Polypharmacy: definition, risks, management

A search was performed in the Scopus, Web of Science, MedLine, The Cochrane Library databases. The term “polypharmacy”, in contrast to the term “polypragmasia”, does not always has a negative meaning and is often used to describe the simultaneous use of five or more drugs, and polypharmacy is considered intensive, when the patient takes 10 or more drugs at the same time. One of the main causes of polypharmacy is polymorbidity. Severe condition of the patient, self-medication and inappropriate recommendations can also cause polypharmacy, as well as some demographic factors (age, gender, level of education) and the level of the health care system development. Polypharmacy can be appropriate when the prescription of a large number of drugs is justified, and inappropriate (problematic) when the number of prescribed drugs is incorrect and/or unbalanced. Problematic polypharmacy is a manifestation of polypragmasia, with several drugs prescribed improperly that does not allow realizing the expected advantage of these drugs. The risk of harm from treatment outweighs the benefits due to drug interactions, adverse reactions, increasing economic burden of treatment. Problematic polypharmacy is especially dangerous for critically ill patients. The management of problematic polypharmacy should be based on its transition into an appropriate form. The combination of drugs is substantiated, which allows treating the patient effectively, safely and economically expediently through the prevention of drug interaction and adverse effects. Deprescribing of certain drugs can be used as a therapeutic intervention, it should be performed in each individual patient through the assessment of benefits and risks. Beers criteria, ARMOR, STOPP-START criteria are offered for prevention and correction of problematic polypharmacy in the elderly.

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Incidences of Adverse Reactions in BNT162b2: A Meta-analysis

10.37766/inplasy2022.1.0043 ◽

2022 ◽

Author(s):

Yi Dong ◽

◽

LiJia Liu ◽

Jianing Liu ◽

Tianqi Liao ◽

...

Keyword(s):

Adverse Reactions ◽

Web Of Science ◽

Controlled Trial ◽

Meta Analysis ◽

Previous History ◽

Healthy Adults ◽

Cochrane Library ◽

Total Incidence ◽

Review Question ◽

The Cochrane Library

Review question / Objective: This study searched PubMed, Cochrane Library, Web of Science, Embase Electronics, and other databases to collect healthy adults aged 16 and older, subjects with no previous history of COVID-19 infection, A randomized controlled trial of Pfizer's vaccine BNT162b2 versus placebo. Using RevMan5.4 software, meta-analysis was conducted to compare the effects of injection of BNT162b2 and placebo on the incidence of adverse reactions in healthy adults over 16 years of age. Main indexes include total incidence of adverse reactions, the incidence of local adverse reactions at the injection site (including red hot accessories), the incidence of systemic adverse reactions, including fever, headache, rash, urticaria, joint pain, muscle pain, gastrointestinal tract reaction, fatigue, cough, etc.), death rate, so as to provide a reference for clinical practice. Information sources: The following electronic databases will be searched from January 2020 to November 2021: PubMed, the Cochrane Library, Web of Science, Embase Electronics. In addition, reference lists of the included studies were manually searched to identify additional relevant studies.

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Neuroimaging Outcomes in Studies of Cognitive Training in Mild Cognitive Impairment and Early Alzheimer’s Disease: A Systematic Review

Current Alzheimer Research ◽

10.2174/1567205017666200624202425 ◽

2020 ◽

Vol 17 (5) ◽

pp. 472-486

Author(s):

Lucy Beishon ◽

Kannakorn Intharakham ◽

David Swienton ◽

Ronney B. Panerai ◽

Thompson G. Robinson ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Cognitive Impairment ◽

Search Strategy ◽

Web Of Science ◽

Cochrane Library ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Early Alzheimer’S Disease ◽

