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Clinical and Applied... 2023Sepsis is a syndrome of severe systemic inflammatory response. When combined with disseminated intravascular coagulation, mortality is increased. The need for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Sepsis is a syndrome of severe systemic inflammatory response. When combined with disseminated intravascular coagulation, mortality is increased. The need for anticoagulant therapy is still the focus of debate.
METHODS
PubMed, Embase, Cochrane Library, and Web of Science were searched. Adult patients with sepsis-induced disseminated intravascular coagulation were included in this study. All-cause mortality as efficacy and serious bleeding complications as adverse effect were measured as primary outcomes. Methodological quality of included studies were assessed using the Methodological Index for Non-randomized Studies (MINORS). Meta-analysis was performed using R software (version 3.5.1) and Review Manager (version 5.3.5).
RESULTS
There were nine eligible studies with 17,968 patients included. There were no significant reductions in mortality between the anticoagulant group and the non-anticoagulant group (RR, 0.89; 95% CI, 0.72-1.10; = 0.27). The DIC resolution rate in the anticoagulation group has a statistically significant increase compared with the control group [OR: 2.62, 95% CI (1.54-4.45), < 0.05]. And there was no significant difference in bleeding complications between the two groups (RR, 1.27; 95% CI, 0.77-2.09; = 0.69). SOFA score reduction did not change significantly between the two groups ( = 0.13).
CONCLUSIONS
Our study observed no significant benefit of anticoagulant therapy on mortality of sepsis-induced DIC. Anticoagulation therapy can promote DIC resolution in sepsis-induced DIC. In addition, anticoagulant therapy does not increase the risk of bleeding in these patients.
Topics: Adult; Humans; Anticoagulants; Disseminated Intravascular Coagulation; Blood Coagulation; Hemorrhage; Sepsis
PubMed: 36802946
DOI: 10.1177/10760296231157766 -
Nature Communications Feb 2021The COVID-19 pandemic began in early 2020 with major health consequences. While a need to disseminate information to the medical community and general public was...
The COVID-19 pandemic began in early 2020 with major health consequences. While a need to disseminate information to the medical community and general public was paramount, concerns have been raised regarding the scientific rigor in published reports. We performed a systematic review to evaluate the methodological quality of currently available COVID-19 studies compared to historical controls. A total of 9895 titles and abstracts were screened and 686 COVID-19 articles were included in the final analysis. Comparative analysis of COVID-19 to historical articles reveals a shorter time to acceptance (13.0[IQR, 5.0-25.0] days vs. 110.0[IQR, 71.0-156.0] days in COVID-19 and control articles, respectively; p < 0.0001). Furthermore, methodological quality scores are lower in COVID-19 articles across all study designs. COVID-19 clinical studies have a shorter time to publication and have lower methodological quality scores than control studies in the same journal. These studies should be revisited with the emergence of stronger evidence.
Topics: Animals; COVID-19; Clinical Studies as Topic; Data Accuracy; Humans; Pandemics; Peer Review, Research; Periodicals as Topic; Research Design; Time Factors
PubMed: 33574258
DOI: 10.1038/s41467-021-21220-5 -
Frontiers in Public Health 2023In the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the... (Review)
Review
BACKGROUND
In the age of digitalization and big data, personal health information is a key resource for health care and clinical research. This study aimed to analyze the determinants and describe the measurement of the willingness to disclose personal health information.
METHODS
The study conducted a systematic review of articles assessing willingness to share personal health information as a primary or secondary outcome. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis protocol. English and Italian peer-reviewed research articles were included with no restrictions for publication years. Findings were narratively synthesized.
RESULTS
The search strategy found 1,087 papers, 89 of which passed the screening for title and abstract and the full-text assessment.
CONCLUSION
No validated measurement tool has been developed for willingness to share personal health information. The reviewed papers measured it through surveys, interviews, and questionnaires, which were mutually incomparable. The secondary use of data was the most important determinant of willingness to share, whereas clinical and socioeconomic variables had a slight effect. The main concern discouraging data sharing was privacy, although good data anonymization and the high perceived benefits of sharing may overcome this issue.
