scholarly journals Blood Lactate or Lactate Clearance: Which Is Robust to Predict the Neurological Outcomes after Cardiac Arrest? A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Bao-Chun Zhou ◽  
Zheng Zhang ◽  
Jian-Jun Zhu ◽  
Li-Jun Liu ◽  
Chun-Feng Liu
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Lactate Level ◽  
Web Of Science ◽  
Meta Analysis ◽  
Surrogate Marker ◽  
Lactate Clearance ◽  
Time Points ◽  
Neurological Outcomes ◽  
Lactate Levels

Aims. Lactate and lactate clearance were supposed to be associated with cardiac arrest outcomes, but studies obtained different results. Thus, we conducted this meta-analysis to investigate the association between lactate or lactate clearance and neurological outcomes and their usefulness for prediction of neurological outcomes. Methods. We conducted a systematic search in PubMed, Web of science, EMBASE, Medline, and Google Scholar until May 1, 2018, for relevant studies. Studies reporting lactate, lactate clearance on admission, or other time points after admission associated with neurological outcomes were included in our analysis. Pooled effect date was shown as weighed mean difference (WMD) and 95% confidence interval (CI). To measure the usefulness of lactate on admission to predict neurological outcomes, we also pooled the data of diagnostic test. Results. 23 studies involving 6720 cardiac arrest (CA) patients were included. Results from our analysis indicated that patients with good neurological outcomes tended to have a lower lactate level on admission (WMD: -2.66 mmol/L, 95%CI: -3.39 to -1.93) and 12h, 24h, and 48h after admission (P<0.001). Furthermore, the pooled AUC for lactate level on admission to predict neurological outcomes was 0.77 (95%CI: 0.73-0.80). However, a significant association between lactate clearance and neurological outcomes was only found in 24h but not 12h lactate clearance rate. Conclusions. Lactate levels on admission and all time points up to 48h were associated with neurological outcomes after CA, whereas the association between lactate clearance and neurological outcomes was not so stable. Lactate was a more robust surrogate marker than lactate clearance to predict neurological outcomes after CA.

scholarly journals Impact of Coronavirus Disease 2019 on Out-of-Hospital Cardiac Arrest Survival Rate: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 10 (6) ◽  
pp. 1209
Author(s):  
Magdalena J. Borkowska ◽  
Miłosz J. Jaguszewski ◽  
Mariusz Koda ◽  
Aleksandra Gasecka ◽  
Agnieszka Szarpak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Meta Analysis ◽  
Spontaneous Circulation ◽  
Neurological Outcomes ◽  
Substantial Risk ◽  
Bystander Cpr ◽  
Optimal Procedures ◽  
Favorable Neurological Outcome ◽  
Hospital Cardiac Arrest

Out-of-hospital cardiac arrest (OHCA) is a challenge for medical staff, especially in the COVID-19 period. The COVID-19 disease caused by the SARS-CoV-2 coronavirus is highly infectious, thus requiring additional measures during cardiopulmonary resuscitation (CPR). Since CPR is a highly aerosol-generating procedure, it carries a substantial risk of viral transmission. We hypothesized that patients with diagnosed or suspected COVID-19 might have worse outcomes following OHCA outcomes compared to non-COVID-19 patients. To raise awareness of this potential problem, we performed a systematic review and meta-analysis of studies that reported OHCA in the pandemic period, comparing COVID-19 suspected or diagnosed patients vs. COVID-19 not suspected or diagnosed group. The primary outcome was survival to hospital discharge (SHD). Secondary outcomes were the return of spontaneous circulation (ROSC), survival to hospital admission or survival with favorable neurological outcomes. Data including 4210 patients included in five studies were analyzed. SHD in COVID-19 and non-COVID-19 patients were 0.5% and 2.6%, respectively (odds ratio, OR = 0.25; 95% confidence interval, CI: 0.12, 0.53; p < 0.001). Bystander CPR rate was comparable in the COVID-19 vs. not COVID-19 group (OR = 0.88; 95% CI: 0.63, 1.22; p = 0.43). Shockable rhythms were observed in 5.7% in COVID-19 patients compared with 37.4% in the non-COVID-19 group (OR = 0.19; 95% CI: 0.04, 0.96; p = 0.04; I2 = 95%). ROSC in the COVID-19 and non-COVID-19 patients were 13.3% vs. 26.5%, respectively (OR = 0.67; 95% CI: 0.55, 0.81; p < 0.001). SHD with favorable neurological outcome was observed in 0% in COVID-19 vs. 3.1% in non-COVID-19 patients (OR = 1.35; 95% CI: 0.07, 26.19; p = 0.84). Our meta-analysis suggests that suspected or diagnosed COVID-19 reduces the SHD rate after OHCA, which seems to be due to the lower rate of shockable rhythms in COVID-19 patients, but not due to reluctance to bystander CPR. Future trials are needed to confirm these preliminary results and determine the optimal procedures to increase survival after OHCA in COVID-19 patients.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

