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The management of urinary tract infection (UTI) in infants and children has changed significantly over the past few decades based on scientific evidence that questioned the efficacy of strategies used to prevent kidney injury and subsequent progression to chronic kidney disease, which is very unlikely in most paediatric cases. However, there is still substantial heterogeneity in its management and uncertainty regarding the diagnosis, indication of imaging tests, treatment or follow-up in these patients. The Spanish clinical practice guideline has been updated through the review of the literature published since 2009 and a rigorous evaluation of current clinical practice aspects, taking into account the evidence on the benefits of each intervention in addition to its risks and drawbacks to attempt to provide more precise recommendations. Resumen: En las últimas décadas, se han producido profundos cambios en el manejo de la infección urinaria en pediatría, a partir de estudios que cuestionaban la eficacia de las estrategias para prevenir el daño renal y la evolución posterior a enfermedad renal crónica, muy poco probable en la mayoría de casos. No obstante, todavía existe una gran variabilidad clínica en el manejo e incertidumbre en cuestiones relativas al diagnóstico, la indicación de una exploración radiológica, el tratamiento o el seguimiento de estos niños. La actualización de la guía de práctica clínica española ha examinado en la literatura publicada desde el año 2009 y de modo riguroso aspectos de la práctica actual, considerando la evidencia de los beneficios de cada intervención, junto con los riesgos asociados y desventajas, para intentar delimitar las pautas de actuación más precisas.

Copyright of Journal of the Argentine Society of Dermatology / Revista de la Journal Sociedad Argentina de Dermatología is the property of Editorial Biotecnologica S.R.L 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 ADM is the property of Asociacion Dental Mexicana 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. This paper is based on the third Edition of the RNAO “Pain Assessment and Management” guideline applied to total hip arthroplasty (THA) patients and the evaluation of clinical practice guidelines on pain management and patient satisfaction. Objective: To apply the Third Edition Guideline for the Pain Assessment and Management from RNAO to patients after total hip arthroplasty and evaluate its effectiveness. Division of topics covered. Evaluate the knowledge, assessment of pain by nursing, and satisfaction in the care of patients with total hip arthroplasty before and after the implementation of the guide, according to the Knowledge to Action Framework. According to 20 recommendations from the Guideline, 6 quality review indicators were formulated: 1. Establish and implement standard assessment processes and forms; 2. Conduct nurse training and patient education; 3. Compare nurses’ pain knowledge and attitude levels before and after evidence-based practice; 4. Compare nurses’ implementation of various indicators of patient pain assessment and management; 5. Compare pain control satisfaction of total hip arthroplasty patients before and after Best Practice Guideline implementation; and 6. Ensure nurses use the same proven tool to assess pain in patients. Results. After implementing the Guideline, the rate of nurses’ knowledge of pain assessment and management has increased from 42.6% to 48%. Nurses’ pain screening and evaluation, strategies to encourage patients and if the families participated in pain management were recorded after an assessment, and they were statistically significant (all P

Foundation: Class II malocclusion has the highest prevalence among dentoskeletal disorders.Objective: to propose a care guide for patients with class II malocclusion with actively growing permanent dentition.Methods: a mixed approach technological innovation research was carried out in the Clinical Sciences Department from the Stomatology Faculty of the Villa Clara Medical Sciences University, from 2020 to 2023. The studied universe was all the Orthodontic specialists in the Villa Clara province, Sancti Spíritus and Cienfuegos, from which an intentional non-probabilistic sampling was carried out by criteria and the sample was made up of 20 specialists and seven experts (higher category specialists) with criteria of inclusion.Results: The reviewed documentation provided valuable information to determine the current state of care for malocclusion under study. Specialists issued different criteria on the diagnosis and treatment of class II malocclusion. The experts established the invariable elements for their classification. Finally, a care guide was designed for patients with class II malocclusion with actively growing permanent dentition, rated by specialists as excellent.Conclusions: the proposed guide contains invariable diagnostic elements and treatment guidelines in order to achieve more comprehensive and efficient malocclusion care.

Objetivo. Analizar la existencia y actualización de las listas de medicamentos nacionales (LMN) y guías de práctica clínica (GPC) para el tratamiento de la diabetes en América Latina y el Caribe (ALC). Comparar los fármacos incluidos en las listas y guías de cada país, entre sí y con los de la Organización Mundial de la Salud (OMS). Métodos. Estudio de corte transversal. Se identificaron las LMN y GPC para diabetes en los sitios web de la Organización Panamericana de la Salud y de las autoridades sanitarias nacionales. Se relevaron los fármacos y se analizaron por grupo farmacológico según el cuarto nivel de la nomenclatura ATC. Se utilizó el puntaje F1 para evaluar la proximidad de las LMN con la lista modelo de medicamentos esenciales (LMME) de la OMS. Resultados. Del total de países, 87,2% cuentan con LMN, y 91% con GPC (78% y 45% actualizadas en los últimos 5 años, respectivamente). En comparación con los 6 grupos de hipoglucemiantes de la LMME, las LMN tenían una mediana (rango) de 6 (4-13) y un puntaje F1 de 0,80; esto indica una consonancia adecuada. Las GPC tenían una mediana (rango) de 12 (1-12) hipoglucemiantes frente a los 8 de las guías de la OMS. Las GPC tuvieron una mediana de 15 fármacos más que las respectivas LMN. Conclusiones. Si bien la mayoría de los países de ALC cuentan con LMN y GPC para diabetes, la falta de concordancia entre ellas limita su eficacia. Es necesario alinear los procesos y criterios de elaboración de estas dos herramientas de la política de medicamentos.

Chronic renal disease constitutes a health problem due to its impact on individuals, society and economy. Taking into account the above-mentioned, and after a wide literature search, a clinical practice guide was designed in Luis Augusto Turcios Lima Polyclinic from Pinar del Río province, directed to primary health care professionals, aimed at improving the life quality of children and adolescents with this disease. It was elaborated by medicine methods based on the evidence, according to the consent and opinion of experts. It was possible to generalize this tool, give recommendations and up to date according to the new medical evidences. Finally, it was evaluated by experts as very recommended. [ABSTRACT FROM AUTHOR]