Topics: Health Records, Personal; Privacy; Information Dissemination; Surveys and Questionnaires
PubMed: 37546309
DOI: 10.3389/fpubh.2023.1213615 -
BMC Neurology Nov 2023Fatigue is the most disabling symptom for individuals with multiple sclerosis (MS), which can significantly affect postural control (PC) by impairing the ability of the...
BACKGROUND
Fatigue is the most disabling symptom for individuals with multiple sclerosis (MS), which can significantly affect postural control (PC) by impairing the ability of the central nervous system to modulate sensory inputs and coordinate motor responses. This systematic review aimed to investigate the effect of fatigue on PC in individuals with MS..
METHODS
This systematic review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline and registered in PROSPERO with ID CRD42022376262. A systematic search was performed in the Web of Science, PubMed, Scopus, and Google Scholar until January 2023, and a manual search was performed using the reference lists of included studies. Two authors independently selected the studies, extracted data, and evaluated their methodological quality using the Downs and Black checklist. The process was later discussed with a third author..
RESULTS
Five studies were included in this review, of which consistent evidence investigating a direct relationship between fatigue and PC in individuals with MS. All the studies reported negative effects on PC. Four studies employed walking tests as their primary protocol for inducing fatigue, while one study implemented a strength testing protocol for both legs, serving as a fatigue-inducing activity.
CONCLUSIONS
The evidence suggests that individuals with MS may experience PC deficits due to fatigue. However, the present body of literature exhibits limitations regarding its quality and methodology. Gender differences, balance, fatigue task, and muscle function are essential factors that need to be considered when investigating the relationship between fatigue and PC deficits in MS. Further high-quality research is necessary to comprehend the complex interplay between MS-related fatigue and PC deficits after physical activity.
Topics: Humans; Exercise; Multiple Sclerosis; Fatigue; Postural Balance
PubMed: 37978449
DOI: 10.1186/s12883-023-03464-4 -
International Journal of Preventive... 2021Seizure and epilepsy are among the initial symptoms of multiple sclerosis (MS), yet different prevalence rates are reported for them in the previous studies. The goal of... (Review)
Review
BACKGROUND
Seizure and epilepsy are among the initial symptoms of multiple sclerosis (MS), yet different prevalence rates are reported for them in the previous studies. The goal of this systematic review is to estimate the pooled prevalence of seizure and epilepsy in patients with MS.
METHODS
We searched PubMed, Scopus, EMBASE, Web of Science, google scholar, and gray literature including references from identified studies and conference abstracts published up to October 2019. The search strategy included the MeSH terms and text words as ((Epilepsies OR Seizure Disorder OR Seizure Disorders OR Awakening Epilepsy OR Epilepsy, Awakening OR Epilepsy, Cryptogenic OR Cryptogenic Epilepsies OR Cryptogenic Epilepsy OR Epilepsies, Cryptogenic OR epilepsy OR seizure) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR Sclerosis, Disseminated) OR Disseminated Sclerosis) OR MS (Multiple Sclerosis)) OR Multiple Sclerosis, Acute Fulminating).
RESULTS
The literature review resulted in 4860 articles; 2593 articles remained after eliminating the duplicates. For the final analysis, 39 articles were included, 9 of which were conference abstracts. The pooled prevalence of seizure in MS cases was 2%, 95% confidence interval (CI)(1%-3%) (I = 91.8%, < 0.001). The pooled prevalence of epilepsy in MS cases was 3%, 95% CI (2%-4%) (I2 = 92.9%, < 0.001). The pooled prevalence of epilepsy in Asia, Europe, and America was 6%, 3%, and 3%, respectively. The level of heterogeneity decreased after subgroup analysis in Asian and American subgroups. Meta-regression analysis showed continent is not a source of heterogeneity (coefficient = -0.007, = 0.6).
CONCLUSIONS
The result of this systematic review shows that the pooled prevalence of seizure and epilepsy among MS patients is 2% and 3%, respectively.
PubMed: 34084311
DOI: 10.4103/ijpvm.IJPVM_75_20 -
Journal of Hazardous Materials Aug 2022Increasing usage of antimicrobials is a significant contributor to the emergence and dissemination of antimicrobial resistance. Wastewater-based epidemiology is a useful...
