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Journal of Clinical Laboratory Analysis May 2022Interest revolving around coronavirus disease 2019 (COVID-19) reinfection is escalating rapidly. By definition, reinfection denotes severe acute respiratory syndrome... (Review)
Review
INTRODUCTION
Interest revolving around coronavirus disease 2019 (COVID-19) reinfection is escalating rapidly. By definition, reinfection denotes severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), PCR redetection, and COVID-19 recurrence within three months of the initial symptoms. The main aim of the current systematic review was to evaluate the features of COVID-19 relapse patients.
MATERIALS AND METHODS
For this study, we used a string of terms developed by a skilled librarian and through a systematical search in PubMed, Web of Science, and Embase for eligible studies. Clinical surveys of any type were included from January 2019 to March 2021. Eligible studies consisted of two positive assessments separated by a negative result via RT-PCR.
RESULTS
Fifty-four studies included 207 cases of COVID-19 reinfection. Children were less likely to have COVID-19 relapse. However, the most patients were in the age group of 20-40 years. Asthenia (66.6%), headache (66.6%), and cough (54.7%) were prevalent symptoms in the first SARS-CoV-2 infection. Asthenia (62.9%), myalgia (62.9%), and headache (61.1%) were most frequent in the second one. The most common treatment options used in first COVID-19 infection were lopinavir/ritonavir (80%), oxygen support (69.2%), and oseltamivir (66.6). However, for the treatment of second infection, mostly antibiotics (100%), dexamethasone (100%), and remdesivir (80%) were used. In addition, obesity (32.5%), kidney failure (30.7%), and hypertension (30.1%) were the most common comorbidities. Unfortunately, approximately 4.5% of patients died.
CONCLUSION
We found the potency of COVID-19 recurrence as an outstanding issue. This feature should be regarded in the COVID-19 management. Furthermore, the first and second COVID-19 are similar in clinical features. For clinically practical comparison of the symptoms severity between two epochs of infection, uniform data of both are required. We suggest that future studies undertake a homogenous approach to establish the clinical patterns of the reinfection phenomena.
Topics: Adult; Asthenia; COVID-19; Child; Headache; Humans; Reinfection; SARS-CoV-2; Young Adult
PubMed: 35396748
DOI: 10.1002/jcla.24402 -
Biosensors Dec 2022To enhance the treatment of motor function impairment, patients' brain signals for self-control as an external tool may be an extraordinarily hopeful option. For the... (Review)
Review
A Systematic Review of Virtual Reality and Robot Therapy as Recent Rehabilitation Technologies Using EEG-Brain-Computer Interface Based on Movement-Related Cortical Potentials.
To enhance the treatment of motor function impairment, patients' brain signals for self-control as an external tool may be an extraordinarily hopeful option. For the past 10 years, researchers and clinicians in the brain-computer interface (BCI) field have been using movement-related cortical potential (MRCP) as a control signal in neurorehabilitation applications to induce plasticity by monitoring the intention of action and feedback. Here, we reviewed the research on robot therapy (RT) and virtual reality (VR)-MRCP-based BCI rehabilitation technologies as recent advancements in human healthcare. A list of 18 full-text studies suitable for qualitative review out of 322 articles published between 2000 and 2022 was identified based on inclusion and exclusion criteria. We used PRISMA guidelines for the systematic review, while the PEDro scale was used for quality evaluation. Bibliometric analysis was conducted using the VOSviewer software to identify the relationship and trends of key items. In this review, 4 studies used VR-MRCP, while 14 used RT-MRCP-based BCI neurorehabilitation approaches. The total number of subjects in all identified studies was 107, whereby 4.375 ± 6.3627 were patient subjects and 6.5455 ± 3.0855 were healthy subjects. The type of electrodes, the epoch, classifiers, and the performance information that are being used in the RT- and VR-MRCP-based BCI rehabilitation application are provided in this review. Furthermore, this review also describes the challenges facing this field, solutions, and future directions of these smart human health rehabilitation technologies. By key items relationship and trends analysis, we found that motor control, rehabilitation, and upper limb are important key items in the MRCP-based BCI field. Despite the potential of these rehabilitation technologies, there is a great scarcity of literature related to RT and VR-MRCP-based BCI. However, the information on these rehabilitation methods can be beneficial in developing RT and VR-MRCP-based BCI rehabilitation devices to induce brain plasticity and restore motor impairment. Therefore, this review will provide the basis and references of the MRCP-based BCI used in rehabilitation applications for further clinical and research development.
