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Endocrinology ; 161(1)2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31865385


Follicle-stimulating hormone (FSH) is a dimeric glycoprotein secreted by the anterior pituitary gonadotrope that is necessary for reproductive function in mammals. FSH primarily regulates granulosa cells and follicular growth in females, and Sertoli cell function in males. Since its identification in the 1930s and sequencing in the 1970s, significant progress has been made in elucidating its regulation and downstream function. Recent advances provide deeper insight into FSH synthesis, and effects in the gonads suggest potential roles in extragonadal tissues and examine pharmacological approaches and clinical applications in infertility treatment that now affect 18% of couples. These advances were discussed in detail in a number of reviews published in the last 2 years in Endocrinology. In this brief commentary, we summarize these reviews and point to the outstanding questions that should be answered in the near future to bridge a gap in our understanding of this hormone.

Hormona Folículo Estimulante/genética , Regulación de la Expresión Génica , Células de la Granulosa/metabolismo , Procesamiento Proteico-Postraduccional , Células de Sertoli/metabolismo , Animales , Femenino , Hormona Folículo Estimulante/metabolismo , Humanos , Masculino , Folículo Ovárico/citología , Folículo Ovárico/metabolismo , Unión Proteica , Subunidades de Proteína/genética , Subunidades de Proteína/metabolismo , Receptores de HFE/metabolismo , Literatura de Revisión como Asunto , Transducción de Señal , Espermatogénesis/genética
Movimento (Porto Alegre) ; 25(1): e25067, jan.- dez. 2019.
Artículo en Inglés | LILACS | ID: biblio-1047352


The purpose of this paper was to provide a critical review of the literature related to pedagogy of physical education in urban schools using culturally sustaining pedagogy as a lens. Data was collected via keyword searches, table of contents searches in three U.S.-based journals, and additional references from retrieved articles. The sample included 54 studies which were analyzed in depth and coded for various factors. The findings provide descriptive statistics about the literature, as well as three major themes highlighting cultural relevance in PE, urban student resistance to traditional curriculum, and urban PE to address deficits. The discussion suggests "loving critiques" that could apply to the field of PE, especially in urban contexts

O objetivo deste artigo foi providenciar uma revisão crítica na literatura relacionada com pedagogia da Educação Física em escolas urbanas utilizando como "lente" uma pedagogia sustentada culturalmente. Dados foram coletados por meio da busca de palavras-chaves e nos sumários de três revistas norte-americanas, bem como em adicionais referências recuperadas dos artigos. A amostra incluiu 54 estudos que foram analisados em profundidade e codificados em vários fatores. Os resultados providenciam estatísticas descritivas sobre literatura, bem como três temas principais que destacam a relevância cultural em Educação Física, a resistência de estudantes urbanos ao currículo tradicional e os déficits a serem enfrentados pela Educação Física urbana. A discussão sugere "críticas carinhosas" que podem ser aplicadas no campo da Educação Física, especialmente em contextos urbanos

El objetivo de ese artículo fue presentar una revisión crítica en la literatura relacionada con pedagogía de la Educación Física en escuelas urbanas usando como "lente" una pedagogía sostenida culturalmente. Los datos fueron recolectados por medio de la búsqueda de palabras-clave y en los índices de tres revistas norteamericanas, al mismo tiempo en referencias adicionales recuperadas de los artículos. La muestra incluyó 54 estudios que fueron analizados a profundidad y codificados en varios factores. Los resultados presentan estadísticas descriptivas y también tres temas principales, que destacan la relevancia cultural en Educación Física, la resistencia de los alumnos urbanos al currículo tradicional y los déficits a ser enfrentados por la Educación Física urbana. La discusión sugiere "críticas cariñosas" que pueden ser aplicadas al campo de la Educación Física, especialmente en contextos urbanos

