Brazilian Consensus on Photoprotection

Brazil is a country of continental dimensions with a large heterogeneity of climates and massive mixing of the population. Almost the entire national territory is located between the Equator and the Tropic of Capricorn, and the Earth axial tilt to the south certainly makes Brazil one of the countries of the world with greater extent of land in proximity to the sun. The Brazilian coastline, where most of its population lives, is more than 8,500 km long. Due to geographic characteristics and cultural trends, Brazilians are among the peoples with the highest annual exposure to the sun. Epidemiological data show a continuing increase in the incidence of nonmelanoma and melanoma skin cancers. Photoprotection can be understood as a set of measures aimed at reducing sun exposure and at preventing the development of acute and chronic actinic damage. Due to the peculiarities of Brazilian territory and culture, it would not be advisable to replicate the concepts of photoprotection from other developed countries, places with completely different climates and populations. Thus the Brazilian Society of Dermatology has developed the Brazilian Consensus on Photoprotection, the first official document on photoprotection developed in Brazil for Brazilians, with recommendations on matters involving photoprotection

3PC-031 A Delphi method to standardise the preparation of autologous serum eye drops?

International audienceBackground and Importance Dry eye disease is a frequent cause of ophthalmology consultation (5%–34% of population worldwide). Severe forms, refractory to conventional treatments (artificial tears, topical corticosteroids, cyclosporine A, contact lenses, punctual occlusion, systemic diseases appropriate management), are responsible for a significant visual impairment and disability. Autologous serum eye drops (ASEDs) are then proven to be an interesting therapeutic alternative. First, in March 2019 we carried out a national inventory of ASED preparations practice that highlights: low supply (13 producer centres) and production heterogeneity. General objective to improve ASEDs quality, safety and supply in our country care institutions. Specific objectives to define the consensual items, in order to establish a national standardised preparation protocol. Method for consensus reaching Delphi method. Four protocol parts aborded: sampling, preparation, controls, conservation. Expert panel recruited by remobilising centres approached in 2019 (ASEDs producers, non-producers, or did not respond). Local steering group: pharmacy resident, head of compounding unit, pharmacy methodologist. Circuit: questionnaire construction, mailing with link access to Google Forms®, response analyses, consensus rate calculation (consensus when ≥ 80%), result synthesis, anonymous referral to experts. As many rounds as necessary to achieve consensus. Twelve answering experts After 4 rounds: out of 39 proposals initially submitted, 26 validated and 10, abandoned. In sampling: 15 items validated, 5 dropped. Preparation: 5 validated, 1 dropped. Control: 3 validated, 4 dropped. Conservation: 3 validated. Four rounds took 86 days. Conclusion and Relevance A standardised protocol ASEDs preparation will be proposed. This could improve the supply of care across the country. Method strengths: Expert opinion solicited on the initial questionnaire; qualified experts on the topic; no geographical limitations; anonymity avoiding opinion leader influence; applicability criteria. Limitations: no ophthalmologists, biologists, patients in the panel; no participation of the largest eye drop producer (despite requests).A clear definition of this eye drop status (pharmaceutical preparation or not) is also necessary. Biochemical quality controls, abandoned, to be resubmitted (molecules supposed to support ASEDs efficacy). Supplementary round necessary to decide the fate of the last item (solution volume in each eye drop bottle). References and/or Acknowledgements 1. Acknowledgements to all colleagues participating to 2019 study or/and Delphi method. Conflict of Interest No conflict of interes

Association Between Endometriosis and Preterm Birth in Women With Spontaneous Conception or Using Assisted Reproductive Technology: A Systematic Review and Meta-Analysis of Cohort Studies

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.OBJECTIVE: To perform a systematic review and meta-analysis to estimate the effect of endometriosis on preterm birth (PB) risk. METHODS: Searches were conducted in PubMed-MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, Google Scholar, and SciELO for studies published in all languages from inception through April 2017. We included cohort studies evaluating pregnant women with and without endometriosis and conception either by spontaneous conception (SC) or with assisted reproductive technology (ART). Primary outcome was PB (<37 weeks), and secondary outcomes were intrauterine growth restriction (IUGR), low birthweight, small for gestational age (SGA), and birthweight. Pooled odds ratios (ORs) and its 95% confidence interval (CI) were calculated as effects, and random-effects models were used for meta-analyses. Risk of bias was assessed with the Newcastle-Ottawa Scale, and heterogeneity of effects among studies was described with the I2 statistic. RESULTS: We identified 9 cohort studies including a total of 1 496 715 pregnancies (13 798 with endometriosis diagnosis). In women with endometriosis, the PB risk was significantly increased in both SC (OR: 1.59; 95% CI: 1.32-1.90) and ART (OR: 1.43; 95% CI: 1.14-1.79). The SGA risk was increased in women with endometriosis (OR: 1.16; 95% CI: 1.05-1.28), while the IUGR and low birthweight risks and birthweight were not affected by endometriosis. CONCLUSION: Endometriosis is associated with increased PB risk in both SC and women who obtained pregnancy using ART. Prospective studies evaluating relevant outcomes are needed to confirm these results.Revisión por pare