Acesso livre
Acesso livre

Medicina de Emergências

Covid: especialistas afirmam que oxímetros de pulso não funcionam tão bem em pele mais escura.

3 Ago, 2021 | 11:28h

Covid: Pulse oxygen monitors work less well on darker skin, experts say – BBC

Conteúdos relacionados:

FDA issues alert on ‘limitations’ of pulse oximeters, without explicit mention of racial bias

“Racial Bias in Pulse Oximetry Measurement”. In two large cohorts, Black patients had nearly three times the frequency of occult hypoxemia that was not detected by pulse oximetry as White patients

Diretriz | Abordagem clínica de adultos com COVID-19 fora da UTI.

2 Ago, 2021 | 19:13h

Clinical Management of Adult Patients with COVID-19 Outside Intensive Care Units: Guidelines from the Italian Society of Anti-Infective Therapy (SITA) and the Italian Society of Pulmonology (SIP) – Infectious Diseases and Therapy

O que todo intensivista deveria saber sobre o tocilizumabe.

2 Ago, 2021 | 19:11h

What every intensivist should know about Tocilizumab – Critical Care

Conteúdos relacionados:

Tocilizumab in COVID-19 therapy: who benefits, and how?

A living WHO guideline on drugs for covid-19 – interleukin-6 receptor blockers are now recommended for patients with severe or critical covid-19.

M-A: Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19 – “The 4% absolute risk reduction in mortality from 25% to 21% with IL-6 inhibition added to glucocorticoids may not translate to patients with a lower baseline mortality risk and likely do not justify the additional expense and risk for toxicities for patients hospitalized with modest oxygen requirements and a stable clinical course (from editorial)”.

RECOVERY trial: In hospitalized COVID-19 patients with hypoxia and systemic inflammation (C-reactive protein ≥75 mg/L), tocilizumab improved survival and other clinical outcomes

Secondary analysis of RCT finds Tocilizumab was beneficial to patients hospitalized with Covid-19 if CRP levels were greater than 15.0 mg/dL, but not if CRP levels were 15.0 mg/dL or less.

M-A: Tocilizumab in COVID-19 – “For hospitalized COVID-19 patients, there is some evidence that tocilizumab use may be associated with a short-term mortality benefit, but further high-quality data are required”.

Diretriz de prática clínica para o tratamento de volvo colônico e pseudo-obstrução colônica aguda.

2 Ago, 2021 | 18:59h

The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Colonic Volvulus and Acute Colonic Pseudo-Obstruction – Diseases of the Colon & Rectum

Comunicado de imprensa: American Society of Colon & Rectal Surgeons Publishes New Guidelines for Colonic Volvulus and Acute Colonic Pseudo-Obstruction

Estudo observacional | Balanço hídrico positivo está associado a piores desfechos em pacientes criticamente doentes com lesão cerebral traumática.

2 Ago, 2021 | 18:40h

Fluid balance and outcome in critically ill patients with traumatic brain injury (CENTER-TBI and OzENTER-TBI): a prospective, multicentre, comparative effectiveness study – The Lancet Neurology (link para o resumo – $ para o texto completo)

Comentário: Traumatic Brain Injury: Fluid Overload Tied to Higher Mortality in ICU Patients – Physician’s Weekly

 

Comentário no Twitter

 

Diretriz rápida NICE COVID-19 | Trombocitopenia trombótica imune induzida por vacina.

2 Ago, 2021 | 18:37h

COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis – National Institute for Health and Care Excellence

Comunicado de imprensa: NICE publishes new rapid guideline to diagnose and treat rare blood clotting condition associated with COVID-19 vaccination – National Institute for Health and Care Excellence

Conteúdo relacionado: 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)

Trombocitopenia trombótica imune induzida por vacina: o que se sabe e o que não se sabe.

2 Ago, 2021 | 18:33h

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

Conteúdo relacionado: 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)

Risco de infarto agudo do miocárdio e AVC isquêmico após COVID-19 na Suécia – “o risco real é aumentado em 3 a 8 vezes para o infarto agudo do miocárdio e entre 3 e 7 vezes para o AVC isquêmico após COVID-19.”

2 Ago, 2021 | 18:27h

Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study – The Lancet

Comentário convidado: What is the association of COVID-19 with heart attacks and strokes? – The Lancet

 

Comentário no Twitter

 

Diretrizes brasileiras sobre angina instável e infarto agudo do miocárdio sem elevação do segmento ST – 2021.

2 Ago, 2021 | 18:15h

Brazilian Society of Cardiology Guidelines on Unstable Angina and Acute Myocardial Infarction without ST-Segment Elevation – 2021 – Arquivos Brasileiros de Cardiologia (PDF)

Revisão sistemática | Não há evidências que suportem o uso de ivermectina no tratamento ou na prevenção de COVID-19.

2 Ago, 2021 | 17:48h

Ivermectin for preventing and treating COVID‐19 – Cochrane Library

Resumo: Ivermectin for preventing and treating COVID-19 – Cochrane Library

Comentário: Ivermectin treatment in humans for COVID-19 – Liverpool School of Tropical Medicine

Conteúdos relacionados:

Why was a major study on ivermectin for covid-19 just retracted?

RCT: Ivermectin does not prevent hospitalizations in patients with COVID-19.

Ivermectin for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials – “IVM did not reduce all-cause mortality, length of stay or viral clearance in RCTs in COVID-19 patients with mostly mild disease”.

Ivermectin is the new hydroxychloroquine, take 2 – “Ivermectin shouldn’t be used to treat COVID-19 outside of the context of a well-designed clinical trial”.

Therapeutics and COVID-19 | WHO guideline update advises Ivermectin should only be used to treat COVID-19 within clinical trials

RCT: Ivermectin does not improve time to resolution of symptoms among adults with mild COVID-19

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