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International Journal of Environmental... Apr 2022Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy... (Meta-Analysis)
Meta-Analysis Review
Malaria and helminthic co-infection during pregnancy causes fetomaternal haemorrhage and foetal growth retardation. This study determined the pooled burden of pregnancy malaria and helminthic co-infection in sub-Saharan Africa. CINAHL, EMBASE, Google Scholar, Scopus, PubMed, and Web of Science databases were used to retrieve data from the literature, without restricting language and publication year. The Joanna Briggs Institute's critical appraisal tool for prevalence studies was used for quality assessment. STATA Version 14.0 was used to conduct the meta-analysis. The statistics and Egger's test were used to test heterogeneity and publication bias. The random-effects model was used to estimate the pooled prevalence at a 95% confidence interval (CI). The review protocol has been registered in PROSPERO, with the number CRD42019144812. In total, 24 studies (n = 14,087 participants) were identified in this study. The pooled analysis revealed that 20% of pregnant women were co-infected by malaria and helminths in sub-Saharan Africa. The pooled prevalence of malaria and helminths were 33% and 35%, respectively. The most prevalent helminths were (48%), (37%), and (15%). Significantly higher malaria and helminthic co-infection during pregnancy were observed. Health systems in sub-Saharan Africa must implement home-grown innovative solutions to underpin context-specific policies for the early initiation of effective intermittent preventive therapy.
Topics: Africa South of the Sahara; Coinfection; Female; Helminthiasis; Humans; Malaria; Pregnancy; Pregnant Women; Prevalence
PubMed: 35564842
DOI: 10.3390/ijerph19095444 -
Frontiers in Endocrinology 2022Diabetic foot ulcers are a major complication of diabetes mellitus (DM), when heparin and heparin related substances may be potentially used as an adjuvant treatment. We... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Diabetic foot ulcers are a major complication of diabetes mellitus (DM), when heparin and heparin related substances may be potentially used as an adjuvant treatment. We aimed to evaluate the efficacy and safety of heparin and heparin related substances for the treatment of diabetic foot ulcers.
METHODS
We searched up to March 2021 in the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; EBSCO CINAHL; VIP Chinese Science and Technique Journals Database; China National Knowledge Infrastructure (CNKI) Database and Wan Fang Database investigating heparin or heparin-related substances in patients with diabetic foot ulcers. The primary outcomes included proportion of ulcers completely healed and time to complete ulcer healing. We assessed each included study with the Cochrane 'Risk of bias' tool and used the GRADE approach to assess the overall quality of the evidence.
RESULTS
We included nine randomized studies involving 620 participants in the meta-analysis, involving two different heparin and heparin-related substances, low molecular weight heparin (LMWH) and hyaluronic acid. Our study did not show the benefits from LMWH on increasing chance of the ulcer healing (RR: 1.26; 95% CI: 0.78 to 2.04; P=0.35; very low) or shortening the time to complete ulcer healing (SMD: 0.13 d; 95% CI: -0.29 to 0.56; P=0.54; very low). Hyaluronic acid may improve the complete ulcer healing (RR: 1.57; 95% CI: 1.29 to 1.91; P˂0.00001; very low) and shorten the time to complete ulcer healing (SMD -0.84, 95% CI -1.15 to -0.53; P<0.00001; low). Hyaluronic acid and LMWH were generally well tolerated for treating diabetic foot ulcers in this review.
CONCLUSION
Hyaluronic acid may improve diabetic foot ulcer with very low quality evidence but not LMWH. However, the benefits and harms need further validation in larger trials with different population.
SYSTEMATIC REVIEW REGISTRATION
[https://www.crd.york.ac.uk/prospero/], identifier [PROSPERO, CRD42021269212].
Topics: Diabetes Mellitus; Diabetic Foot; Heparin; Heparin, Low-Molecular-Weight; Humans; Hyaluronic Acid; Wound Healing
PubMed: 35282468
DOI: 10.3389/fendo.2022.749368 -
Psychiatric Research and Clinical... 2021Individuals with severe and persistent mental illness (SPMI) have a higher risk of contracting COVID-19 than individuals without SPMI. In combination with physical... (Review)
Review
BACKGROUND
Individuals with severe and persistent mental illness (SPMI) have a higher risk of contracting COVID-19 than individuals without SPMI. In combination with physical distancing, hygiene protocols, and vaccines, quarantine and self-isolation are primary means of viral containment. However, individuals with SPMI may experience more difficulties with mandated quarantine or self-isolation because of their illness(es), stigma, and marginalization. To date, there is a lack of consensus on strategies that could aid such individuals in completing isolation.
AIM
This review aimed to synthesize evidence for interventions to support self-isolation and mandated quarantine for COVID-19 among individuals with SPMIs.
METHODS
We followed the PRISMA guidelines, searching 19 electronic databases (9 published literature registries and 10 gray literature sources). We looked for relevant randomized controlled trials, quasi-experimental studies, and program evaluations of the effectiveness of relevant psychosocial, pharmacological, harm reduction, and addiction management strategies to support isolation settings or quarantine requirements for individuals with any SPMI (e.g., any mental disorder, substance use disorder, or their combination).
FINDINGS
Of 10,298 total records that were located, 5582 were duplicate citations. Upon screening the remaining 4716 unique records by title and abstract, we excluded a further 3562 records. Only one original article met our inclusion criteria after reviewing the full texts of the remaining 1154 citations. To support individuals experiencing homelessness during the COVID-19 pandemic, San Francisco developed an isolation hotel that reduced COVID-19 hospital strain for 1009 participants (25% had a mental health disorder and 26% had a substance use disorder). While 81% completed their hotel stay, 48 patients had behavioral health needs that exceeded the hotel's capabilities. No other studies met our review's eligibility criteria. Most articles located by the search simply proposed solutions or discussed the challenges brought by COVID-19 for people with SPMIs. While some documents went a step further (e.g., shelter guidance documents to support individuals experiencing homelessness), these rarely addressed individuals with SPMIs directly.
CONCLUSIONS
This systematic review evaluated evidence from published and gray literature on interventions to support self-isolation and mandated COVID-19 quarantine for individuals with SPMIs. Only one study met our inclusion criteria. This study found a beneficial effect of a dedicated isolation hotel for individuals experiencing homelessness and COVID-19-where approximately 25%-50% of the study sample had a mental or substance use disorder. While there has been an abundance of COVID-19 protocols in general, information for SPMIs is lacking. As the pandemic continues and we better prepare for future pandemics, developing protocols for supporting SPMIs in this context is imperative.
PubMed: 34901762
DOI: 10.1176/appi.prcp.20210022 -
Therapeutic Advances in Urology 2021Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are a bothersome frequent symptom in adult males. This systematic review analyzed the... (Review)
Review
BACKGROUND
Lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) are a bothersome frequent symptom in adult males. This systematic review analyzed the available evidence on the pharmacokinetic and pharmacodynamic features of alfuzosin, and its clinical efficacy both as monotherapy and in combination with other drugs for the treatment of male LUTS/BPH.
METHODS
A systematic review of the last 10 years was performed using the MEDLINE, EMBASE and Cochrane libraries in March 2020. The protocol for this systematic review was registered on PROSPERO (Central Registration Depository: CRD42020136120) and is available in full on the University of York website.
RESULTS
Alfuzosin is a quinazoline derivative and, although a nonspecific α1-blocker, exhibits a selective concentration in the prostate compared with plasma in patients with BPH. Three registration trials assessed the safety and efficacy of alfuzosin. The 10 mg daily formulation has a three-layered matrix containing the active substance between two inactive coats allowing a drug release over 20 h. Alfuzosin showed high tolerability, few vasodilatory effects and a low rate of ejaculation disorders over older alpha-blocking compounds thanks to the high uroselectivity of alfuzosin and its preferential concentration at urinary level. Six randomized clinical trials (RCTs) assessed efficacy and safety of alfuzosin other alpha-blockers ± placebo: three studies comparing with tamsulosin, one with doxazosin, and two with silodosin or tamsulosin. One RCT investigated the clinical outcomes of alfuzosin with finasteride, two with propiverine and two with phosphodiesterase-5 inhibitors.
CONCLUSIONS
Alfuzosin is an effective drug for the treatment of LUTS/BPH, with a lower rate of sexual disorders compared with other alpha-blockers. Alfuzosin is also safe with low adverse events in case of concomitant antihypertensive therapy and in patients with cardiovascular morbidity. Safety and efficacy of alfuzosin has been reported also in case of combination therapy with antimuscarinic agents and PDE5i.
PubMed: 33912246
DOI: 10.1177/1756287221993283 -
European Journal of Sport Science May 2022Sodium bicarbonate (SB) is considered an effective ergogenic supplement for improving high-intensity exercise capacity and performance, although recent data suggests... (Meta-Analysis)
Meta-Analysis
Sodium bicarbonate (SB) is considered an effective ergogenic supplement for improving high-intensity exercise capacity and performance, although recent data suggests that women may be less amenable to its ergogenic effects than men. Currently, an apparent paucity of data on women means no consensus exists on whether women benefit from SB supplementation. The aim of the current study was to quantify the proportion of the published literature on SB supplementation that includes women, and to synthesise the evidence regarding its effects on blood bicarbonate and exercise performance in women by performing a systematic review and meta-analysis. Electronic searches of the literature were undertaken using three databases (MEDLINE, Embase, SPORTDiscus) to identify relevant articles. All meta-analyses were performed within a Bayesian framework. A total of 149 SB articles were identified, 11 of which contained individual group data for women. Results indicated a pooled blood bicarbonate increase of 7.4 [95%CrI: 4.2-10.4 mmol·L] following supplementation and a pooled standardised exercise effect size of 0.37 [95%CrI: -0.06-0.92]. The SB literature is skewed, with only 20% (30 studies) of studies employing female participants, of which only 11 studies (7.4%) provided group analyses exclusively in women. Despite the small amount of available data, results are consistent in showing that SB supplementation in women leads to large changes in blood bicarbonate and that there is strong evidence for a positive ergogenic effect on exercise performance that is likely to be small to medium in magnitude.HighlightsThis study aimed to quantify the proportion of the published literature on sodium bicarbonate supplementation that includes women and to synthesise the evidence regarding its ergogenic effect on women, using a systematic review and meta-analytic approach.The sodium bicarbonate literature is skewed, with only 30 studies (20%) employing female participants, of which only 11 studies (7.4%) provided group analyses exclusively in women.Despite the small amount of available data, results are consistent in showing that sodium bicarbonate supplementation in women leads to large changes in blood bicarbonate and that there is strong evidence for a positive ergogenic effect on exercise performance that is likely small to medium in magnitude.Based on these findings, we do not believe there is any evidence to support sex-specific sodium bicarbonate dosing recommendations and that current recommendations of 0.2-0.3 g·kgBM of SB taken 60-180 min prior to high-intensity exercise appear appropriate for the female athlete.
Topics: Athletes; Athletic Performance; Bayes Theorem; Bicarbonates; Dietary Supplements; Female; Humans; Male; Performance-Enhancing Substances; Sodium Bicarbonate
PubMed: 33487131
DOI: 10.1080/17461391.2021.1880649 -
Scientific Reports Jan 2023Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI)... (Meta-Analysis)
Meta-Analysis
Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is concern that resistance to topical biocides may be emergeing, although the potential clinical implications remain unclear. The objective of this systematic review was to determine whether the minimum bactericidal concentration (MBC) of topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. We included studies reporting the MBC of laboratory and clinical isolates of common microbes to CHX and PVI. We excluded studies using non-human samples and antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses and the change in MBC over time was explored using meta-regression. Seventy-nine studies were included, analysing 6218 microbes over 45 years. Most studies investigated CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in the MBC of CHX to Staphylococci or Streptococci over time. Overall, we find no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. This provides reassurance and confidence in the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.
Topics: Humans; Anti-Infective Agents, Local; Povidone-Iodine; Chlorhexidine; Preoperative Care; Surgical Wound Infection
PubMed: 36611032
DOI: 10.1038/s41598-022-26658-1 -
Medicina (Kaunas, Lithuania) Nov 2023: More than a billion people worldwide suffer from chronic periodontitis. The primary etiological factor of periodontal diseases is dental plaque and the bacteria it... (Review)
Review
: More than a billion people worldwide suffer from chronic periodontitis. The primary etiological factor of periodontal diseases is dental plaque and the bacteria it contains, particularly , , , , and . Zinc, owing to its antibacterial properties, can be employed in periodontology. The objective of this review was to analyze scientific literature that examines the effects of zinc on periopathogens. : A systematic review protocol of scientific literature was designed following PRISMA recommendations. Data search was conducted in PubMed, Web of Science, and ScienceDirect databases. Full-text articles in English that examine the effects of zinc on periopathogens and were published between 2011 and 2021 were included. Fifteen articles were included in the analysis based on inclusion criteria. ZnO exhibited antibacterial activity against and ( < 0.001). The minimum inhibitory concentration against was 10 μg/mL. ZnO demonstrated a significant antibacterial effect, as evidenced by inhibition zones of 15.10 mm for , 13.36 mm for , 12.98 mm for , and 14.01 mm for Zn (II)-based polymers inhibited the and genes of . Titanium dental implants coated with ZnO effectively disrupted the cell walls of and . ZnO inhibited the growth of within 2 h and the growth of and within 3 h. ZnO exhibited nontoxic effects, and concentrations up to 0.8 mg/L increased cell survival rates by up to 90%. The analysis of the literature confirms the antibacterial action of zinc against periodontal pathogenic bacteria. At low concentrations, these substances do not exhibit cytotoxic effects on fibroblasts.
Topics: Humans; Anti-Bacterial Agents; Anti-Infective Agents; Chronic Periodontitis; Organic Chemicals; Porphyromonas gingivalis; Systematic Reviews as Topic; Zinc; Zinc Oxide
PubMed: 38138191
DOI: 10.3390/medicina59122088 -
Tropical Medicine & International... Mar 2023HIV (human immunodeficiency virus) infection remains a major public health challenge. Infected young people at any age are less likely to adhere to care in a timely... (Review)
Review
OBJECTIVE
HIV (human immunodeficiency virus) infection remains a major public health challenge. Infected young people at any age are less likely to adhere to care in a timely manner and to maintain a suppressed VL. This review aims to identify factors associated with virologic failure and adherence to drug therapy in adolescents and young adults (10-24 years) living with HIV.
METHODS
Systematic review using the PubMed and Virtual Health Library databases and including articles published between 2009 and 2021. Data were analysed in six categories: individual factors, pharmacological/therapy-related aspects, factors related to HIV/acquired immunodeficiency syndrome (AIDS) infection, HIV/AIDS stigma, social support and health system/services. The study's protocol was registered on the PROSPERO platform (CRD42020167581).
RESULTS
A total of 19,819 articles were found in the initial search and 31 studies were included in this systematic review. Most studies were carried out on the African continent. Male sex, alcohol use, low education, adverse effects of medication, lack of social support, stigma related to HIV/AIDS, need for transportation to access the health service and forgetfulness were linked to poor adherence to therapy. Good adherence was achieved with sufficient nutrition, good social support, greater confidence in the use of therapy and fewer ART side effects. Low levels of CD4, alcohol use, substance abuse, low education, non-adherence to medication and forgetfulness were linked to virological failure.
CONCLUSION
Individual, social and structural factors constitute barriers to adherence to ART among adolescent and young adults. It is necessary to know the difficulties related to the use of therapy to work out specific strategies that create conditions to improve medication adherence and viral suppression, reducing the levels of virological failure in this population.
Topics: Adolescent; Humans; Male; Young Adult; Acquired Immunodeficiency Syndrome; Anti-HIV Agents; HIV; HIV Infections; Medication Adherence; Female; Child
PubMed: 36647818
DOI: 10.1111/tmi.13854 -
Frontiers in Psychiatry 2022Substance use disorders (SUDs) are a common yet poorly studied comorbidity in individuals with psychotic disorders. The co-occurrence of the two complicates recovery and...
BACKGROUND
Substance use disorders (SUDs) are a common yet poorly studied comorbidity in individuals with psychotic disorders. The co-occurrence of the two complicates recovery and interferes with pharmacological and behavioral treatment response and adherence. Recently, researchers have been exploring both invasive and non-invasive neuromodulation techniques as potential treatment methods for SUDs. We review the evidence that neuromodulation may reduce substance craving and consumption in individuals with schizophrenia.
METHODS
A comprehensive literature search of PubMed, MEDLINE, and PsycINFO databases was conducted ( = 1,432). Of these, we identified seven studies examining the effects of repetitive transcranial magnetic stimulation (rTMS) and two studies using transcranial direct current stimulation (tDCS) on drug consumption and craving in schizophrenia or schizoaffective disorders.
RESULTS
Despite the limited number of studies in this area, the evidence suggests that rTMS to the dorsolateral prefrontal cortex (DLPFC) may reduce cannabis and tobacco use in patients with schizophrenia and schizoaffective disorder. Findings with tDCS, however, were inconclusive.
DISCUSSION
Our systematic review suggests that rTMS applied to DLPFC is a safe and promising therapeutic technique for the management of comorbid schizophrenia and SUDs, with the majority of the evidence in tobacco use disorder. However, there was substantial heterogeneity in study methods, underscoring the need to optimize stimulation parameters (e.g., frequency, duration, and target regions). Larger clinical trials are needed to establish the efficacy of rTMS in reducing drug consumption and craving in psychotic patients, ideally in comparison to existing pharmacological and behavioral interventions.
PubMed: 35237187
DOI: 10.3389/fpsyt.2022.793938 -
The Pan African Medical Journal 2023Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts... (Meta-Analysis)
Meta-Analysis Review
Schistosomes are parasitic diseases caused by flatworms (schistosomes or bilharzia), transmitted in the urine or in the faeces, and involving intermediate hosts (freshwater molluscs). Their recrudescence in endemic areas is no longer in question and remains a crucial public health problem in the world in general and in West Africa in particular. In order to eradicate bilharzia, many control strategies and policies have been implemented on both sides. The objective of this systematic literature review is to synthesize the existing evidence on control strategies implemented by West African countries. To achieve this, data were collected from PubMed, Direct Science, Web of Sciences, Google Scholar, PloS and Banque de Données de Santé Publique (BDSP), using appropriate keywords. Academic articles and theses written in French or English that evaluated the analysis of a bilharzia situation in West Africa were selected. Sixteen scientific papers were selected for the study, ten of which were used for a meta-analysis. The systematic review revealed that bilharzia is still an endemic disease in West Africa. Clearly, it continues to wreak havoc on the population, especially among school children. Rural areas are the most affected by the disease. Strategies to control bilharzia are based on preventive and curative treatment of the infection with chemotherapy and vector control of soil molluscs (host and vector of bilharzia eggs). Praziquantel is the main known antibilharzian. Also, the species most frequently found in analyses are S. haematobiumand S. mansonii. This review has allowed to evaluate the control strategies carried out and to deduce the strengths and weaknesses, in order to define the perspectives for the efficiency of the anti-bilharzia control for the eradication of bilharzia in the endemic zones of West Africa.
Topics: Child; Humans; Schistosomiasis; Africa, Western; Praziquantel
PubMed: 37034484
DOI: 10.11604/pamj.2023.44.35.33766