Hematologia

Teste do D-dímero para excluir embolia pulmonar tem utilidade clínica limitada em pacientes internados com COVID-19 – A maioria dos pacientes, com ou sem embolia pulmonar, apresenta níveis elevados.

13 Out, 2021 | 12:54h

D-Dimer Testing for the Exclusion of Pulmonary Embolism Among Hospitalized Patients With COVID-19 – JAMA Network Open

Comentário: D-Dimer Level Not Useful for Ruling Out PE in COVID-19 Patients – HealthDay

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Estudo randomizado | Dose terapêutica de heparina se mostrou superior à dose profilática ou à dose intermediária para tromboprofilaxia em pacientes de alto risco internados com COVID-19.

12 Out, 2021 | 11:22h

Efficacy and Safety of Therapeutic-Dose Heparin vs Standard Prophylactic or Intermediate-Dose Heparins for Thromboprophylaxis in High-risk Hospitalized Patients With COVID-19: The HEP-COVID Randomized Clinical Trial – JAMA Internal Medicine

Comentário convidado: Anticoagulant Therapy in Patients Hospitalized With COVID-19 – JAMA Internal Medicine

Estudos relacionados (alguns resultados conflitantes)

Another meta-analysis suggests standard-dose prophylactic anticoagulation is the best option for patients hospitalized with Covid-19.

M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

RCT: In noncritically ill patients hospitalized with Covid-19, therapeutic-dose anticoagulation with heparin increased the probability of survival to hospital discharge compared with usual-care thromboprophylaxis.

RCT: In critically ill patients with Covid-19, therapeutic anticoagulation with heparin did not result in improved outcomes compared to usual-care pharmacologic thromboprophylaxis.

RCT: In patients hospitalized with Covid-19 with elevated D-Dimer, a full-dose anticoagulation strategy based on rivaroxaban (full-dose heparins in unstable patients) + rivaroxaban to day 30 was not better than prophylactic anticoagulation and increased bleeding risk.

 

Comentário no Twitter

Thromboprophylaxis w therapeutic-dose LMWH reduced major thromboembolism and death by 32% compared with institutional standard heparin without increased major bleeding among #COVID19 inpatients with elevated D-dimers. The effect wasn't seen in ICU patients https://t.co/Wrgj2Ho5lv

— JAMA Internal Medicine (@JAMAInternalMed) October 7, 2021

 

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Revisão do estado de arte | Avanços na leucemia mieloide aguda.

8 Out, 2021 | 12:08h

Advances in acute myeloid leukemia – The BMJ

 

Comentário no Twitter

Acute myeloid leukemia is an uncommon but potentially catastrophic diagnosis.

This review looks at new updates in our understanding of the biology of acute myeloid leukemia, its genetic and environmental risk factors, and new treatment options https://t.co/ugaCeYkqSH

— The BMJ (@bmj_latest) October 6, 2021

 

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Séries do Lancet | Malignidades hematológicas em idosos.

8 Out, 2021 | 10:57h

Página principal: Haematological malignancies in older people – The Lancet Haematology

Comentário: Living longer and better with haematological malignancies: a promise for older adults too? (necessário cadastro gratuito)

A comprehensive approach to therapy of haematological malignancies in older patients (necessário cadastro gratuito)

Frailty assessment in the care of older people with haematological malignancies

Haematopoietic stem-cell transplantation in older adults: geriatric assessment, donor considerations, and optimisation of care (necessário cadastro gratuito)

Palliative care of patients with haematological malignancies: strategies to overcome difficulties via integrated care

Implementation of geriatric haematology programmes for the treatment of older people with haematological malignancies in low-resource settings

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Revisão | Inibição da agregação plaquetária após colocação de stent coronariano em pacientes em uso de anticoagulação oral.

8 Out, 2021 | 10:55h

Inhibition of Platelet Aggregation After Coronary Stenting in Patients Receiving Oral Anticoagulation – Deutsches Ärzteblatt International

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Estudo randomizado | Mais um estudo mostra que plasma convalescente não melhora os desfechos em pacientes criticamente doentes com Covid-19.

5 Out, 2021 | 11:32h

Effect of Convalescent Plasma on Organ Support–Free Days in Critically Ill Patients With COVID-19 A Randomized Clinical Trial – JAMA

Commentary: Convalescent plasma futile as treatment for critically ill COVID-19 patients, study finds – University of Pittsburgh

Conteúdos relacionados:

RCT: Convalescent plasma does not improve outcomes and may be harmful to hospitalized patients with COVID-19.

NIH study shows no significant benefit of convalescent plasma for COVID-19 outpatients with early symptoms.

M-A: Convalescent plasma is safe but does not improve outcomes in the treatment of COVID-19.

RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.

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Trombose e trombocitopenia imune induzidas por vacina: resumo da diretriz NICE.

4 Out, 2021 | 10:36h

Vaccine induced immune thrombocytopenia and thrombosis: summary of NICE guidance – The BMJ

Diretriz original: NICE COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis.

Conteúdos relacionados:

Clinical features of vaccine-induced immune thrombocytopenia and thrombosis.

Review: Clinical characteristics and pharmacological management of COVID-19 vaccine–induced immune thrombotic thrombocytopenia with cerebral venous sinus thrombosis.

Vaccine-induced immune thrombotic thrombocytopenia: what we know and do not know.

Very rare cases of thrombosis with thrombocytopenia syndrome (TTS) after AstraZeneca vaccine: a global safety database analysis – the estimated rate of TTS after the first dose was 8.1 per million vaccinees; after the second dose, the estimated rate was 2.3 per million vaccinees. (vários artigos e fontes sobre o tema)

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Revisão sistemática | Testes de rotina para investigar câncer em pacientes com coágulos sanguíneos não provocados nas pernas e nos pulmões podem melhorar os desfechos?

4 Out, 2021 | 10:16h

Resumo: Does testing for cancer in people with unprovoked blood clots in the legs and lungs reduce cancer- and blood clot-related death and illness? – Cochrane Library

Artigo original: Effect of testing for cancer on cancer‐ or venous thromboembolism (VTE)‐related mortality and morbidity in people with unprovoked VTE – Cochrane Library

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Mais uma metanálise sugere que anticoagulação profilática é a melhor opção para pacientes hospitalizados com Covid-19.

1 Out, 2021 | 22:02h

A Systematic Review and a Meta-Analysis Comparing Prophylactic and Therapeutic Low Molecular Weight Heparins for Mortality Reduction in 32,688 COVID-19 Patients – Frontiers in Pharmacology

Conteúdo relacionado: M-A: Safety and efficacy of different prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 – According to this analysis, standard-dose prophylactic anticoagulation should be the standard of care for hospitalized patients with COVID-19 who do not have an indication for therapeutic anticoagulation, irrespective of disease severity.

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Diretriz de prática clínica da AGA sobre o tratamento de distúrbios de coagulação em pacientes com cirrose.

1 Out, 2021 | 19:20h

AGA Clinical Practice Guideline on the Management of Coagulation Disorders in Patients With Cirrhosis – Gastroenterology

Ver também: AGA Technical Review on Coagulation in Cirrhosis – Gastroenterology

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