scholarly journals Comparing of the First Electrocardiographic Variables in Patients with Newly Diagnosed COVID-19 with Healthy Men Volunteer: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Mahdieh ARIAN ◽  
Ali VALINEJADI ◽  
Farveh VAKILIAN
Keyword(s):  
Meta Analysis ◽  
Substantial Effect ◽  
Library Science ◽  
Cochrane Library ◽  
Qtc Interval ◽  
Healthy Men ◽  
Pr Interval ◽  
Qrs Duration ◽  
Time Of Admission ◽  
Ecg Abnormalities

Background: We aimed to report the findings of the first Electrocardiography (ECG), before therapy initiation and receiving medication in COVID-19 patients, and to compare them with the ECG findings of healthy men. Methods: A comprehensive and regular search was performed through the keywords (“Electrocardiographic” OR “ECG” OR; ‘‘COVID-19’’ OR ‘‘Coronavirus Disease 2019’’) without time and language restrictions in the Web of Science, Scopus, ProQuest, Cochrane Library, Science Direct, Medline, PubMed and Google Scholar. After evaluating the quality and reviewing the biases, 27 studies were finally enrolled. Results: In 27 studies with a total number of 3994 COVID-19 patients, and mean age of 62.7 yr, 1993 subjects were male. The most common type of arrhythmia in them, especially in severe and critical cases, was 7% based on 10 studies (Atrial Fibrillation); while in 7 studies, QTc interval prolong (≥ 460 msec) was 15% and in 5 studies, QTc interval prolong (≥ 500 msec) was 18%. In COVID-19 patients at the time of admission and healthy men, HR (b per / min) was 85, 61.7 and PR interval (msec) was 285.4, 156 and QRS duration (msec) was 95, 94.3 and QT (msec) was 380. 384.1 and QTc (msec) (Bazett's formula) was 437, 387.1, respectively. In most cases, the variables were higher for COVID-19 patients. Conclusion: ECG abnormalities at the time of admission and prior to the initiation of medication that cause arrhythmic may have a clinically substantial effect on the course of the disease and confirm the effect of COVID-19 on increased cardiovascular risk in long-term.  

scholarly journals Efficacy and safety of daratumumab in the treatment of multiple myeloma: a systematic review and meta-analysis

2021 ◽  
Vol 49 (8) ◽  
pp. 030006052110381
Author(s):  
Yin Wang ◽  
Yanqing Li ◽  
Ye Chai
Keyword(s):  
Multiple Myeloma ◽  
Meta Analysis ◽  
Complete Response ◽  
Library Science ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
Risk Patients ◽  
Grade 3 ◽  
Combination Regimens

Objective To systematically evaluate the efficacy and safety of combination regimens containing daratumumab in patients with multiple myeloma (MM). Methods A systematic search of publications listed on electronic databases (PubMed®, The Cochrane Library, Science Direct and Web of Science) between inception and 13 November 2020 was conducted to find randomized controlled trials (RCTs) that included patients with MM that were treated with combination regimens containing daratumumab. Results A total of seven RCTs were included ( n = 4268 patients). Meta-analysis showed that compared with the control group, the group containing daratumumab showed a significantly better overall response rate and a complete response or better. Daratumumab improved efficacy in both standard-risk and cytogenetically high-risk patients with MM. The prevalence of neutropenia (≥grade 3) and pneumonia was significantly higher in the daratumumab group compared with the control group. Conclusion The available evidence demonstrated that the clinical application of combination regimens containing daratumumab improved the efficacy in patients with MM and had acceptable safety.

scholarly journals Electrocardiographic Changes during Normal Pregnancy

2017 ◽  
Vol 02 (03) ◽  
pp. 035-038
Author(s):  
Beeram Sumalatha ◽  
Maddury Jyotsna ◽  
Garre Indrani
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Systolic Blood Pressure ◽  
Pregnant Women ◽  
Qtc Interval ◽  
Normal Range ◽  
Cardiovascular Changes ◽  
Pr Interval ◽  
Qrs Duration ◽  
The Mean

