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Objective: To determine whether an educational intervention strategy would improve the frequency of medical prescriptions for adequate thromboprophylaxis in a medicine service. Methods: Quasi-experimental study, in which in the pre-intervention phase the frequencies of indication of appropriate thromboprophylaxis by physicians from the medicine service were obtained. An 8-week educational intervention was carried out with this same group of doctors. In the post-intervention phase, the frequency of adequate thromboprophylaxis was measured at 2 and 4 months after the intervention. Results: The educational intervention was implemented in 112 resident physicians in medicine specialties. All prescriptions were made by the first-year resident physicians and endorsed by their supervising physician. Prior to the intervention, 47 (44.35%) adequate prescriptions were obtained, 13 (12.26%) suboptimal, 4 (3.77%) inadequate, and 42 (39, 62%) no prescription. After the intervention, the following 2 months were obtained: 78 (75.72%) adequate prescriptions, 7 (6.79%) suboptimal, 4 (2.91%) inadequate and 15 (14.58%) no prescriptions, there being a significant difference with the baseline level. At the subsequent 4 months post-intervention, the following were obtained: 86 (83.49%) adequate, 5 (4.85%) suboptimal, 2 (1.94%) inadequate and 10 (9.72%) no prescription, with a difference significant with the baseline level. There was no increase in the frequency of overuse. Conclusions: The application of an educational strategy to medical personnel was effective in increasing correctly indicated thromboprophylaxis prescriptions in a medical service. No overuse of thromboprophylaxis was found after the intervention. [ABSTRACT FROM AUTHOR]

The 1st World Telehealth Congress took place in Torre del Mar (Malaga) in 2022. It was organised by the Spanish Association of Health Communication and brought together participants from 43 countries. The congress included round tables on topics such as Tele-Pharmacy, Cybersecurity in Health, Tele-Nursing, Tele-Physiotherapy, Tele-Occupational Therapy and Tele-Psychology. The conclusions highlighted key aspects. In Tele-Pharmacy, the need to improve the use of the pharmaceutical network and the implementation of the E-prescription was pointed out. In Tele-Occupational Therapy, the importance of ICTs to get closer to people's health needs and to promote empowerment and training was highlighted. In Tele-Medicine, it was emphasised that care must be human, and the risks and benefits of new technologies were addressed. In Tele-Nursing, the usefulness of ICTs as a complementary tool was mentioned, but the digital divide and data protection were cautioned against. In Tele-Physiotherapy, the benefit of ICTs in patient assessment and treatment was highlighted. In Tele-Psychology, the advantages and disadvantages of remote psychological care were discussed. Overall, the congress highlighted the potential of new technologies in healthcare, but also pointed out challenges and areas for improvement. [ABSTRACT FROM AUTHOR]

Copyright of Revista Argentina de Terapia Intensiva is the property of Sociedad Argentina de Terapia Intensiva (SATI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista de Enfermagem e Atenção à Saúde (REAS) is the property of Revista de Enfermagem e Atencao a Saude - Reas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The variation in clinical practice observed in the patterns of use or results referring to populations has been subjected to research to question the coherence between science and medical practice, as well as to establish whether or not it is justified by severity of the morbidity and the patient's preferences. The determinants of these variations can be organized into factors related to knowledge, providers and professionals, and patients and their environment. In principle, variations sensitive to demand (patients) would be justified unless there is evidence to the contrary; the burden of proof in supply-sensitive variations (suppliers and professionals) would be reversed. When the aggregate populations move to individual health care, the problem is redefined as appropriate or inappropriate clinical practice, so that by incorporating criteria of necessity, convenience or acceptability, said practice could diverge from the prevailing evidence and consensus and nonetheless still be appropriate. The axes of evidence and consensus allow us to draw three areas of clinical decision, ignorance, uncertainty, and consolidated knowledge, where innovation based on research or collective empiricism is generating transformation dynamics. The area of uncertainty is wide and distinctive of clinical practice and justifies the clinical latitude that the patient and society grant to physicians to address the complexity involved in proposing and developing the most convenient courses of action in each case. The difficulties and responsibility involved in managing this clinical slack lead to the application of good governance criteria (transparency, accountability, participation, integrity and technical capacity); but a change is also required in the contemporary worldview of the clinician, so that they accept and manage the gap between medical science and clinical practice and rediscover their ability to enjoy a rigorous but also a dynamic, creative, humane, sensible and compassionate exercise of medicine. [ABSTRACT FROM AUTHOR]

