scholarly journals Review on Effectiveness of Primary Prophylaxis in aPLs with and without Risk Factors for Thrombosis: Efficacy and Safety

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Nahid A. Qushmaq ◽  
Samar A. Al-Emadi
Keyword(s):  
Risk Factors ◽  
Antiphospholipid Antibodies ◽  
Thrombotic Event ◽  
Autoimmune Disorder ◽  
Primary Prophylaxis ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Pregnancy Morbidity ◽  
Traditional Risk Factors ◽  
The Cochrane Library

Context. Antiphospholipid antibodies syndrome is an autoimmune disorder that is characterized by the association between presence of antiphospholipid antibodies and risk of thrombosis and/or pregnancy morbidity. Objectives. To systematically review the evidence for primary prophylaxis in patients with antiphospholipids antibodies syndrome or APS with or without other traditional risk factors of thrombosis when they did not have any thrombotic event yet. Methods. PubMed, the Cochrane Library, and Allied Health Literature were searched for studies that examined the efficacy and safety of primary prophylaxis in aPL patients from 1990 to February 2013. We examined literature looking at patients with aPLs with other risk factors for thrombosis and aPLs with no additional risk factors for thrombosis. Conclusion. We concluded that, in patients with aPLs, primary prophylaxes with HCQ and aspirin have been observed to reduce the frequency of thrombotic events in the case of asymptomatic aPL-positive patients with SLE. We also in this study concluded that LDA was effective in patients with autoimmune diseases. Independent cardiovascular risk factors include autoimmune defects such as SLE, rheumatoid arthritis, and atherosclerosis, where overall venous thrombosis will be induced by systemic inflammation. This review concludes that HCQ is an effective primary approach when compared to aspirin.

scholarly journals Intravenous dexmedetomidine during spinal anaesthesia for caesarean section: A meta-analysis of randomized trials

2017 ◽  
Vol 45 (3) ◽  
pp. 924-932 ◽  
Author(s):  
Zeqing Bao ◽  
Chengmao Zhou ◽  
Xianxue Wang ◽  
Yu Zhu
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Nausea And Vomiting ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
The Cochrane Library

Objective To evaluate the efficacy and safety of spinal anaesthesia using dexmedetomidine for caesarean section. Methods PubMed, The Cochrane Library, and CNKI were searched for relevant literature. Results The incidence of nausea and vomiting in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.21, 95% CI: 0.12–0.35, P < 0.00001). No difference was found in the incidence of pruritus between the two groups (OR = 1.21, 95% CI: 0.36–4.09, P = 0.76).The dexmedetomidine group had a higher incidence of bradycardia than did the control group (OR = 2.20, 95% CI: 1.02–4.77, P = 0.05). The incidence of shivering in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.20, 95% CI: 0.13–0.32, P < 0.00001). The incidence of hypotension was not different between the two groups (OR = 0.88, 95% CI: 0.49–1.56, P = 0.65). Conclusion Dexmedetomidine can decrease the incidence of nausea, vomiting, bradycardia, and shivering with spinal anaesthesia during caesarean section.

scholarly journals Prevalence and Risk Factors of Thromboembolism among Patients With Coronavirus Disease-19: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 26 ◽  
pp. 107602962096708
Author(s):  
Belayneh Kefale ◽  
Gobezie T. Tegegne ◽  
Amsalu Degu ◽  
Melaku Tadege ◽  
Desalegn Tesfa
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
English Language ◽  
Meta Analysis ◽  
Thrombotic Event ◽  
Cochrane Library ◽  
Pooled Prevalence ◽  
D Dimer

