Comparison the effects and side effects of Covid-19 vaccination in patients with inflammatory bowel disease (IBD): a systematic scoping review.

Covid-19 is a pandemic disease that is more severe and mortal in people with immunodeficiency, such as those with inflammatory bowel disease (IBD). On the other hand, no definitive treatment has been identified for it and the best way to control it is wide spread vaccination. The aim of this study was to evaluate the benefits and side effects of different vaccines in patients with IBD. Three Electronic databases [Medline (accessed from PubMed), Scopus, Science Direct, and Cochrane] were searched systematically without time limit, using MESH terms and the related keywords in English language. We focused on the research studies on the effect and side effects of Covid-19 vaccination in patients with IBD. Articles were excluded if they were not relevant, or were performed on other patients excerpt patients with IBD. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. All included studied were research study, and most of them (12/15) had prospective design. Totally, 8/15 studies were performed in single-center settings. In 8/15 studies, patients with IBD were compared with a control group. The results were summarized the in two categories: (1) the effect of vaccination, and (2) side effects. The effect of vaccination were assessed in 13/15 studies. Side effects of Covid-19 vaccination in patients with IBD were reported in 7/15 studies. Patients with IBD can be advised that vaccination may have limited minor side effects, but it can protect them from the serious complications of Covid-19 and its resulting mortality with a high success rate. They should be also mentioned in booster doses.

The Effects of Risk Factors on One- and Five-Year Survival of Patients with Gastric Cancer in Isfahan in 2016.

Background: Gastric cancer (GC) is a frequent and multifactorial malignancy worldwide. The aim of this study was to investigate the relationship between some risk factors of GC and the 1-year or 5-year survival rates in newly diagnosed patients in Isfahan in 2016. Methods: We included 274 newly diagnosed patients in this survival analysis from a database of 484 GC cases. We used a checklist to collect information. To inform about missed data, we call the patients or their families in non-survived cases. We evaluated each patient's age, sex, body mass index (BMI), education, salt, salty foods, and red meat consumption. In addition, we asked patients about the intake of fresh fruits and vegetables, tobacco smoking, opium usage, and alcohol consumption. We surveyed the patient's job, physical activity, Helicobacter pylori infection, family history of GC, history of gastric surgery, and survival status after 1 or 5 years. Variables were evaluated between survived and dead patients and compared for means and frequencies using the independent samples t-test or Mann-Whitney, or chi-square test. The univariate relationship of each risk factor, with 1- and 5-year survival, was examined by the log-rank test and the Kaplan-Meyer method and their multivariate relationship with Cox regression. Results: 1- and 5-year survived patients were younger than dead patients with GC (P<0.001; HR for 1-year survival: 1.014, 95% CI: 0.997 to 1.030; HR for 5-year survival: 1.005, 95% CI: 0.994 to 1.017), and had more frequent higher educational levels (P<0.05; HR for 1-year survival: 1.887, 95% CI: 1.046 to 3.406; HR for 5-year survival: 1.482, 95% CI: 0.987 to 2.223). The death rate after 5 years was higher in men than in women (P=0.009; HR: 1.009, 95% CI: 0.593 to 1.717) and depended on the job status of the patients (P=0.021). The other studied variables were not significantly different between 1- or 5-year survived and dead patients. Conclusion: GC development depends on genomic changes, environmental factors, and lifestyle status. But all risk factors that play a role in its development are not notable for a patient's survival. We suggest that risk factors for these patients' survival become elucidated in future studies. It helps to gather the necessary pieces of evidence for the enhancement of survival in patients with GC.

Inflammation Progresses to Normal Tissue in Patients with Anthracosis after Discontinuation of Exposure to Fossil Fuel.

