Bisoprolol: Is This Just Another Beta-Blocker for Hypertension or Angina?

1995 ◽  
Vol 29 (4) ◽  
pp. 403-414 ◽  
Author(s):  
Thomas E Johns ◽  
Larry M Lopez
Keyword(s):  
Beta Blockers ◽  
Data Extraction ◽  
Renal Plasma Flow ◽  
Experimental Studies ◽  
Plasma Lipid ◽  
Plasma Renin ◽  
Intrinsic Sympathomimetic Activity ◽  
Study Selection ◽  
Blood Pressures ◽  
Dose Combination

Objective: To review the pharmacology, pharmacokinetics, and clinical experience with bisoprolol and make recommendations regarding its potential clinical usefulness, as well as considerations for formulary inclusion. To review the clinical pharmacology of torsemide and to compare it with currently available loop diuretics, particularly furosemide. Data Sources: Reference citations were sought from Index Medicus and Science Citation Index. Data were collected from abstracts and articles describing experimental studies or blind clinical trials. Study Selection: Studies designed in a randomized, blind, and placebo-controlled manner were emphasized. Studies also were included if bisoprolol was evaluated comparatively with other agents in a randomized, blind fashion. Data Extraction: Data from human studies published in English were evaluated. Studies were assessed by sample size and the clarity of descriptions of methods and results. Data Synthesis: Bisoprolol reduces systolic and diastolic blood pressures in patients with hypertension for a 24-hour dosing interval and is associated with beneficial hemodynamic effects in patients with myocardial ischemia. It is devoid of intrinsic sympathomimetic activity and membrane-stabilizing effects at therapeutic dosages. In patients with hypertension, bisoprolol diminishes plasma renin activity, platelet aggregation, effective renal plasma flow, and creatinine clearance. Bisoprolol has minimal effects on glucose tolerance and plasma lipid profiles. Monotherapy with bisoprolol is as effective as with atenolol, nitrendipine, or nifedipine. Low-dose combination therapy with hydrochlorothiazide is at least as effective as either bisoprolol or hydrochlorothiazide alone. Preliminary experience in the management of angina pectoris suggests that bisoprolol is at least as efficacious as atenolol or verapamil. Thus far, reported adverse effects are similar to those of other beta-blockers. No clinically important drug interactions have been reported at this time. Conclusions: Bisoprolol, alone or in combination with hydrochlorothiazide, is safe and effective for the short-term management of hypertension. Its efficacy in the management of stable angina requires further investigation. There is little clinical evidence that distinguishes bisoprolol from other beta-blockers; therefore, its inclusion on an institutional formulary is not recommended.

Nebivolol/Valsartan: A Novel Antihypertensive Fixed-Dose Combination Tablet

2018 ◽  
Vol 53 (4) ◽  
pp. 402-412
Author(s):  
Dawn Battise ◽  
Cassie L. Boland ◽  
Donald S. Nuzum
Keyword(s):  
Human Subjects ◽  
Data Extraction ◽  
Plasma Renin ◽  
Phase Iii ◽  
Fixed Dose ◽  
Combination Tablet ◽  
Study Selection ◽  
Dose Combination ◽  
Clinically Significant ◽  
The Individual

Data Sources: A PubMed (1966 to October 2018) search was conducted using the following keywords: nebivolol, valsartan, and hypertension (HTN). Additional sources were identified by references. Study Selection and Data Extraction: Articles written in English were included if they evaluated the pharmacology, pharmacokinetics, efficacy, safety, or place in therapy of nebivolol/valsartan in human subjects. Data Synthesis: Most patients with HTN require combination therapy; however, β-adrenergic antagonists and AII type 1 receptor blockers have been considered less effective because of overlapping mechanisms of action. A phase III, randomized trial demonstrated that nebivolol/valsartan produced statistically significant blood pressure (BP) lowering as compared with monotherapy with the individual components or placebo. Substudy analyses confirmed this among subgroups and demonstrated that nebivolol/valsartan decreased plasma renin and aldosterone levels. One trial reported continued BP lowering at 52 weeks. Another study showed that nebivolol/valsartan had similar additivity scores as compared with other antihypertensive combinations. Relevance to Patient Care and Clinical Practice: This review discusses drug information, efficacy, and safety of nebivolol/valsartan and discusses its clinical relevance as a novel combination product in managing patients with HTN. Conclusion: Nebivolol/valsartan combination may offer a benefit to patients with an indication for both classes who desire to decrease pill burden. Although BP lowering was statistically significant in comparison to the individual components as monotherapy, the combination does not offer clinically significant benefits that would elevate its place in HTN management.

