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Wyss F, Barrios V, Méndez M, Ramos S, Gonzalez Á, Ortiz H, Díaz MR, Castillo G, Quesada D, Franco CE, Ventura J, López EP, Somoza F, Montealegre AA, Meneses D, Pichel D, Valdez O. Central American and Caribbean Consensus Document for the Optimal Management of Oral Anticoagulation in Patients with Non-Valvular Atrial Fibrillation Endorsed by the Central American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention. J Clin Med 2024; 13:314. [PMID: 38256448 PMCID: PMC10816126 DOI: 10.3390/jcm13020314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/27/2023] [Accepted: 12/28/2023] [Indexed: 01/24/2024] Open
Abstract
Atrial fibrillation (AF) is the most common arrhythmia in adults. Prevention of the ischaemic risk with oral anticoagulants (OACs) is widely recommended, and current clinical guidelines recommend direct oral anticoagulants (DOACs) as preference therapy for stroke prevention. However, there are currently no clinical practice guidelines or recommendation documents on the optimal management of OACs in patients with AF that specifically address and adapt to the Central American and Caribbean context. The aim of this Delphi-like study is to respond to doubts that may arise in the management of OACs in patients with non-valvular AF in this geographical area. A consensus project was performed on the basis of a systematic review of the literature, a recommended ADOLOPMENT-like approach, and the application of a two-round Delphi survey. In the first round, 31 recommendations were evaluated and 30 reached consensus, of which, 10 unanimously agreed. The study assessed expert opinions in a wide variety of contextualized recommendations for the optimal management of DOACs in patients with non-valvular atrial fibrillation (NVAF). There is a broad consensus on the clinical practice guideline (CPG) statements used related to anticoagulation indication, patient follow-up, anticoagulation therapy complications, COVID-19 management and prevention, and cardiac interventions.
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Affiliation(s)
- Fernando Wyss
- Cardiovascular Services and Technology of Guatemala, CARDIOSOLUTIONS, Central American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention, Guatemala City 01010, Guatemala
| | - Vivencio Barrios
- Cardiology Department, University Hospital Ramon y Cajal, School of Medicine, Alcala University, 28034 Madrid, Spain
| | - Máxima Méndez
- Cardiologist-Internal Medicine, Medicine Autonomous University, Santo Domingo 10105, Dominican Republic;
- Cardiometabolic Unity, The Hub Innovation and Investigation of the Iberoamerican University, UNIBE, Santo Domingo 10203, Dominican Republic
- Lipid Master National Lipid Association, Jacksonville, FL 32216, USA
| | - Samuel Ramos
- Cardiology Department, Presidente Estrella Ureña Hospital, Santiago de los Caballeros, Salvador B. Gautier Hospital, Santo Domingo 10514, Dominican Republic;
| | - Ángel Gonzalez
- Cardiology Department, Hospiten Santo Domingo, Autónoma de Santo Domingo University, Santo Domingo 1355, Dominican Republic;
- American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention, Guatemala City 01010, Guatemala;
| | - Héctor Ortiz
- Cardiology Department, Herrera Llerandi Hospital, Guatemala City 01010, Guatemala;
| | - Marco Rodas Díaz
- Guatemalan Association of Cardiology, Cardiovascular Surgery Unit of Guatemala (UNICAR), Guatemala City 01010, Guatemala;
| | - Gabriela Castillo
- Cardiology Department, Max Peralta Hospital, Costa Rica University Cartago, Cartago 30101, Costa Rica;
| | - Daniel Quesada
- Cardiology Department, Hospital San Vicente de Paul, Universidad de Costa Rica, Heredia 40101, Costa Rica;
| | - Carlos Enrique Franco
- Cardiology Department, Surgical and Oncological Medical Hospital, Instituto Salvadoreño del Seguro Social, Escalon Medical Center, San Salvador 1101, El Salvador;
| | - Jaime Ventura
- Cardiology Department, Instituto Salvadoreño del Seguro Social, San Salvador 1101, El Salvador;
| | - Emilio Peralta López
- Cardiology Department, Instituto Nacional Cardiopulmonar, Tegucigalpa 11101, Honduras;
| | - Francisco Somoza
- Cardiology Department, CEMESA Hospital, San Pedro Sula 21102, Honduras;
| | | | - Daniel Meneses
- Cardiology Department, Del Valle Cardiologic Clinique, Nacional Autónoma of Nicaragua University, Managua 14145, Nicaragua;
| | - Daniel Pichel
- Cardiology Department, Paitilla Hospital, University of Panamá, Paitilla 06001, Panama;
| | - Osiris Valdez
- American and Caribbean Society of Arterial Hypertension and Cardiovascular Prevention, Guatemala City 01010, Guatemala;
- Cardiology Department, Central Romana Hospital, La Romana 22000, Dominican Republic
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Puia S, Pasart J, Gualtieri A, Somoza F, Melo C, Alessandrelo M, Gatti P, Squassi A, Rodriguez PA. Corrigendum to "Assesment of SARS-CoV-2 infection-in dentists and supporting staff at a university dental hospital in Argentina". Journal of Oral Biology and Craniofacial Research Volume 11, Issue 2 (2021) Pages 169-173. J Oral Biol Craniofac Res 2021; 11:659. [PMID: 34549023 PMCID: PMC8445763 DOI: 10.1016/j.jobcr.2021.09.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
[This corrects the article DOI: 10.1016/j.jobcr.2021.01.006.].
