Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 3 de 3
Filtrar
Más filtros











Intervalo de año de publicación
1.
J Cutan Med Surg ; : 12034754241277513, 2024 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-39254194

RESUMEN

BACKGROUND: Mohs micrographic surgery (MMS) is a well-established technique for the removal of various types of skin cancers. While sterile gloves (SG) are commonly used in skin surgeries such as MMS, additional understanding of their effectiveness compared to nonsterile gloves (NSG) in preventing local infection is required. OBJECTIVE: We aimed to perform an updated systematic review and meta-analysis comparing the use of SG with NSG for local infection rate post-MMS and point out cost discrepancies between these 2 scenarios. METHODS: We searched MEDLINE, Embase, and Cochrane for studies published up to August 2023 comparing the use of SG with NSG during MMS that reported the outcome of wound infection. RESULTS: A total of 4 studies with 10,644 MMS were included, of which 7512 (70.6%) were performed with SG and 3132 (29.4%) were done with NSG. In the SG group, 232 out of 7512 cases (3.1%) developed infection compared to 64 out of 3132 (2.0%) in the NSG group [odds ratio (OR) 1.14; 95% confidence interval (CI) 0.85-1.52; P = .39; I2 = 0%]. Therefore, the post-MMS infection rates were not significantly different between SG and NSG groups, including in the excision (OR 0.92; 95% CI 0.48-1.79; P = .81; I2 = 0%) and reconstruction (OR 1.17; 95% CI 0.85-1.60; P = .34; I2 = 0%) subanalysis. Regarding the mean cost of the gloves, the NSG pair was $0.24, approximately 10% of the price of the SG pair ($2.27). CONCLUSION: The results support that, compared to SG, NSG are equally effective in preventing infections during MMS while offering significant cost savings without compromising patient outcomes.Protocol registration: PROSPERO, CRD42023458525.

2.
Clin Drug Investig ; 2024 Aug 22.
Artículo en Inglés | MEDLINE | ID: mdl-39172296

RESUMEN

BACKGROUND AND OBJECTIVE: Plaque psoriasis is commonly treated topically with glucocorticoids and vitamin D derivatives. However, potential side effects such as skin atrophy underscore the need for safe and effective alternative topical therapies. Recently, the US Food and Drug Administration (FDA) and Health Canada approved roflumilast 0.3% cream as an option for treating this disease. A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted to assess the efficacy and safety of topical roflumilast 0.3% compared with vehicle for plaque psoriasis. METHODS: PubMed, Embase, ClinicalTrials.gov, and Cochrane databases were searched from inception to 1 May 2024, assessing the outcomes of Investigator's Global Assessment (IGA) or body-IGA success (clear or almost clear status plus an at least 2-grade improvement from baseline), Psoriasis Area and Severity Index (PASI)-50, PASI-75, PASI-90, intertriginous-IGA success (clear or almost clear status on the intertriginous-IGA plus an at least 2-grade improvement from baseline), and adverse events (AEs). Statistical analysis was performed using Review Manager, R software, and RStudio. Heterogeneity was determined using the Cochran Q test and I2 statistics. RESULTS: Four RCTs were included, comprising a total of 1403 patients, of whom 885 (63.1%) received topical roflumilast 0.3% and 518 (36.9%) received vehicle. At week 8, the achievement of IGA or body-IGA success was significantly higher among those treated with topical roflumilast than in the vehicle group [relative risk (RR) 5.07; 95% confidence interval (CI) 3.55-7.23; p < 0.01]. Similar findings were observed at week 8 for PASI-50 (RR 2.73; 95% CI 2.27-3.29; p < 0.01), PASI-75 (RR 4.48; 95% CI 2.26-8.89; p < 0.01), and PASI-90 (RR 5.61; 95% CI 2.57-12.25; p < 0.01). Corresponding outcomes were found at weeks 2, 4, and 6. Additionally, a higher percentage of patients treated with topical roflumilast 0.3% once daily achieved intertriginous-IGA success, compared with those receiving vehicle, at week 8 (71.9% versus 20.5%; RR 3.32; 95% CI 2.11-5.22; p < 0.01), with similar findings at weeks 2, 4, and 6. While a significant difference was observed in the overall incidence of AEs between the topical roflumilast and vehicle groups, there was no difference in treatment-related AEs, serious AEs, or AEs leading to study discontinuation. CONCLUSION: These findings support the superiority of topical roflumilast 0.3% over vehicle and suggest its use as a valuable asset for the treatment of plaque psoriasis. PROTOCOL REGISTRATION: International Prospective Register of Systematic Reviews (PROSPERO), CRD42023456494.