Humanos , Masculino , Femenino , Educación y Entrenamiento Físico , Instituciones Académicas , Área Urbana , Enseñanza , Literatura de Revisión como Asunto
Rev. bras. cir. plást ; 34(4): 539-545, oct.-dec. 2019. ilus, tab
Artículo en Inglés, Portugués | LILACS | ID: biblio-1047922


Introdução: Realizar levantamento na literatura médica sobre os tratamentos cirúrgicos e não cirúrgicos da ptose de sobrancelha e apresentar um fluxograma de decisão para elevação da sobrancelha. Métodos: Revisão sistemática da literatura disponível no banco de dados da PUBMED seguindo critérios de inclusão e exclusão. Elaboração de um fluxograma para abordagem da queda de sobrancelha baseado na experiência dos autores. Resultados: Foi encontrada uma abundância de artigos descrevendo diversas táticas cirúrgicas e não cirúrgicas para correção da ptose de supercílio. As táticas cirúrgicas mais comuns foram a elevação interna do supercílio, elevação direta, elevação via temporal e ritidoplastia coronal / pré-triquial / endoscópica. Para a abordagem não cirúrgica foram encontradas o uso de toxina botulínica, preenchimento e fios de sustentação. Conclusão: Há diversas táticas cirúrgicas e não cirúrgicas descritas na literatura para elevação da sobrancelha, demonstrando que não há uma tática ideal para todos os pacientes. O uso de fluxograma pode ajudar a realizar uma abordagem sistemática e personalizada e considerando característica de cada paciente.

Introduction: To review the medical literature regarding the surgical and non-surgical treatments of eyebrow ptosis and to present a decision flowchart for eyebrow lift. Methods: A systematic review of the literature available was held in PUBMED following inclusion and exclusion criteria. A flowchart was elaborated to systematize the approach to eyebrow ptosis based on the experience of the authors. Results: Several articles were included describing a variety of surgical and non-surgical correction techniques for eyebrow ptosis. The most common surgical approaches were internal eyebrow elevation, direct elevation, temporal elevation, and coronal/pretrichial/endoscopic rhytidoplasty. The non-surgical approaches found were botulinum toxin injections, fillers, and fixation threads. Conclusion: There are several surgical and non-surgical procedures described in the literature for lifting of the eyebrow, demonstrating that there is no ideal method for all patients. The use of a flowchart can help carry out a systematic and personalized approach according to the characteristics of each patient.

Humanos , Adulto , Persona de Mediana Edad , Historia del Siglo XXI , Procedimientos Quirúrgicos Operativos , Literatura de Revisión como Asunto , Ritidoplastia , Elevación , Blefaroplastia , Cejas , Flujo de Trabajo , Procedimientos Quirúrgicos Operativos/métodos , Ritidoplastia/métodos , Ritidoplastia/estadística & datos numéricos , Blefaroplastia/métodos , Blefaroplastia/estadística & datos numéricos , Cejas/anomalías
J Dent Educ ; 83(10): 1240-1242, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31575751
Medicine (Baltimore) ; 98(38): e17129, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31567952


BACKGROUND: Pulmonary rehabilitation (PR) is an indispensable component in the nonpharmacological management of patients with chronic obstructive pulmonary disease (COPD) with significant improvements in quality of life and exercise capacity. It is strongly supported by systematic reviews (SR) as part of the treatment of these patients. However, it is not known which PR components are essential, such as duration, ideal locations, type and intensity of training, degree of supervision, adherence, cost-effectiveness challenge, and how long the program effects last. This overview aims to evaluate and describe different pulmonary rehabilitation interventions for individuals with COPD. METHODS: Only systematic reviews of randomized controlled trials (RCTs) published in the Cochrane Database of Systematic Reviews will be included. The following results were analyzed: health-related quality of life, functional capacity, mortality, dyspnea, cost-effectiveness, and adverse events. The risk of bias will be assessed by the Risk of Bias in Systematic Reviews (ROBIS). The methodological quality will be analyzed through the Assessment of Multiple Systematic Reviews (AMSTAR-2). We will use the evaluations of the Classification of Recommendations, Evaluation, Development and Evaluation (GRADE) of the authors of the included systematic reviews. The screening of systematic reviews, eligibility evaluation, data extraction, methodological quality, and quality of evidence will be performed in pairs by independent reviewers. The results that have been reported in the included reviews will be summarized in an "Overview of Reviews" table. The main conclusions about the effects of the interventions studied in the included reviews will be summarized and organized in clinically meaningful categories. RESULTS: The article in this overview will be submitted for publication in a peer-reviewed journal. The results will also be included in a doctoral thesis and disclosed in medical conferences. CONCLUSIONS: We expect to compile evidence from multiple systematic reviews of pulmonary rehabilitation in people with COPD in an accessible and useful document. REGISTRATION NUMBER PROSPERO: CRD42019111564.

Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Literatura de Revisión como Asunto , Resultado del Tratamiento
BMC Med ; 17(1): 188, 2019 10 21.
Artículo en Inglés | MEDLINE | ID: mdl-31639007


BACKGROUND: There is growing interest in evaluating differences in healthcare interventions across routinely collected demographic characteristics. However, individual subgroup analyses in randomized controlled trials are often not prespecified, adjusted for multiple testing, or conducted using the appropriate statistical test for interaction, and therefore frequently lack credibility. Meta-analyses can be used to examine the validity of potential subgroup differences by collating evidence across trials. Here, we characterize the conduct and clinical translation of age-treatment subgroup analyses in Cochrane reviews. METHODS: For a random sample of 928 Cochrane intervention reviews of randomized trials, we determined how often subgroup analyses of age are reported, how often these analyses have a P < 0.05 from formal interaction testing, how frequently subgroup differences first observed in an individual trial are later corroborated by other trials in the same meta-analysis, and how often statistically significant results are included in commonly used clinical management resources (BMJ Best Practice, UpToDate, Cochrane Clinical Answers, Google Scholar, and Google search). RESULTS: Among 928 Cochrane intervention reviews, 189 (20.4%) included plans to conduct age-treatment subgroup analyses. The vast majority (162 of 189, 85.7%) of the planned analyses were not conducted, commonly because of insufficient trial data. There were 22 reviews that conducted their planned age-treatment subgroup analyses, and another 3 reviews appeared to perform unplanned age-treatment subgroup analyses. These 25 (25 of 928, 2.7%) reviews conducted a total of 97 age-treatment subgroup analyses, of which 65 analyses (in 20 reviews) had non-overlapping subgroup levels. Among the 65 age-treatment subgroup analyses, 14 (21.5%) did not report any formal interaction testing. Seven (10.8%) reported P < 0.05 from formal age-treatment interaction testing; however, none of these seven analyses were in reviews that discussed the potential biological rationale or clinical significance of the subgroup findings or had results that were included in common clinical practice resources. CONCLUSION: Age-treatment subgroup analyses in Cochrane intervention reviews were frequently planned but rarely conducted, and implications of detected interactions were not discussed in the reviews or mentioned in common clinical resources. When subgroup analyses are performed, authors should report the findings, compare the results to previous studies, and outline any potential impact on clinical care.

Interpretación Estadística de Datos , Ensayos Clínicos Controlados Aleatorios como Asunto/estadística & datos numéricos , Proyectos de Investigación , Literatura de Revisión como Asunto , Distribución por Edad , Factores de Edad , Diseño de Investigaciones Epidemiológicas , Estudios Epidemiológicos , Femenino , Humanos , Medicina de Precisión/métodos , Medicina de Precisión/estadística & datos numéricos , Proyectos de Investigación/normas , Proyectos de Investigación/estadística & datos numéricos
Prensa méd. argent ; 105(9 especial): 546-555, oct 2019. fig
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1046472


The article is devoted to the review of the most developed systems of registration and control of patients suffering from oncological diseases. The creation of registries is based on the public health needs of countries in monitoring, storing and analyzing national data on such serious chronic diseases as cancer. The world and national experience in creating data storage systems shows the need to unify the information collection, to consolidate sources, and to use high quality information technologies that make it possible to exchange, analyze, protect and store data. In European countries and the USA, registries have specialized websites and provide information on epidemiology, trends, forecasts, and survival rate. This information is public.