Magnetic Resonance Imaging Mri ◽

The Cochrane Library

Background: Cognitive Training (CT) has demonstrated some benefits to cognitive and psychosocial function in Mild Cognitive Impairment (MCI) and early dementia, but the certainty related to those findings remains unclear. Therefore, understanding the mechanisms by which CT improves cognitive functioning may help to understand the relationships between CT and cognitive function. The purpose of this review was to identify the evidence for neuroimaging outcomes in studies of CT in MCI and early Alzheimer’s Disease (AD). Methods: Medline, Embase, Web of Science, PsycINFO, CINAHL, and The Cochrane Library were searched with a predefined search strategy, which yielded 1778 articles. Studies were suitable for inclusion where a CT program was used in patients with MCI or AD, with a structural or functional Magnetic Resonance Imaging (MRI) outcome. Studies were assessed for quality using the Downs and Black criteria. Results: Medline, Embase, Web of Science, PsycINFO, CINAHL, and The Cochrane Library were searched with a predefined search strategy, which yielded 1778 articles. Studies were suitable for inclusion where a CT program was used in patients with MCI or AD, with a structural or functional Magnetic Resonance Imaging (MRI) outcome. Studies were assessed for quality using the Downs and Black criteria. Conclusions: CT resulted in variable functional and structural changes in dementia, and conclusions are limited by heterogeneity and study quality. Larger, more robust studies are required to correlate these findings with clinical benefits from CT.

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The value of lncRNAs as prognostic biomarkers on clinical outcomes in osteosarcoma: a meta-analysis

BMC Cancer ◽

10.1186/s12885-021-07882-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Wenchao Zhang ◽

Xiaolei Ren ◽

Lin Qi ◽

Chenghao Zhang ◽

Chao Tu ◽

...

Keyword(s):

Web Of Science ◽

Meta Analysis ◽

Positive Outcome ◽

Clinical Applications ◽

Clinicopathological Features ◽

Cochrane Library ◽

Human Osteosarcoma ◽

Non Coding Rna ◽

The Cochrane Library ◽

Long Non Coding Rna

Abstract Background In recent years, emerging studies have demonstrated critical functions and potential clinical applications of long non-coding RNA (lncRNA) in osteosarcoma. To further validate the prognostic value of multiple lncRNAs, we have conducted this updated meta-analysis. Methods Literature retrieval was conducted by searching PubMed, Web of Science and the Cochrane Library (last update by October 2, 2019). A meta-analysis was performed to explore association between lncRNAs expression and overall survival (OS) of osteosarcoma patients. Relationships between lncRNAs expression and other clinicopathological features were also analyzed respectively. Results Overall, 4351 patients from 62 studies were included in this meta-analysis and 25 lncRNAs were identified. Pooled analyses showed that high expression of 14 lncRNAs connoted worse OS, while two lncRNAs were associated with positive outcome. Further, analysis toward osteosarcoma clinicopathologic features demonstrated that overexpression of TUG1 and XIST indicated poor clinical parameters of patients. Conclusions This meta-analysis has elucidated the prognostic potential of 16 lncRNAs in human osteosarcoma. Evidently, desperate expression and functional targets of these lncRNAs offer new approaches for prognosis and therapy of osteosarcoma.

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Granisetron plus dexamethasone for prevention of postoperative nausea and vomiting in patients undergoing laparoscopic surgery: A meta-analysis

Journal of International Medical Research ◽

10.1177/0300060517703276 ◽

2017 ◽

Vol 45 (3) ◽

pp. 904-911 ◽

Cited By ~ 2

Author(s):

Min Zhu ◽

Chengmao Zhou ◽

Bing Huang ◽

Lin Ruan ◽

Rui Liang

Keyword(s):

Laparoscopic Surgery ◽

Postoperative Nausea ◽

Adverse Reactions ◽

Meta Analysis ◽

Postoperative Nausea And Vomiting ◽

Nausea And Vomiting ◽

Cochrane Library ◽

Randomized Controlled ◽

Laparoscopy Surgery ◽

The Cochrane Library

Objective This study was designed to compare the effectiveness of granisetron plus dexamethasone for preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery. Methods We searched the literature in the Cochrane Library, PubMed, EMBASE, and CNKI. Results In total, 11 randomized controlled trials were enrolled in this analysis. The meta-analysis showed that granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopy surgery. No significant differences in adverse reactions (dizziness and headache) were found in association with dexamethasone. Conclusion Granisetron in combination with dexamethasone was significantly more effective than granisetron alone in preventing PONV in patients undergoing laparoscopic surgery, with no difference in adverse reactions between the two groups. Granisetron alone or granisetron plus dexamethasone can be used to prevent PONV in patients undergoing laparoscopic surgery.

