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Tropical Medicine and Infectious Disease Apr 2023Treatments for COVID-19, including steroids, might exacerbate disease in patients with coinfection. We aimed to systematically review clinical and laboratory features... (Review)
Review
BACKGROUND
Treatments for COVID-19, including steroids, might exacerbate disease in patients with coinfection. We aimed to systematically review clinical and laboratory features of SARS-CoV-2 and coinfection, investigate possible interventions, assess outcomes, and identify research gaps requiring further attention.
METHODS
We searched two electronic databases, LitCOVID and WHO, up to August 2022, including SARS-CoV-2 and coinfection studies. We adapted the World Health Organization-Uppsala Monitoring Centre (WHO-UMC) system for standardized case causality assessment to evaluate if using corticosteroids or other immunosuppressive drugs in COVID-19 patients determined acute manifestations of strongyloidiasis.
RESULTS
We included 16 studies reporting 25 cases of and SARS-CoV-2 coinfection: 4 with hyperinfection syndrome; 2 with disseminated strongyloidiasis; 3 with cutaneous reactivation of strongyloidiasis; 3 with isolated digestive symptoms; and 2 with solely eosinophilia, without clinical manifestations. Eleven patients were asymptomatic regarding strongyloidiasis. Eosinopenia or normal eosinophil count was reported in 58.3% of patients with reactivation. Steroids were given to 18/21 (85.7%) cases. A total of 4 patients (19.1%) received tocilizumab and/or Anakirna in addition to steroids. Moreover, 2 patients (9.5%) did not receive any COVID-19 treatment. The causal relationship between reactivation and COVID-19 treatments was considered certain (4% of cases), probable (20% of patients), and possible (20% of patients). For 8% of cases, it was considered unlikely that COVID-19 treatment was associated with strongyloidiasis reactivations; the relationship between the infection and administration of COVID-19 treatment was unassessable/unclassifiable in 48% of cases. Of 13 assessable cases, 11 (84.6%) were considered to be causally associated with , ranging from certain to possible.
CONCLUSIONS
Further research is needed to assess the frequency and risk of reactivation in SARS-CoV-2 infection. Our limited data using causality assessment supports recommendations that clinicians should screen and treat for infection in patients with coinfection who receive immunosuppressive COVID-19 therapies. In addition, the male gender and older age (over 50 years) may be predisposing factors for reactivation. Standardized guidelines should be developed for reporting future research.
PubMed: 37235296
DOI: 10.3390/tropicalmed8050248 -
International Journal of Environmental... Sep 2022Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity... (Review)
Review
Inadequate water, sanitation, and hygiene (WASH) among urban poor women is a major urban policy concern in low- and middle-income countries (LMICs). There was a paucity of systematic information on WASH among the urban poor during the pandemic. We reviewed the opportunities and challenges faced by the urban poor in LMICs during the COVID-19 pandemic. We used the PRISMA guidelines to conduct a comprehensive search of 11 databases, including MEDLINE, Embase, Web of Science, and CINAHL, between November 2019 and August 2021. We used thematic analysis to synthesize the qualitative data and meta-analyses to estimate the pooled prevalence. We screened 5008 records, conducted a full-text review of 153 studies, and included 38 studies. The pooled prevalence of shared water points was 0.71 (95% CI 0.37-0.97), non-adherence to hygiene practices was 0.15 (95% CI 0.08-0.24), non-adherence to face masks was 0.27 (95% CI 0.0-0.81), and access to shared community toilets was 0.59 (95% CI 0.11-1.00). Insufficient facilities caused crowding and long waiting times at shared facilities, making physical distancing challenging. Women reported difficulty in maintaining privacy for sanitation, as men were present due to the stay-at-home rule. Due to unaffordability, women reported using cloth instead of sanitary pads and scarves instead of masks.
