Background Health-related quality of life (HRQoL) has become a significant outcome in assessing interventions in the pediatric population and could be influenced by diet patterns. The Mediterranean diet (MD) pattern has been related to multiple positive health outcomes, including decreased cardiovascular risk and better mental health. We aimed to evaluate the association between MD adherence and HRQoL in children and adolescents. Methods The literature search was conducted in PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Ovid-MEDLINE databases from inception to May 2022. Two researchers independently checked titles and abstracts, evaluated full-text studies, extracted data, and appraised the risk of bias using the Newcastle–Ottawa Scale (NOS). Results Eleven studies (1 longitudinal and 10 cross-sectional), totaling 6,796 subjects, were included. Ten studies assessed MD adherence with KIDMED index, and one assessed MD adherence with Krece Plus test, while all included studies assessed HRQoL with a KIDSCREEN test. All studies analyzed the association between MD adherence and HRQoL with linear regression, and eight used adjusted models. Five studies found a significant positive association of MD adherence with HRQoL, with β-values ranging from 0.13 to 0.26. Two found a nonsignificant positive relationship, while one found a negative association. According to the NOS criteria, the risk of bias assessment showed four studies with a low risk of bias and seven with a high risk of bias. Conclusion Our findings suggest a positive correlation of MD adherence with HRQoL in children and adolescents. However, future research is needed to strengthen the evidence of this relationship. Trial registration CRD42021236188 (PROSPERO)

Background Evidence-based medicine (EBM) is defined as the integration of the best available evidence from scientific studies with clinical experience (and context) and with patients’ values and preferences. The objective of the present study was to describe self-perceived EBM competencies in physicians and medical students enrolled in a massive virtual EBM course. Methods Analytical cross-sectional study. People interested in a free virtual EBM course fulfilled their data in a virtual form for their registration in September 2020. In this form, 22 competencies related to four dimensions of EBM were evaluated: asking a clinical question, search, analysis, and application; using a 5-option Likert scale. The resulting database was analyzed, selecting people who claimed to be physicians or medical students of 18 years or more. Results 1793 participants were included: 1130 medical students and 663 physicians; more than 80% lived in Peru. The frequency of participants who agreed or strongly agreed with feeling qualified in each competence ranged: from 39.2% to 57.8% for the competencies of the ‘Asking a clinical question’ dimension, from 39.2% to 56.1% for ‘Search,’ from 19.9% to 32.0% for ‘Analysis,’ and from 19.6% to 29.9% for ‘Application.’ Both in physicians and students, the lowest frequencies were for the competencies of interpretation of impact measures, graphs, and results of systematic reviews; as well as shared decision making and calculation of expected benefit. Physicians who graduated more recently scored better on competencies from search and analysis dimensions. Conclusion Among physicians and medical students enrolled in the course, self-perception of competencies was lower in the dimensions of analysis and application. More recently graduated physicians seem to have a greater self-perception of their research and analysis skills, probably due to curricular updates. List of abbreviations: EBM: Evidence-based medicine; CIMBE, for its acronym in Spanish: International Course on Evidence-Based Medicine; SOCIMEP, for its acronym in Spanish: Peruvian Medical Student Scientific Society

Background Telemedicine has become more relevant during the COVID-19 pandemic. However, medical students and professionals do not acquire competences in telemedicine during their training. Our objective was to describe the self-reported perception and baseline knowledge of telemedicine among medical students and professionals enrolled in a virtual course. Methods Cross-sectional study that included physicians or medical students aged 18 years or older who were interested in a free virtual telemedicine course and who completed the data collection questionnaire. We used a Likert scale to assess the self-reported perceptions of four domains related to telemedicine. The participants were grouped into three levels for each domain: low, medium and high. We also objectively assessed telemedicine knowledge by means of 10 questions, with a cut-off point of 50% of correct answers. The Fisher's exact test, the Chi-square test, and the Mann–Whitney U test were used for the comparison of categorical data. A p-value < 0.05 was considered statistically significant. Results We included 161 participants: 118 medical students and 43 physicians. We observed no significant differences between medical students and physicians in self-reported perceptions of knowledge, security, or utility of telemedicine. However, students had a high self-reported perception of the disadvantages of telemedicine especially related to patient security (p = 0.018), efficiency of care (p = 0.040), and the possibility of medical malpractice (p = 0.010) compared to physicians. Nearly half of the students (n = 53,44.9%) and physicians (n = 22,51.7%) answered 50% or more of the questions related to telemedicine knowledge correctly. Conclusion Among the physicians and medical students enrolled in the course, the students perceived the disadvantages of telemedicine more frequently. Although physicians and students have limited knowledge of telemedicine, there appears to be no influence of experience and prior training in telemedicine.

No abstract

Introducción: El presente artículo resume la guía de práctica clínica (GPC) para el tratamiento farmacológico inicial nefritis lúpica en el Seguro Social del Perú (EsSalud). Objetivo: Proveer recomendaciones clínicas basadas en evidencia para tratamiento farmacológico inicial de adultos con nefritis lúpica clase I a V no refractarios en EsSalud. Material y Métodos: Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos, el cual formuló preguntas clínicas. Se realizaron búsquedas sistemáticas de revisiones sistemáticas y –cuando fue considerado pertinente– estudios primarios en PubMed durante el 2021. Se seleccionó la evidencia para responder cada una de las preguntas clínicas planteadas. Se evaluó la certeza de evidencia usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG usó la metodología GRADE para revisar la evidencia y formular las recomendaciones. La GPC fue revisada por expertos externos antes de su aprobación. Resultados: La GPC abordó 6 preguntas clínicas, divididas en 2 temas: tratamiento inicial de la fase de inducción y mantenimiento. En base a dichas preguntas se formularon 11 recomendaciones (todas condicionales), 22 puntos de buena práctica clínica, y 2 flujogramas. Conclusión: Se emitieron recomendaciones basadas en evidencia para el manejo de pacientes con esta patología.