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Copyright of Revista Médica Clínica Las Condes is the property of Editorial Sanchez y Barcelo 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.)

RESUMEN Introducción. Tomar decisiones clínicas basadas en la mejor evidencia disponible es una buena práctica que favorece los resultados en salud. Su uso ha sido promovido por diferentes organismos; sin embargo, aún existen algunas barreras entre profesionales de la salud para su apropiación. El objetivo fue el análisis exploratorio del efecto de un curso sobre los conocimientos, habilidades y actitudes frente a la Medicina Basada en la Evidencia (MBE) en profesionales de la salud que ejercen en Bogotá, Colombia. Metodología. Estudio exploratorio que incluyó un componente cuantitativo y uno cualitativo de carácter descriptivo. El estudio se desarrolló entre agosto de 2022 y abril de 2023. Para el componente cuantitativo se construyó un cuestionario tipo test, compuesto por 38 preguntas, aplicado antes y después del curso. Respecto de lo cualitativo, se realizaron en total 6 entrevistas semiestructuradas a docentes, estudiantes y uno de los gestores del proyecto. Resultados. Los resultados cuantitativos permitieron identificar cambios relacionados con la toma de decisiones clínicas, una mejora en el conocimiento y aplicación de herramientas para la evaluación de la calidad de estudios para resolver preguntas clínicas. El componente cualitativo permitió identificar dos temáticas centrales: pedagogía de la toma de decisiones y los aspectos que posibilitan o no la implementación de estas herramientas para tomar decisiones clínicas. Discusión. Los resultados sobre los efectos del curso son similares a los reportados por otros estudios en contextos diferentes al colombiano. Se requiere investigación que a mediano y largo plazo mida el impacto de la formación en el cambio de práctica. Conclusión. El curso sugiere tener efectos en los conocimientos y habilidades para mejorar la búsqueda y evaluación de la evidencia, así como para la formulación de preguntas clínicas, la comprensión de la certeza de la evidencia y mejorar la actitud hacia el uso de la evidencia para fundamentar la toma de decisiones en la clínica. Palabras clave: Medicina Basada en la Evidencia; Capacitación Profesional; Toma de Decisiones Clínicas; Desarrollo de Personal; Evaluación de Resultado en la Atención de Salud. ABSTRACT Introduction. Making clinical decisions based on the best available evidence is a good practice that favors health outcomes. Different organizations have promoted its use; however, there are still some barriers to its appropriation among health professionals. The objective was the exploratory analysis of the effect of a course on knowledge, skills, and attitudes towards Evidence-Based Medicine (EBM) in health professionals practicing in Bogotá, Colombia. Methodology. Exploratory study that included quantitative and qualitative components with a descriptive approach. The study was conducted between August 2022 and April 2023. For the quantitative component, a questionnaire was developed with 38 questions, applied before and after the course. In the qualitative component, 6 semi-structured interviews were conducted with teachers, students, and a Project manager. Results. The quantitative results showed changes in clinical decision-making and the improvement in the knowledge and application of study quality assessment tools to resolve clinical issues. The qualitative component identified two main themes: pedagogy in decision-making and the aspects that either allow or do not allow the implementation of these tools for clinical decision-making. Discussion. The results on the effects of the course are similar to those reported by other studies in contexts other than Colombia. Research is needed in the medium and long term to measure the impact of the training on practice change. Conclusion. The course suggests effects on knowledge and skills related to searching for and evaluating evidence, formulating clinical questions, understanding the certainty of evidence, and improving attitudes toward the use of evidence to inform clinical decision-making. Keywords: Evidence-Based Medicine; Professional Training; Clinical Decision-Making; Staff Development; Outcome Assessment, Health Care RESUMO Introdução. Tomar decisões clínicas baseadas nas melhores evidências disponíveis é uma boa prática que favorece os resultados em saúde. A sua utilização tem sido promovida por diferentes instâncias, contudo, ainda existem algumas barreiras entre os profissionais de saúde para a sua apropriação. O objetivo foi a análise exploratória do efeito de um curso sobre conhecimentos, habilidades e atitudes em relação à Medicina Baseada em Evidências (MBE) em profissionais de saúde que atuam em Bogotá, Colômbia. Metodologia. Estudo exploratório que incluiu uma componente quantitativa e uma componente qualitativa descritiva. O estudo foi realizado entre agosto de 2022 e abril de 2023. Para a componente quantitativa foi criado um questionário do tipo teste, composto por 38 questões, aplicado antes e após o curso. Quanto aos aspectos qualitativos, foram realizadas um total de 6 entrevistas semiestruturadas com professores, alunos e um dos gestores do projeto. Resultados. Os resultados quantitativos permitiram identificar mudanças relacionadas à tomada de decisão clínica, melhoria no conhecimento e aplicação de ferramentas de avaliação da qualidade dos estudos para resolução de questões clínicas. A componente qualitativa permitiu identificar dois temas centrais: a pedagogía da tomada de decisão e os aspectos que possibilitam ou não a implementação destas ferramentas para a tomada de decisões clínicas. Discussão. Os resultados sobre os efeitos do curso são semelhantes aos relatados por otros estudos noutros contextos que não a Colômbia. É necessária investigação a médio e longo prazo para medir o impacto da formação na mudança de práticas. Conclusão. O curso sugere ter efeitos sobre conhecimentos e competências para melhorar a procura e avaliação de evidências, bem como para formular questões clínicas, compreender a certeza das evidências e melhorar a atitude em relação ao uso de evidências para fundamentar a tomada de decisões na clínica. Palavras-chave: Medicina Baseada em Evidências; Capacitação Profissional; Tomada de Decisão Clínica; Desenvolvimento de Pessoal; Avaliação de Resultados em Cuidados de Saúde

