Medwave
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A new type of coronavirus (SARS-CoV-2) causes a respiratory distress syndrome that has been called COVID-19 and has generated an unprecedented pandemic. Serious complications include pneumonia, and mortality ranges from 2 to 5%. Until March 26, the World Health Organization reports 462 684 confirmed cases and 20 834 deaths worldwide. Dissemination occurs from aerosols or respiratory droplets. Different scientific societies have published clinical practice guidelines regarding ophthalmic care in the COVID-19 pandemic, but the information is presented inconsistently, which makes decision-making difficult. ⋯ The clinical practice guidelines that we reviewed all recommend rescheduling all non-urgent consultations and surgeries, reinforcing contact precautions, the use of personal protection elements, and the disinfection of surfaces and instruments. The guidelines should be improved by incorporating systematic searches for evidence, using GRADE for recommendations, and Appraisal of Guidelines for Research and Evaluation (AGREE II) for reporting.
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Routine outcome assessment is helpful to inform decision-making, resource allocation, and health policy design. Routine outcome assessment in the hospital setting for children and adolescents with psychiatric disorders remains limited. The clinical instrument HoNOSCA (Health of the Nation Outcome Scales for Children and Adolescents), which has recently become available in Spanish and Catalan, allows outcome assessment in this population from the perspective of patients, their parents or legal guardians, and clinicians. HoNOSCA measures 13 areas of health and psychosocial functioning. ⋯ Use of HoNOSCA allows for routine evaluation of mental health outcomes in the psychiatric day hospital setting from the perspective of pa-tients, their parents or legal guardians, and clinicians.
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Multicenter Study
[Association between anemia and chronic obstructive pulmonary disease exacerbations in Cartagena Colombia: a prospective cohort study].
The presence of anemia in chronic obstructive pulmonary disease is not an infrequent event. Exacerbations of this disease have been associated with an increase in mortality in these patients. It is not clear if the presence of anemia is associated with the risk of exacerbations. ⋯ No significant association was established between anemia and the incidence of exacerbations of chronic obstructive pulmonary disease, the incidence of recurrence of first exacerbation, the rate of hospitalizations for chronic obstructive pulmonary disease exacerbations and the recurrence time of the first exacerbation of chronic obstructive pulmonary disease.
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Spontaneous epistaxis is one of the most frequent problems in emergency services. New treatment alternatives have emerged, including topical tranexamic acid. However, there is controversy about the actual efficacy of this alternative. ⋯ We identified five systematic reviews that analyzed only one primary study, corresponding to a randomized trial. We concluded it is not clear whether topical tranexamic acid has any impact on hemostasis or risk of rebleeding because the certainty of the evidence is very low. On the other hand, its use could increase adverse effects.
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Rheumatoid arthritis is the most common inflammatory arthritis worldwide. Chronic pain leads patients to use complementary therapies, including acupuncture. ⋯ We identified 7 systematic reviews including 20 studies overall, all of them randomized trials. We concluded the use of acupuncture probably has little or no impact in rheumatoid arthritis.