RESUMO
BACKGROUND: An increasing body of evidence has revealed that SARS-CoV-2 infection in pregnant women could increase the risk of adverse maternal and fetal outcomes. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted. Therefore, rapid antibody tests have been suggested as an efficient screening tool during pregnancy. CASES: We analysed the clinical performance during pregnancy of a rapid, lateral-flow immunochromatographic assay for qualitative detection of SARS-CoV-2 IgG/IgM antibodies. We performed a universal screening including 169 patients during their last trimester of pregnancy. We present a series of 14 patients with positive SARS-CoV-2 immunochromatographic assay rapid test result. Immunochromatographic assay results were always confirmed by chemiluminescent microparticle immunoassays for quantitative detection of SARS-CoV-2 IgG and IgM+IgA antibodies as the gold standard. We observed a positive predictive value of 50% and a false positive rate of 50% in pregnant women, involving a significantly lower diagnostic performance than reported in non-pregnant patients. DISCUSSION: Our data suggest that although immunochromatographic assay rapid tests may be a fast and profitable screening tool for SARS-CoV-2 infection, they may have a high false positive rate and low positive predictive value in pregnant women. Therefore, immunochromatographic assay for qualitative detection of SARS-CoV-2 IgG/IgM antibodies must be verified by other test in pregnant patients.
Assuntos
Anticorpos Antivirais/imunologia , Teste Sorológico para COVID-19 , COVID-19 , Imunoglobulina G/imunologia , Imunoglobulina M/imunologia , Complicações Infecciosas na Gravidez , SARS-CoV-2/imunologia , Adulto , COVID-19/diagnóstico , COVID-19/imunologia , Feminino , Humanos , Imunoensaio , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/imunologiaRESUMO
Objetivo: Revisar la evidencia científica existente respecto al tratamiento de hipoterapia en niños con parálisis cerebral en función de diferentes variables. Métodos Se ha realizado una búsqueda bibliográfica en las bases de datos Pubmed/Medline, Web of Knowledge, Cochrane, PEDro, Enfispo, y en los metabuscadores Trip Data Base y Excelencia clínica. Los términos utilizados en la búsqueda fueron: equine-assisted therapy, cerebral palsy, hippotherapy y horseback riding, combinados generalmente con el operador boleano AND. Resultados Después de eliminar artículos duplicados de las diferentes bases de datos se obtuvieron 25 artículos. Siete de ellos eran revisiones sistemáticas o metaanálisis, 7 eran ensayos clínicos y 11 estudios eran series clínicas no controladas o estudios descriptivos. La calidad de la evidencia científica proporcionada por los estudios utilizados en esta revisión sistemática fue de nivel I para 7 de ellos, de nivel III (evidencia científica proporcionada buena a regular) para otros 7 artículos, y de nivel VIII (evidencia científica proporcionada pobre) para los restantes 11 artículos. Discusión Las principales limitaciones encontradas en los estudios revisados han sido el tamaño muestral reducido, el uso de herramientas de valoración no estandarizadas y/o la heterogeneidad de los protocolos de tratamiento utilizados. Conclusión Resulta difícil encontrar evidencia científica del tratamiento de hipoterapia en niños con parálisis cerebral como consecuencia de diferentes factores, como son los reducidos tamaños muestrales utilizados por los estudios, la diversidad de escalas de valoración y de protocolos de tratamiento utilizados (AU)
Objective: To review the current scientific evidence regarding hippotherapy treatment in children with cerebral palsy through the analysis of different study variables.Methods: A bibliographic research of Pubmed/Medline, Web of Knowledge, Cochrane, PEDro,Enfispo databases and Trip Data Base and Excelencia clínica metasearchers was carried out. The terms used in the search were: Equine-Assisted Therapy, Cerebral Palsy, Hippotherapy and Horseback riding, usually combined with the Boolean operator AND. Results: After eliminating duplicated articles in the different databases, 25 articles were found. Seven of them were systematic reviews or meta-analysis, 7 articles were clinical trials and11 studies were uncontrolled clinical series or descriptive studies. The quality of scientific evidence provided by the studies used in this systematic review was level I for seven of them, level III for seven articles (scientific evidence provided good to regular) and level VIII (scientificevidence provided poor) for the remaining eleven articles. Discussion: The main limitations found in the studies reviewed have been small sample sizes, use of non-standardized assessment tools and/or heterogeneity of the treatment protocolsused. Conclusion: It is difficult to find scientific evidence regarding hippotherapy treatment in children with cerebral palsy due to different factors such as the small sample sizes used in the studies, the diversity of assessment scales and treatment protocols used (AU)
