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au:Mendoza-Pinto, Claudia
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Recommendations for the diagnosis and management of persons with suspected vaccine-induced immune thrombotic thrombocytopenia (VITT)
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Yomayusa, Nancy
; Acevedo, Juan
; Virginia, Abello Polo
; Izaguirre, Raúl
; Ramírez, Carlos
; Solano, María Helena
; Ramírez, Sergio
; Rodríguez, Patricia
; Morón, Lina
; De la Hoz, Ilich
; Chacón, Kelly Rocio
; Gutiérrez, Paula
; Agudelo, Claudia
; Hernández, Sonia
; León, Guillermo
; Accini, José
; Ortíz, Guillermo
; Concha-Mejia, Alejandro
; Contreras, Rubén
; Escobar, Bibiana
; Espinosa, Tatiana
; González, Camilo
; Yama, Erica
; Aroca, Gustavo
; Guillermo, Cecilia
; Hamann, Otto
; Horlandy, Laura
; Moreno, Claudia
; Mejía, Natalia
; Mendoza, Fernán
; Castellanos, Jeffrey
; Rozo, Jose
; Montero, Camilo
; Navarro, José
; Oñate, José
; Pinto, Diego
; Restrepo, Natalia
; Saenz, Oscar
; Triana, Lina
; Correa, Liliana
; Sabbagh, Luis
; Castillo, Ana
; Torres, Rodolfo
; Lineros, Alberto
.
Resumen En meses recientes se han reportado casos raros de trombocitopenia y trombosis en sitios inusuales, que ocurren dentro de una ventana de riesgo típica ( por ejemplo de 4 a 28 días) luego de recibir vacunas de SARS CoV 2. Los profesionales de la salud deben estar preparados para detectar estos casos a tiempo. Un panel de expertos y una red de transferencia de conocimiento realizó una búsqueda libre de literatura seleccionada. Con la información disponible y la experticia clínica del grupo de trabajo revisamos y dimos recomendaciones para la sospecha temprana, el diagnostico (definición de caso, el uso de pruebas de laboratorio especificas y de imágenes diagnósticas) para le manejo de estas condiciones tromboticas. Este documento es considerado un documento vivo que debe ser actualizado a medida que surja nueva evidencia y las recomendaciones vayan cambiando con el tiempo
Abstract In recent months, rare cases of thrombosis at unusual sites associated with thrombocytopenia, occurring within a typical risk window (i.e., 4-28 days) after receiving SARS CoV2 vaccines, have been reported. Healthcare professionals should be prepared to detect these cases on time. The Expert Panel of the Knowledge Management and Transfer Network conducted a free search of the related literature. With the available information and the clinical expertise of the working group, we formulated, reviewed, and endorsed recommendations for the timely suspicion, diagnosis (case definitions, the use of initial laboratory and imaging tests, specific tests), and management of these thrombotic conditions. This document is considered a living document that will be updated as new evidence emerges, and recommendations may change over time.
https://doi.org/10.22354/in.v26i1.987
68 downloads
2.
Perfil metabolómico de resistencia a la insulina en mujeres no diabéticas con lupus eritematoso sistémico
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Mendoza-Pinto, Claudia
; García-Carrasco, Mario
; Méndez-Martínez, Socorro
; Munguía-Realpozo, Pamela
; Etchegaray-Morales, Ivet
; Díaz-Merino, Gerardo
; Soto-Santillán, Pamela
; Escamilla-Márquez, Marco A.
; Ruiz-Arguelles, Alejandro
.
Abstract Introduction: Patients with systemic lupus erythematosus (SLE) have a higher prevalence of insulin resistance (IR) and metabolic syndrome (MetS) than controls. Objective: To evaluate IR in non-diabetic women with SLE by means of biomarkers using high-throughput metabolomic techniques. Methods: Cross-sectional study in patients with SLE. A metabolomic approach was employed using ultra-high performance liquid chromatography coupled with high-resolution mass spectrometry. MetS was evaluated according to NCEP-ATP III criteria. Results: Seventy patients with SLE were included, out of whom 45 (64.2 %) and 27 (38.5 %) had IR and MetS, respectively. Patients with IR had a higher body mass index and hypertension more often than those without IR. Chronic damage and disease activity were not related to IR. A Quantose-IR score ≥ 63 was more common in patients with MetS (81.5 vs. 53.5 %; p = 0.02). Quantose-IR score was also correlated with the number of criteria for MetS (r: 0.35; p = 0.003). Conclusions: In non-diabetic women with SLE, the prevalence of IR based on Quantose-IR score was 64.2 %.
Resumen Introducción: En lupus eritematoso sistémico (LES) es más frecuente la prevalencia de resistencia a la insulina (RI) y síndrome metabólico (SMet) que en controles. Objetivo: Evaluar la RI en mujeres no diabéticas con LES mediante biomarcadores usando técnicas metabolómicas de alta resolución. Método: Estudio transversal en pacientes con LES. Se empleó un abordaje metabolómico usando cromatografía de líquidos de ultra-alta resolución con espectrometría de masa de alta resolución. El SMet fue evaluado de acuerdo con los criterios NCEP-ATP III. Resultados: Se incluyeron 70 pacientes con LES. Tuvieron RI y SMet 45 (64.2%) y 27 (38.5%), respectivamente. Pacientes con RI tenían un mayor índice de masa corporal e hipertensión con mayor frecuencia que aquellas sin RI. El daño crónico y la actividad de la enfermedad no se relacionaron con RI. Un puntaje de Quantose RI ≥ 63 fue más elevado en pacientes con SMet (81.5 vs 53.5%; p = 0.02). El puntaje Quantose RI también se correlacionó con el número de criterios para SMet (r: 0.35; p = 0.003). Conclusiones: En mujeres con LES no diabéticas, la prevalencia de RI basada en el puntaje de Quantose RI fue del 64.2%.
https://doi.org/10.24875/gmm.21000218
61 downloads
3.
