Outcome and Safety of Different Cumulative Doses and Protocols of Intravenous Methylprednisolone in Moderate to Severe and Active Graves’ Ophthalmopathy

2019 ◽  
Vol 43 (1) ◽  
pp. 15
Author(s):  
Amelya Permata Sari ◽  
M Sidik ◽  
Syntia Nusanti

Background: Graves’ ophthalmopathy (GO), also known as Graves’ orbitopathy or thyroid eye disease, has a potential sight-threatening complications. The activity and severity are important determinants in GO and are implications for treatment. Intravenous Glucocorticoid (GC) was associated with significantly greater efficacy and was better tolerated than oral route in the treatment of patients with moderate to severe and active GO. Intravenous GC has a variation cumulative dose and protocols; meanwhile the optimal treatment is still undefined. The aim of this literature review was to analyze the outcome and safety of different cumulative doses and protocols of intravenous methylprednisolone of patients with moderate to severe and active GO. Methods: The literature search was conducted from Google Scholar and Pubmed for journal articles that were published and related to the use of IVGC in moderate to severe and active GO Results: From the keywords mentioned, titles were screened for eligibility and seventeen articles were found. After being checked for the duplication, the articles were screened based on the abstracts and/or full texts. As many as eight articles met the inclusion criteria, others were excluded. Conclusion: Intravenous GC therapy in moderate to severe and active GO provide effect in reducing CAS, decreasing lid aperture size, decreasing proptosis size, and disappearing diplopia. A protocol uses a low cumulative doses (<5 g) of methylprednisolone weekly for 6 weeks and then halved dose weekly for another 6 weeks are preferred due to higher response in clinical outcome and safety profile.

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Gbadebo Collins Adeyanju ◽  
Teslin Maria Augustine ◽  
Stefan Volkmann ◽  
Usman Adetunji Oyebamiji ◽  
Sonia Ran ◽  
...  

AbstractThe devastating impacts that bio-degradable products such as plastic bags are having on human health, wildlife, and the environment is enormous, especially single-use once. Single-use plastics are non-biodegradable products and does not undergo biological decomposition nor degenerate. This review examines various government regulations targeted at changing behaviour against plastic bags consumption and their effectiveness. Following a rigorous search in 13 databases, including PubMed, Science Direct, Springer Nature, etc. only 17 peer-reviewed journal articles that are published between 2000 and 2019 and met the inclusion criteria were included in the study. Each study’s methodological quality was assessed using the GRADE system, and data were extracted using a uniquely designed form. The results revealed that regulations based solely on the thickness of plastic bags does not reduce plastic bags consumption. However, regulations focused on banning ‘single-use’ plastic bag usage, imposing higher taxes and levies on consumers, significantly reduce plastic bags consumption. Overall, the latter is considered the most effective. Also, the results show that attitude, perception and behaviour change toward bio-degradable products or climate-friendly behaviour can be significantly influenced by public policy or regulations. Although the behaviour seems short-lived in some countries, therefore further studies need to probe on why. Also, the absence of a national regulatory strategy in North America reduced the inclusion of studies from the region, hence need for more research focusing on sub-national regulations.


Author(s):  
Endurance Uzobo ◽  
Aboluwaji D Ayinmoro

Background As it is common with the most devastating events in the world, women always seem to be at the most disadvantage position. This situation manifested during the period of COVID-19 lockdown throughout the world and Africa in particular. The purpose of this study is to explore Domestic Violence (DV) cases in African during the COVID-19 lockdown. Methods Data for this study were gleaned from an electronic literature search using various databases PubMed and BioMed Central, Web of Science, etc. Key search words were gender DV during and after COVID-19. A total of 68 records were identified during the search. However, only 46 of these sources met the inclusion criteria. Results From the review done in selected African countries which include Egypt, South Africa, Kenya, Nigeria, Ghana and Zimbabwe; it was discovered that COVID-19 lockdown across these countries worsens the already existing cases of DV. The study also noted that generally, the response of the government has been very poor in terms of dealing with DV cases in the period of COVID-19 lockdown. Conclusion The study concluded that despite the failures of government in tackling the DV pandemics, NGOs have been very active in championing the cause of those violated while also trying to provide succour to victims. Thus, the study recommended that countries in Africa need to join international initiatives in prioritising DV cases while trying to deal with the virus itself. Thus, one disease should not be traded for another.


