scholarly journals Pharmacokinetics of antiretroviral and tuberculosis drugs in children with HIV/TB co-infection: a systematic review

2020 ◽  
Vol 75 (12) ◽  
pp. 3433-3457
Author(s):  
Tom G Jacobs ◽  
Elin M Svensson ◽  
Victor Musiime ◽  
Pablo Rojo ◽  
Kelly E Dooley ◽  
...  
Keyword(s):  
Systematic Review ◽  
Inclusion Criteria ◽  
Older Children ◽  
First Line ◽  
Once Daily ◽  
Tb Treatment ◽  
Current State ◽  
Trough Concentrations ◽  
The Many ◽  
Treatment Use

Abstract Introduction Management of concomitant use of ART and TB drugs is difficult because of the many drug–drug interactions (DDIs) between the medications. This systematic review provides an overview of the current state of knowledge about the pharmacokinetics (PK) of ART and TB treatment in children with HIV/TB co-infection, and identifies knowledge gaps. Methods We searched Embase and PubMed, and systematically searched abstract books of relevant conferences, following PRISMA guidelines. Studies not reporting PK parameters, investigating medicines that are not available any longer or not including children with HIV/TB co-infection were excluded. All studies were assessed for quality. Results In total, 47 studies met the inclusion criteria. No dose adjustments are necessary for efavirenz during concomitant first-line TB treatment use, but intersubject PK variability was high, especially in children <3 years of age. Super-boosted lopinavir/ritonavir (ratio 1:1) resulted in adequate lopinavir trough concentrations during rifampicin co-administration. Double-dosed raltegravir can be given with rifampicin in children >4 weeks old as well as twice-daily dolutegravir (instead of once daily) in children older than 6 years. Exposure to some TB drugs (ethambutol and rifampicin) was reduced in the setting of HIV infection, regardless of ART use. Only limited PK data of second-line TB drugs with ART in children who are HIV infected have been published. Conclusions Whereas integrase inhibitors seem favourable in older children, there are limited options for ART in young children (<3 years) receiving rifampicin-based TB therapy. The PK of TB drugs in HIV-infected children warrants further research.

scholarly journals Clinical effectiveness of first-line chemoradiation for adult patients with locally advanced non-small cell lung cancer: a systematic review

2013 ◽  
Vol 17 (6) ◽  
pp. 1-99 ◽  
Author(s):  
T Brown ◽  
G Pilkington ◽  
A Boland ◽  
J Oyee ◽  
C Tudur Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Advanced Nsclc ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Clinical Effectiveness ◽  
Adult Patients ◽  
Inclusion Criteria ◽  
Stage Iiia ◽  
First Line ◽  
Locally Advanced Nsclc

