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2.
Rev. colomb. cir ; 36(4): 582-598, 20210000. tab
Article in Spanish | LILACS | ID: biblio-1291151

ABSTRACT

Frente a los desafíos de la Educación Basada en Competencia, este consenso Delphi de la División de Educación de la Asociación Colombiana de Cirugía informa sobre las mínimas competencias profesionales esperadas del cirujano egresado de los veinte programas de Especialización en Cirugía General en Colombia. Un total de 105 profesores de los programas de especialización evaluaron tres áreas de competencia profesional: 1) atributos profesionales generales del residente durante su formación, 2) competencias prácticas (procedimientos quirúrgicos) que los residentes deben realizar al final de su entrenamiento y 3) Actividades Profesionales Confiables (APC) que los residentes deben ejecutar sin supervisión al final de su entrenamiento. Los resultados informan un alto nivel de consenso en el 100 % los atributos profesionales generales y APC, y del 75 % en diferentes procedimientos quirúrgicos. El consenso abre la puerta para el desarrollo de un currículo nacional de la especialidad y tiene implicaciones para la práctica educativa e investigación futura


Faced with the challenges of Competence-Based Education, this Delphi consensus from the Education Division of the Colombian Association of Surgery reports on the minimum professional competencies expected of the surgeon who graduated from the twenty residency programs in General Surgery in Colombia. A total of 105 professors from the training programs evaluated three areas of professional competence: 1) general professional attributes of the resident during their training, 2) practical skills (surgical procedures) that residents must perform at the end of their training, and 3) Activities Trusted Professionals (APC) that residents must run unsupervised at the end of their training. The results report a high level of consensus in 100% general professional attributes and APC, and 75% in different surgical procedures. The consensus opens the door for the development of a national specialty curriculum and has implications for educational practice and future research


Subject(s)
Humans , General Surgery , Health Postgraduate Programs , Delphi Technique , Colombia , Competency-Based Education , Curriculum , Consensus
3.
Rev. colomb. cir ; 36(4): 582-598, 20210000. tab
Article in Spanish | LILACS | ID: biblio-1291152

ABSTRACT

Frente a los desafíos de la Educación Basada en Competencia, este consenso Delphi de la División de Educación de la Asociación Colombiana de Cirugía informa sobre las mínimas competencias profesionales esperadas del cirujano egresado de los veinte programas de Especialización en Cirugía General en Colombia. Un total de 105 profesores de los programas de especialización evaluaron tres áreas de competencia profesional: 1) atributos profesionales generales del residente durante su formación, 2) competencias prácticas (procedimientos quirúrgicos) que los residentes deben realizar al final de su entrenamiento y 3) Actividades Profesionales Confiables (APC) que los residentes deben ejecutar sin supervisión al final de su entrenamiento. Los resultados informan un alto nivel de consenso en el 100 % los atributos profesionales generales y APC, y del 75 % en diferentes procedimientos quirúrgicos. El consenso abre la puerta para el desarrollo de un currículo nacional de la especialidad y tiene implicaciones para la práctica educativa e investigación futura


Faced with the challenges of Competence-Based Education, this Delphi consensus from the Education Division of the Colombian Association of Surgery reports on the minimum professional competencies expected of the surgeon who graduated from the twenty residency programs in General Surgery in Colombia. A total of 105 professors from the training programs evaluated three areas of professional competence: 1) general professional attributes of the resident during their training, 2) practical skills (surgical procedures) that residents must perform at the end of their training, and 3) Activities Trusted Professionals (APC) that residents must run unsupervised at the end of their training. The results report a high level of consensus in 100% general professional attributes and APC, and 75% in different surgical procedures. The consensus opens the door for the development of a national specialty curriculum and has implications for educational practice and future research


Subject(s)
Humans , General Surgery , Health Postgraduate Programs , Delphi Technique , Colombia , Competency-Based Education , Curriculum , Consensus
4.
Medicina (B.Aires) ; 81(2): 257-268, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287278

ABSTRACT

Resumen La transmisión vertical de la infección por Toxoplasma gondii ocurre cuando la madre se infecta por primera vez en el transcurso del embarazo. El diagnóstico de la infección materna y la del re cién nacido se logra con el conjunto de pruebas serológicas, hallazgos clínicos y ecográficos. El reconocimiento temprano de la infección materna permite un tratamiento que reduce la tasa de transmisión y el riesgo de daño en el producto de la concepción. El objetivo de este consenso de expertos fue revisar la literatura científica para actualizar las recomendaciones de práctica clínica respecto de la prevención, el diagnóstico y el tratamiento de la toxoplasmosis congénita en nuestro país.


