Este artículo analiza la enseñanza de la ética médica como un componente esencial de la formación profesional del médico, destacando que la educación médica no debe limitarse a la instrucción técnica, sino incorporar una sólida formación humanística orientada al respeto por la dignidad del ser humano y del paciente. El autor examina críticamente la progresiva deshumanización de la medicina contemporánea, asociada a enfoques economicistas, utilitaristas y al creciente predominio de la tecnología en la atención en salud, factores que han debilitado la relación médico-paciente. Asimismo, se subraya el papel de la universidad y del docente como formadores éticos, responsables no solo de instruir, sino también de educar la conciencia moral. El texto resalta el carácter obligatorio de la enseñanza de la ética médica según el marco legal vigente y propone una formación ética transversal y continua a lo largo del currículo. Se concluye que la enseñanza sistemática y permanente de la ética médica es indispensable para garantizar un ejercicio profesional humanizado, responsable y moralmente comprometido, capaz de responder a los desafíos actuales de la práctica médica.

El Aprendizaje Basado en Problemas (ABP) es una filosofía educativa centrada en el estudiante que emergió formalmente en la Universidad McMaster (Canadá) en la década de 1960 como una alternativa innovadora a la educación médica tradicional. Inspirado en el pensamiento de Dewey y Kilpatrick, su implementación inicial respondió a la insatisfacción de un grupo de médicos con los métodos educativos convencionales. Aunque frecuentemente se atribuye a Howard Barrows, el ABP fue el resultado de una propuesta colectiva cuyo enfoque estructurado integra el trabajo en pequeños grupos, la tutoría activa y la resolución de problemas reales como estímulo para el aprendizaje significativo. El ABP se fundamenta en cuatro principios teóricos: contextualización, construcción activa del conocimiento, autodirección y colaboración. A lo largo de cinco décadas, el ABP ha evolucionado en respuesta a cambios sociales, culturales y educativos. Se ha globalizado con éxito en diversos contextos, aunque persisten desafíos relacionados con su implementación en entornos clínicos, la formación docente continua, la incorporación de tecnologías emergentes y la evaluación longitudinal de sus efectos en el desempeño profesional. El presente artículo ofrece una revisión sobre el estado del arte, fundamentos teóricos e instruccionales, evidencia, vacíos y nuevas direcciones del ABP.

El trabajo describe definiciones básicas, principios guía, enfoques o modelos generales y un posible currículo para la formación docente, con el propósito de mejorar la enseñanza. Se ha enfatizado el valor del desarrollo profesoral para la promoción de la excelencia académica y la vitalidad institucional. De igual manera, se ha planteado la necesidad de mejorar o ampliar la perspectiva del crecimiento profesional formal, la promoción de los aprendizajes informales en contextos reales, el papel del aprendizaje experiencial y la práctica reflexiva en los aspectos individual y grupal. También se ha planteado que convertirse en un profesor efectivo es un proceso de desarrollo que requiere compromiso individual e institucional y que los profesionales se pueden beneficiar de hacer parte de una comunidad de práctica.

El aprendizaje basado en problemas (ABP) ha sido adoptado en la educación médica colombiana con varias décadas de retraso respecto a su implementación en Norteamérica y Europa. Aunque su introducción formal ocurrió en los años noventa, especialmente en la Universidad de Antioquia, y posteriormente en Unisanitas, su consolidación como modelo pedagógico integral ha sido desigual. En Colombia, el ABP ha sido interpretado desde diversos ángulos y perspectivas en el currículo, lo que ha generado prácticas fragmentadas y resistencia institucional. A pesar de ello, experiencias como la de Unisanitas muestran que es posible articular el ABP al diseño curricular completo, logrando coherencia pedagógica y sostenibilidad. Los desafíos actuales incluyen su expansión a programas de posgrado, la integración de tecnologías como inteligencia artificial y la necesidad de investigaciones que evidencien su efectividad. En este contexto, el ABP representa una oportunidad transformadora para la educación médica del país.