Topics: COVID-19; Developing Countries; Female; Humans; Hygiene; Male; Pandemics; Sanitation; Water; Water Supply
PubMed: 36231147
DOI: 10.3390/ijerph191911845 -
Journal of Pharmaceutical and... Jan 2023The current pandemic of the acute severe respiratory syndrome coronavirus 2 (SARS-CoV-2) killed about 6.4 million and infected more than 600 million individuals by... (Review)
Review
The current pandemic of the acute severe respiratory syndrome coronavirus 2 (SARS-CoV-2) killed about 6.4 million and infected more than 600 million individuals by august of 2022, and researchers worldwide are searching for fast and selective approaches for this virus detection. Colorimetric biosensors are an excellent alternative because they are sensitive, simple, fast, and low-cost for rapid detection of SARS-CoV-2 compared to standard Enzyme-linked immunosorbent assay (ELISA) and Polymerase Chain Reaction (PCR) techniques. This study systematically searched and reviewed literature data related to colorimetric biosensors in detecting SARS-CoV-2 viruses, recovered from the Scopus (n = 16), Web of Science (n = 19), PubMed (n = 19), and Science Direct (n = 17) databases totalizing n = 71 articles. Data were analyzed for the type of nanomaterial, biorecognition material at the detection limit (LOD), and devices designed for diagnostics. The most applied nanomaterial were gold nanoparticles, in their original form and hybrid in quantum dots and core-shell. In addition, we show high specificity in point-of-care (POC) diagnostic devices as a faster and cheaper alternative for clinical diagnosis. Finally, the highlights of the colorimetric biosensor developed for diagnostic devices applied in swabs, surgical masks, and lateral flow immunoassays were presented.
Topics: Humans; SARS-CoV-2; Colorimetry; Gold; COVID-19; Metal Nanoparticles
PubMed: 36206693
DOI: 10.1016/j.jpba.2022.115087 -
Journal of Affective Disorders Sep 2023Patients with Post-traumatic stress disorder (PTSD) exposed to traumatic reminders show hyperreactivity in brain areas (e.g., amygdala) belonging or related to the... (Meta-Analysis)
Meta-Analysis Review
Patients with Post-traumatic stress disorder (PTSD) exposed to traumatic reminders show hyperreactivity in brain areas (e.g., amygdala) belonging or related to the Innate Alarm System (IAS), allowing the rapid processing of salient stimuli. Evidence that IAS is activated by subliminal trauma-reminders could shed a new light on the factors precipitating and perpetuating PTSD symptomatology. Thus, we systematically reviewed studies investigating neuroimaging correlates of subliminal stimulation in PTSD. Twenty-three studies were selected from the MEDLINE and Scopus® databases for a qualitative synthesis, 5 of which allowed a further meta-analysis of fMRI data. The intensity of IAS responses to subliminal trauma-related reminders ranged from a minimum in healthy controls to a maximum in the PTSD patients with the most severe (e.g., dissociative) symptoms or the least responsiveness to treatment. Comparisons with other disorders (e.g., phobias) revealed contrasting results. Our findings demonstrate the hyperactivation of areas belonging or related to IAS in response to unconscious threats that should be integrated in diagnostic as well as in therapeutic protocols.
Topics: Humans; Stress Disorders, Post-Traumatic; Subliminal Stimulation; Brain; Amygdala; Brain Mapping; Magnetic Resonance Imaging
PubMed: 37236272
DOI: 10.1016/j.jad.2023.05.047 -
Clinical Ophthalmology (Auckland, N.Z.) 2020The intravitreal injection has become one of the most commonly performed procedures in ophthalmology; however, there is no standardized approach to anesthesia during the... (Review)
Review
BACKGROUND
The intravitreal injection has become one of the most commonly performed procedures in ophthalmology; however, there is no standardized approach to anesthesia during the procedure. The goal of this systematic review is to review approaches to anesthesia for intravitreal injection and look at comparative efficacy between these different anesthetics.
METHODS
A systematic review of literature was performed in the MEDLINE, PubMed, Cochrane Library, and Clinicaltrials.gov databases using the key words "anesthesia", "pain management", and "intravitreal injection". Of the initial 239 search matches, 30 articles were found to be relevant to the topic. 18 studies were excluded as they did not include primary data or did not include the visual analog scale as a primary outcome. The remaining 12 articles were assessed to look at the comparative efficacy of anesthesia and adverse events.
