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1.
Medicine (Baltimore) ; 100(7): e24810, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607845

RESUMEN

BACKGROUND: Infertility is a kind of global disease. Fallopian tubal obstruction is one of the most important causes of female infertility. Complementary and alternative therapies are effective in treating tubal obstructive infertility, but there is no study on a comprehensive comparison among them. So, the purpose of this paper is to evaluate the efficacy and safety of different complementary and alternative therapies for tubal obstructive infertility. METHODS: We will search for randomized controlled trials (RCTs) from the following databases: PubMed, Cochrane Library, EMBASE, Web of Science, Chinese Biomedical Literature Database (SinoMed), Chinese National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database. We will assess the risk of bias of the included studies with the Cochrane tool, and the strength of evidence with the GRADE approach. Both pairwise meta-analyses and network meta-analyses will be performed to examine the relative efficacy and safety of complementary and alternative therapies in the treatment of tubal obstructive infertility. CONCLUSION: Our findings will provide clear evidence based on current available studies, which may lead to some proposals for both patients and researchers. INPLASY REGISTRATION NUMBER: INPLASY202110076.


Asunto(s)
Terapias Complementarias/métodos , Enfermedades de las Trompas Uterinas/complicaciones , Infertilidad/etiología , Infertilidad/terapia , Terapias Complementarias/estadística & datos numéricos , Manejo de Datos , Enfermedades de las Trompas Uterinas/diagnóstico , Femenino , Humanos , Medicina China Tradicional/métodos , Medicina China Tradicional/estadística & datos numéricos , Metaanálisis en Red , Evaluación de Resultado en la Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Resultado del Tratamiento
2.
Medicine (Baltimore) ; 100(7): e24859, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607860

RESUMEN

BACKGROUND: The purpose of this paper is to evaluate the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke. METHODS: We will electronically search PubMed, Medline, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-Fang Database from the date of creation to November 2020. In addition, we will manually retrieve other resources including the reference lists of identified publications, conference articles, and gray literature. The clinical randomized controlled trials or quasi-randomized controlled trials related to electroacupuncture in the treatment of spasticity after stroke will be included in the study. The language is limited to Chinese and English. Research selection, data extraction, and research quality assessment will be independently completed by 2 researchers. Data were synthesized by using a fixed effect model or random effect model depend on the heterogeneity test. The modified Ashworth scale was the primary outcomes. Simplified Fugl-Meyer assessment scale (FMA), Stroke specific quality of life scale (SS-QOL) and adverse events will also be assessed as secondary outcomes. RevMan V.5.3 statistical software will be used for meta-analysis. If it is not appropriate for a meta- analysis, then a descriptive analysis will be conducted. Data synthesis will use the risk ratio and the standardized or weighted average difference of continuous data to represent the results. RESULTS: This study will provide a high-quality synthesis to assess the effectiveness and safety of electroacupuncture in the treatment of spasticity after stroke. CONCLUSION: This systematic review will provide evidence to judge whether electroacupuncture is an effective and safety intervention for patients with spasticity after stroke. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. We will publish this article in peer-reviewed journals and presented at relevant conferences. SYSTEMATIC REVIEW REGISTRATION: CRD42021220300.


Asunto(s)
Electroacupuntura/métodos , Espasticidad Muscular/etiología , Espasticidad Muscular/terapia , Accidente Cerebrovascular/complicaciones , China/epidemiología , Manejo de Datos , Electroacupuntura/efectos adversos , Femenino , Humanos , Masculino , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Accidente Cerebrovascular/psicología , Resultado del Tratamiento
3.
Medicine (Baltimore) ; 100(7): e24873, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33607862

