scholarly journals Thalassemia and COVID-19: Susceptibility and Severity

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Somayeh Rahimi ◽  
Saba Zakeri ◽  
Mahsa Nouri ◽  
Yaser Mohassel ◽  
Bahareh Karami ◽  
...  
Keyword(s):  
Sample Size ◽  
Observational Studies ◽  
Web Of Science ◽  
Case Reports ◽  
Young Patients ◽  
Iron Chelation ◽  
Hemoglobin F ◽  
Adrenal Hypofunction ◽  
Key Terms ◽  
Larger Sample

Context: COVID-19 results in an imbalance between procoagulant and anticoagulant homeostatic mechanisms that could be complicated with thrombotic events. In β-thalassemia patients, the presence of comorbidities, iron overload, adrenal hypofunction, splenectomy, and chronic hypercoagulable state might increase the susceptibility to COVID-19 and its severity. Evidence Acquisition: The search was conducted in PubMed, Web of Science, and Scopus databases for the key terms of β-thalassemia/thalassemia and COVID-19 until July 2021. Results: The survey of published observational studies (mostly multicenter and case reports) indicated a lower prevalence of COVID-19 in β-thalassemia patients compared with the general population, as well as mild to moderate COVID-19 in these patients, especially in those without comorbidity. β-Thalassemia children were susceptible to COVID-19 but with less severity compared to adults. There is no report of pulmonary embolism and thrombotic events in β-thalassemia patients with COVID-19; however, coagulation abnormality and pulmonary microembolism have been found in these patients. Conclusions: Findings could be interpreted by the presence of high hemoglobin F (HbF) levels, the advantage of hydroxyurea (HU) therapy, splenectomy, and iron chelation therapy in these patients. However, due to the low sample size and studying mainly young patients, the results should be interpreted with caution, and it still needs more studies with a larger sample size to confirm these findings.

scholarly journals Post COVID-19 Organizing Pneumonia: A Systematic Review and Meta-analysis

2021 ◽  
pp. 259-270
Author(s):  
Talal Khalid Abdullah Alanazi ◽  
Nasser Faris Ali Alahmari ◽  
Faris Essa Ibrahim Qubays ◽  
Solaiman Hosaian ibraheem Alenezi ◽  
Meshal Faleh Mofadhe Alenezi
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Web Of Science ◽  
Case Reports ◽  
Meta Analysis ◽  
Organizing Pneumonia ◽  
Eligible Study ◽  
Data Synthesis ◽  
Electronic Search ◽  
Review Manager

Introduction: Several observational studies have found parallels between COVID-19 pneumonia and organizing pneumonia (OP). This study aims to investigate the published literature of OP related to COVID-19, estimates the prevalence of OP among COVID-19 patients, and assesses the risk or COVID-19 severity associated with OP. Methodology: This was a systematic review and meta-analysis. A systematic electronic search through PubMed, Web of Science, Science Direct, EBSCO, and Google Scholar was conducted to include relevant and eligible literature. The authors used Review Manager 5.4 to perform quantitative data synthesis for the condition of interest analyses. Results: A total of 9 eligible study articles and 12 case reports were included in this study. The estimated pooled organizing pneumonia prevalence among COVID-19 patients was 45.6% [23.1%-68.2%]. The association between OP and severe COVID-19 infection revealed a pooled OR [95% CI] of 5.22 [-0.96-11.41]. Conclusion: COVID-19 patients had a rather high OP prevalence (43%). Surprisingly, cancer patients with COVID-19 infection had the lowest OP prevalence. OP was identified as a possible risk factor for the severity of COVID-19 infection.