scholarly journals Vulnerability and informal caregiver: a scoping review

2021 ◽  
Author(s):  
Landoni Marta ◽  
Petrovic Milica ◽  
Ionio Chiara ◽  
Gaggioli Andrea
Keyword(s):  
Informal Care ◽  
Scoping Review ◽  
Data Extraction ◽  
Informal Caregivers ◽  
Experimental Studies ◽  
Future Research ◽  
List Type ◽  
Human Beings ◽  
Study Selection ◽  
Emotional Vulnerability

AbstractObjectiveThis review paper examines the concept of vulnerability in the overall literature and its relation to informal caregivers.Vulnerability is frequently associated with the sense of being at risk of harm instead of being acknowledged as a human trait to embrace.Taking a cue from two well-known videos of Brené Brown on how to enact “vulnerability,” we aimed to see if emotional vulnerability - posed/explored as strength or weakness - exists in the informal care context, potentially acting as a powerful resource that teaches individuals to look inward and inspires them to work on themselves.DesignScoping reviewData sourcesFollowing PRISMA-ScR checklist for scoping review, the literature was searched in various databases, including PubMed, Scopus and ScienceDirect.Study selection and data extractionWe systematically searched for: 1) observational studies, experimental studies, and systematic reviews 2) that examined the topic of emotional vulnerability in a caregiving context 3) that were relevant to informal caregivers of older adults 4) that were published from 1976 to 2021 5) in English 6) that included populations ≥18 years old 7) and excluded conceptualization of vulnerability outside of the emotional perspective (i.e., environmental, financial, social, biological, genetic, medical). Two reviewers independently reviewed titles and abstracts, reviewed the full text of relevant articles, and extracted the dataResultsFrom 2502 articles, 21 were determined as eligible.ConclusionThe reviewed articles showed the complexity of the vulnerability construct and several different approaches taken to explore this topic. This research concludes the value of vulnerability for human beings. The paucity of literature on the concept of vulnerability for informal caregivers offers a promising avenue for future research in this field.Article summary: Strengths and limitations of this studyThis study reviews the conceptualization of vulnerability across literature from 1976 to date, which was never done beforeThis study draws a unique parallel between vulnerability in formal care settings and informal careThis study re-defines the concept of emotional vulnerability in informal careThe study lacks more concrete first-person perspectives on vulnerability shared by informal caregivers, hence more concrete involvement of informal caregivers would be desirable for representative understanding of the concept of emotional vulnerability in informal care.

scholarly journals Positive Affect and Chronic Pain:A Preregistered Systematic Review and Meta-Analysis

2019 ◽  
Author(s):  
Anthony Ong ◽  
Felix Thoemmes ◽  
Kaylin Ratner ◽  
Kate Ghezzi-Kopel ◽  
M. Carrington Reid
Keyword(s):  
Cancer Pain ◽  
Positive Affect ◽  
Data Extraction ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Pain Severity ◽  
Random Effects Models ◽  
Study Selection ◽  
Subgroup Analyses ◽  
Lower Pain

Importance: Chronic non-cancer pain (CNCP) is a significant health burden among adults. Standard behavioral therapies typically focus on targeting negative affect and yield only modest treatment effects. Objective: To systematically review and investigate the association between positive affect (PA) and pain severity among adults with chronic non-cancer pain. Data Sources: Databases search included MEDLINE (PubMed), PsycINFO, CINAHL, ProQuest Dissertations and Theses, OLASTER, Open Grey, PeerJ, and PsyArXiv (inception to September 24, 2018). Study Selection: We analyzed studies that: 1) employed a daily diary, longitudinal, laboratory, or intervention study design; 2) enrolled individuals with CNCP (pain ≥ 12 weeks); and 3) reported full quantitative results on outcomes. Data Extraction and Synthesis: At least 2 researchers independently screened articles, extracted data, and assessed the risk of bias. The main meta-analysis was followed by subgroup analyses. All analyses were performed using random-effects models. Formal tests for heterogeneity (Q-statistic; I2) and publication bias (p-curve and p-uniform*) were performed. Main Outcome: Pain severity. Results: We analyzed 26 studies with 2702 participants. Positive affect was associated with reduced pain severity in both observational and experimental studies. In subgroup analyses, only gender demonstrated a consistent effect: Higher PA was associated with lower pain in observational studies that had higher percentages of female participants. Conclusion and Relevance: Positive affect is associated with a reduction in pain severity, with the strongest association observed among women with CNCP.

