scholarly journals COVID-19 Anosmia and Lacunar Stroke.

2021 ◽  
Author(s):  
Humberto Foyaca-Sibat ◽  
Lourdes de Fátima Ibañez-Valdés
Keyword(s):  
Medical Literature ◽  
Brain Mri ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Extensive Literature ◽  
Case Presentation ◽  
Online Databases ◽  
External Capsule ◽  
Almost All ◽  
Work Up

Abstract Background: Despite the worldwide COVID-19 vaccination programme, there is not enough information to predict when the current pandemic will end, and new variants of SASR-CoV-2 are travelling worldwide, leading to the new variability of clinical manifestation, complications and increasing fatal outcomes. Many publications on COVID-anosmia and asymptomatic COVID-stroke have been released, and plenty of studies on novel therapeutic approach have been published. Here we report an atypical case, our findings from review the medical literature, and comment on the treatment modalities. Material and Method: EMBASE, Medline, Scopus online databases, Google Scholar, Science Direct, WHO database, Scielo, LILACS, BIREME, and Cochrane library to identify articles evaluating anosmia*, COVID-19 anosmia*, aetiology of anosmia*, lacunar infarct*, treatment of IS*, and COVID-19 acute stroke* from January 1, 2010, to March 30, 2021.Results: We found 2454publications related to these topics. After removing duplicate articles, considering the title and abstracts, screening full text, PCR positives, symptomatic patients, and manuscript written in other languages, only six matches all the selected parameters, but from this group, none one presented COVID anosmia/PCR negative/ No respiratory disturbances/presence of IgG/ lacune larger than 15 mm (macunes).Case presentation: A 17-years-old male came to the medical outpatient clinic complaining of loss of smell without other symptomatology. The PCR test for SARS-Cov-2 done was negative, and then he did not receive COVID-19 treatment. Four weeks later patient back to the hospital because of no improvement and was admitted to the hospital neurology ward. Apart from anosmia, examination of other systems shows unremarkable findings. We did an extensive serological and CSF work-up to exclude almost all causes of anosmia. Brain MRI confirmed focal oval cyst space with CSF signal measuring 17 mm in the external capsule in the left basal ganglia region like a lacune (macune) from a previous vascular insult.Comments and final remarks: After an extensive literature review of published manuscript related to these topics, we did not find a report like our case, which presented COVID-19 anosmia/ without respiratory symptomatology/silent macune stroke/PCR negative with positive antibodies, apart from the systematic review of published articles related to these issues. We also included an updated list of anosmia aetiology and the recommended treatments for LS published in the medical literature.

scholarly journals Effect of phosphodiesterase-type 5 inhibitors on erectile function: an overview of systematic reviews and meta-analyses

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047396 ◽  
Author(s):  
Nikolaos Pyrgidis ◽  
Ioannis Mykoniatis ◽  
Anna-Bettina Haidich ◽  
Maria Tirta ◽  
Persefoni Talimtzi ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Erectile Function ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Extensive Literature ◽  
Efficacy And Safety ◽  
Phosphodiesterase Type 5 Inhibitors ◽  
Overview Of Systematic Reviews ◽  
Phosphodiesterase Type ◽  
Meta Analyses

IntroductionPhosphodiesterase-type 5 inhibitors (PDE5i) are the recommended first-line treatment for erectile dysfunction. Previous systematic reviews and meta-analyses suggest that they are a safe and effective option in many patient groups. Similarly, PDE5i may be effective as part of combination therapy in non-responders to PDE5i. We will generate an overview of systematic reviews, meta-analyses and network meta-analyses aiming to summarise the available knowledge regarding the efficacy and safety of PDE5i in the general population and in multiple subgroups of patients.Methods and analysisThis overview was designed in accordance with the PRIO-harms and Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines and its protocol was registered at PROSPERO. We will systematically search PubMed, Web of Science, Cochrane Library and Scopus databases from inception to November 2020 without any language restrictions. We will include systematic reviews or meta-analyses: (1) comparing the efficacy and safety of any dose of PDE5i with each other, with placebo or with other effective treatments for the management of erectile function; (2) exploring the use of any PDE5i alone or in combination with other treatment modalities in the general male population or in specific subgroups and (3) conducted with systematic procedures. Our overview will employ the AMSTAR 2 tool to evaluate the quality of the included studies and the Grading of Recommendations Assessment, Development and Evaluation approach to assess the strength of evidence for all outcomes. We will construct forest plots of risk estimates with the corresponding CI for all outcomes.Ethics and disseminationIn this overview, we will undertake an extensive literature search in an attempt to evaluate the potential benefits and risks of treatment with one PDE5i versus another or versus placebo and provide recommendations for clinicians and policy-makers. No ethical approval is required.PROSPERO registration numberCRD42020216754.

