Efficacy of Lopinavir/Ritonavir Compared With Standard Care for Treatment of Coronavirus Disease 2019 (COVID-19): A Systematic Review

2020 ◽  
Vol 20 ◽  
Author(s):  
Timotius Ivan Hariyanto ◽  
Elizabeth Kristine ◽  
Catherine Jillian Hardi ◽  
Andree Kurniawan
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Standard Care ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Antiviral Treatment ◽  
Gastrointestinal Symptoms ◽  
Included Study ◽  
Quality Assessment Tool ◽  
Novel Coronavirus

Background: Coronavirus disease 2019 (COVID-19) is a newly discovered multi-organ disease caused by the novel coronavirus SARS-CoV-2. Currently, there are no official guidelines on the pharmacological treatment of COVID-19. Lopinavir/ritonavir is a licensed antiviral treatment against HIV and has shown activity against other coronaviruses. Objective: In this study, we review the evidence of the use of lopinavir/ritonavir as a potential treatment candidate against COVID-19. Method: This systematic review has been registered in PROSPERO (CRD42020182067). A systematic search of the literature for the observational and randomized controlled trial was conducted in PubMed, PubMed Central, and Google Scholar through May 2nd, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Jadad scale, Newcastle-Ottawa Quality assessment tool, and National Institute of Health quality assessment tool. Results: A total of 1,965 articles were screened from which 6 articles were selected. Of 6 articles that were included in this study, 4 reported no significant benefit in clinical improvement with lopinavir/ritonavir when compared to standard care of treatment, while 2 studies reported otherwise. Lopinavir/ritonavir was also not associated with a reduction of 28-day mortality rate as reported by 1 included study. Most included studies reported gastrointestinal symptoms as side effects from lopinavir/ritonavir therapy. Conclusion: There is not yet enough evidence to support the regular use of lopinavir/ritonavir in the treatment of COVID19. Further clinical trials are needed to evaluate lopinavir/ritonavir's efficacy in treatment.

scholarly journals Impact of integrating pharmacists into primary care teams on health systems indicators: a systematic review

2019 ◽  
Vol 69 (687) ◽  
pp. e665-e674 ◽  
Author(s):  
Benedict Hayhoe ◽  
Jose Acuyo Cespedes ◽  
Kimberley Foley ◽  
Azeem Majeed ◽  
Judith Ruzangi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health System ◽  
Quality Assessment ◽  
Observational Studies ◽  
Assessment Tool ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Quality Assessment Tool

BackgroundEvidence suggests that pharmacists integrated into primary care can improve patient outcomes and satisfaction, but their impact on healthcare systems is unclear.AimTo identify the key impacts of pharmacists’ integration into primary care on health system indicators, such as healthcare utilisation and costs.Design and settingA systematic review of literature.MethodEmbase, MEDLINE, Scopus, the Health Management Information Consortium, CINAHL, and the Cochrane Central Register of Controlled Trials databases were examined, along with reference lists of relevant studies. Randomised controlled trials (RCTs) and observational studies published up until June 2018, which considered health system outcomes of the integration of pharmacists into primary care, were included. The Cochrane risk of bias quality assessment tool was used to assess risk of bias for RCTs; the National Institute of Health National Heart, Lung, and Blood Institute quality assessment tool was used for observational studies. Data were extracted from published reports and findings synthesised.ResultsSearches identified 3058 studies, of which 28 met the inclusion criteria. Most included studies were of fair quality. Pharmacists in primary care resulted in reduced use of GP appointments and reduced emergency department (ED) attendance, but increased overall primary care use. There was no impact on hospitalisations, but some evidence of savings in overall health system and medication costs.ConclusionIntegrating pharmacists into primary care may reduce GP workload and ED attendance. However, further higher quality studies are needed, including research to clarify the cost-effectiveness of the intervention and the long-term impact on health system outcomes.

scholarly journals Coronavirus Disease 2019 and Gastrointestinal Involvement: A Systematic Review

Medicinus ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 62
Author(s):  
Moryella Monica ◽  
Andree Kurniawan
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Intestinal Flora ◽  
Gastrointestinal Symptoms ◽  
Good Evidence ◽  
World Health ◽  
Current Evidence ◽  
Future Research ◽  
Gastrointestinal Involvement

