Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 6.792
Filter
Add filters

Year range
1.
Indian Journal of Pharmaceutical Sciences ; 84(3):519-531, 2022.
Article in English | EMBASE | ID: covidwho-1957665

ABSTRACT

The severe acute respiratory syndrome coronavirus 2, formerly known as 2019 novel coronavirus, the causative pathogen of coronavirus disease 2019 is a major source of disaster in the 21st century. In the second meeting of the Emergency Committee, the World Health Organization declared that coronavirus disease 2019 is a "public-health emergency of international concern" on 30 January, 2020. Coronavirus is transmitted via airborne droplets from human to human or human to animal. Through membrane angiotensin-converting enzyme 2 exopeptidase receptor coronavirus enters in human cell. For the treatment of this sudden and lethal disease during coronavirus disease 2019, there are no specific anti-virus drugs or vaccines. Still, the development of these medicines will take months, even years. Currently there is need of supportive care and non-specific treatment to improve the symptoms of coronavirus disease 2019 infected patient. For this specific indication, rapid performance of herbal medicine or phytochemicals can contribute as an alternative measure. Phytochemicals are a powerful group of chemicals that are derived from plants origin hence causing fewer side effects because of less use of additives, preservatives or excipients. Hence, this review will focus on some phytochemicals which may control and prevent severe acute respiratory syndrome coronavirus 2. Further, the existing healing options, drugs accessible, ongoing trials and current diagnostics to treat severe acute respiratory syndrome coronavirus 2 have been discussed. We suggested phytochemicals extracted from herbal plants are potential novel therapeutic approaches, completely targeting severe acute respiratory syndrome coronavirus 2 and its pathways.

2.
Profilakticheskaya Meditsina ; 25(1):111-119, 2022.
Article in Russian | EMBASE | ID: covidwho-1957616

ABSTRACT

The article is dedicated to the 90th anniversary of the Department of Epidemiology and Evidence-based Medicine of the of F.F. Erisman Public Health Institute of the Sechenov University. The main milestones of the Department development are described. It is shown that throughout its history, the Department played a leading role in defining the methodology of teaching epidemiology, and the formation of epidemiology as a science, its structure, and content. In recent years the work of the Department has undergone several major transformations aimed at introducing new technologies and the latest advances in the teaching of epidemiology into the educational process. Today, the Department staff uses the latest evidence-based data and teaches the discipline based on current standards. Training of students, specialists in residency, and scientific personnel in postgraduate study is conduct-ed following the approved working program, using state-of-the-art teaching materials and interactive technologies. The pandemic of a new coronavirus infection contributed to the rapid development of telecommunication and online education. The student research group and school of excellence «Epidemiologist of the Future» are working, and the student volunteer project «Prophylaxis Forefront» is being implemented, aimed at training specialists with current technologies of preventive medicine. The Department staff is actively involved in scientific projects of F. F. Erisman Public Health Institute. The research results are published in national and foreign publications.

3.
International Journal of Gerontology ; 16(2):89-94, 2022.
Article in English | EMBASE | ID: covidwho-1957563

ABSTRACT

Background: Our study evaluates the efficacy of an outpatient personalized multidisciplinary intervention model guided by comprehensive geriatric assessment (CGA), for pre-frail and frail elderly. Methods: A single-arm self-controlled study was conducted at the outpatient departments (OPD) of a medical center in Taiwan. Subjects received personalized multidisciplinary intervention, including physical therapy, psychotherapy, a nutritional consultation, precise medicine, and social resource linkage, as determined by the results of their CGAs. After 3 months of interventions, change in the proportions of the frail status (frail, pre-frail and robust), functional scores, depressive status, cognition, nutritional status, percentage of inappropriate medication used and social resource usage were analyzed. A logistic regression model was applied to determine the predictive factors associated with an improvement in frail severity. Results: A significant improvement in frail status was found (proportion of frail: 44.5% versus 23.1%, p < 0.001). Physical function, depressive and nutritional status were also significantly improved. 18.5% of participants used inappropriate medications, with benzodiazepine hypnotics the most common (40.9%). 24.2% of subjects were successfully linked to social resources. The presence of the frail phenotypes exhaustion was significantly associated with an improvement in frail severity (odds ratio (OR) = 2.77, 95% confidence interval (CI) = 1.15–6.66, p = 0.023). There was a significant dose response relationship between the improvement of frail status and physical training times (proportion of improved frail status: 23.7%, 40.5% and 47.9% for 0, 1–3, and 4–6 times of physical training, p = 0.03). Conclusion: The reported CGA-based, personalized multidisciplinary intervention model was effective at improving frail severity among pre-frail and frail elderly in OPDs.

