scholarly journals Hemodynamic Dysfunctions in COVID-19 Patients

2021 ◽  
Vol 10 (12) ◽  
pp. e111101220323
Author(s):  
Rubens Barbosa Rezende
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Multiple Organ ◽  
The Novel ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Main Target ◽  
One Year ◽  
Novel Coronavirus

Coronavirus disease 2019 (COVID-19) is a respiratory viral infection caused by the novel coronavirus (SARS-CoV-2). Thus, it objected to comprehend the pathophysiology of COVID-19, as well as its clinical repercussions on hemodynamic alterations. This is an integrative literature review, such a method is able to select and include experimental and non-experimental studies, qualitative in nature, descriptive and exploratory in character. Initially, it started from the guiding question: "What hemodynamic dysfunctions can the positive COVID-19 patient develop?" The study was conducted by searching the database: PUBMED, using the descriptors: "coagulopathy" and "COVID-19", combined by the Boolean operator AND. As inclusion criteria, the filters of one-year version, full text, clinical trial, meta-analysis, and randomized controlled trial were chosen. Coagulopathy and thromboembolic events are manifestations of COVID-19 and are designated as poor prognostic factors. The respiratory system is the main target of SARS-CoV-2, but other body systems may also be involved. Therefore, symptoms can range from respiratory distress to multiple organ failure. It is concluded that the presence of coagulopathy is a major source of mortality in COVID-19 positive patients. Also, coagulopathy is linked to the severity of the symptomatology of COVID-19, and that in more severe cases relatively increased levels of D-dimer, prothrombin time, and fibrinogen are present. In addition, no significant minimization in platelet levels was observed in severe cases of COVID-19.

Abstract P311: Effect of Non-Invasive Imaging on Cardiovascular Risk Factors and Downstream Testing: A Meta-Analysis of Randomized Controlled Trials

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Seamus P Whelton ◽  
Khurram Nasir ◽  
Michael J Blaha ◽  
Daniel S Berman ◽  
Roger S Blumenthal
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Statistical Power ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cardiovascular Imaging ◽  
Significant Trend ◽  
Inclusion Criteria ◽  
Non Invasive ◽  
Randomized Controlled

Introduction: Non-invasive cardiovascular imaging has been proposed as a method to improve risk stratification and motivate improved patient and physician risk factor modification. Despite increasing use of these technologies there remains limited evidence documenting its effect on downstream testing and improvement in risk factor control. Hypothesis: Addition of the EISNER study to a prior meta-analysis will improve statistical power to demonstrate the downstream consequences of non-invasive cardiovascular imaging. Methods: A comprehensive literature search of the MEDLINE database (1966 through July 2011) was conducted. Major inclusion criteria required: 1) randomized controlled trial design, 2) participants with no known history of coronary heart disease or stroke, and 3) comparison of a group provided with results of a non-invasive imaging scan versus those without results. A total of eight trials with 4,084 participants met the inclusion criteria for this analysis. We analyzed the data using a random effects model to allow for heterogeneity. Results: Among imaging groups there was a significant increase in prescribing for statins (RR, 1.15; 95% CI, 1.01–1.32) and a non-significant trend for increased prescription of aspirin (RR, 1.15; 95% CI, 0.97–1.35), ACE/ARB (RR, 1.12; 95% CI, 0.96–1.31), and insulin (RR, 1.54; 95% CI, 0.75–3.18). There was a non-significant trend towards increased smoking cessation (RR, 1.35; 95% CI, 0.88–2.08). For downstream outcomes there was a non-significant increase in coronary angiography (RR, 1.20; 95% CI, 0.92–1.57), but not for revascularization (RR, 0.92; 95% CI, 0.55–1.53). There was no significant effect of imaging on the change in traditional risk factors. Limitations: There remains a limited number of trials in this important area. Therefore, trials included in this analysis use a variety of different imaging modalities and we were not able to pool the results based on appropriate clinical action (intensification at high risk and reduction at low risk). Conclusions: Non-invasive cardiovascular imaging leads to increased statin use, but associations with other downstream treatments and change in risk factors are not statistically significant. Our results highlight the limited amount of data for describing the downstream consequences after CAC testing.

