The University of Medical Sciences (Spanish: Universidad de Ciencias Médicas, UCIMED) is a private medical university in San José, Costa Rica. It is the largest and oldest private medical school in Costa Rica and one of the most prestigious in Latin America. Currently the main campus is located in the country's capital with the latest technology in medical education and one of the best simulated hospitals in the region. The university offers a great variety of degrees such as Doctor of Medicine, Doctor of Microbiology and Clinical Chemistry, Licentiate of Physiotherapy, Licentiate of Nutrition and Doctor of Pharmacy. UCIMED also offers master's degrees and medical specialties such as a Master's Degree in Health Management and Specialty in Gynecology and Obstetrics.
El síndrome de Vogt-Koyanagi-Harada (VKH) y la Oftalmía Simpática (OS) son dos grupos de enfermedades, infrecuentes, inflamatorias, granulomatosas, relacionadas con un proceso autoinmune y de origen desconocido. Ambas patologías se caracterizan por producir un compromiso ocular en forma de uveítis granulomatosa bilateral, y a su vez tienen muchas similitudes en la patogenia, forma de presentación clínica y hallazgos al examen físico. Es por esto que es de gran importancia conocer los aspectos principales de ambas patologías, así como sus criterios diagnósticos, con el fin de poderlas diferenciar adecuadamente y evitar realizar un diagnóstico equivocado. El tratamiento de ambas se ha basado en disminuir el proceso inflamatorio, para lo que se han utilizado corticosteroides, fármacos inmunomoduladores y fármacos biológicos, y en algunos casos incluso requieren de cirugía. El objetivo de esta revisión bibliográfica es analizar los principales aspectos clínicos, fisiopatológicos y diagnósticos compartidos, así como las características distintivas, entre ambas entidades, con el fin de contribuir a un abordaje clínico más integral de los pacientes afectados.
Background: The genus Brucella has expanded considerably in the 21st century. With the advent of advanced phylogenetic analyses, a close genetic relationship between Brucella and Ochrobactrum has been identified, leading to reclassification of Ochrobactrum species within the genus Brucella. Among these, Brucella anthropi (formerly Ochrobactrum anthropi) is increasingly recognized as a rare cause of invasive human infection. We report a clinically significant case of B. anthropi infective endocarditis and review the available literature. Methods: We report a case of B. anthropi infective endocarditis and conducted a narrative review of the English-language medical literature through 2025. Cases were analyzed for demographics, clinical presentation, antimicrobial susceptibility, and outcomes. Results: A 75-year-old man with a prosthetic aortic valve and prior endocarditis presented with fever of unknown origin, weight loss, and prior transient ischemic attacks. Blood cultures grew B. anthropi after prolonged incubation. Transesophageal echocardiography demonstrated vegetations involving both the aortic and tricuspid valves, and the patient required targeted combination antimicrobial therapy due to persistent bacteremia. Seven additional cases of B. anthropi infective endocarditis were identified on review of the literature. Most patients had underlying valvular disease or prosthetic material. Reported lethality approached 25%. Antimicrobial susceptibility patterns were variable, underscoring the importance of targeted individualized therapy. Conclusion: Consistent with other Gram-negative bacilli, B. anthropi is a rare but established cause of acute bacterial endocarditis. Despite its rarity, it may represent an under-recognized cause of invasive disease. This case highlights the importance of prolonged culture incubation, careful microbiologic interpretation, and susceptibility-guided therapy.
El Premédico cubano es una etapa formativa que abre las puertas de la educación superior a miles de jóvenes, especialmente internacionales. Sin embargo, su evolución curricular no ha sido suficientemente estudiada. Por esta razón, este artículo se propone caracterizar diacrónicamente su desarrollo entre 1928 y 2010, deteniéndose en las continuidades, rupturas y reconfiguraciones de sus planes de estudio a la luz de las demandas sociopolíticas de cada época. Para ello, se realizó una investigación histórico-educativa cualitativa, que incluyó el análisis de 15 documentos normativos y 12 entrevistas a directivos y docentes con larga trayectoria en tres instituciones formadoras. Los hallazgos revelan cuatro regularidades: la tensión fundacional entre inclusión y exigencia, el tránsito de un enfoque remedial a otro integral, el impacto de la internacionalización como catalizador de cambios y la consolidación de un modelo tridimensional. Por lo anterior, la evolución del Premédico cubano en la etapa estudiada es un testimonio de aprendizaje institucional acumulativo, con lecciones valiosas para etapas subsiguientes.
Background: Digestive supplements are widely used in the United States, yet their association with gastrointestinal symptoms in the general population remains unclear. Objective: To evaluate the association between digestive supplement use and self-reported abdominal pain among U.S. adults using nationally representative NHANES 2017–2018 data. Methods: We analyzed 5,564 adults aged ≥20 years from NHANES 2017–2018. The exposure was self-reported use of supplements to improve digestion. The outcome was abdominal pain during the past 12 months. Survey-weighted logistic regression models were used to estimate crude and adjusted odds ratios (ORs), accounting for demographic, socioeconomic, behavioral, and clinical covariates. Effect modification by age was assessed through interaction testing and stratified analyses. Results: The analytic sample included 5,569 adults (mean age 48.3 years; 53.1% female; mean BMI 29.8 verall, 5.7% reported supplement use for digestion. In unadjusted analyses, supplement use was significantly associated with abdominal pain (OR 1.76, 95% CI 1.18–2.64, p = 0.009). In the fully adjusted model, the association was attenuated and no longer statistically significant, though a trend remained (OR 1.58, 95% CI 0.96–2.60, p = 0.068). Anxiety (OR 2.21, 95% CI 1.77–2.76), sleep disturbance (OR 1.97, 95% CI 1.62–2.39), and prior gallbladder surgery (OR 2.42, 95% CI 1.61–3.62) were independently associated with abdominal pain. Although the overall supplement-by-age interaction was not statistically significant, stratified analyses demonstrated progressively stronger associations with advancing age, reaching statistical significance among adults aged ≥60 years. Conclusions: Digestive supplement use was more strongly associated with abdominal pain among older adults, although the overall association attenuated after adjustment for demographic, psychosocial, and clinical factors. Anxiety, sleep disturbance, and prior gallbladder surgery emerged as independent correlates of abdominal pain. The cross-sectional design precludes determination of temporality; abdominal pain may lead to increased supplement use, supplement use may contribute to symptoms in some individuals, or both mechanisms may coexist. These findings highlight the importance of contextualizing digestive supplement use within broader clinical and psychosocial profiles, particularly in aging populations.
Los síndromes de compresión nerviosa son afectaciones frecuentes en el miembro superior que pueden provocar síntomas como dolor, debilidad muscular, parestesias, alteraciones funcionales, afectando significativamente la calidad de vida en las personas que los presentan. Estas afecciones se deben a compresiones causadas por alteraciones extrínsecas o intrínsecas del nervio comprometido. La variedad en las manifestaciones clínicas presenta un desafío diagnóstico. El presente estudio pretende realizar una descripción anatómica de los principales sitios de compresión de los ramos terminales del plexo braquial en la región de hombro, axila y brazo, con el fin de facilitar su identificación clínica.