1994 ◽  
Vol 15 (3) ◽  
pp. 177-188 ◽  
Author(s):  
D. Michael Malone ◽  
John Langone

Areview of single-subject research designed to enhance the object-related play of youths with mental retardation is presented. Eleven studies, obtained from a literature search of appropriate journals, references of relevant articles, and computer databases, met inclusion criteria. Studies were organized by intervention type: (a) response to the introduction of toys, (b) programmed reinforcement of toy play, and (c) direct or assertive training procedures. Positive outcomes in the form of improved play behaviors were consistently reported across intervention type. The apparent responsiveness of participants' play skills to intervention indicates a need for further research in appropriate interventions.


2021 ◽  
Vol 11 (4) ◽  
pp. 1903
Author(s):  
Adrian Kahn ◽  
Shlomo Matalon ◽  
Rahaf Bassam Salem ◽  
Lazar Kats ◽  
Liat Chaushu ◽  
...  

This study aimed to characterize the demographic and clinical features of underreported surgical ciliated cysts developing after sinus floor augmentation, based on a series of cases from our files and a systematic review of the literature. A series of five cases (four patients) of microscopically confirmed surgical ciliated cysts following sinus floor augmentation procedures from our files are described. A systematic literature search (1991–2020) with strict clinical-, radiological- and microscopic-based exclusion and inclusion criteria was performed to detect additional similar cases. The systematic review revealed only five cases that fulfilled the inclusion criteria. Altogether, surgical ciliated cysts associated with sinus floor augmentation have been rarely reported in the literature, and have not been characterized either demographically or clinically. Graft materials were diverse, implants were placed simultaneously, or up to two years post-augmentation. The associated surgical ciliated cysts developed between 0.5 and 10 years post-augmentation. Although limited in its extent, this study is the first series to characterize possible underreported sequelae of surgical ciliated cysts associated with sinus floor augmentation. It emphasizes the need for long post-operative follow-up and confirmation of lesion by microscopic examination.


2021 ◽  
pp. 53-53
Author(s):  
Shraddha Tewari ◽  
Tushar Patel ◽  
Rushi Patel ◽  
Naresh Patel

This is a study to correlate vitamin D levels in Covid positive patients admitted in GCS medical hospital, Ahmedabad .Covid 19 can vary in clinical presentation in different patients owing to their age , comorbidities and various other factors. It is now being studied whether Vitamin D levels have any bearing on initial presentation, duration of hospital stay, oxygen requirement and clinical outcome. It is a cross sectional observational study taking into account 100 patients. After applying inclusion criteria, 94 patients were selected ,out of which 37 were vitamin D decient.(39.36%). Mean vitamin D was 17.16 ±10.85 ng/ml. Out of 94 patients 55 were males and 39 were females.34% males(18) were found to be vitamin D decient and in females 51%(19)were vitamin D decient. 38% (14)of vitamin D decient people required oxygen and 48%of vitamin D decient Covid positive patients(17) required prolonged hospitalisation.