RESUMEN

BACKGROUND: Glucokinase activators are a novel family of glucose-lowering agents used for the treatment of type-2 diabetes mellitus (T2DM). Glucokinase activators blind to GK activate the enzyme allosterically. Treatment with different GKAs has been shown to reduce fasting and postprandial glucose in patients with type 2 diabetes. We compared the efficacy/safety of glucokinase activators in T2DM patients through a meta-analysis. METHODS: We searched PubMed, Excerpt Medica Database, and Cochrane Central Register of Controlled Trials databases for articles published before December 30, 2020. Two independent reviewers extracted the information from article. The quality of articles were assessed by 2 independent reviewers using the 5 items of scale proposed by Jadad. We computed the weighted mean difference and 95% confidence interval (CI) for a change from baseline to the study endpoint for glucokinase activators vs placebo. Egger test and Begg test were used to assess the possible publication bias caused by the tendency of published studies to be positive. RESULTS: The present meta-analysis will compare the efficacy and safety of glucokinase activators and placebo for the treatment of T2DM. CONCLUSIONS: This meta-analysis will provide advanced evidence on the efficacy and safety of glucokinase activators for the treatment of T2DM. ETHICS AND DISSEMINATION: Ethical approval and patient consent are not required because this study is a literature-based study. This systematic review and meta-analysis will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021220364.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Activadores de Enzimas/farmacología , Glucoquinasa/efectos de los fármacos , Hipoglucemiantes/uso terapéutico , Glucemia/análisis , Glucemia/efectos de los fármacos , Estudios de Casos y Controles , Manejo de Datos , Activadores de Enzimas/uso terapéutico , Ayuno/sangre , Glucoquinasa/metabolismo , Humanos , Placebos/administración & dosificación , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Resultado del Tratamiento
5.
J Occup Health ; 63(1): e12198, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33527667

RESUMEN

OBJECTIVES: The health effects of telework, which was introduced extensively in the immediate context of the COVID-19 pandemic crisis in Japan, on teleworkers, their families, and non-teleworkers, are unknown. Accordingly, we developed a rapid health impact assessment (HIA) to evaluate positive and negative health effects of telework on these groups and recommended easily implementable countermeasures. METHODS: Immediately after an emergency was declared in Japan, we implemented a rapid, five-step HIA. We screened and categorized health effects of telework for the three above-mentioned groups, extracting their content, directionality, and likelihood. Following a scoping exercise to determine the HIA's overall implementation, five experienced occupational health physicians appraised and prioritized the screened items and added new items. We outlined specific countermeasures and disseminated the results on our website. A short-term evaluation was conducted by three external occupational health physicians and three nurses. RESULTS: Following screening and appraisal, 59, 29, and 27 items were listed for teleworkers, non-teleworkers, and family members of teleworkers, respectively, covering work, lifestyle, disease and medical care, and home and community. Targeted countermeasures focused on the work environment, business management, communications, and lifestyles for teleworkers; safety and medical guidelines, work prioritization, and regular communication for non-teleworkers; and shared responsibilities within families and communication outside families for family members of teleworkers. CONCLUSION: The HIA's validity and the countermeasures' practical applicability were confirmed by the external evaluators. They can be easily applied and adapted across diverse industries to mitigate the wider negative effects of telework and enhance its positive effects.


Asunto(s)
Evaluación del Impacto en la Salud , Salud Laboral , Actitud del Personal de Salud , Comunicación , Seguridad Computacional , Ejercicio Físico , Familia , Evaluación del Impacto en la Salud/métodos , Estado de Salud , Humanos , Japón , Estilo de Vida , Seguridad , Administración del Tiempo , Trabajo/psicología , Lugar de Trabajo/organización & administración
6.
Medicine (Baltimore) ; 100(6): e23843, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578512