Tinea Imbricata: An Overview

2019 ◽  
Vol 15 (3) ◽  
pp. 170-174 ◽  
Author(s):  
Alexander K.C. Leung ◽  
Kin F. Leong ◽  
Joseph M. Lam
Keyword(s):  
Observational Studies ◽  
Search Strategy ◽  
Case Reports ◽  
Skin Lesions ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Pubmed Search ◽  
Meta Analyses ◽  
Clinical Queries ◽  
Key Terms

Background: Tinea imbricata is a chronic superficial mycosis caused mainly by Trichophyton concentricum. The condition mainly affects individuals living in primitive and isolated environment in developing countries and is rarely seen in developed countries. Physicians in nonendemic areas might not be aware of this fungal infection. Objective: To familiarize physicians with the clinical manifestations, diagnosis, and treatment of tinea imbricata. Methods: A PubMed search was completed in Clinical Queries using the key terms "Tinea imbricata" and "Trichophyton concentricum". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The information retrieved from the above search was used in the compilation of the present article.A PubMed search was completed in Clinical Queries using the key terms "Tinea imbricata" and "Trichophyton concentricum". The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, reviews, and case reports. The information retrieved from the above search was used in the compilation of the present article. Results: The typical initial lesions of tinea imbricata consist of multiple, brownish red, scaly, pruritic papules. The papules then spread centrifugally to form annular and/or concentric rings that can extend to form serpinginous or polycyclic plaques with or without erythema. With time, multiple overlapping lesions develop, and the plaques become lamellar with abundant thick scales adhering to the interior of the lesion, giving rise to the appearance of overlapping roof tiles, lace, or fish scales. Lamellar detachment of the scales is common. The diagnosis is mainly clinical, based on the characteristic skin lesions. If necessary, the diagnosis can be confirmed by potassium hydroxide wet-mount examination of skin scrapings of the active border of the lesion which typically shows short septate hyphae, numerous chlamydoconidia, and no arthroconidia. Currently, oral terbinafine is the drug of choice for the treatment of tinea imbricata. Combined therapy of an oral antifungal agent with a topical antifungal and keratolytic agent may increase the cure rate. Conclusion: In most cases, a spot diagnosis of tinea imbricata can be made based on the characteristic skin lesions consisting of scaly, concentric annular rings and overlapping plaques that are pruritic. Due to popularity of international travel, physicians involved in patient care should be aware of this fungal infection previously restricted to limited geographical areas.

scholarly journals Is the incidence of colorectal cancer increasing in the younger population? - a UK DGH experience

2020 ◽  
Vol 8 (1) ◽  
pp. 186
Author(s):  
Shirish Tewari ◽  
Vinay Shah ◽  
Paul Cathcart ◽  
Vivek Gupta ◽  
Nick Reay-Jones
Keyword(s):  
Colorectal Cancer ◽  
Sample Size ◽  
Age Distribution ◽  
Young Patients ◽  
Colorectal Cancers ◽  
Team Meetings ◽  
Younger Age ◽  
Age Range ◽  
Multidisciplinary Team Meetings ◽  
Larger Sample

Background: Over the past few years we have noticed increasing number of young patients diagnosed with colorectal cancer being discussed in colorectal multidisciplinary team meetings. Our aim was to look if the incidence is in fact rising in the younger age-group patients, aged below 40 years.  Methods: Retrospective data was collected from the Info flex database system at our DGH for all colorectal cancers diagnosed between January 2014-December 2019. The incidence of colorectal cancers under the age of 40 years was calculated as well as other demographics parameters were taken into consideration.Results: Total 770 colorectal cancers were diagnosed during the study period. 451 (58.58% were male and 319 (41.42%) were female. The age range was 25-98 years. 2.06%, 3.19%, 1.14%, 0%, 2.22%, 2.38% patients below the age of 40 years were diagnosed with colorectal cancer in 2014, 2015, 2016, 2017, 2018 and 2019 respectively.Conclusions: Our study does not show any increasing trend in the incidence of colorectal cancer in the younger population. One of the limitations of this study is the limited sample size used. A larger sample size or analysis of colorectal registries could be more informative to ascertain if there is a change in the age-distribution pattern of colorectal cancers.  

scholarly journals Effect of COVID-19 on liver abnormalities: a systematic review and meta‐analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Khalid Bzeizi ◽  
Maheeba Abdulla ◽  
Nafeesa Mohammed ◽  
Jehad Alqamish ◽  
Negar Jamshidi ◽  
...  
Keyword(s):  
Liver Function ◽  
Observational Studies ◽  
Case Reports ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Clinical Effects ◽  
Effect Model ◽  
Study Designs ◽  
Larger Sample

AbstractEmerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.

