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au:González-Rincón, Laura Johanna
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Consenso Colombiano para la prevención, diagnóstico y manejo de condiciones trombóticas en pacientes adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE
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Acevedo-Peña, Juan
; Yomayusa-González, Nancy
; Cantor-Cruz, Francy
; Pinzon-Florez, Carlos
; Barrero-Garzón, Liliana
; De-La-Hoz-Siegler, Ilich
; Low-Padilla, Eduardo
; Ramírez-Ceron, Carlos
; Combariza-Vallejo, Felipe
; Arias-Barrera, Carlos
; Moreno-Cortés, Javier
; Rozo-Vanstrahlen, José
; Correa-Pérez, Liliana
; Rojas-Gambasica, José
; González-González, Camilo
; La-Rotta-Caballero, Eduardo
; Ruíz-Talero, Paula
; Contreras-Páez, Rubén
; Lineros-Montañez, Alberto
; Ordoñez-Cardales, Jorge
; Escobar-Olaya, Mario
; Izaguirre-Ávila, Raúl
; Campos-Guerra, Joao
; Accini-Mendoza, José
; Pizarro-Gómez, Camilo
; Patiño-Pérez, Adulkarín
; Flores-Rodríguez, Janine
; Valencia-Moreno, Albert
; Londoño-Villegas, Alejandro
; Saavedra-Rodríguez, Alfredo
; Madera-Rojas, Ana
; Caballero-Arteaga, Andrés
; Díaz-Campos, Andrés
; Correa-Rivera, Felipe
; Mantilla-Reinaud, Andrés
; Becerra-Torres, Ángela
; Peña-Castellanos, Ángela
; Reina-Soler, Aura
; Escobar-Suarez, Bibiana
; Patiño-Escobar, Bonell
; Rodríguez-Cortés, Camilo
; Rebolledo-Maldonado, Carlos
; Ocampo-Botero, Carlos
; Rivera-Ordoñez, Carlos
; Saavedra-Trujillo, Carlos
; Figueroa-Restrepo, Catalina
; Agudelo-López, Claudia
; Jaramillo-Villegas, Claudia
; Villaquirán-Torres, Claudio
; Rodríguez-Ariza, Daniel
; Rincón-Valenzuela, David
; Lemus-Rojas, Melissa
; Pinto-Pinzón, Diego
; Garzón-Díaz, Diego
; Cubillos-Apolinar, Diego
; Beltrán-Linares, Edgar
; Kondo-Rodríguez, Emilio
; Yama-Mosquera, Erica
; Polania-Fierro, Ernesto
; Real-Urbina, Evalo
; Rosas-Romero, Andrés
; Mendoza-Beltrán, Fernán
; Guevara-Pulido, Fredy
; Celia-Márquez, Gina
; Ramos-Ramos, Gloria
; Prada-Martínez, Gonzalo
; León-Basantes, Guillermo
; Liévano-Sánchez, Guillermo
; Ortíz-Ruíz, Guillermo
; Barreto-García, Gustavo
; Ibagón-Nieto, Harold
; Idrobo-Quintero, Henry
; Martínez-Ramírez, Ingrid
; Solarte-Rodríguez, Ivan
; Quintero-Barrios, Jorge
; Arenas-Gamboa, Jaime
; Pérez-Cely, Jairo
; Castellanos-Parada, Jeffrey
; Garzón-Martínez, Fredy
; Luna-Ríos, Joaquín
; Lara-Terán, Joffre
; Vargas-Fodríguez, Johanna
; Dueñas-Villamil, Rubén
; Bohórquez-Feyes, Vicente
; Martínez-Acosta, Carlos
; Gómez-Mesa, Esteban
; Gaitán-Rozo, Julián
; Cortes-Colorado, Julián
; Coral-Casas, Juliana
; Horlandy-Gómez, Laura
; Bautista-Toloza, Leonardo
; Palacios Palacios, Leonardo
; Fajardo-Latorre, Lina
; Pino-Villarreal, Luis
; Rojas-Puentes, Leonardo
; Rodríguez-Sánchez, Patricia
; Herrera-Méndez, Mauricio
; Orozco-Levi, Mauricio
; Sosa-Briceño, Mónica
; Moreno-Ruíz, Nelson
; Sáenz-Morales, Oscar
; Amaya-González, Pablo
; Ramírez-García, Sergio
; Nieto-Estrada, Víctor
; Carballo-Zárate, Virgil
; Abello-Polo, Virginia
.
resumen está disponible en el texto completo
Abstract Recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. In this context, the aim was to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: A rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: Recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.
https://doi.org/10.36104/amc.2021.2078
253 downloads
2.