RESUMEN

BACKGROUND: Diabetes refers to any group of metabolic diseases characterized by high blood sugar and generally thought to be caused by insufficient production of insulin, impaired response to insulin. Globally, patients with type 2 diabetes account for more than 85% of the total diabetic patients, and due to factors, such as obesity, aging, environment and lifestyle, the incidence of diabetes is rising. Salvia miltiorrhiza (SM) is a medicine used to treat diabetes in China. In recent years, it has been reported that SM has the effect of improving type 2 diabetes. However, there is no systematic review of its efficacy and safety yet. Therefore, we propose a systematic review to evaluate the efficacy and safety of SM for T2D. METHODS: Six databases will be searched: China National Knowledge Infrastructure (CNKI), China Biological Medicine (CBM), China Scientific Journals Database (CSJD), Wanfang database, PubMed, and EMBASE. The information is searched from January 2010 to July 2020. Languages are limited to English and Chinese. The primary outcomes include 2 hour plasma glucose, fasting plasma glucose, hemoglobin A1c, homeostasis model assessment of insulin resistance, and fasting plasma insulin. The secondary outcomes include clinical efficacy and adverse events. RESULTS: This systematic review will evaluate the efficacy and safety of Salvia miltiorrhiza in the treatment of type 2 diabetes. CONCLUSION: This systematic review provides evidence as to whether Salvia miltiorrhiza is effective and safe for type 2 diabetes. ETHICS: Ethical approval is not necessary as this protocol is only for systematic review and does not involve in privacy data or an animal experiment. SYSTEMATIC REVIEW REGISTRATION: INPLASY2020110046.


Asunto(s)
Diabetes Mellitus Tipo 2/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Salvia miltiorrhiza/química , China/epidemiología , Manejo de Datos , Diabetes Mellitus Tipo 2/epidemiología , Ayuno/sangre , Femenino , Glucosa/análisis , Hemoglobina A Glucada/análisis , Homeostasis/efectos de los fármacos , Humanos , Incidencia , Insulina/sangre , Masculino , Medicina China Tradicional/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Resultado del Tratamiento
7.
Medicine (Baltimore) ; 100(6): e24217, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578523

RESUMEN

BACKGROUND: We aim to study the treatment of psoriasis vulgaris with moving cupping. METHODS: We will search PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Wanfang Database, and Chinese Biomedical Literature Database of randomized controlled trials beginning from their inception to August 2020. The primary outcomes are that PASI score and clinical effective rate will be the main outcome indicators. Additional outcome is The Quality of life index score and safety assessment will be considered a secondary outcome. Two independent authors will based on the Cochrane system evaluation manual 5.1.0 version of RCT bias risk assessment tool to evaluate the risk of bias among the final included studies. And we will use the RevMan 5.3 software to analysis data. RESULTS: This study will provide an assessment of the current state of moving cupping for the psoriasis vulgaris, aiming to show the efficacy and safety of this treatment. CONCLUSION: This study will provide evidence to judge whether moving cupping is an effective therapy for psoriasis vulgaris. INPLASY REGISTRATION NUMBER: INPLASY2020120061.


Asunto(s)
Terapia con Ventosas/métodos , Medicina China Tradicional/métodos , Psoriasis/terapia , China/epidemiología , Terapia con Ventosas/efectos adversos , Femenino , Humanos , Masculino , Medicina China Tradicional/efectos adversos , Psoriasis/epidemiología , Psoriasis/patología , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Medición de Riesgo , Seguridad , Resultado del Tratamiento
8.
Medicine (Baltimore) ; 100(6): e24279, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578524

RESUMEN

BACKGROUND: Ankylosing spondylitis (AS) is a common infammatory rheumatic disease that affects the axial skeleton. Traditional Chinese medicine (TCM) nonpharmacological interventions are gaining an increasing popularity for AS. Nevertheless, the evidence of efficacy and safety of random controlled trials (RCTs) remains controversial. This study aims to evaluate the efficacy and acceptability of different TCM nonpharmacological therapies by systematic review and network meta-analysis. METHODS: According to the strategy, the authors will retrieve a total of 7 electronic databases by December 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of TCM nonpharmacological interventions for AS. The primary outcome will be the improvement of Pain intensity and functional status/disability and the secondary outcomes will include lobal improvement, health-related quality of life, satisfaction with treatment, and adverse events. Both classical meta-analysis and network meta-analysis will be implemented to investigate direct and indirect evidences on this topic. The quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument. RESULTS: This study will provide a reliable evidence for the selection of TCM nonpharmacological therapies in the treatment of AS. CONCLUSION: This study will generate evidence for different TCM nonpharmacological therapies for AS and provide a decision-making reference for clinical research. ETHICS AND DISSEMINATION: This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/FHD2U.