Introduction: Influencers are gaining more and more prominence on social networks such as Instagram. With millions of followers, these new opinion leaders often recommend and advertise certain products, including medicines. Objectives: This text aims to point out the risks that the recommendation of a drug by an influencer may entail. Methodology: To do this, a qualitative analysis of a real case is used, in which the influencer Paula Gonu recommends Eridosis wipes as a treatment for acne. Results: It is observed that influencers such as the one studied herein treat a drug containing antibiotics as if it were an aesthetic product, generating alarm in the medical and pharmaceutical sector. Conclusion: Drug advertising on Instagram is a complex issue that needs to be further addressed due to its relationship with health, and, above all, greater regulation by institutions. [ABSTRACT FROM AUTHOR]

Introduction : Safe injection practices have gained importance in the last two decades as a consequence of infections associated with their incorrect application. Objective : To analyze the available evidence on safe injection practices carried out by health personnel in their clinical practice. Method : Integrative review of the literature available in 12 databases for the period between 1999 and 2018. Results : Unsafe practices were identified across a selection of 29 articles, including such as reuse of injection devices in the same patient or in others, failures in the aseptic technique, absence of or failure to follow the post-exposure protocol, recapping needles, and a lack of immunization against the hepatitis B virus. Conclusions : Efforts aimed at ensuring patient safety should also focus on concrete actions for better medication administration. [ABSTRACT FROM AUTHOR]

Copyright of Medicina (Buenos Aires) is the property of Medicina (Buenos Aires) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Mexicana de Endocrinología, Metabolismo y Nutrición is the property of Publicidad Permanyer SLU and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In this paper the concept of confidentiality is revisited in the light of the challenges arising from technological and communications advances and their applications in clinical practice and scientific research. The analysis is based on the presentation of philosophical background as well as the distinction and precision regarding related concepts: intimacy, privacy, anonymity, and professional secret. A counterpoint between privacy rights of patients and participants of scientific research and professional secrecy and confidentiality as professional duty is done. Also new challenges to privacy are developed in professional practice and scientific research in mental health, like the protection of confidentiality of the electronic clinical file. The authors conclude emphasizing the need to include the subject in the ethical and legal reflection in research and professional education. [ABSTRACT FROM AUTHOR]

Objective: Reflect about Nursing and the use of psychoactive drugs in children and adolescents in situations of violation of rights and / or criminal situation, who are in the care of the Servicio Nacional de Menores, in the context of deaths in recent years. Methodology: Analytical-synthetic method; Bibliographical review, comprehensive reading, personal reflection and definition of concepts. Results: There are described the current situation of mental health of children and adolescents, the relationship with the Social Determinants of Health and related ethical perspectives for conflict resolution. Conclusions: The use of psychosocial interventions as the first line of treatment is considered in the reflection, besides the fact that the use of psychoactive drugs, if necessary, should be administered and supervised by professionals according to current regulations. [ABSTRACT FROM AUTHOR]

Introduction: Strength and Difficulties Questionnaire (SDQ) is an international screening tool widely used for research and clinical practice on child and adolescents. Objective: The aim of this study was to explore the relationship between SDQ indices and "Hyperactivity/Impulsivity" and "inattention" domains of specific ADHD scale. Method: The SDQ and ADHD-RS-IV were administered to parents and teachers of a sample of 212 children aged between 6 and 16 years old with a prior diagnosis of ADHD. Results: A significant relationship between "Hyperactivity/inattention" Scale (SDQ) and "hyperactivity/impulsivity" and "inattention" ADHD dimensions was confirmed. However, other SDQ scales were also related, depending of informant and ADHD domain. For the family, "hyperactivity/impulsivity" domain was related with high scores on "behavior problems" scale, while the "inattention" was related with "emotional symptoms" scale. Conclusions: This results suggest the possibility of to take into account rating scores on SCT scales to increase the sensitivity of the scale to discriminate ADHD clinical subtypes. [ABSTRACT FROM AUTHOR]

