scholarly journals Splenic Complications of Babesia microti Infection in Humans: A Systematic Review

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Igor Dumic ◽  
Cristian Madrid ◽  
Libardo Rueda Prada ◽  
Charles W. Nordstrom ◽  
Pahnwat Tonya Taweesedt ◽  
...  
Keyword(s):  
Splenic Rupture ◽  
Hemodynamic Instability ◽  
Babesia Microti ◽  
Splenic Infarct ◽  
Pubmed Database ◽  
Increased Risk ◽  
Life Threatening ◽  
Parasitemia Level ◽  
Meta Analyses ◽  
Immunocompetent Patients

Splenic complications of acute Babesia microti infection include splenomegaly, splenic infarct, and splenic rupture. These complications are relatively rarely reported, and the aim of this research was to synthetize data on this topic according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using the PubMed database. In this review, we find that unlike other severe complications of babesiosis, splenic infarct and rupture occur in younger and immunocompetent patients, and they do not correlate with parasitemia level. Furthermore, admission hemoglobin of 10 mg/dl or less, platelet count of 50 × 10⁹/L or less, presence of hemodynamic instability, and splenic rupture were associated independently with an increased risk of requiring splenectomy. As babesiosis is an emerging tick-borne zoonosis, we hope that this review will help to raise awareness among clinicians regarding this rare but potentially life-threatening complication.

scholarly journals Cannabis Use and Risk of Schizophrenia: A Literature Review

2021 ◽  
Vol 6 (2) ◽  
Keyword(s):  
Positive Association ◽  
Epidemiological Studies ◽  
The Body ◽  
Cannabis Use ◽  
Normal Brain ◽  
Brain Functioning ◽  
Pubmed Database ◽  
Increased Risk ◽  
Meta Analyses ◽  
Study Designs

Background and Objective: Cannabis remains the most widely used illicit drug worldwide. The similarity in the chemical structure of tetrahydrocannabinol to the brain chemical anandamide allows the body to recognize it and alter normal brain functioning. The objective of this review article is to summarize the evidence for the association between cannabis and schizophrenia. Methods: A literature search was conducted using the PubMed database and other sources. The keywords used were “cannabis” and “psychosis” and “schizophrenia.” Fifty-two articles relevant to our topic have been selected for this review. Results: Evidence from observational epidemiological studies has shown a positive association between regular cannabis use and schizophrenia risk. Meta-analyses and Mendelian randomization studies support the evidence from observational study designs. Discussion and Conclusions: The association between cannabis and schizophrenia is biologically plausible. Moreover, there has been emerging evidence of genes interacting with cannabis use to confer a higher risk for schizophrenia. There are enough reason and sufficient epidemiological evidence to warn people about the risk of developing schizophrenia with cannabis use. Scientific Significance: The increasing legalization of cannabis for recreational use is of significant concern. Long-term cannabis use might predispose people to increased risk of developing schizophrenia. Health professionals have a major role to play by taking maximum advantage of social and psychological interventions to educate people about the potential danger associated with cannabis and avoid its use.

scholarly journals Mortality rates in matched cohort, pseudo-randomised and randomised trials of convalescent plasma given to COVID-19 patients

2020 ◽  
Author(s):  
Amar Ahmad ◽  
Marwa Salsabil ◽  
Tim Oliver
Keyword(s):  
Vitamin D ◽  
Meta Analysis ◽  
P Value ◽  
Matched Cohort ◽  
Randomised Trials ◽  
Published Evidence ◽  
Increased Risk ◽  
Life Threatening ◽  
Number Of Publications ◽  
Meta Analyses

