Conjunto de recomendaciones nutricionales para desarrollar estrategias dietéticas en atletas

Este estudio partió de una caracterización nutricional en atletas, atendidos desde el punto de vista académico y científico por la Universidad Técnica "Luis Vargas Torres", de Ecuador. Llamó la atención a entrenadores y profesores de este centro pedagógico deportivo que, a pesar de contar con las condiciones básicas adecuadas para la práctica del deporte, se mostraron resultados deportivos desfavorables. Entre los datos recogidos en el estudio exploratorio (encuesta a entrenadores y entrevista a directivos y profesores) se destacó el insuficiente régimen dietético nutricional recibido por los deportistas. Se planteó como objetivo proponer un conjunto de recomendaciones nutricionales que permita perfeccionar las estrategias dietéticas que necesitan los atletas para mantenerse en un estado óptimo en su práctica deportiva y su salud. El diagnóstico, se sustentó en la medición y análisis estadísticos como la correlación de intensidad (Sprints) e ingesta de carbohidratos y la correlación intensidad e ingesta de proteínas. Después de analizar los resultados, se diseñaron y establecieron un grupo de recomendaciones dietéticas enfocadas en mejorar la situación formativa deportiva. Se sugiere que futuras investigaciones profundicen en esta área, para validar y mejorar el marco analítico propuesto.

Este estudo partiu de uma caracterização nutricional em atletas, atendida do ponto de vista acadêmico e científico pela Universidade Técnica "Luis Vargas Torres", do Equador. Chamou a atenção dos treinadores e professores deste centro pedagógico desportivo que, apesar de apresentarem as condições básicas adequadas à prática desportiva, apresentavam resultados desportivos desfavoráveis. Dentre os dados coletados no estudo exploratório (pesquisa com treinadores e entrevistas com dirigentes e professores), destacou-se o insuficiente regime alimentar nutricional recebido pelos atletas. O objetivo foi propor um conjunto de recomendações nutricionais que permitissem aperfeiçoar as estratégias alimentares que os atletas necessitam para se manterem num estado óptimo na sua prática desportiva e saúde. O diagnóstico foi baseado em medidas e análises estatísticas como a correlação de intensidade (Sprints) e ingestão de carboidratos e a correlação de intensidade e ingestão de proteínas. Após a análise dos resultados, foi desenhado e estabelecido um conjunto de recomendações dietéticas focadas na melhoria da situação do treino desportivo. Sugere-se que pesquisas futuras se aprofundem nesta área, para validar e aprimorar o arcabouço analítico proposto.

This study is based on a nutritional characterization of athletes, attended from an academic and scientific point of view by the Luis Vargas Torres Technical University, of Ecuador. It draws the attention of coaches and teachers of this sports pedagogical center that, despite having the appropriate basic conditions for the practice of sports, unfavorable sports results are shown. Among the data collected in the exploratory study (survey of coaches and interviews with managers and teachers), the insufficient nutritional dietary regimen received by athletes was highlighted. The objective was to propose a set of nutritional recommendations that allow perfecting the dietary strategies that athletes need to remain in an optimal state in their sports practice and health. The diagnosis was based on measurement and statistical analysis such as the correlation of intensity (Sprints) and carbohydrate intake and the correlation of intensity and protein intake. After analyzing the results, a group of dietary recommendations focused on improving the sports training situation are designed and established. It is suggested that future research delve into this area, to validate and improve the proposed analytical framework.

Efficiency and comparability of using new evidence platforms for updating recommendations: experience with a type-2 diabetes guideline in Colombia / Eficiencia y comparabilidad del uso de nuevas plataformas de evidencia para la actualización de recomendaciones: experiencia con una guía de diabetes tipo 2 en Colombia

