Adapting Elements of Cleft Care Protocols in Low- and Middle-income Countries During and After COVID-19: A Process-driven Review With Recommendations

A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptations to cleft care protocols during and after COVID-19 as a priority learning area of need. A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptations to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organizations involved in comprehensive cleft care. Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinized and COVID-19 adaptations, specifically in the pre- and perioperative periods, were highlighted. Second, surgical procedures and cleft care services were prioritized according to their relationship to functional outcomes and time-sensitivity. The surgical procedures assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft care services assigned the highest priority were new-born assessments, pediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

A Systematic Review Discussing Biomarkers for Early or Pre-Alzheimer’s Disease for Clinical Diagnosis

Alzheimer’s is a progressive neurodegenerative disease that usually starts slowly and gradually worsens over time. It constitutes for over 65% of dementia cases and currently has no cure. This paper reviews the biomarkers for Alzheimer’s Disease (AD) and evaluates these biomarkers based on various pathologies they are associated with, using the International Working Group (IWG) criteria, sensitivity, specificity etc. This paper summarizes the existing biomarkers, critically compares them and highlights which biomarkers are most effective for clinical diagnosis. It also discusses some of the drawbacks associated with using some biomarkers, either alone or in combination with others

Adapting cleft care protocols in low- and middle-income countries during and after COVID-19: a process-driven review with recommendations

Objective: A consortium of global cleft professionals, predominantly from low- and middle-income countries, identified adaptions to cleft care protocols during and after COVID as a priority learning area of need. Design: A multidisciplinary international working group met on a videoconferencing platform in a multi-staged process to make consensus recommendations for adaptions to cleft protocols within resource-constrained settings. Feedback was sought from a roundtable discussion forum and global organisations involved in comprehensive cleft care. Results: Foundational principles were agreed to enable recommendations to be globally relevant and two areas of focus within the specified topic were identified. First the safety aspects of cleft surgery protocols were scrutinised and COVID adaptions, specifically in the pre and peri-operative periods, were highlighted. Second, surgical operations and access to services were prioritized according to their relationship to functional outcomes and time-sensitivity. The operations assigned the highest priority were emergent interventions for breathing and nutritional requirements and primary palatoplasty. The cleft services assigned the highest priority were new-born assessments, paediatric support for children with syndromes, management of acute dental or auditory infections and speech pathology intervention. Conclusions: A collaborative, interdisciplinary and international working group delivered consensus recommendations to assist with the provision of cleft care in low- and middle-income countries. At a time of global cleft care delays due to COVID-19, a united approach amongst global cleft care providers will be advantageous to advocate for children born with cleft lip and palate in resource-constrained settings.

A relevância da implantação do Centro de Referência do Pé Diabético em Marabá-PA

Objetivo: Demonstrar a importância da criação do Centro de Referência do Pé Diabético de Marabá (CRPDM) para a cidade e região. Metodologia: Trata-se de um estudo transversal, observacional, retrospectivo conduzido em um hospital geral do Município de Marabá-Pa. A população do estudo correspondeu aos pacientes atendidos pela cirurgia vascular, no Hospital Municipal de Marabá, no período entre abril de 2015 a setembro de 2019. Resultados: Verificou-se um número elevado de atendimentos do serviço de cirurgia vascular no período estudado. Foram realizados 621 atendimentos com predominância de procedimentos cirúrgicos (51%), entre amputações e revisões de coto, e pacientes com diagnóstico de diabetes. Em relação ao gênero houve uma prevalência do sexo masculino, quanto ao município de origem 85% eram de Marabá. Conclusão: Nessa perspectiva, o CRPDM tem como objetivo implantar um serviço de referência para os pacientes diabéticos, baseado nos protocolos e recomendações do Ministério da Saúde, Sociedade Brasileira de Diabetes - SBD e International Working Group on the Diabetic Foot - IWGDP. A perspectiva é mudar a realidade da cidade e região de Marabá, promovendo melhorias na assistência, com o intuito de diminuir as complicações e sequelas nessa população.