Pharmacological interventions for COVID-19: a systematic review of observational studies and clinical trials

2021 ◽  
Author(s):  
Nida Bokharee ◽  
Yusra Habib Khan ◽  
Aisha Khokhar ◽  
Tauqeer Hussain Mallhi ◽  
Nasser Hadal Alotaibi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Observational Studies ◽  
Pharmacological Interventions

scholarly journals Associations of Plant-Based Foods and Diets with Gestational Diabetes: A Systematic Review of Observational Studies and Clinical Trials

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 948-948
Author(s):  
Tristesse Burton ◽  
James Alexander ◽  
Petar Planinic ◽  
Arpita Basu
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Gestational Diabetes ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Chinese Herb ◽  
Nutrition Therapy ◽  
Cross Sectional ◽  
Evening Primrose ◽  
Funding Sources

Abstract Objectives Gestational diabetes mellitus (GDM) is one of the most common health complications during pregnancy. Medical nutrition therapy is the mainstay of treatment for GDM, however, there is no current consensus on the optimal dietary approaches for prevention and management of hyperglycemia during pregnancy. Our objective is to assess the relationship of plant-based diets, foods, and dietary supplements with GDM and maternal glycemic biomarkers in observational and clinical studies. Methods A systematic review was performed using PubMed to identify original articles from 1999–2019 following the PRISMA checklist statement. Articles were excluded if they were review articles, conference abstracts, not in English or did not meet the pre-defined PICOS (Population, Intervention/exposure, Comparison, Outcome, Study design) criteria. Articles were screened for relevance, extracted and summarized, and assessed for risk of bias and quality. Results A total of 431 articles were screened, 33 observational studies (prospective cohort: n = 26, case-control: n = 3, cross-sectional: n = 4) involving 147,576 women and 11 randomized clinical trials involving 3940 women were included. Among the observational studies, Mediterranean diet (MedDiet), fiber, and vegetable rich diets were associated with a significant decrease in GDM risk. Among the clinical trials, Dietary Approaches to Stop Hypertension (DASH) diet, MedDiet, soy, phytosterol spread, evening primrose, chili powder and a traditional Chinese herb, Artemisia scoparia Waldst. & Kit. (Asteraceae) (n = 1) exhibited improved maternal hyperglycemia, insulin resistance or sensitivity, and hypoadiponectinemia. Conclusions These findings suggest that plant-based diets may be effective in preventing and managing hyperglycemia during pregnancy. Particularly, adherence to a MedDiet may improve maternal glycemic biomarker and decrease risk of GDM. Funding Sources UNLV Faculty research start up award.

Low Glycemic Load or Index Diet in Association with Acne Vulgaris: A Systematic Review and Meta-analysis

2020 ◽  
Author(s):  
Roya Sakhaei ◽  
Mohammad Ali Mohsenpour
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Social Life ◽  
Observational Studies ◽  
Meta Analysis ◽  
Acne Vulgaris ◽  
Glycemic Load ◽  
Dietary Factors ◽  
Dietary Habit ◽  
The Mean

Background: Social life can be affected by skin condition. Acne Vulgaris (AV) is a multi-factorial skin disorder that affects many people. Several dietary factors are associated with AV. Objectives: Different findings on glycemic indices led us to investigate the effect of the dietary glycemic index (GI) and glycemic load (GL) on AV by a systematic review and meta-analysis. Methods: Observational studies and clinical trials were extracted from PubMed, EMBASE, Scopus, and Google Scholar. The mean ± Standard division (SD) for acne grading in clinical trials and the mean ± SD GI or GL of the diet for observational studies were used for meta-analysis. Results: We found that nine out of 15 studies were eligible for systematic review clinical trials (N = 3) and observational studies (N = 6) designs. The meta-analysis of three studies clinically assessed the effect of GI/GL on acne and showed that a diet with lower GI/GL reduced the acne severity (Hedges’g = -0.91, 95% CI: -1.57, -0.25, P = 0.007). The analysis of six observational studies showed that dietary habit with higher GI might not affect the acne severity in patients with AV (Hedges’g = 0.07, 95%CI: -0.23, 0.38, P = 0.636), but individuals with higher acne severity had a diet with higher GL (Hedges’g = 0.64, 95%CI: 0.01, 1.26, P = 0.045). Conclusions: Diet, as a part of life style, is associated with AV. Adherence to lower GL diet may reduce the severity of AV. Further well-designed clinical trials are required to confirm these results.

scholarly journals 720. Efficacy of Nifurtimox + Eflornithine in the Treatment of African Trypanosomiasis. Systematic Review