AbstractIntroductionFor more than 80 years convalescent or immune sera has been used in severe life threatening infections. Since March of this year a rapidly increasing number of publications have reported series of Convalescent plasma (CP) investigations in severely ill COVID-19 patients.Objectivea brief CP scoping review focusing on early mortalityMethodsWe searched available data bases. Three randomised trials, two pseudo-randomised observations and twelve matched cohort studies were identified. Random-effects meta-analyses were performed on extracted dataResultsA total of 2,378 CP treated and 5188 “controls” in 17 studies. Individually only two studies were significant for reduction of deaths to 30 days, but all showed a similar percentage reduction. When pooled, meta-analysis was undertaken. It showed that the overall reduction of death was significant for all series RR 0.710 (p=0.00001), all matched cohort series RR = 0.610 (p-value = 0.001) and the two pseudo-randomised series RR 0.747 (p=0.005) but not the three technically inadequate randomised trials, RR 0.825 (p=0.397). In two of these randomised trials, there was faster clearance of Viral DNA at 72 hours after CP than placeboConclusionIt is hoped the significance of this less than perfect data will increase interest in completing the delayed randomised trials as the results suggest they could be better than currently licenced drugs. Given increasing published evidence of increased risk of both diagnosis and death from COVID-19 in patients with severe Vitamin-D deficiency, future studies should also study influence of Vitamin-D status of donor and recipient on outcome.

scholarly journals Effect of Egg Consumption on Cardiometabolic Health Outcomes: An Overview of Systematic Reviews and Meta-Analyses (P08-043-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Eunice Mah ◽  
Oliver Chen ◽  
DeAnn Liska
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
General Population ◽  
Systematic Reviews ◽  
Cardiometabolic Health ◽  
Evidence Based ◽  
Egg Consumption ◽  
Pubmed Database ◽  
Increased Risk ◽  
Meta Analyses

Abstract Objectives The relationship of egg consumption and cardiometabolic disease risk is controversial. This report provides an overview on the consistencies and gaps in the evidence base on eggs and cardiometabolic health. Methods PubMed database was screened for evidence-based reviews published in English that assessed human studies on egg consumption and cardiometabolic outcomes, augmented by searches in Web of Science and Google. Results Seven qualitative and 15 quantitative reviews were identified, with >70% having published since 2015. Overall, the systematic reviews were of low quality, while meta-analyses were of moderate to high quality. No association of increased egg intake and risks of heart disease or stroke in the general population were found in the meta-analyses. Increased risk of heart failure was noted in two meta-analyses that analyzed the same three cohort studies. Five recent meta-analyses reported no increased risk of type 2 diabetes mellitus (T2DM) in the general population, although increased risk in US-based populations only was reported. Older (2013) meta-analyses reported increased risk of cardiovascular disease (CVD) or heart disease in T2DM populations and no recent evidence-based reviews were identified. Finally, only one meta-analysis reported intervention studies specifically on eggs and biomarkers (i.e., lipids), and the results contradicted those from observation studies. Conclusions Recent evidence-based reviews conclude that increased egg consumption is not associated with CVD in the general population. More research is needed on the positive associations between heart failure and T2DM risk with egg consumption, as well as CVD risk in diabetics, before firm Conclusions can be made. Funding Sources Partial support from Egg Nutrition Council.

scholarly journals Are Smoke and Aerosols Generated During Laparoscopic Surgery a Biohazard? A Systematic Evidence-Based Review

2021 ◽  
pp. 155335062199230
Author(s):  
Jorge Pasquier ◽  
Oscar Villalta ◽  
Sunaymy Sarria Lamorú ◽  
Carmen Balagué ◽  
Ramon Vilallonga ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Genetic Material ◽  
Airborne Transmission ◽  
Potential Health ◽  
Surgical Smoke ◽  
Qualitative Systematic Review ◽  
Pubmed Database ◽  
Increased Risk ◽  
Long Time ◽  
Meta Analyses

Background. Laparoscopic surgery generates end products that can have potentially harmful effects for the surgical team from short- or long-time exposure. In view of the current SARS-CoV-2 circumstances, controversy has risen concerning the safety of surgical smoke (SS) and aerosols and the perception of an increased risk of exposure during laparoscopic surgery. Methods. The present qualitative systematic review was conducted according to Meta-Analyses and Systematic Reviews of Observational Studies (MOOSE). A literature search was performed from March 2020 up to May 10, 2020, using the PubMed database, Cochrane, and Google Scholar to assess the risk of airborne transmission of viruses and the potential health risk of surgical smoke- and aerosol-generating procedures produced during laparoscopic surgery. The keywords were introduced in combination to obtain better search results. Application of the inclusion and exclusion criteria identified 44 relevant articles. Results. Genetic material from certain viruses, or the virus itself, has been detected in SS and aerosols. However, in the current SARS-CoV-2, as in other coronavirus situations, studies analyzing the presence of airborne transmission of viruses in surgical smoke are lacking. Conclusion. Despite the lack of clear evidence regarding the risk of diseases as the result of smoke- and aerosol-generating procedures during laparoscopic surgery, further investigation is needed. Meanwhile, all available precautions must be taken.

