Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

A Revista Brasileira de Medicina de Família e Comunidade (RBMFC) agradece aos Avaliadores listados abaixo que atuaram como revisores ad hoc durante o ano de 2024, dedicando horas voluntariamente para a emissão de pareceres técnicos sobre manuscritos submetidos a esta revista.

Introduction: It is important for dentists to be aware of biosafety protocols to minimize the occupational risk of COVID-19 transmission. Objective: To determine the level of knowledge of Peruvian dentists regarding biosafety protocols for dental care during the COVID-19 pandemic. Methods: Observational, descriptive, and cross-sectional study that evaluated 240 dentists in Metropolitan Lima (120 general dentists and 120 specialists). A questionnaire consisting of 20 single-choice questions was developed. The level of knowledge was classified as high, medium, and low. Variables such as age, sex, years of work experience, work sector, and university of origin were analyzed. The Fisher and Pearson chi-square tests were used for categorical variables, and the Student T tests were used for numerical variables, depending on compliance with the assumptions. Results: It was found that 70.8% (n=170/240) of dentists had a medium level of knowledge, 22.1% (n=53/240) had a low level, and 7.1% (n=17/240); had a high level. The average overall knowledge level was 12.46 ± 2.72. Specialists (13.38 ± 2.55) had a higher overall average than general dentists (11.53 ± 2.57); p< 0.001. Conclusion: Dentists' level of knowledge about biosafety protocols for dental care during the COVID-19 pandemic was predominantly medium.

Introduction: Currently, there is a legal and axiological discussion regarding whether to approve or deny euthanasia for those suffering from an irreversible and degenerative illness. To prevent this act from being viewed as contrary to all types of norms and being practiced without a rational motive, it must be carried out in accordance with established medical protocols and legal provisions.Objective: Systematize the bioethical and legal arguments that support euthanasia as an alternative for human beings to guarantee their right to a dignified death.Methods: A narrative review was conducted of studies published from 2023 to 2024 on the legal and bioethical aspects of euthanasia as an alternative for a dignified death. The databases consulted were Medline/Pubmed, Scopus, and SciELO, along with the Google Scholar search engine. The search terms used included: autonomy, dignity, human dignity, bioethics, dignified death, euthanasia, and human rights. A total of 41 articles met the inclusion criteria.Development: Studies and trends regarding the implementation of euthanasia have become recurring topics in recent times, as they invoke human dignity. For the science of law, this subject requires epistemic analysis due to its significant implications and derivations for bioethics.Conclusions: The systematization allowed for the identification and argumentation of the main bioethical, legal, theoretical, and practical arguments from the studies conducted on the topic. Euthanasia can constitute an alternative for human beings to guarantee their full right to a dignified death, without violating the existing amalgam of human rights.

Introduction: Irritable bowel syndrome is a common digestive disorder in people under 50 years of age, characterized by abdominal pain, constipation and diarrhea. Objective: To analyze the effect of probiotics on the clinical symptoms of irritable bowel syndrome in adult patients. Methods: A scoping review was conducted using the database of the Virtual Library of the Universidad César Vallejo, including Scopus, PubMed, Proquest and EbscoHost, using probiotics, irritable bowel syndrome and type of study as search terms. Studies published between 2016 and June 2021 were selected; in any language, and included patients over 16 years of age with a diagnosis of IBS according to ROME III and ROME IV criteria, and included probiotic supplementation. Pregnant women and those with medication changes before or during the study were excluded. We found 4989 articles and selected 18 clinical trials. Results: The most commonly used probiotics were Lactobacillus, Bifidobacterium and Bacillus coagulans, and 13 of 18 trials showed improvement in abdominal pain, diarrhea, constipation or bloating in irritable bowel syndrome. The duration of treatment ranged from 4 to 16 weeks, and the dose of probiotics, administered individually or in multi-strain combinations, was found to be in the order of 109 to 1010 CFU/day. Conclusion: Probiotics improve the symptoms of irritable bowel syndrome in patients during their treatment.

Introduction: It has been suggested that the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) could serve as an additional test to support and complement existing tests for hyperglycemic states. Objective: To determine the diagnostic capacity of HOMA-IR for Type 2 diabetes mellitus (T2DM) and prediabetes. Methods: Diagnostic test study. Both were measured according to elevated fasting; postprandial, and glycosylated hemoglobin levels. The receiver operating characteristic curve (ROC) along with its corresponding area under the curve (AUC) was used to evaluate diagnostic efficacy. Sensitivity and specificity metric were calculated. Results: The prevalence of prediabetes and T2DM were 18.82% and 10.52%, respectively. The median HOMA-IR was 1.33. HOMA-IR had an AUC of 0.843 for prediabetes in the total population, with a cutoff point of 1.51, a sensitivity of 88.37%, and a specificity of 73.05%. In the case of T2DM, the AUC was 0.907, with a cutoff point of 2.02, a sensitivity of 90.91%, and a specificity of 77.99%. Conclusions: HOMA-IR demonstrates good diagnostic capability for the detection of prediabetes and T2DM.

