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During the 1940s, aspiration of stomach contents was recognized as a serious problem during labor, which is why fluid and food restriction was adopted for women who would undergo general anesthesia. Currently, the practice of generalized food restriction is a routine that is being discontinued. This review aims to map the evidence on the effects of the intake of foods, supplements and drinks in women on labor outcomes. To that end, documents investigating this topic in pregnant women admitted for uncomplicated deliveries in maternity wards, published from 2013 onwards, will be assessed. This interval was defined based on the publication by Singata et al., who carried out a systematic review on the benefits and harms of oral fluid intake or food restriction during labor. The scoping review methods of the JBI and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review (PRISMA) were followed. Firstly, a preliminary search was carried out to identify the existence of similar scoping reviews or protocols, as well as the keywords and MeSH descriptors in the titles and abstracts, with a view to developing a complete search strategy. Subsequently, a search will be carried out in the Cochrane Library, Medline/PubMed, Embase, SCOPUS and Web of Science databases. The search strategy will be adapted for each of these databases. Finally, a reverse search will be carried out using the references of the included studies. The obtained documents will be imported into Rayyan for duplicate detection and removal. Two independent reviewers will read the titles and abstracts, observing the inclusion and exclusion criteria. The data extraction from each included study will be carried out independently by two reviewers, using the extraction form created for this purpose. In order to report results, we will follow the PRISMA checklist and report descriptive statistics and a narrative summary.

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OBJECTIVES: To evaluate human-based Medical Subject Headings (MeSH) allocation in articles about 'patient simulation'-a technique that mimics real-life patient scenarios with controlled patient responses. METHODS: A validation set of articles indexed before the Medical Text Indexer-Auto implementation (in 2019) was created with 150 combinations potentially referring to 'patient simulation'. Articles were classified into four categories of simulation studies. Allocation of seven MeSH terms (Simulation Training, Patient Simulation, High Fidelity Simulation Training, Computer Simulation, Patient-Specific Modelling, Virtual Reality, and Virtual Reality Exposure Therapy) was investigated. Accuracy metrics (sensitivity, precision, or positive predictive value) were calculated for each category of studies. KEY FINDINGS: A set of 7213 articles was obtained from 53 different word combinations, with 2634 excluded as irrelevant. 'Simulated patient' and 'standardized/standardized patient' were the most used terms. The 4579 included articles, published in 1044 different journals, were classified into: 'Machine/Automation' (8.6%), 'Education' (75.9%) and 'Practice audit' (11.4%); 4.1% were 'Unclear'. Articles were indexed with a median of 10 MeSH (IQR 8-13); however, 45.5% were not indexed with any of the seven MeSH terms. Patient Simulation was the most prevalent MeSH (24.0%). Automation articles were more associated with Computer Simulation MeSH (sensitivity = 54.5%; precision = 25.1%), while Education articles were associated with Patient Simulation MeSH (sensitivity = 40.2%; precision = 80.9%). Practice audit articles were also polarized to Patient Simulation MeSH (sensitivity = 34.6%; precision = 10.5%). CONCLUSIONS: Inconsistent use of free-text words related to patient simulation was observed, as well as inaccuracies in human-based MeSH assignments. These limitations can compromise relevant literature retrieval to support evidence synthesis exercises.

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PURPOSE: Currently, inguinal hernias are highly prevalent in the Brazilian population, accounting for 75% of all abdominal wall hernias. The recommended treatment to correct them is inguinal herniorrhaphy, which can be performed through open surgery, mainly using the Lichtenstein technique, or laparoscopically, primarily through Transabdominal Preperitoneal Repair (TAPP) or Total Extraperitoneal Repair (TEP) approaches. Like any surgery, these procedures have post-operative complications, with pain being the most common and debilitating. Currently, in European and Brazilian guidelines, the open Lichtenstein and endoscopic inguinal hernia techniques are recommended as best evidence-based options for repair of a primary unilateral hernia providing the surgeon is sufficiently experienced in the specific procedure. In that matter, the surgeon should make a choice based on assessment of the benefits and risks of performing each of them, and practice shared making decision with it patient. Therefore, the objective of this review was to assess the incidence of chronic postoperative pain by comparing the aforementioned surgical approaches to evaluate which procedure causes less disability to the patient. METHODS: The search conducted until May 2024 was performed on Medline (PubMed), Cochrane (CENTRAL), and Lilacs databases. The selection was limited to randomized clinical trials, nonrandomized clinical trials and cohort studies comparing TAPP or TEP to LC, evaluating the incidence of chronic postoperative pain published between 2017 and 2023. Evidence certainty was assessed using the GRADE Pro tool, and bias risk was evaluated with the RoB 2.0 tool and ROBINS I tool. Thirteen studies were included.  RESULTS: The meta-analysis showed a significant difference between the groups in both techniques, favoring the laparoscopic approach, which had a lower occurrence of postoperative inguinodynia with a relative risk of 0.49 (95% CI = 0.32, 0.75; I2 = 66% (P = 0.001); Z = 3.28 (P = 0.001) with low certainty of evidence. CONCLUSION: The presence of chronic postoperative pain was lower in laparoscopic TEP/TAPP techniques when compared to the open Lichtenstein technique, meaning that the former can bring more benefits to patients who requires inguinal herniorrhaphy. Nevertheless, further randomized clinical trials are needed to optimize the analysis, minimizing the bias.

