Medwave
-
Healthcare workers have been widely recognized as the mainstay of healthcare systems. Mostly incorporated as human resources into healthcare planning, their expression in the public policies of Chile and Latin America has undergone changes in compliance with the socio-economic and economic development of the countries in the region as well as changes in their healthcare systems. This article offers a historical review of healthcare human resources planning in Chile from a government-level standpoint; thus, enabling the characterization of a path that has added tools from the economic sciences to the healthcare workers own diagnosis, promoting policy actions to improve planning and management at national level, although the results have been inconsistent. Today, the great interest by national and international entities in healthcare human resources constitutes a growing concern about current problems, asymmetries, and expected results-- all of which increase the complexity of healthcare staffing and human resources planning.
-
Randomized Controlled Trial Comparative Study
Naproxen, paracetamol and pamabrom versus paracetamol, pyrilamine and pamabrom in primary dysmenorrhea: a randomized, double-blind clinical trial.
Dysmenorrhea is caused by the discharge of prostaglandins into the uterine tissue; therefore, non-steroidal anti-inflammatory drugs (NSAIDs) are the established initial therapy for dysmenorrhea. Dysmenorrhea therapy may include the administration of drug monotherapy or combination therapy. However, clinical scientific evidence on the efficacy of medications with two or three drugs combined is scarce or nonexistent. ⋯ The results showed that both drug combinations were not different in reducing dysmenorrheic pain. Likewise, both treatments were well tolerated. Therefore, both treatments may be used for the treatment of primary dysmenorrhea.
-
Review Meta Analysis
Are cannabinoids effective for treatment of pain in patients with active cancer?
Cannabinoids have been proposed for the treatment of patients with cancer pain, especially if standard treatment does not control symptoms. Using Epistemonikos database, which is maintained by searching 30 databases, we identified nine systematic reviews including seven trials that answer the question of interest, of which six are randomized trials. We performed a meta-analysis and generated a summary of findings table using the GRADE approach. We concluded it is unclear whether cannabinoids decrease pain and improve quality of life in patients with refractory cancer pain because the certainty of the evidence is very low, and it probably increases adverse effects substantially.
-
Review Multicenter Study
What is the role of corticosteroids in the management of sepsis?
During an episode of sepsis, the systemic inflammatory response phenomenon triggers a deficit in the action and/or secretion of cortisol. It has been suggested that the use of corticosteroids may have a role in the management of sepsis, but there is no consensus. ⋯ We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded the use of corticosteroids during a sepsis episode probably favors reversal of shock, briefly shortens the stay in intensive care unit and might reduce mortality, with few clinically relevant adverse effects.