Abstract Mother-to-child transmission in Toxoplasma gondii infection occurs only when the infection is acquired for the first time during pregnancy. Diag nosis of maternal infection and the newborn is achieved by a combination of serological tests, clinical features and ultrasound images. An early diagnosis of maternal infection allows treatment that offers a reduction both in transmission rate and risk of congenital damage. The aim of this expert consensus was to review the scientific literature which would enable an update of the clinical practice guideline of prevention, diagnosis and treatment of congenital toxoplasmosis in our country.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Child , Toxoplasma , Toxoplasmosis , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/prevention & control , Toxoplasmosis, Congenital/drug therapy , Pregnancy Complications, Parasitic , Infectious Disease Transmission, Vertical/prevention & control , Consensus , Medical History Taking
5.
Rev. Soc. Argent. Diabetes ; 55(supl. 1): 3-70, ene - abr. 2021. ilus, graf
Article in Spanish | LILACS, BINACIS | ID: biblio-1254817

ABSTRACT

Este Consenso sale a la luz en medio de una de las peores crisis sanitarias globales de los últimos 100 años. El SARS-CoV-2 y su manifestación clínica, la COVID-19, han provocado una disrupción en cómo médicos y pacientes nos relacionamos. Si bien se trata de una enfermedad infecciosa, una de las características más notables es que su mortalidad se acrecienta en pacientes con enfermedades crónicas no transmisibles y, en particular, con antecedentes de diabetes y enfermedad cardiovascular. En tal contexto, entonces, creemos que cobran más relevancia las recomendaciones vertidas en este documento, que apuntan a identificar y proteger a estos pacientes, al tiempo que se vuelve prioritaria la implementación, más allá de los enunciados, de políticas concretas de prevención cardiometabólica. Metodología: este consenso es el fruto de la voluntad de dos Sociedades Científicas que han reconocido la necesidad de complementar el enfoque sobre una misma problemática: la de los pacientes con diabetes mellitus (DM) y con enfermedad cardiovascular (ECV), o bien que están en riesgo de sufrirla. Tanto la Sociedad Argentina de Cardiología (SAC) como la Sociedad Argentina de Diabetes (SAD) tienen una reconocida trayectoria en la producción de guías de práctica y documentos de consenso, aunque cada una tiene prácticas y culturas de trabajo diferentes. En consecuencia, la primera tarea que se afrontó fue la de acordar, no solamente el temario y el abordaje de los diferentes asuntos, sino también modalidades de trabajo comunes: objetivo general del documento, forma de analizar y evaluar el peso de la información, definir los niveles de evidencia y determinar los grados de recomendación. Se acordó adoptar la modalidad utilizada por la SAC en todos los documentos producidos por el Área de Consensos y Normas, expuestos en el siguiente cuadro: Grado de recomendación • Clase I: condiciones para las cuales hay evidencia y/o acuerdo general en que el tratamiento/procedimiento es beneficioso, útil y eficaz. • Clase II: evidencia conflictiva y/o divergencia de opinión acerca de la utilidad, eficacia del método, procedimiento y/o tratamiento. - IIa: el peso de la evidencia/opinión está a favor de la utilidad/eficacia. - IIb: la utilidad/eficacia está menos establecida. • Clase III: evidencia o acuerdo general que el tratamiento método/procedimiento no es útil/eficaz y en algunos casos puede ser perjudicial. Nivel de evidencia • A: evidencia sólida, proveniente de estudios clínicos aleatorizados o de cohortes con diseño adecuado para alcanzar conclusiones estadísticamente conectadas y biológicamente significativas. • B: datos procedentes de un único ensayo clínico aleatorizado o de grandes estudios no aleatorizados. • C: consenso de opinión de expertos. Los expertos que colaboraron en la redacción del Consenso fueron seleccionados e invitados a participar con el acuerdo unánime del grupo de Directores y Secretarios pertenecientes a ambas Sociedades Científicas. Se convocó a colegas con reconocida trayectoria en las disciplinas abordadas para el análisis de la evidencia y la redacción de las recomendaciones. Todos los aspectos metodológicos y las recomendaciones finales de este documento fueron definidos por acuerdo entre el grupo de Directores y Secretarios del Consenso. El proceso de consolidación de la información fue lento: desde la decisión de ambas sociedades hasta la redacción de este documento, el campo del manejo de la DM y la ECV sufrió profundas transformaciones que trascienden la aparición de nuevos agentes terapéuticos. Lo que se ha desarrollado es un nuevo modelo de abordaje que es, según las palabras de la Dra. Alicia Elbert, transdisciplinario. Esto ha implicado esperar y poder entender y "procesar" toda la información surgida en estos años. Este documento, que pretende asistir a los médicos en la práctica diaria, ha intentado adoptar esa nueva mirada integradora


