Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review / Paula Andrea Granda Carvajal  

Público ISBD Título : Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review Tipo de documento : documento electrónico Autores : Paula Andrea Granda Carvajal, Fecha de publicación : 2021 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  clinical prediction models  infection  prognosis  systematic literature review Resumen : Introduction: Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions. Objective: To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature. Methods: A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings' archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model. Results: We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic. Conclusions: To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures.Protocol registration number: PROSPERO CRD42020171638. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula A Granda-Carvajal, Daniel C Aguirre, Johanna Hernández-Zapata, Gloria M Vásquez, Fabián Jaimes Referencia : Lupus. 2021 Mar;30(3):421-430. DOI (Digital Object Identifier) : 10.1177/0961203320983462 PMID : 33407048 En línea : https://journals.sagepub.com/doi/10.1177/0961203320983462 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5763 Predictive models of infection in patients with systemic lupus erythematosus: A systematic literature review [documento electrónico] / Paula Andrea Granda Carvajal,  . - 2021. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  clinical prediction models  infection  prognosis  systematic literature review Resumen : Introduction: Having reliable predictive models of prognosis/the risk of infection in systemic lupus erythematosus (SLE) patients would allow this problem to be addressed on an individual basis to study and implement possible preventive or therapeutic interventions. Objective: To identify and analyze all predictive models of prognosis/the risk of infection in patients with SLE that exist in medical literature. Methods: A structured search in PubMed, Embase, and LILACS databases was carried out until May 9, 2020. In addition, a search for abstracts in the American Congress of Rheumatology (ACR) and European League Against Rheumatism (EULAR) annual meetings' archives published over the past eight years was also conducted. Studies on developing, validating or updating predictive prognostic models carried out in patients with SLE, in which the outcome to be predicted is some type of infection, that were generated in any clinical context and with any time horizon were included. There were no restrictions on language, date, or status of the publication. To carry out the systematic review, the CHARMS (Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies) guideline recommendations were followed. The PROBAST tool (A Tool to Assess the Risk of Bias and Applicability of Prediction Model Studies) was used to assess the risk of bias and the applicability of each model. Results: We identified four models of infection prognosis in patients with SLE. Mostly, there were very few events per candidate predictor. In addition, to construct the models, an initial selection was made based on univariate analyses with no contraction of the estimated coefficients being carried out. This suggests that the proposed models have a high probability of overfitting and being optimistic. Conclusions: To date, very few prognostic models have been published on the infection of SLE patients. These models are very heterogeneous and are rated as having a high risk of bias and methodological weaknesses. Despite the widespread recognition of the frequency and severity of infections in SLE patients, there is no reliable predictive prognostic model that facilitates the study and implementation of personalized preventive or therapeutic measures.Protocol registration number: PROSPERO CRD42020171638. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula A Granda-Carvajal, Daniel C Aguirre, Johanna Hernández-Zapata, Gloria M Vásquez, Fabián Jaimes Referencia : Lupus. 2021 Mar;30(3):421-430. DOI (Digital Object Identifier) : 10.1177/0961203320983462 PMID : 33407048 En línea : https://journals.sagepub.com/doi/10.1177/0961203320983462 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5763

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Development and Internal Validation of a Prediction Model to Estimate the Probability of Needing Aggressive Immunosuppressive Therapy With Cytostatics in de Novo Lupus Nephritis Patients / Mauricio Restrepo Escobar ; Paula Andrea Granda Carvajal ; Fabián Alberto Jaimes Barragán  