Asunto(s)
Medicina China Tradicional/métodos , Dimensión del Dolor/estadística & datos numéricos , Satisfacción del Paciente/estadística & datos numéricos , Espondilitis Anquilosante/terapia , China/epidemiología , Manejo de Datos , Bases de Datos Factuales , Evaluación de la Discapacidad , Femenino , Humanos , Masculino , Medicina China Tradicional/efectos adversos , Metaanálisis en Red , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Seguridad , Espondilitis Anquilosante/patología , Espondilitis Anquilosante/psicología , Resultado del Tratamiento
9.
Medicine (Baltimore) ; 100(6): e24657, 2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33578594

RESUMEN

BACKGROUND: Alzheimer's disease (AD) occurs in the elderly and the early stage of aging, with early clinical manifestations of memory impairment, cognitive impairment, behavioral change and decline in language function, etc., and eventually loss of the ability to live independently, requiring 24-hour care, and a variety of complications. However, these complications are the direct cause of death in AD patients. With the acceleration of the aging process of society, the incidence of AD is increasing year by year, seriously threatening the physical health and quality of life of the elderly. There are many ways to treat AD, however, moxibustion is especially popular in China. Therefore, our systematic review aims to evaluate the efficacy and safety of moxibustion in the treatment of ADand to provide reliable evidence for clinical decision-makers. METHODS: We will search electronic databases including PubMed, Embase, Cochrane Library, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database (WF), and China Scientific Journals Database (VIP) from inception to January 2021. Two authors will independently screen the studies, extract data information, and assess methodological quality through the Cochrane risk of bias (ROB) tool. The RevmanV.5.3 software will be used for statistical analysis. RESULTS: The results of this study will evaluate the current status of moxibustion therapy for AD, aiming to prove the effectiveness and safety of moxibustion therapy, and will be published in a peer-reviewed journal. CONCLUSION: This systematic review will provide a credible evidence-based for moxibustion in the treatment of AD. INPLASY REGISTRATION NUMBER: INPLASY202110021.


Asunto(s)
Terapia por Acupuntura/métodos , Enfermedad de Alzheimer/terapia , Moxibustión/métodos , Terapia por Acupuntura/efectos adversos , Anciano , Enfermedad de Alzheimer/epidemiología , Enfermedad de Alzheimer/psicología , China/epidemiología , Toma de Decisiones Clínicas/ética , Manejo de Datos , Femenino , Humanos , Incidencia , Masculino , Moxibustión/efectos adversos , Calidad de Vida , Proyectos de Investigación , Seguridad , Resultado del Tratamiento
11.
Ann Hematol ; 100(2): 563-573, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33404694

RESUMEN

Autologous stem cell transplantation as a frontline treatment for patients with multiple myeloma (MM) requires an adequate peripheral blood stem cell (PBSC) collection before processing. Granulocyte-colony stimulating factor (G-CSF) with or without cyclophosphamide (CTX) is a common regimen for PBSC mobilization; their benefits and risks are controversial. To compare the efficiency, safety, and survival outcomes between the two regimens, we conducted a meta-analysis including 18 studies with 4 prospective and 14 retrospective studies; a total of 2770 patients with MM were analyzed. The CTX plus G-CSF regimen had higher yields of total CD34+ cells (SMD = 0.39, 95% CI (0.30, 0.49)), and higher mobilization rates of the target ⩾ 2 × 106/kg (OR = 3.34, 95% CI (1.82, 6.11)) and 4 × 106/kg (OR = 2.16, 95% CI (1.69, 2.76)) cells. A favorable event-free survival (EFS) (HR = 0.73, 95% CI (0.58, 0.93), p = 0.01) and better 3-year EFS rate (OR = 1.65, 95% CI (1.1, 2.47), p = 0.02) were also reached in the patients with CTX plus G-CSF mobilization, although the risks of admission (OR = 26.49, 95% CI (7.31, 95.97)) and fever (OR = 13.66, 95% CI (6.21, 30.03)) during mobilization were increased, the treatment-related mortality was consistent (p = 0.26). The CTX plus G-CSF regimen was superior to the G-CSF-alone regimen for PBSC mobilization in patients with MM.


