Abstract W P318: Declining Mortality in Cerebral Venous Thrombosis: A Systematic Review

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jonathan M Coutinho ◽  
Susanna M Zuurbier ◽  
Jan Stam
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Low Income ◽  
Cerebral Venous Thrombosis ◽  
Inverse Correlation ◽  
Low Income Countries ◽  
Single Center ◽  
Clear Trend ◽  
Only Children ◽  
Number Of Patients

Introduction: Cerebral venous thrombosis (CVT) is nowadays considered a disease with a good outcome in most cases, but in the past these patients were believed to have a grave prognosis. This apparent decline in mortality has not been investigated systematically Methods: We performed a systematic review of the literature. Older studies were identified from books and by scanning reference lists. Studies with 40 CVT patients or more that minimally reported mortality at discharge were eligible. Care was taken to exclude duplicate publications based on the same patient cohort. Studies were ranked according to the year halfway the period of patient inclusion. If no time span was reported, we assumed a period of inclusion of 10 years prior to the year of publication. Results: Of 4.585 potentially eligible studies, 74 fulfilled the selection criteria and were included in the analysis. The majority of studies were retrospective (80%) and single-center (59%). In total, 23.031 patients were included in the analysis. The number of patients per study varied from 40 to 11.400 (median 79). Seven studies included only children. There was a significant inverse correlation between mortality and year of patient recruitment (Pearson’s correlation coefficient -0.70, p<0.001, figure). In a sensitivity analysis, exclusion of retrospective studies, pediatric studies, single-center studies, or studies from low income countries did not significantly alter the correlation. Conclusions: There is a clear trend in declining mortality among patients with CVT over time. Possible explanations include better diagnosis (with identification of less severe cases), improved treatment and a declining incidence of infection related CVT.

Rivaroxaban for the treatment of cerebral venous thrombosis: a single-center experience

2021 ◽  
Author(s):  
Zoltan Bajko ◽  
Smaranda Maier ◽  
Anca Motataianu ◽  
Rares Cristian Filep ◽  
Adina Stoian ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Single Center ◽  
Single Center Experience

A commentary on “Economic impact of surgery on households and individuals in low income countries: A systematic review” (Int J Surg 2021; 90: 105956)

2021 ◽  
pp. 105991
Author(s):  
Michael Gregorio Ortega-Sierra ◽  
María del Carmen Castillo-Montalvo ◽  
Jesús Alberto Manotas-Berdugo ◽  
Jonhatan Guillermo Jiménez-Chimá ◽  
Maria Paz Bolaño-Romero
Keyword(s):  
Systematic Review ◽  
Economic Impact ◽  
Low Income ◽  
Low Income Countries

scholarly journals A Systematic Review of Neurosurgical Care in Low-Income Countries

2020 ◽  
Vol 5 ◽  
pp. 100068
Author(s):  
Hannah K. Weiss ◽  
Roxanna M. Garcia ◽  
Jesutofunmi A. Omiye ◽  
Dominique Vervoort ◽  
Robert Riestenberg ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Income ◽  
Low Income Countries

scholarly journals Quantifying the under-estimation of cervical Cancer in remote regions of Tanzania

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Mariah P. Gesink ◽  
Robert M. Chamberlain ◽  
Julius Mwaiselage ◽  
Crispin Kahesa ◽  
Kahima Jackson ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Low Income ◽  
Population Based ◽  
Capital City ◽  
Low Income Countries ◽  
Treatment Center ◽  
Large Country ◽  
Number Of Patients ◽  
Sub Saharan ◽  
Radiotherapy Treatment

Abstract Background Cervical cancer is the most common cancer among women in Sub-Saharan countries, including Tanzania. While early detection and diagnosis are available in some parts of this large country, radiotherapy has been only available at the Ocean Road Cancer Institute (ORCI), in the capital city of Dar es Salaam and is just starting in a few regions. Methods The objective of this study was to compare the observed incidence of cervical cancer for the two remote regions of Mwanza in western Tanzania and Mbeya in southern Tanzania, based on their patients treated at the ORCI from 2011 to 2014. Results: The number patients referred and treated at ORCI were (120 from Mwanza, and 171 from Mbeya, representing 24.6 and 32.8% of the patients histopathologically confirmed in the two sites, respectively. The results showed significant underestimation of cervical cancer in the two regions. The vast majority of patients who were histopathologically-confirmed in their local regions (73.92% from Mwanza and 65.1% from Mbeya), but did not receive the needed radiotherapy treatment at the ORCI. The estimated incidence for the two regions based on the number of patients treated at the ORCI were underestimated by 53.9% for Mwanza and 68.9% for Mbeya. Conclusions Local establishment of radiotherapy treatment facilities in remote regions in Tanzania and similar other low-income countries is essential for providing effective treatment and improving survival of diagnosed cervical cancer patients. Linkage between the records of local remote hospitals and the main cancer treatment center in the capital city can also help support the emerging the population-based cancer registry at ORCI.

scholarly journals Challenges of Virtual Medical Sciences Education during the COVID-19 Pandemic: A Systematic Review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Farhad Salari ◽  
Vida Sepahi
Keyword(s):  
Systematic Review ◽  
Medical Education ◽  
Low Income ◽  
Virtual Education ◽  
Low Income Countries ◽  
Medical Sciences ◽  
Study Selection ◽  
E Learning ◽  
Multiple Challenges ◽  
Sudden Transition

