Medicina - Palmira
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Item Conocimiento, actitudes y prácticas del uso del cannabis medicinal en los médicos de la ciudad de Cali en 2024 para el tratamiento del dolor neuropático crónico, y cómo se correlaciona este uso con la efectividad según la revisión sistemática revisada en Colombia por el Instituto de Evaluación de Tecnologías en Salud (IETS) en 2022(Universidad Santiago de Cali, 2024) Rodríguez Játiva, David Ricardo; Morales Galindo, Cesar Alexander; Restrepo Zapata, Jorge Humberto (Director)Chronic neuropathic pain is a significant public health problem that affects patients' quality of life. It is associated with disabling diseases and decreased mobility, which in turn reduces activity in daily life. In primary care, there is a lack of satisfactory tools that allow physicians to specify the type of pain, focused on the patient's needs. Treatment of this type of pain is challenging, and conventional therapies often fail to provide adequate relief. In recent years, medical cannabis has been proposed as a therapeutic option for these patients. Therefore, a descriptive cross-sectional correlational study was carried out, which showed that most physicians in Cali do not formulate this therapy due to different limitations such as: lack of knowledge regarding the benefits of THC/CBD with respect to chronic neuropathic pain, which generates certain limitations for safe use in consultation, professionals agree that lack of training is the main limitation of formulation and better training encourages the use of medical cannabis in patients with chronic neuropathic pain as an alternative to different therapies.Item Factores asociados a mortalidad en pacientes con COVID-19 y síndrome de distrés respiratorio agudo manejados con decúbito prono y ventilación mecánica invasiva(Universidad Santiago de Cali, 2024) Hoyos de Armas, Beatriz Helena; Lozada Ramos, Heiler (Director); Daza Arana, Jorge Enrique (Director)Introduction: the WHO has reported more than 775 million cases of individuals with COVID-19, with more than 7 million deaths around the world, of which 5-15% have developed severe forms that may require management in intensive care. This group of patients generally develops severe forms of the disease with acute respiratory distress syndrome, which are managed with invasive mechanical ventilation, prone position, and intravenous steroids. In turn, this group of individuals could have a fatality rate as high as 50%, with reductions between 10-15% in those who were ventilated in the prone position. Likewise, there remains a high percentage of patients who do not benefit from such management and end up dying; it is therefore essential to identify what factors are associated with mortality in this group of subjects. Objective: to identify risk factors associated with mortality in a group of adult patients with severe COVID-19 managed with invasive mechanical ventilation and prone position in an Intensive Care Unit in Valle del Cauca, Colombia. Methodology: analytical observational epidemiological study of cases and controls. Sociodemographic, clinical and intensive care intervention variables were evaluated. A univariate and bivariate analysis was developed with their respective odds ratios (OR), subsequently a logistic regression was executed to establish the factors related to the in-hospital mortality event. Results: the present study included 61 cases and 61 controls. The cases had more frequency (p<0.05): age >65 years, history of autoimmune diseases, no previous vaccination, anosmia/hypogeusia in the acute period, use of vasopressor and inotrope, thrombocytopenia, high level of LDH, higher averages of PTT, high SOFA score and high modified RALE scale value on chest x-ray. The regression model for predicting mortality included the variables of history of diabetes mellitus (OR 44.91; 95% CI: 2.08-96.74, p=0.015), chronic obstructive pulmonary disease (OR 7.74; 95% CI: : 1.63-30.65, p=0.027), autoimmune (OR 17.84; 95% CI: 4.47-31.05, p=0.004), not having a complete prior vaccination schedule against COVID-19 (OR 29.87; 95% CI: 24.80-35.99, p=0.000), vasopressor requirement (OR 8.37; 95% CI: 1.44-48.40, p=0.018) and inotrope (OR 40, 99; 95%CI: 1.73-96.79, p=0.021), and a severe modified RALE score (OR 7.01; 95%CI: 1.23-48.15, p=0.047). Conclusion: Clinical and vaccination history and admission status to the intensive care unit influence the outcome of in-hospital mortality in subjects with severe COVID-19, which allows clinicians to be alerted to the risk profiles of adult patients. critically. patients in the acute stage of SARS-CoV-2 infection.