Público ISBD Título : Development and Internal Validation of a Prediction Model to Estimate the Probability of Needing Aggressive Immunosuppressive Therapy With Cytostatics in de Novo Lupus Nephritis Patients Otros títulos : Desarrollo y validación interna de un modelo de predicción para estimar la probabilidad de requerir inmunosupresión intensiva con citostáticos en pacientes con nefritis lúpica de novo Tipo de documento : documento electrónico Autores : Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2019 Títulos uniformes : Reumatología Clínica Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  lupus nephritis  immunosuppression  multivariate analysis  decision support techniques  logistic models Resumen : Objective: To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies. Methods: Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model. Goodness of fit was evaluated using a Hosmer–Lemeshow test (H–L) and the discrimination capacity of the model by means of the area under the ROC (AUC) curve. Results: Data from 242 patients was gathered; of these, 18.2% (n = 44) did not need an addition of cytostatics according to the findings of their kidney biopsies. The variables included in the final model were 24-h proteinuria, diastolic blood pressure, creatinine, C3 complement and the interaction of hematuria with leukocyturia in urinary sediment. The model showed excellent discrimination (AUC = 0.929; 95% CI = 0.894–0.963) and adequate calibration (H–L, P = .959). Conclusion: In recent-onset LN patients, the decision to use or not to use intensive immunosuppressive therapy could be performed based on our prediction model as an alternative to kidney biopsies. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula Andrea Granda-Carvajal, Fabián Jaimes Referencia : Reumatol Clin. 2019 Jan - Feb;15(1):27-33. DOI (Digital Object Identifier) : 10.1016/j.reuma.2017.05.010 PMID : 28732643 En línea : https://www.reumatologiaclinica.org/en-linkresolver-development-internal-validat [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4052 Development and Internal Validation of a Prediction Model to Estimate the Probability of Needing Aggressive Immunosuppressive Therapy With Cytostatics in de Novo Lupus Nephritis Patients = Desarrollo y validación interna de un modelo de predicción para estimar la probabilidad de requerir inmunosupresión intensiva con citostáticos en pacientes con nefritis lúpica de novo [documento electrónico] / Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán,  . - 2019. Obra : Reumatología Clínica Idioma : Inglés (eng) Palabras clave : Systemic lupus erythematosus  lupus nephritis  immunosuppression  multivariate analysis  decision support techniques  logistic models Resumen : Objective: To develop a multivariable clinical prediction model for the requirement of aggressive immunosuppression with cytostatics, based on simple clinical record data and lab tests. The model is defined in accordance with the result of the kidney biopsies. Methods: Retrospective study conducted with data from patients 16 years and older, with SLE and nephritis with less than 6 months of evolution. An initial bivariate analysis was conducted to select the variables to be included in a multiple logistic regression model. Goodness of fit was evaluated using a Hosmer–Lemeshow test (H–L) and the discrimination capacity of the model by means of the area under the ROC (AUC) curve. Results: Data from 242 patients was gathered; of these, 18.2% (n = 44) did not need an addition of cytostatics according to the findings of their kidney biopsies. The variables included in the final model were 24-h proteinuria, diastolic blood pressure, creatinine, C3 complement and the interaction of hematuria with leukocyturia in urinary sediment. The model showed excellent discrimination (AUC = 0.929; 95% CI = 0.894–0.963) and adequate calibration (H–L, P = .959). Conclusion: In recent-onset LN patients, the decision to use or not to use intensive immunosuppressive therapy could be performed based on our prediction model as an alternative to kidney biopsies. Mención de responsabilidad : Mauricio Restrepo-Escobar, Paula Andrea Granda-Carvajal, Fabián Jaimes Referencia : Reumatol Clin. 2019 Jan - Feb;15(1):27-33. DOI (Digital Object Identifier) : 10.1016/j.reuma.2017.05.010 PMID : 28732643 En línea : https://www.reumatologiaclinica.org/en-linkresolver-development-internal-validat [...] Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4052

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Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis / Mauricio Restrepo Escobar ; Paula Andrea Granda Carvajal ; Fabián Alberto Jaimes Barragán  

Público ISBD Título : Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis Tipo de documento : documento electrónico Autores : Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán, Fecha de publicación : 2017 Títulos uniformes : Lupus Idioma : Inglés (eng) Palabras clave : Biopsy  nephritis  reliability  renal lupus  reproducibility of results  systematic review Resumen : Objective: Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intraobserver reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis. Methods: We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria. Results: We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair. Conclusion: The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field. Mención de responsabilidad : M Restrepo-Escobar, P A Granda-Carvajal, F Jaimes Referencia : Lupus. 2017 Dec;26(14):1502-1512. DOI (Digital Object Identifier) : 10.1177/0961203317706556 PMID : 28441914 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203317706556 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4048 Systematic review of the literature on reproducibility of the interpretation of renal biopsy in lupus nephritis [documento electrónico] / Mauricio Restrepo Escobar, ; Paula Andrea Granda Carvajal, ; Fabián Alberto Jaimes Barragán,  . - 2017. Obra : Lupus Idioma : Inglés (eng) Palabras clave : Biopsy  nephritis  reliability  renal lupus  reproducibility of results  systematic review Resumen : Objective: Before using a test, it should be determined whether the results are reliable. The reliability of the interpretation of renal biopsy in patients with lupus nephritis has not been clearly elucidated. Our objective was to estimate inter and intraobserver reliability of the histological classification, as well as activity and chronicity indices in renal biopsy of patients with lupus nephritis. Methods: We conducted a systematic search of the literature, which included articles in any language, using PubMed, Embase, Cochrane and Lilacs databases. Search terms included were: reproducibility, reliability, agreement, systemic lupus erythematosus and lupus nephritis. Comparative studies with any design were included, regardless of the year or the language of publication. Two investigators, independently, screened the literature published in accordance with pre-established inclusion and exclusion criteria. Results: We found 13 relevant studies. Inter-observer reproducibility of most measurements was moderate or low, despite the fact that, in most cases, the readings were made by expert nephropathologists. There was great diversity among designs, participants, including samples and outcomes evaluated in different studies. Although there are too many reports on the clinical use, studies evaluating the reliability of classifications on renal biopsy in lupus nephritis are rare. The quality of the methodological design and reporting was fair. Conclusion: The interpretation of renal biopsy in lupus nephritis is poorly reproducible, causing serious doubts about its validity and its clinical application. As it can lead to serious diagnosis, treatment and prognosis errors, it is necessary to intensify research in this field. Mención de responsabilidad : M Restrepo-Escobar, P A Granda-Carvajal, F Jaimes Referencia : Lupus. 2017 Dec;26(14):1502-1512. DOI (Digital Object Identifier) : 10.1177/0961203317706556 PMID : 28441914 En línea : https://journals.sagepub.com/doi/abs/10.1177/0961203317706556 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=4048

