RESUMO
To synthesise the evidence comparing the incidence rates of UAS post-RARC vs Open Radical cystectomy (ORC) in adults undergoing cystectomy and to compare differential stricture rates between Extracorporeal and Intracorporeal urinary diversion (ECUD vs ICUD). The primary outcome was incidence rate of UAS post RARC vs ORC and the secondary outcome was incidence rate of UAS in RARC post ECUD vs ICUD. Review authors conducted comprehensive search for studies comparing RARC with ORC in terms of incidence of UAS. Furthermore, we conducted a secondary search for studies which compared UAS incidence comparing ECUD and ICUD. We found that RARC may have higher incidence of UAS [OR: 1.39; 95% CI 1.11-1.75; p < 0.0001]. ECUD may result in lower rate of UAS as compared to ICUD [OR: 0.74; 95% CI 0.56 to 0.98; p= 0.04].
Assuntos
Anastomose Cirúrgica , Cistectomia , Complicações Pós-Operatórias , Procedimentos Cirúrgicos Robóticos , Ureter , Derivação Urinária , Humanos , Cistectomia/efeitos adversos , Cistectomia/métodos , Incidência , Constrição Patológica/etiologia , Constrição Patológica/epidemiologia , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Anastomose Cirúrgica/efeitos adversos , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Derivação Urinária/efeitos adversos , Derivação Urinária/métodos , Ureter/cirurgia , Neoplasias da Bexiga Urinária/cirurgia , AdultoRESUMO
BACKGROUND: The coronavirus disease-2019 (COVID-19) pandemic is coming to the fore and has surfaced as a public health emergency of international concern. The lack of vaccines or an effective treatment has led to the global hunt for potential pharmaceuticals in adequately managing this disease. This systematic review highlights the efficacy of chloroquine and its derivative hydroxychloroquine in the treatment of COVID-19 and also explores the safety profile of these drugs. METHODS: EMBASE, COCHRANE, and PubMed databases were searched for studies on the use of hydroxychloroquine or chloroquine in the treatment of COVID-19. RESULTS: Twenty articles were selected including expert opinions, National Guidelines, three small randomized controlled trials, and one prospective study. Both hydroxychloroquine and chloroquine have shown promising results including reduction in hospital length of stay and overall mortality. Moreover, concomitant use with azithromycin seems to reduce viral load to a greater extent. CONCLUSIONS: Considering the known safety profile of these drugs in the treatment of other diseases, their availability and affordability, chloroquine and hydroxychloroquine are potential antiviral agents in the treatment of COVID-19. However, reported side effects of these drugs when used in conjunction with azithromycin in patients with comorbidities have raised significant safety concerns. High-quality randomized clinical trials are warranted to provide more comprehensive evidence of the safety of these drugs in patients infected with COVID-19.