RESUMEN Introducción. La Organización Mundial de la Salud considera la violencia de género como un grave problema de salud pública. Una de cada cuatro mujeres entre 15 y 49 años ha sufrido violencia de género a lo largo de su vida desde los 15 años, esto conlleva graves consecuencias para la salud no solo de las mujeres sino también de sus hijas e hijos. Desde la Organización Sanitaria Integrada Bilbao-Basurto y la Universidad del País Vasco existe el compromiso de dar respuesta a este importante problema a través de la implementación de la Guía de Buenas Prácticas: El maltrato contra las mujeres: cribado, identificación y respuesta inicial. Objetivo. Reflexionar acerca del proceso de implementación en los ámbitos asistencial y académico de la guía de buenas prácticas clínicas sobre “El maltrato contra las mujeres de la Registered Nurses’ Association of Ontario RNAO: cribado, identificación y respuesta inicial. Temas de reflexión. En este artículo se abordarán dos temas de reflexión: 1) Descripción de la metodología de implementación. 2) Descripción de cada una de las fases, tanto en el ámbito clínico como académico. Conclusiones. La Guía de Buenas prácticas “El maltrato contra las mujeres de la RNAO: cribado, identificación y respuesta inicial”, presenta una herramienta útil para la implementación de buenas prácticas en los sistemas sanitarios que ayudan a la lucha contra la violencia de género. Las enfermeras y otros profesionales de la salud se encuentran en una posición privilegiada para ayudar a las mujeres que sufren abuso/violencia de su pareja íntima. Palabras clave: Violencia de Género; Centros de Salud; Enfermeras y Enfermeros; Personal de Salud; Guía de Práctica Clínica ABSTRACT Introduction. The World Health Organization considers gender-based violence to be a severe public health problem. One in four women between 15 and 49 years of age has suffered gender-based violence in her lifetime since the age of 15. It has severe consequences for the health not only of women but also of their children. The Bilbao-Basurto Integrated Health Organization and the University of the Basque Country are committed to responding to this critical problem through the implementation of the Good Practice Guide: Abuse against Women: Screening, identification, and initial response. Objective. To reflect on the process of implementation of the good clinical practice guide on “Abuse against women in the RNAO: screening, identification and initial response”. Reflection topics. This article will address two topics for reflection: 1) Description of the implementation methodology. 2) Description of each of the phases, both clinically and academically. Conclusions. The RNAO Good Practice Guide: “RNAO Woman Abuse: Screening, identification and initial response”, presents a useful tool for implementing exemplary practices in health systems that help in the fight against gender-based violence. Nurses and other health professionals are in a privileged position to assist women in the fight agains t gender-based violence. Keywords: Gender-Based Violence; Community Health Centers; Nurses; Health Personnel; Practice Guideline RESUMO Introdução. A Organização Mundial da Saúde considera a violência de gênero um grave problema de saúde pública. Uma em cada quatro mulheres entre 15 e 49 anos de idade sofreu violência de gênero durante a vida, desde os 15 anos. Ela tem sérias consequências para a saúde não apenas das mulheres, mas também de seus filhos. A Organização Integrada de Saúde de Bilbao-Basurto e a Universidade do País Basco estão comprometidas em responder a esse importante problema por meio da implementação do Guia de Boas Práticas: Abuso contra mulheres: triagem, identificação e resposta inicial. Objetivo. Refletir sobre o processo de implementação do guia de boas práticas clínicas sobre “Abuso de mulheres na RNAO: triagem, identificação e resposta inicial”. Temas para reflexão. Este artigo abordará dois tópicos para reflexão: 1) Descrição da metodologia de implementação. 2) Descrição de cada uma das fases, tanto em ambientes clínicos quanto acadêmicos. Conclusões. O Guia de Boas Práticas da RNAO: “RNAO Woman Abuse: Screening, Identification and Initial Response” (Abuso de mulheres na RNAO: triagem, identificação e resposta inicial), apresenta uma ferramenta útil para a implementação de boas práticas nos sistemas de saúde para auxiliar na luta contra a violência de gênero. Os enfermeiros e outros profissionais de saúde estão em uma posição única para ajudar as mulheres na luta contra a violência de gênero. Palavras-chave: Violência de Gênero; Centros de Saúde; Enfermeiras e Enfermeiros; Pessoal de Saúde; Guia de Prática Clínica

RESUMEN Esta editorial proporciona una descripción general de los agentes de cambio que conforman las redes de los Centros Destacados en Buenas Prácticas (BPSO, por su sigla en inglés) de la Asociación de Enfermeras de Ontario (Registered Nurses’ Association of Ontario, RNAO), así como un recuento histórico del crecimiento de la Red Champions Students BPSO de la Universidad Autónoma de Bucaramanga (UNAB). Se concluye que la red es una estrategia exitosa que permite la sostenibilidad de la Certificación como BPSO directo y anfitrión (host). Palabras clave: Enfermería; Práctica Clínica Basada en la Evidencia; Guía de Práctica Clínica; Conocimiento; Estudiantes. Keywords: Nursing; Evidence-Based Practice; Practice Guideline; Knowledge; Students. Palabras-chave: Enfermagem; Prática Clínica Baseada em Evidências; Guia de Prática Clínica; Conhecimento; Estudantes

Objetivos: describir los conocimientos, la idoneidad y las prácticas respecto a la “Guía de práctica clínica (GPC) basada en la evidencia para la atención integral de la sífilis gestacional (SG) y congénita (SC)”. Materiales y métodos: estudio descriptivo de corte transversal. Incluyó médicos generales, especialistas y enfermeras que laboraban en 52 instituciones de salud en el departamento de Bolívar (Colombia) y realizan el control prenatal o la atención al neonato en el 2020. Muestreo por conveniencia. Se aplicó cuestionario digital que recolectó información sociodemográfica; evaluó conocimientos, idoneidad y prácticas sobre la "Guía de práctica clínica (GPC)" mencionada en los objetivos. Se hace análisis descriptivo. Resultados: se incluyeron 101 trabajadores. Hay deficiencias relacionadas con la aplicación correcta del algoritmo inverso de diagnóstico (48 %) y seguimiento de SG (77 %), manejo de la paciente con antecedentes de alergias de manifestaciones sistémicas (31 %) y tratamiento de la SG (61 %) y SC (10 %). La recomendación de no aplicar prueba de penicilina en pacientes sin antecedentes de alergias sistémicas se considera poco útil (60 %). El 23 % de los trabajadores no emplea las pruebas rápidas y el 44 % de los especialistas da tratamiento para sífilis al compañero sexual. Conclusiones: es importante intensificar las estrategias de capacitación en el personal de salud con énfasis en el personal de enfermería y, de manera urgente, empoderar a este personal en las actividades relacionadas con el control de la sífilis. Se requiere hacer nuevas y continúas evaluaciones a nivel nacional y regional de la implementación de esta guía que permitan evaluar los indicadores que contiene la estrategia de eliminación de esta enfermedad.