Emerging evidence shows that the recent pandemic of coronavirus disease 19 (COVID-19) is characterized by coagulation activation and endothelial dysfunction. This increases the risk of morbidity, mortality and economic loss among COVID-19 patients. Therefore, there was an urgent need to investigate the extent and risk factors of thromboembolism among COVID-19 patients. English-language based databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and Cochrane library) were exhaustively searched to identify studies related to prevalence of thromboembolism among hospitalized COVID-19 patients. A random-effects model was employed to estimate the pooled prevalence of thromboembolism. The pooled prevalence of thrombotic events was computed using STATA 16.0 software. Heterogeneity analysis was reported using I2. A total of 19 studies with 2,520 patients with COVID-19 were included. The pooled prevalence of thrombotic events of hospitalized patients with COVID-19 was 33% (95% CI: 25-41%, I2 = 97.30%, p < 0.001) with a high degree of heterogeneity across studies. Elevated D-dimer hospitalized in the intensive care unit and being under mechanical ventilation were the most frequently associated factors for the development of thrombotic events. The pooled prevalence of thrombotic events in COVID-19 patients was 33%. The prevalence of thrombotic event is variables on the basis of study design and study centers. Several risk factors such as, elevated D-dimer, hospitalized in the intensive care unit and being under mechanical ventilation, were the most frequently reported risk factors identified. Therefore, healthcare professionals should consider these risk factors to optimally manage thromboembolism in COVID-19 patients.

Risk factors for a first thrombotic event in antiphospholipid antibody carriers. A multicentre, retrospective follow-up study

2008 ◽  
Vol 68 (3) ◽  
pp. 397-399 ◽  
Author(s):  
A Ruffatti ◽  
T Del Ross ◽  
M Ciprian ◽  
M Nuzzo ◽  
M Rampudda ◽  
...  
Keyword(s):  
Risk Factors ◽  
Thrombotic Event ◽  
Multivariate Logistic Regression Analysis ◽  
Anticardiolipin Antibody ◽  
Primary Prophylaxis ◽  
Antiphospholipid Antibody ◽  
History Of ◽  
Independent Risk Factors

Objectives:To asses risk factors for a first thrombotic event in antiphospholipid antibody (aPL) positive carriers and evaluate the efficacy of prophylactic treatments.Methods:Recruitment criteria were age 18–65 years, no history of thrombosis, positivity for lupus anticoagulant and/or IgG/IgM anticardiolipin antibody (aCL) on ⩾2 occasions at least 6 weeks apart. Demographic, laboratory and clinical parameters were collected at enrolment and at the time of the thrombotic event.Results:370 patients/subjects (mean (SD) age 34 (9.9) years) were analysed retrospectively for a mean (SD) follow-up of 59.3 (45.5) months. Thirty patients (8.1%) developed a first thrombotic event during follow-up. Hypertension and medium/high levels of IgG aCL were identified by multivariate logistic regression analysis as independent risk factors for thrombosis. Thromboprophylaxis during high-risk and long-term periods was significantly protective.Conclusions:Hypertension or medium/high titres of IgG aCL are risk factors for a first thrombotic event in asymptomatic aPL carriers and primary prophylaxis is protective.

scholarly journals Molecular markers of acute kidney injury (review)

2021 ◽  
pp. 24-33
Author(s):  
Л.Д. Мальцева ◽  
Д.Ю. Лакомова ◽  
Д.А. Морозов ◽  
Н.Б. Захарова ◽  
З.Ш. Манасова ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Molecular Markers ◽  
Early Diagnosis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
Early Stages ◽  
High Incidence ◽  
Low Sensitivity ◽  
The Cochrane Library