Topics: Humans; Brain-Computer Interfaces; Electroencephalography; Robotics; Virtual Reality; Brain
PubMed: 36551100
DOI: 10.3390/bios12121134 -
The International Journal of Behavioral... Feb 2020Early experiences in physical activity (PA) are important to shape healthy movement behaviours long-term; as such, it is critical that PA is promoted from infancy, and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Early experiences in physical activity (PA) are important to shape healthy movement behaviours long-term; as such, it is critical that PA is promoted from infancy, and that detrimental behaviours (e.g., prolonged sedentary time [ST]) are minimized. The purpose of this systematic review and meta-analysis was to examine infants' and toddlers' movement behaviours across daytime hours.
METHODS
Seven online databases were searched for terms related to infants (< 12 months), toddlers (12-35.9 months), PA, ST, and accelerometry. Two independent reviewers examined 4873 articles for peer-reviewed original research, published in English, that assessed infants' (counts/min) and/or toddlers' PA or ST (min/day) using accelerometry across daytime hours. Infants' mean PA level (counts/min) was averaged across studies, and ranges were produced. Estimates of toddlers' movement behaviours were aggregated meta-analytically to produce average daily rates, and accelerometer placement, cut-point validity, device type, and epoch length were tested as a moderating variables.
RESULTS
Twenty-four studies from 16 countries (published 2011-2019), representing 3699 participants, were included in the systematic review. Five studies reported on infants' PA, which ranged from 78.2 to 2580.5 cpm. Across 20 studies, toddlers' total PA, light PA, moderate-to vigorous-intensity PA, and ST ranged from 72.9 to 636.5, 48.5 to 582.4, 6.5 to 89.9, and 172.7 to 545.0 min/day, respectively. After taking into account accelerometer placement, cut-point validity, device type, and epoch length, we found that toddlers engaged in 246.19 min/day (SE = 28.50; 95% CI: 190.34, 302.04) of total PA, 194.10 min/day (SE = 28.76; 95% CI: 137.73, 250.47) of light PA, and 60.16 min/day (SE = 5.88; 95% CI: 48.64, 71.69) of moderate-to vigorous-intensity PA. Toddlers engaged in 337.04 min/day (SE = 32.67; 95% CI: 273.01, 401.07) of ST.
CONCLUSIONS
With limited studies conducted in infants (n = 5), PA estimates are inconclusive and largely heterogeneous. Overall, toddlers tend to exceed the total PA recommendation of 180 min/day; however, very little of this time is spent at higher movement intensities. Even with high PA rates, toddlers still engage in substantial ST. More consistent and valid measurement protocols are needed to improve comparability across studies.
Topics: Accelerometry; Child, Preschool; Exercise; Humans; Infant; Monitoring, Ambulatory; Sedentary Behavior
PubMed: 32028975
DOI: 10.1186/s12966-020-0912-4 -
Medicine Sep 2022Double-expressor lymphoma (DEL) is associated with a poor prognosis. The standard treatment for patients with DEL remains controversial. A comparison of the safety and... (Meta-Analysis)
Meta-Analysis
PURPOSE
Double-expressor lymphoma (DEL) is associated with a poor prognosis. The standard treatment for patients with DEL remains controversial. A comparison of the safety and feasibility of R-CHOP and DA-EPOCH-R as the first-line therapy for patients with DEL is urgently needed.
METHODS
The clinical and treatment outcomes of 75 DEL patients were retrospectively analyzed. The role of DA-EPOCH-R was determined and compared to that of R-CHOP in DEL patients. PubMed, Embase, the Cochrane Central Library, and ClinicalTrials.gov were systematically searched up to November 1, 2021 and were evaluated by Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Articles comparing DA-EPOCH-R versus R-CHOP in patients with DEL were included.