Asunto(s)
Ciclofosfamida/uso terapéutico , Factor Estimulante de Colonias de Granulocitos/uso terapéutico , Movilización de Célula Madre Hematopoyética , Trasplante de Células Madre Hematopoyéticas , Mieloma Múltiple , Seguridad , Autoinjertos , Ciclofosfamida/efectos adversos , Supervivencia sin Enfermedad , Factor Estimulante de Colonias de Granulocitos/efectos adversos , Humanos , Mieloma Múltiple/mortalidad , Mieloma Múltiple/terapia , Tasa de Supervivencia
12.
Ann Glob Health ; 87(1): 5, 2021 01 05.
Artículo en Inglés | MEDLINE | ID: mdl-33505864

RESUMEN

COVID-19 is now impacting every country in Africa and healthcare workers (HCWs) across the continent remain susceptible to professional burnout. We designed a 43-question survey addressing multiple aspects of the COVID-19 pandemic. The survey was anonymous, distributed via email and phone messaging to 13 countries in Africa. We obtained 489 analyzable responses. 49% off HCWs reported a decrease in income, with the majority experiencing between 1-25% salary reduction. Sixty-six percent reported some access to personal protective equipment (PPE), 20% had no access to PPE and only 14% reported proper access. Strikingly, the percentage reporting never feeling depressed changed from 61% before the pandemic to 31% during the pandemic, with an increase in daily depression from 2% to 20%. We found no association between depression and change in income, household size, availability of PPE or lockdown. Safety concerns related to stigma from being HCWs affected 56% of respondents.


Asunto(s)
Agotamiento Profesional/epidemiología , Depresión/epidemiología , Personal de Salud/psicología , Seguridad , Adulto , África/epidemiología , Femenino , Humanos , Renta/estadística & datos numéricos , Masculino , Equipo de Protección Personal/provisión & distribución , Factores de Riesgo , Estigma Social , Encuestas y Cuestionarios , Carga de Trabajo/psicología
13.
Artículo en Inglés | MEDLINE | ID: mdl-33466495

RESUMEN

Pedestrians are the most vulnerable road users in the traffic system and thousands of pedestrians are injured or killed globally as a result of traffic crashes every year. With their popularity and enriched functions, mobile phones are playing an increasingly important role in people's lives, and records of vehicle crashes involving pedestrians have shown the hazards caused by distraction of mobile phone use, especially in the context of crossing the street. The present study employed the theory of planned behavior (TPB) to investigate the behavior of using a mobile phone while crossing the street in China. An online questionnaire based on the TPB framework was developed to collect data, and 387 eligible samples were retained after inspection. Mobile phone use while crossing the street is prevalent in China (i.e., 53%). The results show that three standard TPB constructs (i.e., attitudes, intention and perceived behavioral control) emerged as significant predictors of the behavior of using mobile phone while crossing, and two extended constructs (i.e., situation, mobile phone involvement) also significantly predicted the behavior. In addition, for this population, intention was the strongest predictor of the behavior among these significant constructs. Moreover, the results were discussed and compared with some existing studies and safety interventions were also provided.


Asunto(s)
Atención , Teléfono Celular , Peatones , Accidentes de Tránsito , Adolescente , Adulto , China , Femenino , Humanos , Masculino , Persona de Mediana Edad , Asunción de Riesgos , Seguridad , Encuestas y Cuestionarios , Caminata , Adulto Joven
14.
JAMA Netw Open ; 4(1): e2033484, 2021 01 04.
Artículo en Inglés | MEDLINE | ID: mdl-33394004