Objective: To analytically identify, in the periodical El Centinela, news related to the sanitary conditions and care towards the wounded in the Paraguay war. Method: Serial history approach three news fragments were used to illustrate the sanitary conditions and care towards the wounded. Results: The hostile sanitary conditions where the practice of care, compress with rips of skirts of women to stop the bleeding and the use of medicinal and nutritional marijuana were one of the methods used for care. Conclusion: There wasn't the pretense of deepen the sanitary conditions and care to injured in action but carried that El Centinela periodical has regular daily richness of war, which allows somehow reassemble, even minimally, the history of care. [ABSTRACT FROM AUTHOR]

Objective: To provide an evidence-based clinical practice guideline for the screening of colon and rectal cancer for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. None of the guidelines met the criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence-based Clinical Practice Guidelines for the screening of colorectal cancer was developed for the Colombian context. Conclusions: The opportune detection of colon cancer would have an impact of the disease in Colombia. [ABSTRACT FROM AUTHOR]

Objective: To design a clinical practice guideline to reduce unwarranted variation in the diagnosis and treatment of patients over 18 years old with irritable bowel syndrome in Colombia through targeted diagnosis and a treatment guidelines established. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated quality and applicability. No guideline met the criteria for adaptation, so the group decided to develop the guideline de novo. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. Results: An evidence-based Clinical Practice Guidelines for the diagnosis and treatment of irritable bowel syndrome in patients over 18 years old was developed for the Colombian context. Conclusions: the clinical criteria and warning signs, diagnostic tests and therapeutic approaches were established in accordance with the predominant symptom in patients with irritable bowel syndrome in Colombia. [ABSTRACT FROM AUTHOR]

Objective: To provide an evidence-based clinical practice guideline for detection, diagnosis and treatment of early gastric cancer considering the efficacy and safety and interventions for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated quality and usability. None of the guidelines met criteria for adaptation, so the group decided to develop a de novo guideline. Systematic literature searches were conducted by Cochrane STI. The tables of evidence and recommendations were developed based on the GRADE approach. Results: A Clinical Practice Guidelines for the detection, diagnosis and treatment of early gastric cancer was developed for the Colombian context. Conclusions: The opportune detection and appropriate management of premalignant and malignant lesions of early gastric cancer would impact the burden of the disease. [ABSTRACT FROM AUTHOR]

Objective: To provide an evidence-based clinical practice guideline for the diagnostic and treatment of ulcerative colitis for patients, caregivers, administrative, and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. One of the guidelines met the criteria for adaptation, so the group decided to update the search and develop de novo the additional questions. Systematic literature searches were conducted. The tables of evidence and recommendations were made based on the GRADE methodology. Results: An evidence-based Clinical Practice Guidelines for the management of ulcerative colitis was developed for the Colombian context. Conclusions: The opportune management of ulcerative colitis would have an impact of the disease in Colombia. [ABSTRACT FROM AUTHOR]

Objective: To provide a clinical practice guideline with the latest evidence for diagnosis and treatment of gastroesophageal reflux for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated quality and applicability. One guideline met the criteria for adaptation, so the group decided to adapt 3 clinical questions. Systematic literature searches were conducted by the Cochrane Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence-based Clinical Practice Guidelines for the diagnosis and treatment of gastroesophageal reflux was developed for the Colombian context. Conclusions: The opportune detection and appropriate management of gastroesophageal reflux would contribute to the burden of the disease in Colombia and its associated diseases. [ABSTRACT FROM AUTHOR]

Objective: To provide an evidence-based clinical practice guideline for the management of dyspepsia for patients, caregivers, administrative and government bodies at all levels of care in Colombia. Materials and Methods: This guide was developed by a multidisciplinary team with the support of the Colombian Association of Gastroenterology, Cochrane STI Group and Clinical Research Institute of the Universidad Nacional de Colombia. Relevant clinical questions were developed and the search for national and international guidelines in databases was performed. Existing guidelines were evaluated for quality and applicability. One guideline met the criteria for adaptation of two of its clinical questions. Systematic literature searches were conducted by the Cochrane STI Group. The tables of evidence and recommendations were made based on the GRADE methodology. The recommendations of the guide were socialized in a meeting of experts with government agencies and patients. Results: An evidence-based Clinical Practice Guidelines for the management of dyspepsia was developed for the Colombian context. Conclusions: The opportune management of dyspepsia would have an impact of the disease in Colombia. [ABSTRACT FROM AUTHOR]