BackgroundThe National Institute for Health and Clinical Excellence has issued guidelines on the treatment of non-small cell lung cancer (NSCLC) and recommends that patients with stage IIIA–IIIB disease who are not amenable to surgery be treated with potentially curative chemoradiation (CTX-RT). This review was conducted as part of a larger systematic review of all first-line chemotherapy (CTX) and CTX-RT treatments for patients with locally advanced or metastatic NSCLC. However, it was considered that patients with potentially curable disease (e.g. stage IIIA) are different from those with advanced disease, who are suitable for palliative treatment only, and therefore the results should be reported separately.ObjectiveTo evaluate the clinical effectiveness of first-line CTX in addition to radiotherapy (RT) (CTX-RT vs CTX-RT) for adult patients with locally advanced NSCLC who are suitable for potentially curative treatment.Data sourcesThree electronic databases (MEDLINE, EMBASE and The Cochrane Library) were searched from January 1990 to September 2010.Review methodsInclusion criteria comprised adult patients with locally advanced NSCLC, trials that compared any first-line CTX-RT therapy (induction, sequential, concurrent and consolidation) and outcomes of overall survival (OS) and/or progression-free survival (PFS). The results of clinical data extraction and quality assessment were summarised in tables and with narrative description. Direct meta-analyses using OS data were undertaken where possible: sequential CTX-RT compared with concurrent CTX-RT; sequential CTX-RT compared with concurrent/consolidation CTX-RT; and sequential CTX-RT compared with concurrent CTX-RT with or without consolidation. There were not sufficient data to perform meta-analysis on PFS.ResultsOf the 240 potentially relevant studies that were published post 2000, 19 met the inclusion criteria and compared CTX-RT with CTX-RT. The results from the OS meta-analysis comparing sequential CTX-RT with concurrent CTX-RT appear to show an OS advantage for concurrent CTX-RT arms over sequential arms; this result is not statistically significant [hazard ratio (HR) 0.79; 95% confidence interval (CI) 0.50 to 1.25)]. The results from the OS meta-analysis comparing sequential CTX-RT with concurrent/consolidation CTX-RT appear to show a statistically significant OS advantage for concurrent/consolidation CTX-RT treatment over sequential treatment (HR 0.68; 95% CI 0.55 to 0.83). The results from the OS meta-analysis comparing sequential CTX-RT with concurrent CTX-RT with or without consolidation appear to show a statistically significant OS advantage for concurrent CTX-RT with or without consolidation over sequential treatment (HR 0.72; 95% CI 0.61 to 0.84).LimitationsThis report provides a summary and critical appraisal of a comprehensive evidence base of CTX-RT trials; however, it is possible that additional trials have been reported since our last literature search. It is disappointing that the quality of the research in this area does not meet the accepted quality standards regarding trial design and reporting.ConclusionsThis review identified that the research conducted in the area of CTX-RT was generally of poor quality and suffered from a lack of reporting of all important clinical findings, including OS. The 19 trials included in the systematic review were too disparate to form any conclusions as to the effectiveness of individual CTX agents or types of RT. The focus of primary research should be good methodological quality; appropriate allocation of concealment and randomisation, and comprehensive reporting of key outcomes, will enable meaningful synthesis and conclusions to be drawn.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals A Systematic Review of Commercial Smart Gloves: Current Status and Applications

Sensors ◽  
2021 ◽  
Vol 21 (8) ◽  
pp. 2667
Author(s):  
Manuel Caeiro-Rodríguez ◽  
Iván Otero-González ◽  
Fernando A. Mikic-Fonte ◽  
Martín Llamas-Nistal
Keyword(s):  
Degrees Of Freedom ◽  
Motion Tracking ◽  
Reference Model ◽  
Tactile Feedback ◽  
Current Status ◽  
Inclusion Criteria ◽  
Reference Models ◽  
Current State ◽  
Kinesthetic Feedback ◽  
The Many

Smart gloves have been under development during the last 40 years to support human-computer interaction based on hand and finger movement. Despite the many devoted efforts and the multiple advances in related areas, these devices have not become mainstream yet. Nevertheless, during recent years, new devices with improved features have appeared, being used for research purposes too. This paper provides a review of current commercial smart gloves focusing on three main capabilities: (i) hand and finger pose estimation and motion tracking, (ii) kinesthetic feedback, and (iii) tactile feedback. For the first capability, a detailed reference model of the hand and finger basic movements (known as degrees of freedom) is proposed. Based on the PRISMA guidelines for systematic reviews for the period 2015–2021, 24 commercial smart gloves have been identified, while many others have been discarded because they did not meet the inclusion criteria: currently active commercial and fully portable smart gloves providing some of the three main capabilities for the whole hand. The paper reviews the technologies involved, main applications and it discusses about the current state of development. Reference models to support end users and researchers comparing and selecting the most appropriate devices are identified as a key need.

scholarly journals Pharmacologic Treatment of Idiopathic Chilblains (Pernio): A Systematic Review

2021 ◽  
pp. 120347542199513
Author(s):  
Michelle Pratt ◽  
Farhan Mahmood ◽  
Mark G. Kirchhof
Keyword(s):  
Systematic Review ◽  
Pharmacologic Therapy ◽  
Pharmacologic Treatment ◽  
Inclusion Criteria ◽  
First Line ◽  
Therapeutic Trials ◽  
Preventative Measures ◽  
Topical Minoxidil ◽  
Study Population ◽  
Topical Glyceryl Trinitrate

