ABSTRACT
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Introduction: Pediatric ulcerative colitis (CUP), pediatric Crohn's disease (PCD), and pediatric inflammatory bowel disease not classifiable (PIDNCID) have clinical and psychosocial particularities that differentiate them from those of adults and may condition different therapeutic approaches due to possible nutritional, growth and developmental repercussions, representing a challenge for the pediatrician and gastroenterologist. Objective: Develop expert consensus evidence-based recommendations for the timely and safe diagnosis and treatment of Pediatric Inflammatory Bowel Disease (PID) in children under 18 years of age for professionals caring for these patients and healthcare payers. Methodology: Through a panel of experts from the Colombian College of Pediatric Gastroenterology, Hepatology and Nutrition (COLGAHNP) and a multidisciplinary group, 35 questions were asked regarding the clinical picture, diagnosis, and treatment of PID. Through a critical review and analysis of the literature with particular emphasis on the main clinical practice guidelines (CPGs), randomized clinical trials (RCTs), and meta-analyses of the last ten years, from which the experts made 77 recommendations that responded to each of the research questions with their respective practical points. Subsequently, each of the statements was voted on within the developer group, including the statements that achieved > 80%. Results: All statements scored > 80%. PID has greater extension, severity, and evolution towards stenosis, perianal disease, extraintestinal manifestations, and growth retardation compared to adult patients, so its management should be performed by multidisciplinary groups led by pediatric gastroenterologists and prepare them for a transition to adulthood. Porto's criteria allow a practical classification of PID. In CPE, we should use the Paris classification and perform ileocolonoscopy and esophagogastroduodenoscopy, since 50% have upper involvement, using the SES-CD (UCEIS/Mayo in CUP) and taking multiple biopsies. Initial labs should include inflammatory markers and fecal calprotectin and rule out intestinal infections. Treatment, induction, and maintenance of PID should be individualized and decided according to risk stratification. Follow-up should use PCDAI and PUCAI for the last 48 hours. Immunologists and geneticists should evaluate patients with early and infantile PID. Conclusion: A consensus guideline is provided with evidence-based recommendations on timely and safe diagnosis and treatments in patients with ILD.
ABSTRACT
Introducción: la fármaco-dependencia en el adulto mayor se ha convertido en objeto de atención prioritario de justificado interés. La calidad de la atención geriátrica en Cuba constituye una realidad impostergable. Objetivo: evaluar la calidad de la atención de enfermería brindada a adultos mayores Fármaco-dependientes. Método: investigación evaluativa, descriptiva de corte transversal en el Policlínico 30 de Noviembre durante 2013. Universo constituido por 17 enfermeras de los consultorios de un grupo básico de trabajo vinculadas a la asistencia y 112 adultos mayores fármaco-dependientes; de ellos, 75 seleccionados por muestreo aleatorio simple. Se evaluaron los datos de estructura, proceso y resultado, los cuales fueron procesados con frecuencias absolutas y el porcentaje. Resultados: la estructura resultó adecuada con un 77, 9 por ciento, el proceso con un 70,5 por ciento y el resultado con 71,4 por ciento. Conclusiones: la calidad de la atención al adulto mayor fármaco-dependiente fue adecuada, lo que demuestra que se mantiene la calidad del desempeño profesional y satisfacción por parte de los gerentes, así como disminuida la fármaco-dependencia en la tercera edad(AU)
Introduction: Pharmacy depends at older adults had become on the actual interest justify priority attention. In Cuba quality at the geriatric attention is an unpostpone reality. Objective: To evaluate the nurse attention given to pharmacy depend older adults. Methods: Has used evaluated investigation and descriptive transversal cut at 30 of November polyclinic during 2013. The universe was formed by 17 nurses at the consulted house of a basic work group which are involved at the assistance and 112 pharmacies depends older adults whose 75 older adults belongs to a random selected group. Data of structure, process and results was evaluated and processing by computer methods, using like a resume guide the absolute numbers and percentile numbers. Results: Has concluded the structure was adequate at 77.9 percent, process was adequate at 70.5 percent and the result was adequate at 71.4 percent. Conclusions: Has concluded that quality attention at pharmacy depends older adults was adequate, showing that if the professional performance quality and the gerents satisfaction continue, the pharmacy depend at 3er age goes down(AU)
Subject(s)
Humans , Aged , Quality Assurance, Health Care/methods , Drug Users/psychology , Nursing Care/methods , Physicians' Offices , Cross-Sectional StudiesABSTRACT
Se realizó una intervención educativa sobre aspectos relacionados con la alimentación, dirigida a 25 madres de lactantes que pertenecían a un consultorio médico del Policlínico Universitario 30 de Noviembre de Santiago de Cuba, desde junio de 2008 hasta octubre de 2009, para lo cual se desarrolló un programa de clases durante 3 meses. Los encuentros sistemáticos garantizaron modificar positivamente los conocimientos de la mayoría de las progenitoras sobre la adecuada selección de los componentes de su dieta para alimentar y nutrir a sus neonatos a través de la lactancia materna. Se recomendó efectuar a largo plazo una investigación para evaluar el impacto de ese adiestramiento en el crecimiento y desarrollo de sus hijos.