Consenso colombiano para la prevención, el diagnóstico y el tratamiento de condiciones trombóticas en adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE
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Acevedo-Peña, Juan
; Yomayusa-González, Nancy
; Cantor-Cruz, Francy
; Pinzón-Flórez, Carlos
; Barrero-Garzón, Liliana
; De-La-Hoz-Siegler, Ilich
; Low-Padilla, Eduardo
; Ramírez-Cerón, Carlos
; Combariza-Vallejo, Felipe
; Arias-Barrera, Carlos
; Moreno-Cortés, Javier
; Rozo-Vanstrahlen, José
; Correa-Pérez, Liliana
; Rojas-Gambasica, José
; González-González, Camilo
; La-Rotta-Caballero, Eduardo
; Ruíz-Talero, Paula
; Contreras-Páez, Rubén
; Lineros-Montañez, Alberto
; Ordoñez-Cardales, Jorge
; Escobar-Olaya, Mario
; Izaguirre-Ávila, Raúl
; Campos-Guerra, Joao
; Accini-Mendoza, José
; Pizarro-Gómez, Camilo
; Patiño-Pérez, Adulkarín
; Flores-Rodríguez, Janine
; Valencia-Moreno, Albert
; Londoño-Villegas, Alejandro
; Saavedra-Rodríguez, Alfredo
; Madera-Rojas, Ana
; Caballero-Arteagam, Andrés
; Díaz-Campos, Andrés
; Correa-Rivera, Felipe
; Mantilla-Reinaud, Andrés
; Becerra-Torres, Ángela
; Peña-Castellanos, Ángela
; Reina-Soler, Aura
; Escobar-Suarez, Bibiana
; Patiño-Escobar, Bonell
; Rodríguez-Cortés, Camilo
; Rebolledo-Maldonado, Carlos
; Ocampo-Botero, Carlos
; Rivera-Ordoñez, Carlos
; Saavedra-Trujillo, Carlos
; Figueroa-Restrepo, Catalina
; Agudelo-López, Claudia
; Jaramillo-Villegas, Claudia
; Villaquirán-Torres, Claudio
; Rodríguez-Ariza, Daniel
; Rincón-Valenzuela, David
; Lemus-Rojas, Melissa
; Pinto-Pinzón, Diego
; Garzón-Díaz, Diego
; Cubillos-Apolinar, Diego
; Beltrán-Linares, Edgar
; Kondo-Rodríguez, Emilio
; Yama-Mosquera, Erica
; Polania-Fierro, Ernesto
; Real-Urbina, Evalo
; Rosas-Romero, Andrés
; Mendoza-Beltrán, Fernán
; Guevara-Pulido, Fredy
; Celia-Márquez, Gina
; Ramos-Ramos, Gloria
; Prada-Martínez, Gonzalo
; León-Basantes, Guillermo
; Liévano-Sánchez, Guillermo
; Ortíz-Ruíz, Guillermo
; Barreto-García, Gustavo
; Ibagón-Nieto, Harold
; Idrobo-Quintero, Henry
; Martínez-Ramírez, Ingrid
; Solarte-Rodríguez, Ivan
; Quintero-Barrios, Jorge
; Arenas-Gamboa, Jaime
; Pérez-Cely, Jairo
; Castellanos-Parada, Jeffrey
; Garzón-Martínez, Fredy
; Luna-Ríos, Joaquín
; Lara-Terán, Joffre
; Vargas-Rodríguez, Johanna
; Dueñas-Villamil, Rubén
; Bohórquez-Reyes, Vicente
; Martínez-Acosta, Carlos
; Gómez-Mesa, Esteban
; Gaitán-Rozo, Julián
; Cortes-Colorado, Julián
; Coral-Casas, Juliana
; Horlandy-Gómez, Laura
; Bautista-Toloza, Leonardo
; Palacios, Leonardo Palacios
; Fajardo-Latorre, Lina
; Pino-Villarreal, Luis
; Rojas-Puentes, Leonardo
; Rodríguez-Sánchez, Patricia
; Herrera-Méndez, Mauricio
; Orozco-Levi, Mauricio
; Sosa-Briceño, Mónica
; Moreno-Ruíz, Nelson
; Sáenz-Morales, Oscar
; Amaya-González, Pablo
; Ramírez-García, Sergio
; Nieto-Estrada, Víctor
; Carballo-Zárate, Virgil
; Abello-Polo, Virginia
.
resumen está disponible en el texto completo
Abstract Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.
https://doi.org/10.1016/j.rccar.2020.08.003
86 downloads
3.