Introduction: Congenital cardiovascular disorders are anomalies of the structure or function of the cardio-circulatory system present at the time of birth. Atrial septal defect is the defect that most frequently reaches adulthood without being diagnosed. Objective: To present the clinical case of a patient with atrial septal defect, ostium secundum type, diagnosed in adulthood. Clinical Case: Female patient, 56 years old, seen in consultation for dyspnea on exertion. The physical examination revealed a constant split second sound and a mid-systolic murmur in the pulmonary focus. Atrial septal defect was diagnosed through electrocardiogram and transthoracic and trans-esophageal echocardiography. The patient did not accept the interventional treatment; however, she maintains a good quality of life. Conclusions: Atrial septal defect is the congenital heart disease that most frequently reaches adulthood without being diagnosed, is relatively well tolerated, can be asymptomatic and can be managed conservatively.

Introduction:  Distal aneurysms of the anterior cerebral artery are rare vascular lesions. Microsurgical clipping constitutes a therapeutic modality used in a traditional way, which is accompanied by high complexity due to its intricate and varied topography, as well as its close neurovascular relationships. Objective:  To describe the surgical results of distal aneurysms of the anterior cerebral artery operated by microsurgical clipping. Methods: A descriptive, prospective study was carried out, which included 11 distal aneurysmal sacs of the anterior cerebral artery operated by microsurgical clamping at the Hermanos Ameijeiras Hospital. An interhemispheric and pterional approach was performed. Imaging, preoperative and postoperative clinical variables were used with greater importance related to the Glasgow Coma Scale for results and complications. For data analysis, absolute and relative frequencies were used as summary measures. Results: Aneurysms with A3 or Precallosal topography predominated (45.5%); and of size between 6-10 millimeters (66.6%). The interhemispheric approach was used most frequently (72.7%); and clipping was achieved in all patients. There was a predominance of the Glasgow Coma Scale for results of 4 (36.4%) and 5 (54.5%). Among the main complications, pneumonia and hydrocephalus (18.2%), respectively, stood out. Conclusions:  Microsurgical clipping in patients with distal aneurysms of the anterior cerebral artery is characterized by being a safe, effective procedure with low complications related to the surgical procedure.

Introduction: COVID-19 is a severe disease that has resulted in high mortality rates among patients with risk factors, such as advanced age and preexisting conditions. Objective: To determine the relationship between non-communicable diseases (NCDs) and COVID-19 mortality. Methods: Descriptive study using secondary data from the Peruvian National Death System. A total of 55 deaths per outbreak at the start of each lockdown period in 2020 and 2021 were included. Data were coded from national death repositories and analyzed using SPSS by gender, age group, non-communicable diseases, and causes of death. Results: In 2020, the average age at death was 65.6±14.6 years, 67.3% were male, and 60% of deaths occurred in Lima. The main chronic diseases were diabetes, obesity (14.5%), hypertension, and kidney disease (9.1%). A significant relationship was found between age and obesity (p= 0.016). In 2021, the average age was 71.7±9.8 years, 70.9% were male, and 30.9% of deaths occurred in Lima. Hypertension (18%) and kidney disease (1.8%) were the main NCDs affecting primarily those over 70 years old (3.6%). Conclusions: Non-communicable diseases were associated with COVID-19 deaths, particularly among the elderly. These findings underscore the importance of protecting the most vulnerable age groups and implementing appropriate preventive and treatment measures during health emergencies.

Introduction: Stigma continues to be a barrier in the prevention and control of HIV, which also entails physical and psychological consequences for those who perceive it. Objective: Assess factors associated with HIV stigma. Methods: Analytical study of cases and controls in people living with HIV: 73 with high stigma (cases) and 73 with low stigma (controls). The variables studied were age, sex, sexual orientation, employment status, marital status, time of diagnosis, and HIV stigma. Data collection was carried out in the waiting room of the HAART program of a publicly managed hospital in Trujillo, Peru; using the HIV Stigma Scale and a data identification sheet. For data analysis, the Odds ratios (OR) were determined, and the confidence intervals (CI) were calculated. Results: The associated factors were employment status (OR= 2.94; CI= 1.32-6.55) and gender (OR= 2.35; CI= 1.14-4.85); while, marital status (OR= 1.57; CI= 0.77-3.20), age (OR= 1.43; CI= 0.62‑3.28), sexual orientation (OR= 0.95; CI= 0.49-1.82) and time of diagnosis (OR= 0.82; CI= 0.34-1.97) did not represent associated factors. Conclusions: Being unemployed and being a woman acted as factors associated with HIV stigma.