Plataforma Online de Evaluación de Compromiso Escolar, Versión 3.0: avance hacia un sistema de protección de las trayectorias educativas

Este artículo presenta el Sistema Integrado de Evaluación, Seguimiento y Estrategias de Promoción de Compromiso Estudiantil y Factores Contextuales desarrollado en Chile para su uso potencial en escuelas Iberoamericanas. El sistema web ha tenido un desarrollo incremental basado en diversos proyectos de investigación I+D y busca aportar a uno de los retos de América Latina y el Caribe señalado por organismos internacionales, como es avanzar hacia la construcción de sistemas de protección de las trayectorias escolares. Para su realización se implementó una metodología de desarrollo ágil de software que facilita el trabajo colaborativo llamada SCRUM. Entre los principales resultados se encuentra una plataforma con seis pasos que guían su implementación con recursos de apoyo gráficos y audiovisuales, cuyo potencial de uso es de alto interés para las escuelas en términos de diagnóstico, monitoreo e intervención. Dado que el concepto de compromiso escolar ha adquirido mayor relevancia producto de las consecuencias que tuvo la pandemia del COVID 19, todo el sistema fue ajustado para un contexto de clases presenciales o remotas. El desafío pendiente es la consolidación de esta plataforma en la política educativa nacional para facilitar su uso y masificación.

Multivariate Base Rates of Low Scores on Tests of Learning and Memory among Spanish-Speaking Children

To determine the prevalence of low scores on two neuropsychological tests commonly used to evaluate learning and memory in children. 6,030 healthy children from 10 countries in Latin America and Spain were administered Rey-Osterrieth Complex Figure (ROCF) and the Test de Aprendizaje y Memoria Verbal-Infantil (TAMV-I). Results showed that low scores are common when multiple neuropsychological outcomes (tests and/or scores) are evaluated in healthy individuals. Clinicians should consider the higher probability of low scores in a given individual when evaluating learning and memory using various sets of scores to reduce false-positive diagnoses of cognitive deficits in pediatric populations.

Absence of tobramycin pharmacokinetic and creatinine clearance variation during the menstrual cycle: implied absence of variation in glomerular filtration rate

During the menstrual cycle, a 20% increase in creatinine clearance (CL(CR] has previously been reported between the menstrual (phase 1) and late luteal (phase 4) phases. Tobramycin pharmacokinetics and CL(CR) were studied in eight healthy women with documented, regular, ovulatory menses. During the first and fourth phases of the menstrual cycle (as determined by urinary luteinizing hormone peak and basal body temperature shift), subjects received tobramycin by intravenous bolus. Tobramycin half-life, total body clearance, and volume of distribution were not significantly different between the two study phases. No significant change in total urinary creatinine excretion or CL(CR) was seen between phases. Total 24 hour urinary recovery of tobramycin was 98-99.7%. We conclude that no significant changes in renal function, as evaluated by tobramycin pharmacokinetics and CL(CR), occur between these hormonally different phases of the menstrual cycle, and that urinary recovery of a single dose of tobramycin is nearly complete within 24 hours in premenopausal women with normal renal function.

Amikacin pharmacokinetics during continuous ambulatory peritoneal dialysis

The pharmacokinetics of amikacin were investigated in five stable patients undergoing continuous ambulatory peritoneal dialysis (CAPD). Each patient was studied after the administration of 7.5 mg of amikacin per kg by both the intravenous (i.v.) and intraperitoneal (i.p.) route, allowing a 1-month washout period between doses. No differences in amikacin half-life, volume of distribution, total body clearance, or time-averaged peritoneal clearance were noted between the two routes of administration. After a 5-h dwell period, bioavailability as calculated by the area under the curve for i.p. amikacin was 53 +/- 14.0%. Amikacin pharmacokinetics parallel those of other aminoglycosides in CAPD patients when the drug is administered either i.v. or i.p. Single loading doses of amikacin administered i.v. to uninfected CAPD patients provided therapeutic serum and dialysate levels for many aerobic gram-negative organisms for up to 72 h. Because of the variability of absorption of i.p. administered amikacin, single i.p. doses are not recommended.

Glomerular annular-tubular immune deposits in adult hemolytic uremic syndrome

An 82-year-old female developed hemolytic uremic syndrome (HUS) after a prodromal illness of bloody diarrhea. No specific enteric pathogen was isolated. A renal biopsy performed 5 days after the onset of azotemia revealed typical thrombotic microangiopathy. By electron microscopy, massive annular-tubular deposits admixed with fibrillar fibrin were demonstrated in glomerular capillaries. Immunofluorescent staining of the intracapillary material was positive for IgG, IgM, C3, C1q and fibrin-related antigens. No evidence of plasma cell dyscrasia, cryoglobulinemia or systemic lupus erythematosus was found, and the patient recovered renal function uneventfully in 2 months. Organized immune deposits appear to have played a role in the pathogenesis of HUS in this patient.

Vitamin D toxicity complicating the treatment of senile, postmenopausal, and glucocorticoid-induced osteoporosis. Four case reports and a critical commentary on the use of vitamin D in these disorders

Hypervitaminosis D developed in four patients with osteoporosis or osteomalacia. All patients were given pharmacologic doses of vitamin D, had reduced baseline levels of renal function, and became hypercalcemic with acute renal failure. Measured 25-hydroxyvitamin D (25-OH D) levels were elevated in three patients; levels were not determined in a fourth patient who became normocalcemic when vitamin D therapy was discontinued. Published data on the use of vitamin D for prophylaxis or treatment of any form of osteoporosis fail to document benefits superior to those of calcium alone or calcium with estrogens and fluoride. Data on the use of 25-OH D show no greater benefit than for vitamin D. The use of 1,25-dihydroxyvitamin D (1,25-OH2 D) plus calcium may be superior to the use of calcium alone in some forms of osteoporosis. Vitamin D toxicity is associated with enhanced resorption of bone in some patients. Morbidity included extended hospitalization, dialysis, and chronic renal failure. Pharmacologic doses of vitamin D cannot be recommended for any form of osteoporosis.

Factors affecting aminoglycoside disposition: effects of circadian rhythm and dietary protein intake on gentamicin pharmacokinetics

The effects of dietary protein loading and circadian cycle on the pharmacokinetics of gentamicin were studied in healthy adult men. Ten subjects fasted overnight, and at 8 AM the next morning they received gentamicin, 1.5 mg/kg. Serum and urine samples were obtained over a 6-hour period. In two additional clearance studies with 2-week washout periods in between, 10 subjects were given the same dose of gentamicin at 8 PM in the fasted state and six subjects were also studied in a protein-supplemented (90 gm) state. Pharmacokinetic analysis revealed no significant effect of circadian cycle on gentamicin pharmacokinetic parameters at each of the two fasted periods. In contrast, dietary protein loading resulted in a significant decrease in the elimination t1/2 (P less than 0.05) and an increase in total body clearance compared with the fasted 8 PM study. Urinary excretion of gentamicin was also found to increase significantly (P = 0.03) as a result of protein intake compared with the fasted evening study period. Our study demonstrates the importance of dietary controls in chronopharmacokinetic studies of drugs eliminated predominantly by renal mechanisms.