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Manzano-Aquiahuatl C, Tobar-Fredes R, Zavala-Solares MR, Salle-Levy D, Imamura R, Morales-Fernández R, Ojeda-Peña L, Parra-Reyes D, Santoro P, Ton V, Trujillo-Benavides OE, Vargas-García MA, Furkim AM. Position statement of the Latin American Dysphagia Society for the management of oropharyngeal and esophageal dysphagia during the COVID-19 pandemic. Rev Gastroenterol Mex (Engl Ed) 2021; 87:63-79. [PMID: 34973937 PMCID: PMC8716087 DOI: 10.1016/j.rgmxen.2021.12.004] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 08/05/2021] [Indexed: 11/28/2022] Open
Abstract
Introduction The SARS-CoV-2 virus that causes the COVID-19 disease is transmitted through the inhalation of droplets or aerosols and inoculation via the oronasal or ocular routes, transforming the management of swallowing disorders into a challenge for healthcare teams, given their proximity to the aerodigestive tract and the high probability of aerosol generation during patient evaluation and treatment. Aim To provide essential guidance for Latin American multidisciplinary teams, regarding the evaluation and treatment of oropharyngeal and esophageal dysphagia, at the different levels of healthcare. The position statement was formulated for the purpose of maintaining medical service continuity, in the context of a pandemic, and minimizing the propagation and infection risks of the virus. Methods Thirteen experts in swallowing disorders were summoned by the Latin American Dysphagia Society to formulate a series of clinical suggestions, based on available evidence and clinical experience, for the management of dysphagia, taking the characteristics of Latin American healthcare systems into account. Results The position statement of the Latin American Dysphagia Society provides a series of clinical suggestions directed at the multidisciplinary teams that manage patients with oropharyngeal and esophageal dysphagia. It presents guidelines for evaluation and treatment in different contexts, from hospitalization to home care. Conclusions The present statement should be analyzed by each team or healthcare professional, to reduce the risk for COVID-19 infection and achieve the best therapeutic results, while at the same time, being mindful of the reality of each Latin American country.
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Affiliation(s)
- C Manzano-Aquiahuatl
- Sociedad Latinoamericana de Disfagia (The Latin American Dysphagia Society); Sociedad Mexicana de Disfagia, Mexico City, Mexico
| | - R Tobar-Fredes
- Sociedad Chilena de Deglución y Alimentación, Santiago, Chile; Departamento de Fonoaudiología, Universidad de Chile, Santiago, Chile//Unidad de Fonoaudiología, Hospital del Trabajador, Santiago, Chile
| | - M R Zavala-Solares
- Sociedad Mexicana de Disfagia, Mexico City, Mexico; Escuela de Altos Estudios en Salud, Universidad La Salle México, Mexico City, Mexico
| | - D Salle-Levy
- Academia Brasileira de Disfagia, Sao Paulo, Brazil; Departamento de Disfagia de la Sociedad Brasileira de Fonoaudiología, Brazil
| | - R Imamura
- Academia Brasileira de Laringología y Voz, Brazil; Hospital de las Clínicas de la Facultad de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brazil
| | - R Morales-Fernández
- Sociedad Latinoamericana de Disfagia (The Latin American Dysphagia Society); Instituto Nacional de Rehabilitación Pedro Aguirre Cerda, Santiago, Chile
| | - L Ojeda-Peña
- Sociedad Latinoamericana de Disfagia (The Latin American Dysphagia Society); Asociación Paraguaya de Disfagia, Asunción, Paraguay
| | - D Parra-Reyes
- Sociedad Latinoamericana de Disfagia (The Latin American Dysphagia Society); Sociedad Peruana de Disfagia, Lima, Peru
| | - P Santoro
- Academia Brasileira de Laringología y Voz, Brazil; Hospital de las Clínicas de la Facultad de Medicina de la Universidad de Sao Paulo, Sao Paulo, Brazil
| | - V Ton
- Asociación Argentina de Disfagia, Buenos Aires, Argentina; Departamento de Endoscopia Hospital General de Zona No. 42. Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | - O E Trujillo-Benavides
- Departamento de Endoscopia Hospital General de Zona No. 42. Instituto Mexicano del Seguro Social, Ciudad de México, Mexico
| | - M A Vargas-García
- Sociedad Latinoamericana de Disfagia (The Latin American Dysphagia Society); Departamento de Fonoaudiología, Universidad Metropolitana, Barranquilla, Colombia
| | - A M Furkim
- Sociedad Latinoamericana de Disfagia (The Latin American Dysphagia Society); Universidad Federal de Santa Catarina, Curso de Fonoaudiología, Florianópolis, Brazil.