This Consensus comes to light in the midst of one of the worst global health crises in the last 100 years. SARS-CoV-2 and its clinical manifestation, COVID-19, have caused a disruption in how doctors and patients interact. Although it is an infectious disease, one of the most notable characteristics is that its mortality increases in patients with chronic non-communicable diseases and, in particular, with a history of diabetes and cardiovascular disease. In this context, then, we believe that the recommendations made in this document, which aim to identify and protect these patients, become more relevant, while the implementation, beyond the statements, of specific cardiometabolic prevention policies becomes a priority. Methodology: this consensus is the result of the will of two Scientific Societies that have recognized the need to complement the focus on the same problem: that of patients with diabetes mellitus (DM) and cardiovascular disease (CVD), or who are at risk to suffer it. Both the Argentine Society of Cardiology (SAC) and the Argentine Society of Diabetes (SAD) have a recognized track record in the production of practice guidelines and consensus documents, although each has different work practices and cultures. Consequently, the first task that was faced was to agree, not only on the agenda and the approach to the different issues, but also on common working methods: general objective of the document, how to analyze and evaluate the weight of the information, define the levels of evidence and determine the degrees of recommendation. It was agreed to adopt the modality used by the SAC in all the documents produced by the Consensus and Standards Area, set out in the following table: Grade of recommendation • Class I: conditions for which there is evidence and/or general agreement that the treatment/procedure is beneficial, useful and effective. • Class II: conflicting evidence and/or divergence of opinion about the usefulness, efficacy of the method, procedure and / or treatment. - IIa: the weight of evidence/opinion is in favor of utility/ efficacy. - IIb: utility/efficacy is less established. • Class III: evidence or general agreement that the treatment method/procedure is not useful/effective and in some cases may be harmful. Level of evidence • A: solid evidence, from randomized clinical studies or from cohorts with adequate design to reach statistically connected and biologically significant conclusions. • B: data from a single randomized clinical trial or large nonrandomized studies. • C: consensus of expert opinión. The experts who collaborated in the drafting of the Consensus were selected and invited to participate with the unanimous agreement of the group of Directors and Secretaries belonging to both Scientific Societies. Colleagues with recognized experience in the disciplines addressed were summoned to analyze the evidence and write the recommendations. All the methodological aspects and the final recommendations of this document were defined by agreement between the group of Directors and Consensus Secretaries. The information consolidation process was slow: from the decision of both companies until the writing of this document, the field of DM and CVD management underwent profound transformations that transcend the appearance of new therapeutic agents. What has been developed is a new approach model that is, in the words of Dr. Alicia Elbert, transdisciplinary. This has implied waiting and being able to understand and "process" all the information that has emerged in these years. This document, which aims to assist physicians in daily practice, has tried to adopt this new integrative perspective


Subject(s)
Consensus , Cardiology , Cardiovascular Diseases , Epidemiology , Risk Factors , Diabetes Mellitus , Drug Therapy , Heart Failure
6.
Rev. Soc. Argent. Diabetes ; 55(supl. 1): 1-2, ene - abr. 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1254803