Background: Exposure to toxic materials predisposes the lungs to infectious agents and inflammatory responses. The present study was performed on patients with anthracosis caused by exposure to fossil fuels in previous years, and histopathological features of airways' normal-appearing tissue were compared with histopathological features of anthracotic plaques in these patients. Methods: Bronchoscopic evaluations were performed on bakery workers who were directly in contact with fossil fuels. Samples were taken from anthracotic plaques (Group A) or seemingly intact tissues at their periphery (Group B). Pathological evaluations were done after hematoxylin and eosin staining. Then, microbiological cultures were performed for the diagnosis of Mycobacterium tuberculosis. Data obtained from bronchoscopy, pathology, and cultures were compared between anthracotic and normal-appearing peripheral tissues using chi-square and analysis of variances (ANOVA) at a 95% confidence level. Results: Sixty-eight patients were diagnosed with anthracotic plaques. The mean ± SD of the patients' age was 72.12 ± 13.74 years. Females comprised 58.8% of the sample, and 85.3% of the patients were Iranian. The frequency rates of disseminated plaques and obstructive types were 86.8% and 48.5%, respectively. Ten patients (14.70%) were diagnosed with tuberculosis, and 4.41% (3 of 68) had granuloma, which was detectable only in samples gathered from Group A. Fibrosis was more common in Group A (10.3%, p = 0.03), and most of the evaluated samples in both groups exhibited inflammatory features. Conclusion: Inflammatory changes and tissue damage can be seen in anthracotic plaques and the surrounding normal-appearing tissue, even after removing the triggering factors. So, it is suggested to take a biopsy from seemingly intact tissue at the periphery of the anthracotic plaque when a biopsy is needed in a patient with anthracosis to reduce the risk of bleeding. Besides, medical treatment should be done to control inflammation.

Investigation of plasma exchange and hemoperfusion effects and complications for the treatment of patients with severe COVID-19 (SARS-CoV-2) disease: A systematic scoping review.

Some previous studies suggested that the plasma exchange (PE) and hemoperfusion (HP) played a cardinal role in the treatment of severe coronavirus disease 2019 (COVID-19) cases by diminishing the cytokine storm. This study aimed to assess the effects of PE and HP on cytokine storms in patients with severe COVID-19 through a systematic scoping review. Four Electronic databases (Medline [accessed from PubMed], Scopus, Science Direct, and Cochrane library) were searched systematically on February 2, 2021, using MESH terms and related keywords in the English language. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, their findings were assessed and reported. A total of 755 articles were obtained within the first step of searching, and 518 remained after removing the duplications. Through the title and abstract screening, 438 were removed. Of the rest, 59 papers were excluded. Finally, after reading the full text of the remained articles, 21 were included in data extraction. Most of the previously reported evidence were case reports and case series. Findings were summarized in two categories. The first category encompassed nine studies regarding HP and continuous renal replacement therapy, and the second category included twelve studies about PE. The results revealed that HP and PE within the cytokine storm phase would be beneficial with a high probability in the treatment of severely ill COVID-19 patients. Highlights Some studies showed that plasma exchange (PE) and hemoperfusion (HP) played an important role in the treatment of patients with severe COVID-19 disease. The results of this systematic scoping review revealed that HP and PE within the cytokine storm phase would be beneficial with a high probability in the treatment of severely ill COVID-19 patients.

A complementary critical appraisal on systematic reviews regarding the most efficient therapeutic strategies for the current COVID-19 (SARS-CoV-2) pandemic.