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S459-S459
Author(s):  
Jessica Hidalgo ◽  
Raghavendra Tirupathi ◽  
Juan Fernando Ortiz ◽  
Stephanie P Fabara ◽  
Dinesh Reddy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Trypanosoma Brucei ◽  
Observational Studies ◽  
Case Fatality ◽  
Patient Discharge ◽  
Tsetse Fly ◽  
Open Label ◽  
Second Stage ◽  
Additional Clinical Trial

Abstract Background Sleeping sickness is an infectious disease transmitted mainly by the Trypanosoma Brucei, with the tsetse fly as a vector. The condition has two stages: The hemolymphatic and the meningo-encephalitic stage. The second stage is caused mainly by the Trypanosoma Brucei Gambiense. The treatment of the second stage has changed from melarsoprol, eflornithine, to now nifurtimox-eflornithine (NECT). This systematic review will focus on the efficacy and the toxicity of the medication. Methods We use PRISMA and MOOSE protocol for this review. On figure 1, we detail the methodology used for the extraction of information from the systematic review. To assess the study's bias, we used Cochrane Collaboration’s tool for risk assessment of the clinical trials and the Robins I tool for the observational studies. Results We collected four clinical trials and two observational studies after an extensive search. Three clinical trials showed that NECT was non-inferior to eflornithine with the following cure rates (NECT VS eflornithine): 1) 96.3% vs. 94.1% ; 2) 90.9% vs. 88.9%; 3) 91.6% vs. 96.5%. An additional clinical trial revealed that the proportion of patient discharge from the hospital was 98.4% (619/629); 95% CI [97.1%; 99.1%]). The two observational studies discussed the pharmacovigilance of the drug and toxicity related to NECT. In one study, patients treated with NECT, 589 (86%) experienced at least one adverse effect (AE) during treatment, and 70 (10.2%) experience serious AE. On average, children experienced fewer AEs than adults. In the other study at least one AE was described in 1043 patients (60.1%), and Serious AE was reported in 19 patients (1.1% of treated), leading to nine deaths (case fatality rate of 0.5%). The major limitations of the studies were the lack of blinding because most of them were open-label. Also, there was heterogenicity in the definition of the outcomes in the observational studies. PRISMA Flow Chart Conclusion NECT is not inferior to eflornithine, and the proportion of patients discharged from the hospital alive showed favorable results. The observational studies revealed a high frequency of AE. However, NECT is more convenient and safe than Eflornithine and Melarsoprol. Disclosures All Authors: No reported disclosures

scholarly journals The efficacy of topical, oral and surgical interventions for the treatment of tungiasis: A systematic review of the literature

2021 ◽  
Vol 15 (8) ◽  
pp. e0009722
Author(s):  
Ana Carolina Tardin Martins ◽  
Amanda Ramos de Brito ◽  
Patrícia Shu Kurizky ◽  
Rodrigo Gurgel Gonçalves ◽  
Yago Ranniere Teixeira Santana ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Observational Studies ◽  
Treatment Options ◽  
Sufficient Evidence ◽  
Tissue Destruction ◽  
Adequate Treatment ◽  
Surgical Interventions ◽  
Surgical Extraction ◽  
Quantitative Descriptive

Background Tungiasis is a neglected disease caused by Tunga penetrans that can be complicated by secondary infections and local tissue destruction. Adequate treatment is important, especially in vulnerable populations; potential treatment options proposed range from surgical extraction to the use of oral and topical medications. We aimed to perform a systematic review to assess the efficacy of topical, oral and surgical interventions for the treatment of tungiasis. Methodology/Principal findings The present review is registered in PROSPERO (CRD42021234741). On September 1, 2020, we searched PubMed, EMBASE, Scopus, Web of Science, Science Direct, Scielo and LILACS BVS. We included clinical trials and longitudinal observational studies that evaluated any topical, systemic or mechanical treatment for tungiasis. We used the Revised Cochrane Risk of Bias (RoB) Tool for Randomized Trials for clinical trial analysis. Qualitative and quantitative descriptive syntheses were performed. Our search strategy resulted in 3376 references. Subsequently, 2568 titles/abstracts and 114 full texts were screened. We finally included 19 articles; 9 were classified as clinical trials. Two and 3 articles presented low and some RoB, respectively, according to the tool. Only two articles tested the efficacy of oral medications (niridazole, ivermectin), with discouraging results. Six clinical trials evaluated topical products for the treatment of tungiasis; 2 evaluated dimeticone-based compounds and reported positive results in lesion reduction and cure. None reported significant adverse reactions. Surgical extraction was evaluated only in observational studies. Conclusions/Significance We conclude that, although surgical extraction is the most commonly used treatment, there is sufficient evidence supporting the use of occlusive agents, especially manufactured dimeticone-based products.