Foundation: Asthma is a chronic inflammatory disease with a high prevalence in South America, which requires proper diagnosis, optimal management and prevention measures supported by constantly updated scientific evidence.Objective: to carry out a comparative analysis between the Global Initiative for Asthma and the South American guidelines for the diagnosis, management and prevention of asthma in pediatric patients.Methods: descriptive observational study that compares the 2023 Global Initiative for Asthma guideline with national guidelines from the South American countries Colombia, Argentina, Chile, Uruguay, Venezuela and Peru, in the following parameters: diagnostic recommendations, management recommendations and prevention strategies.Results: differences were found in prevention and education recommendations in the guides analyzed, while the Global Initiative for Asthma and some South American guides mention prevention measures, other guides do not mention them or have limited information in this regard. In auxiliary tests, all guidelines mention performing spirometry to evaluate lung function, but there are differences with the inclusion of other tests, such as the allergy test or the measurement of exhaled nitric oxide.Conclusions: Greater standardization and updating of South American guidelines is required to guarantee adequate and consistent management of asthma in the region.

ABSTRACT Introduction. The management of patients with chronic noncommunicable diseases, when it follows evidence-based recommendations, improves clinical outcomes and health costs. Despite its importance, little is known about adherence to guidelines and the processes for its monitoring in our environment. The objective of this study was to report the applicability and adherence to a selection of recommendations from clinical practice guidelines for noncommunicable chronic diseases by doctors in Bogotá. Methods. This was a cross-sectional study, the baseline of a cluster experiment that assessed the impact of disseminating recommendations on seven chronic diseases to patients, caregivers, and physicians. A total of 177 physicians from public and private health institutions were invited. Consecutive samples of their medical records were manually reviewed in predefined time ranges (up to 20 patients per physician, with up to two diseases of interest). The proportions of applicability and adherence were calculated according to 40 recommendations. Results. The 177 physicians who participated (out of 266 eligible) were from seven institutions, and 3,747 medical records (21,093 patients/recommendation) were analyzed. The general applicability was 31.9% (95% CI 31.3-32.6%), and it varied considerably by recommendation (range 0.3-100%) and disease (range 10.7-65%). Overall adherence was 42.0% (95% CI 40.8-43.2%), with higher adherence in acute coronary syndrome patients (58.4%) and lower adherence in diabetes mellitus patients (23.7%). Discussion. This is the most up-to-date, exhaustive, and representative measurement of adherence to guideline recommendations by doctors in Bogotá. Conclusions. Adherence to evidence-based recommendations for patients with chronic noncommunicable diseases in Bogotá is poor and highly variable. Keywords: Practice Guideline; Evidence-Based Medicine; Noncommunicable Diseases; Quality of Health Care; Implementation Science; Internal Medicine; Primary Health Care RESUMEN Introducción. El manejo de pacientes con enfermedades crónicas no transmisibles, cuando se realiza a partir de recomendaciones basadas en la evidencia, mejora los desenlaces clínicos y los costos en salud. Pese a su importancia, poco se conocen la adherencia a las recomendaciones de guías y los procesos para su monitoreo en nuestro medio. El objetivo de este estudio es reportar la aplicabilidad y la adherencia a una selección de recomendaciones de guías de práctica clínica, en enfermedades crónicas no transmisibles, por médicos de Bogotá. Metodología. Estudio de corte MSc.Participaron 177 médicos de instituciones de salud públicas y privadas. Se revisaron manualmente muestras consecutivas de sus historias clínicas en rangos de tiempo predefinidos (meta hasta 20 pacientes por médico, en hasta dos enfermedades de interés). Se calcularon las proporciones de aplicabilidad y adherencia en 40 recomendaciones. Resultados. Participaron 177 médicos (de 266 elegibles), de 7 instituciones, con 3,747 historias clínicas (21,093 pacientes/recomendación) analizadas. La aplicabilidad general fue 31.9% (IC95% 31.3%-32.6%), y varió considerablemente por recomendación (rango 0.3%-100%) y enfermedad (rango 10.7%-65%). La adherencia general fue 42.0% (IC95% 40.8% -43.2%), siendo mayor en síndrome coronario agudo (58.4%) y menor en diabetes mellitus (23.7%). Discusión. Esta es la medición más actualizada, exhaustiva y representativa de la adherencia a las recomendaciones de guías por parte de médicos de Bogotá. Conclusiones. La adherencia a recomendaciones basadas en evidencia, para pacientes con enfermedades crónicas no transmisibles de Bogotá, es deficiente y altamente variable. Palabras clave: Guía de Práctica Clínica; Medicina Basada en la Evidencia; Enfermedades no Transmisibles; Calidad de la Atención de Salud; Ciencia de la Implementación; Medicina Interna; Atención Primaria de Salud RESUMO Introdução. O manejo de pacientes com doenças crônicas não transmissíveis, quando realizado com base em recomendações baseadas em evidências, melhora os resultados clínicos e os custos de saúde. Apesar da sua importância, pouco se sabe sobre a adesão às recomendações das diretrizes e os processos para monitorá-la em nosso meio. O objetivo deste estudo é relatar a aplicabilidade e adesão a uma seleção de recomendações das diretrizes de prática clínica, em doenças crônicas não transmissíveis, por médicos em Bogotá. Metodologia. Estudo transversal (linha de base de um experimento cluster que avalia o impacto da divulgação de recomendações sobre sete doenças crônicas a pacientes, cuidadores e médicos). Participaram 177 médicos de instituições de saúde públicas e privadas. Foram revisadas manualmente amostras consecutivas de seus prontuários em intervalos de tempo pré-definidos (alvo de até 20 pacientes por médico, em até duas doenças de interesse). Foram calculadas proporções de aplicabilidade e adesão para 40 recomendações. Resultados. Participaram 177 médicos (de 266 elegíveis), de 7 instituições, com 3,747 prontuários (21,093 pacientes/recomendação) analisados. A aplicabilidade geral foi de 31.9% (IC 95% 31.3%-32.6%) e variou consideravelmente por recomendação (intervalo 0.3%-100%) e doença (intervalo 10.7%-65%). A adesão geral foi de 42.0% (IC 95% 40.8%-43.2%), sendo maior na síndrome coronariana aguda (58.4%) e menor na diabetes mellitus (23.7%). Discussão. Esta é a medição mais atualizada, exaustiva e representativa da adesão às recomendações das diretrizes por médicos em Bogotá. Conclusões. A adesão às recomendações baseadas em evidências para pacientes com doenças crônicas não transmissíveis em Bogotá é fraca e altamente variável. Palavras-chave: Guia de Prática Clínica; Medicina Baseada em Evidências; Doenças não Transmissíveis; Qualidade da Assistência à Saúde; Ciência da Implementação; Medicina Interna; Atenção Primária à Saúde

