Medicina de Emergências
[Preprint] Heparina para pacientes com Covid-19 moderada – “Em pacientes com Covid-19 moderada e D-dímero elevado, a terapia com heparina não reduziu significativamente o desfecho primário, mas reduziu as chances de morte em 28 dias de doença.”
12 Jul, 2021 | 11:41hHeparin for Moderately Ill Patients with Covid-19 – medRxiv
Relacionado: 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. E [Preprint] Practice Changing RCT: Therapeutic-dose anticoagulation with heparin (LMWH or unfractionated heparin) improves outcomes in non-critically ill patients with Covid-19 – the superiority of therapeutic-dose anticoagulation was seen in both high and low D-dimer groups. E [Preprint] RCT: Full-dose/therapeutic anticoagulation provides no benefit in critically ill patients with Covid-19
Comentário no Twitter (fio – clique para saber mais)
🚨Final results of the RAPID trial now pub'd @medrxivpreprint 🚨 RAPID was an open-label trial that randomly assigned hospitalized ward patients with COVID-19 and elevated D-dimer levels to therapeutic or prophylactic heparin. 🧵 1/10 https://t.co/oxiyXQAPeK pic.twitter.com/V2GtruEyM2
— Michelle Sholzberg (@sholzberg) July 9, 2021
Estudo randomizado | Outro estudo mostra que a azitromicina não melhora os desfechos em pacientes com Covid-19.
12 Jul, 2021 | 11:37hComentários: Trial shows that the antibiotic azithromycin does not prevent mild COVID cases progressing to hospitalization, death – European Society of Clinical Microbiology and Infectious Diseases E Azithromycin: can its benefit be ruled out in mild COVID-19? – The Lancet Respiratory Medicine
Relacionado: M-A: Azithromycin does not reduce the need for invasive mechanical ventilation or mortality in patients with Covid-19. E RCT: Azithromycin provides no benefit for community treatment of patients with suspected COVID-19 E RECOVERY trial: Azithromycin not beneficial for patients admitted to hospital with COVID-19 E E Coalition Covid-19 Brazil – Randomized trial: Azithromycin not beneficial for patients admitted to the hospital with severe Covid-19 E Coalition Covid-19 Brazil – Randomized trial: hydroxychloroquine with or without azithromycin in mild-to-moderate Covid-19
Comentário no Twitter
In patients with mild-to-mod #COVID19 managed without hospital admission, azithromycin + SOC did not reduce the risk of subsequent hospital admission or death
Read the ATOMIC2 trial here https://t.co/QXJ7T08JZS, being presented at #ECCMID2021 by lead author Tim Hinks @HinksLab pic.twitter.com/ZDiPhuQqFB
— The Lancet Respiratory Medicine (@LancetRespirMed) July 9, 2021
Relatório oficial do American Thoracic Society Workshop | Entendendo o hospedeiro no tratamento da pneumonia.
12 Jul, 2021 | 11:26hEstudo randomizado | Outro estudo mostra a segurança do tratamento ambulatorial sem antibióticos na diverticulite aguda leve.
12 Jul, 2021 | 11:19hEfficacy and Safety of Non-Antibiotic Outpatient Treatment in Mild Acute Diverticulitis (DINAMO-study): A Multicentre, Randomised, Open-Label, Non-Inferiority Trial – Annals of Surgery (link para o resumo – $ para o texto completo)
Relacionado: State of the Art Review: Management of colonic diverticulitis E Treatment of Uncomplicated Acute Diverticulitis Without Antibiotics: A Systematic Review and Meta-analysis – Diseases of the Colon & Rectum E Antibiotics Do Not Reduce Length of Hospital Stay for Uncomplicated Diverticulitis in a Pragmatic Double-Blind Randomized Trial – Clinical Gastroenterology and Hepatology E Randomized Trial: Antibiotic Avoidance Associated with Similar Long-term Outcomes in Uncomplicated Diverticulitis
Comentário no Twitter
Another (final?) nail in the coffin for antibiotics in uncomplicated diverticulitis? DINAMO study from Spain – Outpatient treatment with antibiotics versus symptomatic Tx.