4.
Pharmacognosy Journal ; 14(3):681-689, 2022.
Article in English | EMBASE | ID: covidwho-1957553

ABSTRACT

Background: Antiviral vaccine is not effective, synthetic antiviral drugs are highly toxic, leading to increased interest in herbal medicines as promising antiviral drugs. Recently, Vipdervir has been developed from medicinal herbs with the aim to support and treat diseases caused by viruses such as H5N1 and SARSCoV- 2. In the present study, we assessed Vipdervir's antiviral activity against H5N1 and SARS-CoV-2. In addition, we also evaluated the acute toxicity and repeated dose toxicity of Vipdervir in mice and rabbits, respectively. Methods: H5N1 inhibitory effect of Vipdervir was assessed using hemagglutination inhibition assay. Vipdervir's SARS-CoV-2 inhibitory effect was evaluated by Plaque Reduction Neutralization assay. Acute and repeated dose oral toxicities of Vipdervir were determined according to OECD 423 and OECD 407 guidelines, respectively. Results: Data show that Vipdervir is effective against both H5N1 and SARSCoV- 2. At concentrations of 3 mg/mL and 5 mg/mL Vipdervir completely inhibits H5N1. At a concentration of 50 μg/mL Vipdervir showed an inhibitory effect on SARS-CoV-2. Acute toxicity data revealed that the LD50 of Vipdervir is greater than 35200 mg/kg, b.wt. in mice. Repeated toxicity data indicated that Vipdervir did not induce significant differences in body weight gain, hematology and clinical biochemistry in compared to the control group. The No Observed Adverse Effect Level of Vipdervir is greater than 613.8 mg/kg b.wt./day in rabbits. No delayed toxicity effects of Vipdervir were observed. Conclusion: Vipdervir capsules were found to be antiviral effective and relatively safe in the tested doses and experimental conditions.

5.
Indian Journal of Psychiatry ; 64(4):401-407, 2022.
Article in English | EMBASE | ID: covidwho-1957515

ABSTRACT

Background: The Indian population is suffering from a high prevalence of mental stress and the situation has been worsened by the COVID-19 pandemic. Mindfulness, which can also be conducted online, has been used as a stress-relieving therapy in the Western world. There is not much experience with mindfulness in the Indian population. The COVID-19 pandemic demands the development of alternative therapies which can reach out to the masses at a minimal cost, avoiding direct personal contact. The researchers wanted to explore the potential of mindfulness as a stress-relieving therapy. Aim: To note any improvement in perceived stress of the participants compared to the controls. Methods: Ninety apparently healthy adults were randomized into group M (all of whom participated in an online mindfulness program) and group C (all of whom attended placebo sessions), with 45 participants each. Final sample size was n = 42 (group M) and n = 38 (group C). The perceived stress was measured using the perceived stress scale before and after the program. Qualitative data was collected in the form of written responses to the question 'Which aspect of mindfulness meditation appealed to you the most for stress relief?' and some themes were formed. Results: There was a significant decrease in perceived stress scale scores on completion of the program in group M. 'Positive mental state' and 'non-judgmental' were the most prominent emergent themes suggested by the participants, as per the qualitative data analysis. Conclusion: This preliminary study sees potential in an online mindfulness program as an alternative stress-relieving therapy. Further research is suggested to substantiate the results and optimize the implementation.