ABSTRACT Introduction. Intravenous treatments are necessary in multiple situations; however, they do have complications. The vascular access guideline provides assessed and synthesized evidence to be transferred to care. The aim of this study is to describe the process of implementation of the vascular access guideline in the organizations of Euskadi Regional Host by monitoring the use of alternative catheters, early removal and the presence of complications. Methodology. Descriptive study of process. The cut-off times are 3 months pre- implementation and 6, 12, 48 months post- implantation. Descriptive and comparative analysis with Chisquare. Results. A total of 7,074 patients and 12,363 devices were evaluated; The short peripheral catheter is the most frequently used. The use of alternative catheters increased over time, showing a significant difference in the 3 months pre- implementation period with the 48-month post-implantation period (from 6.81% preimplementation to 10.58% post 48 months). The percentage of short intravenous catheters removal in les than 48 hours increased from 53.25% to 57.54% of the pre-implantation of the 48 months post-implantation. Discussion. The results obtained after the implementation of the guideline highlight the impact of the use of alternative catheters and their early removal. Further work needs to be done to reduce complications and rates of peripheral venous catheter phlebitis. Conclusions. The implementation of the good practices guidelines for vascular access care improves the results in the use of alternative catheters or the reduction in peripheral venous catheters in days. Keywords: Implementation Science; Vascular Access Devices; Practice Guideline; Evidence-Based Practice; Nursing RESUMEN Introducción. Los tratamientos endovenosos son necesarios en multitud de situaciones; sin embargo, presentan complicaciones. La guía de acceso vascular ofrece evidencia valorada y sintetizada para ser trasladada al cuidado. El objetivo del estudio es describir el proceso de implantación de la guía de acceso vascular en las organizaciones del Host Regional Euskadi monitorizando uso de catéteres alternativos, retirada precoz y presencia de complicaciones. Metodología. Estudio descriptivo de proceso. Se establecen como momentos de corte 3 meses preimplantación y 6, 12 y 48 meses postimplantación. Análisis descriptivo y de comparación con Chi cuadrado. Resultados. Se evaluaron 7,074 pacientes y 12,363 dispositivos; siendo el catéter periférico corto el de uso más frecuente. La utilización de catéteres alternativos aumentó a lo largo del tiempo, mostrando diferencias significativas en el periodo 3 meses preimplantación con el de 48 meses postimplantación (del 6.81% preimplantación al 10.58% post 48 meses). El porcentaje de catéteres venosos periféricos cortos retirados en menos de 48h aumentó del 53.25% al 57.54% de la preimplantación a los 48 meses postimplantación. Discusión. Los resultados obtenidos tras la implantación de la guía ponen de relieve el impacto de la utilización de catéteres alternativos y la retirada precoz de estos. Se ha de seguir trabajando en disminuir las complicaciones y las tasas de flebitis de catéter venosos periféricos. Conclusiones. La implantación de la guía de buenas prácticas para el cuidado del acceso vascular mejora los resultados en el uso de catéteres alternativos o la disminución en días de los c atéteres venosos periféricos. Palabras clave: Ciencia de la Implementación; Dispositivos de Acceso Vascular; Guía de Práctica Clínica; Práctica Clínica Basada en la Evidencia; Enfermería RESUMO Introdução. Os tratamentos intravenosos são necessários em muitas situações; porém, apresentam complicações. O guia de acesso vascular oferece evidências avaliadas e sintetizadas para serem transferidas para o cuidado. O objetivo do estudo é descrever o processo de implementação do guia de acesso vascular nas organizações do Host Regional Euskadi, monitorando o uso de cateteres alternativos, remoção precoce e presença de complicações. Metodologia. Estudo descritivo de processo. São estabelecidos como momentos de corte 3 meses pré-implantação, e 6, 12 e 48 meses pós-implantação. Análise descritiva e comparativa com Qui-quadrado. Resultados. Foram avaliados 7,074 pacientes e 12,363 dispositivos, sendo o cateter periférico curto o mais utilizado. O uso de cateteres alternativos aumentou ao longo do tempo, apresentando diferenças significativas no período de 3 meses pré-implantação com o de 48 meses pós-implantação (de 6.81% pré-implantação para 10.58% pós 48 meses). A porcentagem de cateteres venosos periféricos curtos removidos em menos de 48 horas aumentou de 53.25% para 57.54% desde a pré-implantação até 48 meses pós-implantação. Discussão. Os resultados obtidos após a implementação do guia destacam o impacto do uso de cateteres alternativos e sua remoção precoce. O trabalho deve continuar para reduzir complicações e taxas de flebite por cateter venoso periférico. Conclusões. A implementação do guia de boas práticas para cuidados com acesso vascular melhora os resultados no uso de cateteres alternativos ou na redução de dias de cateteres venosos periféricos. Palavras-chave: Ciência da Implementação; Dispositivos de Acesso Vascular; Guia de Prática Clínica; Prática Clínica Baseada em Evidências; Enfermagem

RESUMEN Introducción. La instauración de una ostomía digestiva tiene una importante repercusión física y emocional en las personas. El objetivo de este estudio es analizar la adherencia de las enfermeras a las buenas prácticas en el manejo de las ostomías, la disminución de complicaciones y la adquisición de destrezas de los pacientes en su propio autocuidado tras la implementación de la Guía de Buenas Prácticas de la asociación de enfermeras de Ontario. Metodología. Estudio cuasiexperimental prospectivo en una unidad de cirugía digestiva desde 2017 hasta 2022. La intervención ha consistido en la implementación de las recomendaciones de cuidados de una Guía de Buenas Prácticas, analizando variables de proceso y de resultados en la salud a lo largo del proceso. Resultados. Se han encontrado diferencias significativas (p

ABSTRACT This editorial provides healthcare professionals with critical reflection on the importance of evidence-based practice, as well as the challenges inherent in its implementation. It concludes that the successful integration of scientific evidence in clinical care requires individual and collective commitment ensuring coordinated action. The implementation of evidence-based practice guidelines serves as a catalyst. RESUMEN Esta editorial proporciona a los profesionales de la salud una reflexión crítica sobre la importancia de la práctica basada en la evidencia, así como los desafíos inherentes a su implementación. Concluye, que la integración exitosa de la evidencia científica en la atención clínica reclama un compromiso individual y colectivo asegurando una acción coordinada. La implementación de guías de práctica basada en evidencia sirve como catalizador.

Chronic renal disease constitutes a health problem due to its impact on individuals, society and economy. Taking into account the above-mentioned, and after a wide literature search, a clinical practice guide was designed in Luis Augusto Turcios Lima Polyclinic from Pinar del Río province, directed to primary health care professionals, aimed at improving the life quality of children and adolescents with this disease. It was elaborated by medicine methods based on the evidence, according to the consent and opinion of experts. It was possible to generalize this tool, give recommendations and up to date according to the new medical evidences. Finally, it was evaluated by experts as very recommended.