scholarly journals Neonate born with ischemic limb to a COVID-19 positive mother: management and review of literature

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Shahana Perveen ◽  
Karmaine A. Millington ◽  
Suchitra Acharya ◽  
Amit Grag ◽  
Vita Boyar
Keyword(s):  
Differential Diagnosis ◽  
Compartment Syndrome ◽  
Upper Extremity ◽  
Preterm Neonate ◽  
Review Of Literature ◽  
Case Presentation ◽  
Ischemic Limb ◽  
History Of ◽  
Hand Amputation ◽  
Work Up

AbstractObjectivesTo describe challenges in diagnosis and treatment of congenital neonatal gangrene lesions associated with history of maternal coronavirus disease 2019 (COVID-19) infection.Case presentationA preterm neonate was born with upper extremity necrotic lesions and a history of active maternal COVID-19 infection. The etiology of his injury was challenging to deduce, despite extensive hypercoagulability work-up and biopsy of the lesion. Management, including partial forearm salvage and hand amputation is described.ConclusionsNeonatal gangrene has various etiologies, including compartment syndrome and intrauterine thromboembolic phenomena. Maternal COVID-19 can cause intrauterine thrombotic events and need to be considered in a differential diagnosis.

Evidence-Based Podiatric Medicine

2009 ◽  
Vol 99 (3) ◽  
pp. 260-266 ◽  
Author(s):  
Fiona Hawke ◽  
Joshua Burns ◽  
Karl B. Landorf
Keyword(s):  
Systematic Reviews ◽  
Medical Literature ◽  
Cochrane Collaboration ◽  
The United States ◽  
Evidence Base ◽  
Cochrane Library ◽  
Free Access ◽  
Evidence Based ◽  
User Friendliness ◽  
The Cochrane Library

Due to the exponential increase in the quantity and quality of podiatric medicine–related research during the past decade, podiatric physicians are inundated with an insurmountable volume of research relevant to clinical practice. Systematic reviews can refine this literature by using explicit, rigorous, and reproducible methods to identify, critically appraise, and synthesize the best evidence from all clinical trials to answer clearly defined clinical questions. The Cochrane Collaboration is an international not-for-profit organization created to improve the user-friendliness and accessibility of medical literature mainly through preparing and maintaining systematic reviews of health-care interventions. The Cochrane Library currently contains more than 50 podiatric medicine–relevant systematic reviews summarizing and synthesizing evidence from many hundreds of randomized controlled trials evaluating interventions for foot problems. Although more than 60 countries worldwide have open online access to The Cochrane Library, in the United States, only the state of Wyoming has free access to full-text reviews. In an era demanding an evidence-based approach for every clinical intervention, high-quality systematic reviews streamline podiatric medical literature by reducing the time, cost, and training necessary to establish a solid evidence base for practice. (J Am Podiatr Med Assoc 99(3): 260–266, 2009)

Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis

2021 ◽  
Author(s):  
Rahele Tavakoly ◽  
Amir Hadi ◽  
Nahid Rafie ◽  
Behrouz Talaei ◽  
Wolfgang Marx ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Monocyte Count ◽  
Randomized Controlled ◽  
Immunological Markers ◽  
Online Databases ◽  
Immunological Effects

AbstractThe possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger’s and Begg’s statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=−0.08 cells×109/L; 95% CI: −0.15 to −0.01; p=0.022) with evidence of moderate heterogeneity (I 2=59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=−0.08 cells×109/L; 95% CI: −0.16 to −0.001; I 2=0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×109/L; 95% CI: 0.02 to 0.93; I 2=0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.

scholarly journals A scoping review of considerations and practices for benefit sharing in biobanking