Introduction: chronic kidney disease is a pathology that reduces the expectancy and quality of life of patients. Doctors are primarily responsible for preserving the patient's life and are responsible for shared decision making. Objective: to analyze the perception of medical personnel regarding the prolongation of renal replacement treatment in patients with chronic kidney disease in the terminal phase in the dialysis unit at the General Teaching Hospital of Ambato, Ecuador. Method: a qualitative research was carried out, with a semi-structured interview that consisted of questions guided by the theory-hypothesis of the topic. The study sample was made up of doctors from the Dialysis Unit, responsible for the clinical management of patients with chronic kidney disease undergoing dialysis treatment. The protocol was approved by the Human Research Ethics Committee of the Pontificia Universidad Católica del Ecuador, with approval code CEI-88-2020. Results: the thematic analysis showed that doctors need to comprehensively ethically and clinically evaluate the patient before maintaining or terminating hemodialysis; The level of knowledge and ethical-clinical skills influence decision making. Furthermore, the application of Beauchamp and Childress' bioethical principles to decision making is vague, morbidly confusing, and therefore irrelevant to this type of decision. Conclusions: doctors perceive the need to comprehensively evaluate the patient, taking into account not only the physical but also the psychological, social and economic condition of the patient. They consider it unnecessary to maintain hemodialysis treatment in a patient with a deteriorated quality of life, with reduced autonomy and whose prolonged treatment could cause more pain than benefit.

Objective: To assess the reproducibility of symptoms in drug challenge tests. Methods: The study included patients with positive cutaneous or challenge test throughout 2019. For each patient, clinical suspicion according to Karch-Lasagna algorithm was registered. Primary outcome was the reproducibility of symptoms in the provocation tests using a paired analysis of data with McNemar test. Results: Eighty-nine patients were included, 16 of them presented more than one positive test. Thirty were skin tests positive and 75 reacted to provocation tests. Eighty nine percent of patients who reacted in challenge test were probably or possibly reactors according to Karch-Lasagna scale. Symptoms of initial reaction did not differ from those triggered in challenge tests. Conclusions: Karch-Lasagna scale is useful in predicting the response to drug provocation tests. In most of the positive studies, results were suggested by clinical history and no differences were found between symptoms triggered in challenge test and that referred to in the previous reaction. [ABSTRACT FROM AUTHOR]

Fundamento: la toma de decisiones como habilidad profesional en la formación del especialista en Pediatría es un aspecto que requiere atención desde el punto de vista didáctico.Objetivo: presentar una estrategia didáctica para la toma de decisiones como habilidad profesional en la formación del especialista en Pediatría, así como un acercamiento a su implementación.Métodos: se utilizaron métodos y técnicas de investigación cualitativa como la observación y el grupo de discusión mediante talleres para describir los resultados que se presentan en el artículo.Resultados: se ofrecen acciones metodológicas llevadas a cabo mediante la ejecución de un taller de socialización, el registro de actividades prácticas con profesores/tutores y residentes en diferentes escenarios docente-asistenciales. Se muestran los resultados de la implementación de las acciones de la estrategia didáctica, así como las premisas y etapas que se determinaron durante su proceso de construcción. Se describen las principales regularidades.Conclusiones: la estrategia didáctica propuesta, y su carácter flexible, permiten su articulación durante los tres años de residencia de Pediatría, en beneficio de la toma de decisiones como habilidad profesional y asumiendo el principio de educación en el trabajo como la principal forma de enseñanza del especialista en formación.