Background Pregnancy is a physiologic condition which is unique in that it alters the physiology of each organ in the body. Cardiovascular changes during pregnancy are significant and start at 6 to 8 weeks of gestation. Physiologic cardiovascular changes during pregnancy suggest the chance of altered electrocardiographic (ECG) parameters during pregnancy. Study of variations in ECG in normal pregnant women serves as a basis to detect pathologic changes in pregnant women. Material and Methods This is a cross-sectional data of case series of pregnant women across all stages of gestation who attended antenatal clinic of our teaching hospital, on Women's Day (March 8, 2017). A 12-lead ECG was recorded in all the participants in supine position. The parameters noted from the ECG include heart rate, PR interval, QRS duration, QRS axis, corrected QT (QTc) interval, and ST-T changes. Results Total 151 pregnant women were studied. The average age was 23.38 ± 3.49 years. With respect to gestational age, 12 (7.94%), 48 (31.78%), and 91 (60.26%) women were in the first, second, and third trimesters of pregnancy, respectively. With respect to parity, 60 (39.7%) were primigravidae and 91 (60.26%) were multigravidae. The mean ECG heart rate was increased (100.15 ± 12.48 beats/min). The mean systolic blood pressure (109.67 ± 9.34 mm Hg) and the mean diastolic blood pressure (71.32 ± 6.89 mm Hg) were decreased. The mean of ECG intervals and durations (PR, QRS, QTc) were in normal range (0.14 ± 0.01, 0.08 ± 0.008, and 407.83 ± 11.98, respectively). There was no abnormal P-wave dispersion. Even though the QTc was in normal range in 63.56% of pregnant women, this parameter was in upper quadrant of the normal range. General linear regression demonstrated that systolic blood pressure and palpitations were the only variables to independently predict QTc in upper quadrant of normal range (p = 0.05, 0.03, respectively). Conclusion The cardiovascular hemodynamic adaptation to pregnancy is a well-established fact that is also seen in our study. There is shortening of PR interval and QRS duration. Even though QTc is with in normal range, in more than half (63.56%) of pregnant women, it is in the upper quadrant of the normal range.

scholarly journals Health Care Waste Management Improvement Interventions Specifications and Results: A Systematic Review and MetaAnalysis

2020 ◽  
Author(s):  
Ali ASHTARI ◽  
Jafar SADEGH TABRIZI ◽  
Ramin REZAPOUR ◽  
Mohammad RASHIDIAN MALEKI ◽  
Saber AZAMI-AGHDASH
Keyword(s):  
Health Care ◽  
Waste Management ◽  
Waste Disposal ◽  
Meta Analysis ◽  
Educational Interventions ◽  
Library Science ◽  
Cochrane Library ◽  
Control Group ◽  
Infectious Waste ◽  
Health Care Waste

Background: Given the importance of proper management of Health Care Waste Management (HCWM), comprehensive information on interventions in this field is necessary. Therefore, we aimed to systematically review and meta-analysis of characteristics and results of interventions in the field of HCWM. Methods: The required data were gathered through searching the keywords such as waste management, biomedical waste, hospitals waste, health care waste, infectious waste, medical waste, Waste Disposal Facilities, Garbage, Waste Disposal Facilities, Hazardous Waste Sites in PubMed, Scopus, EMBASE, Google scholar, Cochrane library, Science Direct, web of knowledge, SID and MagIran and hand searching in journals, reference by reference, and search in Gray literatures between 2000 and 2019. CMA software: 2 (Comprehensive Meta-Analysis) was used to perform the meta-analysis. Results: Twenty-seven interventions were evaluated. Most of the studies were conducted after 2010, in the form of pre and post study, without control group, and in hospital. Interventions were divided into two categories: educational interventions (19 studies) and multifaceted managerial interventions (8 studies). The most studied outcome (in 11 studies) was KAP (knowledge, attitude and practice). The mean standard difference of interventions on KAP was estimated 3.04 (2.54–3.54) which was significant statistically (P<0.05). Also, interventions were considerably effective in improving the indicators of waste production amount, waste management costs and overall waste management performance. Conclusion: Despite positive effect of interventions, due to the methodological deficiencies of published studies and high heterogeneity in results of studies, caution should be exercised in interpreting and using the results of the studies.