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S-1 and Capecitabine for the Treatment of Colorectal Cancer: A Meta-Analysis

Journal of Biomaterials and Tissue Engineering ◽

10.1166/jbt.2021.2673 ◽

2021 ◽

Vol 11 (6) ◽

pp. 1144-1152

Author(s):

Ping Huang ◽

Zhenfen Wang ◽

Qian Liu ◽

Guohao Cai

Keyword(s):

Colorectal Cancer ◽

Web Of Science ◽

Advanced Colorectal Cancer ◽

Meta Analysis ◽

Cochrane Library ◽

Therapeutic Effects ◽

Chemotherapeutic Drugs ◽

The Third ◽

Hand Foot Syndrome ◽

The Cochrane Library

Colorectal cancers common tumors that develop in the large intestines. The incidence of colorectal cancer is second only to gastric and esophageal cancers. Both S-1 and capecitabine are the third-generation fluorouracil-based chemotherapeutic drugs. We hope to summarize the therapeutic effects of tecotae and capecitabine in patients with colorectal cancer through this Meta-analysis. We performed a meta-analysis of the findings in the current literature. We performed a systematic review of outcomes associated with S-1 and capecitabine used to treat advanced colorectal cancer based on findings from both English and Chinese publications listed in PubMed, Embase, CNKI, Wanfang, EBSCO, Web of Science and the Cochrane Library. End-points included ORR, DCR, OS, and PFS; adverse events (grades 1–2 and 3–4) were also evaluated. Statistical analysis was performed using RevMan 5.3. A total of 12 studies were eventually included, involving a total of 3,375 patients. Of this group, 1,683 and 1,692 patients underwent treatment with S-1 or capecitabine, respectively. There were no greatly differences with respect to ORR, DCR, or OS; however, PFS was bettered in the group of S-1 compared to those treated with capecitabine. The incidence of leukopenia, diarrhea and anorexia were all higher among those in S-1 group compared to the capecitabine group, but a higher incidence of hand-foot syndrome was linked with use of capecitabine. Use of S-1 for the treatment of colorectal cancer may result in superior outcomes when compared to use of capecitabine.

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Clinical simulation with dramatization: gains perceived by students and health professionals

Revista Latino-Americana de Enfermagem ◽

10.1590/1518-8345.1807.2916 ◽

2017 ◽

Vol 25 (0) ◽

Cited By ~ 10

Author(s):

Elaine Cristina Negri ◽

Alessandra Mazzo ◽

José Carlos Amado Martins ◽

Gerson Alves Pereira Junior ◽

Rodrigo Guimarães dos Santos Almeida ◽

...

Keyword(s):

Latin American ◽

Web Of Science ◽

Cochrane Library ◽

Inclusion Criteria ◽

National Library ◽

Electronic Library ◽

Clinical Simulation ◽

Self Confidence ◽

The Cochrane Library ◽

Latin American And Caribbean

ABSTRACT Objective: to identify in the literature the gains health students and professionals perceive when using clinical simulation with dramatization resources. Method: integrative literature review, using the method proposed by the Joanna Briggs Institute (JBI). A search was undertaken in the following databases: Latin American and Caribbean Health Sciences Literature, Web of Science, National Library of Medicine, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Scopus, Scientific Electronic Library Online. Results: 53 studies were analyzed, which complied with the established inclusion criteria. Among the different gains obtained, satisfaction, self-confidence, knowledge, empathy, realism, reduced level of anxiety, comfort, communication, motivation, capacity for reflection and critical thinking and teamwork stand out. Conclusion: the evidence demonstrates the great possibilities to use dramatization in the context of clinical simulation, with gains in the different health areas, as well as interprofessional gains.