scholarly journals Eosinophilic pancreatitis: a review of the pathophysiology, diagnosis, and treatment

2020 ◽  
Author(s):  
Yue Sun ◽  
Dan Pan ◽  
Kai Kang ◽  
Ming-Jun Sun ◽  
Yi-Ling Li ◽  
...  
Keyword(s):  
Diagnostic Criteria ◽  
Literature Search ◽  
Web Of Science ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Diagnostic Algorithm ◽  
Diagnosis And Treatment ◽  
Ultrasound Computed Tomography ◽  
Key Terms

Abstract Eosinophilic pancreatitis (EP) is an extremely rare disease caused by purely eosinophilic infiltration of the pancreas. EP is prone to being misdiagnosed as pancreatic cancer, causing unnecessary economic and physical harm to the patient. We report three cases of EP that were cured by steroids without relapse from 2017 to now. The clinical data of the three patients, including clinical manifestations, serological manifestations, imaging (ultrasound, computed tomography, and MRI), pathological diagnosis and treatment, and telephone follow-up of all patients, were retrospectively analysed. In addition, a literature search was conducted on the Web of Science and PubMed databases using key terms related to EP, considering case reports with no restrictions on the date of publication or language. In conclusion, we analysed 19 cases and determined the diagnostic criteria for EP. The diagnostic algorithm for EP can be used to diagnose EP easily. We hope that our standards and algorithm can reduce the rate of misdiagnosis and contribute to clinical diagnosis and treatment. In addition, we expect to evaluate more EP cases to test our diagnostic criteria and design a systematic diagnostic flow chart.

Planning the Size of Clinical Trials with Allowance for Patient Noncompliance

1990 ◽  
Vol 29 (03) ◽  
pp. 243-246 ◽  
Author(s):  
M. A. A. Moussa
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Sample Size ◽  
Event Rate ◽  
Survival Functions ◽  
Time Intervals ◽  
Patient Noncompliance ◽  
Event Rates ◽  
Larger Sample

AbstractVarious approaches are considered for adjustment of clinical trial size for patient noncompliance. Such approaches either model the effect of noncompliance through comparison of two survival distributions or two simple proportions. Models that allow for variation of noncompliance and event rates between time intervals are also considered. The approach that models the noncompliance adjustment on the basis of survival functions is conservative and hence requires larger sample size. The model to be selected for noncompliance adjustment depends upon available estimates of noncompliance and event rate patterns.

Augmentation Strategies for Clozapine-Resistant Patients with Schizophrenia

2020 ◽  
Vol 26 (2) ◽  
pp. 218-227
Author(s):  
Yi-Hang Chiu ◽  
Chia-Yueh Hsu ◽  
Mong-Liang Lu ◽  
Chun-Hsin Chen
Keyword(s):  
Sample Size ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Mood Stabilizers ◽  
Treatment Resistant ◽  
Double Blind ◽  
Beneficial Effects ◽  
Augmentation Strategies ◽  
Pubmed Database ◽  
Augmentation Strategy ◽  
Larger Sample

Background: Clozapine has been used in treatment-resistant patients with schizophrenia. However, only 40% of patients with treatment-resistant schizophrenia have response to clozapine. Many augmentation strategies have been proposed to treat those clozapine-resistant patients, but the results are inconclusive. In this review, we intended to review papers dealing with the augmentation strategies in the treatment of clozapineresistant patients with schizophrenia. Method: We reviewed randomized, double-blind, placebo- or sham-controlled trials (RCT) for clozapine-resistant patients with schizophrenia in Embase, PsycINFO, Cochrane, and PubMed database from January 1990 to June 2019. Results: Antipsychotics, antidepressants, mood stabilizers, brain stimulation, such as electroconvulsive therapy (ECT) and repetitive transcranial magnetic stimulation, and other strategies, were used as an augmentation in clozapine-resistant patients with schizophrenia. Except for better evidence in memantine with 2 RCTs and cognitive behavior therapy in 2 studies to support its effectiveness, we found that all the other effective augmentations, including sulpiride, ziprasidone, duloxetine, mirtazapine, ECT, sodium benzoate, ginkgo biloba, and minocycline, had only one RCT with limited sample size. Conclusion: In this review, no definite effective augmentation strategy was found for clozapine-resistant patients. Some potential strategies with beneficial effects on psychopathology need further studies with a larger sample size to support their efficacy.