Несмотря на высокую частоту встречаемости острого повреждения почек (ОПП), диагностика его ранних этапов затруднена в связи с низкой чувствительностью и специфичностью стандартных методов исследования. Общеклинические и биохимические показатели крови и мочи не позволяют прогнозировать течение и исход патологии. Целью данного обзора явилась систематизация литературных данных относительно молекулярных маркёров ОПП. Проведён анализ белее ста источников по таким базам индексирования, как Scopus, MEDLINE, The Cochrane Library. Учитывались как факторы риска возникновения и прогрессирования заболевания, так и механизмы развития ОПП, а также маркеры его диагностики и прогноза исходов. Подробно представлены генетические аспекты возникновения и развития ОПП и перспективные методы ранней диагностики. Установлена возможность использования молекулярных маркёров для определения степени тяжести процесса. Предполагается, что идентификация конкретных генов и биомаркёров начальных стадий ОПП улучшит диагностику и поможет прогнозировать течение заболевания и его исходы. Despite the high incidence of acute kidney injury (AKI), diagnosis of its early stages is difficult due to low sensitivity and specificity of standard study methods. General clinical and biochemical blood and urine tests cannot predict the course and outcome of the disease. The aim of this review was to systematize reports of molecular markers for AKI. More than a hundred sources indexed in Scopus, MEDLINE, and Cochrane Library were analyzed. Both risk factors of AKI onset and progression and its mechanisms, and its diagnostic and predictive markers were included in the analysis. The review focused on genetic aspects of AKI onset and development and on promising methods for early diagnosis. A possibility of using molecular markers to determine the AKI severity has been demonstrated. The authors suggested that identifying specific genes and biomarkers for early stages of AKI would improve the diagnosis and the prediction of AKI course and outcome.

scholarly journals Robotic-Assisted vs. Open Simple Prostatectomy for Large Prostates: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhongyou Xia ◽  
Jinze Li ◽  
Xiaoying Yang ◽  
Hao Jing ◽  
Chao Niu ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Similar Efficacy ◽  
Prostatic Hyperplasia ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Robotic Assisted ◽  
Simple Prostatectomy ◽  
The Cochrane Library ◽  
Large Prostate ◽  
Review Manager

Purpose: To compare the efficacy and safety of robotic-assisted simple prostatectomy and open simple prostatectomy for large benign prostatic hyperplasia.Methods: We systematically searched the Cochrane Library, PubMed, Embase, and Science databases for studies published through December 2020. Controlled trials on RASP and OSP for large prostates were included. The meta-analysis was conducted with the Review Manager 5.4 software.Results: A total of seven studies with 3,777 patients were included in the analysis. There were no significant differences in IPSS (WMD, 0.72; 95%CI: −0.31, 1.76; P = 0.17), QoL (WMD, 0.00; 95%CI: −0.39, 0.39; P &gt; 0.99), Qmax (WMD, 1.88; 95% CI: −1.15, 4.91; P = 0.22), or PVR (WMD, −10.48; 95%CI: −25.13, 4.17; P = 0.16) among patients undergoing RASP and OSP. However, compared with patients who underwent OSP, patients who underwent RASP had a shorter LOS (WMD, −2.83; 95%CI: −3.68, −1.98; P &lt; 0.001), less EBL (WMD, −304.68; 95% CI: −432.91, −176.44; P &lt; 0.001), a shorter CT (WMD, −2.61; 95%CI: −3.94, −1.29; P &lt; 0.001), and fewer overall complications (OR, 0.30; 95% CI: 0.16, 0.57; P &lt; 0.001). Nevertheless, RASP was associated with a longer OT (WMD, 59.69, 95% CI: 49.40, 69.98; P &lt; 0.001).Conclusion: The results of the current study demonstrated that RASP provided similar efficacy to those of OSP in the treatment of large prostate, while maintaining better security. Our findings indicate that RASP is a feasible and effective alternative to OSP.

scholarly journals Risk Factors of Invasive Fungal Infection in Recipients After Liver Transplantation: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Min Liu ◽  
Zhijun Zhu ◽  
Liying Sun
Keyword(s):  
Risk Factors ◽  
Liver Transplantation ◽  
Fungal Infection ◽  
Invasive Fungal Infection ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Fungal Colonization ◽  
Newcastle Ottawa Scale ◽  
The Cochrane Library