2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Fortune Effiong ◽  
Abdulhammed opeyemi Babatunde ◽  
Olaoluwa Ezekiel Dada ◽  
Kenneth Enwerem

Context: The transmission of COVID-19 was reported to have started at a Seafood Market in Wuhan, China predominantly through droplets from coughing and sneezing. Gatherings like schools, religious and worship centers as well as market places are usually densely populated and congested thereby facilitating the spread of the virus via droplets. This research aims to explore the transmission of COVID-19 in schools, religious gatherings and markets. Evidence Acquisition: Literature search of available evidences was conducted on biomedical databases such as PubMed and Google Scholar using keywords, and articles that met inclusion criteria were selected. Results: Results show that transmission of SARS-CoV-2 has been recorded in schools, religious centres and market places in different countries and regions. Transmission was found to be less prevalent among school children unlike in influenza outbreaks due to some notable factors highlighted in the articles. Numerous evidences stated cases of transmission of SARS-CoV-2 linked to intimacy and close contacts in religious gatherings. Transmission in market place marked the genesis of the pandemic at Huanan Seafood Wholesales Market, Wuhan although only limited evidences are available about transmission in other market places in the world. Conclusions: Although these gatherings are seen to be vital to our daily lives, they are risk settings for SARS-CoV-2 transmission. It is important for government to ensure strict compliance to the COVID-19 protocols in order mitigate the spread of the virus causing the current pandemic.


2015 ◽  
Vol 10 (1) ◽  
pp. 95
Author(s):  
Elizabeth Margaret Stovold

A Review of: Perrier, L., Farrell, A., Ayala, A. P., Lightfoot, D., Kenny, T., Aaronson, E., . . . Weiss, A. ( 2014). Effects of librarian-provided services in healthcare settings: A systematic review. Journal of the American Medical Informatics Association, 21(6), 1118-1124. http://dx.doi.org/10.1136/amiajnl-2014-002825 Abstract Objective – To assess the effects of librarian-provided services, in any healthcare setting, on outcomes important to patients, healthcare providers, and researchers. Design – Systematic review and narrative synthesis. Setting – MEDLINE, CINAHL, ERIC, LISA, and CENTRAL databases; library-related websites, conference proceedings, and reference lists of included studies. Subjects – Twenty-five studies identified through a systematic literature search. Methods – In consultation with the review team, a librarian designed a search to be run in MEDLINE that was peer-reviewed against a published checklist. The team then conducted searches in the five identified databases, adapting the search as appropriate for each database. Authors also checked the websites of library and evidence based healthcare organisations, along with abstracts of relevant conference proceedings, to supplement the electronic search. Two authors screened the literature search results for eligible studies, and reached agreement by consensus. Studies of any librarian-delivered service in a healthcare setting, directed at either patients, clinicians of any type, researchers, or students, along with studies reporting outcomes relevant to clinicians, patients, or researchers, were eligible for inclusion. The authors assessed results initially on the titles and abstracts, and then on the full-text of potentially relevant reports. The data from included studies were then extracted into a piloted data extraction form, and each study was assessed for quality using the Cochrane EPOC risk of bias tool or the Newcastle-Ottawa scale. The results were synthesised narratively. Main Results – The searches retrieved a total of 25 studies that met the inclusion criteria, comprised of 22 primary papers and 3 companion reports. Authors identified 12 randomised trials, 4 controlled before-and-after studies, 3 cohorts, 2 non-randomised trials, and 1 case-control study. They identified three main categories of intervention: librarians teaching search skills; providing literature searching as a service; and a combination of the teaching and provision of search services. The interventions were delivered to a mix of trainees, clinicians, and students. None of the studies examined services delivered directly to patients or to researchers. The quality assessment found most of the studies had a mid- to high-risk of bias due to factors such as lack of random sequence generation, a lack of validated tools for data collection, or a lack of statistical analysis included in the study. Two studies measured patient relevant outcomes and reported that searches provided by librarians to clinicians had a positive impact on the patient’s length of stay in hospital. Five studies examined the effect of librarian provided services on outcomes important to clinicians, such as whether a literature search influenced a clinical decision. There was a trend towards a positive effect, although two studies found no significant difference. The majority of studies investigated the impact of training delivered to trainees and students on their literature search skills. Twelve of these studies found a positive effect of training on the recipients’ search skills, while three found no difference. The secondary outcomes considered by this review were satisfaction with the service (8 studies), relevance of the answers provided by librarians (2), and cost (3). The majority reported good satisfaction, and relevance. A cost benefit was found in 2 of 3 studies that reported this outcome. Conclusion – Authors report a positive effect of training on the literature search skills of trainees and students, and identified a benefit in the small number of studies that examined librarian services to clinicians. Future studies should use validated data collection tools, and further research should be conducted in the area of services provided to clinicians. Research is needed on the effect of librarian-provided services to patients and researchers as no studies meeting the inclusion criteria examining these two groups were identified by the literature search.