ABSTRACT

Frente a los significativos y rápidos cambios en los conocimientos relacionados con la fisiopatología de la diabetes mellitus (DM) y los mecanismos involucrados en el desarrollo de las enfermedades cardiovasculares (ECV) por un lado y, por otro, frente al desarrollo de diferentes fármacos con inesperados efectos a nivel cardiovascular, nos propusimos desarrollar un consenso actualizado entre la Sociedad Argentina de Cardiología y la Sociedad Argentina de Diabetes, dos sociedades con reconocida trayectoria en la confección de guías y consensos que, en última instancia, tienen el objetivo de brindar un material actualizado y práctico para el manejo de los pacientes que presentan DM y ECV. Si bien nuestra tarea conjunta había comenzado hace tiempo atrás, este Consenso sale a la luz en medio de una de las peores crisis sanitarias a nivel mundial con el surgimiento del SARS-CoV2 y su manifestación clínica, la COVID-19.


Subject(s)
Humans , Consensus , Cardiovascular Diseases , Diabetes Mellitus
8.
Int. braz. j. urol ; 47(2): 359-373, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1154467

ABSTRACT

ABSTRACT Background: Non-metastatic castration resistant prostate cancer (M0 CRPC) has seen important developments in drugs and diagnostic tools in the last two years. New hormonal agents have demonstrated improvement in metastasis free survival in M0 CRPC patients and have been approved by regulatory agencies in Brazil. Additionally, newer and more sensitive imaging tools are able to detect metastasis earlier than before, which will impact the percentage of patients staged as M0 CRPC. Based on the available international guidelines, a group of Brazilian urology and medical oncology experts developed and completed a survey on the diagnosis and treatment of M0 CRPC in Brazil. These results are reviewed and summarized and associated recommendations are provided. Objective: To present survey results on management of M0 CRPC in Brazil. Design, setting, and participants: A panel of six Brazilian prostate cancer experts determined 64 questions concerning the main areas of interest: 1) staging tools, 2) treatments, 3) side effects of systemic treatment/s, and 4) osteoclast-targeted therapy. A larger panel of 28 Brazilian prostate cancer experts answered these questions in order to create country-specific recommendations discussed in this manuscript. Outcome measurements and statistical analysis: The panel voted publicly but anonymously on the predefined questions. These answers are the panelists' opinions, not a literature review or meta-analysis. Therapies not yet approved in Brazil were excluded from answer options. Each question had five to seven relevant answers including two non-answers. Results were tabulated in real time. Conclusions: The results and recommendations presented can be used by Brazilian physicians to support the management of M0 CRPC patients. Individual clinical decision making should be supported by available data, however, for Brazil, guidelines for diagnosis and management of M0 CRPC patients have not been developed. This document will serve as a point of reference when confronting this disease stage.


Subject(s)
Humans , Male , Physicians , Prostatic Neoplasms, Castration-Resistant/diagnosis , Prostatic Neoplasms, Castration-Resistant/drug therapy , Perception , Brazil , Treatment Outcome , Patient Selection , Consensus
9.
Rev. colomb. obstet. ginecol ; 72(1): 53-68, Jan.-Mar. 2021. tab
Article in Spanish | LILACS | ID: biblio-1251613

ABSTRACT

RESUMEN Objetivo: sintetizar la evidencia disponible en torno a las intervenciones para la prevención de eventos tromboembólicos venosos durante el cuidado perioperatorio de las mujeres con patología ginecológica benigna, buscando reducir la morbi-mortalidad asociada a esta condición. Materiales y métodos: el grupo desarrollador estuvo integrado por profesionales de la salud, tomadores decisiones y un representante de las pacientes. Todos los participantes declararon sus conflictos de interés. Se construyeron preguntas clínicas contestables y se realizó la graduación de los desenlaces. Se elaboró la pesquisa de la información en Medline/PubMed, Embase, Epistemonikos y LILACS. La búsqueda también abarcó fuentes de literatura gris y se actualizó el 22 de septiembre de 2020 sin restricciones por fecha o idioma. Se implementó la aproximación GRADE (Grading of Recommendations Assessment, Development and Evaluation) para establecer la calidad de la evidencia y la fuerza de las recomendaciones, se realizó consenso formal acorde con la metodología RAND/UCLA. Previo a la publicación, el documento fue objeto de revisión por pares. Resultados: se presenta la versión corta del consenso "para la prevención de eventos tromboembólicos venosos durante el cuidado perioperatorio de las mujeres con patología ginecológica benigna", junto a su evidencia de soporte y respectivas recomendaciones. Conclusiones: como recomendaciones claves para la implementación, se proponen el uso de la escala de Caprini y el uso de intervenciones acorde con el nivel de riesgo perioperatorio de las pacientes.