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INTRODUCTION: These guidelines aim to provide evidence-based recommendations for the supplementation of Vitamin D in maintaining bone health. An unmet need persists in Latin American regarding the availability of clinical and real-world data for rationalizing the use of vitamin D supplementation. The objective of these guidelines is to establish clear and practical recommendations for healthcare practitioners from Latin American countries to address Vitamin D insufficiency in clinical practice. METHODS: The guidelines were developed according to the GRADE-ADOLOPMENT methodology for the adaptation or adoption of CPGs or evidence-based recommendations. A search for high quality CPGs was complemented through a comprehensive review of recent literature, including randomized controlled trials, observational studies, and systematic reviews evaluating the effects of Vitamin D supplementation on bone health. The evidence to decision framework proposed by the GRADE Working Group was implemented by a panel of experts in endocrinology, bone health, and clinical research. RESULTS: The guidelines recommend Vitamin D supplementation for individuals aged 18 and above, considering various populations, including healthy adults, individuals with osteopenia, osteoporosis patients, and institutionalized older adults. These recommendations offer dosing regimens depending on an individualized treatment plan, and monitoring intervals of serum 25-hydroxyvitamin D levels and adjustments based on individual results. DISCUSSION: The guidelines highlight the role of Vitamin D in bone health and propose a standardized approach for healthcare practitioners to address Vitamin D insufficiency across Latin America. The panel underscored the necessity for generating local data and stressed the importance of considering regional geography, social dynamics, and cultural specificities when implementing these guidelines.

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Contexto: O coronavírus da Síndrome Respiratória Aguda Grave (SARS-CoV-2) espalhou-se rapidamente em todo o mundo, a partir de dezembro de 2019. A vacinação tornou-se prioridade para a prevenção da doença, mas junto surgiu o temor de eventos adversos. Objetivo: Avaliar as evidências de possíveis eventos adversos das vacinas para COVID-19 em crianças e adolescentes. Material e Métodos: Trata-se de sinopse baseada em evidências. Procedeu-se à busca por estudos que associavam as vacinas para COVID-19 a eventos adversos a elas relacionados em três bases de dados: PubMed (1966-2024), Portal BVS (1982-2024) e Embase (1974-2024) e também no metabuscador de evidências TRIP DATABASE (2024). Foram utilizados os termos "COVID-19 Vaccines/adverse effects "[Mesh] Filters: Child: birth-18 years". Dois pesquisadores independentemente extraíram os dados e avaliaram a qualidade dos estudos para a síntese. O desfecho de análise envolveu a efetividade das vacinas para COVID-19 em crianças e adolescentes e a ocorrência de eventos adversos. Resultados: Foram encontradas 552 referências, seis estudos (3 revisões sistemáticas e 3 ensaios clínicos) foram incluídos (n = 13.642.718 participantes). Discussão: Há um número bastante razoável de estudos e amostragem sobre a vacinação para a COVID-19 em crianças e adolescentes. Esses estudos mostram efetividade e segurança das vacinas, sendo a ocorrência de eventos adversos mais associada a efeitos locais leves a moderados e um risco muito baixo de eventos adversos sistêmicos graves. Conclusões: Há evidência de efetividade das vacinas e baixo risco de complicações a elas associado, considerando-se que o risco-benefício justifica sua utilização em crianças e adolescentes nesse momento. Termos DeCS: Prática clínica baseada em evidências, vacina, COVID-19, eventos adversos, revisão.

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Introducción. Los errores de medicación (EM) pueden estar asociados con el ejercicio profesional en la prescripción, dispensación, distribución, administración de medicamentos, monitoreo y problemas de comunicación entre profesionales de la salud. La preparación y administración de medicamentos es un proceso de gran complejidad en el que los profesionales de enfermería desempeñan un papel fundamental como la última línea de defensa para evitar posibles daños relacionados con los fármacos en el paciente. El profesional de enfermería es el llamado a liderar el proceso de administración de medicamentos, asumiendo un rol esencial en el equipo de enfermería. Objetivo. Identificar los principales factores contributivos y estrategias de prevención, abordaje y gestión de servicios de enfermería frente a los errores de medicación desde la seguridad del paciente. Métodos: Se realizó una revisión de alcance tipo Scoping Review en Pubmed, EBSCO host, y Science Direct. Se emplearon descriptores identificados en Desc y Mesh artículos. Para seleccionar los artículos del presente artículo se utilizó la metodología prisma para revisiones. Resultados: Se encontraron 369 artículos en las bases abordadas de acuerdo con los criterios determinados,43 artículos se seleccionaron para la investigación. Conclusiones. Se identificaron los diferentes elementos que componen a la presencia de errores en la medicación; a su vez los factores generadores y/o contributivos para la presencia de estos errores durante la administración de medicamentos, a su vez se determinaron estrategias para prevención, abordaje y gestión de servicios de enfermería que disminuyan los potenciales riesgos identificados. Palabras clave: enfermería basada en la evidencia; seguridad del paciente; errores de medicación; enfermería; seguridad del paciente