RESUMEN

Importance: Violence is a significant public health problem that has become entwined with the coronavirus disease 2019 (COVID-19) pandemic. Objective: To describe individuals' concerns regarding violence in the context of the pandemic, experiences of pandemic-related unfair treatment, prevalence of and reasons for firearm acquisition, and changes in firearm storage practices due to the pandemic. Design, Setting, and Participants: This survey study used data from the 2020 California Safety and Well-being Survey, a probability-based internet survey of California adults conducted from July 14 to 27, 2020. Respondents came from the Ipsos KnowledgePanel, an online research panel with members selected using address-based sampling methods. Responses were weighted to be representative of the adult population of California. Main Outcomes and Measures: Topics included worry about violence for oneself before and during the pandemic; concern about violence for someone else due to a pandemic-related loss; experiences of unfair treatment attributed to the pandemic; firearm and ammunition acquisition due to the pandemic; and changes in firearm storage practices due to the pandemic. Results: Of 5018 invited panel members, 2870 completed the survey (completion rate, 57%). Among respondents (52.3% [95% CI, 49.5%-55.0%] women; mean [SD] age, 47.9 [16.9] years; 41.9% [95% CI, 39.3%-44.6%] White individuals), self-reported worry about violence for oneself was significantly higher during the pandemic for all violence types except mass shootings, ranging from a 2.8 percentage point increase for robbery (from 65.5% [95% CI, 62.8%-68.0%] to 68.2% [95% CI, 65.6%-70.7%]; P = .008) to a 5.6 percentage point increase for stray bullet shootings (from 44.5% [95% CI, 41.7%-47.3%] to 50.0% [47.3%-52.8%]; P < .001). The percentage of respondents concerned that someone they know might intentionally harm themselves was 13.1% (95% CI, 11.5%-15.3%). Of those, 7.5% (95% CI, 4.5%-12.2%) said it was because the other person had experienced a pandemic-related loss. An estimated 110 000 individuals (2.4% [95% CI, 1.1%-5.0%] of firearm owners in the state) acquired a firearm due to the pandemic, including 47 000 new owners (43.0% [95% CI, 14.8%-76.6%] of those who had acquired a firearm). Of owners who stored at least 1 firearm in the least secure way, 6.7% (95% CI, 2.7%-15.6%) said they had adopted this unsecure storage practice in response to the pandemic. Conclusions and Relevance: In this analysis of findings from the 2020 California Safety and Well-being Survey, the COVID-19 pandemic was associated with increases in self-reported worry about violence for oneself and others, increased firearm acquisition, and changes in firearm storage practices. Given the impulsive nature of many types of violence, short-term crisis interventions may be critical for reducing violence-related harm.


Asunto(s)
Ansiedad/epidemiología , Discriminación Social/estadística & datos numéricos , Violencia/psicología , Adulto , Afroamericanos , Ansiedad/psicología , Americanos Asiáticos , California/epidemiología , Comercio , Grupo de Ascendencia Continental Europea , Miedo/psicología , Femenino , Armas de Fuego/estadística & datos numéricos , Hispanoamericanos , Humanos , Internet , Masculino , Persona de Mediana Edad , Propiedad , Policia , Seguridad , Discriminación Social/etnología , Encuestas y Cuestionarios
15.
Clin Appl Thromb Hemost ; 27: 1076029620980067, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33443453

RESUMEN

This study aimed to investigate the long-term safety and benefits of antiplatelet therapy in patients with cerebral infarction with thrombocytopenia, as evidence regarding this was limited. This cohort trial assessed patients with acute cerebral infarction with thrombocytopenia treated in the Neurology Department of Shanghai Tenth People's Hospital from January 2016 to December 2018, and enrolled patients were followed up for 9 months. The patients were divided into non-antiplatelet and antiplatelet groups based on the actual intake of antiplatelet drugs. Primary endpoints included hemorrhagic events, recurrence of cerebral infarction, and activity of daily living (ADL) score changes. To balance baseline clinical data, propensity score matching was applied, and there were finally 65 matched patients, including 30 and 35 in the antiplatelet and non-antiplatelet groups, respectively. There were no differences in hemorrhagic and cerebral infarction recurrence rates between the 2 groups. ADL score change was higher in the antiplatelet group than in the non-antiplatelet group (10 vs 5, p = 0.039). In multivariate regression analysis, antiplatelet therapy significantly predicted a positive change in ADL scores [B = 8.381, 95% confidence interval (0.56-16.19)]. In patients with acute cerebral infarction with thrombocytopenia, antiplatelet therapy could the improve the quality of life in the chronic stage.