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Experiencia con la implementación del uso de soluciones estandarizadas de cloruro de potasio / Érika Alejandra del Río Crespo ; Paula Andrea Granda Carvajal ; Sergio Andrés Castañeda Garcés    

Público ISBD Título : Experiencia con la implementación del uso de soluciones estandarizadas de cloruro de potasio Otros títulos : Experience with implementation of standardized using potassium chloride solutions Tipo de documento : documento electrónico Autores : Érika Alejandra del Río Crespo, ; Paula Andrea Granda Carvajal, ; Sergio Andrés Castañeda Garcés, Fecha de publicación : 2015 Títulos uniformes : Avances en Enfermería Idioma : Español (spa) Palabras clave : Seguridad del Paciente  Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos  Errores de Medicación  Prescripciones de Medicamentos  Potasio Resumen : El cloruro de potasio es un medicamento de alto riesgo que se utiliza frecuentemente en los hospitales. En el Hospital Pablo Tobón Uribe se conformó un grupo para liderar la implementación de una práctica segura para el uso de este medicamento. Inicialmente, se realizó un diagnóstico y con sus resultados se definió el retiro de las ampollas de cloruro de potasio de las unidades asistenciales, la prescripción de mezclas estandarizadas con este electrolito para pacientes pediátricos y adultos y su preparación centralizada por el Servicio Farmacéutico. Se hizo un seguimiento para evaluar la adherencia a la práctica implementada, en el que se encontró un cumplimiento del 91,2%, sin presencia de viales almacenados en las unidades donde se restringió; además, se encontró la no influencia en las tasas de flebitis en comparación con meses previos al uso de estas mezclas y el reconocimiento de los riesgos inherentes al uso de un medicamento como el cloruro de potasio dentro del personal asistencial. En el momento actual, esta práctica continúa ejerciéndose en la institución, aunque se han tenido mejoras de acuerdo a los hallazgos en los seguimientos realizados. Por lo tanto, es modelo a seguir para la implementación de otras medicaciones y mezclas que contienen electrolitos. Mención de responsabilidad : Erika Alejandra Del Rio Crespo, Paula Andrea Granda Carvajal, Sergio Andrés Castañeda Garcés Referencia : Av Enferm. 2015;33(1):19-28. DOI (Digital Object Identifier) : 10.15446/av.enferm.v33n1.48648 Derechos de uso : CC BY En línea : https://revistas.unal.edu.co/index.php/avenferm/article/view/48648 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3925 Experiencia con la implementación del uso de soluciones estandarizadas de cloruro de potasio = Experience with implementation of standardized using potassium chloride solutions [documento electrónico] / Érika Alejandra del Río Crespo, ; Paula Andrea Granda Carvajal, ; Sergio Andrés Castañeda Garcés,  . - 2015. Obra : Avances en Enfermería Idioma : Español (spa) Palabras clave : Seguridad del Paciente  Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos  Errores de Medicación  Prescripciones de Medicamentos  Potasio Resumen : El cloruro de potasio es un medicamento de alto riesgo que se utiliza frecuentemente en los hospitales. En el Hospital Pablo Tobón Uribe se conformó un grupo para liderar la implementación de una práctica segura para el uso de este medicamento. Inicialmente, se realizó un diagnóstico y con sus resultados se definió el retiro de las ampollas de cloruro de potasio de las unidades asistenciales, la prescripción de mezclas estandarizadas con este electrolito para pacientes pediátricos y adultos y su preparación centralizada por el Servicio Farmacéutico. Se hizo un seguimiento para evaluar la adherencia a la práctica implementada, en el que se encontró un cumplimiento del 91,2%, sin presencia de viales almacenados en las unidades donde se restringió; además, se encontró la no influencia en las tasas de flebitis en comparación con meses previos al uso de estas mezclas y el reconocimiento de los riesgos inherentes al uso de un medicamento como el cloruro de potasio dentro del personal asistencial. En el momento actual, esta práctica continúa ejerciéndose en la institución, aunque se han tenido mejoras de acuerdo a los hallazgos en los seguimientos realizados. Por lo tanto, es modelo a seguir para la implementación de otras medicaciones y mezclas que contienen electrolitos. Mención de responsabilidad : Erika Alejandra Del Rio Crespo, Paula Andrea Granda Carvajal, Sergio Andrés Castañeda Garcés Referencia : Av Enferm. 2015;33(1):19-28. DOI (Digital Object Identifier) : 10.15446/av.enferm.v33n1.48648 Derechos de uso : CC BY En línea : https://revistas.unal.edu.co/index.php/avenferm/article/view/48648 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3925