scholarly journals The Potential Role of Extracorporeal Cytokine Removal in Hemodynamic Stabilization in Hyperinflammatory Shock

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 768
Author(s):  
Fatime Hawchar ◽  
Cristina Rao ◽  
Ali Akil ◽  
Yatin Mehta ◽  
Christopher Rugg ◽  
...  
Keyword(s):  
Critically Ill ◽  
Hemodynamic Instability ◽  
Pooled Analysis ◽  
Organ Support ◽  
Pubmed Database ◽  
Threatening Condition ◽  
Life Threatening ◽  
Mean Differences ◽  
The Impact

Hemodynamic instability due to dysregulated host response is a life-threatening condition requiring vasopressors and vital organ support. Hemoadsorption with Cytosorb has proven to be effective in reducing cytokines and possibly in attenuating the devastating effects of the cytokine storm originating from the immune over-response to the initial insult. We reviewed the PubMed database to assess evidence of the impact of Cytosorb on norepinephrine needs in the critically ill. We further analyzed those studies including data on control cohorts in a comparative pooled analysis, defining a treatment effect as the standardized mean differences in relative reductions in vasopressor dosage at 24 h. The literature search returned 33 eligible studies. We found evidence of a significant reduction in norepinephrine requirement after treatment: median before, 0.55 (IQR: 0.39–0.90); after, 0.09 (0.00–0.25) μg/kg/min, p <0.001. The pooled effect size at 24 h was large, though characterized by high heterogeneity. In light of the importance of a quick resolution of hemodynamic instability in the critically ill, further research is encouraged to enrich knowledge on the potentials of the therapy.

scholarly journals Otorhinolaryngological manifestations of COVID-19-A systematic review

2020 ◽  
Author(s):  
Priyadarshini Govindarajalu ◽  
Rahulkumar Shah ◽  
Monil Parsana
Keyword(s):  
Systematic Review ◽  
Respiratory Tract ◽  
Upper Respiratory Tract ◽  
Pubmed Database ◽  
Increased Risk ◽  
Life Threatening ◽  
Risk Of Exposure ◽  
Taste Dysfunction ◽  
Insight Into ◽  
Nose And Throat

Abstract Background: In early December 2019, an outbreak of COVID-19, caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), occurred in Wuhan City, Hubei Province, China causing havoc all over the world. As clinicians, recognition of this disease is necessary to isolate these patients to prevent further human to human transmission. Due to its affinity to the respiratory tract and increased viral load in the nose and throat, we as practising otorhinolaryngologists are at increased risk of exposure to this life-threatening virus and warrants an in-depth knowledge on the symptomatology of this disease. This systematic review is intended to highlight the otorhinolaryngological manifestations of COVID-19.Methodology: The literature search was performed on PubMed database using Boolean operators ‘and ‘, ‘or’ as “otorhinolaryngological manifestations” or “rhinology” or “otology” or “larynx” or “hearing” or “olfaction” and “covid19” or “novel corona virus” or “SARS-CoV” with filters as ‘2020’ year of study on 7/08/2020 at 11.30 Am.Review Results: Total of 357 articles were obtained on search and the final 12 articles extracted based on our selection criteria were reviewed. The studies included 6825 laboratory confirmed COVID -19 patients with varying severity of disease. Olfactory dysfunction and taste dysfunction were noted in 2355 and 2224 patients respectively. Nasal obstruction was reported in 323 patients and sore throat in 261 patients. Rhinorrhoea was reported in 209 patients .158 patients complained of post nasal drip and 152 patients presented with facial pain.Conclusion: As a practising otorhinolaryngologist, a good insight into the otorhinolaryngological manifestations of COVID-19 is essential to differentiate between the prodromal symptoms of COVID-19 and non-COVID viral upper respiratory tract infection.