Recomendaciones para el uso racional de la prueba 25-hidroxivitamina D Resumen de política
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Herrera-Molina, Emilio
; González, Nancy Yomayusa
; Low-Padilla, Eduardo
; Oliveros-Velásquez, Juan David
; Mendivelso-Duarte, Fredy
; Gómez-Gómez, Olga Victoria
; Castillo, Ana María
; Barrero-Garzón, Liliana Isabel
; Álvarez-Moreno, Carlos Arturo
; Moscoso-Martínez, Ernesto Augusto
; Ruíz-Blanco, Pilar Cristin
; Luna-Ríos, Joaquín Gustavo
; Ortiz, Natasha
; Herrera, Emiliano Mauricio
; Guevara-Santamaría, Fabián
; Moreno-Gómez, Jairo Enrique
; Cárdenas-Ramírez, Héctor Mauricio
; González-González, Camilo Alberto
; Jannauth, María José
; Patiño-Pérez, Adulkarin
; Pinto, Diego Alejandro
; Acevedo, Juan Ramon
; Torres, Rodolfo Eduardo
; Montero, Jairo Camilo
; Acevedo, Andrés David
; Caceres, Ximena Adriana
; Acuña-Olmos, Jairo
; Arias, Carlos Andrés
; Medardo-Rozo, José
; Castellanos-Parada, Jeffrey
; López-Miranda, Ángelo Mauricio
; Pinzón-Serrano, Estefanía
; Rincón-Sierra, Oswaldo
; Isaza-Ruget, Mario
; Suárez-Ramos, María del Pilar
; Vargas-Rodríguez, Johanna
; Mejia-Gaviria, Natalia
; Moreno-Marín, Sandra Yadira
; García-Guarín, Bibiana María
; Cárdenas, Martha Lucía
; Chavarro, Luis Fernando
; Ronderos-Bernal, Camila
; Rico-Landazabal, Arturo
; Coronado-Daza, Jorge Antonio
; Alfaro-Tejeda, Mercedes Teresa
; Yama-Mosquera, Erica
; Hernández-Sierra, Astrid Patricia
; Restrepo-Valencia, César Augusto
; Arango-Álvarez, Javier
; Rosero-Olarte, Francisco Oscar Fernando
; Medina-Orjuela, Adriana
; Robayo-García, Adriana
; Carballo-Zarate, Virgil
; Rodríguez-Sánchez, Martha Patricia
; Bernal, Dora P.
; Jaramillo, Laura
; Baquero-Rodríguez, Richard
; Mejía-Gaviria, Natalia
; Aroca, Gustavo
.
resumen está disponible en el texto completo
Abstract The exponential increase in the request for laboratory tests of 25-Hydroxyvitamin D or [25 (OH) D has ignited the alarms and generated a strong call for attention, since it may reflect deficiencies in the standardization of clinical practice and in the use non-systematic scientific evidence for decision-making in real life, which allows to analyze the indications of the test, its frequency, interpretation and even to assess the impact for health systems, especially when contrasted with the minimum or almost. No effects of the strategy of screening or supplying indiscriminately to the general population, without considering a comprehensive clinical assessment of risks and needs of people. From a purely public health impact point of view, the consequence of massive and unspecified requests is affecting most of the health systems and institutions at the global level. The primary studies that determined average population intake values have been widely used in the formulation of recommendations in Clinical Practice Guidelines, but unfortunately misinterpreted as cut points to diagnose disease and allow the exaggerated prescription of nutritional substitution. The coefficient of variation in routine tests to measure blood levels of 25 (OH) D is high (28%), decreasing the overall accuracy of the test and simultaneously, increasing both the falsely high and falsely low values. The most recent scientific evidence analyzes and seriously questions the usefulness and the real effect of the massive and indiscriminate practice of prescribing vitamin D without an exhaustive risk analysis. The available evidence is insufficient to recommend a general substitution of vitamin D to prevent fractures, falls, changes in bone mineral density, incidence of cardiovascular diseases, cerebrovascular disease, neoplasms and also to modify the growth curve of mothers' children. They received vitamin D as a substitute during pregnancy. The recommendations presented in the document are based on the critical analysis of current evidence and the principles of good clinical practice and invite to consider a rational use of 25 (OH) D tests in the context of a clinical practice focused on people and a comprehensive assessment of needs and risks. The principles of good practice suggest that clinicians may be able to justify that the results of the 25 (OH) D test strongly influence and define clinical practice and modify the outcomes that interest people and impact their health and wellness. Currently there is no clarity on how to interpret the results, and the relationship between symptoms and 25 (OH) D levels, which may not be consistent with the high prevalence of vitamin D deficiency reported. For this reason, it is suggested to review the rationale of the request for tests for systematic monitoring of levels of 25 (OH) D or in all cases where substitution is performed. Consider the use of 25 (OH) D tests within the comprehensive evaluation of people with suspicion or confirmation of the following conditions: rickets, osteomalacia, osteoporosis, hyper or hypoparathyroidism, malabsorption syndromes, sarcopenia, metabolic bone disease.
