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BACKGROUND: COVID-19-related acute illness is associated with an increased risk of venous thromboembolism (VTE). OBJECTIVE: These evidence-based guidelines from the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in making decisions about the use of anticoagulation in patients with COVID-19. METHODS: ASH formed a multidisciplinary guideline panel that included patient representatives and applied strategies to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process and performed systematic evidence reviews (through November 2021). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to assess evidence and make recommendations, which were subject to public comment. This is an update to guidelines published in February 2021 as part of the living phase of these guidelines. RESULTS: The panel made one additional recommendation. The panel issued a conditional recommendation in favor of therapeutic-intensity over prophylactic-intensity anticoagulation in patients with COVID-19-related acute illness who do not have suspected or confirmed VTE. The panel emphasized the need for an individualized assessment of risk of thrombosis and bleeding. The panel also noted that heparin (unfractionated or low molecular weight) may be preferred because of a preponderance of evidence with this class of anticoagulants. CONCLUSION: This conditional recommendation was based on very low certainty in the evidence, underscoring the need for additional, high-quality, randomized controlled trials comparing different intensities of anticoagulation in patients with COVID-19-related acute illness.

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BACKGROUND: COVID-19-related acute illness is associated with an increased risk of venous thromboembolism (VTE). OBJECTIVE: These evidence-based guidelines of the American Society of Hematology (ASH) are intended to support patients, clinicians, and other health care professionals in decisions about the use of anticoagulation for thromboprophylaxis in patients with COVID-19 who do not have confirmed or suspected VTE. METHODS: ASH formed a multidisciplinary guideline panel, including 3 patient representatives, and applied strategies to minimize potential bias from conflicts of interest. The McMaster University GRADE Centre supported the guideline development process, including performing systematic evidence reviews (up to March 2021). The panel prioritized clinical questions and outcomes according to their importance for clinicians and patients. The panel used the grading of recommendations assessment, development, and evaluation (GRADE) approach to assess evidence and make recommendations, which were subject to public comment. RESULTS: The panel agreed on 1 additional recommendation. The panel issued a conditional recommendation against the use of outpatient anticoagulant prophylaxis in patients with COVID-19 who are discharged from the hospital and who do not have suspected or confirmed VTE or another indication for anticoagulation. CONCLUSIONS: This recommendation was based on very low certainty in the evidence, underscoring the need for high-quality randomized controlled trials assessing the role of postdischarge thromboprophylaxis. Other key research priorities include better evidence on assessing risk of thrombosis and bleeding outcomes in patients with COVID-19 after hospital discharge.

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Objective: To evaluate the awareness of medical emergencies among dental practitioners in three dental schools. Material and methods: The study group included 384 dental practitioners, including dental staff members, post-graduate students, and dental interns. These professionals were attending three dental educational institutions in Egypt. Two of them were governmental and one was a private school. The educational model is almost the same in most Egyptian dental schools. Results: The response rate was 100%. Most of the participants worked in private academia (44.16%) or practice (42.34%) and 65.20% of them were females. The participants who recorded the medical history and filled a form (91.17%, 80.52 % respectively) while only 41.82% obtained the vital signs. Among the participants, 48.57 % were confident about handling medical emergency and 74.29 % reported their capability of intramuscular injection while only 25.71 % for intravenous injection and 49.35% knew about emergency kits. Management knowledge of airway obstruction and prosthetic heart valve patients was reported by 80.27 % and 71.94 % respectively, while less percentage for activation of EMS, chest compression, CPR ratio, and infant rescue breathing. The mean preparedness percent score was 54.57% and it was inversely correlated to the years of experiences and directly correlated to the degree of confidence in their ability to manage the dental emergency. Conclusion: The current study results reflected a deficiency in the dental practitioner awareness about the medical emergency especially the practical part. (AU)

Objetivo: Avaliar a consciência das emergências médicas entre os dentistas de três faculdades de odontologia. Material e Métodos: O grupo de estudo incluiu 384 dentistas, abrangendo membros da equipe odontológica, alunos de pós-graduação e estagiários de odontologia. Esses profissionais frequentavam três instituições de ensino de odontologia no Egito. Duas eram governamentais e uma era uma instituição particular. O modelo educacional é similar na maioria das escolas de odontologia egípcias. Resultados:A taxa de resposta foi de 100%. A maioria dos participantes trabalhava na área acadêmica (44,16%) ou clínica privadas (42,34%) e 65,20% deles eram do sexo feminino. Os participantes registraram o histórico médico e preencheram um formulário (91,17%, 80,52% respectivamente) enquanto apenas 41,82% obtiveram os sinais vitais. Entre os participantes, 48,57% estavam confiantes para lidar com emergências médicas e 74,29% relataram sua capacidade de injeção intramuscular, enquanto apenas 25,71% para injeção intravenosa e 49,35% sabiam sobre kits de emergência. O conhecimento do manejo de pacientes com obstrução das vias aéreas e válvula cardíaca protética foi relatado por 80,27% e 71,94%, respectivamente, enquanto menos porcentagem para a ativação do serviço de emergência médica (SEM), compressão torácica, índice de reanimação cardiorrespiratória (RCP) e respiração de resgate infantil. A pontuação percentual média de preparação foi de 54,57% e foi inversamente correlacionada aos anos de experiência e diretamente correlacionada ao grau de confiança em sua capacidade de gerenciar a emergência odontológica. Conclusão: Os resultados do presente estudo refletiram uma deficiência na conscientização do dentista sobre a emergência médica principalmente a parte prática (AU)

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