RESULTS
Overall, 49 and 26 DEL patients received R-CHOP and DA-EPOCH-R, respectively. Although the difference in response for patients who received R-CHOP and DA-EPOCH-R was not significant (P = .347), DA-EPOCH-R may improve the prognosis compared to R-CHOP (P = .056 for progression-free survival [PFS], P = .009 for overall survival [OS]). A systematic review and meta-analysis including 412 DEL patients in six articles were conducted. The event rate for 3-year PFS was significantly lower in patients receiving DA-EPOCH-R treatment than in those undergoing R-CHOP treatment (OR = 0.63, 95% CI = 0.42-0.94, P = .02), whereas no statistically significant difference was found in the HRs for both PFS and OS or the event rate for 3-year OS.
CONCLUSION
The results of this study indicated that DA-EPOCH-R might improve the prognosis of DEL patients compared with R-CHOP.
Topics: Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Doxorubicin; Etoposide; Humans; Lymphoma, Large B-Cell, Diffuse; Prednisone; Prognosis; Retrospective Studies; Rituximab; Vincristine
PubMed: 36197215
DOI: 10.1097/MD.0000000000030620 -
Frontiers in Oncology 2022Given the paucity of evidence-based treatment recommendations, the most appropriate first-line regimen for adult Burkitt lymphoma is currently undefined. We aimed to...
BACKGROUND AND AIM
Given the paucity of evidence-based treatment recommendations, the most appropriate first-line regimen for adult Burkitt lymphoma is currently undefined. We aimed to identify the optimal treatment regimen containing rituximab for adult Burkitt lymphoma patients.
METHODS
The PubMed, Embase, Web of Science, and Cochrane databases were searched in December 2021 (10). We included all studies for the treatment of Burkitt lymphoma including rituximab. We excluded studies of patients aged ≤14 years old and those with sample numbers ≤10 patients. Random-effects models were used to compare different chemotherapy regimens regarding estimated 2-year overall survival (OS) rate, 2-year progression-free survival (PFS) rate, and overall response rate (ORR).
RESULTS
A total of 17 studies were included in this meta-analysis and divided into four groups: CODOX-M/IVAC, DA-EPOCH, GMALL-B-ALL/NHL2002, and Hyper-CVAD. DA-EPOCH was associated with a significantly higher 2-year OS rate [0.95, 95% confidence interval (CI) 0.86-1.00]. There was no significant difference in the 2-year PFS rates (0.81, 95% CI 0.76-0.85) and ORR (0.90, 95% CI 0.87-0.94) between these four treatment regimens.
CONCLUSIONS
The meta-analysis indicates that DA-EPOCH could be more effective in providing curative treatment for adult Burkitt lymphoma patients, especially without CNS and BM involvement considering OS time. Due to the types of studies and the limited number of included studies, bias should be acknowledged and a randomized controlled trial (RCT) needs to be performed to further identify the optimal treatment regimen for such patients.
PubMed: 36620579
DOI: 10.3389/fonc.2022.1063689 -
British Journal of Haematology Aug 2015'Double-hit lymphomas' (DHL), defined by concurrent MYC and BCL2 (or, alternatively, BCL6) rearrangements, have a very poor outcome compared to standard-risk, diffuse... (Meta-Analysis)
Meta-Analysis Review
Front-line, dose-escalated immunochemotherapy is associated with a significant progression-free survival advantage in patients with double-hit lymphomas: a systematic review and meta-analysis.
'Double-hit lymphomas' (DHL), defined by concurrent MYC and BCL2 (or, alternatively, BCL6) rearrangements, have a very poor outcome compared to standard-risk, diffuse large B-cell lymphomas (DLBCL). Consequently, dose-intensive (DI) therapies and/or consolidation with high-dose therapy and transplant have been explored in DHL, although benefit has been debated. This meta-analysis compared survival outcomes in DHL patients receiving dose-escalated regimens [DI: R-Hyper-CVAD (rituximab, cyclophosphamide, vincristine, doxorubicin, dexamethasone) or R-CODOX-M/IVAC (rituximab, cyclophosphamide, doxorubicin, vincristine, methotrexate/ifosfamide, etoposide, high dose cytarabine); or intermediate-dose: R-EPOCH (rituximab, etoposide, doxorubicin, cyclophosphamide, vincristine, prednisone)] versus standard-dose regimens (R-CHOP; rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone) in the first-line setting. Data were synthesized to estimate hazard ratios of dose-escalated treatments versus R-CHOP using a Weibull proportional hazards model within a Bayesian meta-analysis framework. Eleven studies examining 394 patients were included. Patients were treated with either front-line R-CHOP (n = 180), R-EPOCH (n = 91), or R-Hyper-CVAD/rituximab, methotrexate, cytarabine (R-M/C), R-CODOX-M/R-IVAC (DI) (n = 123). Our meta-analysis revealed that median progression-free survival (n = 350) for the R-CHOP, R-EPOCH and DI groups was 12·1, 22·2, and 18·9 months, respectively. First-line treatment with R-EPOCH significantly reduced the risk of a progression compared with R-CHOP (relative risk reduction of 34%; P = 0·032); however, overall survival (n = 374) was not significantly different across treatment approaches. A subset of patients might benefit from intensive induction with/without transplant. Further investigation into the role of transplant and novel therapy combinations is necessary.