Abstract TP12: Comparison of 3D Stent Retriever to Solitaire in Patients with Small Ischemic Cores: An Analysis of the Penumbra 3D Trial

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Adnan Siddiqui ◽  
Donald Frei ◽  
Albert J Yoo ◽  
Ghita Soulimani ◽  
Hope Buell ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Meta Analysis ◽  
Analysis Data ◽  
Functional Independence ◽  
Stent Retriever ◽  
The Novel ◽  
Inclusion Criteria ◽  
Aspiration System ◽  
Randomized Controlled ◽  
Scale 8

Introduction: A recent meta-analysis of four randomized controlled trials (RCTs) concluded that mechanical thrombectomy using Solitaire for large vessel ischemic stroke was effective with significantly reduced disability. Hypothesis: Our hypothesis was that treatment with the Penumbra Aspiration System and the novel 3D Stent Retriever would demonstrate similar angiographic and functional outcomes compared to use of Solitaire. Methods: The 3D trial was a RCT to compare the safety and effectiveness of the 3D Stent Retriever when used with the Penumbra Aspiration System (3D/PS) compared to the PS alone. Inclusion criteria for the 3D RCT included presentation with NIH Stroke Scale ≥ 8 and refractory to or not eligible for IV rtPA. Analysis compared reperfusion to mTICI 2b or 3 and functional independence (mRS 0-2 at 90 days) in a 3D Trial cohort with ASPECTS 8-10 vs the meta-analysis data reported by Campbell et al ( Stroke 2016). Results: One hundred four (104) of 198 patients met analysis criteria. Baseline ASPECTS (median [IQR]) were similar between the 3D Trial ASPECTS 8-10 cohort (3D/PS, PS, combined: 9 [8,10]) and Campbell group (9 [7,10]). Substantial reperfusion (mTICI 2b or 3) was experienced in 84.6% (44/52) of 3D/PS and 75.0% (39/52) of PS alone cases, similar to the Campbell group (76.6%). When both arms were pooled, results (79.8%) were also similar to Campbell. With regards to functional independence, both 3D cohorts and pooled trial results showed similar rates compared with Campbell (Figure). Conclusions: The novel 3D Stent Retriever + Penumbra System and the Penumbra Aspiration System alone showed similar reperfusion and functional outcomes compared to Solitaire.

scholarly journals Role of Multifunctional Cytoskeletal Filaments in Coronaviridae Infections: Therapeutic Opportunities for COVID-19 in a Nutshell

Cells ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1818
Author(s):  
Victor Norris ◽  
Judit Ovádi
Keyword(s):  
Drug Targets ◽  
Controlled Trial ◽  
Host Cells ◽  
Immunomodulatory Agents ◽  
Randomized Controlled ◽  
Treatment And Prevention ◽  
Scientific World ◽  
One Year ◽  
Novel Coronavirus

A novel coronavirus discovered in 2019 is a new strain of the Coronaviridae family (CoVs) that had not been previously identified in humans. It is known as SARS-CoV-2 for Severe Acute Respiratory Syndrome Coronavirus-2, whilst COVID-19 is the name of the disease associated with the virus. SARS-CoV-2 emerged over one year ago and still haunts the human community throughout the world, causing both healthcare and socioeconomic problems. SARS-CoV-2 is spreading with many uncertainties about treatment and prevention: the data available are limited and there are few randomized controlled trial data on the efficacy of antiviral or immunomodulatory agents. SARS-CoV-2 and its mutants are considered as unique within the Coronaviridae family insofar as they spread rapidly and can have severe effects on health. Although the scientific world has been succeeding in developing vaccines and medicines to combat COVID-19, the appearance and the spread of new, more aggressive mutants are posing extra problems for treatment. Nevertheless, our understanding of pandemics is increasing significantly due to this outbreak and is leading to the development of many different pharmacological, immunological and other treatments. This Review focuses on a subset of COVID-19 research, primarily the cytoskeleton-related physiological and pathological processes in which coronaviruses such as SARS-CoV-2 are intimately involved. The discovery of the exact mechanisms of the subversion of host cells by SARS-CoV-2 is critical to the validation of specific drug targets and effective treatments.

scholarly journals Impact of Adjuvant Use of Midodrine to Intravenous Vasopressors: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ahmad Al-Abdouh ◽  
Sadam Haddadin ◽  
Atul Matta ◽  
Ahmad Jabri ◽  
Mahmoud Barbarawi ◽  
...  
Keyword(s):  
Retrospective Studies ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Icu Length Of Stay ◽  
Significant Difference ◽  
Risk Ratios