ABSTRACT Objective: To draw a synthesis of the available evidence regarding interventions for the prevention of venous thromboembolic events during the peri-operative care of women with benign gynecological pathology, with the aim of reducing the associated morbidity and mortality. Materials and methods: The development group included healthcare professionals, decision-makers and one patient representative. All the participants stated their disclosures. Answerable clinical questions were built and outcomes were graded. The search for information was conducted in Medline, Embase, Epistemonikos and LILACS, but it also included grey literature and was updated on September 22, 2020, with no date or language restrictions. The GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach was used to determine the quality of the evidence and the strength of the recommendations. Formal consensus was developed in accordance with the RAND/UCLA methodology. The document was submitted to peer review before publication. Results: The abbreviated version of the "consensus on the prevention of venous thromboembolic events during the perioperative care of women with benign gynecological pathology" is presented together with the supporting evidence and respective recommendations. Conclusions: The key recommendations for implementation include the use of the Caprini scale and of interventions consistent with the individual peri-operative risk level.


Subject(s)
Humans , Female , Consensus , Venous Thromboembolism , Pulmonary Embolism , General Surgery , Women , Perioperative Care
10.
Acevedo-Peña, Juan; Yomayusa-González, Nancy; Cantor-Cruz, Francy; Pinzon-Florez, Carlos; Barrero-Garzón, Liliana; De-La-Hoz-Siegler, Ilich; Low-Padilla, Eduardo; Ramírez-Ceron, Carlos; Combariza-Vallejo, Felipe; Arias-Barrera, Carlos; Moreno-Cortés, Javier; Rozo-Vanstrahlen, José; Correa-Pérez, Liliana; Rojas-Gambasica, José; González-González, Camilo; La-Rotta-Caballero, Eduardo; Ruíz-Talero, Paula; Contreras-Páez, Rubén; Lineros-Montañez, Alberto; Ordoñez-Cardales, Jorge; Escobar-Olaya, Mario; Izaguirre-Ávila, Raúl; Campos-Guerra, Joao; Accini-Mendoza, José; Pizarro-Gómez, Camilo; Patiño-Pérez, Adulkarín; Flores-Rodríguez, Janine; Valencia-Moreno, Albert; Londoño-Villegas, Alejandro; Saavedra-Rodríguez, Alfredo; Madera-Rojas, Ana; Caballero-Arteaga, Andrés; Díaz-Campos, Andrés; Correa-Rivera, Felipe; Mantilla-Reinaud, Andrés; Becerra-Torres, Ángela; Peña-Castellanos, Ángela; Reina-Soler, Aura; Escobar-Suarez, Bibiana; Patiño-Escobar, Bonell; Rodríguez-Cortés, Camilo; Rebolledo-Maldonado, Carlos; Ocampo-Botero, Carlos; Rivera-Ordoñez, Carlos; Saavedra-Trujillo, Carlos; Figueroa-Restrepo, Catalina; Agudelo-López, Claudia; Jaramillo-Villegas, Claudia; Villaquirán-Torres, Claudio; Rodríguez-Ariza, Daniel; Rincón-Valenzuela, David; Lemus-Rojas, Melissa; Pinto-Pinzón, Diego; Garzón-Díaz, Diego; Cubillos-Apolinar, Diego; Beltrán-Linares, Edgar; Kondo-Rodríguez, Emilio; Yama-Mosquera, Erica; Polania-Fierro, Ernesto; Real-Urbina, Evalo; Rosas-Romero, Andrés; Mendoza-Beltrán, Fernán; Guevara-Pulido, Fredy; Celia-Márquez, Gina; Ramos-Ramos, Gloria; Prada-Martínez, Gonzalo; León-Basantes, Guillermo; Liévano-Sánchez, Guillermo; Ortíz-Ruíz, Guillermo; Barreto-García, Gustavo; Ibagón-Nieto, Harold; Idrobo-Quintero, Henry; Martínez-Ramírez, Ingrid; Solarte-Rodríguez, Ivan; Quintero-Barrios, Jorge; Arenas-Gamboa, Jaime; Pérez-Cely, Jairo; Castellanos-Parada, Jeffrey; Garzón-Martínez, Fredy; Luna-Ríos, Joaquín; Lara-Terán, Joffre; Vargas-Fodríguez, Johanna; Dueñas-Villamil, Rubén; Bohórquez-Feyes, Vicente; Martínez-Acosta, Carlos; Gómez-Mesa, Esteban; Gaitán-Rozo, Julián; Cortes-Colorado, Julián; Coral-Casas, Juliana; Horlandy-Gómez, Laura; Bautista-Toloza, Leonardo; Palacios Palacios, Leonardo; Fajardo-Latorre, Lina; Pino-Villarreal, Luis; Rojas-Puentes, Leonardo; Rodríguez-Sánchez, Patricia; Herrera-Méndez, Mauricio; Orozco-Levi, Mauricio; Sosa-Briceño, Mónica; Moreno-Ruíz, Nelson; Sáenz-Morales, Oscar; Amaya-González, Pablo; Ramírez-García, Sergio; Nieto-Estrada, Víctor; Carballo-Zárate, Virgil; Abello-Polo, Virginia.
Acta méd. colomb ; 46(1): 51-72, ene.-mar. 2021. tab, graf
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1278159

