Management of pelvic organ prolapse and quality of life: a systematic review and meta-analysis.

INTRODUCTION AND HYPOTHESIS: One of the main outcomes in the assessment of the treatment of pelvic organ prolapse in women is quality of life. Using quality of life as an outcome measure is increasing in the majority of clinical trials. The aim of current study was to determine the effects of the treatment of pelvic organ prolapse on patients' quality of life using systematic review and meta-analysis. METHODS: A systematic search for finding randomized controlled studies on pelvic organ prolapse published before October 2012 was conducted. The JAMA users' guide to the medical literature quality assessment scales for randomized clinical trials was used to assess the quality of included articles. The mean difference in total quality of life score between before and after intervention (surgical or pelvic floor training) with 95 % confidence interval (CI) was considered as a primary summary measure. Egger's test was used to evaluate the publication bias. Heterogeneity was assessed using I(2) Index. RESULTS: Fifty-seven RCT were critically appraised. Thirty-two articles were eligible after critical evaluation. Mean difference in change in the total quality of life score with 95 % CI for surgical treatment was 74.03 (66.3-81.6) by PFDI-20 and was 44.57 (22.53-66.65) by PFIQ-7. The mean difference in changed in the total quality of life score with 95 % CI was 1.32 (-2.8-5.4) for pelvic floor training (PFT). CONCLUSION: We found that surgical interventions on prolapse can improve the quality of life of women. There was a relative effect of PFT on the quality of life of women with prolapse in systematic review. This effect was not seen in meta-analysis, probably because of finding few eligible studies to pool the effect size.

Advances in stimuli-responsive gold nanorods for drug-delivery and targeted therapy systems.

In recent years, the use of gold nanorods (AuNRs) has garnered considerable attention in biomedical applications due to their unique optical and physicochemical properties. They have been considered as potential tools for the advanced treatment of diseases by various stimuli such as magnetic fields, pH, temperature and light in the fields of targeted therapy, imaging and drug delivery. Their biocompatibility and tunable plasmonic properties make them a versatile platform for a range of biomedical applications. While endogenous stimuli have limited cargo delivery control at specific sites, exogenous stimuli are a more favored approach despite their circumscribed penetration depth for releasing the cargo at the specific target. Dual/multi-stimuli responsive AuNTs can be triggered by multiple stimuli for enhanced control and specificity in biomedical applications. This review provides to provide a summary of the biomedical applications of stimuli-responsive AuNRs, including their endogenous and exogenous properties, as well as their dual/multi-functionality and potential for clinical delivery. This review provides a comprehensive review on the improvement of therapeutic efficacy and the effective control of drug release with AuNRs, highlights AuNRs design strategies in recent years, discusses the advantages or challenges so far in the field of AuNRs. Finally, we have addressed the clinical translation bio-integrated nanoassemblies (CTBNs) in this field.

Cardiac Complications in COVID-19: A Systematic Review and Meta-analysis.

BACKGROUND: The newly emerged coronavirus disease 2019 (COVID-19) seems to involve different organs, including the cardiovascular system. We systematically reviewed COVID-19 cardiac complications and calculated their pooled incidences. Secondarily, we compared the cardiac troponin I (cTnI) level between the surviving and expired patients. METHODS: A systematic search was conducted for manuscripts published from December 1, 2019 to April 16, 2020. Cardiovascular complications, along with the levels of cTnI, creatine kinase (CK), and creatine kinase MB (CK-MB) in hospitalized PCR-confirmed COVID-19 patients were extracted. The pooled incidences of the extracted data were calculated, and the unadjusted cTnI level was compared between the surviving and expired patients. RESULTS: Out of 1094 obtained records, 22 studies on a total of 4,157 patients were included. The pooled incidence rate of arrhythmia was 10.11%. Furthermore, myocardial injury had a pooled incidence of 17.85%, and finally, the pooled incidence for heart failure was 22.34%. The pooled incidence rates of cTnI, CK-MB, and CK elevations were also reported at 15.16%, 10.92%, and 12.99%, respectively. Moreover, the pooled level of unadjusted cTnI was significantly higher in expired cases compared with the surviving (mean difference = 31.818, 95% CI = 17.923-45.713, P value <0.001). CONCLUSION: COVID-19 can affect different parts of the heart; however, the myocardium is more involved.