Preclinical and clinical relevance of probiotics and synbiotics in colorectal carcinogenesis: a systematic review

2020 ◽  
Vol 78 (8) ◽  
pp. 667-687 ◽  
Author(s):  
Bruna C S Cruz ◽  
Mariáurea M Sarandy ◽  
Anny C Messias ◽  
Reggiani V Gonçalves ◽  
Célia L L F Ferreira ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Data Extraction ◽  
Experimental Studies ◽  
Intestinal Barrier ◽  
Colorectal Carcinogenesis ◽  
Growth Modulation ◽  
Positive Effects ◽  
Study Selection ◽  
Inhibition Of Tumor Growth

Abstract Context Recent evidence suggests that modulation of the gut microbiota may help prevent colorectal cancer. Objective The aim of this systematic review was to investigate the role of probiotics and synbiotics in the prevention of colorectal cancer and to clarify potential mechanisms involved. Data Sources The PubMed, ScienceDirect, and LILACS databases were searched for studies conducted in humans or animal models and published up to August 15, 2018. Study Selection Clinical trials and placebo-controlled experimental studies that evaluated the effects of probiotics and synbiotics in colorectal cancer and cancer associated with inflammatory bowel disease were included. Of 247 articles identified, 31 remained after exclusion criteria were applied. A search of reference lists identified 5 additional studies, for a total of 36 included studies. Data Extraction Two authors independently assessed risk of bias of included studies and extracted data. Data were pooled by type of study, ie, preclinical or clinical. Results The results showed positive effects of probiotics and synbiotics in preventing colorectal cancer. The main mechanisms identified were alterations in the composition and metabolic activity of the intestinal microbiota; reduction of inflammation; induction of apoptosis and inhibition of tumor growth; modulation of immune responses and cell proliferation; enhanced function of the intestinal barrier; production of compounds with anticarcinogenic activity; and modulation of oxidative stress. Conclusions Probiotics or synbiotics may help prevent colorectal cancer, but additional studies in humans are required to better inform clinical practice.

Ultrasound for Cutaneous Wound Healing

1995 ◽  
Vol 10 (1) ◽  
pp. 2-4 ◽  
Author(s):  
E. Ernst
Keyword(s):  
Wound Healing ◽  
World Literature ◽  
Data Extraction ◽  
Experimental Studies ◽  
Published Data ◽  
Cutaneous Wound Healing ◽  
Cutaneous Wound ◽  
Manual Search ◽  
Study Selection ◽  
Treatment Of Wounds

Objective: To review the published data on ultrasound as a means to enhance wound healing. Study selection: A combined computerized (Medline 1980–94) and manual search of the world literature was performed. Data extraction: All controlled trials on cutaneous wound healing were admitted. Three experimental and five clinical studies were retrieved. Data synthesis: The experimental studies imply that cutaneous wounds treated with ultrasound heal quicker than untreated wounds. Clinical trials suggest that ultrasound speeds the healing of leg ulcers and possibly also of pressure sores Conclusion: Ultrasound is a promising adjunct to the complementary treatment of wounds, which would need more detailed, definitive study.

scholarly journals Epidemiology of hepatitis E virus infection in animals in Africa: a systematic review and meta-analysis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Abdou Fatawou Modiyinji ◽  
Jean Joel Bigna ◽  
Sebastien Kenmoe ◽  
Fredy Brice N. Simo ◽  
Marie A. Amougou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hepatitis E Virus ◽  
Data Extraction ◽  
Meta Analysis ◽  
Hepatitis E ◽  
Epidemiological Studies ◽  
Cross Sectional ◽  
Resource Limited ◽  
Study Selection ◽  
Language Restriction

