Revista Médica UCR
Revista Médica de la Universidad de Costa Rica

Volume 20, No. 1Primer número año 2026

Published February 6, 2026

Issue description

Número en construcción

Articles

  1. Ana Sofía Barrantes Romero, Krystel Gómez Casasola, Jorge Andrés Pacheco Molina, Juan José Mora Román Mora Román (Author)

    COMPARISON OF REQUIREMENTS REQUESTED FOR POST-REGISTRATION CHANGES FOR DRUGS PRODUCED BY CHEMICAL SYNTHESIS IN CENTRAL AMERICAN AND CARIBBEAN COUNTRIES

    The marketing authorization of medicines goods allows their commercialization in a specific nation. In addition, they have a dynamic life cycle, promoting previously approved modifications to the process or product. Such variations are known as post-approval changes. Because each country has regulations, the objective was to compare said changes and the associated requirements to modify the current marketing authorizations of drugs produced by chemical synthesis for human use in Central America, Jamaica, the Dominican Republic, and Trinidad and Tobago. For this, a review of regulations, standards, resolutions, and laws related to registering formulations produced by chemical synthesis for human use was done, precisely the requirements to make such modifications. Next, aspects shared by the nations of interest were compared, and differences in the requirements were established. The results showed 27 possible variations to the marketing authorization for Central America, while in Panama, the Dominican Republic, Jamaica, and Trinidad and Tobago, there are 31, 26, 23, and 9, respectively. It was proven that Central America has the most complete document regarding the number of changes and their respective requirements. As a complement, the various regulations associated with modifying the marketing authorization of drugs produced by chemical synthesis for human use in the countries of interest did not have harmonized variations and requirements.

  2. Josué Brenes-Camacho, Abigail Fallas-Mora, Viviana Ramos-Rodríguez, Marietta Somarribas, Navilla Apú (Author)

    PESTICIDE POISONINGS IN AREAS OUTSIDE THE GREATER METROPOLITAN AREA OF COSTA RICA: CHALLENGES IN THE CARE OF POISONED PATIENTS

    Between 2014 and 2024, the Centro Nacional de Control de Intoxicaciones (CNCI) in Costa Rica recorded 11,907 cases of pesticide poisoning, with 20 fatal outcomes (1). This issue is particularly serious in regions outside the Greater Metropolitan Area (GAM), where access to specialized services is limited. The objective of the study was to determine the main challenges in the management of pesticide poisoning in healthcare centers outside the GAM, based on the identification of the most commonly involved pesticides. A quantitative, cross-sectional, and retrospective study was conducted through the analysis of CNCI records, the application of questionnaires to healthcare professionals in the cantons with the highest incidence, and a review of scientific literature. The main pesticides involved were identified (pyrethroids, organophosphates, and unspecified substances), as well as the cantons with the highest number of reports (San Carlos, Pérez Zeledón, and Pococí). Additionally, challenges such as lack of medical training and limited access to supplies were identified

  3. Roberto Tovar-Arrieta, Victoria Hall-Ramírez, Alfonso Pereira-Céspedes Ph.D., Milania Rocha-Palma (Author)

    DEVELOPMENT AND EVALUATION OF AN INFORMATION BULLETIN FROM THE NATIONAL DRUG INFORMATION CENTER OF COSTA RICA FOR HEALTH PROFESSIONALS AND STUDENTS

    Objective: To develop a bulletin from the National Drug Information Center (CIMED®) of Costa Rica that complies with the accreditation standards of the International Society of Drug Bulletins, thereby enhancing access to reliable updated health-related information for healthcare professionals and students in Costa Rica. Method: The bulletin was desing based on a needs assessment conducted through surveys, along with benchmarking analysis of bulletins accredited by the International Society of Drug Bulletins. Results: Two initial editions were designed on topics of interest—Parkinson’s disease and oncology patients—and published in the Kérwá repository of the University of Costa Rica. The evaluation revealed high levels acceptance regarding design, content, and format. Conclusion: The bulletin represents a key tool for strengthening academic training, clinical practice, and scientific dissemination, consolidating CIMED® as a reference center in pharmaceutical and health information.

  4. Horacio Alejandro Chamizo Garcia, Juan José Romero Zúñiga (Author)

    Composite Risk Index for covid-19 from a geographic perspective: Costa Rica, March 2020 to May 2022.

    An epidemiological, ecological, and territorial study was designed. Morbidity and mortality data between March 2020 and May 2022 were combined to build the district Composite Risk Index, from the geospatial perspective and with a focus on the Social Determinants of Health. Hot clusters of the Composite Risk Index (high risk) located in the Greater Metropolitan Area and cold (low risk) clusters were identified flanking or limiting. The increase in the average number of vaccines per inhabitant in one unit was associated with a 2% decrease in the ICR. The increase in the percentage of overcrowded housing, uninsured people, foreign-born people, population density, and the Social Development Index increased the ICR by 1% or 2%.  The ICR provides knowledge about the severity of the covid-19 epidemic, their behavior in geographical space is clearly differentiated, as well as the explanatory capacity of social determinants. Geographical proximity played a very important role in the covid-19 epidemic in Costa Rica.

Artículos de Revisión Bibliográfica

  1. TATIANA KARINA MACIAS OROSCO (Translator); JENIFFER JOHANA SALGUERO ALARCON, LUIS ESCOBAR RONQUILLO (Author)

    “MULTIMODAL ARTERIOGRAPHY IN OTORHINOLARYNGOLOGY: ROLE IN PULSATILE TINNITUS AND VASCULAR PATHOLOGY OF THE EAR.”

    Pulsatile tinnitus represents 5-10% of tinnitus cases and is characterized by the perception of sound synchronous with the cardiac pulse. Its etiology is frequently related to vascular pathology of the temporal bone, including arteriovenous malformations, vascular anomalies, and hypervascularized tumoral lesions.

    Pulsatile tinnitus constitutes a relatively infrequent clinical manifestation, but of high diagnostic relevance in otorhinolaryngology, since in a significant percentage of cases it reflects the presence of underlying vascular pathology of the ear, skull base, or cerebral circulation. Unlike subjective tinnitus, pulsatile tinnitus is usually associated with potentially treatable entities such as arteriovenous malformations, dural fistulas, vascular anatomical variants, or paraganglioma tumors, which requires a precise and systematic diagnostic approach.

    In this context, it is essential to critically review the role of multimodal arteriography in the diagnosis and management of vascular pathology of the ear and, in particular, in the evaluation of pulsatile tinnitus. An updated synthesis of the literature will allow for the identification of the strengths and limitations of each technique, the establishment of indication criteria, and the definition of the added value of invasive arteriography compared to non-invasive modalities.

    This work aims to carry out a systematic and critical literature review on the role of multimodal arteriography in otorhinolaryngology, emphasizing its application in the differential diagnosis of pulsatile tinnitus and in the management of vascular pathology of the ear, including glomus tumors, arteriovenous malformations, dural fistulas, and clinically relevant anatomical variants.