6.
Drugs of the Future ; 47(5):381-385, 2022.
Article in English | EMBASE | ID: covidwho-1957096

ABSTRACT

The 2022 American Society for Clinical Pharmacology and Therapeutics (ASCPT) Annual Meeting held virtually, with "Disruptive innovation" as the motto, offered attendees an outstanding scientific program focused on clinical pharmacology, translational medicine, drug discovery and drug development. It is the most important event for scientists involved in clinical pharmacology and translational medicine. The ASCPT conference offers scientists from different professional scopes and around the world the perfect opportunity to discuss emerging science. It focuses on improving the understanding and use of existing drug therapies and developing safer and more effective treatments for the future. Oral and poster presentations were available for participants during the running of the conference to accommodate the different time zones. Presentations covered the latest research with the option to ask questions after each presentation via a chat function. Discussion boards were available to provide networking opportunities for virtual attendees.

7.
Drugs of the Future ; 47(3):229-231, 2022.
Article in English | EMBASE | ID: covidwho-1957095

ABSTRACT

The 70th annual meeting of the American Society of Tropical Medicine and Hygiene was kicked off by Dr. Tedros Ghebreyesus, the Director-General of the World Health Organization (WHO). The virtual gathering format included plenary sessions, science and clinical sessions, E-poster sessions, and an exhibit hall featuring the latest products and services for tropical diseases and global health. This report provides highlights from the oral and poster sessions, focusing on developments in the treatment of tropical diseases.

8.
Natural Product Communications ; 17(7), 2022.
Article in English | EMBASE | ID: covidwho-1956964

ABSTRACT

Objective: The Chinese herbal formula Huo-Xiang-Zheng-Qi (HXZQ) is effective in preventing and treating coronavirus disease 19 (COVID-19) infection;however, its mechanism remains unclear. This study used network pharmacology and molecular docking techniques to investigate the mechanism of action of HXZQ in preventing and treating COVID-19. Methods: The Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) was used to search for the active ingredients and targets of the 10 traditional Chinese medicines (TCMs) of HXZQ prescription (HXZQP). GeneCards, Online Mendelian Inheritance in Man (OMIM), Pharmacogenomics Knowledge Base (PharmGKB), Therapeutic Target Database (TTD), and DrugBank databases were used to screen COVID-19-related genes and intersect them with the targets of HXZQP to obtain the drug efficacy targets. Cytoscape 3.8 software was used to construct the drug-active ingredient–target interaction network of HXZQP and perform protein–protein interaction (PPI) network construction and topology analysis. R software was used to perform Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis. Finally, AutoDock Vina was utilized for molecular docking of the active ingredients of TCM and drug target proteins. Results: A total of 151 active ingredients and 250 HXZQP targets were identified. Among these, 136 active ingredients and 67 targets of HXZQP were found to be involved in the prevention and treatment of COVID-19. The core proteins identified in the PPI network were MAPK1, MAPK3, MAPK8, MAPK14, STAT3, and PTGS2. Using GO and KEGG pathway enrichment analysis, HXZQP was found to primarily participate in biological processes such as defense response to a virus, cellular response to biotic stimulus, response to lipopolysaccharide, PI3K-Akt signaling pathway, Th17 cell differentiation, HIF-1 signaling pathway, and other signaling pathways closely related to COVID-19. Molecular docking results reflected that the active ingredients of HXZQP have a reliable affinity toward EGFR, MAPK1, MAPK3, MAPK8, and STAT3 proteins. Conclusion: Our study elucidated the main targets and pathways of HXZQP in the prevention and treatment of COVID-19. The study findings provide a basis for further investigation of the pharmacological effects of HXZQP.