BACKGROUND: This critical appraisal aims to clarify which systematic reviews on COVID-19 treatment are based on high-value evidence. Hereby, the most profitable medicines can be suggested. METHODS: The mesh terms of "COVID-19 drug treatment" (Supplementary Concept) and "COVID-19 drug treatment" were sequentially utilized as search strategies in Medline and Science direct on October 18, 2020. Searches were confined to systematic reviews/meta-analyses. The Cochrane database was searched on November 1, 2020 with "COVID." With adding up four articles from other resources, 84 systematic reviews were considered for initial screening. Finally, 22 articles fulfilled the criteria and were assessed using PRISMA guidelines. RESULTS: Increasing number of clinical trials from the onset of the COVID-19 pandemic has revealed that hydroxychloroquine and chloroquine are not only profitable but also deleterious. Lopinavir/ritonavir failed to maintain their initial efficacy in improving clinical symptoms and mortality rate. Steroids and tocilizumab were suggested in patients with intensely severe symptoms. Steroids reduced mechanical ventilation and death in severely ill patients. Plasma or immunoglobulins effects are absolutely controversial. Favorable impressions of remdesivir have been relied on for the early onset of this drug. Hypotension and abnormal liver function tests were realized as its side effects. Favipiravir has resulted in a higher viral clearance than remdesivir. However, this claim needs to be proved with subsequent clinical trials. CONCLUSIONS: Currently, remdesivir and favipiravir are advantageous drugs that should be administered in the early phases. Their side effects are not well known and need to be found in the following research projects. Steroids and tocilizumab have been considered beneficial in the cytokine storm phase.

Nutritional status of patients hospitalized in the intensive care unit: A comprehensive report from Iranian hospitals, 2018.

INTRODUCTION AND AIM: Malnutrition is a complication of hospitalization in critically ill patients. This event is occurred because of disease and therapeutic processes for curing the patients. Determination of nutritional status helps physicians and clinical nutritionists decide on the best regimen which should be prescribed for a patient. In the current study, we aimed to report the nutritional status ofpatientshospitalizedin the intensive care unit (ICU). METHOD OF STUDY: We used three standard tolls, including Subjective global assessment (SGA), Nutrition Risk in the Critically Ill (NUTRIC) Score and nutrition risk screening (NRS) questionnaires via a multi-stage sampling for different ICU wards of 32 university hospitals in Iran. Frequencies and rates of nutritional scores, comparative studies, and determined agreement of scoring systems and nutritional status in any ward of hospitals were evaluated. RESULTS: There were 771 males and 540 female Cancer and trauma patients had the best and worst nutritional scores, respectively. Using NRS and NUTRIC, the low-risk scores were more frequent than thehigh-riskscores among ICU patients. SGA showed that most patients were in grades A (well nutritional status) or B (moderate nutritional status), andfew caseswere in grade C (poor nutritional status).The high-risk nutritional score wasobtained for older patients. NUTRIC and NRS had better agreement for diagnosis and differentiation of malnutrition than NUTRIC-SGA or NRS-SGA pairs. However, there was no strong agreement between the mentioned pairs. CONCLUSION: Nutritional status of patients hospitalized in ICU wards in Iran wassomewhat better than other countries that this could be due to the highly observed guidelines of patient's care in Iran. Anyway,it is suggested that a more precise tool of nutritional scoresto be validated for patients hospitalized in ICU·In addition, better medical care needs a well evaluation of nutritional insufficiencies and what is necessary for compensation using complementary regimens.

Corrigendum to "Current Status of Sodium Bicarbonate in Coronary Angiography: An Updated Comprehensive Meta-Analysis and Systematic Review".

[This corrects the article DOI: 10.1155/2015/690308.].

Baseline and postoperative levels of C-reactive protein and interleukins as inflammatory predictors of atrial fibrillation following cardiac surgery: a systematic review and meta-analysis.