Objetivo: verificar la validez clínica de la proposición de un nuevo diagnóstico de enfermería denominado sed perioperatoria, basado en la precisión diagnóstica de sus indicadores clínicos, incluyendo la magnitud del efecto de sus factores etiológicos. Método: estudio de validación clínica diagnóstica con 150 pacientes quirúrgicos en un hospital universitario. Se recogieron variables sociodemográficas e indicadores clínicos relacionados con la sed. Se utilizó la técnica de análisis de clases latentes. Resultados: se propusieron dos modelos de clases latentes para las características definitorias. El modelo ajustado en el preoperatorio incluía: labios resecos, saliva espesa, lengua espesa, ganas de beber agua, informe del cuidador, garganta seca y deglución constante de saliva. En el postoperatorio: sequedad de garganta, saliva espesa, lengua espesa, constante deglución de saliva, ganas de beber agua, mal gusto en la boca. Los factores relacionados “temperatura ambiente elevada” y “sequedad de boca” se asocian a la presencia de sed, así como las condiciones asociadas “uso de anticolinérgicos” e “intubación”. La prevalencia de sed fue del 62,6% en el preoperatorio y del 50,2% en el postoperatorio inmediato. Conclusión: la proposición diagnóstica de la sed perioperatoria mostró buenos parámetros de precisión de sus indicadores clínicos y efectos etiológicos. Esta propuesta en una taxonomía de enfermería permitirá una mayor visibilidad, apreciación y tratamiento de este síntoma.

Copyright of Acta Medica Colombiana is the property of Acta Medica Colombiana 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.)

Objetivo. Desarrollar una plataforma virtual de aprendizaje (PVA) para el entrenamiento de razonamiento clínico en estudiantes de fonoaudiología. Método. Investigación aplicada en base al desarrollo de software; se utilizó lenguaje de programación PHP en su versión 7.3.26, gráficas y transiciones en framework Laravel 8 y Vue 2 con Vuetify. El manejo de base de datos se ejecutó en MySql 5.5. Resultados. Se creó una PVA para el almacenamiento y uso de guiones clínicos basados en la teoría de concordancia de guiones (scripts). La operatividad de la plataforma contempló tres perfiles diferenciados para docentes, estudiantes y gestores. Los estudiantes accedieron a un corpus aleatorio de guiones clínicos previamente validados. El profesor contó con acceso a las estadísticas de usabilidad y notas de los estudiantes y el gestor pudo cargar nuevos guiones, revisar estadísticas, resolver dificultades de soporte y asignar roles. Conclusiones. La PVA desarrollada ofrece un soporte informático para la metodología de entrenamiento del RC scripts en fonoaudiología. Los procesos de innovación educativa diversifican las estrategias de aprendizaje y promueven el desarrollo de competencias relevantes para la toma de decisiones clínicas en los ámbitos de diagnóstico, estudio e intervención.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina 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 Investigación e Innovación en Ciencias de la Salud (RIICS) is the property of Fundacion Universitaria Maria Cano 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.)

Background: decision-making as a professional skill in the training of the Pediatrics specialist is an aspect that requires attention from the didactic point of view. Objective: to present a didactic strategy for decision making as a professional skill in the Pediatrics specialist training, as well as an approach to its implementation. Methods: Qualitative research methods and techniques such as observation and group discussion through workshops were used to describe the results presented in the article. Results: methodological actions carried out through the execution of a socialization workshop, the record of practical activities with teachers/tutors and residents in different teaching-assistance scenarios are offered. The results of the implementation of the actions of the didactic strategy are shown, as well as the premises and stages that were determined during its construction process. The main regularities are described. Conclusions: the proposed didactic strategy, and its flexible nature, allow its articulation during the three years of Pediatrics residency, to the benefit of decision-making as a professional skill and assuming the principle of education at work as the main way of teaching the pediatrician training specialist. [ABSTRACT FROM AUTHOR]