Purpose. To evaluate the efficacy and safety of midodrine use in intensive care units (ICU) to facilitate weaning off intravenous vasopressors (IVV). Methods. We searched PubMed/MEDLINE, Cochrane library, and Google Scholar (inception through October 18th, 2020) for studies evaluating adjuvant use of midodrine to IVV in the ICU. The outcomes of interest were ICU length of stay (LOS), hospital LOS, mortality, IVV reinstitution, ICU readmission, and bradycardia. Estimates were pooled using the random-effects model. We reported effect sizes as standardized mean difference (SMD) for continuous outcomes and risk ratios (RRs) for other outcomes with a 95% confidence interval (CI). Results. A total of 6 studies were found that met inclusion criteria and had sufficient data for our quantitative analysis (1 randomized controlled trial and 5 retrospective studies). A total of 2,857 patients were included: 600 in the midodrine group and 2,257 patients in the control group. Midodrine use was not associated with a significant difference in ICU LOS (SMD 0.16 days; 95% CI −0.23 to 0.55), hospital LOS (SMD 0.03 days; 95% CI −0.33 to 0.0.39), mortality (RR 0.87; 95% CI 0.52 to 1.46), IVV reinstitution (RR 0.47; 95% CI 0.17 to 1.3), or ICU readmission (RR 1.03; 95% CI 0.71 to 1.49) when compared to using only IVV. However, there were higher trends of bradycardia with midodrine use that did not reach significance (RR 7.64; 95% CI 0.23 to 256.42). Conclusion. This meta-analysis suggests that midodrine was not associated with a significant decrease in ICU LOS, hospital LOS, mortality, or ICU readmissions.

scholarly journals Is there a place for mesenchymal stromal cell-based therapies in the therapeutic armamentarium against COVID-19?

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Kátia Nunes da Silva ◽  
André Luiz Nunes Gobatto ◽  
Zaquer Suzana Munhoz Costa-Ferro ◽  
Bruno Raphael Ribeiro Cavalcante ◽  
Alex Cleber Improta Caria ◽  
...  
Keyword(s):  
Multiple Organ ◽  
The Novel ◽  
Systemic Complications ◽  
Medical Needs ◽  
Potential Efficacy ◽  
Global Spread ◽  
Challenges And Opportunities ◽  
One Year ◽  
Novel Coronavirus ◽  
Unmet Medical Needs

AbstractThe COVID-19 pandemic, caused by the rapid global spread of the novel coronavirus (SARS-CoV-2), has caused healthcare systems to collapse and led to hundreds of thousands of deaths. The clinical spectrum of COVID-19 is not only limited to local pneumonia but also represents multiple organ involvement, with potential for systemic complications. One year after the pandemic, pathophysiological knowledge has evolved, and many therapeutic advances have occurred, but mortality rates are still elevated in severe/critical COVID-19 cases. Mesenchymal stromal cells (MSCs) can exert immunomodulatory, antiviral, and pro-regenerative paracrine/endocrine actions and are therefore promising candidates for MSC-based therapies. In this review, we discuss the rationale for MSC-based therapies based on currently available preclinical and clinical evidence of safety, potential efficacy, and mechanisms of action. Finally, we present a critical analysis of the risks, limitations, challenges, and opportunities that place MSC-based products as a therapeutic strategy that may complement the current arsenal against COVID-19 and reduce the pandemic’s unmet medical needs.

scholarly journals Asynchronous automated electronic laboratory result notifications: a systematic review

2017 ◽  
Vol 24 (6) ◽  
pp. 1173-1183 ◽  
Author(s):  
Benjamin H Slovis ◽  
Thomas A Nahass ◽  
Hojjat Salmasian ◽  
Gilad Kuperman ◽  
David K Vawdrey
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Cochrane Collaboration ◽  
Health Records ◽  
Randomized Controlled ◽  
New Methods ◽  
Laboratory Results ◽  
Quasi Experimental ◽  
The Cochrane Collaboration

Abstract Objective To systematically review the literature pertaining to asynchronous automated electronic notifications of laboratory results to clinicians. Methods PubMed, Web of Science, and the Cochrane Collaboration were queried for studies pertaining to automated electronic notifications of laboratory results. A title review was performed on the primary results, with a further abstract review and full review to produce the final set of included articles. Results The full review included 34 articles, representing 19 institutions. Of these, 19 reported implementation and design of systems, 11 reported quasi-experimental studies, 3 reported a randomized controlled trial, and 1 was a meta-analysis. Twenty-seven articles included alerts of critical results, while 5 focused on urgent notifications and 2 on elective notifications. There was considerable variability in clinical setting, system implementation, and results presented. Conclusion Several asynchronous automated electronic notification systems for laboratory results have been evaluated, most from >10 years ago. Further research on the effect of notifications on clinicians as well as the use of modern electronic health records and new methods of notification is warranted to determine their effects on workflow and clinical outcomes.