INTRODUCTION: Updating recommendations for guidelines requires a comprehensive and efficient literature search. Although new information platforms are available for developing groups, their relative contributions to this purpose remain uncertain. METHODS: As part of a review/update of eight selected evidence-based recommendationsfor type 2 diabetes, we evaluated the following five literature search approaches (targeting systematic reviews, using predetermined criteria): PubMed for MEDLINE, Epistemonikos database basic search, Epistemonikos database using a structured search strategy, Living overview of evidence (L.OVE) platform, and TRIP database. Three reviewers independently classified the retrieved references as definitely eligible, probably eligible, or not eligible. Those falling in the same "definitely" categories for all reviewers were labelled as "true" positives/negatives. The rest went to re-assessment and if found eligible/not eligible by consensus became "false" negatives/positives, respectively. We described the yield for each approach and computed "diagnostic accuracy" measures and agreement statistics. RESULTS: Altogether, the five approaches identified 318 to 505 references for the eight recommendations, from which reviewers considered 4.2 to 9.4% eligible after the two rounds. While Pubmed outperformed the other approaches (diagnostic odds ratio 12.5 versus 2.6 to 5.3), no single search approach returned eligible references for all recommendations. Individually, searches found up to 40% of all eligible references (n = 71), and no combination of any three approaches could find over 80% of them. Kappa statistics for retrieval between searches were very poor (9 out of 10 paired comparisons did not surpass the chance-expected agreement). CONCLUSION: Among the information platforms assessed, PubMed appeared to be more efficient in updating this set of recommendations. However, the very poor agreement among search approaches in the reference yield demands that developing groups add information from several (probably more than three) sources for this purpose. Further research is needed to replicate our findings and enhance our understanding of how to efficiently update recommendations.

INTRODUCCIÓN: La actualización de recomendaciones de las guías de práctica clínica requiere búsquedas bibliográficas exhaustivas y eficientes. Aunque están disponibles nuevas plataformas de información para grupos desarrolladores, su contribución a este propósito sigue siendo incierta. MÉTODOS: Como parte de una revisión/actualización de 8 recomendaciones basadas en evidencia seleccionadas sobre diabetes tipo 2, evaluamos las siguientes cinco aproximaciones de búsqueda bibliográfica (dirigidas a revisiones sistemáticas, utilizando criterios predeterminados): PubMed para MEDLINE; Epistemonikos utilizando una búsqueda básica; Epistemonikos utilizando una estrategia de búsqueda estructurada; plataforma (L.OVE) y TRIP . Tres revisores clasificaron de forma independiente las referencias recuperadas como definitivamente o probablemente elegibles/no elegibles. Aquellas clasificadas en las mismas categorías "definitivas" para todos los revisores, se etiquetaron como "verdaderas" positivas/negativas. El resto se sometieron a una nueva evaluación y, si se consideraban por consenso elegibles/no elegibles, se convirtieron en "falsos" negativos/positivos, respectivamente. Describimos el rendimiento de cada aproximación, junto a sus medidas de "precisión diagnóstica" y las estadísticas de acuerdo. RESULTADOS: En conjunto, las cinco aproximaciones identificaron 318-505 referencias para las 8 recomendaciones, de las cuales los revisores consideraron elegibles el 4,2 a 9,4% tras las dos rondas. Mientras que Pubmed superó a las otras aproximaciones (odds ratio de diagnóstico 12,5 versus 2,6 a 53), ninguna aproximación de búsqueda identificó por sí misma referencias elegibles para todas las recomendaciones. Individualmente, las búsquedas identificaron hasta el 40% de todas las referencias elegibles (n=71), y ninguna combinación de cualquiera de los tres enfoques pudo identificar más del 80% de ellas. Las estadísticas Kappa para la recuperación entre búsquedas fueron muy pobres (9 de cada 10 comparaciones pareadas no superaron el acuerdo esperado por azar). CONCLUSIONES: Entre las plataformas de información evaluadas, Pubmed parece ser la más eficiente para actualizar este conjunto de recomendaciones. Sin embargo, la escasa concordancia en el rendimiento de las referencias exige que los grupos desarrolladores incorporen información de varias fuentes (probablemente más de tres) para este fin. Es necesario seguir investigando para replicar nuestros hallazgos y mejorar nuestra comprensión de cómo actualizar recomendaciones de forma eficiente.