Introduction: This article summarizes the clinical practice guide (CPG) for management of essential arterial hypertension in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for management of essential arterial hypertension in EsSalud. Methods: A guideline development group (GDG) was formed, which included specialist physicians and methodologists, who formulated clinical questions. Systematic searches of systematic reviews were conducted and - when deemed relevant - primary studies in PubMed during 2022. Evidence was selected to answer each of the proposed clinical questions. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GDG used the GRADE methodology to review the evidence and formulate recommendations, points of good clinical practice, and flowcharts. Finally, the CPG was approved with Resolution No. 109-IETSI-ESSALUD-2022. Results: The CPG addressed 6 clinical questions regarding management. Based on these questions, 14 recommendations were formulated (7 strong and 7 conditional), 2 points of good clinical practice, and 1 flow chart. Conclusion: Evidence-based recommendations were statement for the management of patients with essential arterial hypertension. [ABSTRACT FROM AUTHOR]

Introduction: This article summarizes the clinical practice guideline (CPG) for the prevention and management of acute kidney injury in the Social Security of Peru (EsSalud). Objective: Provide clinical recommendations based on evidence for the prevention and management of acute kidney injury in EsSalud. Methods: A guideline development group (GEG) was formed that included medical specialists and methodologists. The GEG formulated 6 clinical questions to be answered by this CPG. Systematic searches of systematic reviews and -when considered relevant-primary studies were carried out in PubMed during 2022. Evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In regular work meetings, the GEG used the GRADE methodology to review the evidence and formulate the recommendations, the points of good clinical practice, and the corresponding flowcharts. Finally, the CPG was approved with Resolution No. 099-IETSI-ESSALUD-2022. Results: This CPG addressed 6 clinical questions on prevention, diagnosis and management (fluid therapy). Based on these questions, 5 recommendations (3 strong and 2 conditional), 2 BPCs, and 2 flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the prevention and management of acute kidney injury in EsSalud. [ABSTRACT FROM AUTHOR]

Chronic heart failure continues to be one of the main causes of impairment in the functioning and quality of life of people who suffer from it, as well as one of the main causes of mortality in our country and around the world. Mexico has a high prevalence of risk factors for developing heart failure, such as high blood pressure, diabetes, and obesity, which makes it essential to have an evidence-based document that provides recommendations to health professionals involved in the diagnosis and treatment of these patients. This document establishes the clinical practice guide (CPG) prepared at the initiative of the Mexican Society of Cardiology (SMC) in collaboration with the Iberic American Agency for the Development and Evaluation of Health Technologies, with the purpose of establishing recommendations based on the best available evidence and agreed upon by an interdisciplinary group of experts. This document complies with international quality standards, such as those described by the US Institute of Medicine (IOM), the National Institute of Clinical Excellence (NICE), the Intercollegiate Network for Scottish Guideline Development (SIGN) and the Guidelines International Network (G-I-N). The Guideline Development Group was integrated in a multi-collaborative and interdisciplinary manner with the support of methodologists with experience in systematic literature reviews and the development of CPG. A modified Delphi panel methodology was developed and conducted to achieve an adequate level of consensus in each of the recommendations contained in this CPG. We hope that this document contributes to better clinical decision making and becomes a reference point for clinicians who manage patients with chronic heart failure in all their clinical stages and in this way, we improve the quality of clinical care, improve their quality of life and reducing its complications. [ABSTRACT FROM AUTHOR]

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Foundation: Asthma is a chronic inflammatory disease with a high prevalence in South America, which requires proper diagnosis, optimal management and prevention measures supported by constantly updated scientific evidence. Objective: to carry out a comparative analysis between the Global Initiative for Asthma and the South American guidelines for the diagnosis, management and prevention of asthma in pediatric patients. Methods: descriptive observational study that compares the 2023 Global Initiative for Asthma guideline with national guidelines from the South American countries Colombia, Argentina, Chile, Uruguay, Venezuela and Peru, in the following parameters: diagnostic recommendations, management recommendations and prevention strategies. Results: differences were found in prevention and education recommendations in the guides analyzed, while the Global Initiative for Asthma and some South American guides mention prevention measures, other guides do not mention them or have limited information in this regard. In auxiliary tests, all guidelines mention performing spirometry to evaluate lung function, but there are differences with the inclusion of other tests, such as the allergy test or the measurement of exhaled nitric oxide. Conclusions: Greater standardization and updating of South American guidelines is required to guarantee adequate and consistent management of asthma in the region. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension is a group of entities whose most severe form is represented by pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension. Patient survival is reduced without treatment, so early diagnosis and treatment should be the primary objective. The Instituto Mexicano del Seguro Social participates in this fight to improve the care of these patients, since it has doctors with knowledge in the entity and even a department of Pulmonary Hypertension and Right Heart from where a successful, viable and versatile structure proposal has been made. Time has shown that this may not be enough and that, due to the size of the national territory for effective medical coverage, the time for care may be prolonged. For this reason, other similar departments would be required within the highly specialize. [ABSTRACT FROM AUTHOR]

Introducción: un tercio de los pacientes con psoriasis comienzan con sus síntomas en la niñez y la adolescencia, con fuerte impacto emocional y psicosocial. Objetivo: elaborar una guía de tratamiento sistémico de la psoriasis en pacientes pediátricos mediante recomendaciones fundamentadas en la mejor evidencia disponible. Materiales y métodos: Fuentes: artículos indexados en PubMed, Epistemonikos, Google Académico, Cochrane Library y Scielo, publicados entre enero de 2010 y mayo de 2022, en inglés, castellano y portugués. Selección de estudios: se consideraron guías de práctica clínica basadas en la evidencia, revisiones sistemáticas, metanálisis, estudios controlados y aleatorizados, estudios observacionales (casos y controles, estudios de cohortes, registros de la vida real) y evaluaciones de medicamentos biosimilares en pacientes de hasta 17 años de edad inclusive. Se utilizaron las palabras clave “psoriasis” y “tratamiento” en los tres idiomas. Extracción de datos: la bibliografía fue evaluada mediante las recomendaciones del sistema Grading of Recommendations Assessment, Development and Evaluation (GRADE). Síntesis de datos: elaboración de tablas de evidencia que fueron analizadas por el comité de expertos. Las preguntas para el desarrollo de recomendaciones se fundamentaron en el sistema PICO (población, intervención, comparación, outcome [desenlace]). Resultados: se elaboraron un total de 8 recomendaciones y 7 puntos de buena práctica. La dirección y fuerza de las recomendaciones se expresaron de acuerdo con lo sugerido por el sistema GRADE. Conclusiones: la decisión final de una terapia específica se fundamentará en la mejor opinión del médico tratante, las características individuales, y los valores y preferencias de los pacientes y sus cuidadores.