Idiopathic chilblains is a cold-induced inflammatory condition that causes significant morbidity. When preventative measures alone are inadequate, oral nifedipine is generally recommended as first-line pharmacologic therapy. Given the natural course of this spontaneously remitting/relapsing condition, controls are needed to critically appraise studies and determine the value of treatments. We report a systematic review of placebo-controlled or comparative therapeutic trials for the treatment of idiopathic chilblains. Our search of PubMed, Embase, and Cochrane databases, identified 11 studies that met our inclusion criteria for a combined study population n = 576. Therapies included nifedipine, pentoxifylline, tadalafil, topical glyceryl trinitrate (GTN), topical minoxidil, diltiazem, corticosteroids, and vitamin D. There was moderate evidence to support the use of nifedipine and pentoxifylline in the treatment of severe or refractory cases of idiopathic chilblains, while other therapies had inadequate evidence or nonsignificant results compared to placebo.

scholarly journals Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-15 ◽  
Author(s):  
Sophia Yui Kau Fong ◽  
Qiong Gao ◽  
Zhong Zuo
Keyword(s):  
Systematic Review ◽  
Drug Interactions ◽  
Dietary Supplements ◽  
Dietary Supplement ◽  
Plasma Concentrations ◽  
Inclusion Criteria ◽  
First Line ◽  
Pharmacodynamic Interaction ◽  
Herbal Products ◽  
Therapeutic Outcomes

Background. Carbamazepine (CBZ) is a first-line antiepileptic drug which may be prone to drug interactions. Systematic review of herb- and food-drug interactions on CBZ is warranted to provide guidance for medical professionals when prescribing CBZ.Method. A systematic review was conducted on six English databases and four Chinese databases.Results. 196 out of 3179 articles fulfilled inclusion criteria, of which 74 articles were reviewed and 33 herbal products/dietary supplement/food interacting with CBZ were identified. No fatal or severe interactions were documented. The majority of the interactions were pharmacokinetic-based (80%). Traditional Chinese medicine accounted for most of the interactions (n=17), followed by food (n=10), dietary supplements (n=3), and other herbs/botanicals (n=3). Coadministration of 11 and 12 of the studied herbal products/dietary supplement/food significantly decreased or increased the plasma concentrations of CBZ. Regarding pharmacodynamic interaction, Xiao-yao-san, melatonin, and alcohol increased the side effects of CBZ while caffeine lowered the antiepileptic efficacy of CBZ.Conclusion. This review provides a comprehensive summary of the documented interactions between CBZ and herbal products/food/dietary supplements which assists healthcare professionals to identify potential herb-drug and food-drug interactions, thereby preventing potential adverse events and improving patients’ therapeutic outcomes when prescribing CBZ.

scholarly journals Criminal justice responses to child sexual abuse material offending: a systematic review and evidence and gap map

2021 ◽  
Author(s):  
Elizabeth Eggins ◽  
Lorraine Mazerolle
Keyword(s):  
Systematic Review ◽  
Sexual Abuse ◽  
Criminal Justice ◽  
Child Sexual Abuse ◽  
Criminal Justice System ◽  
Justice System ◽  
Future Research ◽  
Research Needs ◽  
Inclusion Criteria ◽  
Current State

This report provides the world’s first systematic review of criminal justice responses to child sexual abuse material (CSAM) offending. The systematic search identified 20,820 records, yielding eight eligible impact evaluations. Six studies focused on policing and two on the judicial arm of the criminal justice system. No correctional impact evaluations met our inclusion criteria. We qualitatively synthesise the evidence and use an evidence and gap map to visualise the current state of the evaluation evidence. Future research needs to prospectively design and rigorously evaluate evidence-informed interventions that are specifically tailored to CSAM offending.