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Influence ofDPYDGenetic Polymorphisms on 5-Fluorouracil Toxicities in Patients with Colorectal Cancer: A Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2014/827989 ◽

2014 ◽

Vol 2014 ◽

pp. 1-11 ◽

Cited By ~ 9

Author(s):

Qiang Li ◽

Ying Liu ◽

Hong-Mei Zhang ◽

Yin-Peng Huang ◽

Tian-Yi Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Genetic Polymorphisms ◽

Web Of Science ◽

Meta Analysis ◽

Dihydropyrimidine Dehydrogenase ◽

Cochrane Library ◽

Inclusion Criteria ◽

Meta Analyses ◽

The Cochrane Library ◽

Stratified Analysis

Our meta-analysis aggregated existing results from relevant studies to comprehensively investigate the correlations between genetic polymorphisms in dihydropyrimidine dehydrogenase (DPYD) gene and 5-fluorouracil (5-FU) toxicities in patients with colorectal cancer (CRC). The MEDLINE (1966∼2013), the Cochrane Library Database (Issue 12, 2013), EMBASE (1980∼2013), CINAHL (1982∼2013), Web of Science (1945∼2013), and the Chinese Biomedical Database (CBM) (1982∼2013) were searched without language restrictions. Meta-analyses were conducted with the use of STATA software (Version 12.0, Stata Corporation, College Station, TX, USA). Seven clinical cohort studies with a total of 946 CRC patients met our inclusion criteria, and NOS scores of each of the included studies were ≥5. Our findings showed thatDPYDgenetic polymorphisms were significantly correlated with high incidences of 5-FU-related toxicity in CRC patients. SNP-stratified analysis indicated that there were remarkable connections of IVS14+1G>A, 464T>A, and 2194G>A polymorphisms with the incidence of marrow suppression in CRC patients receiving 5-FU chemotherapy. Furthermore, we found that IVS14+1G>A, 496A>G, and 2194G>A polymorphisms were correlated with the incidence of gastrointestinal reaction. Ethnicity-stratified analysis also revealed thatDPYDgenetic polymorphisms might contribute to the development of marrow suppression and gastrointestinal reaction among Asians, but not among Caucasians. The present meta-analysis suggests thatDPYDgenetic polymorphisms may be correlated with the incidence of 5-FU-related toxicity in CRC patients.

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Regulation of miRNA content. Part 1. Editing miRNA. Тailing miRNA

CHILD`S HEALTH ◽

10.22141/2224-0551.16.4.2021.236911 ◽

2021 ◽

Vol 16 (4) ◽

pp. 317-324

Author(s):

A.E. Abaturov ◽

V.L. Babуch

Keyword(s):

Secondary Structure ◽

Posttranscriptional Regulation ◽

Web Of Science ◽

Cochrane Library ◽

Transcriptional Elongation ◽

Transcription Control ◽

Scientific Review ◽

Molecular Effects ◽

The Cochrane Library ◽

Mirna Content

This scientific review presents the processes of regulation of miRNA content. To write the article, information was searched using Scopus, Web of Science, MedLine, PubMed, Google Scholar, EMBASE, Global Health, The Cochrane Library, CyberLeninka databases. The article presents the characteristics of the processes of microRNA editing and microRNA tailing, which regulate the content of microRNA through the transcription control. It is emphasized that editing is the most important mechanism of posttranscriptional regulation of microRNA that occurs with the help of RNA-specific adenosine deaminase. The article shows that editing leads to a change in the secondary structure of the microRNA molecule and the deviation of the process of microRNA maturation. It is shown that microRNA tailing is a posttranscriptional elongation of the tail of the molecule by adding nucleotides to the 3’-end of RNA. It has been found that uridinylation is a very common posttranscriptional process that regulates gene expression. The effect of uridinylation on microRNA biogenesis has been demonstrated on the example of the miR let-7 family, which inhibits proliferation and promotes cell differentiation. It has been established that another type of microRNA tailing, namely adenylation, most often contributes to the stabilization of the molecule, but in some cases can lead to microRNA degradation. Thus, the regulation of miRNA content is carried out by editing miRNA, microRNA tailing. Due to editing, the secondary structure of the microRNA molecule changes and the microRNA maturation process deviates. MicroRNA tailing is a post-transcriptional elongation of the tail of the molecule by adding nucleotides to the 3’-end of RNA by polyuridinylation or polyadenylation. Uridinylation affects the processing and degradation of miRNA precursors with different molecular effects, which in some cases contribute to the development of diseases.

