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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.
Use of anaerobic cecal microflora, lactose and acetic acid for the protection of broiler chicks against experimental infection with Salmonella Typhimurium and Salmonella enteritidis
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Andreatti Filho, Raphael Lucio
; Silva, Edir Nepomuceno da
; Ribeiro, Aldemir Reginato
; Kondo, Nancy
; Curi, Paulo Roberto
.
Estudaram-se os efeitos do tratamento de frangos com microbiota cecal anaeróbia (MCA) isolada ou associada à lactose ou ao ácido acético, sobre a infecção sistêmica e do trato digestivo de aves por Salmonella Typhimurium e S. Enteritidis. Foi usada MCA sem prévia identificação bacteriana. O tratamento com MCA contribuiu na resistência dos frangos à infecção por Salmonella spp. As infecções eram mais persistentes, em ordem, nos cecos, reto e inglúvio. As infecções também eram autolimitantes, pois lotes tratados e controles apresentaram índices semelhantes de infecção ao final dos experimentos. Isoladamente ou em associação com lactose, MCA reduziu a colonização do trato digestivo das aves por S. Typhimurium e S. Enteritidis. As associações MCA com lactose ou ácido acético, não tiveram seus efeitos potencializados na redução da excreção fecal. O tratamento com MCA diminuiu a quantidade de S. Typhimurium e S. Enteritidis nas fezes. O uso de MCA isolada ou associada com lactose contribuiu na redução do pH cecal das aves tratadas. A S. Enteritidis foi mais invasiva que a S. Typhimurium e, o uso da MCA isoladamente foi mais eficaz em evitar a infecção sistêmica que os outros tratamentos. A explicação do processo de prevenção da colonização intestinal por Salmonella spp. passa, provavelmente, pela inter-relação de fenômenos fisiológicos, microbiológicos e imunológicos, além da possível variação do pH cecal.
The effects of treatment with anaerobic cecal microflora (ACM) and/or lactose and/or acetic acid on systemic and digestive tract of broiler chicks infection with Salmonella Typhimurium and S. Enteritidis were studied. ACM was used without previous bacterial identification. Treatment with ACM contributed to the resistance of broiler chicks to infection with Salmonella spp. The infections were more persistent in the cecum, rectum and crops in decreasing order of intensity. The infections were also self-limiting since treated and control lots presented similar infection rates at the end of the experiments. Alone or in combination with lactose, ACM reduced the colonization of the digestive tract of broiler chicks by S. Typhimurium and S. Enteritidis. The effect of the combination of ACM with lactose or acetic acid was not potentiated in terms of reduction of fecal excretion of Salmonella spp. Treatment with ACM reduced the amount of S. Typhimurium and S. Enteritidis in the feces. Alone or in combination with lactose, ACM reduced the cecal pH in treated birds. S. Enteritidis was much more invasive than S. Typhimurium and the use of ACM alone was more effective on the reduction of systemic infection. An explanation for the process of prevention of intestinal colonization with Salmonella spp. probably resides in the interrelationship of physiological, microbiological and immunological phenomena, as well as the variation in cecal pH.
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