Los médicos refugiados se enfrentan a numerosos obstáculos a la hora de ejercer la medicina, a pesar de las importantes contribuciones que pueden hacer. [ABSTRACT FROM AUTHOR]

The aim of this article is to provide information about the relationship between theoretical orientation and clinical practice in Buenos Aires. Data was gathered from a sample of 314 psychotherapists in hospitals of the City of Buenos Aires and Gran Buenos Aires. The psychoanalytic model emerged as the predominant model, representing 52.9% of the sample. Integrative models, with 41.7% of the sample, were the second largest group. Within the group of integrationists, 61% of psychotherapists reported using psychoanalytic theory as the main theory, followed by a cognitive theory, reported by 19.1%. These results reveal both the importance of psychoanalysis in Buenos Aires, and the trend towards integrationism. [ABSTRACT FROM AUTHOR]

The author reflects on the models for medical training and practice.

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To describe the distribution, mechanisms, treatment and clinical evolution of patients with peripheral vascular trauma attended at a general hospital. Methods: Retrospective study among patients admitted to HNCH between 2010 and 2012.The information was gathered from clinical charts. Results: A total of 46 patients were included; 55 vascular lesions were observed, of which 43 involved arteries and 12 involved veins. The most frequent mechanism of injury was gunshot (43.5%), the most frequent reason was aggression (57%). Of all arterial lesions, 27 were on upper limbs and 16 in the lower limbs. The most frequent type of lesion was complete section (61%), and the most frequent treatment was saphenous vein graft in the sectioned arteries in 40%. A total of 12 vein lesions were observed, half of them in each upper and lower limbs; complete section was the most common lesion (59%), and ligation was the repair method more used. Out of 30 patients who suffered arterial lesions and were treated promptly, 14 had no functional limitation, 13 had some degree of limitation and 3 were amputated. Conclusions: including selection of antimicrobials, dosing and dosing regimens, but most of the prescriptions are not based on microbiologic documentation. [ABSTRACT FROM AUTHOR]

The aim of this article is to describe the use of relaxation tech-niques (RT) in the practice of clinic psychology care. Relaxation techniques are analyzed considering what type of technique they are and their use, go-ing from a general overview to a specific diagnosis context and treatment results. 67.2 percent of 880 clinic patients with all types of diagnosis are women and the average age is 32.79 years old. The results show that some RT has been used in 70.5 per cent of the cases being breath control the most frequent one (72.3 per cent). It is mainly used for anxiety disorders (87.8%), somatoform disorder (84.2%) and impulse control disorder (77.8%). The use of these techniques is more frequent in cases of comor-bid disorder (82.4% versus 68%). Breathe control and progressive muscular relaxation techniques are used in about 69 per cent of discharged patients. The discussion of this paper focuses on the results of using RT regardless of the diagnosis. [ABSTRACT FROM AUTHOR]

Background: Bedwetting is an involuntary urination during sleep at the age of 5 years or older. Clinical Practice Guidelines (CPG) have been developed to improve decision-making strategies and standardize medical practice. The Ministry of health in Mexico developed the CPG diagnosis and treatment of nonorganic enuresis at the first level of prevention in children. Its evidence is evaluated with the USPSTF (United States Preventive Services Task Force). Material and methods: Original articles that justify the evidence of Mexican CPG were sought and identified in virtual libraries: Pubmed, Embase, Cochrane Library plus, and then analyzed with the instrument of the USPSTF. Results: Sixty articles were reviewed. They're the basis for evidence formulation of the Mexican CPG. Only nine articles were level I, adequately powered and well conducted trials and recommendation Grade A, with a substantial net profit. Evidences that were substantial fed by these articles obtained the highest scores. Discussion: The methodological rigor of the original articles that support the CPG is highly variable. This instrument is meant to evaluate the evidence of the guide but is far from being a reflection of the rigor in the development and applicability of Mexican CPG. [ABSTRACT FROM AUTHOR]