Systematic review and meta-analysis of effectiveness of preoperative embolization in surgery for metastatic spine disease

2017 ◽  
Vol 10 (6) ◽  
pp. 596-601 ◽  
Author(s):  
Panya Luksanapruksa ◽  
Jacob M Buchowski ◽  
Sasima Tongsai ◽  
Weerasak Singhatanadgige ◽  
Jack W Jennings
Keyword(s):  
Observational Studies ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Spinal Metastases ◽  
Mean Difference ◽  
Control Group ◽  
Preoperative Embolization ◽  
Inclusion Criteria ◽  
Qualitative Synthesis ◽  
Randomized Controlled

BackgroundPreoperative embolization (PE) may decrease intraoperative blood loss (IBL) in decompressive surgery of hypervascular spinal metastases. However, no consensus has been found in other metastases and no meta-analysis which reviewed the benefit of PE in spinal metastases has been conducted.ObjectiveTo assess IBL in spinal metastases surgery in a randomized controlled trial (RCT) and cohort studies comparing PE and a control group of non-embolized patients.MethodsA systematic search of relevant publications in PubMed and EMBASE was undertaken. Inclusion criteria were RCTs and observational studies in patients with spinal metastases who underwent spine surgery and reported IBL. Meta-analysis was performed using standardized mean difference (SMD) and mean difference (MD) of IBL. Heterogeneity was assessed using the I2 statistic.ResultsA total of 265 abstracts (126 from PubMed and 139 from Embase) were identified through database searching. The reviewers selected six studies for qualitative synthesis and meta-analysis. The pooled SMD of the included studies was 0.58 (95% CI −0.10 to 1.25, p=0.09). Sensitivity analysis revealed that, if the study by Rehak et al was omitted, the pooled SMD was significantly changed to 0.88 (95% CI 0.39 to 1.36, p<0.001) and PE reduced the IBL significantly. The pooled MD was 708.3 mL (95% CI −224.4 to 1640.9 mL, p=0.14). If the results of the Rehak et al study were omitted, the pooled MD was significantly changed to 1226.9 mL (95% CI 345.8 to 2108.1 mL, p=0.006).ConclusionsPE can be effective in reducing IBL in spinal metastases surgery in both renal cell carcinoma and mixed primary tumor groups.

Abstract WMP6: Treatment Effect of 3D Stent Retriever with Aspiration and Aspiration Alone in Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Raul Nogueira ◽  
Donald Frei ◽  
Ghita Soulimani ◽  
Sophia S Kuo ◽  
Hope Buell ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Functional Independence ◽  
Stent Retriever ◽  
The Novel ◽  
Inclusion Criteria ◽  
Vessel Occlusion ◽  
Randomized Controlled ◽  
Scale 8

Introduction: A recent meta-analysis of five stroke endovascular therapy (EVT) randomized controlled trials (RCTs) confirmed EVT’s benefits in patients with acute ischemic stroke caused by proximal large vessel occlusion (LVO). Hypothesis: We hypothesize that treatment with the novel 3D Stent Retriever used with the Penumbra System and the Penumbra System alone could confer similar benefits in this stroke cohort. Methods: The Penumbra 3D trial was a RCT to compare the safety and efficacy of the 3D Stent Retriever when used in conjunction with the Penumbra Aspiration System (3D/PS) versus the PS alone. Inclusion criteria for the 3D RCT included presentation within 8 hours of symptom onset, NIH Stroke Scale ≥ 8, and refractory to or not eligible for IV rtPA. Analysis compared 90-day mRS 0-2 vs the EVT RCT meta-analysis reported by the HERMES collaboration (Goyal et al., Lancet 2016). Results: A total of 172 of 198 enrolled patients met analysis criteria. Baseline NIHSS, ASPECTS, and age were similar between the 3D RCT and HERMES control. Successful reperfusion (mTICI 2b-3) occurred in 74.1% of PS alone (63/85) and 83.9% of 3D/PS (73/87) cases. When both arms were pooled, 79.1% (136/172) of cases achieved successful reperfusion. Results on 90-day functional independence showed both 3D cohorts and the pooled results of the trial had significantly higher rates compared to the HERMES control (IV rtPA). Conclusions: Both the 3D/PS and the PS devices alone showed benefit compared to IV rtPA monotherapy from a recent EVT RCT meta-analysis.

