Gac Med Mex
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Health promotion and disease prevention are essential components of prenatal care. Maternal nutrient insufficiencies could negatively impact the morbidity and mortality of the mother-fetus pair as well as the health of the next generations. Although a healthy diet is usually sufficient to meet the increased nutrient needs, supplementation is part of routine care to ensure a healthy pregnancy and optimal fetal development. ⋯ However, there are vulnerable groups of women who could benefit from complementary individualized supplementation schemes. Recently, relevant information has been published related to the supplementation of single and multiple micronutrients with significant effects on maternal and fetal health, which could have implications in the clinical practice of health professionals. This review presents scientific evidence and the recommendations of different entities on the supplementation of iron, folic acid, calcium, vitamin D and multiple micronutrient supplementation during pregnancy.
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In SARS-CoV-2 infection (COVID-19), the most common manifestations involve the upper airways; in complicated cases, bilateral interstitial pneumonia, severe acute respiratory failure and multiple organ failure occur, which require hospital treatment and ventilatory support with nasal cannula or mask and high flow oxygen, or orotracheal intubation and mechanical ventilation. There are no specific antivirals, and thus management is symptomatic, as well as with antiplatelet drugs (acetylsalicylic acid, dipyridamole), low molecular weight heparin when there is hypercoagulability (increased D-dimer), dexamethasone when inflammation indicators are elevated; experimentally, under informed consent, antibiotics are used according to microbiological results, as well as interferon beta 1b, favipiravir, tocilizumab, ivermectin and immunoglobulin G. When gastroenteritis occurs, nitazoxanide can be indicated.
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The Glasgow-Blatchford scale (GBS) classifies the risk of re-bleeding after upper gastrointestinal bleeding (UGIB) using clinical data, whereas the Forrest and Dagradi scales do it by endoscopy. ⋯ La EG-B es sencilla, objetiva y útil para identificar riesgo de resangrado después de HTDA; se sugiere como herramienta de triaje en urgencias.
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The use of soap for skin cleansing is common among the population. However, it is possible that it causes damage to skin cells and disrupts the skin barrier. ⋯ Soaps marketed for skin cleansing can contain chemical ingredients that damage human keratinocytes and cause skin barrier subclinical irritation. Their use can worsen preexisting dermatoses, generate xerotic or irritant contact dermatitis, and cause atrophy and dermatoporosis.
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Neutrophil-to-lymphocyte (NLR) and lymphocyte-to-C-reactive protein (LCR) ratios are used to predict severity and mortality in various infections. ⋯ INL > 12 e ILR < 0.03 son biomarcadores útiles para evaluar el riesgo de mortalidad en pacientes mexicanos con COVID-19 grave.