BACKGROUND: Postoperative atrial fibrillation (POAF) is a leading arrhythmia with high incidence and serious clinical implications after cardiac surgery. Cardiac surgery is associated with systemic inflammatory response including increase in cytokines and activation of endothelial and leukocyte responses. AIM: This systematic review and meta-analysis aimed to determine the strength of evidence for evaluating the association of inflammatory markers, such as C-reactive protein (CRP) and interleukins (IL), with POAF following isolated coronary artery bypass grafting (CABG), isolated valvular surgery, or a combination of these procedures. METHODS: We conducted a meta-analysis of studies evaluating measured baseline (from one week before surgical procedures) and postoperative levels (until one week after surgical procedures) of inflammatory markers in patients with POAF. A compre-hensive search was performed in electronic medical databases (Medline/PubMed, Web of Science, Embase, Science Direct, and Google Scholar) from their inception through May 2017 to identify relevant studies. A comprehensive subgroup analysis was performed to explore potential sources of heterogeneity. RESULTS: A literature search of all major databases retrieved 1014 studies. After screening, 42 studies were analysed including a total of 8398 patients. Pooled analysis showed baseline levels of CRP (standard mean difference [SMD] 0.457 mg/L, p < 0.001), baseline levels of IL-6 (SMD 0.398 pg/mL, p < 0.001), postoperative levels of CRP (SMD 0.576 mg/L, p < 0.001), postoperative levels of IL-6 (SMD 1.66 pg/mL, p < 0.001), postoperative levels of IL-8 (SMD 0.839 pg/mL, p < 0.001), and postoperative levels of IL-10 (SMD 0.590 pg/mL, p < 0.001) to be relevant inflammatory parameters significantly associated with POAF. CONCLUSIONS: Perioperative inflammation is proposed to be involved in the pathogenesis of POAF. Therefore, perioperative assessment of CRP, IL-6, IL-8, and IL-10 can help clinicians in terms of predicting and monitoring for POAF.

Appropriate bolus administration of glycoprotein IIb/IIIa inhibitors for patients with acute coronary syndromes undergoing percutaneous coronary intervention: intracoronary or intravenous? A comprehensive and updated meta-analysis and systematic review.

BACKGROUND AND AIM: This systematic review with meta-analysis sought to compare the efficacy and safety of intracoronary (IC) vs. intravenous (IV) administration of glycoprotein (GP) IIb/IIIa receptor inhibitors on clinical outcomes following per-cutaneous coronary intervention in patients with acute coronary syndromes (ST-segment elevation myocardial infarction or non-ST-segment-elevation acute coronary syndrome). METHODS: Medline, Embase, Elsevier, and Sciences online databases as well as Google Scholar literature were used to select appropriate studies with randomised controlled design. The primary end-points were mortality and target vessel revascularisation (TVR), whereas the secondary end points were incidence of thrombolysis in myocardial infarction score 3 flow (TIMI 3 flow means complete perfusion in distal coronary artery bed), re-myocardial infarction (re-MI), major bleeding, stent thrombosis left ventricular ejection fraction (LVEF), and heart failure (HF). The literature search of all major databases retrieved 1006 stud-ies. After screening, a total of 18 trials (5812 patients) were identified with reported outcomes. RESULTS: Pooled analysis showed IC administration of GP IIb/IIIa receptor inhibitors can significantly increase LVEF (WMD 4.97; 95% CI 3.34-6.60; p = 0.000) and the incidence of TIMI 3 flow (OR of 0.77; 95% CI 0.64-0.92; p = 0.005), and significantly decrease in incidence of HF (OR of 1.927; 95% CI 1.189-3.124; p = 0.008). Incidences of TVR, re-MI, major bleeding, stent thrombosis, and mortality showed no significant differences between the IC and IV groups. CONCLUSIONS: Overall, the most appropriate route of administration of GP IIb/IIIa inhibitors for patients with acute coronary syndromes appeared to be an IC injection that could increase LVEF and TIMI 3 flow and decrease the incidence of HF. Furthermore, the IC administration was not associated with increased adverse event rates when compared to IV injection.

Current status of sodium bicarbonate in coronary angiography: an updated comprehensive meta-analysis and systematic review.