Introduction. Medication errors (ME) can be associated with professional practice in prescribing, dispensing, distributing, administering medications, monitoring and communication problems between health professionals; The preparation and administration of medications is a highly complex process in which nursing professionals play a fundamental role as the last line of defense to prevent possible drug-related harm to the patient. The nursing professional is called upon to lead the medication administration process, assuming an essential role in the nursing team. Objective. To identify the main contributing factors and strategies for prevention, approach and management of nursing services in the face of medication errors from the perspective of patient safety. Methods: A Scoping Review type literature search was conducted in Pubmed, EBSCO host, and Science Direct. Descriptors identified in Desc and Mesh articles were used; the PRISMAmethodology for reviews was used to select the articles for this article.Results: 369 articles were found in the databases addressed according to the determined criteria; 43 articles were selected for the research.Conclusion. The different elements that make up the presence of medication errors were identified; in turn, the generating and/or contributing factors for the presence of these errors during the administration of medications, in turn, strategies for prevention, approach and management of nursing services that reduce the potential risks identified were determined. Key words:evidence-based nursing; patient safety; medication errors medication errors; nursing;patient safety

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BACKGROUND: Metabolic dysfunction-associated steatotic liver disease (MASLD) is the most common liver disease affecting 30% of the world's population and is often associated with metabolic disorders such as metabolic syndrome, type 2 diabetes (T2D), and cardiovascular disease. This review is an update of the Brazilian Diabetes Society (Sociedade Brasileira de Diabetes [SBD]) evidence-based guideline for the management of MASLD in clinical practice. METHODS: The methodology was published previously and was defined by the internal institutional steering committee. The SBD Metabolic Syndrome and Prediabetes Department drafted the manuscript, selecting key clinical questions for a narrative review using MEDLINE via PubMed with the MeSH terms [diabetes] and [fatty liver]. The best available evidence was reviewed, including randomized clinical trials (RCTs), meta-analyses, and high-quality observational studies related to MASLD. RESULTS AND CONCLUSIONS: The SBD Metabolic Syndrome and Prediabetes Department formulated 9 recommendations for the management of MASLD in people with prediabetes or T2D. Screening for the risk of advanced fibrosis associated with MASLD is recommended in all adults with prediabetes or T2D. Lifestyle modification (LSM) focusing on a reduction in body weight of at least 5% is recommended as the first choice for these patients. In situations where LSMs are insufficient to achieve weight loss, the use of anti-obesity medications is recommended for those with a body mass index (BMI) ≥ 27 kg/m2. Pioglitazone and glucagon-like peptide-1 receptor agonists (GLP-1RA) monotherapy are the first-line pharmacological treatments for steatohepatitis in people with T2D, and sodium-glucose cotransporter-2 (SGLT2) inhibitors may be considered in this context. The combination of these agents may be considered in the treatment of steatohepatitis and/or fibrosis, and bariatric surgery should be considered in patients with a BMI ≥ 35 kg/m2, in which the combination of LSM and pharmacotherapy has not been shown to be effective in improving MASLD.

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Abstract Introduction: Over the last decade, and following the publication of an instructional methodological guide for the development of clinical practice guidelines (CPG), the Colombian Ministry of Health and Social Protection (CMHSP) commissioned the development or update of a series of CPGs. However, to date, there is no diagnosis of the characteristics of the recommendations made in such CPGs. Objective: To explore the characteristics of the recommendations included in CPGs commissioned by the CMHSP between 2013 and 2021. Materials and methods: A systematic review of Colombian CPGs published between 2013 and 2021 was conducted. Only CPGs reporting the level of certainty of the supporting evidence and the strength of the recommendation in at least 70% of its recommendations using the GRADE approach were included. Information on the certainty, direction, and strength of each recommendation was extracted. Additionally, the agreement between the language used (wording) in the recommendation and its strength was assessed in a random sample of 20% of the recommendations. Results: Of the 59 CPGs retrieved, 36 met the inclusion criteria, for a total of 1 609 recommendations analyzed. The median number of recommendations per CPG was 41 (IQR: 27-55), 81.4% were in favor, 62.77% were classified as strong, 58.23% were based on low/very low-quality evidence, and 56.06% were intended for treatment. Furthermore, 51.39% and 74.60% of strong and weak recommendations were based on low/very low-quality evidence, respectively. Regarding the analysis of their wording, there was disagreement between the language and the certainty of evidence in 50.31% of the 324 recommendations randomly reviewed. Conclusions: The CPGs evaluated include a relatively high number of recommendations, most of them in favor and rated as strong but based on low-quality evidence, which may be controversial and generate barriers to their understanding and implementation. These results also indicate the need to improve adherence to the CPG development methodology and standards among Colombian CPG development groups.