ABSTRACT

resumen está disponible en el texto completo


Abstract Recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. In this context, the aim was to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: A rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: Recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.


Subject(s)
Humans , Male , Female , Adult , SARS-CoV-2 , COVID-19 , Embolism and Thrombosis , Consensus , Anticoagulants
11.
Med. U.P.B ; 40(1): 46-54, 03/03/2021. tab
Article in Spanish | LILACS, COLNAL | ID: biblio-1177497

ABSTRACT

El trauma sigue siendo una de las principales causas de morbimortalidad mundial. Entre las causas de muerte de estos pacientes cabe destacar el paro cardiaco traumático (PCT). Múltiples autores afirman que, a pesar de los avances médicos, los esfuerzos de resucitación de estos pacientes pueden llevar a malos desenlaces, ya que aquellos que sufren PCT tienen gran mortalidad y pronóstico neurológico poco alentador. Este artículo hace una recopilación de la evidencia disponible, que, a pesar de ser poca, señala los avances recientes en el enfoque y manejo de estos pacientes. Se busca que con esta revisión se logre un consenso sobre el abordaje de los pacientes en paro en el contexto de trauma, basado en la literatura y evidencia más reciente.


Trauma is still one of the main causes of morbidity and mortality worldwide. Traumatic cardiac arrest (TCA) stands out among the causes of death of these patients. Multiple authors claim that, despite medical advances, resuscitation efforts in these patients may lead to poor outcomes, since those suffering from TCA have high mortality rates and poor neurological prognosis. This article compiles the available evidence, which despite being limited, points to recent advances in the management and approach of these patients. The aim of this review is to reach a consensus on the approach to patients in cardiac arrest in the context of trauma, based on the most recent literature and evidence.


O trauma continua sendo uma das principais causas de morbimortalidade em todo o mundo. Dentre as causas de óbito nesses pacientes, vale destacar a parada cardíaca traumática (PCT). Vários autores afirmam que, apesar dos avanços médicos, os esforços de ressuscitação nesses pacientes podem levar a resultados ruins, uma vez que aqueles que sofrem de PCT apresentam alta mortalidade e prognóstico neurológico ruim. Este artigo faz uma compilação das evidências disponíveis, que, apesar de poucas, apontam para avanços recentes na abordagem e manejo desses pacientes. O objetivo desta revisão é chegar a um consenso sobre a abordagem do PCT com base na literatura e nas evidências mais recentes.


Subject(s)
Heart Arrest , Resuscitation , Wounds and Injuries , Indicators of Morbidity and Mortality , Cause of Death , Death , Consensus , Emergencies
12.
Chinese Journal of Hepatology ; (12): 216-226, 2021.
Article in Chinese | WPRIM | ID: wpr-879636

ABSTRACT

In order to standardize the effective prevention, early screening and diagnosis of the population at risk of primary liver cancer, the Chinese Society of Hepatology and Chinese Medical Association organized the relevant domestic experts to formulate the "Consensus on Secondary Prevention of Primary Liver Cancer (2021 version)," based on the basic, clinical and preventive research progress, combined with the actual situation at home and abroad, so as to provide an important basis for the prevention, screening and early diagnosis of primary liver cancer in the population of chronic liver disease.