9.
BJOG: An International Journal of Obstetrics and Gynaecology ; 129:131-132, 2022.
Article in English | EMBASE | ID: covidwho-1956653

ABSTRACT

Objective: Despite advances in the care of the multiply injured trauma patient, clear understanding and guidance for the management of major obstetric trauma is lacking. Explanations may include the altered physiology of pregnancy, as well as the relative infrequent occurrence of obstetric trauma. Following a recent serious incident, it was recognised that greater trust-wide awareness and understanding of the management of an injured parturient was needed. University Hospitals Coventry & Warwickshire is one England's busiest trauma centres. Therefore, it was of paramount importance that an intervention was introduced to improve staff confidence and competence. The COVID-19 pandemic necessitated socially distanced multidisciplinary teaching. Although trainees engage in PROMPT and MOET courses to focus on inter-specialty team working, we felt a greater emphasis on major obstetric trauma management would be beneficial. Design: A high-fidelity trauma simulation video was developed following a multidisciplinary meeting with representatives from Emergency Medicine, Anaesthesia and Obstetrics, enabling specialty specific learning points to be highlighted. Method: The video outlined the management sequence of an obstetric trauma. Starting with the trauma call and paramedic handover, a rapid primary survey identified multiple injuries including an abdomino-pelvic injury. The scenario demonstrated a collaborative team approach, culminating in a resuscitative hysterotomy. Visual annotations highlighted important learning points. The video was used as a departmental induction teaching session for rotating trainees in Anaesthetics, Obstetrics and Emergency Medicine. The video encouraged facilitated group discussion of learning points. We plan for the session to be included in future departmental teaching. Results: Feedback forms were completed before and after the session. Only 35.7% of trainees reported prior involvement in the management of major obstetric trauma or obstetric cardiac arrest. Prior to the session, 42.9% of trainees did not feel confident to manage a major obstetric trauma. Encouragingly, this reduced to only 7.1% post-session. Overall 85.7% of candidates agreed or strongly agreed the session had improved their understanding of the management of major obstetric trauma. Conclusion: Creating a high performing team takes significant work and motivation. A serious event provided the impetus to develop a cross specialty teaching session aimed at improving trainees confidence and ability in major obstetric trauma management. The video facilitated the discussion of important learning points, and feedback showed improved trainee confidence and understanding. We aim to tackle low trainee confidence and overcome the challenges caused by frequently changing trauma teams through ensuring continued use and development of this standardised multi-specialty teaching session.

10.
European Journal of Clinical Pharmacology ; 78:S62-S63, 2022.
Article in English | EMBASE | ID: covidwho-1955960

ABSTRACT

Background: Further understanding on the safety profile of vaccines in a real-world still need to be elucidated, such as the comparative tolerability and reactogenicity of mRNA vaccines (BNT162b2 and MRNA- 1273) beyond the controlled context of clinical trials. An active pharmacovigilance study was designed to capture a complete short-term safety profile of two mRNA vaccines BNT162b2 and mRNA- 1273, targeting incidence rates of adverse reactions within a pre-defined denominator of vaccinated healthcare professionals. Methods: A prospective active surveillance study was implemented during the vaccination campaign at Hospital Clínic by a multidisciplinary team, involving the Pharmacovigilance Technical Committee, the Department of Preventive Medicine and Epidemiology and the Department of Occupational Health Care of the Hospital. Target population of the program included vaccinated professionals from Hospital Clínic and affiliated institutions, who were vaccinated with BNT162b2 and mRNA-1273. The program was based on the delivery of a structured questionnaire by telephonic interview after each vaccine dose. A total of 64% of vaccinated professionals completed the questionnaire (n=5088). Results: A total of 85% subjects suffered at least 1 AR reaction with the vaccine. The proportion of professionals developing any AR was 2878 (81.2%) after vaccination with BNT162b2 and 1463 (92.9%) after vaccination with mRNA-1273. Severe ARs (VAS scoring ≥ 7) were reported in 1184 (33.7%) professionals after vaccination with BNT162b2 and 886 (56.4%) after mRNA-1273. In the multivariate analysis, mRNA-1273 showed a greater reactogenicity than BNT162b2 (OR=3.04 (95% CI 2.48 - 3.73;p-value: <0.0001)). Conclusions: Our study shows that mRNA-1273 has greater reactogenicity than BNT162b2. Overall, both mRNA vaccines had a reasonable tolerability profile, compared in a real-world scenario. This can be understood as a reassuring message for the medical and scientific community.