scholarly journals Effects of Haloperidol on Delirium in Adult Patients: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 27 (3) ◽  
pp. 250-259 ◽  
Author(s):  
Ying-zi Shen ◽  
Ke Peng ◽  
Juan Zhang ◽  
Xiao-wen Meng ◽  
Fu-hai Ji
Keyword(s):  
Systematic Review ◽  
Second Generation ◽  
Meta Analysis ◽  
Adult Patients ◽  
Surgical Patients ◽  
Cochrane Library ◽  
High Dose ◽  
Qtc Interval ◽  
Second Generation Antipsychotics ◽  
The Cochrane Library

Objective: The aim of this systematic review and meta-analysis was to investigate whether or not the use of haloperidol could reduce the incidence of delirium in adult patients. Subjects and Methods: PubMed, Embase, the Cochrane Library, Elsevier, Wiley, and Ovid were searched for randomized controlled trials and prospective interventional cohort studies that compared haloperidol with placebo for delirium prophylaxis or with second generation antipsychotics for delirium treatment. The primary end point was the incidence and severity of delirium. After reviewing 272 relevant articles, 10 studies with 1,861 patients were finally included (haloperidol vs. placebo in 8 studies [n = 1,734], and haloperidol vs. second-generation antipsychotics in 2 studies [n = 127]). Revman 5.3 was used for the data analysis. Results: Compared with placebo, a high dose of prophylactic haloperidol (≥5 mg/day) may help reduce the incidence of delirium in surgical patients (risk ratio 0.50, 95% CI 0.32, 0.79). There were no differences in the duration of delirium, QTc interval prolongation, extrapyramidal symptoms, intensive care unit stay, hospital stay, or mortality between the haloperidol and placebo groups. For delirium treatment, haloperidol exhibited similar effects as the second-generation antipsychotics. Conclusions: In this study, the limited available data revealed that prophylaxis haloperidol at a dose of ≥5 mg/day might help reduce delirium in adult surgical patients. Further outcome studies with larger sample sizes are required to confirm these findings.

scholarly journals Microvessel density as a prognostic indicator of prostate cancer: A systematic review and meta-analysis

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 882-891
Author(s):  
Guangui Feng ◽  
Kai Wang ◽  
Zhao Jiang
Keyword(s):  
Prostate Cancer ◽  
Microvessel Density ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Library Science ◽  
Cochrane Library ◽  
Recurrence Free Survival ◽  
Disease Specific Survival ◽  
Free Survival ◽  
Disease Specific

Abstract The aim of this study is to evaluate prognostic and therapeutic implications of microvessel density (MVD) in the recurrence-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) in prostate cancer (PCa). As of April 2019, EMBASE, PubMed, Cochrane Library, Science Direct/Elsevier, MEDLINE, and CNKI are used for systematic literature retrieval to investigate the correlation between MVD and PCa. Meta-analysis was performed using Review Manager and Stata software. Combined hazard ratio (HR) was identified with 95% confidence intervals (95% CI) in a random or fixed effects model. Thirteen studies were identified in this article. Of which, 8 studies analyzed for the recurrence-free survival (2,399 patients) demonstrated that MVD significantly elevated in the poor recurrence-free survival (HR 2.57, 95% CI 2.21–2.97). Other 2 eligible studies (330 patients) with 3 data sets for the MVD-OS analysis and the pooled HR (HR 1.70, 95% CI 1.27–2.28) suggested a weak risk of overall death rate in patients with high-MVD levels. The last 3 studies for disease-specific survival (220 patients) suggested that the association with high MVD and disease-specific survival may not have statistically significance (HR 1.32, 95% CI 0.49–3.56). This study suggests that high intratumoral MVD appears a significant progenitor for poor recurrence-free survival of PCa.