Abstract Background Hepatitis E virus (HEV) is a major cause of acute hepatitis in humans worldwide and have high burden in the resource-limited countries. Better knowledge of the epidemiology of hepatitis in animals in Africa can help to understand the epidemiology among humans. The objective of this study was to summarize the prevalence of HEV infection and distribution of HEV genotypes among animals in Africa. Methods In this systematic review and meta-analysis, we comprehensively searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to March 22th, 2020 without any language restriction. We considered cross-sectional studies of HEV infection in animals in Africa. Study selection, data extraction, and methodological quality of included studies were done independently by two investigators. Prevalence data were pooled using the random-effects meta-analysis. This review was registered in PROSPERO, CRD42018087684. Results Twenty-five studies (13 species and 6983 animals) were included. The prevalence (antibodies or ribonucleic acid [RNA]) of HEV infection in animals varied widely depending on biological markers of HEV infection measured: 23.4% (95% confidence interval; 12.0–37.2) for anti-HEV immunoglobulins G, 13.1% (3.1–28.3) for anti-HEV immunoglobulins M, and 1.8% (0.2–4.3) for RNA; with substantial heterogeneity. In subgroup analysis, the immunoglobulins G seroprevalence was higher among pigs 37.8% (13.9–65.4). The following HEV genotypes were reported in animals: Rat-HEV genotype 1 (rats and horses), HEV-3 (pigs), HEV-7 (dromedaries), and Bat hepeviruses (bats). Conclusions We found a high prevalence of HEV infection in animals in Africa and HEV genotypes close to that of humans. Some animals in Africa could be the reservoir of HEV, highlighting the need of molecular epidemiological studies for investigating zoonotic transmission.

Lead in Mineral or Multivitamin-Multimineral Products

2021 ◽  
pp. 106002802110233
Author(s):  
C. Michael White
Keyword(s):  
English Language ◽  
Data Extraction ◽  
The United States ◽  
Third Party ◽  
Reference Level ◽  
Study Selection ◽  
Pubmed Search ◽  
Zinc Supplements ◽  
Average Lead ◽  
Year 2000

Objective Assess the current daily interim reference level of lead and the amount contained in current mineral and multivitamin-multimineral (MVM) products. Data Sources PubMed search from 1980 to May 15, 2021, limited to the English language, via the search strategy ((mineral OR multivitamin OR calcium OR iron OR magnesium OR copper OR zinc OR chromium OR selenium) AND (heavy metals OR Pb OR lead)). Study Selection and Data Extraction Narrative review of studies assessing lead content in mineral or MVM products. Data Synthesis Products containing different calcium forms (dolomite, bone meal, natural carbonate) have historically had higher lead levels than others (refined carbonate, lactate, gluconate, acetate, sevelamer), but the gap has closed considerably since the year 2000. Although only limited assessments of magnesium and zinc supplements have been conducted, no alarming average lead amounts were found. MVM products assessed since 2007 had low median or mean lead concentrations. However, large interproduct differences exist, with many products having very little lead and some products having concerning amounts. Relevance to Patient Care and Clinical Practice It is difficult for pharmacists and consumers to know the amount of lead in an actual product unless it is tested in an independent third-party lab. The United States Pharmacopeia and NSF International will provide a seal on the products stating that the products have a low level of lead, but even so, children could receive more lead than the Food and Drug Administration’s Interim Reference Level. Conclusions The threat from lead exposure in mineral and MVM products have diminsihed considerably over time but some products can still have excessive amounts. Without third-party testing, it is difficult for clinicians and consumers to know which outlier products to avoid.

scholarly journals Prioritising recommendations following analyses of adverse events in healthcare: a systematic review

2020 ◽  
Vol 9 (4) ◽  
pp. e000843
Author(s):  
Kelly Bos ◽  
Maarten J van der Laan ◽  
Dave A Dongelmans
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Data Extraction ◽  
Data Sources ◽  
Cochrane Library ◽  
High Quality ◽  
Data Synthesis ◽  
Study Selection ◽  
Personal Opinion ◽  
User Friendly

