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      Pensamiento complejo en la educación médica: un reto ineludible ante la pandemia de COVID-19 Translated title: Complex Thinking in Medical Education: An Unavoidable Challenge in the Face of the COVID-19 Pandemic

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          Abstract

          Resumen. Ante la crisis de la pandemia de COVID-19, la educación médica debe transformarse, a fin de que contribuya a edificar una práctica clínica innovadora y factible. En el camino por recorrer, es esencial el desarrollo de los principios del pensamiento complejo, que inducen a: mirar las interacciones de los elementos que subyacen a la emergencia, ejercer el trabajo interprofesional, vivir relaciones humanas auténticas con el paciente, investigar la multi-inter-dimensionalidad de los fenómenos, articular la atención clínica del individuo con el contexto del sistema de salud. Por consiguiente, las escuelas de medicina tienen el reto ineludible de formar a estudiantes capaces de integrar tales principios, a fin de complejizar su pensar y su actuar. Frente a la disrupción que la pandemia provoca en las actividades docentes en las universidades y en los hospitales, la tecnología y las bases didácticas son decisivas para construir aulas virtuales, sin embargo, debe permear el paradigma de la complejidad en las tareas académicas. En este sentido, es fundamental implementar experiencias de pensamiento complejo, de modo que los estudiantes aprendan a aproximarse sistémicamente a los problemas de salud-enfermedad, a navegar en la incertidumbre, y a ser co-creadores de una realidad que manifieste las cualidades de salud y bienestar individual, local y global.

          Translated abstract

          Abstract. In the face of the COVID-19 pandemic crisis, the medical education must be transformed in order to help build an innovative clinical practice. On the way forward, is essential the development of the principles of complex thinking, which induce: look at the interactions of the elements underlying the emergency, practice interprofessional work, live authentic human relationships with the patient, investigate the multi-inter-dimensionality of phenomena, articulate the clinical care of the individual with the context of the health system. Therefore, medical schools have the inescapable challenge of training students capable of think and act from perspective of complexity, integrating such principles. Faced with the disruption that the pandemic causes in teaching activities in universities and hospitals, technology and didactic basis are decisive to build virtual classrooms, however, the paradigm of complexity must permeate academic tasks. It is fundamental to implement complex thinking experiences, so that students learn to approach systemically to health - disease problems, to navigate amidst the uncertainty, and to be co-creators of a reality, in which the qualities of individual, local and global health and well-being are manifested.

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          Virtually Perfect? Telemedicine for Covid-19

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            Compassionate Use of Remdesivir for Patients with Severe Covid-19

            Abstract Background Remdesivir, a nucleotide analogue prodrug that inhibits viral RNA polymerases, has shown in vitro activity against SARS-CoV-2. Methods We provided remdesivir on a compassionate-use basis to patients hospitalized with Covid-19, the illness caused by infection with SARS-CoV-2. Patients were those with confirmed SARS-CoV-2 infection who had an oxygen saturation of 94% or less while they were breathing ambient air or who were receiving oxygen support. Patients received a 10-day course of remdesivir, consisting of 200 mg administered intravenously on day 1, followed by 100 mg daily for the remaining 9 days of treatment. This report is based on data from patients who received remdesivir during the period from January 25, 2020, through March 7, 2020, and have clinical data for at least 1 subsequent day. Results Of the 61 patients who received at least one dose of remdesivir, data from 8 could not be analyzed (including 7 patients with no post-treatment data and 1 with a dosing error). Of the 53 patients whose data were analyzed, 22 were in the United States, 22 in Europe or Canada, and 9 in Japan. At baseline, 30 patients (57%) were receiving mechanical ventilation and 4 (8%) were receiving extracorporeal membrane oxygenation. During a median follow-up of 18 days, 36 patients (68%) had an improvement in oxygen-support class, including 17 of 30 patients (57%) receiving mechanical ventilation who were extubated. A total of 25 patients (47%) were discharged, and 7 patients (13%) died; mortality was 18% (6 of 34) among patients receiving invasive ventilation and 5% (1 of 19) among those not receiving invasive ventilation. Conclusions In this cohort of patients hospitalized for severe Covid-19 who were treated with compassionate-use remdesivir, clinical improvement was observed in 36 of 53 patients (68%). Measurement of efficacy will require ongoing randomized, placebo-controlled trials of remdesivir therapy. (Funded by Gilead Sciences.)
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              Cytokine release syndrome in severe COVID-19

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                Author and article information

                Journal
                iem
                Investigación en educación médica
                Investigación educ. médica
                Universidad Nacional Autónoma de México, Facultad de Medicina (México, Distrito Federal, Mexico )
                2007-5057
                December 2020
                : 9
                : 36
                : 87-95
                Affiliations
                [1] Cd. Mx. orgnameUniversidad Panamericana orgdiv1Facultad de Ciencias de la Salud Mexico
                Article
                S2007-50572020000400087 S2007-5057(20)00903600087
                10.22201/fm.20075057e.2020.36.20268
                6c2b147e-0e5d-44c1-b610-71ed230df9cc

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 28 August 2020
                : 07 September 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 57, Pages: 9
                Product

                SciELO Mexico

                Categories
                Artículo de revisión

                Pensamiento complejo,educación médica,incertidumbre,pandemia COVID-19,Complex thinking,medical education,uncertainty,COVID-19 pandemic

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