scholarly journals Validation of a 6-lead smartphone ECG against 12-lead ECG in athletes

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Orchard ◽  
JW Orchard ◽  
H Raju ◽  
A La Gerche ◽  
R Puranik ◽  
...  
Keyword(s):  
Heart Rate ◽  
Research Training ◽  
Complete Agreement ◽  
Rate Variation ◽  
Qtc Interval ◽  
Continuous Variables ◽  
Pr Interval ◽  
Qrs Duration ◽  
The Mean ◽  
Exercise Induced

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JO is supported by an Australian Government Research Training Program scholarship. CS is the recipient of a National Health and Medical Research Council (NHMRC) Practitioner Fellowship (#1154992). Background Athletes sometimes experience transient arrhythmias during intense exercise, which may be difficult to capture with traditional monitors. New highly portable technology, such as smartphone electrocardiogram (ECG) devices, may be useful in documenting and diagnosing exercise-induced arrhythmias. Accuracy of the Kardia single-lead ECG (1L) has been documented, but little data exists for the 6-lead device (6L). Purpose To examine the level of similarity between resting 6L and 12L readings to build evidence for the utility of the 6L as a practical diagnostic tool in athletes. Methods Participants (n = 30 healthy athletes, mean age 18.9 years, 57% male) had a resting supine 12-lead ECG (12L) as part of cardiac screening required by their sport. Within 1 hour, a 30 second 6L reading (leads I, II, III, aVR, aVL, aVF) was taken whilst seated. Data were analysed by 4 expert cardiologists. Manual measurements were taken for PR, QT and RR intervals and QRS duration using EPS digital calipers. To calculate mean 6L RR interval and QT prior to QTc, &lt;10 sequential RR/QT measurements were taken from the middle 10 seconds. QTc was calculated using Bazett’s formula. ECGs were reviewed for rhythm and presence of atrial/ventricular ectopics. Continuous variables were expressed as the mean of 4 cardiologists’ values ± standard deviation. Two-tailed paired t-tests were used to compare continuous variables (p &lt; 0.05 significant). Bland-Altman plots were used to assess quantitative agreement between QRS axis and mean values for QTc interval, QRS duration and PR interval for paired 6L and 12L ECGs. Results There were relatively high levels of agreement between the mean 6L and 12L measures for QTc and PR interval and QRS duration, with the 6L readings slightly but significantly shorter on average. The largest difference was seen in the QTc intervals (391ms vs 401ms, p = 0.003). The 6L QRS durations were shorter on average by 3ms (89ms vs 92ms, p = 0.025) and PR intervals were shorter on average by 6ms (163ms vs 169ms, p &lt; 0.001). There was complete agreement for all cardiologists for sinus rhythm and the presence of ectopics for the 6L and 12L readings. Conclusions The 6L readings had relatively high agreement with the 12L. All 6L measures (except heart rate) were slightly shorter on average than 12L. These small differences are unlikely to have any clinical significance, and are similar to findings comparing the 1L to 12L. 6L heart rates were slightly higher, which is best explained by seated compared to lying position. The reading with the greatest variation was QT interval, some of which is explained by heart rate variation. These pilot data suggest the 6L is sufficiently accurate to be useful in an athletic population as an event monitor for exercise-induced arrhythmias. This may provide more useful diagnostic data than the 1L. Larger studies showing higher levels of agreement with 12L would be required to expand the role of 6L beyond an event monitor. Abstract Figure 1: 6L device, Bland-Altman plots

