Effects of postoperative atrial fibrillation on cardiac surgery outcomes in Vietnam: a prospective multicenter study.

BACKGROUND: This study was designed to assess the impact of postoperative atrial fibrillation (POAF) on short- and long-term outcomes after cardiac surgery. METHODS: We prospectively assessed POAF concerning outcomes in 379 adult patients who had undergone cardiac surgery in two heart surgery centers with a follow-up period of one year for every patient. The effects of POAF on postoperative events were evaluated using Logistic regression, Cox regression (adjusted for propensity score), and Kaplan-Meier analysis. RESULTS: The incidence of POAF was 27.2%. Multivariable logistic regression analysis revealed POAF was associated with an increased risk of 6-month (OR = 5.36; CI: 1.51-18.94; p = 0.009), and 1-year mortality (OR = 4.56; CI: 1.29-16.04; p = 0.018) as well as Major Adverse Cardiocerebral Events (MACEs; acute MI, cardiac arrest, low cardiac output after surgery, third-degree atrioventricular block or stroke; OR = 3.02; CI: 1.29-7.05; p = 0.011), Intensive Care Unit (ICU) stay > 3 days (OR = 2.39; CI: 1.14-5.00; p = 0.021), and postoperative stay > 14 days (OR = 3.12; CI: 1.65-5.90; p < 0.001). Multivariable Cox regression analysis showed POAF as an independent predictor of mortality at one year (HR = 2.86; CI: 1.05-7.75; p = 0.038). Discharge plans including statin and beta-blocker had an independent association with a reduced mortality at one year (HR = 0.22; CI: 0.05-0.96; p = 0.045; HR = 0.16; CI: 0.03-0.87; p = 0.034, respectively). CONCLUSIONS: POAF is associated with an increased risk of morbidity, all-cause mortality, and hospital duration. Statins and beta-blockers that were included in discharge plans had an independent association with reduction in 1-year all-cause mortality.

Association of anthelmintic treatment with malaria prevalence, incidence, and parasitemia: A systematic review and meta-analysis.

A chronic helminth infection can alter host immune response and affect malaria infection. We conducted a systematic review and meta-analysis to find the impact of anthelmintic treatment on malaria prevalence, incidence, and parasitemia. Nine and 12 electronic databases were searched on 28th July 2015 and 26th June 2020 for relevant studies. We performed meta-analysis for malaria prevalence, incidence, parasitemia, and a qualitative synthesis for other effects of anthelmintic treatment. Seventeen relevant papers were included. There was no association between anthelmintic treatment and malaria prevalence or change of parasitemia at the end of follow up period (pooled OR 0.93, 95% CI: 0.62, 1.38, p-value=0.71 and SMD -0.08, 95%CI: -0.24, 0.07, p-value=0.30 respectively) or at any defined time points in analysis. Pooled analysis of three studies demonstrated no association between malaria incidence and anthelmintic treatment (rate ratio 0.93, 95%CI: 0.80, 1.08, p-value=0.33). Our study encourages anthelmintic treatment in countries with high burden of co-infections as anthelmintic treatment is not associated with change in malaria prevalence, incidence, or parasitemia.

Cluster analysis of epidemiological characteristic features of confirmed cases with the novel coronavirus (COVID-19) outside China: a descriptive study

BackgroundNovel coronavirus COVID-19 has caused significant global outbreaks outside China. Many countries have closed their borders with China and performed obligate protective procedures, however, this disease was still rising worldwide. In this report, we aim to identify transmission patterns from China to other countries, along with describing the disease control situation of countries. MethodsWe retrospectively collected information about infected cases with COVID-19 from WHO situation reports, official notification websites of health ministries and reliable local newspapers from each country. Descriptive and cluster analysis was performed to describe the transmission characteristics while the logistic regression test was used to estimate the risk factors for the occurrence of an infected individual with an unknown source. ResultsA total of 446 infected cases were recorded from 24 countries outside China until 12 February 2020, with the number of reported infected cases were doubled every 3.08 {+/-} 0.35 days (range from 2.6 to 3.9). Besides the spread from China, the transmission was originated from sub-endemic countries (Japan, Thailand, Singapore, Malaysia, France, German). Out of 6 countries got occurrence of an infected individual with unknown source and possible potential factors contributed to this occurrence was a time of epidemic circulating, number of patients and number of clusters when the occurrence still has not happened, and notably, the unreported situation of Chinese tourists information. ConclusionsThe situational reports of each country about COVID-19 should be more detailed mentioning the transmissions routes with keeping contact tracing of the unknown cases to increase the control of this disease.

The best route of administration of lavender for anxiety: a systematic review and network meta-analysis.

BACKGROUND: There is preliminary evidence for lavender as an anxiolytic agent through various routes of administration. Our goal is to elucidate the best route of administration for lavender as a treatment for anxiety. METHODS: Thirteen electronic search engines were systematically scanned for relevant publications. The relevant articles were included after the title and abstract screening followed by the full-text screening. This study included randomized control trials reporting lavender for the treatment of anxiety. The protocol was registered in PROSPERO (CRD42017076711). Frequentist network meta-analysis and Bayesian meta-regression were conducted to report the best treatment modality and the effect of covariates on the effectiveness as an anxiolytic. Treatment arms were ordered according P-scores, where higher P-score indicates better treatment choice. RESULTS: Forty studies were eligible for qualitative analysis, and 32 were included in quantitative analysis. Lavender aromatherapy was the best approach for the treatment of anxiety among other lavender modalities at the first week recording [Standardized Mean Difference (SMD) = -0.57, 95% CI (-1.14-0.01), P-score = 0.72], in addition to achieve at the first time points [SMD = -0, 95% CI (-0.97 ̶ -0.16), P-score = 0.69], compared to placebo; however, lavender massage along with foot bath were found to be the most efficacious for anxiety treatment at the study endpoint [SMD = -1.10, 95% CI = (-7.41 ̶ 5.21), P-score = 0.65]. Furthermore, network meta-regression revealed that the duration of therapy influenced treatment, suggesting Silexan (oral lavender) 80 mg (first rank probability = .116) as the favorable option for anxiety in long-term treatment. CONCLUSIONS: Lavender aromatherapy is, clinically, superior in short-duration, while Silexan (oral lavender) 80 mg is preferable for long-term treatment of anxiety.