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Abreu Y Abreu AT, Velarde-Ruiz Velasco JA, Zavala-Solares MR, Remes-Troche JM, Carmona-Sánchez RI, Aldana-Ledesma JM, Camacho-Ortiz A, Contreras-Omaña R, Díaz-Seoane R, Elizondo-Vázquez CT, Garza-González E, Grajales-Figueroa G, Gómez-Escudero O, Jacobo-Karam JS, Morales-Arámbula M, Olivares-Guzmán LO, Sifuentes-Osornio J, Siu-Moguel AG, Soto-Solís R, Valdovinos-García LR, Valdovinos-Díaz MA, Vázquez-Elizondo G, Lazo-de la Vega Jasso SA. Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection. Rev Gastroenterol Mex (Engl Ed) 2019; 84:204-219. [PMID: 30987771 DOI: 10.1016/j.rgmx.2018.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 11/26/2018] [Accepted: 12/10/2018] [Indexed: 02/07/2023]
Abstract
In recent decades, Clostridium difficile infection (CDI) has become a worldwide health problem. Mexico is no exception, and therefore the Asociación Mexicana de Gastroenterología brought together a multidisciplinary group (gastroenterologists, endoscopists, internists, infectious disease specialists, and microbiologists) to carry out the "Consensus on the prevention, diagnosis, and treatment of Clostridium difficile infection", establishing useful recommendations (in relation to the adult population) for the medical community. Said recommendations are presented herein. Among them, it was recognized that CDI should be suspected in subjects with diarrhea that have a history of antibiotic and/or immunosuppressant use, but that it can also be a community-acquired infection. A 2-step diagnostic algorithm was proposed, in which a highly sensitive test, such as glutamate dehydrogenase (GDH), is first utilized, and if positive, confirmed by the detection of toxins through immunoassay or nucleic acid detection tests. Another recommendation was that CDI based on clinical evaluation be categorized as mild-moderate, severe, and complicated severe, given that such a classification enables better therapeutic decisions to be made. In mild-moderate CDI, oral vancomycin is the medication of choice, and metronidazole is recommended as an alternative treatment. In addition, fecal microbiota transplantation was recognized as an efficacious option in patients with recurrence or in the more severe cases of infection, and surgery should be reserved for patients with severe colitis (toxic megacolon), in whom all medical treatment has failed.
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Affiliation(s)
| | - J A Velarde-Ruiz Velasco
- Servicio de Gastroenterología, Hospital Civil de Guadalajara «Fray Antonio Alcalde», Guadalajara, Jalisco, México.
| | - M R Zavala-Solares
- Servicio de Gastroenterología, Hospital General de México, Ciudad de México, México
| | - J M Remes-Troche
- Laboratorio de Fisiología Digestiva y Motilidad Gastrointestinal, Instituto de Investigaciones Médico Biológicas, Universidad Veracruzana, Veracruz, Veracruz, México
| | - R I Carmona-Sánchez
- Unidad de Medicina Ambulatoria Christus Muguerza, San Luis Potosí, S.L.P., México
| | - J M Aldana-Ledesma
- Servicio de Gastroenterología, Hospital Civil de Guadalajara «Fray Antonio Alcalde», Guadalajara, Jalisco, México
| | - A Camacho-Ortiz
- Servicio de Infectología, Hospital Universitario «Dr. José Eleuterio González», Monterrey, Nuevo León, México
| | - R Contreras-Omaña
- Centro de Investigación en Enfermedades Hepáticas y Gastroenterología, Pachuca, Hidalgo, México
| | | | | | - E Garza-González
- Servicio de Gastroenterología, Hospital Universitario «Dr. José Eleuterio González», Monterrey, Nuevo León, México
| | - G Grajales-Figueroa
- Departamento de Endoscopia, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México
| | - O Gómez-Escudero
- Clínica de Gastroenterología, Endoscopía Digestiva y Motilidad Gastrointestinal, Hospital Ángeles, Puebla, Puebla, México
| | - J S Jacobo-Karam
- Hospital General 450, Secretaría de Salud, Durango, Durango, México
| | | | | | - J Sifuentes-Osornio
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México
| | | | - R Soto-Solís
- Departamento de Endoscopia, Centro Médico Nacional 20 de Noviembre, ISSSTE, Ciudad de México, México
| | - L R Valdovinos-García
- Departamento de Gastroenterología y Laboratorio de Motilidad Gastrointestinal, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México
| | - M A Valdovinos-Díaz
- Departamento de Gastroenterología y Laboratorio de Motilidad Gastrointestinal, Instituto Nacional de Ciencias Médicas y Nutrición «Salvador Zubirán», Ciudad de México, México
| | - G Vázquez-Elizondo
- Escuela Nacional de Medicina, Tecnológico de Monterrey, Monterrey, Nuevo León, México
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