Prevalence of Influenza Among Hajj Pilgrims: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-8
Author(s):  
Hamid Safarpour ◽  
Meysam Safi-Keykaleh ◽  
Iman Farahi-Ashtiani ◽  
Jafar Bazyar ◽  
Salman Daliri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Influenza Infection ◽  
Meta Analysis ◽  
Library Science ◽  
Cochrane Library ◽  
English Studies ◽  
Comprehensive Management ◽  
Mass Gatherings ◽  
Analysis Process ◽  
Fixed And Random Effects

Abstract Objectives: Respiratory transmission, especially in mass gatherings, is considered one of the main ways of influenza transmission. The Hajj ceremony, as one of the largest gatherings worldwide, can increase the distribution of influenza infection. Thus, the present study aimed to evaluate the incidence of influenza among Hajj pilgrims. Methods: In this present systematic review and meta-analysis, all English studies published by 2019 were extracted from several databases such as the Web of Science, PubMed, Scopus, Cochrane Library, Science Direct, and Google Scholar. Finally, the data were extracted using a pre-prepared checklist and then analyzed by fixed and random effects model tests in the meta-analysis, Cochran, meta-regression, and Begg’s test. Results: Eighteen studies with a sample size of 62 431 were entered into the meta-analysis process. The overall prevalence of influenza, in addition to the prevalence of types A, B, and C influenza, was estimated at 5.9 (95% CI: 4.3-8.0), 3.6 (95% CI: 2.6-4.9), 2.9 (95% CI: 2.8-3.1), and 0.9% (95% CI: 0.5-1.5), respectively. Conclusions: In general, influenza remains widespread regardless of vaccinating pilgrims and following health protocols. Therefore, it is recommended that comprehensive management and educational approaches be used to reduce the prevalence of influenza and its adverse consequences among the pilgrims.

scholarly journals Electrocardiogram abnormalities in obese adolescents

2019 ◽  
Vol 60 (1) ◽  
pp. 18-23
Author(s):  
Elizabeth Joan Salim ◽  
Eka Gunawijaya ◽  
Ni Putu Veny Kartika Yantie
Keyword(s):  
Heart Rhythm ◽  
Cross Sectional Study ◽  
P Wave ◽  
Qtc Interval ◽  
Cross Sectional ◽  
Sinus Arrhythmia ◽  
Obese Adolescents ◽  
T Wave ◽  
Pr Interval ◽  
Ecg Abnormalities

Background Obesity in adolescents is a known risk factor for cardiovascular disease mortality and sudden cardiac death. Obesity is associated with a wide variety of electrocardiogram (ECG) abnormalities. Objective  To assess prevalence and describe the ECG abnormalities in obese adolescents. Methods This cross-sectional study was conducted at Children’s Cardiology Clinic – Integrated Heart Center of Sanglah General Hospital, Denpasar, Bali, by recording ECGs of obese adolescents aged 11-15 years from several junior high schools from December 2016 to April 2017. The inclusion criteria were obese adolescents aged 11 to 15 years, who were willing to participate in the study and provided informed consent. Results A total of 78 ECGs of obese adolescents (60% male) were selected. Subjects’ mean weight and age were 82.6 (SD 15.2) kg and 13.2 (SD 1) years, respectively. Pre-hypertension was found in 25 (32%) subjects, while hypertension was found in 18 (23%) subjects. There were 29 (37%) subjects with abnormal ECGs. Sinus tachycardia was present in 13 (17%) subjects, and sinus arrhythmia was identified in 11 (14%) subjects. Eight (10%) patients experienced prolongation of QTc interval and 5 (6%) patients presented with prolongation of PR interval. There were no shifts of the P wave, QRS wave and T wave axes, changes of P wave morphology, low QRS voltage, T wave flattening, ventricular enlargement, or ST segment changes found in this study. Conclusion The prevalence of cardiac abnormalities based on ECG examination in obese adolescents is 37%, consisting of heart rhythm abnormalities, prolonged PR interval, and prolonged QTc interval.

