Search

Resumen Introduccion La colchicina es ampliamente utilizada en enfermedades inflamatorias como la gota y la fiebre mediterranea familiar. Debido a su capacidad inmunomoduladora, podria tener un papel importante en el tratamiento de la COVID-19. Objetivo Explorar la evidencia medica publicada hasta el 28 de diciembre del 2020, acerca de la eficacia y la seguridad de la colchicina en el tratamiento de pacientes con infeccion confirmada por SARS-CoV-2. Material y metodos Revision exploratoria de la literatura que incluyo PubMed y Scopus. Se tuvieron en cuenta registros de ensayos clinicos y publicaciones con datos empiricos (estudios observacionales y experimentales) en ingles y espanol. Resultados Se encontraron 33 ensayos clinicos y 6 publicaciones empiricas: estudios de cohorte prospectivos (n = 2) y retrospectiva (n = 2), ensayo clinico aleatorizado (n = 1) y estudio casos y controles (n = 1). La suma de los participantes en los ensayos es de 46.324 individuos, el 73% (24/33) de los estudios recluta a la poblacion de estudio y el 51% (17/33) son fase 3. Conclusiones Un ensayo clinico respalda la disminucion en marcadores inflamatorios pronosticos y el tiempo de estancia hospitalaria en la infeccion por SARS-CoV-2. Los ensayos clinicos en desarrollo ayudaran a esclarecer la eficacia y la seguridad de la colchicina para el manejo de pacientes con COVID-19.

Problem Routine evacuation of pregnant Indigenous women from remote regions to urban centres for childbirth is a central strategy for addressing maternal health disparities in Canada. Maternal evacuation continues despite mounting evidence of its negative impacts on Indigenous women and families. Background Since the 1960s, pregnant Indigenous women living in remote regions in Canada have been transferred to urban hospitals for childbirth. In the following decades, evidence emerged linking maternal evacuation with negative impacts on Indigenous women, their families, and communities. In some communities, resistance to evacuation and the creation of local birthing facilities has resulted in highly diverse experiences of childbirth and evacuation. Aim A scoping review mapped the evidence on maternal evacuation of Indigenous women in Canada and its associated factors and outcomes from 1978 to 2019. Methods We searched MEDLINE, Embase, and CINAHL, and grey literature from governmental and Indigenous organizations. We collated the evidence on maternal evacuation into 12 themes. Results Factors related to evacuation include (a) evacuation policies (b) institutional coercion (c) remoteness and (d) maternal-fetal health status. Evacuation-related outcomes include (e) maternal-child health impacts (f) women’s experience of evacuation (g) financial hardships (h) family disruption (i) cultural continuity and community wellness (ij) engagement with health services (k) self-determination, and (l) quality of health services. Discussion Numerous emotional, social and cultural harms are associated with evacuation of Indigenous women in Canada. Little is known about the long-term impacts of evacuation on Indigenous maternal-infant health. Evidence on evacuation from remote Metis communities remains a critical knowledge gap.