Humanos , Instituciones Oncológicas/estadística & datos numéricos , Literatura de Revisión como Asunto , Registros Electrónicos de Salud , Acceso a Medicamentos Esenciales y Tecnologías Sanitarias
Prensa méd. argent ; 105(9 especial): 556-562, oct 2019. tab
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1046483


The access to education for children and young people with special needs is an indicator of the humanization of society, a sign that this society can care for one of its most vulnerable groups. This paper reviews the principles and trends in studying the issues of organising an inclusive education environment. Particular emphasis is placed on the scientific novelty of the research, research methods and goals, the main purpose of which is to create a comfortable educational environment and find a solution to the problems of inclusive space. Further, the authors provide a detailed analysis of the project content in the conditions of Kazakhstan. They develop an experimental model of a spatial solution for an inclusive education environment. The results of this study contribute to the architectural and compositional improvement of educational buildings, increasing their comfort. The paper analyzes the role of the virtual environment in the development of experimental projects. It contains a diagram of the project time frame, a sample schedule and a description of the research group composition.

Humanos , Grupos de Riesgo , Propensión (Educación) , Literatura de Revisión como Asunto , Modelos Educacionales , Personas con Discapacidad/educación , Políticas Públicas Antidiscriminatorias
Rev Med Suisse ; 15(664): 1694-1698, 2019 Sep 25.
Artículo en Francés | MEDLINE | ID: mdl-31553532


Narrative overviews of scientific literature contribute to the updating and critique of available medical knowledge. Indirectly, they help to formulate new research projects based on the synthesis and interpretation of the results of a non-systematic selection of published studies. To facilitate both optimal reading and synthesis of studies we deem useful to propose a standardized approach to the various steps of the development and writing of a narrative literature overview.

Narración , Literatura de Revisión como Asunto , Escritura/normas
Nephrol Nurs J ; 46(4): 413-445, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31490051


Pediatric patients with chronic kidney disease (CKD) have an increased risk of developing vaccine-preventable diseases due to reduced immunization coverage. Studies have demonstrated that reduced immunization coverage in this population is related to barriers, such as frequent hospitalization, lack of knowledge, and concerns about safety and efficacy. This article examines a nurse practitioner-led quality improvement project (QIP) conducted in an outpatient pediatric nephrology clinic. The QIP focused on educating pediatric providers related to age-appropriate immunizations for children with CKD or nephrotic syndrome, and those who are renal transplant candidates and recipients. A process is now in place to review immunization records upon initial visit and annually, and to notify primary care providers of current recommendations for this population.

Inmunización/normas , Trasplante de Riñón , Síndrome Nefrótico , Insuficiencia Renal Crónica , Niño , Humanos , Profesionales de Enfermería Pediátrica , Guías de Práctica Clínica como Asunto , Mejoramiento de la Calidad , Literatura de Revisión como Asunto
Braz J Cardiovasc Surg ; 34(4): 396-405, 2019 08 27.
Artículo en Inglés | MEDLINE | ID: mdl-31454193