Introduction: This article summarizes the clinical practice guideline (CPG) for the treatment of metastatic hormone-sensitive prostate cancer in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for the treatment of adults with hormone-sensitive metastatic adenocarcinoma of the prostate with de novo or recurrent presentation and high or low metastatic volume in EsSalud. Methods: A guideline development group (GDG) was formed, which included specialist physicians and methodologists, who formulated clinical questions. Systematic searches were conducted for systematic reviews and - when deemed relevant - primary studies in PubMed during 2022. Evidence was selected to answer each of the clinical questions posed. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GEG used the GRADE methodology to review the evidence and formulate recommendations. The CPG was reviewed by external experts before its approval. Results: The CPG addressed 6 clinical questions, divided into 2 main topics: considerations on androgen deprivation therapy (ADT) and ADT combined with other therapies. Based on these questions, 10 recommendations were formulated (4 strong and 6 conditional), and 6 points of good clinical practice. Conclusion: Evidence-based recommendations were issued for the management of patients with this pathology. [ABSTRACT FROM AUTHOR]

Introduction: This article summarizes the clinical practice guideline (CPG) for the management of enteral nutrition in premature newborns with very low birth weight in the Social Security of Peru (EsSalud). Objective: Provide evidence-based clinical recommendations for the management of premature newborns with very low birth weight in EsSalud. Methods: A guideline development group (GDG) was formed that included medical specialists and methodologists. The GDG formulated 5 clinical questions to be answered by this CPG. Systematic searches were carried out for systematic reviews and - when considered relevant - primary studies in Medline and CENTRAL during 2021. The evidence was selected to answer each of the clinical questions posed. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic working meetings, the GDG used the GRADE methodology to review the evidence and formulate recommendations, good clinical practice points, and the management flowchart. Finally, the CPG was approved with Resolution No. 071-IETSI-ESSALUD-2022. Results: This CPG addressed 5 clinical questions, all referring to the management of enteral nutrition in premature newborns with very low birth weight. Based on these questions, 5 recommendations were formulated (1 strong recommendation and 4 conditional recommendations), 5 GCP, and 1 flow chart. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of enteral nutrition in premature newborns with very low birth weight in EsSalud. [ABSTRACT FROM AUTHOR]

Copyright of Revista Facultad de Medicina de la Universidad Nacional de Colombia is the property of Universidad Nacional de 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.)

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte 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.)

The article describes a descriptive process study that evaluates the implementation of the good practices guide for vascular access in the Regional Host Euskadi of Osakidetza-Basque Health Service. The results show an increase in the use of alternative catheters and in the early removal of short peripheral venous catheters. It is concluded that the implementation of the guide improves the results in the use of alternative catheters and the decrease in days of peripheral venous catheters. The study evaluates the results of the implementation of the clinical practice guide for vascular access in the organizations of the Regional Host Euskadi. An increase in the use of alternative catheters to peripheral venous catheters and a decrease in the days of use of central venous catheters are observed. However, conclusive results have not been obtained in reducing complications of vascular access devices. [Extracted from the article]

The article reports on a study conducted on doctors in Bogota to evaluate adherence to evidence-based recommendations for non-communicable chronic diseases (NCDs). The results showed that the overall applicability was 31.9% and the overall adherence was 42.0%. Considerable variability in adherence was found depending on the disease. In conclusion, adherence to recommendations for NCDs in Bogota is deficient and highly variable. [Extracted from the article]

La enfermedad renal crónica constituye un problema de salud debido su impacto sobre los individuos, la sociedad y la economía. Se propone una guía de práctica clínica para atención de la enfermedad renal crónica en la Atención Primaria de Salud. Se realizó una investigación clínica epidemiológica entre los años 2017-2019, en el Policlínico Luis Augusto Turcios Lima, del municipio de Pinar del Río. La guía fue elaborada siguiendo criterios de la medicina basada en la evidencia, por consenso y por opinión de expertos. La evaluación de calidad se realizó con el Instrumento Appraisal of Guidelines, Research and Evaluation for Europe. Se elaboraron recomendaciones, se generalizó y actualizó permanentemente con las nuevas evidencias médicas. Se sistematizaron las prácticas preventivas y de detección precoz de la enfermedad. La guía propuesta provee a los profesionales que laboran en la Atención Primaria de Salud, las herramientas apropiadas para la detección y manejo de la enfermedad renal crónica; además de facilitar la coordinación entre los ámbitos de los niveles primario y secundario de Salud. Se concluye que permite mejorar la atención de los pacientes con esta enfermedad, particularmente en la Atención Primaria de Salud.

Objective: As part of the development of a clinical practice guideline (CPG) for the care of individuals with low vision in Colombia, it is recommended to include patient involvement. The objective was to identify aspects of daily life most affected by low vision, which should be addressed in a vision rehabilitation process, and to recognize barriers to accessing that process. Additionally, the aim was to assess the importance of outcomes for patients and their caregivers. Methodology: Patients with low vision and their family members were invited to participate in a focus group that explored their perceptions regarding the most affected aspects of low vision, the key elements of vision rehabilitation processes, and the most common barriers they face. Results: Difficulties were reported in performing instrumental activities such as computer or cellphone use, using public transportation, handling money, shopping, mobility, and orientation. Successful vision rehabilitation was defined as the ability to recover independence and gain self-confidence. Rehabilitation interventions that improve orientation and mobility skills, include psychological support for patients and their families, and incorporate group approaches were highly valued. Administrative barriers were the most frequently mentioned. Conclusion: These results supported the decision-making process in the development of recommendations for the CPG for individuals with low vision in Colombia. [ABSTRACT FROM AUTHOR]

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Introducción: La enseñanza en enfermería debe transitar desde una perspectiva tradicionalista, centrada en el docente, a un enfoque que esté centrado al estudiante. Esto último promueve el aprendizaje autónomo, donde el docente actúa como mediador, no como fuente de conocimiento. Objetivo: Identificar la necesidad de usar guías y videos de simulación clínica para el aprendizaje autónomo de estudiantes de enfermería de la Universidad de Cundinamarca. Materiales y Métodos: Investigación bajo el paradigma positivista, de diseño descriptivo, con enfoque cuantitativo, de corte transversal, durante el primer trimestre de 2020. Población 376. Se realizó un muestreo intencional no probabilístico, conformado por 95 estudiantes de enfermería. Los datos se obtuvieron mediante una encuesta autoadministrada y anónima. Se realizó una evaluación descriptiva de los datos. Resultados: El 75 % de los estudiantes demostró un nivel alto de necesidad de usar guías y videos para su aprendizaje autónomo, consideran un mayor grado de seguridad y claridad al realizar procedimientos en las prácticas simuladas, 62 % aseguró que es una herramienta pertinente para el aprendizaje de enfermería. Conclusiones: Se demostró alta necesidad de guías y videos de simulación clínica para el aprendizaje autónomo en estudiantes de enfermería. Estos recursos fomentan la motivación, seguridad y habilidades para el cuidado, reduciendo riesgos en prácticas clínicas. La actualización periódica es crucial para garantizar su utilidad e innovación.