Methodology for the Development of Clinical Practice Guidelines for Chinese Patent Medicine （Part 6）： Formation and Presentation of Recommendations / 中医杂志

Recommendation formation is a key component of clinical practice guidelines for Chinese patent medicine （CPM）， and should encompass the determination of the strength and direction of the recommendation， the rationale for the recommendation， and the methodology for implementing the recommendation. Recommendations can be formed through formal consensus and informal consensus. The strength and direction of recommendations for CPM guidelines should be determined by considering the quality of evidence for CPMs， the priority of the clinical questions， the pros and cons of efficacy and adverse effects， patient acceptance， the feasibility of the recommendation and the availability of resources， social fairness， economic benefits， and other influencing factors. In order to better guide guideline developers to consider these factors more rationally， this article provideed a detailed explanation of each factor in the context of the characteristics of TCM.

Break the domestic public hospital clinical research evaluation system under the background of"five only" / 现代医院

Objective The purpose of this article is to summarize and review the current status of the construction of clinical research evaluation systems in domestic public hospitals,identify existing problems in the evaluation system,and propose development strategies and suggestions.Methods Retrieved relevant articles,dissertations and policies from the past five years(2018-2022),screened the titles,viewed the full texts of 52 selected papers and their references,and summarized them.Results The"five-only"indicators have long been an important indicator for evaluating clinical research in public hospitals,but in today's scientific research environment and policy environment,the"five-only"evaluation system has revealed its utilitarian draw-backs and gradually evolved into a hindrance to scientific research.It is urgent to break through the"five-only"orientation and establish a clinical research evaluation system oriented towards"transforming and applying transformation of scientific research achievements".Conclusion The evaluation system for clinical research should break the previous"five-only"evaluation model based on quantity-oriented scientific research evaluation.We can draw on the framework of the research output,influence,and environment indicators in the UK's REF Excellence Framework model,combine the American APT system and the Chinese STEM indicator dimensions,explore multi-outcome evaluation,integrate developmental indicators,and continuously improve the indica-tor system and application methods in practice to promote the development of clinical research in public hospitals.

Research on Management Policies of Laboratory Animals in Sichuan Province / 实验动物与比较医学

Improving laboratory animal management system is one of the effective ways to promote the legalization and standardization of laboratory animal management. This article systematically reviews the relevant content and requirements of the latest laws, regulations, normative documents, and standards formulated and promulgated by the state since 2019 regarding the management of experimental animals. It also analyzes the current institutional framework in managing experimental animals in Sichuan Province from four aspects: administrative management, quality assurance, biosafety, and local standards. Furthermore, this article summarizes the existing problems and proposes corresponding policy recommendations in a targeted manner, aiming to provide a reference for the formulation of robust experimental animal management policies in Sichuan Province.

Chinese clinical guidelines on diagnosis and treatment of lung cancer bone metastasis (version 2024) / 中国胸心血管外科临床杂志

@#Lung cancer is the highest morbidity of malignant tumor in China, and bone metastasis is one of the common sites. With the development of imaging and nuclear medicine technology, the level of early diagnosis of bone metastasis has been improved. There are also many evidence-based evidences and advances in systemic therapy (chemotherapy, targeted therapy, immunotherapy) and bone modification drugs for treatment of bone metastases from lung cancer. The comprehensive treatment model under the guidance of multiple disciplines (including medical oncology, surgery, radiotherapy, interventional medicine, nuclear medicine, psychological rehabilitation, etc.) has been widely implemented in clinical practice. Therefore, Lung Cancer Medical Education Committee of China Medicine Education Association, Youth Specialists Committee of Lung Cancer, Beijing Medical Award Foundation and Lung Cancer Specialty Committee of Chinese Elderly Health Care Association have written the "Chinese Clinical Guidelines on Diagnosis and Treatment of Lung Cancer Bone Metastasis (Version 2024)", based on the "Expert Consensus on Diagnosis and Treatment of Lung Cancer Bone Metastasis (Version 2019)". The aim is to enhance the comprehensive treatment level of lung cancer bone metastasis in China.

The Difficulties and Methodological Suggestions for the Recommendation Formation of Clinical Practice Guidelines of Traditional Chinese Medicine / 中医杂志

Currently， there are many difficulties in formulating recommendations of traditional Chinese medicine （TCM） clinical practice guidelines. This paper analyzed and summarized the unique or prominent difficult issues in the formulation of recommendations faced by TCM guidelines， such as experts' professional background and experience bringing about the preferance from the academic emotion， inconsistency between different academic schools making it difficult to reach consensus， lack of guiding principles of the decision weight of different dimensions for recommendations. Therefore， methodological suggestions have been put forward， including organizing parallel TCM and western medicine consensus group， improving the method of combining TCM and western medicine paradigm， attaching great importance to the evidence-based governance of academic schools， and promoting the research on different dimensions for recommendation formulation， which may provide a methodological reference for the guideline development.