An educational intervention on aspects related to nourishment addressed to 25 infant mothers belonging to a doctor's office at 30 de noviembre University Polyclinic in Santiago de Cuba was carried out from June, 2008 to October, 2009, in which case a class program was performed during 3 months. Systematic encounters guaranteed the positive modification to knowledge of most mothers about the appropriate selection of their diet components to feed and nourish their neonates through breastfeeding. It was recommended to perform a long-term research to assess the impact of that training for the growth and development of their children.
Subject(s)
Humans , Male , Female , Breast Feeding , Diet , Health Knowledge, Attitudes, Practice , Maternal Nutrition , Primary Health CareABSTRACT
O objetivo desse estudo foi verificar o papel do exercício aeróbio no controle glicêmico em diabéticos freqüentadores do Programa Pé-Diabético no Hospital Regional de Taguatinga, DF. Trata-se de um programa referência Nacional e Internacional. A amostra de conveniência foi constituída por 30 diabéticos (tipo 2), sendo 20 mulheres e 10 homens (50 a 60 anos). A glicemia foi aferida por glicosímetro portátil (modelo Advantage, Brasil). As analises estatísticas foram realizadas por ANOVA Two Way para amostras independentes, com nível de significância p ≤ 0,05, e analisados no programa Microcal Origin, versão 8.0. Valores glicêmicos no pré-teste para homens (500 ± 180 mg/dL-1) e mulheres (467 ± 290 mg/dL-1) não diferiram estatisticamente entre grupos. Por outro lado, os resultados no pós-teste revelaram que os grupos reduziram significativamente (p ≤ 0,05) as médias glicêmicas comparados ao pré-teste. Conclui-se que o exercício aeróbio associado à alimentação saudável pode contribuir com o controle glicêmico de diabéticos.
The aim of this study was to evaluate the influence of aerobic exercise on glycemic control in diabetics attend the program at the Diabetic Foot-Hospital Regional Taguatinga, DF. This is a program National and International reference. The sample of convenience was formed by 30 patients (type 1 and 2), 20 women and 10 men (50 to 60 years). The statistics analyzed by Two Way ANOVA for independent samples with significance set at p ≤ 0.05, and analyzed in Microcal Origin program, version 8.0. A glucose was measured by portable glucometer (model Advantage, Brazil). Glucose values in the pre-test for men (500 ± 180 mg/dL-1) and women (467 ± 290 mg/dL-1) did not differ among groups. Furthermore, the post-test results showed that the groups decreased significantly (p ≤ 0.05) mean glucose compared to pre-test. It is concluded that exercise aerobic associated with healthy eating can help with glycemic control in diabetics.
Subject(s)
Humans , Male , Female , Middle Aged , Blood Glucose , Diabetes Mellitus , Exercise , Glycemic Index , Men , Women , Diet , Motor ActivityABSTRACT
Objetivos Revisar los aspectos históricos del trastorno esquizoafectivo, así como la importancia del abordaje, teniendo en cuenta la personalidad. Métodos. Revisión de la literatura. Se presenta una revisión literaria centrada en los aspectos históricos y la polémica que ha existido acerca del trastorno esquizoafectivo como una entidad independiente dentro de la nosografía. Se revisa también la importancia del estudio de la dimensión de la personalidad en el diagnóstico y el manejo de este trastorno. Conclusiones La comprensión del trastorno esquizoafectivo requiere de un abordaje multidimensional, con especial interés en los rasgos de personalidad.