Copyright of CES Medicina is the property of Universidad CES 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 Española de Quimioterapia is the property of Sociedad Espanola de Quimioterapia 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 develop an operational definition of the "diagnostic reasoning" concept in nursing. Materials and methods: This concept analysis is based on Walker and Avant's model. All the referential steps were followed: concept selection, determining the objectives and proposals for concept analysis, identifying the possible uses of the concept, determining the defining attributes, identifying a model case, identifying the contrary case, and identifying the precedents and consequences of the concept. Results: A sample of 20 studies was selected, identifying the following attributes: specialized thinking, cognitive skills, existing knowledge, intellectual competence; hypothesis-oriented reasoning; precedents: clinical assessment, practical experience, data interpretations, intuition, diagnostic judgment, information processing, clinical reasoning; consequences: improvement of nursing care, communication, planning interventions, addressing the identified problem, achieving effective results, autonomous actions, and quality of patient records. Conclusions: The study contributes to understanding the operational definition of the diagnostic reasoning concept in nursing by identifying the core attributes, precedents, and consequences. [ABSTRACT FROM AUTHOR]

Objective: To analyse the critical thinking developed by students participating in a curricular component of undergraduate nursing programmes. Method: Qualitative, observational and comparative study before and after the intervention. A sociodemographic questionnaire and text stimulus were applied in two phases. The sample consisted of 48 students enrolled in the Critical Thinking In Nursing course. Results: In the first phase, the students recognized critical thinking as important in decision-making, in the development of skills and in the process of educating them to think. In the second phase, the comments indicated an active role of the school, and the knowledge of students improved in the formative context. Final considerations: In the critical thinking developed by the students who participated in the curricular component of the nursing programme, a significant change was found in the lexicon in both phases, and critical thinking skills were developed, in particular interpretation, argumentation, analysis, and evaluation. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem 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.)

Conformity in decision making has a relevant impact in surgical environments. This manuscript reveals how group-based opinions can distort the surgeon's individual judgment, even in critical situations. Two key phenomena are analysed: communication cascades and group polarisation, which amplify conformity and lead to extreme and sometimes harmful decisions. It is important to highlight the importance of evidence-based education, critical thinking, and diversification of information sources to counteract the negative effects of conformity. Self-identifying conformist tendencies, encouraging open debate, and implementing constructive dissent strategies can help mitigate the effects of conformity in decision-making. Reviewing authority models and promoting diversity in surgical settings may improve decision-making and the quality of patient care., (Copyright © 2024 AEC. Published by Elsevier España, S.L.U. All rights reserved.)

Copyright of Investigacion & Educacion en Enfermeria is the property of Universidad de Antioquia, Facultad de Enfermeria 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: Acute viral bronchiolitis (AB) is one of the most common respiratory diseases in infants. However, diagnostic criteria for AB are heterogeneous and not very well known. Objective: To identify the diagnostic criteria for AB used by experts and clinical paediatricians in Spain. Methods: Delphi study with Spanish AB experts, looking for the points of agreement about AB diagnosis. A subsequent cross-sectional study was conducted by means of an online questionnaire addressed to all Spanish paediatricians, reached through electronic mail messages sent by nine paediatric scientific societies. Descriptive and factorial analyses were carried out, looking for any association of diagnostic criteria with demographic or geographic variables, or with paediatric subspecialty. Results: Agreement was reached by 40 experts in many issues (first episode of respiratory distress and high respiratory frequency, diagnosis in any season of the year, and usefulness of virus identification in making diagnosis), but opposite views were maintained on key characteristics such as the maximum age for diagnosis. The online questionnaire was completed by 1297 paediatricians. Their diagnostic criteria were heterogeneous and strongly associated with their paediatric sub-specialty. Their agreement with the Spanish expert consensus and with international standards was very poor. Conclusions: Diagnostic criteria for AB in Spain are heterogeneous. These differences could cause variability in clinical practice with AB patients. Resumen: Introducción: La bronquiolitis vírica aguda (BA) es una de las enfermedades respiratorias más frecuentes en los lactantes. Sin embargo, los criterios utilizados para su diagnóstico son heterogéneos e insuficientemente conocidos. Objetivo: Identificar los criterios de diagnóstico de BA empleados en España, tanto por expertos como por pediatras clínicos. Métodos: Estudio de metodología Delphi con expertos españoles en BA, buscando los puntos de consenso sobre el diagnóstico de BA. Posteriormente se realizó un estudio transversal mediante encuesta online dirigida a todos los pediatras españoles, contactados a través de mensajes de correo electrónico enviados por nueve sociedades científicas pediátricas. Se hizo análisis descriptivo y análisis factorial de los resultados de la encuesta, buscando si los criterios diagnósticos empleados se relacionaban con variables demográficas, geográficas o con la subespecialidad pediátrica. Resultados: Los 40 expertos participantes alcanzaron un consenso en muchos aspectos (primer episodio de dificultad respiratoria y aumento de la frecuencia respiratoria, diagnóstico en cualquier estación del año, y utilidad de la identificación de virus para el diagnóstico), pero manteniendo opiniones enfrentadas en cuestiones importantes como la edad máxima aceptable para el diagnóstico. A la encuesta online respondieron 1297 pediatras. Los criterios diagnósticos que aplican son heterogéneos y están fuertemente asociados con la subespecialidad pediátrica. Su acuerdo con el consenso de expertos y con estándares internacionales es muy bajo. Conclusiones: Los criterios usados en España para el diagnóstico de BA son heterogéneos. Esas diferencias pueden causar variabilidad en la práctica clínica en pacientes con BA.