Topics: Antineoplastic Combined Chemotherapy Protocols; DNA-Binding Proteins; Disease-Free Survival; Humans; Lymphoma, Large B-Cell, Diffuse; Proto-Oncogene Proteins c-bcl-2; Proto-Oncogene Proteins c-bcl-6; Proto-Oncogene Proteins c-myc; Survival Rate
PubMed: 25907897
DOI: 10.1111/bjh.13463 -
Archives of Women's Mental Health Apr 2024Pregnancy and the immediate postpartum period are considered at high risk for women who have already received a previous psychiatric diagnosis and might represent a... (Review)
Review
Pregnancy and the immediate postpartum period are considered at high risk for women who have already received a previous psychiatric diagnosis and might represent a stressful event favoring the onset of new psychiatric disorders. The electroconvulsive therapy (ECT) is effective for the treatment of severe, treatment-resistant mental disorders, and it could represent a therapeutic choice for psychiatric conditions during pregnancy. The purpose of this systematic review is to evaluate the safety of ECT during pregnancy and to update the state of the art of its use. An extensive literature search on PubMed, APA PsycInfo, and Scopus databases for relevant articles published from inception to September 2023 has been performed. A final number of 45 articles (34 case reports and 11 case series, for a total of 130 pregnant women) were included in the present review. The limited evidence confirmed that ECT is effective in determining a partial remission of symptoms in women suffering from severe mental disorders, especially in the presence of suicidal ideation or psychosis, during all pregnancy epochs. However, ECT is not free from side effects, although the majority of possible complications were of low- or moderate-grade and not life-threatening for the women. Exposure to pharmacological treatment before or during the ECT or to the anesthetic during ECT might have contributed to the onset of these complications. ECT techniques evolved over years, increasing the degree of its safety, and according to our review it appears to be relatively safe and effective during pregnancy in the majority of cases.
Topics: Female; Humans; Pregnancy; Electroconvulsive Therapy; Psychotic Disorders; Pregnancy Complications; Postpartum Period; Treatment Outcome
PubMed: 37957411
DOI: 10.1007/s00737-023-01394-1 -
JACC. Clinical Electrophysiology Apr 2017The aims of this study were to quantify the degree of improvement in vasovagal syncope after assessment and to identify predictive factors. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aims of this study were to quantify the degree of improvement in vasovagal syncope after assessment and to identify predictive factors.
BACKGROUND
No treatments for vasovagal syncope have been proved effective, but patients in all prospective studies appear to show a reduction in the likelihood of fainting.
METHODS
A systematic review and meta-analysis was performed of studies published from 1993 through 2013. Inclusion criteria were: 1) vasovagal syncope frequency in the preceding 1 to 2 years; and 2) the proportion of subjects with syncope in at least the first follow-up year. Random-effects methods were used.
RESULTS
Of 338 screened studies, 17 were analyzed, with a mean of 112 subjects (range 9 to 511 subjects). In the preceding epoch, 97% of subjects fainted, with 2.6 ± 1.0 syncopal spells per year. In the follow-up year, the proportion of patients with ≥1 syncope recurrence was 677 of 1,912 (35.4%), and in the meta-analysis, the proportion of subjects fainting was only 0.44 (95% confidence interval: 0.41 to 0.46; p < 0.001). Subjects in larger studies were less likely to faint than those in randomized trials (relative risk: 0.35 vs. 0.55; p = 0.004). The probabilities of ≥1 syncope recurrence in the observational versus randomized studies were 0.30 (95% confidence interval: 0.24 to 0.37) and 0.54 (95% confidence interval: 0.46 to 0.62), respectively (p < 0.001). None of the degree of blinding, type of intervention, age, sex, and number of recent faints predicted the probability of syncope recurrence. Heterogeneity was very high in all analyses (I = 60% to 96%).
