The Effect of Recurrent Heart Failure Hospitalizations on the Risk of Cardiovascular and all-Cause Mortality: a Systematic Review and Meta-Analysis.

INTRODUCTION: Heart failure (HF) is a significant worldwide concern due to its substantial impact on mortality rates and recurrent hospitalizations. The relationship between recurrent hospitalizations and mortality in individuals diagnosed with heart failure has been the subject of conflicting findings in previous studies. A meta-analysis was conducted to investigate the association between recurrent heart failure hospitalizations (HFHs) and mortality. METHODS: We conducted a systematic search across various online databases, such as PubMed, Embase, Web of Science, ProQuest, Scopus, Science Direct, and Google Scholar, to locate studies that examined the connection between recurrent HFHs and cardiovascular (CV) mortality as well as all-cause mortality until January 2023. To evaluate the heterogeneity among the studies, we employed I2 and Cochran's Q test. RESULTS: In total, 143,867 participants from seven studies were included in the analysis. Recurrent HFHs were found to be strongly associated with elevated risks of both cardiovascular (CV) mortality and all-cause mortality. The pooled hazard ratios (HRs) indicated a non-significant association for CV mortality (HR = 4.28, 95% CI: 0.86-7.71) but a significant association for all-cause mortality (HR = 2.76, 95% CI: 2.05-3.48). Subgroup analyses revealed a reduction in heterogeneity when stratified by factors such as quality score, sample size, hypertension comorbidity, number of recurrent HFHs, and follow-up time. A clear correlation was observed between the frequency of HFH and the mortality risk. Various subgroups, including those with diabetes, atrial fibrillation, and chronic kidney disease, showed significant associations between recurrent HFHs and all-cause mortality. Additionally, recurrent HFHs were significantly associated with CV mortality in subgroups such as heart failure with reduced ejection fraction (HFrEF), atrial fibrillation, and diabetes. CONCLUSION: This meta-analysis provides evidence of an association between recurrent HFH and elevated risk of both CV mortality and all-cause mortality. The findings consistently indicate that a higher frequency of HFH is strongly associated with an increased likelihood of mortality.

The impact of flaxseed oil on lipid profiles, weight loss, and inflammatory markers in hemodialysis patients: A systematic review and meta-analysis of randomized controlled trials.

Studies investigating the effects of flaxseed oil on lipid profiles, weight loss, and inflammatory markers have produced inconsistent results. This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to explore the impact of flaxseed oil on these parameters in hemodialysis patients. The study protocol was registered online (PROSPERO number: CRD42023484076). The meta-analyses showed a significant decrease in triglyceride (TG) levels (WMD = -85.78 mg/dL, 95% CI: -155.24 to -16.32, I2 = 98.32%) and C-reactive protein (CRP) levels (WMD = -2.66 mg/L, 95% CI: -4.07 to -1.24, I2 = 92.26%) following consumption of flaxseed oil. Subgroup analyses revealed significant changes in LDL-C, HDL-C, and TC levels only in trials utilizing a dosage higher than 10 g per day and using ground flaxseed oil. Based on the results, flaxseed oil improves CRP and TG levels, and higher doses positively affect lipid profiles. However, it has no significant effect on anthropometric measures.

Prevalence of Fungal Drug Resistance in COVID-19 Infection: a Global Meta-analysis.

Purpose: Secondary bacterial or fungal infections are one of the most important medical complications among patients with Coronavirus Disease 2019 (COVID-19). The emergence of multidrug-resistant (MDR) candida can cause many problems such as treatment failure, adverse clinical outcomes, and even disease outbreaks. This systematic review and meta-analysis aims to investigate the prevalence and outcomes of fungal drug-resistant in COVID-19 patients. Methods: PubMed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for peer reviewed-articles published in English up to May 20, 2021. Heterogeneity across studies was evaluated using Cochrane's Q test and the I2 index. The pooled point prevalence and their corresponding 95% confidence intervals (CIs) were considered to estimate the prevalence of fungal drug resistance infection in COVID-19 patients. Results: Eight eligible articles were included in our meta-analysis. The number of COVID-19 patients with fungal co-infection varied from 5 to 35 among selected studies. The overall pooled prevalence of fungal drug resistance among patients with co-infections of fungal and COVID-19 was 69% (95% CI: 37%, 94%) by using a random-effects model. In terms of specific species, the pooled meta-analysis for Candida Auris was estimated to be 100% (95%CI: 98%, 100%; I2 = 0%), for Multi-Candida 59% (95%CI: 38%, 79%; I2 = 12.5%), and for Aspergillus 15% (95%CI: 0%, 42%; I2 = 0%). Conclusion: Our study shows the high prevalence of fungal drug resistance in COVID-19 patients and emphasizes the need to strengthen antimicrobial stewardship programs, close monitoring for treatment failure, and the emergence of resistance upon treatment. Supplementary Information: The online version contains supplementary material available at 10.1007/s12281-022-00439-9.