The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization, virological clearance, and severe adverse events. A total of 48 studies were retrieved from the databases. Eleven articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. We can conclude that dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries, since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. The reviews of this paper are available via the supplemental material section.

Objective Pain treatment is an essential component of care for elderly patients with advanced dementia. The objective of this study was to identify and analyze the different scales used for pain assessment in elderly persons diagnosed with dementia, in the literature available at the Latin American level. Method A systematic review was performed on the existing scales for pain assessment in elderly people diagnosed with Alzheimer's disease, vascular dementia, and dementia with Lewy bodies. Results 226 articles were retrieved from the PUBMED, BIREME, and Scielo databases, of which a total of 10 articles entered the systematic review. The instruments identified in these publications were PAINAD, Abbey, McGill, and PACSLAC, while the Colored Pain Scale, Faces Pain Scale, and VAS scales were used as the silver standard. In Spanish, the Abbey scale, and in Portuguese, the PACSLAC scale showed the best reliability and validity coefficients. Significance of results It is concluded that there are only two appropriate scales for the assessment of pain in people with dementia in the region of interest of this study. It is recommended to generate more evidence for a more accurate assessment of pain in people with dementia.

<p>Introducción: La calidad de vida de los cuidadores de pacientes en fase terminal, puede verse seriamente afectada. Algunos autores señalan que los cónyuges de pacientes con enfermedades terminales pueden pasar hasta 100 horas semanales abocados a su atención, esa situación puede comprometer la salud física, psicosocial y el bienestar espiritual del cuidador. Esta dimensión es de fundamental importancia para gestionar el cuidado de los pacientes con enfermedad terminal de manera integral.</p><p>Objetivo: Analizar la calidad de vida en los cuidadores familiares de pacientes con enfermedad terminal, bajo un programa de cuidados paliativos domiciliarios en un hospital de gestión privada de la ciudad de Córdoba en el período diciembre 2015-abril de 2017.</p><p>Metodología: Se realizó un estudio descriptivo y transversal en familiares cuidadores de pacientes ingresados en el Programa de Atención Domiciliaria del Hospital Privado de Córdoba. La muestra fue no probabilística de 310 pacientes y sus familiares cuidadores. El instrumento aplicado para medir calidad de vida relacionada a la salud fue el SF-36. Se realizaron análisis descriptivos exploratorios e inferenciales multivariados.</p><p>Resultados: Se identificó un perfil de cuidador que es mujer de más de 60 años de edad, que es esposa o hija del/la paciente y que en promedio ejerce esa función por un año. Los cuidadores de 60 o más años tienen menos percepción de la calidad de vida que los cuidadores menores de 60 años en las siguientes dimensiones: rol físico, vitalidad, dolor, salud general, función física, y por último en ambos componentes sumarios de la escala: el físico y el mental.</p><p>Conclusión: Se puede afirmar que independientemente del tipo de patología y del tiempo que pueda estar internado el paciente en atención domiciliaria, la edad de los cuidadores [a partir de los 60 años] es un factor importante para la afectación de las dimensiones señaladas de la calidad de vida.</p><p> </p>

Given the variability of previously reported results, this systematic review aims to determine the clinical effectiveness of convalescent plasma employed in the treatment of hospitalized patients with diagnosis of COVID-19.We conducted a systematic review of controlled clinical trials assessing treatment with convalescent plasma for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, and ventilation requirement.A total of 50 studies were retrieved from the databases. Four articles were finally included in the data extraction, qualitative and quantitative synthesis of results. The meta-analysis suggests that there is no benefit of convalescent plasma compared to standard care or placebo in the reduction of the overall mortality and in the ventilation requirement; but there could be a benefit for the clinical improvement in patients treated with plasma.We can conclude that the convalescent plasma transfusion cannot reduce the mortality or ventilation requirement in hospitalized patients diagnosed with SARS-CoV-2 infection. More controlled clinical trials conducted with methodologies that ensure a low risk of bias are still needed.

Aims: Given the variability of previously reported results, this systematic review aims to determine the clinical effectiveness of convalescent plasma employed in the treatment of hospitalized patients diagnosed with COVID-19. Methods: We conducted a systematic review of controlled clinical trials assessing treatment with convalescent plasma for hospitalized patients diagnosed with SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, and ventilation requirement. Results: A total of 51 studies were retrieved from the databases. Five articles were finally included in the data extraction and qualitative and quantitative synthesis of results. The overall risk of bias in the reviewed articles was established at low-risk only in two trials. The meta-analysis suggests that there is no benefit of convalescent plasma compared with standard care or placebo in reducing the overall mortality and the ventilation requirement. However, there could be a benefit for the clinical improvement in patients treated with plasma. Conclusion: Current results led to assume that the convalescent plasma transfusion cannot reduce the mortality or ventilation requirement in hospitalized patients diagnosed with SARS-CoV-2 infection. More controlled clinical trials conducted with methodologies that ensure a low risk of bias are still needed. The reviews of this paper are available via the supplemental material section.

Objective. The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. Method. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events. Results. A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. Conclusions. Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. Significance of results. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. Keywords: Drugs; Antivirals; Clinical improvement; Mortality; COVID-19; SARS-CoV2.

En México, durante la presidencia de Porfirio Díaz (época conocida como el “Porfiriato”), tuvo lugar la construcción de La Castañeda. Este hospital ofrecía atención psiquiátrica y asilo a personas de cualquier edad, fue inaugurado oficialmente en el año 1910 en el barrio de Mixcoac, lo que hoy en día forma parte de la Delegación Benito Juárez de la ciudad de México Se trataba de una importante época para México, en la cual se consideraba que era necesario mantener “cierto nivel” entre la población, pues la imagen resultaba fundamental. La Castañeda fue construida con la idea de reproducir los modelos a seguir en la época: el tratamiento de la locura en Estados Unidos y Europa. Con esa idea, La Castañeda sería un espacio para mantener alejados a los “dementes” (en su mayoría pobres) alejados de la ciudad para mantener ese nivel deseado por el General Porfirio Díaz.

Objective: The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection.Method: We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events.Results: A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir.Conclusions: Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings.Significance of results: The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources.