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Objectives: This scoping review aimed to determine whether the COVID-19 pandemic influenced any modifications to patient selection methods or prioritisation and services provided by proton therapy centres. Method(s): This review was conducted based on the PRISMA methodology and Joanna Briggs Institute scoping review guidelines.1,2 A literature search was performed in Medline, Embase, Web Of Science and Scopus as well as grey literature. Keywords including "COVID-19" and "Proton Therapy" were used. Articles published from 1 January 2020 in English were included. In total, 138 studies were identified of which 14 articles met the inclusion criteria. A scoping review design was chosen to capture the full extent of information published relating to the aim. Result(s): Six of 14 articles included statements regarding treatment of COVID-19 patients. Three publications recommended deferred or alternative treatment, two indicated to treat urgent/emergency patients and one reported continuous treatment for infectious patients. Recurring impacts on PT provision included more frequent use of alternative therapies, reduced referrals, delayed treatment starts and CT simulation, change in treatment volume and staffing limitations due to pandemic restrictions. Consequently, telehealth consults, remote work, reduction in patient visitors, screening procedures and rigorous cleaning protocols were recommended. Discussion/Conclusion: Few publications detailed patient selection or workflow methods used during the pandemic. Further research is needed to obtain more detailed information regarding current global patient selection methods in proton therapy, collecting this data could aid in future planning for proton therapy in Australia.
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Introduction: The COVID-19 pandemic has negatively impacted clinical experience and case volumes. Surgical simulation is now an even more powerful training tool and, to maximize potential, we must ensure learner engagement. Our aim was to identify barriers to surgical simulation engagement and strategies to mitigate these. Method(s): Scoping search was performed with a trained librarian of PubMed, EMBASE and Web of Science. Title and screening were completed with inclusion criteria: articles describing barriers to engagement with surgical simulation. After full text screening, data was extracted from included articles: type of study, MERSQI score, type/number of participants, barriers to engagement and strategies to mitigate these. Result(s): Twenty-nine manuscripts were included with 951 faculty and 2,467 residents. The majority (86%) were in high income countries (HIC) and four in LMICs. Most were surveys (22/29), and five involved semi-structured interviews/focus groups. Mean adjusted MERSQI score was 8. Commonest barriers to HIC engagement were learner clinical duties (9/25), lack of learner time (13/25), lack of learner interest/motivation (9/25) and lack of faculty time or interest to participate (12/25). In LMIC, commonest barriers were lack of simulation lab/equipment (4/4), cost (3/4) and inadequate supervision (3/4). Strategies to improve HIC engagement were mandatory/protected resident simulation training (9/25) and, in LMIC, low cost simulators (4/4) and sharing resources (2/4). Conclusion(s): Identification of barriers to simulation engagement is crucial for successful learning. Given the increased importance of simulation education due to the COVID-19 pandemic, surgical educators should strategize to maximize engagement.
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Introduction: Loop diuretics are the first-line treatment for volume overload in acute decompensation of congestive heart failure (AHF). Loop diuretic resistance is common due to pharmacologic tachyphylaxis. Therefore, thiazide and thiazide-like diuretics are often used as add-on therapy to combine two different pharmacologic mechanisms. This systemic review and meta-analysis aimed to synthesize the current evidence on the efficacy and safety of metolazone and other thiazide-like diuretics in AHF. Method(s): PRISMA guidelines were followed in conducting this systematic review. PubMed, Scopus, PubMed Central, and Embase databases were searched using relevant keywords for studies published before 5 Jan 2022. and title screening was performed, followed by full-text screening using the Covidence software. Data were extracted, and analysis was done using Cochrane Review Manager (RevMan v5.1). The results were reported in odds ratio and mean difference with 95% confidence intervals. Result(s): Out of 2999 studies identified by database search, eight studies met the inclusion criteria (2 RCTs and 6 cohort studies). Pooled analysis using a random-effects model showed no difference in mean difference among the metolazone group and control group for 24 hours total urine output (MD 69.32, 95% CI -638.29 to 776.94;n = 551;I2 = 84%), change in urine output in 24 hours (MD -284.09, 95% CI -583.99 to 15.81;n = 345;I2 = 0%), 48 hours total urine output (MD -465.62, 95% CI -1302.22 to 370.99;n = 242;I2 = 0%) and urine output at 72 hours (MD -13.24, 95% CI -90.88 to 64.40;n = 205;I2 = 0%). However, studies with furosemide only in the comparator arm, 24 hours of total urine outcome favored metolazone (MD 692.70, 95% CI 386.59 to 998.82;n = 334;I2 = 0%). There was no difference between the two groups in the rate of adverse events, loss of weight, mortality, or readmission rates. Conclusion(s): Metolazone therapy in diuretic resistant AHF may improves urine output and facilitates achieving a net negative balance. Thus, metolazone and thiazide-like diuretics can be used as add-on therapy in acute decompensation of heart failure, especially in diuretic resistance.Copyright © 2023 The Author(s)
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Introduction: The COVID-19 pandemic and duty hour restrictions have illuminated a role for surgical simulation in trainees that permits meaningful technical experience outside the operating room. There is a need for the implementation of surgical simulation infrastructure adjacent to clinical training with practical considerations for complexity and cost. This systematic review analyzes surgical simulations that train hand surgical techniques and procedures with subjective or objective competency assessment. Method(s): A systematic review was conducted according to PRISMA- P guidelines using the PubMed, Medline, Scopus, Embase, Web of Science, and Cochrane databases. Selected search terms included procedures relevant to the field of hand surgery and various types of simulation training. Data, including skills and techniques taught and assessed, model type, equipment, cost, and emphasis placed in training for each article, were extracted. Result(s): Of 2,519 articles, 40 met inclusion criteria. Models were described as: synthetic benchtop/3D-printed (40.0%), animal (22.5%), cadaveric (20.0%), augmented and virtual reality (AR/ VR;12.5%), and other computer simulation (12.5%). Three models incorporated both a physical benchtop component and an AR/ VR component. The procedures most represented included tendon repair (30.0%), fracture fixation (27.5%), wrist arthroscopy (15.0%), and carpal tunnel release (15.0%). Sixty-five percent of articles emphasized the importance of surgical simulation in a surgeon's training. Conclusion(s): A diversity of surgical simulation models exist for the practice of various aspects of hand surgery. The existing literature demonstrates their utility for increasing expertise with surgical techniques and procedures in a low-risk setting.
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Objectives: A LSR is a systematic review that is continually updated, incorporating new evidence as it becomes available. They are conducted in research areas where new evidence is constantly emerging on diagnostic methods, treatments, and outcomes. The objective of this study was to understand the current application of LSRs across research areas. Method(s): Embase, MEDLINE, and the Cochrane Database of Systematic Reviews were searched to identify LSRs. Only the most recent update of a LSR was included. Data regarding the indication, intervention, methods, frequency of updates, and funding were extracted. Result(s): Of the 1,243 records identified, 126 LSRs were included for analysis. The first LSR was published in 2015, with a significant increase in the number of LSRs published starting in 2020, coinciding with the COVID-19 pandemic. The most common indication represented by LSRs was COVID-19 (72%), followed by oncology (10%). Other indications with LSRs included chronic pain, traumatic brain injury, and skin disorders, among others. While most oncology LSRs identified interventional randomized-controlled trials (RCTs) (85%), only 54% of COVID-19 LSRs were restricted to interventional studies, including a combination of RCTS and real-world observational studies. Oncology LSRs included common cancers such as prostate, renal, or multiple myeloma. Of the reviews that reported update frequency, 28% planned monthly, 12% yearly, and 12% weekly updates. Only 46% of LSRs were registered. The majority of LSRs were funded by government or research organizations. Objectives of LSRs varied, with most stating the need to maintain up-to-date databases;however, several studies used LSRs to facilitate network meta-analysis or mixed treatment comparisons. Conclusion(s): While LSRs were introduced over five years ago, their frequency increased during the COVID-19 pandemic. Apart from COVID-19, LSRs are commonly used in oncology settings. LSRs provide high-level, relevant, and up-to-date evidence, making them a useful tool for clinical and real-world research.Copyright © 2023
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Objectives: To systematically review longitudinal studies to determine the prevalence and time-course of fatigue after stroke (post-stroke fatigue, PSF). Material(s) and Method(s): A study protocol was registered on PROSPERO. Five databases (PUBMED, MEDLINE, EMBASE, PSYCHINFO and CINAHL) were searched (10th to 13th June 2022). Citations were imported into Covidence software, s screened by one author, full texts of potentially eligible studies retrieved, and one author applied inclusion criteria (longitudinal cohort studies of patients with acute stroke). Quality assessment of included studies was performed using the Joanna Briggs institute tool for observational studies. A meta-analysis was performed for the prevalence of PSF at different time-points after stroke onset, and changes over time. Subgroup analyses were performed by type of stroke and study location. Result(s): A total of 13,991 records were returned from the searches. Nine studies were eligible and were included. Five studies were of strong and four of moderate quality. Of the studies suitable for meta-analysis, the prevalence of PSF was 42% (95% CI - 39-44%) at six months after ischaemic stroke;and 34% (95% CI - 28-40%) at one year in stroke survivors excluding subarachnoid haemorrhage. Subgroups analyses found no differences in PSF prevalence between Asian countries and others. Of those with PSF at first assessment, 66% (95% CI - 61-71%) remained fatigued at follow-up;of those without PSF initially, 15% (95% CI - 11-20%) developed PSF at follow-up. Conclusion(s): PSF is common and around two-thirds with fatigue remain fatigued. This justifies the development of new interventions for PSF treatment.Copyright © 2023 The Author(s)
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Objectives: Assessment of the literature on the ProtekDuo cannula when used as venopulmonary (V-P) extracorporeal membrane oxygenation (ECMO) in ARDS secondary to COVID-19. Method(s): Systematic literature search in EMBASE, Medline (Pubmed) and NHS library using appropriate keywords as well as PICOS and PRISMA approach. Result(s): We found 285 publications, of which 5 publications met the search criteria and were included in this review. A total of 194 patients with COVID-19 related ARDS had a ProtekDuo placed to establish venovenous (V-V) ECMO and right ventricular (RV) support. Patients treated with the ProtekDuo cannula had survival rates between between the studies of 59 and 89%, with a significant survival compared to an invasive ventilation group or when compared to dual site V-V ECMO or other double lumen ECMO cannulas. One of the studies focused on extubation and early discontinuation of ventilator support, which the authors achieved in 100% of ProtekDuo patients. The incidence of acute kidney injury (AKI) and use of continuous renal replacement therapy (CRRT) was significantly reduced in the ProtekDuo versus other groups. Conclusion(s): The ProtekDuo displayed lower mortality rates, AKI occurrence and CRRT need as compared to other respiratory support modalities and has shown to be a game changer for ECMO support in patients suffering from COVID-19 ARDS. Many authors suggested the ProtekDuo for first line use in these patients.
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Introduction: The COVID-19 pandemic necessitated proliferation of telesimulation. This pedagogy may be useful in rural areas to increase procedural adoption and reduce healthcare disparities. Our aim was to determine the current status of surgical simulation education to retool rural practicing Urologists. Method(s): Literature search was performed with a trained librarian for PubMed, EMBASE and Web of Science. Title/ screening were performed to include all studies of surgical simulation involving rural surgical learners to identify simulation education opportunities for practicing rural Urologists. Data was then extracted: simulation event, skills focus, MERSQI score, type/number of learners, learner assessment and event evaluation. Result(s): Seven manuscripts met inclusion criteria. Most were published 2019-2020 and were cross sectional (5/7, 71%). Mean adjusted MERSQI score was 13 (range 6-15.5). A wide range of surgical skills were taught (incl. laparoscopy, cricothyroidotomy, chest tube insertion, damage control laparotomy), but no Urological surgical skills. Two articles described mobile simulation units for rural areas. A total of 232 learners were identified including 69 medical students. One fifth of rural learners were non-medical or non-physicians. Only one study involved faculty, who were general surgeons. Conclusion(s): Telesimulation education for practicing Urologists in rural areas is lacking. Current in-operating room telementoring for rural Urologists requires surgeons to travel and perform their first cases utilizing this new technique on patients. Telesimulation to teach Urological skills in rural areas of the US may increase dissemination of techniques with no patient risk and has significant potential to redress current healthcare disparities.
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This paper examines the relevance of the use of a single irradiation of lungs in treatment of pneumonia caused by a new coronavirus infection. Clinical observations are presented that demonstrate perspectives in the treatment of this disease. Patients with severe pneumonia who were prescribed LD-RT (low-dose radiation therapy) at a dose of 0.5-1.5 Gy showed shorter recovery times and no complications. This method of treatment has shown its effectiveness in a number of studies from different countries, predicting success and economic benefits in its further use and study. A literature search containing information on relevant studies was carried out in PubMed, EMBASE, Web of Science and Google Scholar systems. Attention was focused on full-text articles given their general availability in a pandemic.Copyright © 2021 VIDAR Publishing House. All right reserved.
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Background: The recent pandemic prompted a number of clinical trials to assess the efficacy and safety of medication use for the treatment for COVID-19. As pregnant women are excluded or vastly underrepresented in clinical research, there is a paucity of data on how pregnancy and perinatal outcomes are impacted by such medications. Considering that pregnant women are at increased risk for COVID-19 infection and that pregnancy is also associated with an increased risk of developing severe COVID-19, it is of utmost importance to assess the effect of gestational medications use for COVID-19 on pregnancy outcomes. Objective(s): The aims of this systematic review were to (1) determine and quantify COVID-19-specific and repurposed medication use during pregnancy, and (2) provide an overview of the pregnancy and neonatal outcomes that have occurred in COVID-19-positive pregnant women exposed to COVID-19-specific or repurposed medications compared to use in pregnant women without COVID-19;neonatal outcomes compared between COVID-19 positive pregnant women treated and untreated with these medications. Method(s): A systematic literature search was conducted in Ovid and executed in the following databases: MEDLINE, Embase, and Global Health. Search strategies applied combined database-specific subject headings and keywords relevant to the topic. Some subject headings used in databases were pregnancy outcome, COVID-19, SARS-CoV-2, pharmaceutical preparations, drugs, and prescription. Some keywords used for the searches were pregnancy outcome, neonatal outcome, coronavirus disease 2019, drug, medication, and treatment. For each database, keywords were searched within the , keyword heading word or heading words, and title fields. Restrictions were applied regarding the date of publication and searches were limited to English publications. Study selection was accomplished by two independent investigators (NSK, NAB). Only original research articles were considered for inclusion. Included studies investigated pregnancy or neonatal outcomes in women with COVID-19 receiving medication to treat COVID-19. A standardized extraction form was used to independently extract relevant information. Result(s): The literature search yielded a total of 344 records. After deduplication, 69 records were removed. The title and of 275 publications were screened.
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Male reproductive health depends on many factors, including whether infectious diseases occur in the reproductive system. Such changes may be reflected in the semen analysis. In the past three years, the number of individuals who fell ill with COVID-19 caused by SARS-CoV-2 has been growing worldwide, including in Russia. This infection causes dysfunction and a negative effect on many organs and systems, including reproductive organs, which is reflected in abnormal semen parameters. Despite the high efficacy and small number of side effects found in clinical trials, only 56% of the population in the US and 49% in the Russian Federation reported wanting the vaccine. One of the reasons for distrust of vaccines is the potential negative impact on fertility. A literature review is devoted to the study of the effect of SARS-CoV-2 and vaccination on male reproductive health. The search was carried out using Medline, PubMed, and EMBASE databases.Copyright © 2023 Authors. All rights reserved.
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Objectives: Social distancing requirements and lockdowns due to COVID-19 resulted in a rapid integration of telehealth into HIV care. To maximize patient retention and ensure quality of care, it is vital to understand patient perspectives and preferences for various attributes of telehealth. This study aims to identify preference-relevant features of telehealth. Method(s): A review of PubMed and Embase was conducted in September 2022. Search terms describing telehealth (e.g., telehealth, telemedicine) and its features (e.g., attribute, characteristic) were combined for the search. Duplicate and non-English records, as well as irrelevant records, were removed. Literature was analyzed and synthesized using meta-synthesis and thematic synthesis methodology. Result(s): 10 records were included in the review (5 qualitative studies, 1 mixed-methods study, 4 discrete choice experiments). No HIV-specific studies were identified that described preference-relevant telehealth features. Studies primarily reported telehealth features in primary care, oncology, and rheumatology settings. Data synthesis revealed four domains of preference-relevant telehealth features: administration, technology, visit-related, and other features. Administrative features included waiting time for and during an appointment, scheduling flexibility, and out-of-pocket costs. Technology features included hardware and software used for telehealth visits, extent of privacy, and type of telehealth (e.g., video or voice-only). Visit-related features included relationship to the provider, consultation purpose, and severity of the patient's health concern. Other features included technological support options, convenience, and ease of telehealth use. Continuity of care with a patient's regular provider was the most often reported feature of telehealth within the identified literature. Conclusion(s): While there is no HIV-specific literature, preference-relevant administrative, technology, visit-related, and other features were identified in non-HIV-related literature. Future research needs to assess the importance of identified features to people living with HIV and which tradeoffs they are willing to make. This will inform tailored telehealth options addressing patients' needs and preferences for optimal utilization and care.Copyright © 2023
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Objectives: The objective of this study is to assess the clinical benefits and potential risks of using venovenous extracorporeal membrane oxygenation (VV ECMO) as a treatment for COVID-19 patients with severe respiratory failure. Method(s): Relevant studies were identified through searches of electronic databases, including PubMed, EMBASE, and the Cochrane Library, from January 2020 to December 2022. We included observational studies on adult patients who received venovenous (VV) ECMO support for COVID-19-induced ARDS. The primary outcome was in-hospital mortality, 3-month mortality, and complications associated with VV ECMO. Statistical analysis was performed using R version 4.0.3 and the metafor and meta packages. Result(s): The final analysis included 39 studies comprising 10,702 patients. In-hospital mortality for adults receiving ECMO was 34.2% (95% CI: 28.5% - 40.3%;I2 = 93%), while the 3-month mortality rate was 50.2% (95% CI: 44.4% - 56.0%;I2 = 51%). Bleeding requiring transfusion occurred in 33.7% of patients (95% CI, 23.9 - 45.1;I2 = 96%). The pooled estimates for other complications were as follows: overall thromboembolic events 40.9% (95% CI, 24.8 - 59.3;I2 = 97%), stroke 8.7% (95% CI, 5.7 - 13.2;I2 = 72%), deep vein thrombosis 15.4% (95% CI, 9.7 - 23.6;I2 = 80%), pulmonary embolism 15.6% (95% CI, 9.3 - 25.1;I2 = 92%), gastrointestinal haemorrhage 8.1% (95% CI, 5.5 - 11.8;I2 = 56%), and the need for any renal replacement therapy in 38.0% of patients (95% CI, 31.6 - 44.8;I2 = 84%). Bacterial pneumonia occurred in 46.4% of patients (95% CI, 32.5 - 61.0;I2 = 96%). Conclusion(s): Venovenous extracorporeal membrane oxygenation (VV ECMO) may be an effective treatment option for COVID-19 patients with severe respiratory failure. The use of VV ECMO was associated with reduced in-hospital and 3-month mortality. However, bleeding is a common complication that should be closely monitored. Further research is needed to determine the optimal use of VV ECMO in this patient population and to identify factors that may predict a favourable response to treatment.
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Objectives: The aim of this systematic review and metaanalysis was to evaluate the effectiveness of ECMO in pediatric COVID-19 patients in terms of mortality rate, rate of successful weaning, and frequency of complications. Method(s): A comprehensive search of electronic databases including PubMed, Cochrane Library, and EMBASE was conducted to identify relevant studies published up to December 2022. Inclusion criteria for the studies included observational studies and case series with a minimum of five patients that reported on the use of ECMO in children with COVID-19. Statistical analysis was performed using R version 4.0.3 and the metafor and meta packages. Result(s): Seven studies involving a total of 73 pediatric COVID-19 patients who received ECMO were identified. The pooled estimate of mortality in children receiving ECMO was 21.5% (15 out of 73 patients;95% CI: 9.9% to 40.5%;I2 = 14%). The success rate for weaning off/decannulation of ECMO was estimated to be 85.1% (52 out of 61 patients;95% CI, 67.8-93.9;I2 = 1%). The overall complication rate was 32.6% (14 out of 43;95% CI, 20.3-47.7;I2 = 0%). Conclusion(s): The results of this systematic review and meta-analysis indicate that ECMO may be an effective treatment option for children with severe COVID-19, particularly those requiring mechanical ventilation. The success rate for weaning off/decannulation of ECMO was estimated to be 85.1%, while the overall complication rate was 32.6%. However, the small sample size and high risk of bias in the included studies should be taken into consideration when interpreting these results. Further research is necessary to confirm the efficacy of ECMO in pediatric COVID-19 patients and determine the optimal use of this treatment.
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Objectives: Meta-analyses have investigated associations between race and ethnicity and COVID-19 outcomes. However, there is uncertainty about these associations' existence, magnitude, and level of evidence. We, therefore, aimed to synthesize, quantify, and grade the strength of evidence of race and ethnicity and COVID-19 outcomes in the US. Method(s): In this umbrella review, we searched four databases (Pubmed, Embase, the Cochrane Database of Systematic Reviews, and Epistemonikos) from database inception to April 2022. The methodological quality of each meta-analysis was assessed using the Assessment of Multiple Systematic Reviews, version 2 (AMSTAR-2). The strength of evidence of the associations between race and ethnicity with outcomes was ranked according to established criteria as convincing, highly suggestive, suggestive, weak, or non-significant. The study protocol was registered with PROSPERO, CRD42022336805 Results: Of 880 records screened, we selected seven meta-analyses for evidence synthesis, with 42 associations examined. Overall, 10 of 42 associations were statistically significant (p <= 0.05). Two associations were highly suggestive, two were suggestive, and two were weak, whereas the remaining 32 associations were non-significant. The risk of COVID-19 infection was higher in Black individuals compared to White individuals (risk ratio, 2.08, 95% Confidence Interval (CI), 1.60-2.71), which was supported by highly suggestive evidence;with the conservative estimates from the sensitivity analyses, this association remained suggestive. Among those infected with COVID-19, Hispanic individuals had a higher risk of COVID-19 hospitalization than non-Hispanic White individuals (odds ratio, 2.08, 95% CI, 1.60-2.70) with highly suggestive evidence which remained after sensitivity analyses. Conclusion(s): Individuals of Black and Hispanic groups had a higher risk of COVID-19 infection and hospitalization. These associations of race and ethnicity and COVID-19 outcomes existed more obviously in the pre-hospitalization stage. More consideration should be given in this stage for addressing health inequity.Copyright © 2023
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Objective. The prognosis value of fibrosis-4 score (FIB-4) in COVID-19 is controversial. Hence, we conducted a systematic review and meta-analysis to investigate the association between the FIB-4 index and COVID-19 disease progression. Methods. We performed meta-analysis using the PubMed, Embase, and Cochrane databases. A fixed- or random-effects model was used for evaluating heterogeneity. Results. Thirteen studies were included. The meta-analysis of unadjusted results showed that compared to lower FIB-4 index, patients with higher FIB-4 index had increased odds of mortality (OR=5.1, 95%CI 3.67-7.09;P<0.001), ICU admission (OR=2.32, 95%CI: 1.65-3.25, P<0.00001) and need for mechanical ventilator support (OR=3.51, 95%CI: 2.1-5.85, P<0.001). In addition, the meta-analysis of adjusted results showed patients with higher FIB-4 index was associated with increased risk of mortality (OR=3.01, 95%CI: 2.21-4.09, P<0.001) and need for mechanical ventilator support (OR=3.76, 95%CI: 2.08-6.82, P<0.001) compared to patients with lower FIB-4 index. Conclusion. This meta-analysis indicated that high FIB-4 index score was associated with the severity and mortality in COVID-19 infected patients.Copyright © 2022 by the Association of Clinical Scientists, Inc.
