Acta Med Peru. 2017;34(3):203-7
En el Perú, la elaboración de guías de práctica clínica tiene exigencia normativa desde el año
2005; sin embargo, su desarrollo ha ténido poco énfasis en la calidad metodológica de las mismas, prefiriendo el tipo narrativo. Desde hace varios años se realiz...an esfuerzos dispersos para mejorar la calidad metodológica, principalmente que su elaboaración esté basada en evidencias científicas. Actualmente se cuenta con una nueva normativa que pone mayor enfasis en esta exigencia y algunas instituciones ya trabajan para adecuarse a estandares internacionales y poder generar impactos positivos en nuestro sistema de salud a través del adecuado desarrollo de guias de practica clínica en nuestro pais
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This report, examining the mood of a country that holds the top spot in the Fragile States Index, is based on field research conducted in South Sudan in April and May 2014.
The Guide to operationalize HIV viral load testing HIV presents 60 lessons learnt from the project in a systemic approach including: viral load strategy, laboratories, procurement and supply management, patient care and economy.
Prepared by the monitoring and learning unit
2nd edition.
The practical aspects of TB patient care from the onset of symptoms to the completion of treatment are covered in this guide
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Jin et al. Military Medical Research (2020) 7:4 https://doi.org/10.1186/s40779-020-0233-6
Position Article und Guideline
The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir...ometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
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The study on single-dose cholera vaccine in Zambia evaluates the effectiveness of using a single dose of the oral cholera vaccine (OCV) during a 2016 outbreak in Lusaka. Due to limited vaccine supply, authorities opted for a one-dose emergency campaign instead of the usual two-dose regimen. A matche...d case-control study was conducted to assess vaccine effectiveness, showing 88.9% short-term protection against cholera. The findings suggest that a single-dose approach can be an effective strategy in outbreak settings, especially when vaccine supplies are constrained. However, further research is needed to determine long-term immunity and effectiveness in young children.
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In early 2015, the Americas region began to experience a surge in migration flows due in large part to the rise of people emigrating from Venezuela in response to the country’s faltering economy. This swell in migration continued in the years following, as the number of Venezuelans living in Latin... American countries rose from an estimated 700,000 in 2015 to over 3 million by late 2018.1 As of June 2019, an estimated 4.3 million Venezuelan’s have left the country since 2015
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