Bowel ischaemia after endovascular aneurysm repair

VASA ◽  
2018 ◽  
Vol 47 (4) ◽  
pp. 273-277
Author(s):  
Christopher Lowe ◽  
Oussama El Bakbachi ◽  
Damian Kelleher ◽  
Imran Asghar ◽  
Francesco Torella ◽  
...  
Keyword(s):  
Case Reports ◽  
Endovascular Aneurysm Repair ◽  
Artery Occlusion ◽  
Bibliographic Databases ◽  
Bowel Ischaemia ◽  
Prophylactic Measures ◽  
Increased Risk ◽  
Prisma Statement ◽  
Meta Analyses ◽  
Aneurysm Repair

Abstract. The aim of this review was to investigate presentation, aetiology, management, and outcomes of bowel ischaemia following EVAR. We present a case report and searched electronic bibliographic databases to identify published reports of bowel ischaemia following elective infra-renal EVAR not involving hypogastric artery coverage or iliac branch devices. We conducted our review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards. In total, five cohort studies and three case reports were included. These studies detailed some 6,184 infra-renal elective EVARs, without procedure-related occlusion of the hypogastric arteries, performed between 1996 and 2014. Bowel ischaemia in this setting is uncommon with an incidence ranging from 0.5 to 2.8 % and includes a spectrum of severity from mucosal to transmural ischaemia. Due to varying reporting standards, an overall proportion of patients requiring bowel resection could not be ascertained. In the larger series, mortality ranged from 35 to 80 %. Atheroembolization, hypotension, and inferior mesenteric artery occlusion were reported as potential causative factors. Elderly patients and those undergoing prolonged procedures appear at higher risk. Bowel ischaemia is a rare but potentially devastating complication following elective infra-renal EVAR and can occur in the setting of patent mesenteric vessels and hypogastric arteries. Mortality ranges from 35 to 80 %. Further research is required to identify risk factors and establish prophylactic measures in patients that have an increased risk of developing bowel ischaemia after standard infra-renal EVAR.

Cardiovascular Complications of Sleep Disorders: A Better Night’s Sleep for a Healthier Heart / From Bench to Bedside

2020 ◽  
Vol 19 (2) ◽  
pp. 210-232 ◽  
Author(s):  
Theodora A. Manolis ◽  
Antonis A. Manolis ◽  
Evdoxia J. Apostolopoulos ◽  
Helen Melita ◽  
Antonis S. Manolis
Keyword(s):  
Sleep Disorders ◽  
Disease Risk ◽  
Behavioral Therapy ◽  
Benzodiazepine Receptor ◽  
Cardiovascular Complications ◽  
Gamma Aminobutyric Acid ◽  
Acid Type ◽  
Increased Risk ◽  
Cv Disease ◽  
Meta Analyses

: Sleep is essential to and an integral part of life and when lacking or disrupted, a multitude of mental and physical pathologies ensue, including cardiovascular (CV) disease, which increases health care costs. Several prospective studies and meta-analyses show that insomnia, short (<7h) or long (>9h) sleep and other sleep disorders are associated with an increased risk of hypertension, metabolic syndrome, myocardial infarction, heart failure, arrhythmias, CV disease risk and/or mortality. The mechanisms by which insomnia and other sleep disorders lead to increased CV risk may encompass inflammatory, immunological, neuro-autonomic, endocrinological, genetic and microbiome perturbations. Guidelines are emerging that recommend a target of >7 h of sleep for all adults >18 years for optimal CV health. Treatment of sleep disorders includes cognitive-behavioral therapy considered the mainstay of non-pharmacologic management of chronic insomnia, and drug treatment with benzodiazepine receptor agonists binding to gamma aminobutyric acid type A (benzodiazepine and non-benzodiazepine agents) and some antidepressants. However, observational studies and meta-analyses indicate an increased mortality risk of anxiolytics and hypnotics, although bias may be involved due to confounding and high heterogeneity in these studies. Nevertheless, it seems that the risk incurred by the non-benzodiazepine hypnotic agents (Z drugs) may be relatively less than the risk of anxiolytics, with evidence indicating that at least one of these agents, zolpidem, may even confer a lower risk of mortality in adjusted models. All these issues are herein reviewed.