Copyright of Revista Bioetica is the property of Conselho Federal de Medicina 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.)

Objectives: To develop and validate a risk model for 1-year mortality based on variables available from early prehospital emergency attendance of patients with infection., Material and Methods: Prospective, observational, noninterventional multicenter study in adults with suspected infection transferred to 4 Spanish hospitals by advanced life-support ambulances from June 1, 2020, through June 30, 2022. We collected demographic, physiological, clinical, and analytical data. Cox regression analysis was used to develop and validate a risk model for 1-year mortality., Results: Four hundred ten patients were enrolled (development cohort, 287; validation cohort, 123). Cumulative mortality was 49% overall. Sepsis (infection plus a Sepsis-related Organ Failure Assessment score of 2 or higher) was diagnosed in 29.2% of survivors vs 56.7% of nonsurvivors. The risk model achieved an area under the receiver operating characteristic curve of 0.89 for 1-year mortality. The following predictors were included in the model: age; institutionalization; age-adjusted Charlson comorbidity index; PaCO2; potassium, lactate, urea nitrogen, and creatinine levels; fraction of inspired oxygen; and diagnosed sepsis., Conclusion: The model showed excellent ability to predict 1-year mortality based on epidemiological, analytical, and clinical variables, identifying patients at high risk of death soon after their first contact with the health care system.

La pandemia por COVID-19 nos presenta un contexto difícil para la toma de decisiones clínicas. En este escenario, el presente artículo tiene por objetivo explicar al personal de salud asistencial algunos conceptos fundamentales sobre la toma de decisiones basadas en evidencias con respecto a brindar o no cierta intervención. Para ello, primero se discutirá en qué casos realizar un proceso de toma de decisiones basadas en evidencias. Luego se aclararán ciertos conceptos previos (toma de decisiones en base a la plausibilidad fisiopatológica, las observaciones realizadas durante la práctica clínica, la evidencia de estudios clínicos; así como la influencia de la industria farmacéutica). Seguidamente, se presentan los pasos para tomar decisiones basadas en evidencias: Formular una pregunta, buscar los estudios que respondan a dicha pregunta, leer críticamente dichos estudios, entender la lógica de la toma de decisiones, prepararse para tomar la decisión, realizar el balance (entre los beneficios, daños y costos), realizar un proceso de toma de decisiones compartidas y reevaluar la evidencia.