Background and Objectives: E-cigarette use among middle and high school students steadily increased in the last decade, raising significant public health concerns. It is argued that e-cigarettes contain a lower level of toxicants than combustible tobacco cigarettes. This perception has contributed to the growing popularity of e-cigarettes among youth. However, lower level of toxicants does not mean addiction is less likely. In this study, we examine trends in the usage of electronic cigarettes among middle and high school students in the U.S. from 2018 to 2023, compare these patterns with traditional cigarette use over the same period and population, and explore the underlying reasons driving e-cigarette use within this demographic. Understanding patterns and motivations are essential for developing effective prevention and intervention strategies. Materials and Methods: Data were derived from the National Youth Tobacco Survey (NYTS), administered by the Centers for Disease Control and Prevention (CDC). Population-level estimates and standard errors were calculated to facilitate comparisons across subgroups and time points. Results: A declining trend in e-cigarette use was observed over the study period. The proportion of students who reported exclusive e-cigarette use was significantly higher than that of those who used combustible cigarettes exclusively. Among reported motivations, anxiety consistently ranked among the top three reasons for vaping for current users. Conclusions: The downward trend in youth e-cigarette experimentation is encouraging. However, the period from 2020 to 2023, which includes the COVID-19 pandemic (2020 and 2021) era, may have impacted usage patterns. Alarmingly, the number of students who vape exclusively is approximately five times greater than that of those who smoke only cigarettes. This finding contradicts claims by e-cigarette manufacturers that their products facilitate smoking cessation. Further rising e-cigarette smoking exclusively is of public health concern, which warrants targeted intervention.

Background and Objectives: Long COVID-19 (LC) is a multifaceted condition characterized by persistent fatigue and impaired health-related quality of life (HRQoL). Exercise intolerance and post-exertional symptom exacerbation (PESE) pose challenges for rehabilitation. This study aimed to evaluate the effects of a 12-week core-focused plank exercise program on fatigue and HRQoL in women with LC, using validated patient-reported measures. Materials and Methods: A pilot quasi-experimental design was implemented, with non-randomized group allocation. Thirty-nine women with LC were recruited from the Madrid Long COVID Association. Participants were assigned to either an intervention group (n = 20), which completed a supervised plank-based motor control program, or a control group (n = 19), which maintained usual activity. Fatigue was assessed using the Modified Fatigue Impact Scale (MFIS), and HRQoL was measured using the EQ-5D-5L and EQ Visual Analog Scale (EQ-VAS). Body composition was evaluated via bioelectrical impedance analysis. Results: The intervention group showed significant reductions after intervention in the MFIS total scores compared to the control group, particularly in the physical (21.26 ± 6.76 vs. 25.21 ± 6.06; p < 0.001) and psychosocial domains (4.51 ± 0.41 vs. 5.21 ± 0.38; p < 0.001), without triggering PESE. EQ-VAS scores improved significantly (63.94 ± 15.33 vs. 46.31 ± 14.74; p = 0.034). No significant changes were found in body composition parameters, suggesting that benefits were driven by neuromuscular adaptations rather than morphological changes. Conclusions: A core-focused, non-aerobic exercise program effectively reduced fatigue and improved perceived health status in women with LC. These findings support the use of motor control-based interventions as a safe and feasible strategy for LC rehabilitation, particularly in populations vulnerable to PESE, suggesting clinical applicability for the rehabilitation of women with LC. Further randomized trials are warranted to confirm these results and explore long-term outcomes.