scholarly journals How Effective Is Auditory–Verbal Therapy (AVT) for Building Language Development of Children with Cochlear Implants? A Systematic Review

Life ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 239
Author(s):  
Paris Binos ◽  
Elina Nirgianaki ◽  
George Psillas
Keyword(s):  
Systematic Review ◽  
Young Children ◽  
Cochlear Implants ◽  
Research Question ◽  
Voice Quality ◽  
Receptive Vocabulary ◽  
Pubmed Database ◽  
Mainstream Society ◽  
Meta Analyses ◽  
Auditory Verbal Therapy

This systematic review sheds light on the effectiveness of auditory–verbal therapy (AVT) outcomes in children with cochlear implants (CIs). The presented outcome is based on research findings from the last 10 years. The systematic review was designed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and Critical Appraisal of Treatment Evidence (CATE) checklist. Specific keywords were chosen based on the research question and searched on the PubMed database. All searched papers were analysed based on specific exclusion criteria and classified into four evidence levels. The results revealed that children who participated in AV therapy can achieve linguistic skills at the same level as their hearing peers. Voice quality seemed positively affected, placing young children with CIs in the normal range for receptive vocabulary development. In contrast, reading skills seemed less benefited. AV therapy seems to contribute to integration into mainstream society. Despite the recorded speech and language improvements of young children with CIs, the aim of AV therapy is still not fulfilled. AV therapy can be seen as the best clinical practice for young children with CIs till now, but the lack of well-controlled studies is undermining.

scholarly journals Exploring the Relationship between Biologics and Postoperative Surgical Morbidity in Ulcerative Colitis: A Review

2021 ◽  
Vol 10 (4) ◽  
pp. 710
Author(s):  
Abel Botelho Quaresma ◽  
Fernanda da Silva Barbosa Baraúna ◽  
Fábio Vieira Teixeira ◽  
Rogério Saad-Hossne ◽  
Paulo Gustavo Kotze
Keyword(s):  
Ulcerative Colitis ◽  
Postoperative Complications ◽  
Meta Analysis ◽  
Qualitative Evaluation ◽  
Complication Rates ◽  
Surgical Morbidity ◽  
Randomized Studies ◽  
Pubmed Database ◽  
Increased Risk ◽  
The Impact

Background: With the paradigm shift related to the overspread use of biological agents in the treatment of inflammatory bowel diseases (IBD), several questions emerged from the surgical perspective. Whether the use of biologicals would be associated with higher rates of postoperative complications in ulcerative colitis (UC) patients still remains controversial. Aims: We aimed to analyze the literature, searching for studies that correlated postoperative complications and preoperative exposure to biologics in UC patients, and synthesize these data qualitatively in order to check the possible impact of biologics on postoperative surgical morbidity in this population. Methods: Included studies were identified by electronic search in the PUBMED database according to the PRISMA (Preferred Items of Reports for Systematic Reviews and Meta-Analysis) guidelines. The quality and bias assessments were performed by MINORS (methodological index for non-randomized studies) criteria for non-randomized studies. Results: 608 studies were initially identified, 22 of which were selected for qualitative evaluation. From those, 19 studies (17 retrospective and two prospective) included preoperative anti-TNF. Seven described an increased risk of postoperative complications, and 12 showed no significant increase postoperative morbidity. Only three studies included surgical UC patients with previous use of vedolizumab, two retrospective and one prospective, all with no significant correlation between the drug and an increase in postoperative complication rates. Conclusions: Despite conflicting results, most studies have not shown increased complication rates after abdominal surgical procedures in patients with UC with preoperative exposure to biologics. Further prospective studies are needed to better establish the impact of preoperative biologics and surgical complications in UC.

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