Asunto(s)
Infarto Cerebral/complicaciones , Infarto Cerebral/tratamiento farmacológico , Inhibidores de Agregación Plaquetaria/uso terapéutico , Trombocitopenia/complicaciones , Trombocitopenia/tratamiento farmacológico , Actividades Cotidianas , Anciano , Anciano de 80 o más Años , Aspirina/efectos adversos , Aspirina/uso terapéutico , China , Clopidogrel/efectos adversos , Clopidogrel/uso terapéutico , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Inhibidores de Agregación Plaquetaria/efectos adversos , Puntaje de Propensión , Calidad de Vida , Seguridad , Resultado del Tratamiento
17.
Int Heart J ; 62(1): 175-177, 2021 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-33455991

RESUMEN

Off-pump coronary artery bypass grafting (OPCABG) may be performed on patients with high surgical risk who are poor candidates for traditional mechanical circulatory support. Hemodynamic support with micro-axial mechanical circulatory devices has been performed with limited but promising results.We report a case of a 66-year-old male with multiple comorbidities and low cardiac output undergoing OPCABG. Impella CP device was deployed for "in-pump" support during surgical coronary revascularization resulting in intraoperative stability and uncomplicated post-operative recovery.Previous reports have described the use of the Impella Recover LP 5.0 device for use during OPCABG. We describe the successful and safe perioperative use of the Impella CP device. Despite lower flow rates, adequate support was achieved and the transfemoral cannulation and smaller outer diameter than the Impella 5.0 device may decrease the risk of complications and expedite recovery. Further research will be necessary to determine the optimal perioperative hemodynamic support strategy to offer hemodynamically unstable, high, and prohibitive risk patients.


Asunto(s)
Gasto Cardíaco Bajo/cirugía , Puente de Arteria Coronaria Off-Pump/instrumentación , Corazón Auxiliar/efectos adversos , Anciano , Cateterismo Cardíaco/métodos , Gasto Cardíaco Bajo/diagnóstico , Puente de Arteria Coronaria Off-Pump/métodos , Hemodinámica/fisiología , Humanos , Masculino , Atención Perioperativa/estadística & datos numéricos , Complicaciones Posoperatorias/prevención & control , Factores de Riesgo , Seguridad , Resultado del Tratamiento
18.
Artículo en Inglés | MEDLINE | ID: mdl-33445452

RESUMEN

The coronavirus disease (COVID-19) pandemic in 2020 resulted in widespread interruption of team sports training and competitions. Our aim was to review the recommendations and best practices in return to play in non-professional football after activity lockdown. The authors searched two electronic databases (PubMed, Web of Science) to extract studies published before September 15 2020. Twenty studies explained recommendations, considerations, or best practices in return to play in football, and all of them were clustered into three groups: (1) training load management (n = 10), (2) medical recommendations (n = 9), and (3) recovery related issues (n = 5). The way to establish a progression in training process should be based on training load management and managing the number of stimuli per time. Following the studies, this training process should be divided into three phases: phase 1-physical distancing should be maintained; phases 2 and 3-group training should start. Medical considerations were clustered into different groups: general, pre- and post- training, during training, education, planning to return to competition, and suggestions for post confinement weeks. In particular, social issues, strict hygiene questions, and continuous PCR testing should be considered in return to play over football season. Finally, since a correlation has been found between high-intensive training loads and immunoglobulin A, nutritional and lifestyle recovery strategies should be performed. Moreover, since immunosuppression has been related to congested schedules (<72 h between matches), football federations should avoid this situation.