scholarly journals Systematic Review and Network Meta-Analysis of Bevacizumab Plus First-Line Topotecan-Paclitaxel or Cisplatin-Paclitaxel Versus Non–Bevacizumab-Containing Therapies in Persistent, Recurrent, or Metastatic Cervical Cancer

2017 ◽  
Vol 27 (6) ◽  
pp. 1237-1246 ◽  
Author(s):  
Virginia M. Rosen ◽  
Ines Guerra ◽  
Mary McCormack ◽  
Angélica Nogueira-Rodrigues ◽  
Andre Sasse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Meta Analysis ◽  
Cervical Cancer Prevention ◽  
Standards Of Care ◽  
Inclusion Criteria ◽  
First Line ◽  
Recurrent Cervical Cancer ◽  
Random Effects Models ◽  
Fixed And Random Effects

ObjectiveDespite advances in cervical cancer prevention and diagnosis, outcomes for patients given a diagnosis of advanced and recurrent disease are poor. In the GOG240 trial, the addition of bevacizumab to paclitaxel-topotecan or paclitaxel-cisplatin has been shown to prolong survival compared with paclitaxel-topotecan or paclitaxel-cisplatin in patients with persistent, recurrent, or metastatic disease. However, standards of care vary between regions and countries. The purpose of this systematic review and network meta-analysis was to enable a comparison between bevacizumab + chemotherapy with multiple monotherapy or combination chemotherapy regimens in the treatment for women with advanced, recurrent, or persistent cervical cancer.Methods/MaterialsA systematic literature review was conducted to identify randomized or nonrandomized controlled trials of patients with recurrent, persistent, or metastatic cervical cancer published in English from 1999 to 2015. A feasibility study was performed to assess the heterogeneity of the trials, and a network meta-analysis was conducted. Fixed- and random-effects models were fitted to calculate the hazard ratio for overall survival (OS) for all pairwise comparisons and ranking of all interventions.ResultsTwenty-three studies (19 trials) met inclusion criteria and were included in the review. Sample sizes ranged from 69 to 452, and median patient age ranged from 45 to 53 years. There was a trend toward prolonged OS with cisplatin-paclitaxel-bevacizumab and topotecan-paclitaxel-bevacizumab compared with all non–bevacizumab-containing therapies. Cisplatin-paclitaxel-bevacizumab had the highest probability of being the most efficacious compared with all regimens (68.1%), and cisplatin monotherapy had the lowest (0%).ConclusionsThe results of this network meta-analysis show that bevacizumab in combination with paclitaxel-topotecan or paclitaxel-cisplatin is likely to prolong OS over other non–bevacizumab-containing chemotherapies (eg, paclitaxel-carboplatin), which were not included in the GOG240 trial. In patients with advanced, persistent, and recurrent cervical cancer, cisplatin-paclitaxel-bevacizumab and topotecan-paclitaxel-bevacizumab showed the highest efficacy in all regimens investigated in this analysis.

scholarly journals The Use of Health Technology to Enhance the Adherence of Tuberculosis Treatment: A Systematic Review

Jurnal NERS ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. 65
Author(s):  
Dwi Uswatun Sholikhah ◽  
Gevi Melliya Sari ◽  
Cahya Mustika Narendri ◽  
Sariati Sariati ◽  
Nora Dwi Purwanti
Keyword(s):  
Chronic Disease ◽  
Digital Technology ◽  
Relevant Literature ◽  
Health Technology ◽  
Tuberculosis Treatment ◽  
Inclusion Criteria ◽  
Disease Treatment ◽  
Preventive Effort ◽  
Tb Treatment ◽  
The Many