OBJECTIVE: To evaluate whether there is any difference on the results of patients treated with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) in the setting of ischemic heart failure (HF). METHODS: Databases (MEDLINE, Embase, Cochrane Controlled Trials Register [CENTRAL/CCTR],, Scientific Electronic Library Online [SciELO], Literatura Latino-americana e do Caribe em Ciências da Saúde [LILACS], and Google Scholar) were searched for studies published until February 2019. Main outcomes of interest were mortality, myocardial infarction, repeat revascularization, and stroke. RESULTS: The search yielded 5,775 studies for inclusion. Of these, 20 articles were analyzed, and their data were extracted. The total number of patients included was 54,173, and those underwent CABG (N=29,075) or PCI (N=25098). The hazard ratios (HRs) for mortality (HR 0.763; 95% confidence interval [CI] 0.678-0.859; P<0.001), myocardial infarction (HR 0.481; 95% CI 0.365-0.633; P<0.001), and repeat revascularization (HR 0.321; 95% CI 0.241-0.428; P<0.001) were lower in the CABG group than in the PCI group. The HR for stroke showed no statistically significant difference between the groups (random effect model: HR 0.879; 95% CI 0.625-1.237; P=0.459). CONCLUSION: This meta-analysis found that CABG surgery remains the best option for patients with ischemic HF, without increase in the risk of stroke.

Puente de Arteria Coronaria/mortalidad , Insuficiencia Cardíaca/cirugía , Isquemia Miocárdica/cirugía , Intervención Coronaria Percutánea/mortalidad , Accidente Cerebrovascular/etiología , Anciano , Brasil/epidemiología , Puente de Arteria Coronaria/efectos adversos , Métodos Epidemiológicos , Medicina Basada en la Evidencia , Femenino , Humanos , Masculino , Metaanálisis como Asunto , Estudios Multicéntricos como Asunto , Isquemia Miocárdica/mortalidad , Intervención Coronaria Percutánea/efectos adversos , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/mortalidad , Guías de Práctica Clínica como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Literatura de Revisión como Asunto , Accidente Cerebrovascular/mortalidad , Resultado del Tratamiento
Rev Panam Salud Publica ; 43, August 2019
Artículo en Español | PAHO-IRIS | ID: phr-51435


[RESUMEN]. Objetivos. Sintetizar la información disponible sobre el efecto del etiquetado nutricional frontal en la elección, compra y consumo de alimentos y bebidas, y el estado nutricional de los consumidores, e identificar los factores que influyen en su efectividad. Métodos. Se realizó una sinopsis de revisiones sistemáticas (RS) conforme a las recomendaciones PRISMA. La búsqueda bibliográfica se realizó en Medline (Pubmed), The Cochrane Library, LILACS, EBSCOhost y Scopus, limitada a estudios publicados en español o inglés sin restricción por fecha de publicación. La calidad metodológica se evaluó utilizando la herramienta AMSTAR 2. Resultados. Se incluyeron siete RS. El etiquetado frontal facilitó la elección de alimentos saludables y tuvo un efecto variable sobre las dimensiones de consumo y compra. Ninguna RS evaluó el efecto sobre el estado nutricional. El costo y sabor, los hábitos alimentarios, el nivel educativo y los sistemas dominantes de procesamiento de información en el consumidor influyeron en su efectividad. La mayoría de RS mostraron limitaciones metodológicas y un nivel de confianza críticamente bajo. Conclusiones. El etiquetado frontal tuvo efecto positivo en la elección de alimentos saludables, con resultados variables en las dimensiones de compra y consumo. Se necesitan estudios locales con una adecuada calidad metodológica para identificar el formato de etiquetado más efectivo en cada país. Su implementación como política de salud pública debe acompañarse de estrategias para mejorar el acceso a alimentos saludables, promover la actividad física y brindar educación nutricional a los consumidores.