Hospital Disaster Preparedness in Iran: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Jafar BAZYAR ◽  
Negar POURVAKHSHOORI ◽  
Hamid SAFARPOUR ◽  
Mehrdad FARROKHI ◽  
Hamid Reza KHANKEH ◽  
...  
Keyword(s):  
Systematic Review ◽  
Disaster Preparedness ◽  
Fixed Effects ◽  
Emergency Services ◽  
Meta Analysis ◽  
Library Science ◽  
Structural Safety ◽  
Cochrane Library ◽  
Fixed Effects Model ◽  
Hospital Preparedness

Background: Disasters are increasing all over the world. Iran, is one of the high-risk countries in this regard; so it is unavoidable to prepare hospitals as vital centers when disasters happen. This study aimed to evaluation the hospital preparedness based on previous studies in Iran. Methods: A systematic review and meta-analysis by browsing through all articles published since 2006 to 2017, in English and Persian both languages were designed. Databases that we searched to, include Google Scholar, PubMed, Web of Science, Scopus, Medlib, Cochrane Library, Science Direct, Internationally and SID, Irandoc and Magiran, domestically. Two expert researchers investigated separately. Researchers used random and fixed effect models in the meta-analysis. Moreover, random and fixed effects model and meta-regression tests were applied by using STATA ver. 11. The P<0.05 was considered statistically significant. Results: Twenty-five studies with a sample size of 181 hospitals were introduced to the process of metaanalysis. Iranian hospital preparedness is 53%, totally, that is moderate. Preparedness in different categories is as follows: emergency services 62%, communication 57%, security 54%, education 57%, logistic 65%, human resources 52%, Management and command 64%, reception 43%, transfer and evacuation 44%, traffic 47%, non-structural safety 57%, and structural safety 49%. Conclusion: Hospital preparedness is moderate in Iran. Optimal management of existing resources and the use of Update technologies in the field of hospital services be directed towards improving the preparedness of hospitals for disasters.

scholarly journals Electrocardiogram Standards for Children and Young Adults Using Z -Scores

2020 ◽  
Vol 13 (8) ◽  
Author(s):  
András Bratincsák ◽  
Chieko Kimata ◽  
Blair N. Limm-Chan ◽  
Kevin P. Vincent ◽  
Matthew R. Williams ◽  
...  
Keyword(s):  
Age Groups ◽  
High Volume ◽  
Qtc Interval ◽  
T Wave ◽  
New Concepts ◽  
Pr Interval ◽  
Z Scores ◽  
Qrs Duration ◽  
Children And Young Adults ◽  
Lower Limits

Background: Normative ECG values for children are based on relatively few subjects and are not standardized, resulting in interpersonal variability of interpretation. Recent advances in digital technology allow a more quantitative, reproducible assessment of ECG variables. Our objective was to create the foundation of normative ECG standards in the young utilizing Z -scores. Methods: One hundred two ECG variables were collected from a retrospective cohort of 27 085 study subjects with no known heart condition, ages 0 to 39 years. The cohort was divided into 16 age groups by sex. Median, interquartile range, and range were calculated for each variable adjusted to body surface area. Results: Normative standards were developed for all 102 ECG variables including heart rate; P, R, and T axis; R-T axis deviation; PR interval, QRS duration, QT, and QTc interval; P, Q, R, S, and T amplitudes in 12 leads; as well as QRS and T wave integrals. Incremental Z -score values between –2.5 and 2.5 were calculated to establish upper and lower limits of normal. Historical ECG interpretative concepts were reassessed and new concepts observed. Conclusions: Electronically acquired ECG values based on the largest pediatric and young adult cohort ever compiled provide the first detailed, standardized, quantitative foundation of traditional and novel ECG variables. Expression of ECG variables by Z -scores lends an objective and reproducible evaluation without interpreter bias that can lead to more confident establishment of ECG-disease correlations and improved automated ECG readings in high-volume cardiac screening efforts in the young. Graphic Abstract: A graphic abstract is available for this article.

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