scholarly journals ‘Statistical Irreproducibility’ Does Not Improve with Larger Sample Size: How to Quantify and Address Disease Data Multimodality in Human and Animal Research

2021 ◽  
Vol 11 (3) ◽  
pp. 234
Author(s):  
Abigail R. Basson ◽  
Fabio Cominelli ◽  
Alexander Rodriguez-Palacios
Keyword(s):  
Sample Size ◽  
Data Visualization ◽  
Random Sampling ◽  
Intestinal Inflammation ◽  
Random Number Generation ◽  
Outcome Data ◽  
Multimodal Distributions ◽  
Disease Subtypes ◽  
Study Designs ◽  
Larger Sample

Poor study reproducibility is a concern in translational research. As a solution, it is recommended to increase sample size (N), i.e., add more subjects to experiments. The goal of this study was to examine/visualize data multimodality (data with >1 data peak/mode) as cause of study irreproducibility. To emulate the repetition of studies and random sampling of study subjects, we first used various simulation methods of random number generation based on preclinical published disease outcome data from human gut microbiota-transplantation rodent studies (e.g., intestinal inflammation and univariate/continuous). We first used unimodal distributions (one-mode, Gaussian, and binomial) to generate random numbers. We showed that increasing N does not reproducibly identify statistical differences when group comparisons are repeatedly simulated. We then used multimodal distributions (>1-modes and Markov chain Monte Carlo methods of random sampling) to simulate similar multimodal datasets A and B (t-test-p = 0.95; N = 100,000), and confirmed that increasing N does not improve the ‘reproducibility of statistical results or direction of the effects’. Data visualization with violin plots of categorical random data simulations with five-integer categories/five-groups illustrated how multimodality leads to irreproducibility. Re-analysis of data from a human clinical trial that used maltodextrin as dietary placebo illustrated multimodal responses between human groups, and after placebo consumption. In conclusion, increasing N does not necessarily ensure reproducible statistical findings across repeated simulations due to randomness and multimodality. Herein, we clarify how to quantify, visualize and address disease data multimodality in research. Data visualization could facilitate study designs focused on disease subtypes/modes to help understand person–person differences and personalized medicine.

scholarly journals Immediate Post-Extraction Short Implant Placement with Immediate Loading and without Extraction of an Impacted Maxillary Canine: Two Case Reports

Materials ◽  
2021 ◽  
Vol 14 (11) ◽  
pp. 2757
Author(s):  
José Antonio Moreno-Rodríguez ◽  
Julia Guerrero-Gironés ◽  
Francisco Javier Rodríguez-Lozano ◽  
Miguel Ramón Pecci-Lloret
Keyword(s):  
Dental Implant ◽  
Alveolar Bone ◽  
Case Reports ◽  
Young Patients ◽  
Aesthetic Result ◽  
First Choice ◽  
Surgical Extraction ◽  
Impacted Canine ◽  
Short Implant

For the treatment of impacted maxillary canines, traction associated with a complete orthodontic treatment is the first choice in young patients. However, in adults, this treatment has a worse prognosis. The surgical extraction of the impacted tooth can result in a series of complications and a compromised alveolar bone integrity, which may lead to the requirement of a bone regeneration/grafting procedure to replace the canine with a dental implant. These case reports aimed to describe an alternative treatment procedure to the surgical extraction of impacted maxillary canines in adults. Following clinical and computerized tomography-scan (CT-Scan) examination, the possibility of maintaining the impacted canine in its position and replacing the temporary canine present in its place with a dental implant was planned. A short dental implant with an immediate provisional crown was placed, without contacting the impacted canine. At 3 months follow-up, a definitive metal-ceramic restoration was placed. Follow-up visits were performed periodically. The implant site showed a physiological soft tissue color and firmness, no marginal bone loss, no infection or inflammation, and an adequate aesthetic result in all follow-up visits. These results suggest that the treatment carried out is a valid option to rehabilitate with an osseointegrated short implant area where a canine is included, as long as there is a sufficient amount of the remaining bone.

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