11.
Journal of Chinese Medicine ; 2022(129):9-14, 2022.
Article in English | EMBASE | ID: covidwho-1955736

ABSTRACT

More than half of the human body consists of non-human microbes such as bacteria and viruses. Microbes can cause infection, inflammation, immune system disorders, obesity, diabetes, respiratory and cardiovascular illnesses, even heart failure. Microbes are governed by the cycles of nature, including the cycles of day and night, and are influenced by what and when we eat. Research has shown intermittent fasting to be a promising approach for reducing inflammation, improving metabolic health and reducing risk factors for cardiovascular disease, possibly through influencing gut microbial composition. This article explores the role of the microbiome and intermittent fasting on human health from the perspective of traditional Chinese medicine (TCM).

12.
Thermology International ; 31(4):163-171, 2021.
Article in English | EMBASE | ID: covidwho-1955693

ABSTRACT

This is an updated historical perspective on the European Thermology Congresses in the period from 2009 to 2021. As with the previous review article, the schedules for lectures, the lists of delegates, books, congress proceedings and photos of the congress participants were checked from the recent 5 conferences. Descriptive statistics were compiled regarding the origin of the participants, the number of participants and presentations per conference and the topics of the presentations. In total 275 presentations have been given at the recent 5 European Congresses of Thermology. The median number of delegates at the congresses between 2009 and 2021 was 61, slightly higher than the median number of participants in the period 1990 to 2006 despite the pandemic-related low number of participants in the online congress 2021. Approximately 20% of all presentation originated from outside of Europe. There was a shift of topics predominant in the first 10 and the 5 recent congresses. In the period from 2009 to 2021, the topic of sport and/or exercise was at the top, followed by applications in veterinary medicine, vascular diseases, and standards/quality assurance. The Online Congress 2021 suffered from the COVID-19 pandemic but mastered this difficult challenge quite well in terms of scientific output. Similar as the scientific literature on thermology, the history of the recent five European Congress of Thermology reflects the trends in thermographic research with a currently high interest in standard protocols for applications in sports and exercise science, animal thermography and vascular diseases.

13.
BMJ Leader ; 4, 2020.
Article in English | EMBASE | ID: covidwho-1955682

ABSTRACT

The proceedings contain 198 papers. The topics discussed include: can a magazine mentor? how a student-led publication is shaping prospective current medical, veterinary and dental student leaders;the four watches: a small island approach to COVID-19 in the emergency department;care navigation in primary care: a student-led clinical audit quality improvement project;wicked problem? trainees creating a novel foundation interim year 1 (FiY1) program at South Tees NHS foundation trust;quality improvement project on community induction for foundation year 2 doctors;centralizing the renal cancer multi-disciplinary team for equitable access to specialist services;improving wellbeing through peer to peer support;skills for collaborative change;and leadership during the COVID-19 crisis: how did we do and how can we do better?.