Objectives: Invasive fungal infection (IFI) remains an important cause of mortality in liver transplantation (LT). The objective of this meta-analysis was to identify the risk factors for IFI after LT.Methods: We searched for relevant studies published up to June 2020 from PubMed, Web of Science, Embase, and the Cochrane Library. Odds ratios (ORs) and their corresponding 95% CIs were used to identify significant differences in the risk factors. Heterogeneity between studies was evaluated by the I2 test, and potential publication bias was assessed with Egger's test. The quality of included studies was evaluated with the Newcastle-Ottawa Scale (NOS).Results: A total of 14 studies enrolling 4,284 recipients were included in the meta-analysis. Reoperation (OR = 2.18, 95% CI: 1.61–2.94), posttransplantation dialysis (OR = 2.03, 95% CI: 1.52–2.72), bacterial infection (OR = 1.81, 95% CI: 1.33–2.46), live donor (OR = 1.78, 95% CI: 1.20–2.63), retransplantation (OR = 2.45, 95% CI: 1.54–3.89), and fungal colonization (OR = 2.60, 95% CI: 1.99–3.42) were associated with the risk factors of IFI after LT.Conclusions: Despite some risk factors that have been identified as significant factors for IFI post-LT, which may inform prevention recommendations, rigorous and well-designed studies with adequate sample sizes should be conducted to solve the limitations of this study.

scholarly journals Prevalence of the Antiphospholipid Antibodies in Young Adults with Ischemic Stroke

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4952-4952
Author(s):  
Antonella Vaccarino ◽  
Maria Pagliaro ◽  
Clara Rollone ◽  
Fabio Melis ◽  
Federica De Marco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Cardiovascular Risk ◽  
Ct Scan ◽  
Cardiovascular Risk Factors ◽  
Antiphospholipid Antibodies ◽  
Thrombotic Event ◽  
Ischemic Lesion ◽  
Number Of Patients

Background: Ischemic stroke is rare in young adults, with an incidence of about 10-15% of all the ischemic strokes. In about one third of these patients a cause is missing. Among patients with antiphospholipid antibodies syndrome (APS), stroke is the first thrombotic event in about 13% of cases. Aims of our project were: to evaluate the prevalence of antiphosfolipid antibodies (aPL),to investigate on the prevalence of conventional risk factors and to define the radiological characteristics of the ischemic lesion. Materials and methods: this is a no profit, observational multicenter prospective study. Inclusion criteria were: age older than 18 and younger than 55 years, informed written consent, a clinical and radiological diagnosis of stroke. Patient's data were collected at diagnosis and after 30 days from stroke. If any aPL positivity was found the patient was referred to our service to further/eventually confirm the diagnosis of APS. For each patient these data were collected: age, sex, body mass index, personal and familial history, concomitant co morbidities and therapies, cardiovascular risk factors, drug abuse. CT scan or angioCT or MRI was always performed at diagnosis, aPL profile was determined at diagnosis and eventually confirmed after 12 weeks according to the Sapporo criteria. None of the patients had a previous diagnosis of APS. Results: enrolled patients from January 2017 to December2018 were 46 out of 425 ischemic stroke (10.8%). We found 11/46 aPL positivity patients. Among these patients, 7 were confirmed at 12 weeks (15%). Baselines characteristics of the study population are detailed in table 1. We found a high prevalence of associated conventional cardiovascular risk factors: hypertension (56%), dyslipidemia ( 50%), obesity (55%), smoke ( 52%). We didn't find any correlation between APS and a clear radiological pattern on MRI and CT scan. Conclusions: Prevalence of APS was 15% in our cohort of young patients with stroke, 85% of which had an high risk aPL profile. The detection frequency is similar to the recent APS-ACTION and literature findings. In our cohort stroke was a relapse of a previous ischemic event in 24% of the patients, while in 15% there was a stroke's relapse. Even if these data should be confirmed with a wider number of patients, it seems to be useful to evaluate the presence of aPL in a young patient with ischemic stroke . Disclosures No relevant conflicts of interest to declare.

scholarly journals Efficacy and safety of iron supplementation in patients with heart failure and iron deficiency: a meta-analysis