Context: Since the onset of the COVID-19 pandemic, there have been numerous higher education challenges. Medical universities have been urged to dispel students from educational and clinical settings and led them toward virtual education. This sudden transition has been accompanied by multiple challenges. Objectives: The present study aimed to evaluate the challenges of virtual medical education in the COVID-19 pandemic. Study Selection: This systematic review was performed by reviewing the current literature on the research subject and the studies conducted in this regard during March 2019 to April 2021 by searching via five key search engines and databases, including Google Scholar, ScienceDirect, PubMed, Scopus, and ERIC. Results: In total, 23 studies were assessed, and different virtual education challenges in medical universities were classified into three categories of structural challenges, student-related challenges, and teacher-related challenges. In addition, strategies were proposed for overcoming the identified challenges. Conclusions: Since medical education was not properly pursued before the COVID-19 pandemic and the necessary infrastructures are lacking in this area, designing and implementing such programs could bring about fundamental challenges in several countries (especially developing and low-income countries), thereby decreasing their success rate. On the other hand, the coronavirus crisis could be an opportunity to identify the weaknesses, shortcomings, and infrastructural deficiencies in e-learning and address these issues effectively.

scholarly journals International barriers and facilitators for cervical cancer screening among young people: a systematic review

2021 ◽  
Author(s):  
Abirami Kirubarajan ◽  
Shannon Leung ◽  
Xinglin Li ◽  
Matthew Yau ◽  
Mara Sobel
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Young People ◽  
Cervical Cancer Screening ◽  
Low Income ◽  
Healthcare Providers ◽  
Barriers And Facilitators ◽  
Low Income Countries ◽  
Age Group

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

scholarly journals Clinical effectiveness of drugs in hospitalized patients with COVID-19 infection: a systematic review and meta-analysis.

2020 ◽  
Author(s):  
Roberto Ariel Abeldano Zuniga ◽  
Silvia Coca ◽  
Giuliana Abeldano ◽  
Ruth Ana Maria Gonzalez Villoria
Keyword(s):  
Systematic Review ◽  
Clinical Improvement ◽  
Low Income ◽  
Randomized Clinical Trials ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Hospitalized Patients ◽  
Low Income Countries ◽  
Qualitative Synthesis

Objective. The aim was to assess the clinical effectiveness of drugs used in hospitalized patients with COVID-19 infection. Method. We conducted a systematic review of randomized clinical trials assessing treatment with remdesivir, chloroquine, hydroxychloroquine, lopinavir, ritonavir, dexamethasone, and convalescent plasma, for hospitalized patients with a diagnosis of SARS-CoV-2 infection. The outcomes were mortality, clinical improvement, duration of ventilation, duration of oxygen support, duration of hospitalization), virological clearance, and severe adverse events. Results. A total of 48 studies were retrieved from the databases. Ten articles were finally included in the data extraction and qualitative synthesis of results. The meta-analysis suggests a benefit of dexamethasone versus standard care in the reduction of risk of mortality at day 28; and the clinical improvement at days 14 and 28 in patients treated with remdesivir. Conclusions. Dexamethasone would have a better result in hospitalized patients, especially in low-resources settings. Significance of results. The analysis of the main treatments proposed for hospitalized patients is of vital importance to reduce mortality in low-income countries; since the COVID-19 pandemic had an economic impact worldwide with the loss of jobs and economic decline in countries with scarce resources. Keywords: Drugs; Antivirals; Clinical improvement; Mortality; COVID-19; SARS-CoV2.

scholarly journals Cerebral Venous Thrombosis Case Series at a Tertiary Care Hospital: Exploring Treatment Safety and Efficacy of Direct Oral Anticoagulants

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3658-3658
Author(s):  
Mohammed Abdullah Alsheef ◽  
Mukhtar Alomar ◽  
Abdul Rehman Z. Zaidi ◽  
Ghaydaa Juma Kullab ◽  
Mohammed AlHazzaa ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Tertiary Care ◽  
Case Series ◽  
Case Report Form ◽  
Care Hospital ◽  
Safety And Efficacy ◽  
Number Of Patients

Background: Cerebral venous thrombosis (CVT) is an uncommon cause of stroke that mainly affects young adults and children. Initial treatment with heparin followed by wafarin is the mainstay of treatment. Only insufficient experience is available for direct oral anticoagulants (DOACs). Aims: The study aims to demonstrate the efficacy and safety of DOACs such as (Rivaroxaban and Dabigatran) in patients with objectively confirmed CVT. Methods: Data of 46 cases of CVT collected using a standardized case report form. Inclusion criteria were patients diagnosed with CVT, confirmed by CT or MRI imaging. Results: The total number of patients was 46 (9 males and 37 females). The mean age of the patients was 35.2± 5 years. The most common clinical manifestations among our patients were headache followed by seizure. 52% of cases were unprovoked, while 48% were provoked by pregnancy and oral contraceptive pills. Superior sagittal sinus (55%) and transverse sinus (44.9%) were the most common sites. Involvement of more than three venous sinuses was 34.8%. Thrombophilic abnormality was detected in 21.7% of patients. Initiation of anticoagulation (AC) was mostly low molecular weight heparin (LMWH) (80%), followed by unfractionated heparin (UFH) (17.7%) and fondaparinex (2%). Maintenance AC with Rivaroxaban after heparin (LMWH/UFH) was in 63% of our patients, the rest were switched from Warfarin to Rivaroxaban (34.8%), and one was treated by Dabigatran (2%). CVT recurrence was observed in one patient. Major bleeding (according to ISTH criteria) was not reported in our case series. Conclusions: DOACs demonstrated good safety and efficacy profile and can potentially replace warfarin in CVT patients. Disclosures No relevant conflicts of interest to declare.

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