In this work, the use of the traditional and natural medicine is investigated, by means of an analysis from the theory of complexities, with an interpretation of the organization and the existence of the alive beings, from regularities not applied in the alopathic and bioenergetic medicine, when assisting man and his social and cultural environment, which favors a more systemic, efficient and ethical medical practice. Besides, it is intended to improve the bioenergetic medicine, supplemented by the complex systemic approach and its application in different scenarios. The mentioned theory strengthens the scientific vision of the traditional and natural medicine from the theoretical and practical points of view. [ABSTRACT FROM AUTHOR]

Clinical researchers as professionals of the medical sciences, develop the capacity to combine the pertinent medical practices with the advanced scientific researches. For this purpose, the present investigation was carried out with the objective of describing the training alternatives of this professional related to his ethical behavior, who has in his hands the attention to the processes health-disease and to guarantee the correspondence of his practical and medical behaviour with the human connotation in the investigative processes. [ABSTRACT FROM AUTHOR]

Copyright of Science & Technology in Ocular Health & Vision / Ciencia y Tecnología para la Salud Visual y Ocular is the property of Ciencia y Tecnologia para la Salud Visual y Ocular and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Excess body weight (overweight and obesity) is currently recognized as one of the most important challenges of public health in the world, due to its size, speed of growth and the negative effect on health. Currently, Mexico and United States have the highest prevalence of obesity in the adult population (30 %), which is nearly ten times higher than that of Japan or Korea (4 %). In our country, the trends of overweight and obesity in different national surveys show steady increase in prevalence over time. According to the results of the National Survey of Health and Nutrition 2012 (Ensanut, according to its initials in Spanish), the combined prevalence of overweight or obese (BMI ≥ 25 kg/m²) in the population over 20 years, is higher in women (73.0 %) than men (69.4 %), while the prevalence of obesity (BMI ≥ 30 kg/m²) is almost higher in females than in males. Global experience shows that proper care of obesity and overweight requires formulating and coordinating comprehensive and efficient multilevel strategies for enhancing protective factors to health, particularly to modify individual, family and community behavior. It is unlikely that a single intervention can modify the incidence or natural history of overweight and obesity. [ABSTRACT FROM AUTHOR]

This paper is focused on the study of an inventory carried out in the pharmacy belonging to Colegio Máximo de Santafé of the Company of Jesus in 1767. This inventory is intended to recognize medical practices performed by missionaries in the province of Santafé during the first half of the XVIIIth century. In the same way, importance is given to the exchange of healing knowledge between Jesuits and American natives, which was crucial for the colonial and local establishment of the paradigm of Humanist Galenism. [ABSTRACT FROM AUTHOR]

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Ciencias de la Salud is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Antibiotic use in Mexico is characterized by high levels of consumption, irrational use in primary care services, and high rates of bacterial resistance that cause hospital infections. Changes are needed in the recommended method for reporting antimicrobial drug use, so that quantification can be carried out through drug utilization studies. Such studies, which make it possible to know which drugs are used in hospitals, require an accessible source of data on antimicrobial drug use with the least risk of biases, a single drug identification system, and the adoption of units of measure that can be extrapolated. The methodology developed by the WHO Collaborating Centre for Drug Statistics Methodology, based on the anatomical, therapeutic, and chemical classification (ATC) system and the daily defined dosage (DDD), is proposed. Despite its limitations, employing this methodology to monitor local antimicrobial drug use will make it possible to detect differences in usage patterns among institutions, and, especially, trends within a given institution. This would facilitate timely alerts about potential problems related to the use of antimicrobial drugs and the need for specific interventions. [ABSTRACT FROM AUTHOR]

In the last 15 years medical schools and medical colleges of the American union have been working hard in the study and implementation of a professionalism more in line with the society, with doctors in training, both undergraduate and graduate, as physicians currently in practice, motivated probably by high levels of dissatisfaction with their society, assuming this one a questioning and demanding posture. In our environment there is no change in the traditional teaching in this area with doctors in training and physicians who already practice their profession, despite showing the same indicators of dissatisfaction. The responsibility for training better doctors with professionalism, must be of the health authorities and institutions that form the health staff, and from the doctors in training, remembering that our profession has a contract with the society which we serve and sooner or later will claim these changes. [ABSTRACT FROM AUTHOR]