Comparative Study on the Payment of Medical Insurance for Innovative Drugs Between China and Foreign Countries / 医药导报

Payment by diagnosis related groups(DRG)is an important research direction in China's current medical insurance payment reform.However,it limits the clinical development and utilization of innovative medicines to a certain extent.Additional payments for innovative medicines have been thoroughly studied in many countries.This paper conducted an analysis and summary of the global experience regarding additional payment for innovative medicines under the DRG payment system.U-sing the United States,France,and Germany as case studies,this paper also examined the current state of medical insurance pay-ment for innovative medicines in China and the influence of DRG payment on the development of such medicine.In addition,it has put forward explicit policy recommendations,including the establishment of inclusion criteria,the selection of appropriate payment modes,the implementation of dynamic adjustment mechanisms,the enhancement of payment methods,etc.This paper aims to provide references to comprehensively promote DRG payment reform while further establishing and enhancing medical in-surance payment mechanisms related to innovative medicines in the context of China's national conditions.

Research status and reflections on stroke health management in China / 中华行为医学与脑科学杂志

Stroke is a major public health problem in China and the world. Health management can reduce morbidity, disability rate, recurrence rate, mortality and burden of stroke patients effectively.And it can also improve the quality of life of stroke patients effectively. Although the research on stroke health management in China started later than that in foreign countries, a series of research achievements have been obtained in recent years. Therefore, this article reviews the research status of stroke health management in China, and put forward reflections and suggestions for future research and clinical practice. This literature review can provide reference for stroke health management in China.

Clinical Advantages of Traditional Chinese Medicine in Treatment of Pediatric Diseases / 中国实验方剂学杂志

The traditional Chinese medicine （TCM） in pediatric care has a long history，proven efficacy，and distinctive characteristics.The China Association of Chinese Medicine has organized a series of youth salons to discuss the clinical advantages of treating diseases.Experts at this seminar proposed that the superior disease categories in pediatric TCM are significant for showcasing the unique strengths and advantages of TCM in the treatment of pediatric diseases，enhancing diagnostic and treatment levels，inheriting TCM knowledge，promoting the integration of TCM and Western medicine，and meeting patients' needs.The strengths of pediatric TCM are summed up as "having what others do not，excelling at what others have，being special in what others excel at，and ensuring safety in what others specialize in." The scope of superiority in pediatric TCM covers multiple systems，including respiratory，digestive，endocrine，psychological，and dermatological systems.This article summarized the advantages of TCM in treating 13 diseases discussed in the salon，such as upper respiratory tract infections，coughs，pneumonia，allergic rhinitis，bronchial asthma，atopic dermatitis，functional dyspepsia，functional constipation，enuresis，marginal short stature，simple obesity，attention deficit hyperactivity disorder，and tic disorders.The overall advantages were reflected in three aspects：First，the holistic concept and treatment based on syndrome differentiation in TCM highlight the advantage of treating the root causes of diseases，making the treatment methodical and precise.Second，most traditional Chinese herbs are natural and have strong safety profiles.Third，TCM treatment methods are abundant，especially the external treatment methods，which are widely used in pediatrics，highly accepted by parents，and have definite efficacy，as well as good safety and compliance.

Tips y fundamentos para el uso de la unidad electroquirúrgica en endoscopia / Recommendations and rationale for the use of electrosurgical unit in endoscopy

Electrosurgical unit (ESU) is a critical piece of equipment in any endoscopy rooms because is used in the ma- jority of endoscopic therapeutic procedures. However, many endoscopists are not well-trained on their use and their physical bases are usually not properly studied or understood. A good understanding of the principles of electrosurgery and various configurations available in the ESU is essential for the effective and safe use during endoscopy. The aims of these article are to: (1) expose physical principles relevant to the understanding of elec- trosurgery during endoscopy; (2) describe and provide practical recommendations regarding two ESU that are commonly in use; (3) review usually factors relevant to commonly performed therapeutic procedures, including polypectomy, sphincterotomy, contact thermal hemostasis, argon plasma coagulation, etc. (4) discuss the clinical relevance of technologies recently implemented in newer electrosurgical units and future perspectives with the artificial intelligence.

