Evidencia, actualizacion en la práctica ambulatoria

Screens, children and lockdown in pandemics: should we limit their exposition?

Leticia Gavoto — 2020-11-05

Since the creation of cinema more than a century ago, and until the current invasion of mobile devices, the speed in the evolution of the screens has been exponential, which comes with new ways of consuming multimedia, communicating and managing our leisure time. Applications have made a leap from desktop computers to smartphones, facilitating their access anywhere and anytime, allowing children and teenagers today (Generation Z, digital and neo-digital natives) to have more access to electronic media than any other previous generation.

At the same time, concern has grown about the effect these screens could have on child development. Based on the results of several investigations, different entities developed recommendations on the use of screens in children, setting most of them a "safe" limit of consumption of two hours a day. However, the supporting evidence is very weak. In the context of the current pandemic, which forces us to confine ourselves to our homes, physically away from other people and without access to recreational outdoor activities, most of these recommendations sound quite limiting and difficult to accomplish.

This article proposes: 1) to review the information available on-screen consumption in children, 2) to expose the evidence that supports current recommendations of different institutions regarding its use,3) to critically evaluate it, making the gaps in knowledge visible, in order to prioritize them when giving the families we care for advice on parenting.

Clinical practice guideline: Elements of personal protection and pre-surgical testing of asymptomatic patients for prevention of the spread of SARS-CoV2 in the surgical field in emergency surgery

Fernando Tortosa — 2020-09-15

In epidemics of highly contagious diseases such as COVID-19, transmitted through drops expelled from the infected person's mouth, health care workers have a higher risk of infection than the general population, due to their contact with fluids and patient-generated aerosols. The existence of a percentage that could be up to 50% of asymptomatic carriers with contagion capacity, worries when planning surgical care.

To develop an evidence-based protocol, a synthesis and critical evaluation of the evidence was carried out in order to answer clinical questions (use of N95 chinstrap versus surgical chin during surgery, diagnostic test for SARS-CoV2 before surgery) using the GRADE methodology.

The N95 mask could be beneficial for personnel who perform procedures that favor the aerosolization of the virus, such as tracheostomy and manual ventilation with a self-inflating bag before intubation, among others.

The testing of patients prior to surgery can be evaluated in scenarios where the inputs for making determinations are available. It is necessary to evaluate the complexity of the surgery, avoiding that the delay caused by the test results in harm to the patient.

Operational characteristics of inflammatory markers for the diagnosis of infectious, autoimmune and oncological diseases in the primary care setting

Malena Chiaborelli — 2020-09-24

Mask use was associated with reduced face-touching behavior in public settings during the COVID-19 pandemic

Carolina Carrara — 2020-10-14

Nutritional recommendations for the consumption of red and processed meat taking into account population’s preferences

Antonella Stellardo — 2020-10-10

Administration of ondansetron does not improve the course of children with acute gastroenteritis without dehydration

Mauricio Pablo Kemnitz — 2020-09-24

Based on a clinical vignette of a child with acute gastroenteritis without dehydration, the author of this article performs a literature search to review the evidence supporting the use of ondansetron to treat his vomiting, a fairly common practice in institutions with access to this drug in their emergency rooms. After this search, the author concludes that in children with acute gastroenteritis without dehydration, the administration of ondansetron does not reduce the need for intravenous hydration or the frequency or severity of vomiting.

Efficacy of honey for treatment of acute cough in pediatric outpatients

Eros Miguel Angeletti — 2020-09-25

Based on a consultation at the emergency room of a child with acute cough, the author of this article performs a bibliographic search to review the evidence on the use of honey to alleviate this symptom. After the critical appraisal of a systematic review, the author concludes that honey could be an eligible alternative to cough syrups, due to its safety profile and its possible benefit in cough relief.

Management of persistent symptoms of COVID-19 in primary care

Cecilia Fieiras — 2020-10-29

Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy

Agustin Ciapponi — 2020-09-25

Internet-delivered cognitive behavioral therapy is noninferior to a face-to-face modality for treating health anxiety

Alan Gauna — 2020-09-16

Psychological therapies could reduce depression and anxiety in women victims of intimate partner violence

Ximena García Bianchi — 2020-10-14

Intra-articular injections with dextrose were effective in relieving pain and improving functionality in patients with temporomandibular dysfunction

Sergio Adrian Terrasa — 2020-10-29

Remdesivir for the treatment of COVID-19

Agostina Risso — 2020-11-02