Resumen Introducción. En la última década, y previa publicación de una guía metodológica para el desarrollo de guías de práctica clínica (GPC), el Ministerio de Salud y Protección Social de Colombia (MSPS) comisionó la generación o actualización de una serie de GPC. Sin embargo, hasta el momento no hay un diagnóstico de las características de las recomendaciones realizadas en dichas GPC. Objetivo. Explorar las características de las recomendaciones incluidas en las GPC comisionadas por el MSPS entre 2013 y 2021. Materiales y métodos. Se realizó una revisión sistemática de GPC colombianas publicadas entre 2013 y 2021. Para su inclusión, las GPC debían reportar la certeza de la evidencia y la fuerza de la recomendación en 70% o más de sus recomendaciones según la metodología GRADE. Se extrajo información sobre la certeza, dirección y fuerza de cada recomendación. También se evaluó la concordancia entre el lenguaje utilizado y la calificación de la fuerza en una muestra aleatoria de 20% de las recomendaciones. Resultados. De 59 GPC obtenidas, 36 fueron incluidas para un total de 1 609 recomendaciones analizadas. La mediana de recomendaciones por GPC fue 41 (RIC: 27-55), 81.04% de las recomendaciones tienen dirección a favor, 62.77% son fuertes, 58.23% tienen evidencia de baja/muy baja calidad y 56.06% son sobre tratamiento. Además, 51.39% de las recomendaciones fuertes y 74.60% de las débiles se basan en evidencia de certeza baja/muy baja. En lo que respecta al análisis de redacción, se encontró discordancia entre el lenguaje utilizado y la calificación de la certeza de la evidencia en 50.31% de las 324 recomendaciones revisadas. Conclusiones. Las GPC evaluadas tienen un número relativamente alto de recomendaciones, la mayoría a favor y calificadas como fuertes pero basadas en evidencia de baja calidad, lo que podría ser controversial y generar barreras para su comprensión e implementación. Estos resultados señalan la necesidad de mejorar la adherencia a la metodología y los estándares de elaboración de GPC por parte de los grupos desarrolladores de GPC colombianos.

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Background: Traditionally, X-rays have remained the standard modality for bone fracture diagnosis. However, other diagnostic modalities most notably ultrasound have emerged as a simple, radiation-safe, effective imaging tool to diagnose bone fractures. Despite the advantages, there is a prevalent scarcity of literature recognizing its significance in bone trauma management. This review investigates the effectiveness of ultrasound in the diagnosis of various bone fractures when compared to conventional radiography such as X-rays. Methodology: Electronic databases such as PubMed/Medline, SCOPUS, and Web of Science (WOS) were reviewed for observational studies and review articles from the years 2017-2022 utilizing MESH terminology in a broad term search strategy. The search returned a total of 248 articles. After removal of duplicates, abstract, and full-text screening this systematic review ultimately utilized data from 31 articles. All searches were performed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) methodology and were conducted during August 2022. In accordance with the guidelines for assessing the quality of included systematic reviews, we used the AMSTAR 2020, Supplemental Digital Content 2, http://links.lww.com/MS9/A241 (A Measurement Tool to Assess Systematic Reviews) tool to evaluate the methodological quality of the included studies. A data extraction form based on the Cochrane Consumers and Communication Review group's extraction template for quality assessment and evidence synthesis was used for data extraction. The information extracted included details such as author information, database, journal details, type of study, etc. Studies included will be classified into long bones, short bones, pneumatic bones, irregular bones, ankle and knee, stress fractures, hip fractures, POCUS, and others. All included studies considered bias and ethical criteria and provided valuable evidence to answer the research question. Results: The search returned a total of 248 articles, with 192 articles remaining after the removal of duplicates. Primary screening of the title and abstract articles from the database search and additional sources identified 68 relevant articles for full-text screening. This systematic review ultimately used data from 33 articles of the remaining articles we included all of them because they had more than 70% certainty, using the STROBE tool for observational articles, narrative reviews with the ENTREQ guide, and systematic reviews and meta-analyses with the PRISMA guide; however, two articles were excluded at the eligibility stage because of risk of bias. Conclusion: This systematic review provides insightful evidence on safety and effectiveness of ultrasound in diagnosing fractures when compared to the conventional imaging modalities such as X-rays. This shall promote further large-scale, multi-centre research that can eventually guide clinic practice in diagnosing and managing various bone fractures.

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Abstract Objectives: To present and execute a protocol for the capture of 3D facial images using photogrammetry through the open access software Blender and its add-on OrtogOnBlender (OOB) and to evaluate the compatibility of the 3D meshes generated with Computed tomography (CT) of the sinuses. Methods: Individuals > 18 years old, candidates for Rhinoseptoplasty in a tertiary hospital, were submitted to a photographic session to perform the standardized protocol. In the session, divided into 3 phases, sequential photos were taken for processing the photogrammetry in the OOB and producing 3D meshes of the face. The photogrammetry reconstructions were compared with the reference mesh of the soft tissue surface of the Sinus CT scan to assess compatibility between them. Results: 21 patients were included, 67% female. 3 photogrammetry meshes and 1 CT reference mesh were generated, which demonstrated matching compatibility, as most of the mean distances between cloud points were <1.48mm. Phase 3 of the session with the highest number of photos (54.36 ± 15.05) generated the most satisfactory mesh with the best resolution. Conclusions: The proposed protocol is reproducible and feasible in clinical practice, generated satisfactory 3D meshes of the face, being a potential tool for surgical planning and comparison of results. For the implementation of photogrammetry for use in 3D anthropometry, it is necessary to validate this method. Level of evidence: 3. OCEBM Levels of Evidence Working Group.1 The Oxford 2011 Levels of Evidence. Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653