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Evaluación de la calidad de vida según el estado nutricional del paciente paliativo adulto: revisión sistemática

Hospital a Domicilio ◽

10.22585/hospdomic.v1i4.27 ◽

2017 ◽

Vol 1 (4) ◽

pp. 199 ◽

Cited By ~ 1

Author(s):

Ester Aracil-Lavado ◽

Carmina Wanden-Berghe ◽

Javier Sanz-Valero

Keyword(s):

Quality Of Life ◽

Clinical Trial ◽

Palliative Care ◽

Web Of Science ◽

Cochrane Library ◽

Calidad De Vida ◽

Revisión Sistemática ◽

Literatura Latinoamericana ◽

The Cochrane Library

Objetivo: Revisar la literatura científica relacionada con la calidad de vida según el estado nutricional del paciente paliativo adulto.Método: Análisis crítico de los trabajos recuperados mediante revisión sistemática. Los datos se obtuvieron de la consulta directa y acceso, vía Internet, a las siguientes bases de datos bibliográficas del ámbito de las ciencias de la salud: MEDLINE (vía PubMed), The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL), Web of Science y la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Se consideró adecuado el uso de los Descriptores “Quality of life”, “Nutritional Status” y “Palliative care”, utilizando los filtros: «Humans», «Adult» y «Comparative Study» o «Clinical Trial». Fecha de la búsqueda: noviembre de 2016.Resultados: Tras aplicar los criterios de inclusión y exclusión se aceptaron 4 estudios para su revisión y análisis crítico. Al evaluar la calidad de los artículos seleccionados para la revisión mediante el cuestionario CONSORT, las puntuaciones oscilaron entre 11 y 20 sobre una puntuación máxima de 25.Conclusiones: El seguimiento nutricional de los enfermos estaba relacionado directamente con la mejora del estado nutricional, y se correspondía con el incremento de la calidad de vida. Sería deseable utilizar cuestionarios específicos y validados para evaluar la calidad de vida según el estado nutricional que permitirán minimizar cualquier tipo de subjetividad del paciente. Serían necesarios futuros estudios, con una adecuada población, que aclaren la relación directa entre el estado nutricional y la calidad de vida en los enfermos paliativos.

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Nasal Decolonization of Staphylococcus Aureus and the Risk of Surgical Site Infection After Surgery: A Meta-Analysis

10.21203/rs.3.rs-30729/v1 ◽

2020 ◽

Author(s):

Jia Tang ◽

Jiangjin Hui ◽

Jing Ma ◽

Mingquan Chen

Keyword(s):

Staphylococcus Aureus ◽

Web Of Science ◽

Meta Analysis ◽

Surgical Site Infections ◽

Cochrane Library ◽

Randomized Controlled ◽

Pulmonary Surgery ◽

Different Types ◽

The Cochrane Library ◽

Risk Ratios

Abstract Aim: To assess the effects of nasal decontamination on preventing surgical site infections (SSIs) in people who are S aureus carriers undergoing different types of surgeries. Methods: Relevant randomized controlled trials (RCTs) were identified through systematic searches of the PubMed, Embase, Web of science, and the Cochrane Library databases. The risk ratios (RRs) and 95% confidence intervals (CIs) were calculated and the effects model was chosen according to the heterogeneity. Subgroup analyses were performed according to different types of surgeries that S aureus carriers were applied.Results: Twenty RCTs published between 1996 and 2019 involving 10526 patients were included. Pooled results showed that the overall SSIs and pulmonary surgery SSIs presented with a statistical difference in measures of nasal decontamination (RR=0.59 and 0.47, respectively, both p<0.01). However, the associations between nasal decolonization and increased risks of SSIs in orthopedics surgery or cardiovascular surgery remained insignificant in studies.Conclusion: It seems that nasal decolonization of Staphylococcus aureus may be associated with a reduction of SSI in these patients, especially in patients receiving pulmonary surgeries.

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