This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes. We searched major electronic databases for studies in randomized controlled trials. A value of P < 0.1 for Q test or I (2) > 50% indicated significant heterogeneity between the studies. Literature search of all databases retrieved 650 studies. 29 studies enrolled in meta-analysis. Pooled analysis indicated about the incidence of CIN (OR of 0.718; 95% CI: 0.60 to 0.85; P = 0.000), requirement of hemodialysis (OR of 1.00; 95% CI: 0.49 to 2.01; P = 0.9), mean changes of serum creatinine (WMD of 2.321; 95% CI: 1.995 to 2.648; P = 0.000), length of hospital stays (WMD of -0.774; 95% CI: -1.65 to 0.10; P = 0.08), major adverse cardiovascular events (OR = 1.075, 95% CI: 0.59 to 1.95; P = 0.8), and mortality (OR of 0.73; 95% CI: 0.42 to 1.26; P = 0.2). Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride. In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.

Transplantation of bone marrow stem cells during cardiac surgery.

BACKGROUND: This systematic review with meta-analysis sought to determine the efficacy and safety of intramyocardial transplantation of bone marrow stem cells during coronary artery bypass graft surgery on postoperative cardiac functional parameters such as left ventricular ejection fraction and left ventricular end-diastolic volume. METHODS: Medline/PubMed, Embase, Elsevier, Sciences online database, and Google Scholar literature search were searched. The effect sizes measured were risk ratio for categorical variables and weighted mean difference with 95% confidence interval for calculating differences between mean values of baseline and follow-up cardiac functional parameters. A value of p < 0.1 for Q test, or I(2 )> 50%, indicated significant heterogeneity among studies. The literature search retrieved 2900 studies from screened databases, of which 2866 (98.6%) were excluded and 34 (619 patients) were included for scoping review. The final analysis included 9 studies (335 patients). RESULTS: Pooled effects estimates of left ventricular ejection fraction and left ventricular end-diastolic volume showed that bone marrow stem cell transplantation had a weighted mean difference of 4.06 (95% confidence interval: 0.41-7.72; p = 0.02) and 7.06 (95% confidence interval: -8.58-22.7; p = 0.3), respectively. CONCLUSIONS: Intramyocardial transplantation of bone marrow stem cells improves cardiac functional parameters, significantly increasing left ventricular ejection fraction with a nonsignificant reduction in left ventricular end-diastolic volume. Also, this therapeutic method has no life-threatening complications and was therefore found to be an effective and safe method.

Antioxidant supplementations for prevention of atrial fibrillation after cardiac surgery: an updated comprehensive systematic review and meta-analysis of 23 randomized controlled trials.

This systematic review with meta-analysis sought to determine the impact of antioxidants (N-acetylcysteine [NAC], polyunsaturated fatty acids [PUFAs] and vitamins) on incidence of postoperative atrial fibrillation (POAF) and duration of length of hospital stay. Medline, Embase, Elsevier, Sciences online database and Google Scholar literature search was made for studies in randomized controlled trials. The effect sizes measured were odds ratio (OR) for categorical variable and standard mean difference (SMD) with 95% confidence interval (CI) for calculating differences between mean values of duration of hospitalization in intervention and control groups. A value of P < 0.1 for Q-test or I(2) > 50% indicated significant heterogeneity between the studies. Literature search of all major databases retrieved 355 studies. After screening, a total of 23 trials were identified that reported outcomes of 4278 patients undergoing cardiac surgery. Pooled effects estimates on POAF showed a significant reduction after NAC (OR: 0.56, 95% CI: 0.40-0.77, P < 0.001), PUFA (OR: 0.84, 95% CI: 0.71-0.99, P = 0.03) and vitamin C treatment (OR: 0.50, 95% CI: 0.27-0.91, P = 0.02). Hospital length of stay was not reduced after NAC therapy (SMD: 0.082, 95% CI -0.09 to 0.25, P = 0.3), but could be decreased with PUFA (SMD: -0.185, 95% CI: -0.35 to -0.018, P = 0.03) and vitamin C (SMD: -0.325, 95% CI -0.50 to -0.14, P < 0.01). In conclusion, perioperative antioxidant supplementations with NAC, PUFA and vitamin C prevent atrial fibrillation after cardiac surgery. Moreover, PUFA and vitamin C are capable to reduce hospital stay, whereas NAC lacks this capacity.