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Contextualização: A vitamina D tem sido utilizada na prática clínica e amplamente divulgada na mídia como opção preventiva ou terapêutica em muitas doenças esqueléticas e não esqueléticas, mas sua efetividade, em muitos casos, é ainda incerta. Objetivos: Sumarizar as evidências de revisões sistemáticas da Cochrane, referentes à efetividade da vitamina D para tratamento e prevenção de doenças. Métodos: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca na Cochrane Library (2023), sendo utilizado o descritor MeSH "VITAMIN D". Todas as revisões sistemáticas de ensaios clínicos foram incluídas. O desfecho primário de análise foi a melhora clínica, a redução dos sintomas ou a prevenção da doença. Resultados: 22 estudos foram incluídos, totalizando 284.404 participantes. Há evidência de baixa qualidade relativa a benefícios da suplementação da vitamina D na gestação para mãe e recém-nascido, não sendo encontrados, até o momento, benefícios para outras condições avaliadas. Discussão: Nenhuma intervenção mostrou efetividade com evidência de boa qualidade. Embora haja descrição de benefícios na redução do risco de pré-eclâmpsia, diabetes gestacional, baixo peso do bebê ao nascimento, redução no risco de hemorragia grave pós-parto e redução de fraturas em idosos (quando associada à suplementação de cálcio), esses achados têm evidência limitada e carecem de melhor análise no futuro próximo, a partir de novos ensaios clínicos. Conclusão: Atualmente, não há suporte com bom nível de evidência para a maioria das intervenções com suplementação de vitamina D, sendo recomendada a realização de novos ensaios clínicos para melhor robustez dos achados desses estudos.

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OBJECTIVES: To present and execute a protocol for the capture of 3D facial images using photogrammetry through the open access software Blender and its add-on OrtogOnBlender (OOB) and to evaluate the compatibility of the 3D meshes generated with Computed tomography (CT) of the sinuses. METHODS: Individuals >18 years old, candidates for Rhinoseptoplasty in a tertiary hospital, were submitted to a photographic session to perform the standardized protocol. In the session, divided into 3 phases, sequential photos were taken for processing the photogrammetry in the OOB and producing 3D meshes of the face. The photogrammetry reconstructions were compared with the reference mesh of the soft tissue surface of the Sinus CT scan to assess compatibility between them. RESULTS: 21 patients were included, 67% female. 3 photogrammetry meshes and 1 CT reference mesh were generated, which demonstrated matching compatibility, as most of the mean distances between cloud points were <1.48 mm. Phase 3 of the session with the highest number of photos (54.36 ±â€¯15.05) generated the most satisfactory mesh with the best resolution. CONCLUSIONS: The proposed protocol is reproducible and feasible in clinical practice, generated satisfactory 3D meshes of the face, being a potential tool for surgical planning and comparison of results. For the implementation of photogrammetry for use in 3D anthropometry, it is necessary to validate this method. LEVEL OF EVIDENCE: 3: OCEBM Levels of Evidence Working Group.1 "The Oxford 2011 Levels of Evidence". Oxford Centre for Evidence-Based Medicine. http://www.cebm.net/index.aspx?o=5653.

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Peripheral neuropathy (PN) is frequently observed in systemic rheumatic diseases and is a challenge in clinical practice. We aimed to review the evidence on the subject and proposed a comprehensive approach to these patients, facilitating diagnosis and management. We searched the MEDLINE database for the terms (and its respective Medical Subject Headings (MeSH) terms): "peripheral neuropathy" AND "rheumatic diseases" OR "systemic lupus erythematosus", "rheumatoid arthritis", "Sjogren syndrome", and "vasculitis" from 2000 to 2023. This literature review focuses on the diagnostic workup of PNs related to systemic lupus erythematosus, Sjögren's syndrome, rheumatoid arthritis, and systemic vasculitis. For every type of PN, we provide a pragmatic flowchart for diagnosis and also describe evidence-based strategies of treatment.

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PURPOSE: Brazilian nutrition recommendations for bariatric and metabolic surgery aim to provide knowledge, based on scientific evidence, on nutritional practices related to different surgical techniques in the surgical treatment of obesity and metabolic diseases. MATERIALS AND METHODS: A systematic literature search was carried out with the appropriate MeSH terms using Medline/Pubmed/LiLACS and the Cochrane database, with the established criteria being based on the inclusion of articles according to the degree of recommendation and strength of evidence of the Classification of Recommendations, Evaluation, Development, and Evaluation System (GRADE). RESULTS: The recommendations that make up this guide were gathered to assist in the individualized clinical practice of nutritionists in the nutritional management of patients with obesity, including nutritional management in the intragastric balloon; pre and postoperative nutritional treatment and supplementation in bariatric and metabolic surgeries (adolescents, adults, elderly, pregnant women, and vegetarians); hypoglycemia and reactive hyperinsulinemia; and recurrence of obesity, gut microbiota, and inflammatory bowel diseases. CONCLUSION: We believe that this guide of recommendations will play a decisive role in the clinical practice of nutritionists who work in bariatric and metabolic surgery, with its implementation in health services, thus promoting quality and safety in the treatment of patients with obesity. The concept of precision nutrition is expected to change the way we understand and treat these patients.