Introducción. La hipertensión arterial es una de las enfermedades crónicas no transmisibles más prevalentes; es causa de enfermedad cardiovascular y la primera causa de muerte atribuible en la Región de las Américas. Objetivos. Sintetizar las recomendaciones desarrolladas por la Organización Mundial de la Salud (OMS) con el fin de mejorar la calidad del cuidado y los desenlaces en salud de las personas adultas con hipertensión arterial y abordar aspectos sobre su implementación. Métodos. Se llevó a cabo una síntesis de las recomendaciones consignadas en las Directrices para el tratamiento farmacológico de la hipertensión en adultos, una guía publicada por la OMS. Adicionalmente, se realizó una búsqueda sistemática en PubMed, Lilacs, Health Systems Evidence, Epistemonikos y literatura gris de estudios desarrollados en las Américas con el fin de identificar barreras, facilitadores y estrategias de implementación, así como indicadores. Resultados. Se formularon diez recomendaciones aplicables a personas adultas con hipertensión arterial. Se identificaron barreras, facilitadores y estrategias de implementación y se crearon indicadores de adherencia terapéutica y resultado. Conclusiones. Las recomendaciones formuladas buscan proveer orientación sobre cómo enfocar el tratamiento farmacológico de la hipertensión en personas adultas, excepto en mujeres embarazadas, así como consideraciones para su implementación en América Latina y el Caribe.

The implementation of Clinical Practice Guidelines, with effective evidence-based interventions, has improved the results of managing patients with ST-segment elevation acute myocardial infarction in high-income countries, however, the same is not true in countries with medium and low incomes, where there are large gaps in its implementation, due to multiple factors. This Clinical Practice Guideline refers to patients presenting with ischemic symptoms or their equivalents and persistent ST-segment elevation on the electrocardiogram. This guideline does not address elements directly related to percutaneous coronary intervention procedures or surgical myocardial revascularization.

Objetivo. Proporcionar recomendaciones para la detección temprana de pacientes con alto riesgo de desarrollar cáncer de pulmón (CP) en el primer nivel de atención y su referencia oportuna. Material y métodos. Se realizó una búsqueda detallada de la evidencia científica disponible para responder las preguntas de investigación clínica y se utilizó el Panel Delphi modificado para lograr un consenso entre expertos. Resultados. Se generaron 14 recomendaciones siguiendo los estándares de una GPC. Conclusión. El CP representa un problema de salud pública en México; por ello, esta guía establece recomendaciones que apoyan la toma de decisiones sobre la detección precoz y la referencia de pacientes con sospecha de CP en el primer nivel de atención.

Introduction: Practical guidelines for head and neck cancer care currently address the functional preservation of some organs within oncospecific treatment. Objectives: To evaluate clinical practice guidelines and how they address the preservation of the submandibular gland in neck dissection. Methods: A quantitative, descriptive and cross-sectional research was carried out to evaluate six guidelines for head and neck cancer care, in terms of their methodological quality and the preservation of the submandibular gland in neck dissection. The Appraisal of Guidelines Research and Evaluation instrument was used, a team was composed by four evaluators who gave their consent and were trained to use such instrument. For the analysis of the information, the Statistical Package for Social Sciences version 21 was used and the quality score for each domain and the intraclass correlation coefficient were calculated. Results: The highest quality score corresponded to domains 1, 4 and 6. The guide with the highest quality score was that of the European Society of Medical Oncology reporting an average of 94.3%, while that of the Chinese Society of Clinical Oncology obtained the lowest value (71.5%). Three guidelines had the highest quality score (7) in the global evaluation. The highest strength of agreement between the evaluators corresponded to the guideline of the American Society of Clinical Oncology (1) and the lowest to that of the National Institute of Oncology and Radiobiology (0.93). Conclusions: The head and neck cancer clinical practice guidelines evaluated presented high methodological quality and the preservation of the submandibular gland in neck dissection was not addressed in any of them.

Objective: The objective of this research is to describe adherence to the neonatal sepsis clinical practice guideline according to the type of sepsis in a perinatal maternal institute in Lima, Peru. Method: A descriptive study was carried out between the months of June to December 2021 at the Instituto Nacional Maternal Perinatal (INMP). The adherence of care to the CPG for the prevention, diagnosis and treatment of neonatal sepsis based on the INMP evidence was evaluated. Medical care was evaluated by two physicians who reviewed compliance or not with the 16 CPG recommendations. Adequate adherence was considered to be compliance of 80% or more of the recommendations established by the guideline in one care. Global adherence was calculated in percentages, by dimensions, by item and according to maternal and perinatal characteristics of care. Results: A total of 968 medical attentions were evaluated, of which 553 were early neonatal sepsis cases and 435 late. For early sepsis, an adherence of 84.4% was found, while for late sepsis, 66.8% was found. The lowest percentage of adherence was found in recommendations 2.7 and 3.2 of late sepsis care. Conclusions: An adequate adherence was found in early neonatal sepsis care, while, in relation to late neonatal sepsis, an adequate level of adherence was not reached. [ABSTRACT FROM AUTHOR]

Introduction: the process of medical care for patients with complex haemorrhagic trauma in the province of Sancti Spíritus shows insufficiencies in the uniformity of the use of the clinical method in a structured way based on the diagnosis and treatment of these patients. Objective: to design a Clinical Practice Guide for in-hospital emergency medical care for patients with complex haemorrhagic trauma. Methods: an investigation was carried out that corresponds to the type of researchdevelopment, multistage, with a mixed approach, in the province of Sancti Spíritus from 2012 to 2019. Results: methodological insufficiencies were detected in the medical care process of patients with haemorrhagic complex trauma. A clinical practice guide was prepared and executed that allowed the structuring of theoretical, clinical and investigative elements to evaluate this type of patients. Conclusions: the clinical practice guideline proved to be relevant, feasible and effective; it made possible a first approach to Cuban patients with complex haemorrhagic trauma and allowed raising the level of knowledge of doctors about this condition. [ABSTRACT FROM AUTHOR]

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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 Gastroenterología del Perú is the property of Sociedad de Gastroenterologia 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 Revista Habanera de Ciencias Médicas is the property of Universidad de Ciencias Medicas de La Habana 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.)