Subject(s)
Carcinoma, Hepatocellular/prevention & control , Consensus , Gastroenterology , Humans , Liver Cirrhosis , Liver Neoplasms/prevention & control , Mass Screening , Secondary Prevention
13.
Article in Chinese | WPRIM | ID: wpr-879616

ABSTRACT

The use of whole exome sequencing (WES) for the detection of disease-causing variants of genetic diseases and for non-invasive prenatal screening (NIPS) of fetal aneuploidies are two major clinical applications of next generation sequencing (NGS). This article has summarized the official documents developed and updated by the American College of Medical Genetics and Genomics (ACMG) on governing WES and NIPS. These include the development of expert consensus policies and position statements on an ongoing basis to guide clinical application of NGS technology and variant analysis, establish evidence-based practical resources, as well as standards and guidelines to govern diagnosis and screening. These ACMG documents are valuable references to Chinese geneticists, but direct adoption of these standards and guidelines may not be practical due to the differences in disease-associated variant frequencies in Chinese population, socioeconomic status, and medical practice between the two countries. It is hoped that this review could facilitate the development of NGS and NIPS standards and guidelines that are consistent with international standards and concordant with medical genetics practice in China to provide high-quality, efficient and safe clinical services for patients and their families with genetic diseases.


Subject(s)
China , Consensus , Female , Genomics , High-Throughput Nucleotide Sequencing , Humans , Pregnancy , Technology , United States
14.
Article in Chinese | WPRIM | ID: wpr-880392

ABSTRACT

With the development of surgical treatment for gastric cancer, under the premise of ensuring the effect of surgical treatment, the objectives of preserving the function of stomach, diminishing the influence of quality of life and keeping the outcome of treatment, are the expectation of patients and the goal of surgeons. The emerge of function-preserving gastrectomy (FPG) indicates that the surgical treatment of gastric cancer steps into the individualized and precision era. Because the concept and operation procedures of FPG have not achieved consensus, the Gastrointestinal Surgery Branch, Surgery Branch, Chinese Medical Association (CMA) with Chinese Society of Surgical Oncology of Chinese Medical Doctor Association(CMDA), Chinese Society of Upper Gastrointestinal Surgeon of CMDA, Stomach and Intestines Committee of Chinese Anticancer Association, convenes some experts to summarize the recent literatures and discuss to reach the consensus about the FPG in the treatment of early gastric cancer. The definition of FPG is as follows: without compromising the oncological efficacy of early gastric cancer, decrease of the operational scale, selection of optimal reconstruction procedures and preservation of the gastric function as much as possible. The most common operation methods are procedures of minimized scale (pylorus-preserving gastrectomy, segmental gastrectomy, local gastrectomy and endoscopic resection) and proximal gastrectomy (PG). Besides the anastomosis of esophagus and gastric remnants, the reconstruction method after proximal gastrectomy also includes tubular gastroesophagostomy, double tract reconstruction, Interposition jejunostomy, side to side gastroesophagostomy (SOFY), double flap gastroesophagostomy (Kamikawa anastomosis), etc. The evaluation of gastric function after FPG includes the assessment of gastric remnant function, the functional complications and the nutritional status. We believe the publication of consensus will properly popularize FPG, promote further research about the gastric cancer and function of gastric remnant, and improve the theoretical study about FPG. Moreover, the indications and procedures of FPG will be broadened and renovated.


