BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE...COVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
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Wound care is a regular component of the package of care we offer in the majority of our health care facilities and represents a high volume of activities. The current practices in MSF projects are often based on the habits of each individual supervisor, the wound care material we off...er is partly outdated and does not allow optimal wound care. There is a need for standardization of wound care and it needs to be evidence based as much as possible, taking into account the realities of the field.
The scope of this document is to guide the caregiver in the wound care process. It does not intend to provide in depth information on wound healing or physiology. There is a wide range of literature and background information available for this purpose in the references and in the list of extra reading
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Guide de mise en œuvre à l’intention des Sociétés nationales de la Croix-Rouge et du Croissant-Rouge
orientations provisoires, première publication: 10 février 2021, mise à jour : 21 avril 2021, dernière mise à jour : 30 juillet 2021
Document d'orientation pour le personnel de santé
Nachsynodales Apostolisches Schreiben uber die liebe in der familie (2016)
Carta Enciclica Fratelli Tutti
sobre a fraternidade a amizade social
Analysis of fake news disseminated during the COVID-19 pandemic in Brazil
After completing this activity, pharmacists should be able to:
1. List populations for which the compounding of an oral liquid may be necessary
2. Outline necessary considerations that should be made by the pharmacist to ensure product stability
3. Describe methods used in the compounding of liqu...id preparations
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Relatório especial do IPCC sobre mudança do clima,
desertificação, degradação da terra, manejo sustentável da
terra, segurança alimentar, e fluxos de gases de efeito estufa
em ecossistemas terrestres
Updated Treatment Guidelines
Le Guide de formation aux actions essentielles de nutrition et aux actions essentielles d'hygiène : Travailleurs communautaires renforce la capacité des travailleurs communautaires à fournir et à promouvoir les actions essentielles en matière de nutrition et d'hygiène. Il présente le contenu ...technique dans le cadre de sessions pratiques de conseil et de négociation, à l'aide de jeux de rôle et de pratiques sur le terrain. Il aide les agents communautaires à comprendre pourquoi et comment intégrer des messages sur la nutrition et l'hygiène dans leurs différentes plates-formes de programme en utilisant une approche de cycle de vie pour délivrer le bon message à la bonne personne au bon moment.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Esta publicação apresenta a Agenda para as Américas sobre Saúde, Meio Ambiente e Mudança Climática 2021–2030 (a Agenda). Esta Agenda é um apelo ao setor da saúde para que se posicione na vanguarda da abordagem aos determinantes ambientais da saúde nas Américas. A Organização Pan-Americ...ana da Saúde (OPAS) trabalhará com os Estados Membros para alcançar a meta e objetivo desta agenda: assegurar uma vida saudável e promover o bem-estar para todos, em todas as idades, usando um enfoque sustentável e equitativo que priorize a redução das iniquidades em saúde. A Agenda foi desenvolvido sob a égide da Estratégia Mundial da Organização Mundial da Saúde (OMS) sobre a Saúde, o Meio Ambiente e a Mudança Climática e se baseia nos compromissos estabelecidos na Agenda de Saúde Sustentável para as Américas 2018–2030 e no Plano Estratégico da OPAS 2020–2025. A Agenda foi desenvolvida em consulta com o Grupo Técnico Assessor (GTA), por meio de um processo decisório consensual com os Estados Membros, durante os anos de 2019 e 2020. Para alcançar o Objetivo de Desenvolvimento Sustentável 3, a Agenda enfoca: melhoria do desempenho dos programas e instituições de saúde pública ambiental; promoção de sistemas de saúde ambientalmente resilientes e sustentáveis; e promoção de cidades e comunidades ambientalmente saudáveis e resilientes. A implementação da Agenda deverá ser contextual, com base nas necessidades e realidades de cada país. Ela beneficiará países e territórios ao promover boas práticas de governança; fortalecer as funções de liderança e coordenação do setor da saúde; favorecer ações intersetoriais; focar na prevenção primária; e melhorar as evidências e a comunicação. Facilitará o acesso aos recursos humanos, técnicos e financeiros necessários para abordar os determinantes ambientais da saúde e garantir que a Região esteja totalmente engajada nos processos e acordos globais de saúde, meio ambiente e mudança climática. O objetivo desta Agenda é fortalecer a capacidade dos atores da saúde, tanto no setor da saúde quanto em outros setores, para abordarem e se adaptarem aos determinantes ambientais da saúde (DAS), priorizando as populações que vivem em condições de vulnerabilidade, a fim de atingir o Resultado Intermediário 18 do Plano Estratégico da OPAS 2020–2025, diretamente, e vários outros resultados do Plano, indiretamente. Para enfrentar e se adaptar aos desafios dos DEA na Região, será necessária uma abordagem integrada e baseada em evidências dentro do setor da saúde e entre os setores, possibilitada e favorecida por boas práticas de governança, mecanismos de gestão adequados, vontade política de alto nível e dotação adequada de recursos humanos, técnicos, tecnológicos e financeiros.
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