14.
Vaccines (Basel) ; 10(8)2022 Jul 25.
Article in English | MEDLINE | ID: covidwho-1957473

ABSTRACT

Pregnancy is a well-known factor for vaccine hesitancy and immunization remains the most effective form of prevention against coronavirus disease (COVID-19) related complications. The objective was to estimate vaccine uptake and hesitancy rate, characteristics, and factors contributing to a decision-making process among pregnant and postpartum individuals. This was a prospective cross-sectional study on 1033 pregnant (54.1%) and postpartum (45.9%) women conducted between December 2021 and March 2022 in a tertiary center for maternal-fetal medicine. Logistic regression was used to assess characteristics related to the vaccination decision process. Among responders, 74% were vaccinated and 26% were hesitant (9% planning to vaccinate and 17% totally opposed). Only 59.8% were offered a vaccine by healthcare professionals. Women with higher levels of education (OR 2.26, p < 0.0001), who received positive feedback about vaccination (OR 2.74, p = 0.0172), or were informed about COVID-19 complications in pregnancy (OR 2.6, p < 0.0001) were most likely to accept the vaccination. Hesitancy was associated with multiparity (≥3, OR 4.76, p = 0.006), worse educational status (OR 2.29, p < 0.0001), and lack of previous COVID-19 infection (OR 1.89, p < 0.0001). The most common reason for rejection was insufficient safety data (57%). Understanding factors behind vaccination status is crucial in lowering complications in mothers and newborns and targeted action may facilitate the uptake.

15.
J Clin Med ; 11(15)2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1957361

ABSTRACT

The SARS-CoV-2 pandemic heavily impacted healthcare workers, increasing their physical and psychological workload. Specifically, COVID-19 patients' airway management is definitely a challenging task regarding both severe and acute respiratory failure and the risk of contagion while performing aerosol-generating procedures. The category of anesthesiologists and intensivists, the main actors of airway management, showed a poor psychological well-being and a high stress and burnout risk. Identifying and better defining the specific main SARS-CoV-2-related stressors can help them deal with and effectively plan a strategy to manage these patients in a more confident and safer way. In this review, we therefore try to analyze the relevance of human factors and non-technical skills when approaching COVID-19 patients. Lessons from the past, such as National Audit Project 4 recommendations, have taught us that safe airway management should be based on preoperative assessment, the planning of an adequate strategy, the optimization of setting and resources and the rigorous evaluation of the scenario. Despite, or thanks to, the critical issues and difficulties, the "take home lesson" that we can translate from SARS-CoV-2 to every airway management is that there can be no more room for improvisation and that creating teamwork must become a priority.

16.
Int J Environ Res Public Health ; 19(15)2022 Jul 23.
Article in English | MEDLINE | ID: covidwho-1957305

ABSTRACT

Managing the COVID-19 pandemic posed several challenges for healthcare professionals, which likely heightened their risk of burnout (Amanullah and Ramesh Shankar, 2020) and, consequently, their general physical and mental health. Although it may not be possible to address and eliminate the causes of burnout, current research informs healthcare organizations about protective strategies to reduce its detrimental consequences. The promotion of compassionate interactions among healthcare professionals may play such a role. Compassion within healthcare organizations positively affects individual performance and well-being. Building on these considerations and within the framework of the Conservation of Resources theory, this study explores the relationships among burnout dimensions, received compassion at work, and general health in 711 Italian healthcare professionals (68.5% female), aged between 21 and 73 years (Mage = 36.4, SD = 11.2). Analyses were conducted to investigate the association between burnout and general well-being (H1) and between burnout symptoms and perceived compassion at work (H2); and the mediational role of compassion in the relationship between burnout symptoms and general well-being. H1 and H2 were confirmed (r < 0.01 for both), and a SEM model showed the mediating role of compassion at work in the association between burnout symptoms and general well-being (RMSEA < 0.08, SRMR < 0.08, CFI and TLI > 0.90). Theoretical and practical implications of the findings are discussed in the paper.


Subject(s)
Burnout, Professional , COVID-19 , Compassion Fatigue , Adult , Aged , Burnout, Professional/epidemiology , Compassion Fatigue/psychology , Delivery of Health Care , Empathy , Female , Humans , Male , Middle Aged , Pandemics , Young Adult
17.
Int J Environ Res Public Health ; 19(15)2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1957290

