ABSTRACT
Los ensayos controlados y aleatorizados y la investigación en general deberían correlacionarse mejor con las necesidades de salud de los niños a nivel mundial.
Subject(s)
Humans , Male , Female , Child , Randomized Controlled Trials as Topic/methods , Randomized Controlled Trials as Topic/trends , Randomized Controlled Trials as Topic , Randomized Controlled Trials as Topic/ethics , Pediatrics/instrumentation , Child HealthABSTRACT
A revista Femina vem utilizando os graus de recomendações e força de evidência da Associação Médica Brasileira (AMB)1 para classificar as referências bibliográficas contidas no texto de seus artigos com o objetivo de dar ao leitor o verdadeiro valor atribuído a cada intervenção utilizada nas investigações
Subject(s)
Consensus , Randomized Controlled Trials as Topic/methods , Randomized Controlled Trials as Topic/trends , Meta-Analysis as Topic , Evidence-Based Medicine/methods , Observational Studies as TopicABSTRACT
O papel específico das modificações da dieta no tratamento da nefropatia diabética (ND) ainda não está elucidado. A substituição de proteína de origem animal por soja em pacientes com Diabete Melito (DM) poderia ser benéfica para a função renal. O objetivo do presente manuscrito foi revisar criticamente as evidências acerca do papel da soja na ND. Foram selecionados seis ensaios clínicos randomizados conduzidos em pacientes com DM, dentre os quais cinco demonstraram melhora de pelo menos um marcador de função renal com a dieta com soja. Os mecanismos através dos quais essas dietas promoveriam melhora da ND não foram elucidados, assim como não está estabelecido ainda se há distinção no efeito benéfico aos rins dos diferentes produtos à base de soja disponíveis no mercado. Novos estudos são necessários para que tais questões possam ser elucidadas e para que os benefícios da soja na ND possam ser confirmados.
The specific role of dietary changes in the treatment of diabetic nephropathy (DN) has not yet been elucidated. The animal source protein replacement for soy in patients with Diabetes Mellitus (DM) may provide potential benefits for renal function. The aim of the present manuscript was to perform a critical review of evidence about the role of soy in DN. Six randomized clinical trials conducted in patients with DM were selected, and five of them showed improvement of at least one marker of renal function with the soy diet. However, the mechanisms by which these diets promote improvement in DN have not been elucidated. It is not yet known whether there are distinguishable renal benefits ensured by different soy-based products available on the market. Further studies are needed to clarify theses aspects and to confirm the benefits of soy in DN.
Subject(s)
Humans , Male , Female , Diet/methods , Diet/trends , Diet , Diabetic Nephropathies/complications , Diabetic Nephropathies/diagnosis , Diabetic Nephropathies/epidemiology , Diabetic Nephropathies/pathology , Diabetic Nephropathies/therapy , Renal Insufficiency, Chronic , Soy Foods , Diabetes Mellitus , Randomized Controlled Trials as Topic/statistics & numerical data , Randomized Controlled Trials as Topic/standards , Randomized Controlled Trials as Topic/trends , Randomized Controlled Trials as Topic , Soybean Proteins/antagonists & inhibitors , Soybean Proteins , Soybean Proteins/therapeutic use , Plant Proteins, DietaryABSTRACT
The need to improve the quality of health care and to contain its costs has become mandatory. Simultaneously we are confronted by a growing body of clinical information, most of it irrelevant. This paper discribes the origin and methods of Evidence-Based Madicine, a new alternative to the usual ways of medical information. The recent development of computarized data bases in permitting the rapid location of relevant clinical information concerning specific questions on diagnosis, therapy or prognosis. Critical analysis is then used to determine the validity of the evidence obtained, which can be employed in clinical decision making. The future role of Evidence-Based Medicine in education and clinical practice seems highly promissory