Abstract 15722: Proton Pump Inhibitors and Risk of Myocardial Infarction: A Systematic Review and Meta-analysis

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmed Ullah Mishuk ◽  
Shahariar Mohammed Fahim ◽  
Richard Hansen ◽  
Li Chen ◽  
Philippe Gaillard ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Clinical Trials ◽  
Quality Assessment ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Observational Studies ◽  
Meta Analysis ◽  
Pharmacovigilance System ◽  
Increased Risk

Introduction: Proton Pump Inhibitors (PPIs) are generally considered safe, but recent evidence suggests otherwise. Objective: This systematic review and meta-analysis assessed the association between PPIs and the risk of myocardial infarction (MI), using both clinical trials and observational studies. Methods: A systematic search was performed in December 2019 to retrieve all potential studies using PubMed, PsycInfo, International Pharmaceutical Abstracts, Web of Science, and Clinicaltrials.gov. This search initially identified any published studies describing any adverse event (AE) or outcomes related to PPI. Records were included in this study if 1) studies were published in English, 2) study design was clinical trials or observational studies, 3) PPI use was the exposure or treatment, and 4) study outcome was the incidence of MI. Two researchers independently reviewed all identified records, performed full article review, extracted data into structured evidence table, and conducted quality assessment using Newcastle-Ottawa Scale and Quality Assessment Tool for Quantitative Studies. Meta-analysis was performed using the RStudio software to assess the risk of MI with PPI use. Results: A total of 4,507 abstracts meeting the inclusion criteria were identified, and 20 full articles were included in this study, among which 10 were cohort, 3 were case-control, 3 were RCT post-hoc analysis, and 4 were RCT studies. The pooled Odds Ratio (OR)=1.40 with 95% CI=1.20-1.63 for all studies indicated the presence of an association between PPI use and increased risk of MI compared to PPI non-users. Meta-analysis found a similar association between PPI use and increased risk of MI in observational studies (OR=1.40; 95% CI=1.20, 1.64) but no association (OR=0.90; 95% CI=0.47, 1.73) in RCT-studies. Heterogeneity was high (I 2 > 75%) for all analyses except for RCTs (I 2 =0%). Conclusion: Although our meta-analysis identified the association between PPI use and increased risk of MI, results from RCTs did not agree with observational studies. Due to the mixed findings by study designs and high variation of heterogeneity among studies, the pharmacovigilance system should evaluate different levels of evidence to support decision making in safety of drug products.

Efficacy of Glucocorticoid Administration in Patients with Cardiac Arrest: A Systematic Review of Clinical Studies

2021 ◽  
Vol 28 ◽  
Author(s):  
Adeleh Sahebnasagh ◽  
Farhad Najmeddin ◽  
Atabak Najafi ◽  
Fatemeh Saghafi ◽  
Amin Salehi-Abargouei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cardiac Arrest ◽  
Observational Studies ◽  
Inflammatory Responses ◽  
Survival Rates ◽  
Small Sample ◽  
Endothelial Glycocalyx ◽  
Relative Adrenal Insufficiency ◽  
Cochrane Central Register

Background: The pathophysiology of cardiac arrest (CA) involves over-activation of systemic inflammatory responses, relative adrenal insufficiency, and glycocalyx damage. Corticosteroids have beneficial effects in preventing the perturbation of the endothelial glycocalyx. Objectives: The aim of this systematic review was to determine the efficacy of glucocorticoids in patients with cardiac arrest. Methods: We searched PubMed, Scopus, ISI Web of Science, Google Scholar and Cochrane central register for relevant clinical trials and cohort studies until September 2019. Results: We retrieved 7 peer-reviewed published studies for the systematic review. Two studies were clinical trials evaluating 147 patients, while five illustrated cohort design, evaluating 196,192 patients. In total, 196,339 patients were assessed. There was limited evidence and conflicting results to establish a correlation between glucocorticoids and the survival of patients suffering from cardiac arrest. However, the link between these medications and survival-to-admission, survival-to discharge, and 1-year survival rates was strong and consistent in observational studies. Conclusion: The clinical evidence regarding the efficacy and safety of glucocorticoids in CA is limited to observational studies with inconsistent methodology and few clinical trials with small sample size. Nevertheless, it seems that glucocorticoid supplementation during and after cardiopulmonary resuscitation (CPR) may have significant effects in terms of survival-to-admission, survival to discharge, 1-year survival rates and an improved return of spontaneous circulation (ROSC) rate, especially in patients with hemodynamic instability and cardiovascular diseases (i.e., refractory hemodynamic shock). Future studies with high-quality, large-scale, long-term intervention and precise baseline characteristics are needed to evaluate the exact effective dose, duration, and efficacy of glucocorticoids in CA.

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