ABSTRACT

Despite some preliminary studies of the available herbal medicine preparations and their curative effects on COVID-19, experts still fear that unproper use of such homemade medicines could do more harm than good to people relying on unproven alternatives of questionable efficacy. The main purpose of this study was to evaluate the safety of herbal medicines used for respiratory system disorders in the Pasvalys district during the COVID-19 pandemic in Lithuania. An archival source was also studied, looking for possible recipes for the treatment and prevention of respiratory diseases in Lithuanian traditional medicine, emphasizing the safety guidelines. The survey was conducted using the deep interview method. The respondents mentioned 60 species of medicinal plants from 29 different families used for the treatment and prevention of respiratory system disorders (for cough mostly, 51.70% of all indications). Twenty eight out of 60 plant species were not included in the European Medicines Agency monographs and only 50% of all included species were used as indicated by the European Medicines Agency for respiratory system disorders. The trends in the ethnopharmacological choices of modern consumers and the analysis of archival sources can be a great source of ideas for new herbal-based pharmaceutical preparations for COVID-19 symptoms in Lithuania considering the safety recommendations.


Subject(s)
COVID-19 , Plants, Medicinal , Respiratory Tract Diseases , COVID-19/drug therapy , COVID-19/epidemiology , Herbal Medicine , Humans , Lithuania/epidemiology , Pandemics , Pharmaceutical Preparations , Phytotherapy , Plant Preparations/therapeutic use , Respiratory System , Respiratory Tract Diseases/drug therapy , Respiratory Tract Diseases/epidemiology
18.
BMC Infect Dis ; 22(1): 639, 2022 Jul 23.
Article in English | MEDLINE | ID: covidwho-1957047

ABSTRACT

BACKGROUND: The role of ivermectin in the treatment of COVID-19 is still under debate, yet the drug has been widely used in some parts of the world, as shown by impressive market data. The available body of evidence may have changed over the last months, as studies have been retracted and "standards of care" (SOC) used in control groups have changed with rapidly evolving knowledge on COVID-19. This review aims to summarize and critically appraise the evidence of randomized controlled trials (RCTs) of ivermectin, assessing clinical outcomes in COVID-19 patients. METHODS: RCTs evaluating the effects of ivermectin in adult patients with COVID-19 were searched through June 22, 2022, in four databases, L.OVE platform, clinical trial registries and pre-prints platforms. Primary endpoints included all-cause mortality and invasive ventilation requirement. Secondary endpoint was the occurrence of adverse events. Risk of bias was evaluated using the Cochrane Risk of Bias 2.0 tool. Meta-analysis included only studies which compared ivermectin to placebo or SOC. Random-effects were used to pool the risk ratios (RRs) of individual trials. The quality of evidence was evaluated using GRADE. The protocol was register in PROSPERO (CRD42021257471). RESULTS: Twenty-five RCTs fulfilled inclusion criteria (n = 6310). Of those, 14 compared ivermectin with placebo, in night ivermectin associated with SOC was compared to SOC and two studies compared ivermectin to an active comparator. Most RCTs had some concerns or high risk of bias, mostly due to lack of concealment of the randomization sequence and allocation, lack of blinding and high number of missing cases. Ivermectin did not show an effect in reducing mortality (RR = 0.76; 95%CI: 0.52-1.11) or mechanical ventilation (RR = 0.74; 95%CI: 0.48-1.16). This effect was consistent when comparing ivermectin vs. placebo, and ivermectin associated with SOC vs. SOC, as well as in sensitivity analysis. Additionally, there was very low quality of evidence regarding adverse effects (RR = 1.07; 95%CI: 0.84-1.35). CONCLUSIONS: The evidence suggests that ivermectin does not reduce mortality risk and the risk of mechanical ventilation requirement. Although we did not observe an increase in the risk of adverse effects, the evidence is very uncertain regarding this endpoint.