<p><strong>Introduction: </strong>The World Health Organization (WHO) announced the Coronavirus 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) toward the end of January 2020. There is still limited evidence to explain the gastrointestinal involvement in COVID-19. In this study, we aimed to further investigate current evidence describing the gastrointestinal involvement in COVID-19 patients.</p><p><strong>Methods: </strong>This systematic review has been registered in PROSPERO (CRD42020181584). A systematic search of literature for observational and randomized controlled trial was conducted in PubMed, PubMed central, and Google Scholar through April 16, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Newcastle-Ottawa Quality assessment tool.<strong> </strong></p><p><strong>Results: </strong>A total of 1,480 articles were screened from which 12 articles with 5584 subjects were selected. SARS-CoV-2 can invade human body by binding to angiotensin converting enzyme 2 (ACE-2) receptor which also located to small intestinal epithelial cells, crypt cells and colon. The virus itself may cause disorders of the intestinal flora. The diagnosis should be based on a set of symptoms diarrhoea, nausea, vomiting, abdominal discomfort or pain, combined with positivity of faecal PCR test. Treatment of COVID-19 mainly is supportive care. The probiotic may modulate the gut microbiota to alter the gastrointestinal symptoms and reduced enteritis, ventilator associated pneumonia, and reverse certain side effect of antibiotics<strong>.</strong></p><p><strong>Conclusion: </strong>Our synthesis of literature showed that there was no good evidence yet in overall area of gastrointestinal manifestations in COVID-19. Future research is needed to explore all areas, especially in mechanism and treatments</p>

scholarly journals Clinical Outcomes of Molecular Tumor Boards: A Systematic Review

2021 ◽  
pp. 1122-1132
Author(s):  
Kara L. Larson ◽  
Bin Huang ◽  
Heidi L. Weiss ◽  
Pam Hull ◽  
Philip M. Westgate ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Clinical Outcomes ◽  
Assessment Tool ◽  
Progression Free Survival ◽  
Control Group ◽  
Quality Assessment Tool ◽  
Free Survival ◽  
Patients With Cancer ◽  
Recommended Therapy

PURPOSE We conducted this systematic review to evaluate the clinical outcomes associated with molecular tumor board (MTB) review in patients with cancer. METHODS A systematic search of PubMed was performed to identify studies reporting clinical outcomes in patients with cancer who were reviewed by an MTB. To be included, studies had to report clinical outcomes, including clinical benefit, response, progression-free survival, or overall survival. Two reviewers independently selected studies and assessed quality with the Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group or the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies depending on the type of study being reviewed. RESULTS Fourteen studies were included with a total of 3,328 patients with cancer. All studies included patients without standard-of-care treatment options and usually with multiple prior lines of therapy. In studies reporting response rates, patients receiving MTB-recommended therapy had overall response rates ranging from 0% to 67%. In the only trial powered on clinical outcome and including a control group, the group receiving MTB-recommended therapy had significantly improved rate of progression-free survival compared with those receiving conventional therapy. CONCLUSION Although data quality is limited by a lack of prospective randomized controlled trials, MTBs appear to improve clinical outcomes for patients with cancer. Future research should concentrate on prospective trials and standardization of approach and outcomes.

Relationship of the Medial Patellofemoral Ligament Origin on the Distal Femur to the Distal Femoral Physis: A Systematic Review

2020 ◽  
Vol 49 (1) ◽  
pp. 261-266 ◽  
Author(s):  
Kyle R. Sochacki ◽  
Kevin G. Shea ◽  
Kunal Varshneya ◽  
Marc R. Safran ◽  
Geoffrey D. Abrams ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Study Design ◽  
Medial Patellofemoral Ligament ◽  
Distal Femur ◽  
Assessment Tool ◽  
Risk Of Bias ◽  
Skeletally Immature ◽  
Quality Assessment Tool ◽  
Femoral Physis

Background: The relationship between the medial patellofemoral ligament (MPFL) and the distal femoral physis has been reported in multiple studies. Purpose: To determine the distance from the MPFL central origin on the distal femur to the medial distal femoral physis in skeletally immature participants. Study Design: Systematic review. Methods: A systematic review was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched for studies investigating the anatomic origin of the MPFL on the distal femur and its relationship to the medial distal femoral physis in skeletally immature participants. Study methodological quality was analyzed with the Anatomical Quality Assessment tool, with studies categorized as low risk, high risk, or unclear risk of bias. Continuous variable data were reported as mean ± SD. Categorical variable data were reported as frequency with percentage. Results: Seven articles were analyzed (298 femurs, 53.7% male patients; mean age, 11.7 ± 3.4 years). There was low risk of bias based on the Anatomical Quality Assessment tool. The distance from the MPFL origin to the distal femoral physis ranged from 3.7 mm proximal to the physis to 10.0 mm distal to the physis in individual studies. Six of 7 studies reported that the MPFL origin on the distal femur lies distal to the medial distal femoral physis in the majority of specimens. The MPFL originated distal to the medial distal femoral physis in 92.8% of participants at a mean distance of 6.9 ± 2.4 mm. Conclusion: The medial patellofemoral ligament originates distal to the medial distal femoral physis in the majority of cases at a mean proximal-to-distal distance of 7 mm distal to the physis. However, this is variable in the literature owing to study design and patient age and sex.

scholarly journals Shared decision making in breast cancer treatment guidelines: Development of a quality assessment tool and a systematic review