Introduction: Disobedience in the context of TB treatment is one of the major problems around the world. Many efforts have been made to improve the adherence to TB treatment; one of them is the utilization of health technology such as digital technology. The aim of the study was to identify the effectiveness of the use of health technology such as digital technology to improve treatment compliance.Methods: The literature review was used to identify the interventions and then the identification of the relevant literature was done by topic and title, obtaining the literature in full text form. The analysis of the results was drawn from the many interventions in the literature. There were 15 articles found from the systematic search performed in the Scopus, Proquest, Science direct, Spingerlink and Sage databases with an RCTs design. This was conducting by entering the keywords of adherence, promoting adherence, improving adherence, tuberculosis treatment, chronic disease, health technology, digital technology, mhealth and self-reminders.Results: The search was limited to journals from 2013 to 2018, with the inclusion criteria being the use health technology such as digital technology to improve the adherence to chronic disease treatment (TB treatment).Conclusion: There are several uses of health technology when it comes to improving the adherence to TB treatment that can be used as a promotive and preventive effort during the treatment of TB.

Adverse Effects of Natural Products: A Brief Pre-Systematic Review

2020 ◽  
Vol 01 ◽  
Author(s):  
Carla Pires ◽  
Ana Fernandes
Keyword(s):  
Systematic Review ◽  
Adverse Event ◽  
Natural Products ◽  
Adverse Events ◽  
In Vitro Study ◽  
Google Scholar ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Meta Analyses

Background: Natural products are commonly used for treating health problems. These products may be associated with adverse events, which are defined as "noxious and unintended response to a medicinal product" by the European Medicine Agency. Objectives: To identify studies describing at least one adverse event (or with potential to promote an adverse event) related to the use of natural products, as well as to describe the involved product(s) and adverse event(s). Methods: A pre-systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Keywords: "natural product(s)" and ["adverse drug reaction(s)" or "adverse effect(s)"]. Screened databases: PubMed, SciELO, DOAJ and Google Scholar. Inclusion criteria: papers describing at least one adverse event associated with the use of natural products and published between 2017 and 2019. Exclusion criteria: Repeated studies, reviews and papers written in other languages than English, Portuguese, French or Spanish. Results: 104 studies were identified (20 PubMed; 0 SciELO; 2 DOAJ; 82 Google Scholar), but only 10 were selected (4 PubMed and 6 Google Scholar): 1 in-vitro study; 2 non-clinical studies, 1 study reporting in-vitro and clinical data and 5 studies were cases reports. Globally, 997 reports of adverse drug reactions with natural products were identified, mainly non-severe cases. Conclusion: Since a limited number of studies was found, we conclude that adverse events due to natural products may be underreported, or natural products may have a good safety profile. This review contributes for assuring the safety of natural products consumers, by evaluating the knowledge/information on the potential adverse events and interactions of these products.

Individuality and Beyond

2019 ◽  
Author(s):  
Benedetta Zavatta
Keyword(s):  
Moral Autonomy ◽  
First Line ◽  
Philosophical Interpretation ◽  
Individual Personality ◽  
The World ◽  
Regulative Ideal ◽  
Personal Library ◽  
The Many ◽  
The Individual ◽  
The Impact

Based on an analysis of the marginal markings and annotations Nietzsche made to the works of Emerson in his personal library, the book offers a philosophical interpretation of the impact on Nietzsche’s thought of his reading of these works, a reading that began when he was a schoolboy and extended to the final years of his conscious life. The many ideas and sources of inspiration that Nietzsche drew from Emerson can be organized in terms of two main lines of thought. The first line leads in the direction of the development of the individual personality, that is, the achievement of critical thinking, moral autonomy, and original self-expression. The second line of thought is the overcoming of individuality: that is to say, the need to transcend one’s own individual—and thus by definition limited—view of the world by continually confronting and engaging with visions different from one’s own and by putting into question and debating one’s own values and certainties. The image of the strong personality that Nietzsche forms thanks to his reading of Emerson ultimately takes on the appearance of a nomadic subject who is continually passing out of themselves—that is to say, abandoning their own positions and convictions—so as to undergo a constant process of evolution. In other words, the formation of the individual personality takes on the form of a regulative ideal: a goal that can never be said to have been definitively and once and for all attained.

Sign in / Sign up

Export Citation Format

Share Document