Meta-Analysis of the Effect of Probiotics on the Duration of Diarrhea in Children Under Five

2020 ◽  
Author(s):  
Wahyu Agustin Dwi Ciptaningtyas ◽  
◽  
Bhisma Murti ◽  
Setyo Sri Rahardjo ◽  
◽  
...  
Keyword(s):  
Public Health ◽  
Treatment Guidelines ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Industrialized Countries ◽  
Inclusion Criteria ◽  
Children Under Five ◽  
Under Five ◽  
Childhood Malnutrition ◽  
Randomized Controlled

ABSTRACT Background: Diarrhea is a common problem for children under five years of age. Multiple diarrhea episodes can lead to serious problems such as childhood malnutrition in developing or non-industrialized countries. In Indonesia, 70-80% of 60 million people who suffer diarrhea are children under five years of age. Apart from the existing treatment guidelines for diarrhea, probiotic or non-pathogenic living microorganisms are supposed to have preventive and curative effects on many diarrhea forms. This study aimed to estimate the effect of probiotics on the frequency and duration of diarrhea in children under five years of age. Subjects and Method: This was meta-analysis and systematic review.This study collected articles which published year 2010-2020. The articles were obtained from PubMed, Science Direct, Research Gate, and Google Scholar databases. The inclusion criteria were full text, using randomized controlled trial (RCT) study design, using probiotics intervention, the study subjects was children under five with diarrhea, and reporting effect size value (mean and standard deviation). The selected articles were analyzed using Revman 5.3. Results: There were 5 articles reviewed for this study. There was high heterogeneity between experimental groups(I2= 89%; p= 0.09). Probiotics provision were effectively to shortened duration of diarrhea 0.39 times than without probiotics provision (Mean Difference= -0.39; 95% CI= 0.85 to -0.07; p= 0.090). Conclusion: Probiotics are effective to shortened duration of diarrhea in children under five. Keywords: probiotic, diarrhea, meta-analysis Correspondence: Wahyu Agustin Dwi Ciptaningtyas. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java.Email: [email protected]. Mobile : 082229991202. DOI: https://doi.org/10.26911/the7thicph.05.51

Lateral Wedge Insole Uptake in Reducing Pain in Patients with Knee Osteoarthritis: A Meta-Analysis Study

2020 ◽  
Author(s):  
Muhibbah Fatati ◽  
◽  
Setyo Sri Rahardjo ◽  
Hanung Prasetya ◽  
◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Weight Bearing ◽  
Inclusion Criteria ◽  
Keywords Knee ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Randomized Controlled

ABSTRACT Background: The increase in rates of knee replacement for osteoarthritis has made the identification of effective nonsurgical treatments a high priority. One type of treatment for medial knee osteoarthritis involves reducing medial loading to ease the physical stress applied to that compartment of the joint. The wedge is placed under the sole of the foot and angulated so that it is thicker over the lateral than the medial edge, transferring loading during weight bearing from the medial to the lateral knee compartment. This study aimed to investigate the effect of lateral wedge insole uptake in reducing pain in patients with knee osteoarthritis. Subjects and Method: A meta-analysis and systematic review conducted by search published articles from PubMed, Science Direct, Google Scholar, Mendeley, and Clinical key databases. Keywords used “Lateral Wedge Insole” OR “Insole” AND “Foot Orthosis “AND “osteoarthritis” AND “patellofemoral osteoarthritis” AND “knee pain” AND “medial knee osteoarthritis “AND” effect lateral wedge insole for osteoarthritis” AND “randomized controlled trial”. The inclusion criteria were full text, using randomized controlled trial (RCT) study design, and reporting effect size (mean and standard deviation). The intervention was lateral wedge insole with comparison non lateral wedge insole. The study outcome was pain. The data were analyzed by Revman 5.3. Results: 6 studies were met the inclusion criteria. This study showed that the use of lateral wedge insole reduced pain in patients with knee osteoarthritis (Mean Difference= -0.17; 95% CI= -0.51 to 0.18; p= 0.340) with heterogeneity I2= 77%. Conclusion: Lateral wedge insole use reduced pain in patients with knee osteoarthritis. Keywords: knee osteoarthritis, lateral wedge insole, randomized control trial Correspondence: Muhibbah Fatati, Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 089633466598. DOI: https://doi.org/10.26911/the7thicph.05.45

Sign in / Sign up

Export Citation Format

Share Document