597 downloads
4.
Evaluación de rutas de obtención de lípidos y monosacáridos de biomasa de microalgas bajo el concepto de biorefinería
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Peñaranda Rincón, Laura Antonia
; Sepúlveda Ortíz, Karen Johanna
; Álvarez Pacheco, Yury Elena
; González-Delgado, Ángel Darío
; Kafarov, Viatcheslav
.
Al igual que una refinería de petróleo, una biorefinería utiliza todos los componentes de la biomasa para obtener productos aprovechables. Además de los lípidos, la biomasa de microalgas contiene cantidades importantes de proteínas, carbohidratos y otros productos metabólicos. En el presente estudio los autores definieron y evaluaron las rutas de obtención de lípidos y monosacáridos de biomasa de las microalgas Amphiprora sp. y Navicula sp., por medio de la implementación de procedimientos como disrupción celular ácida, extracción Soxhlet, Organosolv, transesterificación in situ y el método del ácido dinitrosalicílico (DNS). Las rutas fueron definidas y comparadas con base en las eficiencias de extracción de lípidos y porcentajes de azucares reductores obtenidos. Para la ruta de hidrólisis ácida - extracción Soxhlet se evaluaron diferentes tiempos, los mejores resultados se obtuvieron mediante los tiempos de 120 y 960 min, respectivamente. Mediante la ruta Organosolv - extracción Soxhlet la mayor eficiencia lipídica obtenida fue 48% y en transesterificación in situ el mayor porcentaje de azúcares reductores totales fue 1,67%p. Además, se determinaron los parámetros cinéticos relacionados con el sistema de lisis celular y transesterificación in situ para Navicula sp., obteniendo constantes de K=0,0003 min-1 para azúcares reductores y K=0,02 min-1 para productos de degradación. Por medio de espectroscopía infrarroja se comparó el pico de absorción del grupo carbonilo característico del biodiésel a través del tiempo. Entre las rutas evaluadas, Organosolv - extracción Soxhlet y transesterificación in situ presentaron mayor obtención de lípidos y monosacáridos, respectivamente.
As an oil refinery, a biorefinery uses all biomass components for obtaining high value usable products. Besides lipids, microalgae biomass contains significant amounts of proteins, carbohydrates and other metabolic products. In the present study, the authors defines routes to obtain monosaccharides and lipids from microalgae biomass of Amphiprora sp. and Navicula sp., through the implementation of acidic cellular disruption procedures, Soxhlet extraction, Organosolv pretreatment, in situ transesterification and the dinitrosalicylic acid method (DNS). The routes were defined and compared based on the percentage of lipids and monosaccharides obtained. For acid hydrolysis - Soxhlet extraction route several times of acid hydrolysis and extraction were evaluated, the best results for this route were obtained using times of 120 and 960 min, respectively. By Organosolv - extraction Soxhlet route, the best lipid efficiency obtained was 48% and in situ transesterification the highest percentage of total reducing sugars was 1.67%wt. Furthermore, kinetic parameters were determined related to the system of cell lysis and in situ transesterification for Navicula sp., getting constants K=0.0003 min-1 for reducing sugars and K=0.02 min-1 for degradation products. Using infrared spectroscopy compared the absorption peak of carbonyl group characteristic of biodiesel over time. Among Organosolv - Soxhlet extraction routes and in situ transesterification - Soxhlet extraction showed higher production of lipids and monosaccharides, respectively.
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