PurposeThe purpose of this systematic review was to identify an appropriate method—a user-friendly and validated method—that prioritises recommendations following analyses of adverse events (AEs) based on objective features.Data sourcesThe electronic databases PubMed/MEDLINE, Embase (Ovid), Cochrane Library, PsycINFO (Ovid) and ERIC (Ovid) were searched.Study selectionStudies were considered eligible when reporting on methods to prioritise recommendations.Data extractionTwo teams of reviewers performed the data extraction which was defined prior to this phase.Results of data synthesisEleven methods were identified that are designed to prioritise recommendations. After completing the data extraction, none of the methods met all the predefined criteria. Nine methods were considered user-friendly. One study validated the developed method. Five methods prioritised recommendations based on objective features, not affected by personal opinion or knowledge and expected to be reproducible by different users.ConclusionThere are several methods available to prioritise recommendations following analyses of AEs. All these methods can be used to discuss and select recommendations for implementation. None of the methods is a user-friendly and validated method that prioritises recommendations based on objective features. Although there are possibilities to further improve their features, the ‘Typology of safety functions’ by de Dianous and Fiévez, and the ‘Hierarchy of hazard controls’ by McCaughan have the most potential to select high-quality recommendations as they have only a few clearly defined categories in a well-arranged ordinal sequence.

scholarly journals Pharmacological Management of Steroid-Induced Psychosis: A Review of Patient Cases

2020 ◽  
pp. 875512252097853
Author(s):  
Grace Huynh ◽  
Justin P. Reinert
Keyword(s):  
Adverse Drug Events ◽  
Data Extraction ◽  
Management Strategies ◽  
Pharmacological Intervention ◽  
Symptom Presentation ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Study Selection ◽  
Cord Injury ◽  
Male Patients

Objective: To review the efficacy and safety of medications used in the management of steroid-induced psychosis. Data Sources: A comprehensive literature search was conducted using PubMed, MEDLINE, ProQuest, and Scopus between May and October 2020 using the following search terminology: “steroid-induced psychosis” OR “corticosteroid-induced psychosis.” Study Selection and Data Extraction: Definitive cases, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, were included in this review. Geriatric patients >65 years of age, those with a confounding neurological condition such as a traumatic brain or spinal cord injury, or those with active malignancy were excluded. Data Synthesis: A total of 13 patient cases were included in this review, representing 8 male patients and 5 female patients. The mean age at symptom presentation was 42.5 years. Six patients presented with delusions, 5 presented with hallucinations, and 2 presented with both manifestations; 12 patients were managed with an antipsychotic, with haloperidol being the most commonly prescribed, followed by risperidone. One patient was managed with lithium and clonazepam alone. All patients returned to their psychological baseline upon the discontinuation or decreased dose of steroids in combination with Pharmacological intervention, though the time to resolution of symptoms varied significantly. No notable adverse drug events associated with treatments were reported. Conclusions: Steroid-induced psychosis is a serious adverse effect of corticosteroid therapy; however, management strategies that combine a dose reduction or elimination of steroids, in combination with an antipsychotic medication, are effective in resolving this syndrome.

Recent Advances: Antiinfectives

1995 ◽  
Vol 29 (10) ◽  
pp. 1035-1040 ◽  
Author(s):  
Laurie L Briceland ◽  
John D Cleary ◽  
Courtney V Fletcher ◽  
Daniel P Healy ◽  
Charles A Peloquin
Keyword(s):  
Infectious Diseases ◽  
English Language ◽  
Data Extraction ◽  
Information Service ◽  
Ulcer Disease ◽  
Additional Information ◽  
Study Selection ◽  
Enterococcus Spp ◽  
Scientific Meetings ◽  
Clinically Significant

Objective: To update readers on the significant changes in infectious diseases pharmacotherapy. Data Sources: An Index Medians and Iowa Drug Information Service search (1993–1994) of English-language literature pertaining to the selected topic areas was performed. Additional information from abstracts presented at scientific meetings were identified by the authors. Study Selection and Data Extraction: All identified studies were screened and those judged relevant to the update were evaluated. Data Synthesis: New or clinically significant data since 1992 that related to peptic ulcer disease, microbial resistance (e.g., Enterococcus spp., Streptococcus pneumoniae, Mycobacterium tuberculosis, Candida albicans), immunomodulators, and AIDS were evaluated and compared with previous data. Conclusions: There have been several exciting and significant changes in infectious diseases pharmacotherapy evident from this review.

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