Increasing usage of antimicrobials is a significant contributor to the emergence and dissemination of antimicrobial resistance. Wastewater-based epidemiology is a useful tool for evaluating public health, via the monitoring of chemical and biological markers in wastewater influent, such as antibiotics. Sixteen antimicrobials and their metabolites were studied: sulfonamides, trimethoprim, metronidazole, quinolones, nitrofurantoin, cyclines, and antiretrovirals. Correction factors (CFs) for human drug excretion, for various drug forms, were determined via a systematic literature review of pharmacokinetic research. Analyte stability was examined over a 24 h study. The estimation of community-wide drug intake was evaluated using the corresponding catchment prescription data. Overall, antimicrobials excreted in an unchanged form were often observed to over-estimate daily intake. This could be attributed to biotransformation, e.g., via glucuronide cleavage, or direct disposal of unused drugs. Acetyl-sulfonamides, trimethoprim, hydroxy-metronidazole, clarithromycin, ciprofloxacin, ofloxacin, tetracycline, and oxytetracycline generally performed well in the estimation of drug intake, relative to prescription records. The low prevalence of quinolone and trimethoprim metabolites, and the low stability of nitrofurantoin, limited the ability to evaluate these metabolites and their respective CFs.
Topics: Anti-Bacterial Agents; Anti-Infective Agents; Humans; Metronidazole; Nitrofurantoin; Quinolones; Sulfonamides; Trimethoprim; Wastewater-Based Epidemiological Monitoring; Water Pollutants, Chemical
PubMed: 35594673
DOI: 10.1016/j.jhazmat.2022.129001 -
Current Nutrition Reports Sep 2022Globally, too few children are breastfed as recommended. Commercial promotion of breast-milk substitutes (BMS) is one factor undermining breastfeeding globally. Although... (Review)
Review
PURPOSE OF REVIEW
Globally, too few children are breastfed as recommended. Commercial promotion of breast-milk substitutes (BMS) is one factor undermining breastfeeding globally. Although the International Code of Marketing of BMS prohibits all forms of marketing, promotion has been observed in digital environments. We aimed to understand the scope and impact of digital marketing for the promotion of BMS.
RECENT FINDINGS
BMS are promoted strategically and in an integrated fashion across multiple digital channels (social media, manufacturer websites, online retailers, blogs, mobile apps and digital streaming services). Traditional marketing strategies like gifts, discounts and coupons are also disseminated digitally. Data mining, real-time direct-to-consumer advertising and partnering with peer-group social media influencers are additional avenues. Exposure to digital marketing is common. Research on the impact of digital marketing is scarce, but its negative impact on breastfeeding intention and initiation has been documented. Case reports from marketing industry press corroborate academic evidence by highlighting the benefits of digital marketing to BMS companies in recruiting new users and increasing sales. To protect and promote breastfeeding, coordinated global action and strengthened national measures will be needed to implement, monitor and enforce the International Code in a digital context. Further action could include voluntary restrictions on BMS marketing by social media platforms and greater use of government-led data and health privacy regulation.
Topics: Breast Feeding; Child; Female; Humans; Marketing; Milk Substitutes
PubMed: 35507274
DOI: 10.1007/s13668-022-00414-3 -
Frontiers in Psychiatry 2022The COVID-19 pandemic raised significant concerns related to the management of care for people with dementia, but few studies have examined the mental health of older...
OBJECTIVES
The COVID-19 pandemic raised significant concerns related to the management of care for people with dementia, but few studies have examined the mental health of older adults with dementia and their caregivers during the pandemic, when compared to other populations. This systematic review thus aims to compare and discuss the impact of the COVID-19 pandemic on people with dementia and on their caregivers' mental health.
METHODS
A search was performed in the PubMed/Medline and ISI databases according to the PRISMA methodology. We included studies published in 2020 and 2021 with the following combinations of keywords: "COVID-19 and mental health and elderly," "COVID-19 and mental health and dementia;" "COVID-19 and dementia and caregivers," "pandemic and mental health and elderly," and "pandemic and anxiety."
RESULTS
Twenty-two studies were included. Technology has proven to be an essential ally during the pandemic, since all 22 studies performed remote data collection. Nearly all the studies emphasized that social isolation and withdrawal can lead to the emergence or increase of neuropsychiatric symptoms and motor difficulties. However, the findings were mixed concerning the pandemic's impact on the cognition of people with dementia. Caregivers also suffered from the pandemic's impact, experiencing an increase in the burden of care and symptoms of stress, depression, and anxiety. Few studies suggested measures to alleviate the difficulties of people with dementia and their caregivers. There are reports of the benefits of technology in communication and treatment through teleconsultations, however, not everyone has access to such technology, making it difficult to disseminate this tool to the target population.