3.
Rev. bras. educ. méd ; 47(2): e066, 2023. tab, graf
Artículo en Portugués | LILACS-Express | LILACS | ID: biblio-1449602

RESUMEN

Resumo: Introdução: Nas últimas décadas, a educação interprofissional vem ganhando cada vez mais visibilidade na área da saúde, a partir do reconhecimento de que essa abordagem é capaz de melhorar a qualidade da assistência à saúde e contribuir para a qualificação dos profissionais de saúde e a formação dos estudantes de diversas graduações. No entanto, no Brasil, ainda são escassas as experiências, bem como as publicações relativas ao tema. Objetivo: Este estudo teve como objetivo apresentar os procedimentos e a análise estatística relacionados às etapas de tradução e adaptação transcultural da Interprofessional Professionalism Assessment (IPA), ferramenta observacional, publicada em 2018, elaborada na língua inglesa, capaz de mensurar o profissionalismo interprofissional entre estudantes e profissionais da saúde, no contexto do cuidado centrado no paciente. Método: O estudo transcorreu na Faculdade Pernambucana de Saúde,,no período de julho de 2020 a outubro de 2021. A amostra foi composta por três tradutores, cinco especialistas e 201 estudantes do curso de Medicina, que foram submetidos ao questionário com a finalidade de testar a confiabilidade e validade da versão final em português. Considerou-se aceitável o alfa de Cronbach igual ou superior a 0,70. Resultado: O estudo cumpriu rigorosamente as exigências metodológicas recomendadas internacionalmente para as etapas de tradução, retrotradução, painel de especialistas, teste, reteste e teste final. Gerou-se a versão traduzida para o português e adaptada para a cultura brasileira. Após o teste da versão final, realizado com estudantes do internato do curso médico, obteve-se coeficiente alfa de Cronbach igual a 0,94. Conclusão: A confiabilidade obtida foi considerada elevada, refletindo a boa consistência interna do instrumento produzido.


Abstract: Introduction: In recent decades, interprofessional education has been gaining increasing visibility in the health area, based on the recognition that this approach is capable of improving the quality of health care and contributing to the qualification of health professionals and the training of students of various degrees. However, in Brazil, there are still few experiences and publications related to this theme. Objectives: To translate into Brazilian Portuguese and carry out a cross-cultural adaptation of the "Interprofessional professionalism assessment" scale, an instrument originally published in 2018 and designed to measure interprofessional professionalism among students and health professionals, in the context of patient-centered care. Methods: The study took place at the Faculdade Pernambucana de Saúde, from July 2020 to October 2021. The sample consisted of three translators, five specialists and two hundred and one medical course students, who were submitted to the questionnaire in order to test the reliability and validity of the final version in Portuguese. Cronbach's Alpha equal to or greater than 0.70 was considered acceptable. Results: The study strictly complied with the methodological requirements recommended internationally for the stages of translation, back-translation, expert panel, test, retest and final test, the version translated to the Portuguese and adapted to the Brazilian culture was generated. After the test of the final version, performed with students from the medical course boarding school, Cronbach's Alpha coefficient equal to 0.94 was obtained. Conclusion: The reliability obtained was considered high, reflecting the good internal consistency of the instrument produced.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA