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BMC Infectious Diseases Aug 2023In 2019, the Coronavirus (SARS-CoV-2) virus was identified, also defined as novel coronavirus or severe acute respiratory syndrome coronavirus 2. The Corona VIrus...
In 2019, the Coronavirus (SARS-CoV-2) virus was identified, also defined as novel coronavirus or severe acute respiratory syndrome coronavirus 2. The Corona VIrus Disease (COVID-19) pandemic generated several changes in society in 2020 as a result of its rapid spread in humans. The main symptoms are high fever (≥ 37.8 °C), dry cough, dyspnea, upper respiratory symptoms, myalgia, fatigue and diarrhea in the most uncommon cases. Considering the emergency situation caused by the COVID-19 pandemic and the effects attributed to it, rehabilitation professionals have a fundamental role in the functional recovery of patients, independence and improvement of quality of life. This is a systematic review of the literature, with the aim of discussing the main findings on physical therapy management in functional changes in post-COVID-19 patients. Pubmed, Scielo, Sciencedirect, BVS and PEDro databases were used. The terms MESH/DECs used for the searches were: Rehabilitation, Physical Therapy Modalities, Covid-19, Post-acute Syndromes COVID-19 and Physical Fitness, the keywords were also used: rehabilitation, physiotherapy, Covid-19, post- acute syndrome COVID-19 and functional capacity. To cross the terms, Boolean operators (AND and OR) were used. Randomized trials, recommendations, quasi-randomized or prospective controlled trials, reports, guidelines, and field updates were included. As for the selected population, studies were included in individuals of both sexes, with no age restriction, that evaluated physiotherapeutic interventions in patients who had COVID-19. Literature reviews, case studies, conferences, abstracts of articles published in conference proceedings and letters to the editor were excluded from the research. To measure methodological quality, the PEDro scale was used.Searches for articles were performed restricting the period of publication between the years 2019 to 2022. The electronic search strategy identified a total of 364 records from the selected databases. After screening for duplicates, 14 articles were excluded, followed by screening by titles and abstracts, another 298 articles were excluded, of these 47 potentially relevant records were submitted to full text review and of these 5 randomized clinical trials were included in this review. In view of the findings of this study, it can be concluded that physical therapy rehabilitation should continue after hospital discharge, with the aim of improving physical performance and activities of daily living (ADL) in post-COVID-19 patients.
Topics: Female; Male; Humans; Patient Discharge; COVID-19; Activities of Daily Living; Pandemics; Prospective Studies; Quality of Life; SARS-CoV-2; Virus Diseases; Hospitals
PubMed: 37587411
DOI: 10.1186/s12879-023-08313-w -
JBI Evidence Synthesis Jan 2024The objective of this umbrella review was to examine various pharmacologic interventions for their potential to reduce etomidate-induced myoclonus. A secondary objective... (Review)
Review
OBJECTIVE
The objective of this umbrella review was to examine various pharmacologic interventions for their potential to reduce etomidate-induced myoclonus. A secondary objective was to compare the relative effectiveness of those medications in reducing the incidence of myoclonus when etomidate is utilized for the induction of general anesthesia.
INTRODUCTION
Etomidate is the drug of choice when inducing general anesthesia in hemodynamically unstable patients. However, its use is limited among the general surgical population due to its ability to cause adrenal suppression, vomiting, and myoclonus. Myoclonus can lead to damage of muscle fibers, myalgias, and patient discomfort, and can also be detrimental in patients with low cardiac reserve. Several systematic reviews have reported on the effectiveness of various intravenous medications in reducing mild, moderate, and severe myoclonus; however, a more thorough examination of their influence was lacking.
INCLUSION CRITERIA
This review included systematic reviews and meta-analyses of randomized controlled trials involving the use of pharmacologic interventions to reduce etomidate-induced myoclonus. Reviews in English and conducted after 1965 were considered for inclusion.
METHODS
A comprehensive search of 11 databases was conducted to identify published and unpublished reviews up to March 2022. Critical appraisal was conducted by 2 independent reviewers using the standardized JBI appraisal tool. Quantitative findings were summarized according to the dose, timing of administration, and relative risk using a data matrix, and were synthesized in tabular format with supporting narrative text. Results were organized by severity of myoclonus (overall, mild, moderate, and severe) and by type of intervention.
RESULTS
Eight systematic reviews were included in this umbrella review, which included 48 relevant studies, after removal of duplicates (3909 participants included in the primary studies). Five of the systematic reviews examined the effectiveness of various types of opioids in the prevention of myoclonus, and 3 systematic reviews examined the effectiveness of non-opioid interventions, such as lidocaine, midazolam, and dexmedetomidine. Seven reviews searched at least 4 databases for pertinent studies and specifically indicated that blinded reviewers appraised the articles. All reviews used a published and validated appraisal instrument. The overall quality of all included reviews was judged to be moderate to high. The absolute risk reduction indicating the effectiveness of the prophylactic medications ranged from 47% to 81% for mild, 52% to 92% for moderate, and 61% to 96% for severe myoclonus. Opioids demonstrated the most consistent and substantial effect on the reduction in myoclonus.
CONCLUSIONS
All pharmacologic interventions identified in this review demonstrated a statistically significant reduction in the incidence of myoclonus. Future studies and reviews should focus on elucidating the particular dose range and timing that is most effective. Anesthesia providers should consider a pre-treatment dose of one of the medications described in this umbrella review as a means to reduce myoclonus and the untoward effects of that condition.
Topics: Humans; Anesthesia, General; Etomidate; Incidence; Lidocaine; Myoclonus
PubMed: 37560913
DOI: 10.11124/JBIES-22-00390 -
Frontiers in Medicine 2023This meta-analysis was exerted in assessing the anticancer efficacy and safety of nab-paclitaxel (nab-P) when combined with platinum compound agents for therapy in...
PURPOSE
This meta-analysis was exerted in assessing the anticancer efficacy and safety of nab-paclitaxel (nab-P) when combined with platinum compound agents for therapy in patients with non-small cell lung cancer (NSCLC).
METHOD
We systematically searched the following seven electronic databases: PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wan Fang, and China Science and Technology Journal Data. Randomized comparative clinical [randomized controlled clinical trial (RCT)] studies on nab-P plus platinum and carboplatin or cisplatin in combination with conventional chemotherapy agents or traditional paclitaxel were searched.
RESULTS
A total of 19 RCT studies involving 6,011 patients were analyzed. The primary outcome includes the overall response rate (ORR), overall survival (OS), and progression-free survival (PFS). The secondary outcome includes adverse events (AEs). Nab-P combined with platinum (carboplatin/cisplatin) had a better ORR [odds ratio (OR) = 1.66, 95% confidence interval (CI) (1.34, 2.05), < 0.001] and improved PFS [hazard ratio (HR) = 0.84, 95% CI: (0.74, 0.94), = 0.01] and OS [HR = 0.86, 95% CI: (0.78, 0.96), = 0.008] in NSCLC patients. ORR [OR = 2.18, 95% CI: (1.07, 4.43)], PFS [HR = 0.62, 95% CI: (0.40, 0.97)], and OS [HR = 0.63, 95% CI: (0.49, 0.81)] were significantly improved among patients aged >70 years, and ORR [OR = 1.80, 95% CI: (1.20, 2.70)] and PFS [HR = 0.74, 95% CI: (0.56, 0.97)] were significantly elevated with SCC rate ≥65% in NSCLC patients (all > 0.05). Among the adverse effects, the prevalence of neutropenia, neuralgia, and arthralgia/myalgia (≥ grade 3) compared to that of the control group. On the other hand, the prevalence of anemia and thrombocytopenia was higher in the nab-P plus platinum (carboplatin/cisplatin) compared to that of controls. It is worth noting that fatigue did not show statistical significance.
CONCLUSION
Nab-P in combination with carboplatin/cisplatin regimen improves efficacy and tolerability in patients with NSCLC.
SYSTEMATIC REVIEW REGISTRATION
http://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022288499.
PubMed: 37554498
DOI: 10.3389/fmed.2023.1139248 -
Frontiers in Oral Health 2023Orofacial pain conditions are complex disorders that involve biological, social, and psychological factors. Temporomandibular Disorders (TMDs) are one of the most common... (Review)
Review
BACKGROUND
Orofacial pain conditions are complex disorders that involve biological, social, and psychological factors. Temporomandibular Disorders (TMDs) are one of the most common orofacial pain conditions, and our previous literature review indicated that exercise therapy has shown promise in reducing TMD-related pain. However, more evidence is needed to firmly establish its effectiveness.
OBJECTIVES
This systematic review aims to investigate the effectiveness of exercise therapy on pain relief and jaw mobility in patients with pain-related TMDs.
METHODS
To include randomized controlled trials (RCTs) written in English, a literature search was performed using PubMed, Scopus, Web of Science, Cochrane Library, Ovid, EBM reviews, and Academic Search Complete initially from 4th November 2020 until March 2022. A PICOS for this review was as follows; P: Patients with TMD myalgia or arthralgia, I: Excursion exercise, Stretch exercises, Resistance exercise, or Coordination exercise, C: No treatment or education only. O: Pain intensity and Range of Motion (ROM), S: RCTs. After title screening, a full-text assessment was done to extract data. According to Risk of Bias (RoB) 2.0, risk of bias was assessed in each included paper by 2 reviewers independently.
RESULTS
A total of 3,388 titles were identified from the electronic database search. After the screening and full-text evaluation, only 5 studies (145 participants) were eligible to be included. Among the exercise modalities, coordination exercise showed a significant effect on pain relief and improvement of joint mobility.
DISCUSSION
Due to the heterogeneity and small sample size of the included studies, a meta-analysis was not feasible. However, this systematic review suggested that exercise therapy, especially coordinate exercise, can be effective in managing painful TMD conditions. Further research is needed to establish optimal parameters for this patient population, as well as standardization and consistency in terminology and treatment structure.
PubMed: 37521175
DOI: 10.3389/froh.2023.1170966 -
Therapeutics and Clinical Risk... 2023The COVID-19 pandemic continues, and this condition has caused many cases in various countries around the world, resulting in more than 6 million deaths worldwide.... (Review)
Review
The Efficacy of Herbs as Complementary and Alternative Therapy in Recovery and Clinical Outcome Among People with COVID-19: A Systematic Review, Meta-Analysis, and Meta-Regression.
BACKGROUND
The COVID-19 pandemic continues, and this condition has caused many cases in various countries around the world, resulting in more than 6 million deaths worldwide. Herbal medicines can act as immunomodulators, anti-inflammatories, antioxidants, antimicrobials, and others depending on the type and content of the herbs used. Previous studies have shown that several types of herbs, such as , have proven their effectiveness as herbal plants for COVID-19.
METHODS
We conducted a comprehensive literature search through five databases, namely, PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of phytopharmaceuticals until July 12, 2022. We used the Cochrane RoB 2.0 for the quality assessment of the study.
RESULTS
Phytopharmaceuticals significantly improved patients' recovery rate (OR = 3.54; < 0.00001) and reduced deaths (OR = 0.24; < 0.0001) compared to the control group. Phytopharmaceuticals also performed as a protective factor for COVID-19 clinical symptoms, such as dyspnea (OR = 0.42; < 0.05) and myalgia (OR = 0.31; = 0.02) compared to the control group. However, there is no statistically significant effect on cough (OR = 0.76; = 0.61) and fever (OR = 0.60; < 0.20). The results were not affected by patients' covariates [hypertension, diabetes mellitus, and cardiovascular diseases (meta-regression > 0.05)].
CONCLUSION
Herbal medicine has the potential as an adjuvant therapy in the management of COVID-19.
PubMed: 37484695
DOI: 10.2147/TCRM.S405507 -
Journal of Global Health Jul 2023The coronavirus (COVID-19) pandemic caused enormous adverse socioeconomic impacts worldwide. Evidence suggests that the diagnostic accuracy of clinical features of... (Meta-Analysis)
Meta-Analysis
Diagnostic accuracy of clinical signs and symptoms of COVID-19: A systematic review and meta-analysis to investigate the different estimates in a different stage of the pandemic outbreak.
BACKGROUND
The coronavirus (COVID-19) pandemic caused enormous adverse socioeconomic impacts worldwide. Evidence suggests that the diagnostic accuracy of clinical features of COVID-19 may vary among different populations.
METHODS
We conducted a systematic review and meta-analysis of studies from PubMed, Embase, Cochrane Library, Google Scholar, and the WHO Global Health Library for studies evaluating the accuracy of clinical features to predict and prognosticate COVID-19. We used the National Institutes of Health Quality Assessment Tool to evaluate the risk of bias, and the random-effects approach to obtain pooled prevalence, sensitivity, specificity, and likelihood ratios.
RESULTS
Among the 189 included studies (53 659 patients), fever, cough, diarrhoea, dyspnoea, and fatigue were the most reported predictors. In the later stage of the pandemic, the sensitivity in predicting COVID-19 of fever and cough decreased, while the sensitivity of other symptoms, including sputum production, sore throat, myalgia, fatigue, dyspnoea, headache, and diarrhoea, increased. A combination of fever, cough, fatigue, hypertension, and diabetes mellitus increases the odds of having a COVID-19 diagnosis in patients with a positive test (positive likelihood ratio (PLR) = 3.06)) and decreases the odds in those with a negative test (negative likelihood ratio (NLR) = 0.59)). A combination of fever, cough, sputum production, myalgia, fatigue, and dyspnea had a PLR = 10.44 and an NLR = 0.16 in predicting severe COVID-19. Further updating the umbrella review (1092 studies, including 3 342 969 patients) revealed the different prevalence of symptoms in different stages of the pandemic.
CONCLUSIONS
Understanding the possible different distributions of predictors is essential for screening for potential COVID-19 infection and severe outcomes. Understanding that the prevalence of symptoms may change with time is important to developing a prediction model.
Topics: United States; Humans; COVID-19; SARS-CoV-2; Myalgia; Cough; Pandemics; COVID-19 Testing; Dyspnea; Fatigue
PubMed: 37441773
DOI: 10.7189/jogh.13.06026 -
Frontiers in Pharmacology 2023Even 3 years into the COVID-19 pandemic, questions remain about how to safely and effectively vaccinate vulnerable populations. A systematic analysis of the safety and...
Even 3 years into the COVID-19 pandemic, questions remain about how to safely and effectively vaccinate vulnerable populations. A systematic analysis of the safety and efficacy of the COVID-19 vaccine in at-risk groups has not been conducted to date. This study involved a comprehensive search of PubMed, EMBASE, and Cochrane Central Controlled Trial Registry data through 12 July 2022. Post-vaccination outcomes included the number of humoral and cellular immune responders in vulnerable and healthy populations, antibody levels in humoral immune responders, and adverse events. A total of 23 articles assessing 32 studies, were included. The levels of IgG (SMD = -1.82, 95% CI [-2.28, -1.35]), IgA (SMD = -0.37, 95% CI [-0.70, -0.03]), IgM (SMD = -0.94, 95% CI [-1.38, -0.51]), neutralizing antibodies (SMD = -1.37, 95% CI [-2.62, -0.11]), and T cells (SMD = -1.98, 95% CI [-3.44, -0.53]) were significantly lower in vulnerable than in healthy populations. The positive detection rates of IgG (OR = 0.05, 95% CI [0.02, 0.14]) and IgA (OR = 0.03, 95% CI [0.01, 0.11]) antibodies and the cellular immune response rates (OR = 0.20, 95% CI [0.09, 0.45]) were also lower in the vulnerable populations. There were no statistically significant differences in fever (OR = 2.53, 95% CI [0.11, 60.86]), chills (OR = 2.03, 95% CI [0.08, 53.85]), myalgia (OR = 10.31, 95% CI [0.56, 191.08]), local pain at the injection site (OR = 17.83, 95% CI [0.32, 989.06]), headache (OR = 53.57, 95% CI [3.21, 892.79]), tenderness (OR = 2.68, 95% CI [0.49, 14.73]), and fatigue (OR = 22.89, 95% CI [0.45, 1164.22]) between the vulnerable and healthy populations. Seroconversion rates after COVID-19 vaccination were generally worse in the vulnerable than healthy populations, but there was no difference in adverse events. Patients with hematological cancers had the lowest IgG antibody levels of all the vulnerable populations, so closer attention to these patients is recommended. Subjects who received the combined vaccine had higher antibody levels than those who received the single vaccine.
PubMed: 37426814
DOI: 10.3389/fphar.2023.1144824 -
Tropical Parasitology 2023Severe acute respiratory syndrome-coronavirus-2 is a viral infection that was first discovered in Wuhan, Hubei province, China, in December 2019. Effects of COVID-19...
AIMS
Severe acute respiratory syndrome-coronavirus-2 is a viral infection that was first discovered in Wuhan, Hubei province, China, in December 2019. Effects of COVID-19 infection could drastically influence other concomitant diseases like Malaria. Malaria and COVID-19 may mimic each other and share look-alike symptoms. The aim of this systematic review was to analyze the clinical and biochemical characteristics of malaria and COVID-19 synergism that was based on the published case reports.
SUBJECTS AND METHODS
An extensive literature search was carried out between May 2020 and February 2022 in PubMed, Google Scholar, and EMBASE. Our study was devised according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.
RESULTS
We have evaluated 16 case reports and one case series of coinfection of malaria with COVID-19. It has been observed that all the patients showed lymphopenia, fever, headache (52%), vomiting (47%), cough (38%), chills (38%), body ache (38%), myalgia (28%), and sweating (14%). Despite unprecedented times, whenever there is a suspicion, we recommend that medical practitioners should be alert to presenting plethora features of COVID-19 and confirm with polymerase chain reaction test.
CONCLUSION
We conclude that screening for COVID-19 should also be performed to mitigate missed diagnoses due to the long incubation period of novel coronavirus. Especially in vulnerable population, we should suspect other concurrent diseases and diagnoses in patients presenting with the symptoms of COVID-19 infection.
PubMed: 37415760
DOI: 10.4103/tp.tp_26_22 -
Imiquimod for Cervical and Vaginal Intraepithelial Neoplasia: A Systematic Review and Meta-analysis.Obstetrics and Gynecology Aug 2023To evaluate the treatment efficacy and the risk of adverse events of imiquimod for cervical intraepithelial neoplasia (CIN) and vaginal intraepithelial neoplasia (VAIN),... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate the treatment efficacy and the risk of adverse events of imiquimod for cervical intraepithelial neoplasia (CIN) and vaginal intraepithelial neoplasia (VAIN), compared with placebo or no intervention.
DATA SOURCES
We searched Cochrane, PubMed, ISRCTN registry, ClinicalTrials.gov , and the World Health Organization International Clinical Trials Registry Platform up to November 23, 2022.