La unidad electroquirúrgica (UEQ) es un equipo fundamental en cualquier sala de endoscopia, ya que se utiliza en la mayoría de los procedimientos terapéuticos. Sin embargo, muchos endoscopistas no están del todo capacitados en su uso y sus bases físicas no suelen estudiarse ni comprenderse adecuadamente. Un buen conocimiento de los principios electroquirúrgicos y de las diversas configuraciones disponibles en la UEQ es esencial para un uso eficaz y seguro durante la endoscopia. Los objetivos de este artículo son: (1) Exponer los principios físicos relevantes de la electrocirugía durante la endoscopia; (2) Describir y proporcionar recomendaciones prácticas con respecto a las dos UEQ más comúnmente utilizadas; (3) Revisar los factores generalmente relevantes para los procedimientos terapéuticos que se realizan con frecuencia, incluida la polipectomía, la esfinterotomía, la hemostasia térmica de contacto, la coagulación con argón plasma, etc. (4) Analizar la relevancia clínica de las tecnologías implementadas recientemente en las UEQ más nuevas y las perspectivas futuras con el advenimiento de la inteligencia artificial.

Recomendaciones basadas en guías de práctica clínica sobre diagnóstico, tratamiento y seguimiento de infección de tracto urinario en pacientes pediátricos en Colombia / Recommendations based on clinical practice guidelines on diagnosis, treatment and follow-up of urinary tract infection in pediatric patients in Colombia

resumen está disponible en el texto completo

ABSTRACT Background: Urinary tract infection (UTI) is a common disease in childhood and one of the most common causes of consultation in the pediatric emergency department. Its incidence ranges between 5% and 10% in children under 2 years old. Objective: To generate recommendations on the diagnosis, treatment, and follow-up of UTI in pediatric patients in Colombia. Methods: 15 questions of clinical interest in the diagnosis, treatment, and follow-up of UTI in pediatric patients were formulated. A systematic review of the literature was carried out to identify the clinical practice guidelines (CPG) available in UTI, in order to use this evidence to answer the proposed questions and articulate the recommendations. Local and international tools were used to select and evaluate the CPGs. Information was retrieved from the selected guidelines, preliminary recommendations were compiled, and final recommendations were approved by expert consensus. Finally, the strength and direction of each recommendation was assessed. Results: A total of 4 CPGs were selected: American Academy of Pediatrics, Spanish Ministry of Health, McTaggart, and National Institute for Health and Care Excellence. Final recommendations for the diagnosis, treatment, and follow-up of UTI are presented in this paper. Conclusions: These recommendations will guide the teams to make clinical decisions regarding health care of pediatric patients with UTI in Colombia. This will help to improve health care and to generate policies for timely diagnosis, treatment, and follow-up in these patients.

Recommendations for Publishing Clinical Cases

The importance of publishing clinical cases lies in the diagnostic or therapeutic developments they can contribute. This paper mainly aims to guide young doctors in writing and publishing a clinical case. Reflections are encouraged on choosing a clinical case and writing it sharply, briefly, and chronologically to improve the chances of acceptance and publication. Recommendations on how to use the CARE (Case Report Statement and Checklist) are also given.

La importancia de la publicación de los casos clínicos radica en las novedades diagnósticas o terapéuticas que el mismo pueda aportar. Este trabajo está dirigido principalmente a los médicos jóvenes con la finalidad de orientarlos en el proceso de la redacción y publicación de un caso clínico. Se plantean reflexiones sobre cómo escoger un caso clínico, como redactarlo de una forma cronológica clara, nítida y breve, para mejorar las posibilidades de que sea aceptado y publicado. También se dan recomendaciones acerca de cómo utilizar la lista de comprobación CARE (Declaración y Lista de Comprobación-Case Report).