The body of Knowledge changing and growing, almost impossible to retain in memory of the doctor as much information, which complicates the decision-marking based on evidence, when one is in direct patient care for better decision marking regarding prevention, diagnosis, prognosis and treatment. Based on this, to have a better quality of information in the clinical record to reduce the possibility of error and therefore medical claims. The emergence of new technologies such as tablets and "smart phones" have different medical programs that allow this and that internationally in United States and Spain, they already have 2-3 years using this technology, with implications important in the quality of care. That is why the importance of knowledge and usefulness of that technology, which is a useful tool in marking decisions, but not replace the knowledge they must have the clinical, his training and the reasoned application of information. [ABSTRACT FROM AUTHOR]

Copyright of Papeles del CEIC is the property of Centro de Estudios sobra la Identidad Colectiva, Facultas de Ciencias Sociales and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction. In addition to clinical examination of patients, conventional radiology is the most useful clinical instrument in differential diagnosis of skeletal injuries. Objective: describe a radiological sign which we have named phantom bone sign, and review the different radiological findings encountered in related bone pathology. Material and methods. Describe and state the clinical meaning of the finding and its different varieties, to then relate it to medical practice through observation of representative radiological images. Results. The phantom bone sign consists of bone loss occurring as a result of neoplastic or infectious processes or in- tolerance to external elements implanted in the patient. Conclusion. Conventional radiology remains a very important tool in diagnosing different bone conditions. Understanding the phantom bone sign may help us make better differential diagnoses, always supported by clinical findings [ABSTRACT FROM AUTHOR]

Copyright of Universitas Médica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Universitas Médica is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Atrial fibrillation (AF) represents a global public health problem. The implementation of a clinical practice guideline is essential to standardize the diagnosis, treatment and prognosis of this rhythm disturbance. However, due to the wide clinical spectrum which is associated with AF, it makes difficult to standardize the recommendations and cause that are not always appropriate interpretations of the same setting, so there will be some clinical reflections of the recommendations in the clinical practice guidelines published in this journal, to assist the medical not specialist to put them in everyday clinical setting. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy is a mainstay in the treatment of oncology patients. Any patient undergoing a radiotherapy scheme will experience some degree of radiodermatitis, most of them degrees 1 and 2. Objective: To list, based on the best scientific evidence currently available, the parameters to prevent and treat acute radiodermatitis that adult patients undergoing radiotherapy, have. Material and methods: Structured and concrete clinical questions were formulated with a standardized sequence to search for practice guidelines. Four guidelines were found from which only one was really attached to the same subject. Results: Although there have been several trials, only few interventions have good level of evidence and degree of recommendation to prevent higher degrees of radiodermatitis (hygiene, topical steroids, oral hydrolytic enzymes and amifostine). For acute radiodermatitis treatment, only few studies have been made and, even those, show very poor results. Conclusions: The following Practice Guideline provides the best current scientific evidence for prevention and treatment of acute radiodermatitis in adult patients of either sex undergoing radiotherapy, and helps dermatologists in making good therapeutic decisions, and encourages scientific research. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) is the most frequently rheumatic disorder seen in clinical practice. Typical sites of inflammatory involvement include hands, knees, and hips. OA diagnosis is based on clinical and radiological findings, while OA therapy consists in drug treatment and support with physical therapy, orthotic devices, and if necessary surgical intervention followed by rehabilitation and pharmacological treatment. Identification of patients with OA remains a challenge. The disparity of diagnostic and therapeutic criteria may delay the initiation of the proper treatment. It is therefore, desirable to unify the existing information and to provide physicians a practical, effective and current guideline derived from evidence-based information in order to guide their management of OA. Methods: Ten physicians and one physiotherapist with expertise in rheumatic diseases were invited to participate in the development of the guideline based on criteria such as experience, knowledge and clinical judgment. results: The discussion panels were set up with expert participants who discussed the topics included in these guidelines according to their evidence and recommendation levels. Conclusions: OA is the most frequently rheumatic disorder seen in clinical practice. It is a major cause of disability in older people, and generates serious health related detriment and social and economic negative impact. Therefore, it is imperative to create a set of clinical practice guidelines that would offer plans for an integral management of OA, in order to optimize resources and eventually improve patients quality of life. [ABSTRACT FROM AUTHOR]