RESULTS
The anesthesia techniques reported include topical methods such as anesthetic eyedrops, anesthetic gels, and anesthetic-soaked pledgets as well as subconjunctival injection of anesthetic. Ultimately, no single anesthetic or delivery mechanism was shown to be superior to the others in a statistically significant way and adverse events were largely insignificant. Limitations of these studies include relatively small sizes of the studies, as well as the lack of masking which may introduce bias.
CONCLUSION
In the current literature, no type of anesthetic method was found to be superior to another for intravitreal injection. Future studies in this area may lead to new insights into the efficacy of different forms of intravitreal anesthesia.
PubMed: 32161439
DOI: 10.2147/OPTH.S223530 -
Computational Intelligence and... 2022Cloud computing is a long-standing dream of computing as a utility, where users can store their data remotely in the cloud to enjoy on-demand services and high-quality... (Review)
Review
Cloud computing is a long-standing dream of computing as a utility, where users can store their data remotely in the cloud to enjoy on-demand services and high-quality applications from a shared pool of configurable computing resources. Thus, the privacy and security of data are of utmost importance to all of its users regardless of the nature of the data being stored. In cloud computing environments, it is especially critical because data is stored in various locations, even around the world, and users do not have any physical access to their sensitive data. Therefore, we need certain data protection techniques to protect the sensitive data that is outsourced over the cloud. In this paper, we conduct a systematic literature review (SLR) to illustrate all the data protection techniques that protect sensitive data outsourced over cloud storage. Therefore, the main objective of this research is to synthesize, classify, and identify important studies in the field of study. Accordingly, an evidence-based approach is used in this study. Preliminary results are based on answers to four research questions. Out of 493 research articles, 52 studies were selected. 52 papers use different data protection techniques, which can be divided into two main categories, namely noncryptographic techniques and cryptographic techniques. Noncryptographic techniques consist of data splitting, data anonymization, and steganographic techniques, whereas cryptographic techniques consist of encryption, searchable encryption, homomorphic encryption, and signcryption. In this work, we compare all of these techniques in terms of data protection accuracy, overhead, and operations on masked data. Finally, we discuss the future research challenges facing the implementation of these techniques.
Topics: Cloud Computing; Computer Security; Confidentiality; Delivery of Health Care; Privacy
PubMed: 35712069
DOI: 10.1155/2022/8303504 -
BMJ Open Feb 2021To identify, appraise and synthesise studies evaluating the downsides of wearing face masks in any setting. We also discuss potential strategies to mitigate these... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To identify, appraise and synthesise studies evaluating the downsides of wearing face masks in any setting. We also discuss potential strategies to mitigate these downsides.
DESIGN
Systematic review and meta-analysis.
DATA SOURCES
PubMed, Embase, CENTRAL and EuropePMC were searched (inception-18 May 2020), and clinical registries were searched via CENTRAL. We also did a forward-backward citation search of the included studies.
INCLUSION CRITERIA
We included randomised controlled trials and observational studies comparing face mask use to any active intervention or to control.
DATA EXTRACTION AND ANALYSIS
Two author pairs independently screened articles for inclusion, extracted data and assessed the quality of included studies. The primary outcomes were compliance, discomforts, harms and adverse events of wearing face masks.
RESULTS
We screened 5471 articles, including 37 (40 references); 11 were meta-analysed. For mask wear adherence, 47% (95% CI 25% to 68%, p<0.0001), more people wore face masks in the face mask group compared with control; adherence was significantly higher (26%, 95% CI 8% to 46%, p<0.01) in the surgical/medical mask group than in N95/P2 group. The largest number of studies reported on the discomfort and irritation outcome (20 studies); fewest reported on the misuse of masks, and none reported on mask contamination or risk compensation behaviour. Risk of bias was generally high for blinding of participants and personnel and low for attrition and reporting biases.
CONCLUSIONS
There are insufficient data to quantify all of the adverse effects that might reduce the acceptability, adherence and effectiveness of face masks. New research on face masks should assess and report the harms and downsides. Urgent research is also needed on methods and designs to mitigate the downsides of face mask wearing, particularly the assessment of possible alternatives.
SYSTEMATIC REVIEW REGISTRATION
Open Science Framework website https://osf.io/sa6kf/ (timestamp 20-05-2020).