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Allan Sudoi ◽  
Jantina De Vries ◽  
Dorcas Kamuya
Keyword(s):  
Scoping Review ◽  
Health Research ◽  
Empirical Studies ◽  
Benefit Sharing ◽  
Cochrane Library ◽  
Policy And Practice ◽  
Online Databases ◽  
Expected Benefits ◽  
Future Policy ◽  
Distinct Features

Abstract Background Despite the rapid global growth of biobanking over the last few decades, and their potential for the advancement of health research, considerations specific to the sharing of benefits that accrue from biobanks have received little attention. Questions such as the types and range of benefits that can arise in biobanking, who should be entitled to those benefits, when they should be provided, by whom and in what form remain mostly unanswered. We conducted a scoping review to describe benefit sharing considerations and practices in biobanking in order to inform current and future policy and practice. Methods Drawing on the Arksey and O’Malley framework, we conducted a scoping review of the literature in three online databases (PubMed, Cochrane library, and Google Scholar). We extracted and charted data to capture general characteristics, definitions and examples of benefits and benefit sharing, justification for benefit sharing, challenges in benefit sharing, governance mechanisms as well as proposed benefit sharing mechanisms. Results 29 articles published between 1999 and 2020 met the inclusion criteria for the study. The articles included 5 empirical and 24 non-empirical studies. Only 12 articles discussed benefit sharing as a stand-alone subject, while the remaining 17 integrated a discussion of benefits as one issue amongst others. Major benefit sharing challenges in biobanking were found to be those associated with uncertainties around the future use of samples and in resultant benefits. Conclusion Most of the benefit sharing definitions and approaches currently in use for biobanking are similar to those used in health research. These approaches may not recognise the distinct features of biobanking, specifically relating to uncertainties associated with the sharing and re-use of samples. We therefore support approaches that allow decisions about benefit sharing to be made progressively once it is apparent who samples are to be shared with, the intended purpose and expected benefits. We also highlight gaps in key areas informing benefit sharing in biobanking and draw attention to the need for further empirical research.

Uso de antioxidantes no tratamento da infertilidade masculina

2021 ◽  
Author(s):  
Júlia Lima Ilydio dos Santos ◽  
Maria Eduarda Baracuhy Cruz Chaves ◽  
Rebeca Fernandes de Azevedo Dantas ◽  
Alessandra Viviane Evangelista Demôro
Keyword(s):  
Retrieval System ◽  
Medical Literature ◽  
Cochrane Library ◽  
Literature Analysis ◽  
Omega 3 ◽  
Electronic Library ◽  
Plasma Séminal

Introdução: A infertilidade é definida como a incapacidade de conceber um filho ou de levar uma gravidez a termo após um ano de relação sexual regular e sem utilização de métodos contraceptivos. As causas de infertilidade são relacionadas ao homem em aproximadamente 40% dos casos. As evidências levam a crer que cerca de 30 a 80% dos casos de infertilidade de fator masculino devem-se a fatores fisiológicos, ambientais e genéticos, incluindo o estresse oxidativo. Estima-se que 25% dos homens inférteis tenham níveis mais elevados de substâncias reativas de oxigênio (ROS) no sêmen do que homens férteis, pois altos níveis de ROS no sêmen podem causar disfunção no esperma, em razão do dano ao DNA e da redução do potencial reprodutivo masculino. Nesse contexto, os antioxidantes atuam como catadores de radicais livres, reduzindo o estresse oxidativo. Naturalmente, no sêmen, são encontrados antioxidantes como vitamina E, vitamina C, zinco, selênio, carnitina, coenzima Q10 e carotenoides. Objetivo: Determinar os benefícios do uso de antioxidantes no tratamento da infertilidade masculina. Métodos: Foi realizada uma revisão sistemática da literatura com artigos publicados entre 2015 e 2020 nas plataformas PubMed, Scientific Electronic Library Online (SciELO), Medical Literature Analysis and Retrieval System Online (MEDLINE) e Cochrane Library. Resultados: Obtiveram-se 29 artigos, dos quais 25 foram incluídos neste estudo. De acordo com os dados estudados, alguns antioxidantes, como ômega 3, selênio, zinco, carnitina, vitamina C, vitamina E, coenzima Q10, glutationa e licopeno, têm se mostrado potencialmente eficazes no intuito de melhorar a qualidade seminal do homem. Eles reduzem a quantidade de ROS, mantendo a integridade da membrana celular dos espermatozoides, atuando como protetores do esperma, reduzindo significativamente a peroxidação lipídica no plasma seminal, melhorando a motilidade do esperma e a contagem de espermatozoides, protegendo-os contra a fragmentação do DNA e, por consequência, melhorando as chances de fecundação. Além disso, foi encontrada uma ação combinada de vitaminas C e E para proteger os espermatozoides contra ataque peroxidativo e fragmentação de DNA. Vale ressaltar que a suplementação de selênio mostrou aumento significativo na motilidade dos espermatozoides e redução no percentual de espermatozoides defeituosos em comparação com o período de pré-suplementação, demonstrando-se potencialmente benéfica. Conclusão: A utilização de algumas vitaminas, nutrientes e minerais parecem melhorar a qualidade seminal. Contudo, o maior problema no uso prático dos antioxidantes reside no fato de que existe uma baixa disponibilidade de estudos e testes sobre o assunto, principalmente no que diz respeito à dose adequada e ao tempo de uso. Diante disso, faz-se necessário o aumento do número de pesquisas e estudos com adequada metodologia a fim de esclarecer ainda mais o efeito dos antioxidantes na fertilidade masculina.