Marcadores bioquímicos propuestos para el estudio de la sarcopenia / Proposed biochemical markers for the study of sarcopenia

La sarcopenia asociada a la edad es una condición clínica caracterizada por una disminución en la fuerza, calidad y cantidad de masa muscular así como también en la función muscular. Un biomarcador se define como una característica que es medible objetivamente y evaluable como indicador de un proceso biológico normal, patológico o respuesta terapéutica a una intervención farmacológica. Los marcadores bioquímicos propuestos para el estudio de la sarcopenia pueden ser categorizados en dos grupos. El primero de ellos evalúa el estatus musculoesquelético; este panel de marcadores está formado por miostatina/folistatina, procolágeno aminoterminal tipo III e índice de sarcopenia. El segundo grupo de marcadores bioquímicos evalúa factores causales, para lo cual se sugiere medir el factor de crecimiento insulino-símil tipo 1 (IGF-1), dehidroepiandrosterona (DHEAS), cortisol, facto-res inflamatorios [proteína C reactiva (PCR), interleuquina 6 (IL-6) y factor de necrosis tu-moral (TNF-a)]. Las recomendaciones realiza-das están basadas en la evidencia científica disponible en la actualidad y la disponibilidad de la metodología apropiada para cada uno de los biomarcadores. (AU)

Sarcopenia is a progressive and generalized skeletal muscle disorder defined by decrease in the strength, quality and quantity of muscle mass as well as in muscle function. A biomarker is defined as a feature objectively measured and evaluated as an indicator of a normal biologic process, a pathogenic process or a pharmacologic response to therapeutic intervention. The biochemical markers proposed for the study of sarcopenia may be classified in two groups. The first group evaluates the musculoskeletal status, made up by myostatin/follistatin, N-terminal Type III Procollagen and the sarcopenia index. The second evaluates causal factors, where the measurement of the following is suggested: hormones insulin-like growth factor-1 (IGF-I), dehydroepiandrosterone sulphate (DHEAS), cortisol, inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-a (TNF-a)]. The recommendations made are based on scientific evidence currently available and the appropriate methodology availability for each biomarker. (AU)

Field Evaluation of Site Specific Drip Fertigation in Tomato

Evaluation of site specific drip fertigation system based on GIS integrated nutrient status maps was conducted at Instructional Farm, KCAET, Tavanur, Malappuram, Kerala. Using the spatial variability maps of the soil nutrients, two test plots, one from high fertility zone and one from low fertility zone were identified with the help of GPS for raising the tomato crop. The experimental plot was laid out in a Completely Randomized Design (CRD) with four treatments and four replications. The results showed an increase in yield and growth parameters under site specific drip fertigation treatment in low fertility area due to the adequate fertiliser application than general recommendation. In high fertility area, reduction of fertilizer to site specific requirements has produced almost similar result of general recommendation which indicates that site specific dose was sufficient to produce optimum yield from the crop. Site specific drip fertigation helped to achieve a higher water and nutrient use efficiency with a high economic return of agricultural produce. From this study, it could be concluded that, instead of going with blanket nutrient recommendation, a site specific nutrient recommendation may help the farmers who want to achieve higher profit from unit land area by using optimum inputs, thereby reducing environmental stress due to over fertilizer application.

Parto humanizado: adherencia del personal de salud a las recomendaciones de la Organización Mundial de la Salud según la opinión de las pacientes / Humanized childbirth: adherence of health personnel to the recommendations of the World Health Organization according to the opinion of patients