Introducción: El Proceso de Atención Nutricional (PAN) y la Terminología Estandarizada (TE) proporcionan un protocolo de actuación que permite fomentar el pensamiento crítico, estructurar y documentar el cuidado dietético-nutricional basado en la evidencia científica, medir los resultados y evaluar la calidad de la atención nutricional. Objetivo: Dar a conocer a los profesionales de la Nutrición y la Dietética el PAN y la TE, sus elementos básicos y su aplicación en la atención nutricional, evaluando su implementación internacional. Material y métodos: Revisión de los trabajos publicados del PAN y la TE en inglés y castellano. Términos de búsqueda: Nutrition Care Process, Dietetic Care Process, Standardized Terminology, Proceso/Plan de Atención/Cuidado Nutricional/Dietético y TE. La búsqueda no se limitó por año de publicación, excluyéndose los artículos publicados con baja evidencia científica o con cambios respecto al modelo original. Resultados: El PAN aporta un enfoque holístico y contribuye a mejorar la calidad asistencial, el intercambio de información y el seguimiento nutricional. La implementación del PAN mejora la productividad profesional y promueve y fortalece aún más las funciones del profesional de la Nutrición y la Dietética en la práctica sanitaria-comunitaria. Conclusiones: El PAN y la TE son reconocidos internacionalmente como herramientas necesarias para promover la atención y cuidado nutricional en clínica, salud pública e investigación nutricional, subrayando la necesidad de incluirlo en el currículo académico y en la práctica profesional de la Nutrición y la Dietética.

El Ministerio de Salud peruano (MINSA) ha publicado resoluciones ministeriales (RM) con el objetivo de normar el tratamiento de personas afectadas por la COVID-19. Estas RM incluyen el uso de fármacos específicos para la COVID-19, como tocilizumab, corticoides, enoxaparina, hidroxicloroquina e ivermectina. Estos lineamientos no dejan claro qué proceso se siguió para tomar decisiones, cómo se justificó cada una de estas decisiones, ni quiénes son sus autores ni sus potenciales conflictos de interés. Resulta importante hacer un esfuerzo por transparentar estos datos, especialmente en un tema en el cual aún no se cuenta con mucha evidencia como es el caso de COVID-19. En el presente artículo presentamos controversias sobre el uso de fármacos específicos para la COVID-19 establecidos por el MINSA, así como recomendaciones sobre el proceso de toma de decisiones.

Copyright of Acta Médica Peruana is the property of Colegio Medico del Peru 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 Cirugía y Cirujanos 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.)

Copyright of Médicas UIS is the property of Universidad Industrial de Santander 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.)

Deliberation is a basic rational human activity recognized since ancient times due to its role in decision making during daily life activities and in specialized areas of knowledge such as medicine, politics and ethics. The objective of this reflection paper is to study the contribution of Aristotle to the deliberative process through his work the Nicomachean Ethics, where the following aspects of deliberation were identified for analysis: origin, definition, characteristics, and types and conditions for its development. Bioethics defend these aspects, since it finds in Aristotelian phronesis the fundamental axis to guide its actions in search of human self-realization and the analysis and decision making of the clinical bioethical problems. Twenty-four centuries have passed until the importance of this process and the need to educate about it was finally rediscovered.

Sin resumen.

Práctica basada en la evidencia científica como fundamento de la práctica clínica Prática baseada em evidências científicas como base da prática clínica To reference this article / Para citar este artículo / Para citar este artigo Moreno-Monsiváis MG. Practice Based on Scientific Evidence as the Foundation of Clinical Practice. Aquichan; 19(3): e1931. DOI: https://doi.org/10.5294/aqui.2019.19.3.1

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El objetivo de este trabajo es mostrar cómo en nuestro país se está transitando hacia una nueva concepción de la viabilidad de la prematuridad extrema (recién nacidos con menos de 28 semanas de gestación), caracterizarla y contextualizarla. Para ello, se utilizan datos procedentes de una investigación (P.N. I+D+i, CSO2011-24294) que ha obtenido resultados válidos sobre el desarrollo de 1200 nacidos con 1500 gramos (g) o menos de peso, mediante encuesta poblacional multimétodo, y producido cuatro grupos de discusión y 25 entrevistas abiertas con agentes cualificados. Se recogen aquí los resultados del análisis sociodiscursivo del material cualitativo centrado en esta cuestión y del estudio de diversos documentos sobre viabilidad en la prematuridad extrema. En cuanto a los resultados, en España se viene transitando de manera más práctica que consciente desde una concepción reduccionista de la prematuridad extrema, ligada al normativismo de la bioética y al aislamiento del recién nacido, a una mirada más ensamblada, compleja y heterogénea, acorde con la vigente renovación de la cultura, la práctica y la política biosanitaria en nuestro país.