2016 ◽  
Author(s):  
Hannah Moshontz

A complete description of the literature search, including the criteria used for the inclusion of reports after they have been located, used in a research synthesis or meta-analysis is critical if subsequent researchers are to accurately evaluate and reproduce a synthesis' methods and results. Based on previous guidelines and new suggestions, we present a set of focused and detailed standards for reporting the methods used in a literature search. The guidelines cover five search strategies: reference database searches, journal and bibliography searches, searches of the reference lists of reports, citation searches, and direct contact searches. First, we bring together all the unique recommendations made in existing guidelines for research synthesis. Second, we identify gaps in reporting standards for search strategies. Third, we address these gaps by providing new reporting recommendations. Our hope is to facilitate successful evaluation and replication of research synthesis results.


2005 ◽  
Vol 6 (1) ◽  
pp. 69-76
Author(s):  
Benedetta Santarlasci ◽  
Giovanni Biricolti ◽  
Cecilia Orsi

BACKGROUND: In schizophrenia the drop-out rate can be used as proxy of effectiveness. The drop-out evaluation is also important considering the relevant economic impact for NHS of an antipsychotic therapy discontinuation in terms of patient hospitalization and other related healthcare resources consumption. OBJECTIVE: To analyze the differences in the rates of drop-out from clinical trials between olanzapine and aripiprazole. METHODS: Literature search was based on MEDLINE, on Iowa-IDIS and Drugdex databases (1966-Dec 2004). Analysis included 12 randomized controlled trials (3.778 patients), 8 for olanzapine (2.559 patients) and 4 for aripiprazole (1.219 patients). RCT inclusion criteria were: a) Patients affected by schizophrenia; b) Randomized assignment to olanzapine or aripiprazole treatment group; c) Number of patients included in the treatment group higher than 100; d) Drop-out frequency evaluation between 4th and 26th weeks of follow-up. RESULTS: The rate of treatment discontinuation was greater for aripiprazole than for olanzapine (42,2% vs. 31,6% respectively). The comparison between drop-out percentages is statistically significant (p


2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Dalia Jarusaitiene ◽  
Rasa Verkauskiene ◽  
Vytautas Jasinskas ◽  
Jurate Jankauskiene

Background. Due to low incidence of Graves’ ophthalmopathy (GO) among children, the manifestation is poorly analyzed, posing a risk to late identification of insidious disease.Purposes. To identify predictive factors that may influence the development of GO in pediatric and young patients with Graves’ disease (GD).Methods. A cross-sectional study of patients newly diagnosed with pediatric or juvenile GD during 2002–2012 was conducted at the Hospital of Lithuanian University of Health Sciences. Ocular evaluation was based on European Group on Graves’ Orbitopathy survey. The ocular manifestations were analyzed in relation to demographic, environmental, and clinical factors.Results. In total, 130 patients with juvenile GD were included; 29.2% had GO. Median age at GD onset was 17 yrs (IQR 4–29). Main symptoms of GO were eyelids retraction (73.7%), proptosis (65.8%), injection of conjunctiva (42.1%), and eyeball motility disturbance (21.1%). Major significant and independent risk factors for GO development were high initial concentration of FT4 (OR = 5.963), TTHAb (OR = 6.358), stress (OR = 6.030), and smoking (OR = 7.098).Conclusion. The major factors that could influence GO development were smoking, stress, and increased levels of initial TRAb, FT4. Slight proptosis, retraction of eyelids, and conjunctive injection were found as predominant ophthalmological symptoms in juvenile GO.


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