scholarly journals Caffeine and Cognitive Functions in Sports: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 868
Author(s):  
Jorge Lorenzo Calvo ◽  
Xueyin Fei ◽  
Raúl Domínguez ◽  
Helios Pareja-Galeano
Keyword(s):  
Systematic Review ◽  
Reaction Time ◽  
Cognitive Performance ◽  
Cognitive Functions ◽  
Web Of Science ◽  
Meta Analysis ◽  
Caffeine Intake ◽  
Inclusion Criteria ◽  
Research Protocols ◽  
The Relationship

Cognitive functions are essential in any form of exercise. Recently, interest has mounted in addressing the relationship between caffeine intake and cognitive performance during sports practice. This review examines this relationship through a structured search of the databases Medline/PubMed and Web of Science for relevant articles published in English from August 1999 to March 2020. The study followed PRISMA guidelines. Inclusion criteria were defined according to the PICOS model. The identified records reported on randomized cross-over studies in which caffeine intake (as drinks, capsules, energy bars, or gum) was compared to an identical placebo situation. There were no filters on participants’ training level, gender, or age. For the systematic review, 13 studies examining the impacts of caffeine on objective measures of cognitive performance or self-reported cognitive performance were selected. Five of these studies were also subjected to meta-analysis. After pooling data in the meta-analysis, the significant impacts of caffeine only emerged on attention, accuracy, and speed. The results of the 13 studies, nevertheless, suggest that the intake of a low/moderate dose of caffeine before and/or during exercise can improve self-reported energy, mood, and cognitive functions, such as attention; it may also improve simple reaction time, choice reaction time, memory, or fatigue, however, this may depend on the research protocols.

A preliminary systematic review and meta-analysis on the effects of heart rate variability biofeedback on heart rate variability and respiration of athletes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jeffrey Cayaban Pagaduan ◽  
Yung-Sheng Chen ◽  
James William Fell ◽  
Sam Shi Xuan Wu
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Web Of Science ◽  
Meta Analysis ◽  
Academic Research ◽  
Experimental Studies ◽  
Quantitative Review ◽  
Heart Rate Variability Biofeedback ◽  
Randomized Control

Abstract To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16–30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.

scholarly journals SARS-CoV-2 genome and antibodies in breastmilk: a systematic review and meta-analysis

2021 ◽  
pp. fetalneonatal-2020-321074
Author(s):  
Faith Zhu ◽  
Carlos Zozaya ◽  
Qi Zhou ◽  
Charmaine De Castro ◽  
Prakesh S Shah
Keyword(s):  
Systematic Review ◽  
Outcome Measures ◽  
Study Design ◽  
Web Of Science ◽  
Meta Analysis ◽  
Respiratory Support ◽  
Common Finding ◽  
Rt Pcr

ObjectiveTo systematically review and meta-analyse the rate of SARS-CoV-2 genome identification and the presence of SARS-CoV-2 antibodies in breastmilk of mothers with COVID-19.DesignA systematic review of studies published between January 2019 and October 2020 without study design or language restrictions.SettingData sourced from Ovid Embase Classic+Embase, PubMed, Web of Science, Scopus, relevant bibliographies and the John Hopkins University COVID-19 database.PatientsMothers with confirmed COVID-19 and breastmilk tested for SARS-CoV-2 by RT-PCR or for anti-SARS-CoV-2 antibodies.Main outcome measuresPresence of SARS-CoV-2 genome and antibodies in breastmilk.ResultsWe included 50 articles. Twelve out of 183 women from 48 studies were positive for SARS-CoV-2 genome in their breastmilk (pooled proportion 5% (95% CI 2% to 15%; I2=48%)). Six infants (50%) of these 12 mothers tested positive for SARS-CoV-2, with one requiring respiratory support. Sixty-one out of 89 women from 10 studies had anti-SARS-CoV-2 antibody in their breastmilk (pooled proportion 83% (95% CI 32% to 98%; I2=88%)). The predominant antibody detected was IgA.ConclusionsSARS-CoV-2 genome presence in breastmilk is uncommon and is associated with mild symptoms in infants. Anti-SARS-CoV-2 antibodies may be a more common finding. Considering the low proportion of SARS-CoV-2 genome detected in breastmilk and its lower virulence, mothers with COVID-19 should be supported to breastfeed.

scholarly journals Glycemic Index of Gluten-Free Bread and Their Main Ingredients: A Systematic Review and Meta-Analysis