Objetivo: evaluar la adherencia del personal de salud de la Clínica Maternidad Santa Ana, del Instituto Venezolano del Seguro Social, a las recomendaciones de la Organización Mundial de la Salud sobre parto humanizado para una experiencia de parto positiva, según la opinión de las pacientes que acudieron para atención obstétrica entre septiembre y noviembre de 2022. Métodos: Estudio observacional, prospectivo, descriptivo, exploratorio y transversal. Incluyó 100 puérperas. Se les aplicó una encuesta ad hoc elaborada según las recomendaciones de la Organización Mundial de la Salud y se relacionó con las características de las pacientes. Previamente, se validó el instrumento. Se aplicó estadística descriptiva. Resultados: El coeficiente de correlación intraclase de la encuesta fue de 0,821 y el r de Guttman fue 0,879. Globalmente, 87 % de las pacientes percibió una adherencia moderada. En la atención durante el trabajo de parto y el nacimiento, 90 pacientes percibieron una adherencia moderada, durante el periodo de dilatación, 85 % encontraron adherencia moderada; en el periodo expulsivo y el alumbramiento, 54 % percibieron que la adherencia era moderada pero 29 % la describieron como mala. En la atención posparto para madre y recién nacido, 47 % percibieron que la adherencia fue excelente, con un 42 % que la percibieron como moderada. La puntuación total fue 3078 puntos (61,6 %) que corresponde a adherencia moderada. Conclusiones: La adherencia del personal de salud a las recomendaciones de la Organización Mundial de la Salud sobre parto humanizado fue moderada y mejoró en las etapas avanzadas del proceso(AU)

Objective: To evaluate the adherence of the health personnel of the Santa Ana Maternity Clinic, of the Venezuelan Institute of Social Security, to the recommendations of the World Health Organization on humanized childbirth for a positive birth experience, according to the opinion of patients who come for obstetric care between September and November 2022. Methods: Observational, prospective, descriptive, exploratory and cross-sectional study. It included 100 puerperal women. An ad hoc survey prepared according to the recommendations of the World Health Organization was applied to them and related to the characteristics of the patients. Previously, the instrument was validated. Descriptive statistics were applied. Results: The intraclass correlation coefficient of the survey was 0.821 and Guttman's r was 0.879. Overall, 87% of patients perceived moderate adherence. In care during labor and birth, 90 patients perceived moderate adherence, during the labor period, 85% found moderate adherence; in the second stage and delivery, 54% perceived that adherence was moderate but 29% described it as poor. In postpartum care for mother and newborn, 47% perceived adherence to be excellent, with 42% perceiving it as moderate. The total score was 3078 points (61.6%) corresponding to moderate adherence. Conclusions: Health personnel's adherence to World Health Organization recommendations on humanized childbirth was moderate, and improved late in the process(AU)

Formulación de conclusiones de investigación

Este artículo trata sobre la metodología de formulación de las conclusiones de una investigación. De forma inicial, se distingue y descarta que los comentarios, las síntesis de resultados, la reiteración de datos y la descripción de las actividades realizadas no son propiamente conclusiones de una investigación. En segundo lugar, se define lo que constituyen las conclusiones, las condiciones, las actividades de formulación y la estructura que se sigue en su exposición. También se sugieren las actividades de evaluación de la investigación, así como la forma y los aspectos sobre los cuales realizar las recomendaciones respectivas en torno al estudio realizado.

This article deals with the methodology for formulating the conclusions of an investigation. Initially, it is distinguished and ruled out that the comments, the synthesis of results, the reiteration of data and the description of the activities carried out are not properly conclusions of an investigation. Secondly, it defines what constitutes the conclusions, the conditions, the formulation activities and the structure that is followed in their presentation. Research evaluation activities are also suggested, as well as the form and aspects on which to make the respective recommendations regarding the study carried out.

Este artigo trata da metodologia para formular as conclusões de uma investigação. Inicialmente, distingue-se e exclui-se que os comentários, a síntese de resultados, a reiteração de dados e a descrição das atividades realizadas não sejam propriamente conclusões de uma investigação. Em segundo lugar, define o que constituem as conclusões, as condições, as atividades de formulação e a estrutura que se segue na sua apresentação. São também sugeridas actividades de avaliação da investigação, bem como a forma e os aspectos sobre os quais fazer as respectivas recomendações relativamente ao estudo realizado.

Opiniones y recomendaciones de la Sociedad Argentina de Diabetes. Hemoglobina A1c / Opinions and recommendations of the Argentine Diabetes Society. Hemoglobin A1c

La estandarización de la hemoglobina A1c (HbA1c) permitió en algunos países su uso para el diagnóstico de la diabetes mellitus (DM) y la prediabetes, además de su empleo en el seguimiento del paciente con DM. Es importante recordar que se trata de una medida indirecta del promedio glucémico durante el tiempo de vida media del eritrocito, pudiendo verse afectada por variables no glucémicas, como también por interferencias analíticas según la metodología empleada para su determinación. A continuación, se describen las recomendaciones y consideraciones a tener en cuenta para la determinación de la HbA1c cuando se emplea como criterio diagnóstico de la DM, teniendo en cuenta que al utilizarla para tal fin es necesario que la medida se realice con métodos certificados y estandarizados al ensayo utilizado en el Diabetes Control and Complications Trial (DCCT).

