Acesso livre
Acesso livre

Medicina de Emergências

Estudo randomizado | Em adultos com Covid-19 e hipoxemia grave, 12 mg vs. 6 mg de dexametasona não resultaram em diferença estatisticamente significativa no número de dias sem terapias de suporte à vida.

22 Out, 2021 | 12:29h

Effect of 12 mg vs 6 mg of Dexamethasone on the Number of Days Alive Without Life Support in Adults With COVID-19 and Severe Hypoxemia: The COVID STEROID 2 Randomized Trial – JAMA

Editorial: Glucocorticoid Dose in COVID-19: Lessons for Clinical Trials During a Pandemic – JAMA

 

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M-A | Acurácia diagnóstica do dispositivo de ultrassonografia cardíaca portátil para avaliar estrutura e função do ventrículo esquerdo.

22 Out, 2021 | 12:14h

Diagnostic accuracy of handheld cardiac ultrasound device for assessment of left ventricular structure and function: systematic review and meta-analysis – Heart

Pneumonia por COVID-19: fisiopatologia e tratamento.

21 Out, 2021 | 11:30h

COVID-19 pneumonia: pathophysiology and management – European Respiratory Review

Estudo randomizado | Interferon não melhora os desfechos de adultos internados com COVID-19.

20 Out, 2021 | 12:10h

Comunicado de imprensa: Interferon does not improve outcomes for hospitalized adults with COVID-19 – NIH News Releases

Estudo original: Efficacy of interferon beta-1a plus remdesivir compared with remdesivir alone in hospitalised adults with COVID-19: a double-bind, randomised, placebo-controlled, phase 3 trial – The Lancet Respiratory Medicine

Coisas que fazemos sem motivo: restrição hídrica para tratar insuficiência cardíaca descompensada aguda em pacientes com fração de ejeção reduzida.

20 Out, 2021 | 11:50h

Things We Do for No Reason™: Fluid Restriction for the Management of Acute Decompensated Heart Failure in Patients With Reduced Ejection Fraction – Journal of Hospital Medicine (gratuito por tempo limitado)

 

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Estudo RECOVERY | Em pacientes internados com COVID-19, colchicina não reduziu a mortalidade em 28 dias, a permanência no hospital ou o risco de progressão para ventilação mecânica invasiva.

19 Out, 2021 | 12:55h

Colchicine in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial – The Lancet Respiratory Medicine

Conteúdos relacionados:

Revisão sistemática | Colchicina para tratamento de COVID-19 – Não há benefício para pacientes hospitalizados; evidências inconclusivas para o tratamento de pacientes não internados mostram que “é provável que reduza levemente a necessidade de hospitalização ou morte em 28 dias, em comparação ao placebo.”

19 Out, 2021 | 12:54h

Colchicine for the treatment of COVID‐19 – Cochrane Library

Conteúdos relacionados:

 

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Urolitíase: apresentações, avaliação, tratamento e prescrições em departamentos de emergência.

19 Out, 2021 | 12:39h

Urolithiasis: ED Presentations, Evaluation, Management, and Disposition – emDocs

Estudo randomizado embasa o uso de heparina em dose terapêutica para pacientes não críticos internados por Covid-19.

18 Out, 2021 | 08:57h

Effectiveness of therapeutic heparin versus prophylactic heparin on death, mechanical ventilation, or intensive care unit admission in moderately ill patients with covid-19 admitted to hospital: RAPID randomised clinical trial – The BMJ

Comentário: High-dose of readily available blood thinner reduces risk of death for moderately ill COVID-19 patients – St. Michael’s Hospital

Estudos relacionados (alguns resultados conflitantes)

RCT: Therapeutic-dose heparin superior to standard prophylactic or intermediate-dose heparins for thromboprophylaxis in high-risk hospitalized patients with COVID-19.

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.

 

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Risco de lesões sérias é maior para cavalgadas do que para futebol, corrida automobilística ou esqui – “O tórax é o sítio mais comum, mas lesões em cabeça e pescoço são mais letais.”

18 Out, 2021 | 08:35h

Comunicado de imprensa: Serious injury risk higher for horse riding than for football, motor racing, or skiing – BMJ

Estudo original: Hearing hoofbeats? Think head and neck trauma: a 10-year NTDB analysis of equestrian-related trauma in the USA – Trauma Surgery & Acute Care Open

Comentário: Horse Riding More Dangerous Than Skiis And Motorcycles, Injury Data Reveal – Science Alert

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