RESUMO
Background: The number of patients treated with coagulation disorders, and more specifically with anticoagulanttherapy, has increased worldwide in recent years due to increased life expectancy in developed countries. Theprotocols for managing this type of patient in oral surgery has varied over recent years, especially after the appear-ance of new direct-acting oral anticoagulants (DOACs). The assessment of risk of bleeding in this type of patientwhen undergoing a surgical procedure continues to be a controversial issue for patients, dentists and general prac-titioners. The objective of this document is to offer recommendations, based on evidence, for decision making forpatients with coagulopathies who require dental surgical intervention. Material and Methods: Based on the indications of the Preparation of Clinical Practice guidelines in the NationalHealth System. Methodological manual, we gathered a group of experts who agreed on 15 PICO questions basedon managing patients with coagulation disorders in dental surgical procedures, such as fitting of implants or dentalextractions.Results: The 15 PICO questions were answered based on the available evidence, being limited in most cases due tothe lack of a control group. Two of the PICO questions were answered by the experts with a grade C recommendation,while the rest were answered with grade D.Conclusions: The results of this review highlight the need to undertake well designed clinical trials with controlgroups and with a representative sample size.(AU)
Assuntos
Humanos , Masculino , Feminino , Acenocumarol , Varfarina , Heparina , Implantes Dentários , Extração Dentária , Cirurgia Bucal , Inibidores do Fator Xa , Espanha , Odontologia , Medicina Bucal , Higiene Bucal , Transtornos da Coagulação SanguíneaRESUMO
Introduction: In general it has been recommended to people with diabetes to follow a low-carb diet. However, diets low in carbohydrates (DLCH) seem to be, at least, just as effective as low-fat, even providing better results in some cases in terms of glycemic control, decreased body weight and improves markers of cardiovascular risk. Objetives: To analyze the effect of the DLCH with respect to a low-fat diet (LFD) or other, as to baseline blood glucose, glycated hemoglobin (HbA1c), body weight, total cholesterol, and triglycerides. Methods: Literature Search of studies published in Medline, Scopus, Cinahl, Lilacs, Dialnet, Scielo and ProQuest. We extracted data on the composition of the diets evaluated, duration, and changes with respect to baseline blood glucose, HbA1c, body weight, cholesterol, and triglycerides. Results: We included 15 studies in the review found one of them significant differences between groups in levels of fasting glucose, in 6 in terms of HbA1c and 3 in terms of body weight. With regard to the levels of blood lipid, are not found in any study, significant differences between groups in regard to total cholesterol, while it is found in three studies with regard to the levels of triglycerides. Conclusions: This review shows that the DLCH can be effective in some aspects such as the reduction of HbA1c, body weight or triglyceride, although there is sufficient evidence to support its long term use over other diets, which requires more future research.
Introducción: usualmente se ha recomendado a personas diabéticas seguir una dieta baja en grasas. Sin embargo, las dietas bajas en carbohidratos (DBCH) parecen ser, al menos, igual de efectivas que las bajas en grasas, incluso aportan mejores resultados en algunos casos en cuanto a control glicémico, disminución de peso corporal y mejora de marcadores de riesgo cardiovascular. Objetivos: analizar el efecto de las DBCH con respecto a dietas bajas en grasas (DBG) u otras, en cuanto a glucemia basal, hemoglobina glicosilada (HbA1c), peso corporal, colesterol total y triglicéridos. Métodos:búsqueda bibliográfica de estudios publicados en Medline, Scopus, Cinahl, Lilacs, Dialnet, Scielo y ProQuest. Se extrajeron datos sobre la composición de las dietas evaluadas, duración y cambios respecto a glucemia basal, HbA1c, peso corporal, colesterol y triglicéridos. Resultados: se incluyen 15 estudios en la revisión: en uno de ellos se encontraron diferencias significativas entre grupos en los niveles de glucemia basal, en 6 en cuanto a HbA1c y en 3 en cuanto a peso corporal. Con respecto a los niveles de lípidos sanguíneos, no se encuentran en ningún estudio diferencias significativas entre grupos en cuanto al colesterol total, mientras que sí se encuentran en 3 estudios respecto a los niveles de triglicéridos. Conclusiones: esta revisión muestra que las DBCH pueden ser efectivas en algunos aspectos como la reducción de HbA1c, de peso corporal o de triglicéridos, aunque no hay suficiente evidencia científica que respalde su uso a largo plazo por encima de otras dietas, por lo que se precisa de más investigaciones futuras.
Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Dieta com Restrição de Carboidratos , Biomarcadores/sangue , Diabetes Mellitus Tipo 2/metabolismo , Carboidratos da Dieta , HumanosRESUMO
Introducción: usualmente se ha recomendado a personas diabéticas seguir una dieta baja en grasas. Sin embargo, las dietas bajas en carbohidratos (DBCH) parecen ser, al menos, igual de efectivas que las bajas en grasas, incluso aportan mejores resultados en algunos casos en cuanto a control glicémico, disminución de peso corporal y mejora de marcadores de riesgo cardiovascular. Objetivos: analizar el efecto de las DBCH con respecto a dietas bajas en grasas (DBG) u otras, en cuanto a glucemia basal, hemoglobina glicosilada (HbA1c), peso corporal, colesterol total y triglicéridos. Métodos: búsqueda bibliográfica de estudios publicados en Medline, Scopus, Cinahl, Lilacs, Dialnet, Scielo y ProQuest. Se extrajeron datos sobre la composición de las dietas evaluadas, duración y cambios respecto a glucemia basal, HbA1c, peso corporal, colesterol y triglicéridos. Resultados: se incluyen 15 estudios en la revisión: en uno de ellos se encontraron diferencias significativas entre grupos en los niveles de glucemia basal, en 6 en cuanto a HbA1c y en 3 en cuanto a peso corporal. Con respecto a los niveles de lípidos sanguíneos, no se encuentran en ningún estudio diferencias significativas entre grupos en cuanto al colesterol total, mientras que sí se encuentran en 3 estudios respecto a los niveles de triglicéridos. Conclusiones: esta revisión muestra que las DBCH pueden ser efectivas en algunos aspectos como la reducción de HbA1c, de peso corporal o de triglicéridos, aunque no hay suficiente evidencia científica que respalde su uso a largo plazo por encima de otras dietas, por lo que se precisa de más investigaciones futuras (AU)
Introduction: In general it has been recommended to people with diabetes to follow a low-carb diet. However, diets low in carbohydrates (DLCH) seem to be, at least, just as effective as low-fat, even providing better results in some cases in terms of glycemic control, decreased body weight and improves markers of cardiovascular risk. Objetives: To analyze the effect of the DLCH with respect to a low-fat diet (LFD) or other, as to baseline blood glucose, glycated hemoglobin (HbA1c), body weight, total cholesterol, and triglycerides. Methods: Literature Search of studies published in Medline, Scopus, Cinahl, Lilacs, Dialnet, Scielo and ProQuest. We extracted data on the composition of the diets evaluated, duration, and changes with respect to baseline blood glucose, HbA1c, body weight, cholesterol, and triglycerides. Results: We included 15 studies in the review found one of them significant differences between groups in levels of fasting glucose, in 6 in terms of HbA1c and 3 in terms of body weight. With regard to the levels of blood lipid, are not found in any study, significant differences between groups in regard to total cholesterol, while it is found in three studies with regard to the levels of triglycerides. Conclusions: This review shows that the DLCH can be effective in some aspects such as the reduction of HbA1c, body weight or triglyceride, although there is sufficient evidence to support its long term use over other diets, which requires more future research (AU)