Foods ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 506
Author(s):  
Bernardo Romão ◽  
Ana Luísa Falcomer ◽  
Gabriela Palos ◽  
Sandra Cavalcante ◽  
Raquel Braz Assunção Botelho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Glycemic Index ◽  
Resistant Starch ◽  
Web Of Science ◽  
Meta Analysis ◽  
Gluten Free ◽  
Inclusion Criteria ◽  
Glycemic Profile

This study aimed to perform a systematic review and meta-analysis of the glycemic index (GI) of gluten-free bread (GFB) and its main ingredients. The systematic review followed PRISMA guidelines, using seven electronic databases (PubMed, EMBASE, Scopus, Science Direct, Web of Science, gray literature research with Google Scholar, and patents with Google Patent tool), from inception to November 2020. Eighteen studies met the inclusion criteria evaluating 132 GFB samples. Five articles tested GI in vivo, eleven in vitro; and two studies tested both methods. The analysis showed that 60.7% (95% CI: 40.2–78.1%) of the samples presented high glycemic indexes, evidencing a high glycemic profile for GFB. Only 18.2% (95% CI: 11.7–27.2%) of the bread samples presented in the studies were classified as a low GI. Meta-analysis presented moderate/low heterogenicity between studies (I2 = 61% and <1% for both high and low GIs) and reinforced the proportion of high GIs. Lower GIs were found in formulations based on Colocasia esculenta flour or enriched with fiber, yogurt and curd cheese, sourdough, psyllium, hydrocolloids, enzymes, fructans, and resistant starch, highlighting the efficacy of these ingredients to lower GFBs’ GI. GFB tends to present high GI, impacting the development of chronic diseases when consumed.

scholarly journals Structural and functional changes related to memory deficit in non-demential elderly individuals

2016 ◽  
Vol 49 (6) ◽  
pp. 533
Author(s):  
Nísea De A. Corrêa ◽  
Maria P. Foss ◽  
Paula R. B. Diniz
Keyword(s):  
Systematic Review ◽  
Web Of Science ◽  
Digit Span ◽  
Meta Analysis ◽  
Memory Deficit ◽  
Trail Making Test ◽  
Elderly Individuals ◽  
Functional Changes ◽  
Wechsler Memory Scale ◽  
Trail Making

Objetivo: Verificar as alterações estruturais e funcionais, evidenciadas através da imagem por ressonância magnética, relacionadas aos déficits de memória identificados em idosos normais, quando comparados a adultos jovens. Metodologia: Procedeu-se à revisão sistemática, cujo protocolo obedeceu ao fluxograma do Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Foram investigadas as bases de dados PubMed, Scopus, EBSCO, utilizando o gerenciador de referências JabRef, na versão 2.10, e o Web of Science, pelo website. Foram incluídos artigos de estudos quase experimentais, transversais, em coorte ou tipo caso-controle, publicados entre 2005 e 2014, em periódicos indexados nacionais e internacionais, cuja amostra incluísse idosos a partir de 60 anos, não dementes, submetidos à investigação de alterações estruturais e funcionais do sistema nervoso central, por ressonância magnética e sua associação com déficits de memória avaliados por testes neuropsicológicos. Resultados: Quanto à técnica de imagem empregada, identificaram-se dois estudos com imagem por ressonância magnética estrutural, seis estudos com utilização de imagem por ressonância magnética funcional, e quatro estudos que empregaram ambas as técnicas. Nos 12 estudos foi identificado o emprego de 38 testes neuropsicológicos distintos, com uma média de cinco testes por estudo, com variação de um a 12 testes. Dentre os testes mais usados, estiveram o WAIS Digit Span Backwards (em sete estudos), o Trail Making Test A and B (em quatro estudos) e o Wechsler Memory Scale (em quatro estudos). Conclusão: Os estudos demonstraram que no envelhecimento normal, ocorre redução do volume de substância branca para-hipocampal, do volume do hipocampo e do córtex entorrinal com redução de memória verbal, possivelmente por desmielinização das fibras; redução das vias que ligam o lobo temporal e frontal, contribuindo para a redução da memória episódica, da memória de trabalho e da fluência verbal; redução da supressão de informações irrelevantes, o que contribui para menor registro de informação; alterações das áreas frontal e parietal que comprometem a memória de reconhecimento; modificações na atividade e na conectividade do default mode network; reorganização das funções cognitivas, bem como alentecimento de resposta por provável redução de ativação do córtex pré- frontal

Does Early Coronary Angiography Improve Survival After out-of-Hospital Cardiac Arrest? A Systematic Review With Meta-Analysis

2018 ◽  
Vol 34 (2) ◽  
pp. 180-194 ◽  
Author(s):  
Michelle Welsford ◽  
Matthias Bossard ◽  
Colleen Shortt ◽  
Jodie Pritchard ◽  
Madhu K. Natarajan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Meta Analysis ◽  
Hospital Cardiac Arrest
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