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Affiliation(s)
- Sebastian Puia
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Cirugía y Traumatología Buco Maxilofacial I, Buenos Aires, Argentina
| | - Jorge Pasart
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Clínica II de Operaoria y Prótesis, Buenos Aires, Argentina
| | - Ariel Gualtieri
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Biofísica y Bioestadística, Buenos Aires, Argentina
| | - Francisco Somoza
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Endodoncia, Buenos Aires, Argentina
| | - Carolina Melo
- Universidad de Buenos Aires, Facultad de Odontología, Extensión Universitaria, Buenos Aires, Argentina
| | - Milton Alessandrelo
- Universidad de Buenos Aires, Facultad de Odontología, Extensión Universitaria, Buenos Aires, Argentina
| | - Patricio Gatti
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Cirugía y Traumatología Buco Maxilofacial I, Buenos Aires, Argentina
| | - Aldo Squassi
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Odontología Preventiva y Comunitaria - Instituto de Investigaciones en Salud Pública, Buenos Aires, Argentina
| | - Pablo Alejandro Rodriguez
- Universidad de Buenos Aires, Facultad de Odontología, Cátedra de Endodoncia, Buenos Aires, Argentina
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Rueda JC, Santos AM, Angarita JI, Giraldo RB, Saldarriaga EL, Ballesteros Muñoz JG, Forero E, Valencia H, Somoza F, Martin-Arsanios D, Quintero EJ, Reyes-Martinez V, Padilla D, Cuervo FM, Peláez-Ballestas I, Cardiel MH, Pavía PX, Londono J. Demographic and clinical characteristics of chikungunya patients from six Colombian cities, 2014-2015. Emerg Microbes Infect 2019; 8:1490-1500. [PMID: 31631794 PMCID: PMC6819954 DOI: 10.1080/22221751.2019.1678366] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 10/04/2019] [Indexed: 02/07/2023]
Abstract
In 2014, the chikungunya virus reached Colombia for the first time, resulting in a nationwide epidemic. The objective of this study was to describe the demographics and clinical characteristics of suspected chikungunya cases. Chikungunya infection was confirmed by enzyme-linked immunosorbent assay and 548 patients where included in the study. Of these patients, 295 were positive for antibodies against chikungunya (53.8%), and 27.6% (151/295) were symptomatic for chikungunya infection, with a symptomatic:asymptomatic ratio of 1.04:1. Factors associated with infection included low income and low socio-economic strata (odds ratio [OR]: 1.8; 95% confidence interval [CI]: 1.0-3.2, p = 0.003 and OR: 2.1; CI: 1.3-3.4, p = 0.002, respectively). Confirmed symptomatic cases were associated with symmetric arthritis (OR: 11.7; CI: 6.0-23.0, p < 0.001) of ankles (OR: 8.5; CI: 3.5-20.9, p < 0.001), hands (OR: 8.5; CI: 3.5-20.9, p < 0.001), feet (OR: 6.5; CI: 2.8-15.3, p < 0.001), and wrists (OR: 17.3; CI: 2.3-130.5, p < 0.001). Our study showed that poverty is associated with chikungunya infection. Public health strategies to prevent and control chikungunya should focus on poorer communities that are more vulnerable to infection. The rate of asymptomatic infections among confirmed cases was 48.8%. However, those with symptoms displayed a characteristic rheumatic clinical picture, which could help differentiate chikungunya infection from other endemic viral diseases.