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Contexto: O aumento de casos de varíola dos macacos fora do continente africano tem causado preocupação às autoridades sanitárias pela maior agressividade, sugerindo a necessidade de maiores cuidados, envolvendo maior risco de evolução desfavorável. Objetivos: Avaliar a efetividade dos mecanismos metabuscadores ao fornecer um mapeamento de evidências com foco em revisões sistemáticas e uma identificação dessas sínteses de evidência para responder questões atreladas à varíola dos macacos para a prática clínica de profissionais de saúde. Métodos: Trata-se de revisão de literatura. Foram pesquisadas cinco ferramentas eletrônicas: Tripdatabase, Epistemonikos, WorldWideScience, Portal Regional BVS e PubMed ­ Clinical Queries. O foco de busca envolveu apenas as sínteses de evidência em revisões sistemáticas. Foi utilizada a terminologia oficial em língua inglesa nos Descritores em Ciências da Saúde (DeCS) e no Medical Subject Headings (MeSH): Monkeypox. Resultados: Os metabuscadores obtiveram os resultados para a identificação das sínteses: PubMed: 16 revisões sistemáticas; Tripdatabase: 4 revisões sistemáticas, nas quais somente 3, de fato, eram sobre a varíola dos macacos; Epistemonikos: 19 revisões sistemáticas; WorldWideScience: 35 revisões sistemáticas e Portal Regional BVS: 22 revisões sistemáticas. Discussão: A maior sensibilidade das ferramentas metabuscadoras alavancou os resultados, tornando possível um melhor cenário para profissionais de saúde tomarem decisões. Recomenda-se que essas ferramentas sejam utilizadas como rotina nas estratégias de busca. Conclusão: A análise estratégica de busca, a partir da varíola dos macacos, demonstrou que as ferramentas metabuscadoras apresentam excelente abrangência e cobertura no que tange à obtenção das melhores informações científicas, focadas em evidências, recomendando-se sua utilização como fonte inicial para as buscas de evidências e, também, no aprimoramento das perguntas de pesquisa.

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INTRODUCTION: For individuals diagnosed with diabetes mellitus, the practice of properly oriented physical exercises brings significant benefits to the individual's health and is considered an indispensable tool for metabolic management. The individualization of exercise routines is an essential aspect for therapeutic success, despite the need to consider some general recommendations. This review is an authorized literal translation of the Brazilian Society of Diabetes (SBD) Guidelines 2021-2022, which is based on scientific evidence and provides guidance on physical activities and exercises aimed at individuals with type 1 and 2 diabetes. METHODS: SBD designated 9 specialists from its "Department of Diabetes, Exercise & Sports" to author chapters on physical activities and exercises directed to individuals with type 1 and 2 diabetes. The aim of these chapters was to highlight recommendations in accordance with Evidence Levels, based on what is described in the literature. These chapters were analyzed by the SBD Central Committee, which is also responsible for the SBD 2021-2022 guidelines. Main clinical inquiries were selected to perform a narrated review by using MEDLINE via PubMed. Top available evidence, such as high-quality clinical trials, large observational studies and meta-analyses related to physical activity and exercise advisory, were analyzed. The adopted MeSh terms were [diabetes], [type 1 diabetes], [type 2 diabetes], [physical activity] [physical exercise]. RESULTS: 17 recommendations were defined by the members. For this review, it was considered different Evidence Levels, as well as different Classes of Recommendations. As to Evidence Levels, the following levels were contemplated: Level A) More than one randomized clinical trial or a randomized clinical trial meta-analysis with low heterogeneity. Level B) Meta analysis with observational studies, one randomized clinical trial, sizeable observational studies and sub-groups analysis. Level C) Small non-randomized studies, cross-sectional studies, case control studies, guidelines or experts' opinions. In respect to Recommendation Classes, the following criteria were adopted: I. "Recommended": Meaning there was a consent of more than 90% of the panel; IIa. "Must be considered": meaning there is a general preference of the panel which 70-90% agrees; IIb. "Can be considered". 50-70% agrees; III Not recommended: There is a consensus that the intervention should not be performed. CONCLUSION: Physical exercise aids on the glycemic control of type 2 diabetes individuals while also decreasing cardiovascular risk in individuals with type 1 and 2 diabetes. Individuals diagnosed with diabetes should perform combined aerobic and resistance exercises in order to manage the disease. In addition, exercises focusing on flexibility and balance should be specially addressed on elderly individuals. Diabetes individuals using insulin as therapeutic treatment should properly monitor glycemia levels before, during and after exercise sessions to minimize health incidents, such as hypoglycemia.

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Introdução: As mudanças nas estratégias de ensino ao longo dos anos têm proporcionado destaque na procura por metodologias ativas que sejam flexíveis e que garantem um melhor aproveitamento dos conteúdos ministrados em sala de aula, nesse sentindo, a aprendizagem baseada em equipe ou team-based learning é uma metodologia ativa que envolve trabalho em equipe, raciocínio e pensamento lógico para estimular os discentes podendo ser efetiva para o ensino em enfermagem. Objetivo: avaliar a efetividade da aprendizagem baseada em equipes na educação de enfermeiros. Metodologia: Trata-se de um estudo de revisão integrativa, com a seguinte questão de pesquisa: O que as evidências mostram sobre a aprendizagem baseada em equipes na educação de enfermeiros? As buscas foram realizadas em três bases de dados, usando descritores do Decs e Mesh terms. Resultados: Ao todo foram selecionados dez estudos na amostra final, que versavam sobre desempenho acadêmico, desenvolvimento de habilidades emocionais e físicas, competências fundamentais para desenvolvimento de aptidões na prática clínica. O estudo permitiu compreender sobre a aprendizagem baseada em equipes e afirmar sua eficácia para atuar na educação de enfermeiros, onde foi evidenciado que os estudantes obtiveram maior conhecimento individual e coletivo, puderam trocar experiências com colegas e foram estimulados a trabalhar em equipe. Conclusão: Dessa forma, considera-se que novas pesquisas devem ser realizadas nesta linha de investigação, a fim de afirmar a necessidade de mais estudos que apoiem a utilização do método no ensino de enfermagem.