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Síndrome hepatopulmonar en paciente con hipertensión portal no cirrótica. Reporte de caso / Octavio Germán Muñoz Maya ; Paula Andrea Granda Carvajal ; Juan Ignacio Marín Zuluaga    

Público ISBD Título : Síndrome hepatopulmonar en paciente con hipertensión portal no cirrótica. Reporte de caso Otros títulos : Case report of hepatopulmonary syndrome in patients with non-cirrhotic portal hypertension Tipo de documento : documento electrónico Autores : Octavio Germán Muñoz Maya, ; Paula Andrea Granda Carvajal, ; Juan Ignacio Marín Zuluaga, Fecha de publicación : 2012 Títulos uniformes : Revista Colombiana de Gastroenterología Idioma : Español (spa) Palabras clave : Síndrome hepatopulmonar  hiperplasia nodular regenerativa  trombosis portal Resumen : Presentamos el caso de una paciente con diagnóstico de síndrome hepatopulmonar (SHP) secundario a hipertensión portal no cirrótica subyacente, en el contexto de trombosis crónica de la vena porta y la mesentérica, por trombofilia primaria (deficiencia de proteína C-S). Se hizo el diagnóstico de SHP al encontrar una ecocardiografía contrastada con solución salina agitada positiva para un shunt extracardíaco, una gammagrafía con macroagregados de albúmina con evidencia de captación a nivel cerebral e hipoxemia persistente con gradiente alvéolo arterial elevado para la edad de la paciente. Mención de responsabilidad : Octavio Germán Muñoz Maya, MD, Oscar Mauricio Santos, MD, Paula Granda, MD, Juliana Vega, MD, Juan-Ignacio Marín, MD, Juan-Carlos Restrepo Gutiérrez, MD, MSc, PhD Referencia : Rev Colomb Gastroenterol. 2012;27(4):323-26. Derechos de uso : CC BY-NC-ND En línea : https://www.gastrocol.com/file/Revista/v27n4a09.pdf.pdf Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3644 Síndrome hepatopulmonar en paciente con hipertensión portal no cirrótica. Reporte de caso = Case report of hepatopulmonary syndrome in patients with non-cirrhotic portal hypertension [documento electrónico] / Octavio Germán Muñoz Maya, ; Paula Andrea Granda Carvajal, ; Juan Ignacio Marín Zuluaga,  . - 2012. Obra : Revista Colombiana de Gastroenterología Idioma : Español (spa) Palabras clave : Síndrome hepatopulmonar  hiperplasia nodular regenerativa  trombosis portal Resumen : Presentamos el caso de una paciente con diagnóstico de síndrome hepatopulmonar (SHP) secundario a hipertensión portal no cirrótica subyacente, en el contexto de trombosis crónica de la vena porta y la mesentérica, por trombofilia primaria (deficiencia de proteína C-S). Se hizo el diagnóstico de SHP al encontrar una ecocardiografía contrastada con solución salina agitada positiva para un shunt extracardíaco, una gammagrafía con macroagregados de albúmina con evidencia de captación a nivel cerebral e hipoxemia persistente con gradiente alvéolo arterial elevado para la edad de la paciente. Mención de responsabilidad : Octavio Germán Muñoz Maya, MD, Oscar Mauricio Santos, MD, Paula Granda, MD, Juliana Vega, MD, Juan-Ignacio Marín, MD, Juan-Carlos Restrepo Gutiérrez, MD, MSc, PhD Referencia : Rev Colomb Gastroenterol. 2012;27(4):323-26. Derechos de uso : CC BY-NC-ND En línea : https://www.gastrocol.com/file/Revista/v27n4a09.pdf.pdf Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3644

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Hemorragia alveolar difusa y nefropatí­a en dos pacientes con sí­ndrome antifosfolipí­dico primario / Paula Andrea Granda Carvajal ; Carlos Jaime Velásquez Franco ; Luis Fernando Pinto Peñaranda ; Javier Darío Márquez Hernández  

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Artritis reactiva asociada con bacteriemia por Brevundimonas diminuta / Paula Andrea Granda Carvajal ; Luis Fernando Pinto Peñaranda ; Carlos Jaime Velásquez Franco  

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