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Affiliation(s)
- Juan C. Rueda
- Biosciences Doctoral Programme, Faculty of Medicine and Engineering, Universidad de La Sabana, Chía, Colombia
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Ana M. Santos
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Jose-Ignacio Angarita
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Rodrigo B. Giraldo
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Elías Forero
- Department of Rheumatology and Internal Medicine, Universidad del Norte, Barranquilla, Colombia
| | - Hugo Valencia
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Francisco Somoza
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Daniel Martin-Arsanios
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Elias-Josué Quintero
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Viviana Reyes-Martinez
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Diana Padilla
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | - Francy M. Cuervo
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
| | | | | | - Paula X. Pavía
- Unidad de Investigación Científica, Hospital Militar Central, Bogotá, Colombia
| | - John Londono
- Grupo Espondiloartropatías, Department of Rheumatology, Universidad de La Sabana, Chía, Colombia
- Department of Rheumatology, Hospital Militar Central, Bogotá, Colombia
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Thiele KH, Gerstner P, Somoza F. Synthese verbrückter binuklearer Titanocenverbindungen - Kristallstruktur von Cl2Ti[(C5H4)(C5H4)(Me)Si-Si(Me)(C5H4)(C5H4)]TiCl2 · PhMe. Z Anorg Allg Chem 2001. [DOI: 10.1002/1521-3749(200101)627:1<28::aid-zaac28>3.0.co;2-r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Wittich A, Mautalen CA, Oliveri MB, Bagur A, Somoza F, Rotemberg E. Professional football (soccer) players have a markedly greater skeletal mineral content, density and size than age- and BMI-matched controls. Calcif Tissue Int 1998; 63:112-7. [PMID: 9685514 DOI: 10.1007/s002239900499] [Citation(s) in RCA: 70] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The total skeletal bone mineral content (BMC), bone mineral density (BMD), bone size, and body composition were measured by dual-energy x-ray absorptiometry (DXA) in all professional male football players of a 1st division team (n = 24) and age- and BMI-matched (n = 22) controls (less than 3 hours of recreational sport activities per week). Average (+/- 1 SD) age of the athletes was 22.6 +/- 2.5 years. Intensive training is conducted during 48 weeks a year for 20-22 hours/week. The length of the registered playing career before the study was 8.2 +/- 2.7 years. Total skeleton BMC was 18.0% (P < 0.001) greater in the football players. The difference resulted from the sum of 5.2% (P < 0.02) increment of bone size and 12.3% (P < 0.001) increment of BMD. The analysis of skeletal subareas revealed that the difference of the BMC and BMD was greater at the level of the pelvis and legs compared with the arms or trunk. The BMC and BMD of the head was equal for both groups. Also, the bone size of the legs and pelvis was significantly greater for the players compared with controls; there was no difference at the level of the arms or head. Within the group of football players the increment of total skeleton BMD was similar in the young players, with less than 7 years of practice (age 20.6 +/- 0.9 years) compared with relative older players (age 24.6 +/- 1.9) with more than 7 years of practice. Lean body mass was significantly greater in the players (63.3 +/- 4.0 kg) compared with the controls (56.7 +/- 3.6, P < 0.001) whereas fat mass was markedly lower (9.4 +/- 2.9 kg versus 14.9 +/- 6.3 kg), P < 0.002). The BMD of the controls was significantly correlated to total weight, height, and lean mass whereas the BMD of the players was only correlated to muscle mass. The calcium intake from dairy products was similar in both groups. The range of calcium intake was wide among the players (184-2519 mg/day) but it was not significantly correlated to BMD (r = 0.03). In conclusion, male professional football players develop a significant increment of BMC as a result of increased bone size and density. This is already present at the end of the second decade and maintained at least to the end of the third decade in active players. As in other high impact loading sports, the effect on area is specific involving mainly the pelvis and legs. The increment was totally unrelated to the calcium intake from dairy products. The fate of the increased BMC after intensive training is discontinued should be assessed. However, if the findings of the present cross-sectional study are supported by detailed longitudinal investigations, the presently reported observations might be important for the prevention of future osteoporotic fractures.
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Affiliation(s)
- A Wittich
- Centro de Osteopatías Médicas, Hospital de Clínicas, University of Buenos Aires, Medical Department of Ferro Carril Oeste, Argentina
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