Examinando por Autor "Carvajal, Cristhian"

Mostrando 1 - 2 de 2
  • Miniatura
    Ítem
    Angiotensin-converting-enzyme inhibitors and angiotensin II re-ceptor blockers for COVID-19: A living systematic review of randomized clinical trials
    (Medwave, 2021) Meza, Nicolás; Pérez-Bracchiglione, Javier; Pérez, Ignacio; Carvajal, Cristhian; Ortiz-Muñoz, Luis; Olguín, Pablo; Rada, Gabriel; Madrid, Eva
    Objective: This living systematic review aims to provide a timely, rigorous, and continuously updated summary of the evidence available on the role of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the treatment of patients with COVID-19. Data sources: We conducted searches in PubMed/Medline, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), grey literature and in a centralized repository in L·OVE (Living OVerview of Evidence), which retrieves articles from multiple sources such as PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Embase, among other pre-print and protocols repositories. In response to the COVID-19 emergency, L·OVE (Living OVerview of Evidence) was adapted to expand the range of evidence and customized to group all COVID-19 evidence in one place on a daily search basis. The search covered a period of time up to July 31, 2020. Eligibility criteria for selecting studies and methods: We adapted an already published standard protocol for multiple parallel living systematic reviews to this question's specificities. We included randomized trials evaluating the effect of either suspension or indication of angiotensin-converting-enzyme inhibitors or angiotensin II receptor blockers as monotherapy, or in combination versus placebo or no treatment in patients with COVID-19.We searched for randomized trials evaluating the effect of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers versus placebo or no treatment in patients with COVID-19. Two reviewers independently screened each study for eligibility, extracted data, and assessed the risk of bias. We pooled the results using meta-analysis and applied the GRADE system to assess the certainty of the evidence for each outcome. We will resubmit results every time the conclusions change or whenever there are substantial updates. Results: We screened 772 records, but none was considered for eligibility. We identified 55 ongoing studies, including 41 randomized trials evaluating angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers for patients with COVID-19. Conclusions: We did not find a randomized clinical trial meeting our inclusion criteria, and hence there is no evidence for supporting the role of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers in the treatment of patients with COVID-19. A substantial number of ongoing studies would provide valuable evidence to inform researchers and decision-makers in the near future.
  • Miniatura
    Ítem
    Cómo interpretar las pruebas diagnósticas
    (Medwave, 2021) Pérez, Ignacio; Taito-Vicenti, Iara Yamila; González-Xuriguera, Catalina Gracia; Carvajal, Cristhian; Ariel Franco, Juan Victor; Loézar, Cristóbal
    En el ámbito de la salud, los profesionales deben tomar decisiones en un marco de incertidumbre. Al realizar un diagnóstico, se categorizan los signos y síntomas, sumados a los hallazgos de exámenes complementarios de una condición clínica particular, implicando la definición de un tratamiento y pronóstico específico. Durante el proceso diagnóstico se utilizan herramientas de la anamnesis, examen físico y exámenes complementarios para apoyar dicha categorización. Estas herramientas, conocidas como pruebas diagnósticas, permiten estimar la probabilidad de la presencia o ausencia de la condición médica sospechada. La utilidad de las pruebas diagnósticas varía para cada condición clínica y se evalúan mediante estudios de exactitud (sensibilidad y especificidad) e impacto diagnóstico (repercusión sobre los desenlaces de salud). En este artículo, se abordan los conceptos teóricos y prácticos generales sobre las pruebas diagnósticas en seres humanos considerando sus antecedentes históricos, su relación con las teorías sobre probabilidades y su utilidad práctica con ejemplos ilustrativos.