% of the patients exhibited overweight and obesity, and only 42,1% of the patients showed complete adherence to the antihypertensive therapy. Additionally, 100% of the patients had at least one of the assessed cardiovascular risks. CONCLUSIONS: high frequency of exposure to cardiovascular risks is an indicator of the lack of treatment adherence. An interdisciplinary team is needed to ensure that patients understand their disease and to develop strategies to improve adherence.

Under certain conditions, a fully developed turbulent flow in a straight pipe may show a secondary flow; for instance, when non-circular cross-section or non-uniform wall roughness around the perimeter of the duct are considered. In horizontal pipe particle-laden gas flow, the non-uniform forcing of the flow by the solids entrained in the gas core may also drive a secondary flow, even with uniform wall roughness along the circumferential direction. In this paper, the effects of wall roughness, particle size and particle mass loading ratio on the secondary flow developing in a horizontal pipe of circular cross-section under turbulent conditions are analysed. The computations are based on the Euler-Lagrange approach accounting for wall roughness and inter-particle collisions (i.e., four-way coupling). In the case of inertial particles, if inter-particle collisions are disregarded, the secondary flow consists of two recirculation cells with an upward flow near the vertical (symmetry) axis and a downward flow close to the walls. On the other hand, when inter-particle collisions are accounted for, the pattern depends on the particle concentration profile: with relatively smooth walls (low roughness), two recirculation cells are found, but with rough walls four recirculation cells are generated. For smaller particles, a transition between two and four recirculation cells in the secondary flow is observed by increasing the mass loading ratio.

Background: Stress caused by the high physical, intellectual and emotional demands imposed to medical students, renders them specially susceptible to the development of mental disorders. Aim: To assess the prevalence of risk for mental disorders among undergraduate students at the Medical School of the Catholic University of Chile. Material and methods: The Twelve Item General Health Questionnaire (GHQ 12) was voluntarily answered by medical students from the first to the fifth year. Results: Sixty eight percent of the total population (305 students) answered the questionnaire. Forty one percent of students were at risk, defined as scoring five or more points in the GHQ 12. The average score was 3.9±2.2. First year students had a higher score than fourth year students (4.6±2.2 and 3.4±2.1 points respectively, p <0.05). No gender differences were observed. Conclusions: Our results are similar to those of other publications concerning psychiatric risk among medical students (Rev Méd Chile 2001; 129: 173-78).