Both obesity and chronic kidney disease (CKD) are increasingly recognized as global epidemics. Their escalating incidence and far-reaching health implications highlight the urgent need for comprehensive prevention and management strategies. This review aims to clarify how obesity interacts with end-stage kidney disease (ESKD) and how to improve the management of obese patients receiving kidney replacement therapy. It also explores underlying mechanisms, current treatments, future directions, and ongoing controversies. By highlighting this intricate relationship, the review seeks to enhance clinical practice and promote further research toward more personalized care for this vulnerable population. Obesity is frequent in dialysis patients and creates challenges related to body composition, metabolism, and treatment. While higher body mass index (BMI) may appear to improve survival, this paradox does not offset the cardiovascular and functional risks of visceral and sarcopenic obesity. Obesity also increases post-transplant complications and can limit access to transplantation. Lifestyle changes rarely achieve lasting weight loss, whereas bariatric surgery—especially sleeve gastrectomy—can improve transplant eligibility with fewer complications. Weight-loss medications may be used before transplantation but remain insufficiently studied in ESKD. After transplantation, weight-reduction efforts should continue, with pharmacotherapy preferred over bariatric surgery. Comprehensive assessment strategies and individualized management approaches in ESKD patients are essential to optimize outcomes in this growing patient population.

Background and Objectives: Preeclampsia (PE) complicates 2–8% of pregnancies globally, with a higher incidence in developing countries. This condition poses significant risks to maternal and fetal health, contributing substantially to maternal and perinatal mortality, particularly in cases of early-onset PE, which is associated with severe complications. This review aims to synthesize current evidence regarding the predictive utility of ophthalmic artery Doppler for preeclampsia. Current strategies focus on early prediction and prevention to mitigate adverse outcomes and reduce the economic burden of hypertensive disorders in pregnancy. The International Federation of Gynecology and Obstetrics (FIGO) recommends first-trimester screening combining maternal risk factors, mean arterial pressure, serum placental growth factor (PlGF), and uterine artery pulsatility index (UtA-PI). High-risk women are advised to take low-dose aspirin (150 mg daily) until 36 weeks of gestation. Materials and Methods: This review explores an innovative predictive tool for PE: ophthalmic artery (OA) Doppler. Results: As a non-invasive and easily accessible method, OA Doppler provides valuable insights into intracranial vascular resistance, offering potential advantages in early risk assessment, particularly for preterm PE, the most severe form of the disease. Conclusions: Our findings suggest that OA Doppler may serve as a promising adjunct in PE screening, enhancing the early identification of high-risk pregnancies and improving clinical outcomes. Further research is warranted to validate its role in routine prenatal care.

Background and Objectives: Soft tissue sarcomas account for approximately 7% of all malignant tumors in the pediatric population. Diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) measurements may provide early functional biomarkers of treatment response by reflecting changes in tumor cellularity. This study evaluated whether ADC-derived parameters can serve as quantitative biomarkers of neoadjuvant chemotherapy response in pediatric rhabdomyosarcoma. Materials and Methods: This retrospective single-center study included 14 patients aged ≤18 years with histopathologically confirmed rhabdomyosarcoma who underwent MRI before treatment and after three cycles of chemotherapy. Twenty-five patients were initially identified; eleven were excluded due to imaging artifacts or absence of baseline examination. ADC maps were generated on 1.5T and 3T scanners. Regions of interest were placed over the entire lesion and areas with the lowest ADC signal. Relative ADC (rADC) was calculated by normalizing tumor ADC to adjacent healthy muscle. Paired t-tests were used to compare pre- and post-treatment values. Results: At baseline, 13/14 patients (93%) demonstrated diffusion restriction. Mean ADC increased from 1.11 × 10−3 mm2/s (SD ± 0.48) at baseline to 1.63 × 10−3 mm2/s (SD ± 0.67) after treatment. The paired t-test for rADC yielded t = −3.089 (p = 0.0086, 95% CI: −0.79 to −0.14), indicating a statistically significant change. There was a significant difference between the ADC values of the entire lesion and the areas with the lowest signal in tumors with a heterogenic structure, t = 2.862, p = 0.013. Conclusions: ADC and rADC increased significantly after neoadjuvant chemotherapy in pediatric rhabdomyosarcoma, suggesting potential utility as early functional biomarkers of treatment response. These preliminary findings require validation in larger multicenter prospective studies with correlation to histopathological response and clinical outcomes before clinical implementation.