CONCLUSIONS
The studies generally showed that social isolation can increase motor deficits and neuropsychiatric symptoms and caregivers' burden and anxiety. New avenues for care and intervention are thus needed for older adults with cognitive deficits and their caregivers to avoid the intensification of physical and psychological suffering. Technological initiatives and support should consider people with cognitive impairment and different levels of technology literacy.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/.
PubMed: 35873228
DOI: 10.3389/fpsyt.2022.879598 -
Frontiers in Medicine 2022The distribution of human T cell lymphotropic virus type 1 (HTLV-1) overlaps with that of . infection has been reported to be impacted by co-infection with HTLV-1....
BACKGROUND
The distribution of human T cell lymphotropic virus type 1 (HTLV-1) overlaps with that of . infection has been reported to be impacted by co-infection with HTLV-1. Disseminated strongyloidiasis and hyperinfection syndrome, which are commonly fatal, are observed in HTLV-1 co-infected patients. Reduced efficacy of anti-strongyloidiasis treatment in HTLV-1 carriers has been reported. The aim of this meta-analysis and systematic review is to better understand the association between HTLV-1 and infection.
METHODS
PubMed, Embase, MEDLINE, Global Health, Healthcare Management Information Consortium databases were searched. Studies regarding the prevalence of , those evaluating the frequency of mild or severe strongyloidiasis, and treatment response in people living with and without HTLV-1 infection were included. Data were extracted and odds ratios were calculated. Random-effect meta-analysis was used to assess the pooled OR and 95% confidence intervals.
RESULTS
Fourteen studies were included after full-text reviewing of which seven described the prevalence of and HTLV-1. The odds of infection were higher in HTLV-1 carriers when compared with HTLV-1 seronegative subjects (OR 3.2 95%CI 1.7-6.2). A strong association was found between severe strongyloidiasis and HTLV-1 infection (OR 59.9, 95%CI 18.1-198). Co-infection with HTLV-1 was associated with a higher rate of strongyloidiasis treatment failure (OR 5.05, 95%CI 2.5-10.1).
CONCLUSION
infection is more prevalent in people living with HTLV-1. Co-infected patients are more likely to develop severe presentation and to fail treatment. Screening for HTLV-1 and sp. should be routine when either is diagnosed.
PubMed: 35237633
DOI: 10.3389/fmed.2022.832430 -
Maedica Dec 2019Sexual dysfunction (SD) is an important issue for women suffering from multiple sclerosis (MS). There is a discrepancy among the reported prevalence of SD in studies...
Sexual dysfunction (SD) is an important issue for women suffering from multiple sclerosis (MS). There is a discrepancy among the reported prevalence of SD in studies that were conducted in different geographical regions. We aimed to conduct this systematic review and meta-analysis to estimate pooled prevalence of SD in women with MS. We searched PubMed, Scopus, EMBASE, CINAHL, Web of Science, Ovid, Google Scholar and gray literature, including references of selected studies and conference abstracts that were published up to April 2019. The search strategy included MeSH and text words as (sexual function) OR (sexual dysfunction) AND (Multiple Sclerosis OR Sclerosis, Multiple) OR (Sclerosis, Disseminated) OR (Disseminated Sclerosis) OR (MS) (Multiple Sclerosis) OR (Multiple Sclerosis, Acute Fulminating) AND (Female Sexual Function Index OR FSFI). Two independent researchers independently assessed the articles. The literature search found 168 articles but only nine were considered for the final analysis. Two studies were from Greece, three from Iran, one from Turkey, one from Poland, one from Germany and one from Italy. In total, 1060 MS cases were analyzed. The prevalence of SD was extremely discrepant, from 27% to 95%, and the pooled estimate was calculated as 55% (95% CI 41%-69%), (I²=96.3%, P<00.1). Prevalence of SD is discrepant among women with MS in different countries and it should be considered as an important concern.
PubMed: 32153674
DOI: 10.26574/maedica.2019.14.4.408