METHODS OF STUDY SELECTION
We included randomized controlled trials and prospective nonrandomized studies with control arms that investigated the efficacy of imiquimod for histologically confirmed CIN or VAIN. The primary outcomes were histologic regression of the disease (primary efficacy outcome) and treatment discontinuation due to side effects (primary safety outcome). We estimated pooled odds ratios (ORs) of imiquimod, compared with placebo or no intervention. We also conducted a meta-analysis of the proportions of patients with adverse events in the imiquimod arms.
TABULATION, INTEGRATION, AND RESULTS
Four studies contributed to the pooled OR for the primary efficacy outcome. An additional four studies were available for meta-analyses of proportions in the imiquimod arm. Imiquimod was associated with increased probability of regression (pooled OR 4.05, 95% CI 2.08-7.89). Pooled OR for CIN in the three studies was 4.27 (95% CI 2.11-8.66); results of one study were available for VAIN (OR, 2.67, 95% CI 0.36-19.71). Pooled probability for primary safety outcome in the imiquimod arm was 0.07 (95% CI 0.03-0.14). The pooled probabilities (95% CI) of secondary outcomes were 0.51 (0.20-0.81) for fever, 0.53 (0.31-0.73) for arthralgia or myalgia, 0.31 (0.18-0.47) for abdominal pain, 0.28 (0.09-0.61) for abnormal vaginal discharge or genital bleeding, 0.48 (0.16-0.82) for vulvovaginal pain, and 0.02 (0.01-0.06) for vaginal ulceration.
CONCLUSION
Imiquimod was found to be effective for CIN, whereas data on VAIN were limited. Although local and systemic complications are common, treatment discontinuation is infrequent. Thus, imiquimod is potentially an alternative therapy to surgery for CIN.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, CRD42022377982.
Topics: Female; Humans; Imiquimod; Antineoplastic Agents; Prospective Studies; Aminoquinolines; Uterine Cervical Dysplasia; Uterine Cervical Neoplasms
PubMed: 37411024
DOI: 10.1097/AOG.0000000000005256 -
Nutrition and Health Mar 2024Curcumin is a polyphenol derived from the L (turmeric) plant and has gained attention through its perceived anti-inflammatory characteristics. The potential... (Meta-Analysis)
Meta-Analysis Review
Curcumin is a polyphenol derived from the L (turmeric) plant and has gained attention through its perceived anti-inflammatory characteristics. The potential interaction with exercise-induced muscle damage (EIMD) and delayed onset muscle soreness (DOMS) has led to investigation of curcumin as a post-exercise strategy that may have the potential to lessen acute reductions in functional strength (FS) following physical activity. The purpose of this review is to assess the evidence examining curcumin in relation to four outcome measures: FS, EIMD, DOMS and inflammation. A Medline, SPORTDiscus and CINAHL database search was undertaken with no publication date limit. Sixteen papers met the inclusion criteria and were included in this review. Three meta-analyses were completed for EIMD, DOMS and inflammation, respectively, with FS being excluded due to limited research. Effect sizes were as follows: EIMD (0.15, -0.12, -0.04, -0.2 and -0.61 corresponding to 0, 24, 48, 72 and 96 h post-exercise, respectively), DOMS (-0.64, -0.33, 0.06, -0.53 and -1.16 corresponding to 0, 24, 48, 72 and 96 h post-exercise, respectively) and inflammation (-0.10, 0.26, 0.15 and 0.26 corresponding to 0, 24, 48 and 72 h post-exercise, respectively). A 96 h post-exercise inflammation meta-analysis was not conducted due to limited data. No effect sizes were statistically significant for EIMD ( = 0.644, 0.739, 0.893, 0.601 and 0.134), DOMS ( = 0.054, 0.092, 0.908, 0.119 and 0.074) and inflammation ( = 0.729, 0.603, 0.611 and 0.396). Further research is needed to thoroughly examine whether an effect exists.
Topics: Humans; Curcumin; Dietary Supplements; Myalgia; Inflammation; Muscles; Muscle, Skeletal
PubMed: 37408367
DOI: 10.1177/02601060231186439