Subject(s)
China , Consensus , Gastrectomy , Humans , Quality of Life , Stomach Neoplasms/surgery , Treatment Outcome
15.
Article in Chinese | WPRIM | ID: wpr-880391

ABSTRACT

With the development of surgical techniques, adjuvant and neoadjuvant therapy, the survival of patients with rectal cancer after surgery has improved significantly, while the organ dysfunction remains an important factor affecting quality of life of patients. In order to improve the awareness of Chinese surgeons in organ function protection for the treatment of rectal cancer, standardize the evaluation method and surgical procedure, reduce the incidence of organ dysfunction, and ultimately improve the quality of life of patients, Colorectal and Anal Function Surgeons Committee of China Sexology Association, Organ Function Protection Committee of Chinese College of Colorectal Cancer, and Colon and Rectal Surgeons Committee of Chinese College of Surgeons jointly organized experts in related fields, in combination with domestic and foreign research and clinical practice, to discuss and formulate a Chinese expert consensus on the protection of pelvic organ function in the rectal cancer surgery, including the definition, risk factors, assessment methods, prevention and treatment of organ dysfunction after rectal cancer surgery.


Subject(s)
China , Consensus , Humans , Quality of Life , Rectal Neoplasms/surgery , Rectum/surgery
16.
Article in Chinese | WPRIM | ID: wpr-880390

ABSTRACT

Robotic minimally invasive surgery is an important trend in the modern surgical techniques. The publish of Chinese Expert Consensus on Robotic Surgery for Colorectal Cancer (2015 Edition) has played an important role in the standardization, promotion and application of robotic colorectal cancer surgery. With the concept update and technological progress, robotic colorectal cancer surgery has been further developed. Based on this, on the basis of 2015 expert consensus, the Chinese Expert Consensus on Robotic Surgery for Colorectal Cancer (2020 Edition) is revised and published to supplement, update and improve the theoretical and technical system, so as to better guide clinical practice.


Subject(s)
China , Colorectal Neoplasms/surgery , Consensus , Humans , Minimally Invasive Surgical Procedures/standards , Robotic Surgical Procedures/standards
18.
Chinese Journal of Burns ; (6): 101-112, 2021.
Article in Chinese | WPRIM | ID: wpr-880190

ABSTRACT

Deep vein catheterization is an important method to prevent and treat burn shock in severe burn patients, monitor hemodynamic changes and provide venous nutritional support. Although deep vein catheterization has been applied widely, there is no standard operation and management process. In order to guide the operation and management of deep vein catheterization in severe burn patients in a more scientific and standard manner, the consensus writing group organized domestic experts in burn field, most of whom are members of the 10th Committee of Chinese Burn Association to discuss and reach a consensus mainly in selection of deep vein catheter and the catheterization site, the method of catheterization operation, catheter maintenance, and prevention and treatment of catheter-related complications. This consensus aims to provide practical basis and guidance for the operation and management of deep vein catheterization in severe burn patients.


Subject(s)
Burns/therapy , Catheterization , Consensus , Humans , Monitoring, Physiologic , Shock
19.
Chinese Journal of Burns ; (6): 113-125, 2021.
Article in Chinese | WPRIM | ID: wpr-880189

ABSTRACT

Recently, more and more clinical and basic studies have shown that early intervention of scars after wound healing can shorten the immature period of scars, improve the final outcome of scars, effectively prevent and control the occurrence and development of pathological scars. However, there are many methods for early management of scars with varying quality, and there is a lack of expert consensus on early scar management. Based on the existing clinical evidence of each intervention method and clinical experience of experts, more than 40 domestic experts from Standing Committee of Chinese Association of Plastics and Aesthetics Scar Medicine Branch have reached a consensus on definition, therapeutic principles, therapeutic methods, and other aspects of early scars after multiple discussions and revisions, providing reference for clinical treatment.


Subject(s)
Cicatrix/therapy , Consensus , Humans , Wound Healing
20.
Article in Chinese | WPRIM | ID: wpr-879854

ABSTRACT

Intravenous immunoglobulin (IVIG) has been widely used in chemotherapy for hematological malignancies, targeted therapy, and hematopoietic stem cell transplantation; however, there are still no available guidelines or consensus statements on the application of IVIG in pediatric hematological/neoplastic diseases at present in China and overseas. This consensus is developed based on the research advances in the application of IVIG in pediatric hematological/neoplastic diseases across the world and provides detailed recommendations for the clinical application of IVIG in pediatric hematological/neoplastic diseases and the prevention and treatment of related adverse reactions.


Subject(s)
Child , China , Consensus , Hematologic Neoplasms/drug therapy , Hematopoietic Stem Cell Transplantation , Humans , Immunoglobulins, Intravenous/therapeutic use
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