2020 ◽  
Vol 23 (5) ◽  
pp. 1045-1064
Author(s):  
Marta Maes‐Carballo ◽  
Isabel Muñoz‐Núñez ◽  
Manuel Martín‐Díaz ◽  
Luciano Mignini ◽  
Aurora Bueno‐Cavanillas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Decision Making ◽  
Quality Assessment ◽  
Assessment Tool ◽  
Treatment Guidelines ◽  
Breast Cancer Treatment ◽  
Shared Decision ◽  
Quality Assessment Tool ◽  
Guidelines Development

scholarly journals A systematic review of statistical models and outcomes of predicting fatal and serious injury crashes from driver crash and offense history data

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Reneta Slikboer ◽  
Samuel D. Muir ◽  
S. S. M. Silva ◽  
Denny Meyer
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Statistical Models ◽  
Assessment Tool ◽  
Systematic Evaluation ◽  
Future Research ◽  
Alternative Measure ◽  
Quality Assessment Tool ◽  
Serious Injury ◽  
The Impact

Abstract Background Expenditure on driver-related behavioral interventions and road use policy is often justified by their impact on the frequency of fatal and serious injury crashes. Given the rarity of fatal and serious injury crashes, offense history, and crash history of drivers are sometimes used as an alternative measure of the impact of interventions and changes to policy. The primary purpose of this systematic review was to assess the rigor of statistical modeling used to predict fatal and serious crashes from offense history and crash history using a purpose-made quality assessment tool. A secondary purpose was to explore study outcomes. Methods Only studies that used observational data and presented a statistical model of crash prediction from offense history or crash history were included. A quality assessment tool was developed for the systematic evaluation of statistical quality indicators across studies. The search was conducted in June 2019. Results One thousand one hundred and five unique records were identified, 252 full texts were screened for inclusion, resulting in 20 studies being included in the review. The results indicate substantial and important limitations in the modeling methods used. Most studies demonstrated poor statistical rigor ranging from low to middle quality. There was a lack of confidence in published findings due to poor variable selection, poor adherence to statistical assumptions relating to multicollinearity, and lack of validation using new data. Conclusions It was concluded that future research should consider machine learning to overcome correlations in the data, use rigorous vetting procedures to identify predictor variables, and validate statistical models using new data to improve utility and generalizability of models. Systematic review registration PROSPERO CRD42019137081

scholarly journals The association between self-efficacy and self-care in essential hypertension: a systematic review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Felicia Clara Jun Hui Tan ◽  
Prawira Oka ◽  
Hajira Dambha-Miller ◽  
Ngiap Chuan Tan
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Self Efficacy ◽  
Observational Studies ◽  
Cognitive Theory ◽  
Assessment Tool ◽  
Self Care ◽  
Quality Assessment Tool ◽  
Medium Quality

Abstract Background The successful management of hypertension requires sustained engagement in self-care behaviour such as adhering to medication regimens and diet. Bandura’s Social Cognitive Theory suggests that self-efficacy is a major determinant of engagement in self-care behaviour. Self-efficacy refers to an individual’s belief in their capacity to execute behaviours necessary to produce specific performance attainments. This systematic review of observational studies aims to summarise and evaluate the quality of evidence available to support the association between self-efficacy and engagement in self-care behaviour in hypertension. Methods Searches were performed of the Pubmed, MEDLINE, CINAHL and OpenSIGLE databases from database inception to January 2020. Reference lists and individual journals were also hand searched. Observational studies in English quantifying self-efficacy and self-care behaviour in hypertensive adults were included. The quality of included articles was assessed with the National Institute of Health Quality Assessment Tool for observational studies. Results The literature search identified 102 studies, of which 22 met the inclusion criteria for full-text review. There were 21 studies which reported that higher self-efficacy was associated with engagement in self-care behaviours including medication adherence (n = 9), physical activity (n = 2) and dietary changes (n = 1). Of these, 12 studies were rated as ‘good’ on the quality assessment tool and 10 were ‘fair’. A common limitation in these studies was a lack of objectivity due to their reliance on self-reporting of engagement in self-care behaviour. Conclusion Our review suggests an association between self-efficacy and self-care. However, the evidence supporting this association is of low to medium quality and is limited by heterogeneity. Our findings suggest the need for further well-designed interventional studies to investigate this association.

Complications following volar locking plate fixation for distal radial fractures: a systematic review

2013 ◽  
Vol 39 (7) ◽  
pp. 745-754 ◽  
Author(s):  
A. Bentohami ◽  
K. de Burlet ◽  
N. de Korte ◽  
M. P. J. van den Bekerom ◽  
J. C. Goslings ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Locking Plate ◽  
Assessment Tool ◽  
Plate Fixation ◽  
Assessment Tools ◽  
Volar Locking Plate ◽  
Locking Plate Fixation ◽  
Distal Radial Fractures ◽  
Level Of Evidence

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.

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