No difference in hospitalization rate or revisits to ER.https://t.co/wOc3tBGfxr @AnnalsofSurgery
— Ville Sallinen (@villesallinen) July 9, 2021
M-A | Comparação de eficácia e segurança de vancomicina, linezolida, tedizolida e daptomicina no tratamento de pacientes com infecção suspeita ou comprovada de pele e partes moles.
9 Jul, 2021 | 15:47h
Comentário no Twitter
🆕💥 Network Meta-Analysis @InfectDis_Ther
20 RCTs N=7804
Comparative Efficacy& Safety of Vancomycin,Linezolid,Tedizolid, and Daptomycin in Treating Patients with Suspected or Proven cSSTI
Linezolid was superior to vancomycin in improving clinical successhttps://t.co/qlZfXoWfaa pic.twitter.com/tO3sIoOMY4— Antibiotic Steward 🇵🇸💔Bassam Ghanem (@ABsteward) June 20, 2021
Série de casos | Plasmaférese em 3 pacientes com trombocitopenia trombótica imune induzida por vacina.
8 Jul, 2021 | 09:56h
Comentário no Twitter
Three patients with severe manifestations of VITT after #COVID19 vaccination had poor response to initial therapy with anticoagulants and intravenous immune globulin. Their condition improved after therapeutic plasma exchange was initiated.
— NEJM (@NEJM) July 7, 2021
Revisão | Suporte ventilatório não invasivo e cateter nasal de alto fluxo como tratamentos de primeira linha na insuficiência respiratória hipoxêmica aguda e na síndrome da angústia respiratória aguda (SARA).
8 Jul, 2021 | 09:48h
Comentário no Twitter
Physiology-to-bedside overview about non-invasive ventilatory support in AHRF & #ARDS
➡️spontaneous breathing: benefits/harms
➡️how to make spontaneous effort non‑injurious?
➡️optimizing HFNO & NIV
➡️monitoring to detect failure & be protective
➡️evidencehttps://t.co/KPW2u8akhA pic.twitter.com/yKVxrYaFmZ— Intens Care Med (@yourICM) July 7, 2021
Comentário sobre estudo | Neutropenia febril – Procalcitonina vs. escore MASCC.
8 Jul, 2021 | 09:45hFebrile Neutropenia – Procalcitonin vs MASCC Score – Journal Feed
Diretriz da OMS sobre drogas para Covid-19 – Bloqueadores do receptor da interleucina-6 agora são recomendados para pacientes com Covid-19 grave ou crítica.
7 Jul, 2021 | 08:14hA living WHO guideline on drugs for covid-19 – The BMJ
Comentário no Twitter
The latest version of this @WHO living guidance provides a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19. Read the updated WHO guideline on drugs for #COVID19 https://t.co/FUb9yzFRwo
— The BMJ (@bmj_latest) July 6, 2021
M-A | Associação entre administração de antagonistas de IL-6 e mortalidade entre pacientes hospitalizados com COVID-19 – “A redução absoluta de 4% no risco de mortalidade (de 25% para 21%) com inibidores de IL-6 somados a glicocorticoides pode não se refletir em pacientes com risco basal de mortalidade mais baixo, e parece não justificar o custo adicional e o risco de toxicidade para pacientes hospitalizados com pouca necessidade de oxigênio e curso clínico estável (do editorial).”
7 Jul, 2021 | 08:12hEditorial: IL-6 Receptor Antagonist Therapy for Patients Hospitalized for COVID-19: Who, When, and How? – JAMA
Comentários: Interleukin-6 antagonists improve outcomes in hospitalised COVID-19 patients – King’s College London E WHO advises 2 monoclonal antibodies for severe COVID – CIDRAP
Comentário no Twitter (fio – clique para saber mais)
1/n
Here we go –
Our paper assessing the role of interleukin-6 antagonists treatments in the management of COVID-19 patients?https://t.co/AJErHypx9a@WHO @jonathanasterne @diazjv @JAMA_current @KCLImmunoMicro @GSTT_ICU @GSTTresearch— Manu Shankar-Hari (@msh_manu) July 6, 2021