Topics: Humans; Masks; Randomized Controlled Trials as Topic
PubMed: 33619199
DOI: 10.1136/bmjopen-2020-044364 -
Infection, Disease & Health May 2022Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Millions of people have acquired and died from SARS-CoV-2 infection during the COVID-19 pandemic. Healthcare workers (HCWs) are required to wear personal protective equipment (PPE), including surgical masks and P2/N95 respirators, to prevent infection while treating patients. However, the comparative effectiveness of respirators and masks in preventing SARS-CoV-2 infection and the likelihood of experiencing adverse events (AEs) with wear are unclear.
METHODS
Searches were carried out in PubMed, Europe PMC and the Cochrane COVID-19 Study Register to 14 June 2021. A systematic review of comparative epidemiological studies examining SARS-CoV-2 infection or AE incidence in HCWs wearing P2/N95 (or equivalent) respirators and surgical masks was performed. Article screening, risk of bias assessment and data extraction were duplicated. Meta-analysis of extracted data was carried out in RevMan.
RESULTS
Twenty-one studies were included, with most having high risk of bias. There was no statistically significant difference in respirator or surgical mask effectiveness in preventing SARS-CoV-2 infection (OR 0.85, [95%CI 0.72, 1.01]). Healthcare workers experienced significantly more headaches (OR 2.62, [95%CI 1.18, 5.81]), respiratory distress (OR 4.21, [95%CI 1.46, 12.13]), facial irritation (OR 1.80, [95%CI 1.03, 3.14]) and pressure-related injuries (OR 4.39, [95%CI 2.37, 8.15]) when wearing respirators compared to surgical masks.
CONCLUSION
The existing epidemiological evidence does not enable definitive assessment of the effectiveness of respirators compared to surgical masks in preventing infection. Healthcare workers wearing respirators may be more likely to experience AEs. Effective mitigation strategies are important to ensure the uptake and correct use of respirators by HCWs.
Topics: COVID-19; Humans; N95 Respirators; Pandemics; Personal Protective Equipment; SARS-CoV-2
PubMed: 35151628
DOI: 10.1016/j.idh.2022.01.001 -
Frontiers in Public Health 2022Face coverings and distancing as preventative measures against the spread of the Coronavirus disease 2019 may impact communication in several ways that may...
INTRODUCTION
Face coverings and distancing as preventative measures against the spread of the Coronavirus disease 2019 may impact communication in several ways that may disproportionately affect people with hearing loss. A scoping review was conducted to examine existing literature on the impact of preventative measures on communication and to characterize the clinical implications.
METHOD
A systematic search of three electronic databases (Scopus, PubMed, CINAHL) was conducted yielding 2,158 articles. After removing duplicates and screening to determine inclusion eligibility, key data were extracted from the 50 included articles. Findings are reported following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews, including the PRISMA-ScR checklist.
RESULTS
Studies fell into three categories: Studies addressing the impacts of personal protective equipment (PPE) and/or distancing on communication in healthcare contexts ( = 20); studies examining the impact of preventative measures on communication in everyday life ( = 13), and studies measuring the impact of face coverings on speech using acoustic and/or behavioral measures ( = 29). The review revealed that masks disrupt verbal and non-verbal communication, as well as emotional and social wellbeing and they impact people with hearing loss more than those without. These findings are presumably because opaque masks attenuate sound at frequencies above 1 kHz, and conceal the mouth and lips making lipreading impossible, and limit visibility of facial expressions. While surgical masks cause relatively little sound attenuation, transparent masks and face shields are highly attenuating. However, they are preferred by people with hearing loss because they give access to visual cues.
CONCLUSION
Face coverings and social distancing has detrimental effects that extend well beyond verbal and non-verbal communication, by affecting wellbeing and quality of life. As these measures will likely be part of everyday life for the foreseeable future, we propose that it is necessary to support effective communication, especially in healthcare settings and for people with hearing loss.