Introduction: The changes in teaching strategies over the years have provided an emphasis in the search for active methodologies that are flexible and that guarantee a better use of the contents taught in the classroom, in this sense, team-based learning is an active methodology that involves teamwork, reasoning and logical thinking to stimulate students and can be effective for nursing education. Objective: To evaluate the effectiveness of team-based learning in nursing education. Methodology: This is an integrative review study, with the following research question: What does the evidence show about team-based learning in nursing education? Searches were conducted on three databases, using Decs descriptors and Mesh terms. Results: All in all, ten studies were selected in the final sample, which dealt with academic performance, emotional and physical skills development, fundamental competencies for the development of skills in clinical practice. The study allowed us to understand about team-based learning and to affirm its effectiveness in nursing education, where it was evidenced that students gained greater individual and collective knowledge, were able to exchange experiences with colleagues and were stimulated to work as a team. Conclusion: Thus, it is considered that new research should be carried out in this line of investigation, in order to affirm the need for more studies that support the use of the method in nursing teaching.

Introducción: Los cambios en las estrategias de enseñanza a lo largo de los años han puesto de relieve la demanda de metodologías activas que sean flexibles y que garanticen un mejor uso del contenido que se enseña en el aula, en este sentido, team- based learning en el equipo o el aprendizaje basado en el equipo es una metodología activa que implica trabajo en equipo, razonamiento y pensamiento lógico para estimular a los alumnos y que puede ser eficaz para la enfermería. Objetivo: evaluar la eficacia del aprendizaje en equipo en la educación de enfermeras. Metodología: Se trata de un estudio de revisión integrador, con la siguiente pregunta de investigación: ¿Qué muestra la evidencia sobre el aprendizaje basado en equipos en la educación de enfermeras? Las búsquedas se realizaron en tres bases de datos utilizando descriptores de términos Decs y Mesh terms. Resultados: En total, se seleccionaron diez estudios en la muestra final, que abarcaron el desempeño académico, el desarrollo de habilidades emocionales y físicas, competencias fundamentales para el desarrollo de aptitudes en la práctica clínica. El estudio permitió comprender el aprendizaje basado en equipos y establecer su efectividad en la educación de enfermeras, donde se evidenció que los estudiantes obtuvieron mayor conocimiento individual y colectivo, fueron capaces de intercambiar experiencias con sus colegas y se les estimuló a trabajar en equipo. Conclusión: De esta manera, se considera que se debe realizar una investigación adicional en esta línea de investigación para confirmar la necesidad de realizar nuevos estudios que apoyen el uso del método en la educación de enfermería.

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BACKGROUND: Insulin therapy regimens for people with type 1 diabetes (PWT1D) should mimic the physiological insulin secretion that occurs in individuals without diabetes. Intensive insulin therapy, whether by multiple daily injections (MDI) or continuous subcutaneous insulin infusion (CSII), constitutes the fundamental therapy from the initial stages of type 1 diabetes (T1D), at all ages. This review is an authorized literal translation of part of the Brazilian Diabetes Society (SBD) Guidelines 2021-2022. This evidence-based guideline supplies guidance on insulin therapy in T1D. METHODS: The methods were published elsewhere in earlier SBD guidelines and was approved by the Internal Institutional Steering Committee for publication. Briefly, the Brazilian Diabetes Society indicated fourteen experts to constitute the Central Committee, designed to regulate the method review of the manuscripts, and judge the degrees of recommendations and levels of evidence. SBD Type 1 Diabetes Department drafted the manuscript selecting key clinical questions to do a narrative review using MEDLINE via PubMed, with the best evidence available, including high-quality clinical trials, metanalysis, and large observational studies related to insulin therapy in T1D, by using the Mesh terms [type 1 diabetes] and [insulin]. RESULTS: Based on extensive literature review the Central Committee defined ten recommendations. Three levels of evidence were considered: A. Data from more than one randomised clinical trial (RCT) or one metanalysis of RCTs with low heterogeneity (I2 < 40%). B. Data from metanalysis, including large observational studies, a single RCT, or a pre-specified subgroup analysis. C: Data from small or non-randomised studies, exploratory analysis, or consensus of expert opinion. The degree of recommendation was obtained based on a poll sent to the panellists, using the following criteria: Grade I: when more than 90% of agreement; Grade IIa if 75-89% of agreement; IIb if 50-74% of agreement, and III, when most of the panellist recommends against a defined treatment. CONCLUSIONS: In PWT1D, it is recommended to start insulin treatment immediately after clinical diagnosis, to prevent metabolic decompensation and diabetic ketoacidosis. Insulin therapy regimens should mimic insulin secretion with the aim to achieve glycemic control goals established for the age group. Intensive treatment with basal-bolus insulin therapy through MDI or CSII is recommended, and insulin analogues offers some advantages in PWT1D, when compared to human insulin. Periodic reassessment of insulin doses should be performed to avoid clinical inertia in treatment.