scholarly journals P.097 Subarachnoid hemorrhage associated with a thromboembolic ischemic stroke- an unexpected observation

2018 ◽  
Vol 45 (s2) ◽  
pp. S42-S42
Author(s):  
A Almutlaq ◽  
S Alhusaini ◽  
C Chalk ◽  
R Cote
Keyword(s):  
Ischemic Stroke ◽  
Subarachnoid Hemorrhage ◽  
Ct Scan ◽  
Inferior Frontal Gyrus ◽  
Brain Mri ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Ct Angiogram ◽  
External Capsule ◽  
Diagnostic Confusion

Atherosclerosis is a significant risk factor for ischemic stroke, and is a frequent cause for extra- and intra-cranial vessels stenosis. Here, we present an unusual case of ischemic stroke associated with intra-cranial vessel stenosis and subarachnoid hemorrhage (SAH) secondary to carotid artery atheroma. A 64-year old female known for hypertension and dyslipidemia presented with a three-day history of three transient episodes (< 30 minutes) of dysarthria and right hand weakness. An initial brain CT scan revealed left frontal SAH. She was admitted to our Stroke Unit for observation and management. CT-angiogram revealed 90% ICAs stenosis bilaterally with several short focal stenotic lesions, involving several left MCA branches. Brain MRI revealed acute infarcts in the left insula, external capsule and inferior frontal gyrus. The clinical picture was attributed to a thromboembolic left MCA ischemic stroke. She was managed with maximum medical therapy, and later underwent successful left carotid endarterectomy. The presence of SAH on our patient’s presenting CT scan lead to an initial radiological diagnosis of RCVS. However, subsequent imaging studies indicated that SAH had occurred in association with a thromboembolic ischemic stroke. Despite its rarity, this clinical association is important to recognize to avoid diagnostic confusion and guide appropriate management.

In iodine-induced thyrotoxicosis, steroid therapy today could keep the surgical knife at bay

2018 ◽  
Vol 31 (5) ◽  
pp. 585-588 ◽  
Author(s):  
Rohan K. Henry ◽  
Monika Chaudhari
Keyword(s):  
Steroid Therapy ◽  
Medical Literature ◽  
Urinary Iodine ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Case Presentation ◽  
Total Triiodothyronine ◽  
History Of ◽  
Daily Allowance

Abstract Background: Amiodarone-induced thyrotoxicosis (AIT) type 2, characterized as a destructive thyroiditis, is well described in the medical literature; however, iodine-induced thyrotoxicosis (IIT) is not, though the latter has similar features and can be managed similarly. Case presentation: We present a 17-year-old female who presented with a history of an intermittent goiter with thyroid function tests (TFTs): thyroid-stimulating hormone (TSH)<0.015 (0.4–4 μU/mL), free thyroxine (T4)≥6 (0.7–2.1 ng/dL) and total triiodothyronine (T3) 651 (50–200 mg/dL). Thyroid antibodies were all negative. Despite methimazole therapy for 6 weeks, hyperthyroidism proved refractory to medical management. 123I scan uptake was suppressed. With hyperthyroidism being recalcitrant to therapy, a nutritional history revealed consumption of an iodine supplement containing at least 7 times the recommended daily allowance (RDA) for 5 years, contributing to the Jod-Basedow phenomenon. Urinary spot and 24-hour urinary iodine were both elevated. Though a surgical consult was obtained, surgery was cancelled once TFTs improved and then normalized with steroid therapy. The TFTs and urinary iodine levels remained normal post steroid therapy. Conclusions: We suggest that in addition to the need for a thorough nutritional history, a trial of corticosteroids should be utilized in the management of IIT which can present with findings similar to AIT type 2 which is recalcitrant to thionamide therapy. If successful, corticosteroids may delay or prevent surgical management thus avoiding possible complications with the latter approach.