Subject(s)
COVID-19 , Adult , COVID-19/drug therapy , Humans , Ivermectin/therapeutic use , Respiration, Artificial
19.
J Prim Care Community Health ; 13: 21501319221113544, 2022.
Article in English | MEDLINE | ID: covidwho-1957032

ABSTRACT

OBJECTIVES: During the COVID-19 pandemic, a quick and reliable phone-triage system is critical for early care and efficient distribution of hospital resources. The study aimed to assess the accuracy of the traditional phone-triage system and phone triage-driven deep learning model in the prediction of positive COVID-19 patients. SETTING: This is a retrospective study conducted at the family medicine department, Cairo University. METHODS: The study included a dataset of 943 suspected COVID-19 patients from the phone triage during the first wave of the pandemic. The accuracy of the phone triaging system was assessed. PCR-dependent and phone triage-driven deep learning model for automated classifications of natural human responses was conducted. RESULTS: Based on the RT-PCR results, we found that myalgia, fever, and contact with a case with respiratory symptoms had the highest sensitivity among the symptoms/ risk factors that were asked during the phone calls (86.3%, 77.5%, and 75.1%, respectively). While immunodeficiency, smoking, and loss of smell or taste had the highest specificity (96.9%, 83.6%, and 74.0%, respectively). The positive predictive value (PPV) of phone triage was 48.4%. The classification accuracy achieved by the deep learning model was 66%, while the PPV was 70.5%. CONCLUSION: Phone triage and deep learning models are feasible and convenient tools for screening COVID-19 patients. Using the deep learning models for symptoms screening will help to provide the proper medical care as early as possible for those at a higher risk of developing severe illness paving the way for a more efficient allocation of the scanty health resources.


Subject(s)
COVID-19 , Deep Learning , COVID-19/diagnosis , Humans , Pandemics , Retrospective Studies , SARS-CoV-2 , Triage
20.
Alcohol Clin Exp Res ; 46(6): 1094-1102, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1956674

ABSTRACT

RATIONALE: Investigations show that medications for alcohol use disorders (MAUD) reduce heavy drinking and relapses. However, only 1.6% of individuals with alcohol use disorders (AUD) receive MAUD across care settings. The epidemiology of MAUD prescribing in the acute care setting is incompletely described. We hypothesized that MAUD would be under prescribed in inpatient acute care hospital settings compared to the outpatient, emergency department (ED), and inpatient substance use treatment settings. METHODS: We evaluated electronic health record (EHR) data from adult patients with an International Classification of Diseases, 10th revision (ICD-10) alcohol-related diagnosis in the University of Colorado Health (UCHealth) system between January 1, 2016 and 31 December, 2019. Data from patients with an ICD-10 diagnosis code for opioid use disorder and those receiving MAUD prior to their first alcohol-related episode were excluded. The primary outcome was prescribing of MAUD, defined by prescription of naltrexone, acamprosate, and/or disulfiram. We performed bivariate and multivariate analyses to identify independent predictors of MAUD prescribing at UCHealth. RESULTS: We identified 48,421 unique patients with 136,205 alcohol-related encounters at UCHealth. Encounters occurred in the ED (42%), inpatient acute care (17%), inpatient substance use treatment (18%), or outpatient primary care (12%) settings. Only 2270 (5%) patients received MAUD across all settings. Female sex and addiction medicine consults positively predicted MAUD prescribing. In contrast, encounters outside inpatient substance use treatment, Hispanic ethnicity, and black or non-white race were negative predictors of MAUD prescribing. Compared to inpatient substance use treatment, inpatient acute care hospitalizations for AUD was associated with a 93% reduced odds of receiving MAUD. CONCLUSIONS: AUD-related ED and inpatient acute care hospital encounters in our healthcare system were common. Nevertheless, prescriptions for MAUD were infrequent in this population, particularly in inpatient settings. Our findings suggest that the initiation of MAUD for patients with alcohol-related diagnoses in acute care settings deserves additional evaluation.


Subject(s)
Alcoholism , Opioid-Related Disorders , Adult , Alcoholism/drug therapy , Alcoholism/epidemiology , Colorado/epidemiology , Delivery of Health Care , Ethanol/therapeutic use , Female , Humans , Naltrexone/therapeutic use
SELECTION OF CITATIONS
SEARCH DETAIL