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Background/Aims Cases of new autoimmune and autoinflammatory conditions have been reported among COVID-19 survivors. A literature review on newonset autoimmune connective tissue diseases (ACTDs) following infection with COVID-19 is lacking.This systematic literature review aimed to evaluate the potential association between COVID-19 infection and the development of new-onset ACTDs in adults. Methods Articles published until September 2022, investigating the association between COVID-19 infection and new-onset ACTDs were included. The ''population'' searched was patients with disease terms for autoimmune connective tissue diseases, including (but not limited to) systemic lupus erythematosus (SLE), Sjogren's syndrome, systemic sclerosis (SSc), any idiopathic inflammatory myositis (IIM), antisynthetase syndrome, mixed CTD and undifferentiated CTD (and related MeSH terms), with ''intervention'' as COVID-19 and related terms. For terms for COVID-19, a dedicated search strategy developed by the National Institute for Clinical Excellence was used.Medline, Embase, and Cochrane databases were searched, restricted to English-language articles only. Eligible articles were: case reports and series (of any sample size), observational studies, qualitative studies and randomised controlled trials. Patients developing ACTDs without prior COVID-19 or reporting flares of existing ACTDs were excluded. Information was extracted on patient demographics, new ACTDs' onset time, clinical characteristics, COVID-19 and ACTD treatment, and COVID-19 and ACTDs outcomes. The protocol was registered in PROSPERO (CRD42022358750). Results After deduplication, 2239 articles were identified. After screening title and , 2196 papers were excluded, with 43 proceeding to fulltext screening. Ultimately, 28 articles (all single case reports) were included. Of the 28 included patients, 64.3% were female. The mean age was 51.1 years (range 20-89 years). The USA reported the most cases (9/28). ACTD diagnoses comprised: 11 (39.3%) IIM (including 4 cases of dermatomyositis);7 (25%) SLE;4 (14.3%) anti-synthetase syndrome;4 (14.3%) SSc;2 (7.1%) other ACTD (one diagnosed with lupus/MCTD overlap). Of eight, four (14.3%) patients (including that with lupus/MCTD) were diagnosed with lupus nephritis. The average onset time from COVID-19 infection to ACTD diagnosis was 23.7days. A third of the patients were admitted to critical care, one for ACTD treatment for SLE with haemophagocytic lymphohistiocytosis (14 sessions of plasmapheresis, rituximab and intravenous corticosteroids) and nine due to COVID-19. The majority (80%) of patients went into remission of ACTD following treatment, while two (10%) patients died- one due to macrophage activation syndrome associated with anti-synthetase syndrome and two from unreported causes. Conclusion Our results suggest a potential association between COVID-19 infection and new-onset ACTDs, predominantly in young females, reflective of wider CTD epidemiology. The aetiology and mechanisms by which ACTDs arise following COVID-19 infection remain unknown and require more robust epidemiological data.
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Male reproductive health depends on many factors, including whether infectious diseases occur in the reproductive system. Such changes may be reflected in the semen analysis. In the past three years, the number of individuals who fell ill with COVID-19 caused by SARS-CoV-2 has been growing worldwide, including in Russia. This infection causes dysfunction and a negative effect on many organs and systems, including reproductive organs, which is reflected in abnormal semen parameters. Despite the high efficacy and small number of side effects found in clinical trials, only 56% of the population in the US and 49% in the Russian Federation reported wanting the vaccine. One of the reasons for distrust of vaccines is the potential negative impact on fertility. A literature review is devoted to the study of the effect of SARS-CoV-2 and vaccination on male reproductive health. The search was carried out using Medline, PubMed, and EMBASE databases.Copyright © 2023 Authors. All rights reserved.
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Objectives: COVID-19 posed profound challenges to nuclear medicine (NM) practice and education on an international scope. Initial lessons learned may be useful in understanding and optimizing dissemination of critical information during global disasters. To better understand the pandemic's initial manifold impact and responses that were in turn enacted, we systematically reviewed relevant articles published during the 2020 calendar year. Method(s): A librarian experienced in systematic reviews performed a rapid scoping review of the English language literature indexed in PubMed, Embase and Web of Science by crossing NM and COVID terms;445 citations were returned. Duplicate, extraneous, non-English and non-full text articles were excluded leaving 248 articles which were analyzed by origin, topic, design, and imaging details. Result(s): An array of topics, techniques, journals and countries of origin were encountered. 158 articles appeared in primary NMjournals, 26 appeared in generic radiology journals and 65 in non-imaging journals. Most frequent countries represented were USA (55), Italy (33), France (19) and UK (17), reflecting the hard-hit countries early during the pandemic. 118 clinical articles were case reports or small series of which 80 featured FDG-PET/CT. There were 36 observational studies. Among non-clinical topics, articles focused on safetymeasures (102), economics and recovery (23), remote reading (17) and education (8). There were 17 surveys. Society-based guidelines (47) and individual-group best practices (79) were published relating to cardiology (33), lung scintigraphy (12), andmultiple topics (48). Systematic (10) and narrative reviews (61) were less frequent than opinion articles (75). Frequent modalities discussed were FDG PET (156), nuclear cardiology (56) and lung scintigraphy (35). Conclusion(s): The medical literature has memorialized a robust response of information sharing during the initial challenges the COVID-19 pandemic relating to patient care, operations and education. Through scoping review, we have analyzed the nature of information disseminated. Opinions and single group best practices dominated the literature. Clinical reports during the first year were primarily case reports or small series, frequently FDG-PET/ CT. The nature of the literature matured as the year progressed, and sources of information broadened as the epidemic spread.