scholarly journals The effectiveness of psychological interventions for anxiety in the perinatal period: A systematic review and meta-analysis

2022 ◽  
Author(s):  
Natalie Clinkscales ◽  
Katherine Berlouis ◽  
Lisa Golds ◽  
Angus MacBeth
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Perinatal Period ◽  
Small Sample ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Psychological Interventions ◽  
Inclusion Criteria ◽  
Compulsive Disorder ◽  
Perinatal Anxiety

Background: Anxiety disorders are a relatively common occurring mental health issue during pregnancy and the perinatal period. There is evidence that untreated perinatal anxiety is a risk factor for adverse outcomes for mother and infant. Despite their potential acceptability to users, psychological interventions research for this population is still in its infancy. This systematic review and meta-analysis aimed to comprehensively evaluate the evidence of the effectiveness of psychological interventions for reducing perinatal anxiety. Method: This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched included EMBASE, MEDLINE, PsychINFO, MIDIRS, CINAHL and the Cochrane Library. Search terms included: Psychological Therapy, Perinatal Period, Antenatal, Postnatal, Anxiety, Obsessive Compulsive Disorder and Phobia. Results: The search strategy identified 2025 studies. A total of 21 studies published between 2004 and 2021 fulfilled inclusion criteria. Of those, 17 were included in the meta-analysis. Overall results indicated that psychological interventions were more effective than control conditions in reducing symptoms of perinatal anxiety with a medium post treatment effect size. Significant effect sizes were also identified for online, face-to-face, group and guided self-help treatment modalities. Limitations: A small sample of studies are represented and limited to articles published in English. The review was unable to draw specific conclusions about what works (i.e. therapeutic modality/delivery) for whom (i.e. specific diagnoses) due to purposefully broad inclusion criteria. The longer-term effects of psychological interventions for perinatal anxiety and infant outcomes could not be established. Conclusions: This review demonstrates that psychological interventions are effective in reducing symptoms of both anxiety and comorbid anxiety and depression in the antenatal and postnatal periods. The results also demonstrate the efficacy of delivering such interventions in multiple settings, including online, and in group format. Further research is required to optimise treatment delivery to individual needs.

scholarly journals Lysergic Acid Diethylamide, Psilocybin and Dimethyltryptamine in Depression Treatment: A Systematic Review

2021 ◽  
Vol 14 (8) ◽  
pp. 793
Author(s):  
Gniewko Więckiewicz ◽  
Iga Stokłosa ◽  
Magdalena Piegza ◽  
Piotr Gorczyca ◽  
Robert Pudlo
Keyword(s):  
Systematic Review ◽  
Medical Literature ◽  
Meta Analysis ◽  
Lysergic Acid ◽  
Lysergic Acid Diethylamide ◽  
Cochrane Library ◽  
Depression Treatment ◽  
Depression Symptom ◽  
Clinical Challenge ◽  
Symptom Intensity

Despite many different kinds of substances available for depression treatment, depression itself still appears to be a clinical challenge. Recently, formerly illicit substances came to scientists’ attention, including lysergic acid diethylamide (LSD), psilocybin and dimethyltryptamine (DMT). Some studies suggest that these substances might be effective in depression treatment. The aim of this study was to evaluate the efficiency of LSD, psilocybin and DMT in depression treatment in the light of current medical literature. The authors followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for this systematic review. The authors searched the PubMed and Cochrane Library databases to identify relevant publications. Finally, 10 papers were included. Most of the selected studies showed significant correlation between psilocybin and DMT use and reduction in depression symptom intensity. By analyzing qualified studies, it can be concluded that psilocybin and DMT could be useful in depression treatment, but further observations are still required.

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