2019 ◽  
Vol 121 (8) ◽  
pp. 841-848 ◽  
Author(s):  
Shuo Zhang ◽  
Fengxiao Zhang ◽  
Meng Du ◽  
Kun Huang ◽  
Cheng Wang
Keyword(s):  
Heart Failure ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Fixed Effects Model ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Randomised Control Trials ◽  
The Cochrane Library

AbstractFe therapy can be effective in heart failure patients both with and without anaemia. However, the role of Fe therapy in such patients is still uncertain. In this review, the aim was to evaluate the efficacy and safety of Fe therapy in adult patients with heart failure who have reduced ejection fraction (HFrEF). Multiple databases (PubMed, Medline, EMBASE, the Cochrane Library and Clinical Trials) were searched up to December 2017 and the reference lists of relevant articles obtained from the search were reviewed. Data extracted from randomised control trials (RCT) selected for the review were pooled using a fixed effects model or a random effects model, according to heterogeneity between trials. Nine RCT were included in this meta-analysis which included a total of 789 patients who received Fe therapy and who in turn were compared with 585 controls. There was significant improvement in the 6-min walk test (19·05 m, 95 % CI 10·48, 27·62) and peak VO2/kg (0·93 ml/kg per min, 95 % CI 0·16, 1·69) in the Fe supplementation arm. With Fe therapy, fewer patients were hospitalised for heart failure (OR: 0·42, 95 % CI 0·27, 0·65), but no relationship was found for total re-hospitalisation (OR: 0·70, 95 % CI 0·32, 1·51) or mortality (OR: 0·70, 95 % CI 0·38, 1·28). Fe therapy has the potential to improve exercise tolerance, reduce re-hospitalisations for patients with HFrEF having Fe deficiency. In addition, Fe supplementation was found to be safe, with no increased rate of adverse events.

AB0471 Risk Factors for Pregnancy Morbidity in Patients with Antiphospholipid Antibodies without A Defined Clinical Antiphospholipid Syndrome

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1067.1-1067
Author(s):  
R. Demetrio Pablo ◽  
P. Muñoz ◽  
L. Riancho-Zarrabeitia ◽  
V. Calvo-Río ◽  
M. Lόpez-Hoyos ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Pregnancy Morbidity

scholarly journals The efficacy and safety of bamlanivimab treatment against COVID-19: A meta-analysis

2021 ◽  
Author(s):  
Huairong Xiang ◽  
Bei He ◽  
Yun Li ◽  
Xuan Cheng ◽  
Qizhi Zhang ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Observational Studies ◽  
Randomized Clinical Trials ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Positive Treatment ◽  
The Cochrane Library

Background: Bamlanivimab is routinely used in the treatment of coronavirus disease 2019 (COVID-19) in worldwide. We performed a meta-analysis to investigate the efficacy and safety of bamlanivimab treatment in patients with COVID-19. Methods: We searched articles from Web of Science, PubMed, Embase, the Cochrane Library and MedRxiv between 30 January 2020 and August 5, 2021. We selected randomized clinical trials (RCTs) and observational studies with a control group to assess the efficiency of bamlanivimab in treating patients with COVID-19. Results: Our meta-analysis retrieved 3 RCTs and 7 cohort studies including 14461 patients. Bmlanivimab may help outpatients to prevent hospitalization or emergency department visit (RR 0.41 95%CI 0.29 to 0.58), reduce ICU admission (RR 0.47 95%CI 0.23 to 0.92) and mortality (RR 0.32 95%CI 0.13 to 0.77) from the disease. The combination of bamlanivimab and etesevimab may had a greater potential for positive treatment outcome. Conclusion: Bamlanivimab has demonstrated clinical efficacy on mild or moderate ill patients with COVID-19 to prevent hospitalization, reduce severity and mortality from the disease. Combinations of two or more monoclonal antibody increase the effect. Well-designed clinical trials to identify the clinical and biochemical characteristics in COVID-19 patients'population that could benefit from bamlanivimab are warranted in the future.

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