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Objetivo: Analisar na literatura o conhecimento dos profissionais da saúde sobre segurança do paciente. Métodos: Revisão integrativa com busca e seleção em cinco bases eletrônicas de dados: MEDLINE, CINAHL, Web of Science, LILACS e BDENF, utilizando descritores controlados e não controlados indexados nos vocabulários DeCS e MESH. Foram incluídos estudos primários, sem delimitação temporal ou de idioma e excluídos os duplicados, editoriais, teses e dissertações. Para análise e síntese, utilizou-se a classificação do nível de evidência baseadas nas recomendações do Oxford Centre for Evidence-based Medicine e os métodos descritivos.Resultados: Foram selecionados 11 artigos desenvolvidos em contexto nacional e internacional, de nível de evidência2C. O nível de conhecimentos gerais sobre segurança do paciente entre os profissionais de saúde foi considerado baixo, envolvendo limitações significativas no entendimento dos conceitos e definições, assim como na aplicação dos pressupostos teóricos na prática assistencial. Nas categorias investigadas,observou-se variação desse nível de conhecimento. Conclusão: Existem lacunas importantes no conhecimento de profissionais de saúde sobre segurança do paciente, que apresentam nível baixo de conhecimento. Destaca-se então,a educação permanente como uma estratégia para promover melhorias. Descritores: Segurança do paciente. Pessoal de saúde. Conhecimento. Enfermagem. Educação continuada.

Objective: To analyze, in the literature, health professionals' knowledge about patientsafety.Methods: An integrative review with searches and selection in five electronic databases: MEDLINE, CINAHL, Web of Science, LILACS and BDENF, using controlled and non-controlled descriptors indexed in the DeCS and MESH vocabularies. Primary studies with no time or language restrictions were included, with exclusion of duplicates, editorials, theses and dissertations. For analysis and synthesis purposes, the level of evidenceclassification based on the Oxford Centre for Evidence-based Medicinerecommendations and the descriptive methods was used. Results: Eleven articles with level of evidence2C and developed in the national and international contexts were selected. The level of general knowledge about patient safety among health professionals was considered low, involving significant limitations in the understanding of concepts and definitions, as well as in the application of theoretical assumptions in the care practice. Inthe categories investigated, certain variation of this knowledge level was observed. Conclusion: There are important gaps in health professionals' knowledge about patient safety, with the subjects presenting low knowledge levels. Therefore, permanent education stands out as a strategy to promote improvements. Descriptors: Patient Safety. Health Personnel. Knowledge. Nursing. Education Continuing

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Gastric-acid suppressants are one of the most frequently used classes of drugs worldwide. Several studies about their overprescribing have been carried out in recent years. The aim of the study was to assess the appropriateness of these drugs at an internal medicine service of a tertiary hospital in Venezuela. A retrospective record review of patients admitted to the internal medicine service from January 2020 to February 2021 was performed. Data about indications for gastric-acid suppressants, the type used, and their continuation at discharge were collected. The prescribing was grouped into two categories, appropriate or inappropriate, according to current clinical guidelines. Of the 1203 patients who were newly prescribed gastric-acid suppressants in hospital during the study period, 993 (82.5%) had an inappropriate prescription. Prophylaxis of peptic ulcers in low-risk patients was the most frequent no evidence-based indication (20.24%). Seven hundred sixty-two patients were discharged on gastric-acid suppressants. Of these, 74.7% did not have an acceptable indication to continue this treatment on an outpatient basis. Many hospitalized patients in a Venezuelan academic tertiary healthcare center were given gastric acid suppressants not in accordance with the current clinical practice guidelines.

Los supresores del ácido gástrico son uno de los grupos farmacológicos más frecuentemente prescritos en todo el mundo. En los últimos años se han realizado varios estudios sobre su prescripción inadecuada. El objetivo del estudio fue evaluar la idoneidad de estos medicamentos en un servicio de medicina interna de un hospital de tercer nivel en Venezuela. Se realizó una revisión retrospectiva de historias medicas de pacientes ingresados en el servicio de medicina interna desde enero de 2020 hasta febrero de 2021. Se recogieron datos sobre indicaciones de supresores de ácido gástrico, tipo utilizado y su continuación al alta. La prescripción se agrupó en dos categorías, adecuada o inadecuada, según las guías clínicas vigentes. Entre los 1203 pacientes a los que se les prescribió recientemente supresores de ácido gástrico en el hospital durante el período de estudio, 993 (82,5%) tenían una prescripción inapropiada. La profilaxis de úlceras pépticas en pacientes de bajo riesgo fue la indicación no basada en evidencia más frecuente (20,24%). Setecientos sesenta y dos pacientes fueron dados de alta con supresores de ácido gástrico. De estos, el 74,7% no tenía una indicación apropiada para continuar este tratamiento de forma ambulatoria. Un alto número de pacientes hospitalizados en un centro asistencial de nivel terciario en Venezuela fueron prescritos con supresores de ácido gástrico que no se ajustaban a las guías de práctica clínica vigentes.