Asunto(s)
/diagnóstico , Fútbol Americano/estadística & datos numéricos , Volver al Deporte , Seguridad , Fútbol/estadística & datos numéricos , /epidemiología , Control de Enfermedades Transmisibles , Alemania/epidemiología , Humanos , Masculino , Guías de Práctica Clínica como Asunto , Evaluación de Síntomas/métodos
19.
Clin Appl Thromb Hemost ; 27: 1076029620979592, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33464938

RESUMEN

Low-molecular-weight heparins are approved for primary and secondary venous thromboembolism prevention. Tinzaparin is the low-molecular-weight heparin with the highest average molecular weight. The purpose of this systematic review is to provide an update regarding the safety profile of tinzaparin, prescribed either as a prophylactic or as a therapeutic regimen for venous thromboembolism in special populations, including cancer patients and patients with renal impairment. We identified prospective studies up to August 2020 reporting safety outcomes for cancer patients and patients with renal impairment on tinzaparin regimens. In patients with cancer major bleeding rates fluctuated between 0.8% and 7%. Patients on tinzaparin exhibited significantly lower rates of clinically relevant nonmajor bleeding events in comparison with those on vitamin K antagonists. Bioaccumulation of tinzaparin was not correlated with age, body weight or creatinine clearance. Periodic administration of either prophylactic or therapeutic doses of tinzaparin did not result in bioaccumulation, even in patients with severe renal impairment and creatinine clearance < 20 ml/min. Major bleeding rates for non-cancer patients with renal impairment on prophylactic tinzaparin regimens were 0%. Non-cancer patients with renal impairment on therapeutic tinzaparin regimens exhibited major bleeding in 0 to 3.4% of cases; major bleeding rates were higher for cancer patients with renal impairment on therapeutic tinzaparin regimens (4.3 to 10%). Tinzaparin can be used without dose adjustment in patients with severe renal impairment and creatinine clearance > 20 ml/min. Tinzaparin represents a safe choice for special populations at increased risk for thrombosis and bleeding.


Asunto(s)
Anticoagulantes/uso terapéutico , Neoplasias/complicaciones , Insuficiencia Renal/complicaciones , Tinzaparina/uso terapéutico , Tromboembolia Venosa/etiología , Tromboembolia Venosa/prevención & control , Anticoagulantes/efectos adversos , Anticoagulantes/farmacocinética , Femenino , Hemorragia/etiología , Humanos , Masculino , Prevención Primaria , Estudios Prospectivos , Seguridad , Prevención Secundaria , Tinzaparina/efectos adversos , Tinzaparina/farmacocinética
20.
Yakugaku Zasshi ; 141(1): 111-124, 2021.
Artículo en Japonés | MEDLINE | ID: mdl-33390438

RESUMEN

Phototoxicity is a toxic response elicited by topically applied or systemically administered photoreactive chemicals after exposure to light and can be broadly categorized into photoirritation, photoallergy, photogenotoxicity, and photocarcinogenicity. The need in the 21st century for accurate evaluation of photosafety has led to the publication of a number of guidelines from government agencies in Europe and the U.S.A. as well as the Organisation for Economic Co-operation and Development (OECD). In this review, we first discuss the mechanisms of phototoxicity and how they can be evaluated. We then discuss the state of the art and challenges now faced in photosafety evaluation of pharmaceuticals and cosmetics. Additionally, we describe the latest developments in OECD test guidelines (TG) for assessing photosafety, including revisions to the in vitro 3T3 neutral red uptake (NRU) phototoxicity test (TG 432) and the newly adopted reactive oxigen species (ROS) assay (TG 495). We will emphasize the importance of selecting the most appropriate means of evaluation with reference to the latest guidelines and other legal criteria for conducting photosafety evaluation.


Asunto(s)
Dermatitis Fototóxica/diagnóstico , Dermatitis Fototóxica/etiología , Luz/efectos adversos , Rojo Neutro/toxicidad , Células 3T3 , Animales , Células Cultivadas , Humanos , Ratones , Especies Reactivas de Oxígeno/análisis , Seguridad , Pruebas de Toxicidad/métodos
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