CONCLUSIONS
The spontaneous remission rate in highly symptomatic syncope patients is high, and remission occurs in all types of studies. Improvement was more likely in larger and observational studies.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Observational Studies as Topic; Randomized Controlled Trials as Topic; Remission, Spontaneous; Syncope, Vasovagal
PubMed: 29759452
DOI: 10.1016/j.jacep.2016.10.012 -
Obesity Reviews : An Official Journal... Apr 2022Interventions for obesity prevention can effectively reduce obesity-related behaviors in young children. Understanding how to leverage and adapt evidence-based...
Interventions for obesity prevention can effectively reduce obesity-related behaviors in young children. Understanding how to leverage and adapt evidence-based interventions is needed to improve reach among culturally and linguistically diverse families. This systematic review aimed to synthesize the approaches and outcomes of culturally adapted early childhood obesity-related behavioral prevention interventions. Multiple electronic databases were systematically searched in March 2021. All study designs were included if they reported cultural adaptations of an intervention targeting at least one obesity-related behavior (infant feeding, nutrition, physical activity, and/or sleep) among children aged 0-5 years. Studies that only conducted language translations or that developed new interventions were excluded. Two authors independently conducted critical appraisals using the Mixed Method Appraisal Tool. Findings were synthesized narratively, based on the Stages of Cultural Adaptation theoretical model and the Framework for Reporting Adaptations and Modifications-Enhanced. Twelve interventions met the inclusion criteria, with varied study designs. Few reported all aspects of cultural adaptation processes, and the cultural adaptation strategies documented varied. The results suggest that cultural adaptation of obesity-related behavioral prevention interventions targeting young children increases acceptability among target cultural groups, yet effectiveness is inconclusive due to a lack of trials. More detailed reporting of cultural adaptation processes and further effectiveness trials are needed to evaluate future work.
Topics: Child; Child, Preschool; Exercise; Humans; Infant; Pediatric Obesity
PubMed: 34866315
DOI: 10.1111/obr.13402 -
Journal of Intensive Care Medicine Nov 2020In the intensive care unit (ICU), prolonged inactivity is common, increasing patients' risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions...
OBJECTIVE
In the intensive care unit (ICU), prolonged inactivity is common, increasing patients' risk for adverse outcomes, including ICU-acquired weakness. Hence, interventions to minimize inactivity are gaining popularity, highlighting actigraphy, a measure of activity involving a wristwatch-like accelerometer, as a method to inform these efforts. Therefore, we performed a systematic review of studies that used actigraphy to measure patient activity in the ICU setting.
DATA SOURCES
We searched PubMed, EMBASE, CINAHL, Cochrane Library, and ProQuest from inception until December 2016.
STUDY SELECTION
Two reviewers independently screened studies for inclusion. A study was eligible for inclusion if it was published in a peer-reviewed journal and used actigraphy to measure activity in ≥5 ICU patients.
DATA EXTRACTION
Two reviewers independently performed data abstraction and risk of bias assessment. Abstracted actigraphy-based activity data included total activity time and activity counts.
RESULTS
Of 16 studies (607 ICU patients) identified, 14 (88%) were observational, 2 (12%) were randomized control trials, and 5 (31%) were published after 2009. Mean patient activity levels per 15 to 60 second epoch ranged from 25 to 37 daytime and 2 to 19 nighttime movements. Actigraphy was evaluated in the context of ICU and post-ICU outcomes in 11 (69%) and 5 (31%) studies, respectively, and demonstrated potential associations between actigraphy-based activity levels and delirium, sedation, pain, anxiety, time to extubation, and length of stay.
CONCLUSION
Actigraphy has demonstrated that patients are profoundly inactive in the ICU with actigraphy-based activity levels potentially associated with important measures, such as delirium, sedation, and length of stay. Larger and more rigorous studies are needed to further evaluate these associations and the overall utility of actigraphy in the ICU setting.
Topics: Actigraphy; Airway Extubation; Critical Care; Exercise; Humans; Intensive Care Units; Length of Stay; Randomized Controlled Trials as Topic
PubMed: 31331220
DOI: 10.1177/0885066619863654