The standardization of hemoglobin A1c (HbA1c) allowed in some countries its use for the diagnosis of diabetes mellitus (DM) and prediabetes, in addition to its use in the follow-up of patients with DM. It is important to highlight that it is an indirect measurement of the glycemic average during the halflife of the erythrocyte, and may be affected by non-glycemic variables, as well as by analytical interferences depending on the methodology used for its determination. The recommendations and considerations to take into account for the determination of HbA1c when it is used as a diagnostic criterion for diabetes are described below. In addition, it is important to emphasize that it is essential that the HbA1c measurement be performed with certified and standardized methods to the Diabetes Control and Complications Trial (DCCT)results.

Opiniones y recomendaciones de la Sociedad Argentina de Diabetes. Glucemia en ayunas alterada: ¿es oportuno utilizar el punto de corte en 100 mg/dl en Argentina? / Opinions and recommendations of the Argentine Diabetes Society. Impaired fasting blood glucose: is it appropriate to use a cut-off point of 100 mg/dl in Argentina?

Establecer el punto de corte entre la glucemia en ayunas normal y la alterada resulta de suma importancia a los efectos de considerar a un paciente en riesgo, tanto de progresar a estdos más avanzados de la enfermedad como de sufrir complicaciones micro y macroangiopáticas. Desde 2006 la Sociedad Argentina de Diabetes (SAD), sobre la base de la evidencia considerada en ese momento, estableció el límite inferior de la glucemia alterada en ayunas (GAA) en 110 mg/dl; posteriormente, durante 2022, la Comisión Directiva de la SAD convocó a un grupo de expertos con el objeto de evaluar si esta recomendación debía mantenerse o, al igual que otras sociedades científicas de prestigio, adoptar a tal efecto 100 mg/dl. En este documento de Opiniones y Recomendaciones se encuentran los fundamentos por los cuales la SAD adoptará, de ahora en más, 100 mg/dl como límite inferior de la GAA, en base a las nuevas evidencias científicas que muestran que desde este punto de corte se produce un aumento en la progresión a la diabetes mellitus y de las complicaciones tanto macro como microangiopáticas.

To establish the cut-off point between normal and impaired fasting glycemia (IFG) is extremely important for the purposes of considering a patient at risk both of progressing to more advanced stages of the disease and of suffering micro- and macroangiopathic complications. Since 2006, the Argentine Diabetes Society (ADS), based on the evidence considered at that time, established the lower limit of IFG at 110 mg/d, laterduring the year 2022, The Board of Directors of the ADS vened a group of experts in order to assess whether this recommendation should be maintained or, like other prestigious scientific societies, adopt 100 mg/dl for this purpose. This Opinions and Recommendations document contains therationale for which the SAD will adopt, from now on, 100 mg/dlas the lower limit of the IFG, based on the new scientific edence that shows that from this cut-off point it produces increase in progression to diabetes and both macro and microangiopathic complications.

Diagnosis and treatment recommendations of dialysis patients with SARS-CoV-2 infection for primary care clinicians / 西安交通大学学报(医学版)

End-stage renal disease (ESRD) patients undergoing outpatient hemodialysis (HD) and home peritoneal dialysis (PD) are high risk population of severe and critical types caused by SARS-CoV-2 infection. In order to improve the quality of diagnosis and treatment in dialysis patients with SARS-CoV-2 infection, we wrote this recommendation for primary care clinicians. During the epidemic period of SARS-CoV-2 infection, all patients should be instructed to strengthen self-management. Once the SARS-CoV-2 infection was found in dialysis patients, early stratified management should be carried out within 72 hours after the first positive nucleic acid or antigen test results, which includes early antiviral therapy, early recognition, and transferring severe patients from community or primary hospital to a referral hospital promptly. Guidance for dietary and sports rehabilitation after SARS-CoV-2 infection should also be started as soon as possible.