Topics: COVID-19; Communication; Humans; Masks; Quality of Life; SARS-CoV-2
PubMed: 35419343
DOI: 10.3389/fpubh.2022.815259 -
The Cochrane Database of Systematic... May 2021Age-related macular degeneration (AMD) is one of the leading causes of blindness in high-income countries. The majority of cases of AMD are of the non-exudative type.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Age-related macular degeneration (AMD) is one of the leading causes of blindness in high-income countries. The majority of cases of AMD are of the non-exudative type. Experts have proposed photobiomodulation (PBM) therapy as a non-invasive procedure to restore mitochondrial function, upregulate cytoprotective factors and prevent apoptotic cell death in retinal tissue affected by AMD.
OBJECTIVES
To assess the effectiveness and safety of PBM compared to standard care, no treatment or sham treatment for people with non-exudative AMD.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (Issue 5, 2020), Ovid MEDLINE, Embase, ISRCTN, ClinicalTrials.gov and the WHO ICTRP to 11 May 2020 with no language restrictions.
SELECTION CRITERIA
The review included randomised controlled trials (RCTs) on participants receiving any type of PBM therapy for non-exudative AMD compared to standard care, sham treatment or no treatment.
DATA COLLECTION AND ANALYSIS
We used standard methodological procedures expected by Cochrane. We considered the following outcome measures at 12 months: best-corrected visual acuity (BCVA) ; contrast sensitivity; near vision; low luminance density score; reading speed; vision-related quality of life score; and adverse events such as progression of AMD and conversion to exudative AMD. We graded the certainty of the evidence using GRADE.
MAIN RESULTS
We included two published RCTs from single centres in the UK and Canada, which recruited 60 participants (60 eyes) and 30 participants (46 eyes) respectively. Participants in these trials were people with non-exudative AMD with Age-Related Eye Disease Study (AREDS) categories 2 to 4. One study compared single wavelength PBM with no treatment. This study was at risk of performance bias because the study was not masked, and there was attrition bias. One study compared multi-wavelength PBM with sham treatment and conflicts of interest were reported by study investigators. We also identified three eligible ongoing RCTs from searching the clinical trials database. When comparing PBM with sham treatment or no treatment for non-exudative AMD, there was no evidence of any meaningful clinical difference in BCVA at 12 months (mean difference (MD) 0.02 logMAR, 95% confidence interval (CI) -0.02 to 0.05; 2 RCTs, 90 eyes; low-certainty evidence). One study comparing multi-wavelength PBM with sham treatment showed an improvement in contrast sensitivity at Level E (18 cycles/degree) at 12 months (MD 0.29 LogCS, 95% CI 0.23 to 0.35; 1 RCT, 46 eyes; low-certainty evidence). Visual function and health-related quality of life scores were comparable between single wavelength PBM and no treatment groups at 12 months (VFQ-48 score MD 0.43, 95% CI -0.17 to 1.03; P = 0.16; 1 RCT, 47 eyes; low-certainty evidence). When comparing PBM with sham treatment or no treatment for non-exudative AMD, there was no evidence of any meaningful clinical difference in conversion to exudative AMD (risk ratio (RR) 0.97, 95% CI 0.17 to 5.44; 2 RCTs, 96 eyes; very low-certainty evidence) at 12 months. There was inconclusive evidence that single wavelength PBM prevents the progression of AMD (RR 0.79, 95% CI 0.41 to 1.53; P = 0.48; 1 RCT, 50 eyes; low-certainty evidence). Disease progression was defined as the development of advanced AMD or significant increase in drusen volume. No included study reported near vision, low luminance vision or reading speed outcomes.
AUTHORS' CONCLUSIONS
Currently there remains uncertainty whether PBM treatment is beneficial in slowing progression of non-exudative macular degeneration. There is a need for further well-designed controlled trials assessing dosimetry, powered for both effectiveness and safety outcomes. Consideration should be given to the adoption of agreed clinical outcome measures and patient-based outcome measures for AMD.
Topics: Bias; Confidence Intervals; Contrast Sensitivity; Disease Progression; Humans; Low-Level Light Therapy; Macular Degeneration; Outcome Assessment, Health Care; Placebos; Quality of Life; Randomized Controlled Trials as Topic; Treatment Outcome; Visual Acuity
PubMed: 34097768
DOI: 10.1002/14651858.CD013029.pub2