Las enfermedades cardiovasculares son la principal causa de muerte en la Región de las Américas y la hipertensión es la causa de más del 50% de ellas. En la Región, más de una cuarta parte de las mujeres adultas y cuatro de cada diez hombres adultos tienen hipertensión y su diagnóstico, tratamiento y control son deficientes. En el 2021, la Organización Mundial de la Salud (OMS) publicó directrices actualizadas sobre el tratamiento farmacológico de la hipertensión en personas adultas. En este artículo se destaca el papel facilitador de la iniciativa mundial HEARTS de la OMS y la iniciativa HEARTS en las Américas para catalizar la implementación de estas directrices, a la vez que se proporciona asesoramiento específico sobre políticas para dicha implementación y se destaca la necesidad de adoptar un enfoque estratégico general para el control de la hipertensión. Los autores instan a quienes abogan por la salud y a los responsables de las políticas a priorizar la prevención y el control de la hipertensión para mejorar la salud y el bienestar de la población, y a reducir las disparidades de salud en relación con las enfermedades cardiovasculares dentro de la población y entre las poblaciones de la Región de las Américas.

Inspirada en la labor de la enfermería en la historia de la humanidad, y entregada como obsequio para el programa de Enfermería de la Universidad Autónoma de Bucaramanga (UNAB) en la celebración de sus 15 años, la obra muestra una enfermera con indumentaria que evoca las voluntarias francocanadienses de la Primera Guerra Mundial, con algunos rasgos fenotípicos de mujer latina en combinación anacrónica con la torre (UNAB), símbolo institucional de fondo. La guerra y el conflicto armado son situaciones presentes desde el inicio de la humanidad. En una guerra todos pierden y el único triunfo lo representan las vidas que se salvan. Las enfermeras en el mundo han sido determinantes para la derrota del coloso devorador de vidas que se alimenta de la codicia sempiterna y hegemónica promotora de la violencia política de los pueblos. Inspired by the work of nursing in the history of humanity, and given as a gift for the Nursing Program of the Autonomous University of Bucaramanga (UNAB) in the celebration of its 15th anniversary. The work exhibits a nurse in clothing that evokes the Franco-Canadian volunteers of the First World War, with some phenotypical features of a Latin woman in anachronistic combination with the tower (UNAB), an institutional symbol in the background. War and armed conflict are present situations since the beginning of humanity. In a war everyone loses and the only triumph is represented by the lives that are saved. Nurses in the world have been decisive for the defeat of the life-devouring colossus that feeds on the eternal greed and hegemonic promoter of the political violence of the peoples.

Objetivos: proveer recomendaciones clínicas basadas en evidencia para la prevención y el manejo de la enfermedad hipertensiva del embarazo EHE en EsSalud. Materiales y métodos: se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos. El GEG formuló ocho preguntas clínicas para ser respondidas por la presente Guía de Práctica Clínica (GPC). Se realizaron búsquedas sistemáticas de revisiones sistemáticas y, cuando se consideró pertinente, estudios primarios en PubMed y Central durante 2021. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. La certeza de la evidencia fue evaluada usando la metodología. En reuniones de trabajo periódicas, el GEG usó la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE) para calificar la evidencia y formular las recomendaciones. Además se resentan los puntos de buenas prácticas clínicas (BPC) y los flujogramas de prevención, manejo y seguimiento. Finalmente, la GPC fue aprobada por Resolución 112-IETSI-ESSALUD-2021. Resultados: en la presente GPC se formularon 11 recomendaciones (6 fuertes y 5 condicionales) que respondieron las preguntas clínicas definidas en el alcance de la GPC, acompañadas de 32 BPC y 3 flujogramas que abordan temas de prevención tratamiento y seguimiento de la EHE Conclusiones: como recomendaciones centrales de la guía se dan el uso de sulfato de magnesio para el tratamiento de la preeclampsia severa y la eclampsia. La guía deberá ser actualizada en tres años.

Introduction: This article summarizes the clinical practice guideline (CPG) for the management of stage 3b, 4, and 5 chronic kidney disease (CKD) in the Social Security of Peru (EsSalud). Objective: To provide evidence-based clinical recommendations for the management of stage 3b, 4, and 5 CKD in EsSalud. Methods: A guideline development group (GDG) was formed, including specialists and methodologists. The GDG formulated 9 clinical questions. Systematic searches for systematic reviews and primary studies were conducted in PubMed from December 2020 to August 2021. Evidence was selected to answer the clinical questions posed. The certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The GDG used the GRADE methodology to review the evidence and formulate recommendations, points of good clinical practice (GPC), and management flowcharts. Finally, the CPG was approved with Resolution No. 88-IETSIESSALUD-2021. Results: This CPG addressed 9 clinical questions. Based on these questions, 17 recommendations (7 strong and 10 conditional), 28 GPC points, and 4 management flowcharts were formulated. Conclusion: This article summarizes the methodology and evidence-based conclusions of the CPG for the management of stage 3b, 4, and 5 CKD in EsSalud. [ABSTRACT FROM AUTHOR]

Objective: To synthesize and critically assess the recommendations on neurocognitive management of patients with congenital heart disease presented in clinical practice guidelines and scientific statements. Method: A systematic review of practice recommendations (PROSPERO CRD42020205202). PubMed, SCOPUS, Ovid/Cochrane, and LILACS were searched, and repositories of scientific societies and references of included documents were reviewed. Critical appraisal was performed using the AGREE-II (ideal scenario) for the guidelines and statements, and recommendations were assessed using the AGREE-REX (ideal and local scenarios). A matrix of recommendations and analysis of potential barriers for its implementation in Colombia is presented. Results: Eighteen related recommendations were included. The average AGREE-II was 89.6. The average AGREE-REX was 90.1 in the ideal setting and 69.9 in the local setting. The included recommendations focus on surveillance, screening, evaluation, and counseling; no recommendations on neurocognitive intervention were identified. The main implementation barriers in Colombia are the unwillingness to pay on the part of the health system and the absence of a comprehensive health care offer for neurocognitive management in congenital heart disease. Conclusion: The identified recommendations could be adapted into a Colombian practice guideline, making modifications that recognize the local context. [ABSTRACT FROM AUTHOR]

In Central America, childhood cancer is one of the leading causes of death. It is also a significant disease burden to health systems, with social and economic implications for families. The World Health Organization (WHO), the Executive Secretary of the Council of Ministers of Health of Central America and the Dominican Republic (SE-COMISCA), the Pan American Health Organization (PAHO), and St Jude Children's Research Hospital are working collaboratively to strengthen the health system's response to childhood cancer in Central America and the Dominican Republic. This collaboration's primary objective is to support the development of national pediatric cancer plans for each country in the subregion and improve overall survival rates and quality of care for children with cancer through a more comprehensive universal health coverage package. This collaborative effort has led to: (i) the development of childhood cancer national action plans; (ii) the launch of awareness and promotion campaigns; (iii) the design of childhood cancer educational material for children and their families; and (iv) a platform for professionals working in childhood cancer to share good practices and successful experiences. The countries of the subregion together with PAHO and St Jude Children's Research Hospital are working to develop standardized evidence-based clinical practice guidelines on childhood cancer for the region. This brief communication reports on this collaborative work. [ABSTRACT FROM AUTHOR]