In accordance with the adaptation of the Postgraduate Diploma in Surgical Nursing at the Vall d'Hebron University Nursing Hospital to the EHEA framework, one of the new methods to be introduced in 2008-09 was the student portfolio. Aim: To construct and consolidate a design for the evaluation using the portfolio, which involves students and nurses in the process of reflecting on learning in surgical care processes. Methodology: The area of activity was clinical practicals for the Postgraduate Diploma in Surgical Nursing during the 2008-09 academic year. 45 students constituted the subjects of the study. 2 members of teaching staff and 62 surgical nurses were also involved as tutors.. Stages: 1) Design of the minimum portfolio content. 2) Presentation of the portfolio to students and nurse tutors. 3) Monitoring of the portfolio during the period of clinical practicals. 4) Analysis of the completed portfolios. 5) Evaluation session with the surgical nurse tutors at the end of the course. Results: Reflection did not appear explicitly in most of the portfolios, but the commentaries showed the importance of including it and reinforcing it with the nurse tutor. Conclusions: The portfolio became an instrument of communication between teaching staff, students and nurse tutors reinforcing the involvement of the latter in the learning process. On the basis of the results strategies were implemented for the improvement and consolidation of the portfolio for the 2009-10 academic year. [ABSTRACT FROM AUTHOR]

In order to identify methodologies for effective identification and incorporation of the user considerations and perspective to the development of clinical practice guidelines, a systematic review of the literature was conducted. A total of 729 articles were identified from the initial search of these, 18 met the criteria and were included in the review. The items were valued according to methodological quality and extracted relevant information from them. No methodological items were found that described or evaluated a specific methodology that incorporates considerations of the patients in the development of GPC. The techniques used for these processes were the formal ones such as Delphi, focus groups, stakeholder analysis, surveys, workshops and preference scales. The reported experiences agree on the need to link patients during the stages of prioritization and approval of the recommendations. [ABSTRACT FROM AUTHOR]

Background: Several international guidelines on immunotherapy exist, but they only apply partially in Mexico. The Mexican guideline of immunotherapy dates from 1998. Objectives: To establish clinical recommendations and suggestions for Allergy residents and specialists for skin testing and allergen immunotherapy based on evidence and Mexican expert opinion, according to the GRADE system. Methods: The guidelines were developed following the methodology of a guideline for clinical practice starting with the formulation of clinical questions, in the context of Mexican environmental conditions and morbidity, with the participation of allergists from all regions of the country. External validation was obtained. Its development followed three steps: 1. formulation of 24 clinical questions. 2. Search for consensus on the answers among members of the Regional chapters of both Mexican Colleges of Allergists (CMICA and COMPEDIA) during regional meetings. 3. Literature search for articles related to the questions and grading of its quality according to GRADE. Results: Based on the regional consensus, 116 articles and the safety, patient acceptance/ comfort and cost clinical recommendations and suggestions were developed on basic aspects of skin testing, subcutaneous and sublingual immunotherapy (patient preparation, vial preparation and application schedules) and the treatment of eventual adverse reactions. Conclusions: A clinical guideline was developed respecting particular methodology, validated by CMICA and COMPEDIA for its implementation among Mexican allergists. Several aspects deserve further study to improve scientific evidence. [ABSTRACT FROM AUTHOR]

Executive functions are critical in our daily life. People with traumatic brain injury (TBI) often have difficulty functioning appropriately in everyday life. The objective of this study was to investigate the relationship between executive function and functional capacity after TBI. The sample consisted of 43 moderate or severe TBI patients (mean age: 32 years, SD= 13.9). All participants were tested with a battery of executive function measures (Trail Making Test-B, Wisconsin Card Sorting Test, Letter-Number Sequencing of the WAIS-III, Stroop Color-Word Interference Test, and Controlled Oral Word Association Test). Patients' everyday functioning was examined with the Patient Competency Rating Scale (PCRS). PCRS was correlated significantly, although moderately, with Trail Making Test-B, Letter-Number Sequencing, and Controlled Oral Word Association Test. These findings suggest that executive function measures used in clinical practice reveal some degree of ecological validity, providing relevant information for predicting daily-life functioning after moderate to severe TBI. [ABSTRACT FROM AUTHOR]