[ABSTRACT]. Objectives. Synthesize available information on the effects of front-of-package nutritional labeling on choice, purchase, and consumption of food and beverages, and nutritional status of consumers, and identify factors that influence its effectiveness. Methods. A synopsis of systematic reviews was carried out following PRISMA recommendations. A literature search was performed in MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost, and Scopus, limited to studies published in Spanish or English with no restrictions on date of publication. Methodological quality was evaluated using AMSTAR 2. Results. Seven systematic reviews were included. Front-of-package labeling facilitated healthy food choices and had a variable effect on consumption and purchase dimensions. No systematic review evaluated effects on nutritional status. Cost and flavor, eating habits, educational level, and dominant information processing systems in the consumer influenced labeling effectiveness. Most of the systematic reviews showed methodological limitations and critically low confidence levels. Conclusions. Front-of-package labeling had a positive effect on healthy food choices, with variable results on purchase and consumption dimensions. Local studies with adequate methodological quality are needed to identify the most effective labeling format in each country. Implementation of labeling as public health policy should be accompanied by strategies to improve access to healthy foods, promote physical activity, and provide nutrition education to consumers.

[RESUMO]. Objetivos. Sumarizar os dados disponíveis referentes ao efeito da rotulagem nutricional frontal na escolha, compra e consumo de alimentos e bebidas e no estado nutricional dos consumidores e identificar os fatores que influenciam a efetividade desta medida. Métodos. Foi realizado um sumário de estudos de revisão sistemática segundo as recomendações PRISMA. Foi feita uma busca da literatura nas bases de dados MEDLINE (PubMed), Cochrane Library, LILACS, EBSCOhost e Scopus de estudos publicados em espanhol ou inglês, sem restrição de data de publicação. A qualidade metodológica foi avaliada com o uso da ferramenta AMSTAR 2. Resultados. Sete estudos de revisão sistemática foram selecionados. A rotulagem frontal facilitou a escolha de alimentos saudáveis e teve um efeito variável nas dimensões de consumo e compra. Nenhum estudo avaliou o efeito no estado nutricional. Custo e sabor, hábitos alimentares, nível educacional e sistemas dominantes de processamento de informação do consumidor tiveram influência na efetividade desta medida. Os estudos de revisão apresentaram, na sua maioria, limitações metodológicas e um grau de confiança criticamente baixo. Conclusões. A rotulagem nutricional frontal teve efeito positivo na escolha de alimentos saudáveis, com resultados variáveis nas dimensões de compra e consumo. É preciso realizar estudos locais com qualidade metodológica adequada para identificar o formato de rotulagem mais efetivo em cada país. A implementação desta medida como política de saúde pública deve ser acompanhada por estratégias para melhorar o acesso a alimentos saudáveis, promover a atividade física e proporcionar educação nutricional aos consumidores.

Etiquetado Nutricional , Comportamiento del Consumidor , Estado Nutricional , Literatura de Revisión como Asunto , Etiquetado Nutricional , Comportamiento del Consumidor , Estado Nutricional , Literatura de Revisión como Asunto , Etiquetado Nutricional , Comportamiento del Consumidor , Literatura de Revisión como Asunto
Z Evid Fortbild Qual Gesundhwes ; 143: 1-7, 2019 Jun.
Artículo en Alemán | MEDLINE | ID: mdl-31296451


Reviews of primary research studies are becoming increasingly important as the concept of evidence-based practice in healthcare is gaining more and more influence and the number of research projects is increasing enormously. One of the less well-known types of review is the "scoping review." Scoping reviews are conducted when one first needs to take stock of the research literature. For example, scoping reviews are conducted in order to establish provisional working definitions or to define topics or subject areas conceptually. Preparing a scoping review also makes sense if the literature has not yet been comprehensively assessed or if it contains a complex or heterogeneous problem so that a more precise systematic review of the evidence is not appropriate. Scoping reviews can also serve to determine the scope and significance of a prospective classical systematic review. Finally, scoping reviews are also a good way to bundle and communicate research results, identify research gaps, and formulate recommendations for future research. This article explains the methodology of scoping reviews, their differences as compared to systematic reviews, and the reasons why they could be conducted. This guide to conducting scoping reviews is based on the methodology developed by the Joanna Briggs Institute (JBI).

Práctica Clínica Basada en la Evidencia , Informe de Investigación , Literatura de Revisión como Asunto , Prestación de Atención de Salud , Alemania , Humanos , Estudios Prospectivos