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
4.
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
5.
Efficiency in bracket bonding with the use of pretreatment methods to tooth enamel before acid etching: sodium hypochlorite vs. hydrogen peroxide techniques
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Rivera-Prado, Hermann
; Moyaho-Bernal, Ángeles
; Andrade-Torres, Alejandro
; Franco-Romero, Guillermo
; Montiel-Jarquín, Álvaro
; Mendoza-Pinto, Claudia
; García-Cano, Eugenio
; Hernández-Ruíz, Ana K
.
Bond failures are produced by the existence of biofilm on the tooth surface. Because biofilm is impermeable, it prevents contact in many areas, reducing the etching effect which selectively dissolves calcified tissues but does not seem to eliminate biofilm from the tooth surface, and thus the bond between the tooth and the bracket is not strong enough. The aim of this study is to compare bracket bonding efficiency with two dental surface pretreatments: sodium hypochlorite vs. hydrogen peroxide techniques. This was a cross-sectional, comparative, in vitro study. Seventy-five premolars extracted for orthodontic purposes were evaluated. They were divided into three groups of 25 teeth and assigned randomly toone of the pretreatment techniques (5.25%sodium hypochlorite or 3.5% hydrogen peroxide) or to a control group. The most efficient pretreatment technique for bonding to brackets was sodium hypochlorite, with an average of 17.15 (kg/F). Significant differences were observed between groups (p=0.0001). The post hoc bond strength test showed statistically significant differences between the sodium hypochlorite technique and the control group (p=0.0001). The sodium hypochlorite technique improves bracket adhesion to tooth enamel.
Las fallas de adhesion se producen por la existencia de la biopelicula en la superficie del organo dental, ya que es impermeable y no permite el contacto en muchas areas, de manera que disminuye el efecto del grabado acido; el cual tiene la capacidad de disolver selectivamente los tejidos calcificados, pero no parece eliminar la biopelicula en la superficie dental, por lo tanto, no se lleva a cabo la suficiente fuerza de adhesion en la interfase diente-bracket. El objetivo es comparar la eficiencia en la adhesion de los brackets con el empleo de dos metodos de pre-tratamientos de la superficie del esmalte, el hipoclorito de sodio vs. peroxido de hidrogeno. Estudio comparativo, transversal, in vitro. Se evaluaron 75 premolares extraidos con fines ortodoncicos, tres grupos de 25 dientes, asignados aleatoriamente con alguna de las dos tecnicas de pre-tratamiento al esmalte, hipoclorito de sodio al 5.25%, peroxido de hidrogeno al 3.5% y un grupo control. La tecnica de pre-tratamiento al esmalte mas eficiente para la fuerza de adhesion a los brackets fue el hipoclorito de sodio, con una media de 17.15 (Kg/F), se observaron diferencias significativas inter-grupos (p= 0.001). Las pruebas post hoc para las fuerzas de adhesion mostraron diferencia estadistica - mente significativa para la tecnica de hipoclorito de sodio/ grupo control (p=.001). La utilizacion de hipoclorito de sodio ayuda a mejorar la adhesion de los brackets en la superficie del esmalte.
523 downloads
6.
The impact of glucocorticoids and anti-cd20 therapy on cervical human papillomavirus infection risk in women with systemic lupus erythematosus
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Mendoza-Pinto, Claudia
; Garcia-Carrasco, Mario
; Vallejo-Ruiz, Veronica
; Taboada-Cole, Alejandro
; Munoz-Guarneros, Margarita
; Solis-Poblano, Juan Carlos
; Pezzat-Said, Elias
; Aguilar-Lemarroy, Adriana
; Jave-Suarez, Luis Felipe
; de Lara, Luis Vazquez
; Ramos-Alvarez, Gloria
; Reyes-Leyva, Julio
; Lopez-Colombo, Aurelio
.
OBJECTIVE: To identify the prevalence and factors associated with cervical human papillomavirus infection in women with systemic lupus erythematosus METHODS: This cross-sectional study collected traditional and systemic lupus erythematosus-related disease risk factors, including conventional and biologic therapies. A gynecological evaluation and cervical cytology screen were performed. Human papillomavirus detection and genotyping were undertaken by PCR and linear array assay. RESULTS: A total of 148 patients were included, with a mean age and disease duration of 42.5±11.8 years and 9.7±5.3 years, respectively. The prevalence of squamous intraepithelial lesions was 6.8%. The prevalence of human papillomavirus infection was 29%, with human papillomavirus subtype 59 being the most frequent. Patients with human papillomavirus were younger than those without the infection (38.2±11.2 vs. 44.2±11.5 years, respectively; p = 0.05), and patients with the virus had higher daily prednisone doses (12.8±6.8 vs. 9.7±6.7 mg, respectively; p = 0.01) and cumulative glucocorticoid doses (14.2±9.8 vs. 9.7±7.3 g, respectively; p = 0.005) compared with patients without. Patients with human papillomavirus infection more frequently received rituximab than those without (20.9% vs. 8.5%, respectively; p = 0.03). In the multivariate analysis, only the cumulative glucocorticoid dose was associated with human papillomavirus infection. CONCLUSIONS: The cumulative glucocorticoid dose may increase the risk of human papillomavirus infection. Although rituximab administration was more frequent in patients with human papillomavirus infection, no association was found. Screening for human papillomavirus infection is recommended in women with systemic lupus erythematosus.
https://doi.org/10.6061/clinics/2013(12)01
4635 downloads
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