ABSTRACT
Anti-VEGF drugs like ranibizumab can be used to treat retinopathy of prematurity (ROP) by halting the formation of abnormal blood vessels, or lasers can be used to burn the edges of the retina where these vessels are present. The objective is to compare the efficacy for ROP between ranibizumab and laser therapy. Material and methods: Electronic searches will be carried out in medical databases with key words and controlled vocabulary terms. Randomized controlled trials (RCT) will be assessed. The primary outcome will be the full ROP regression. Two reviewers will extract the data using predefined forms and, to assess the quality of the study, we will use RoB 2.0, the tool for randomized controlled trials developed by the Cochrane Collaboration. We used a combination of the inverse-variance approach and random-effects models for the meta-analysis. Results: The eyes of 182 preterm infants who had ranibizumab treatment were assessed in a total of 364 eyes, and 135 infants received laser therapy. The follow-up period was between 6 and 24 months. Ranibizumab was not associated with greater regression of ROP compared to laser therapy in preterm infants (RR: 1.09, CI 95%: 0.95-1.24; p: 0.22). Also, ranibizumab was not associated with recurrence of ROP compared to laser therapy in preterm infants (RR: 3.77, CI 95%: 0.55-25.81; p: 0.22). Conclusions: The efficacy of ranibizumab compared to laser is very uncertain in terms of ROP regression and decreased ROP recurrence in preterm infants. Systematic Review Registration: identifier PROSPERO (CRD42022324150).
ABSTRACT
The most recent monkeypox (Mpox) outbreak is mostly affecting men who have sex with men (MSM) who participate in high-risk sexual behaviors, which is typically the case among human immunodeficiency virus (HIV) carriers, according to clinical and epidemiological statistics. The objective of this research is to determine the epidemiological situation of HIV and smallpox co-infection. Until 1 October 2022, a thorough evaluation of the literature was conducted utilizing the databases PubMed, Embase, Scopus, and Web of Science. Studies were evaluated based on the criteria for selection. Fifty-three studies met the selection criteria. A total of 6345 confirmed cases of monkeypox were recorded, and 40.32% (n = 2558) of these cases also had HIV co-infection. In addition, 51.36% (n = 3259) of the men (91.44%; n = 5802), whose ages ranged from 18 to 71 years, exhibited MSM-specific sexual behaviors. Co-infection with these two viruses can be especially dangerous because it can exacerbate the symptoms of both diseases and make them more difficult to treat. People with HIV are more vulnerable to certain infections, including monkeypox, because their immune systems are weakened. Therefore, it is important that they take measures to prevent infection, such as avoiding contact with infected animals, risky behaviors, and maintaining good hygiene.
ABSTRACT
OBJECTIVE.: To determine the risk factors for admission to the intensive care unit (ICU) or mortality in patients hospitalized for COVID-19 in a hospital in Puno, Peru. MATERIALS AND METHODS.: Retrospective cohort study in adults hospitalized between April and December 2020. We evaluated Sociodemographic characteristics, vital functions, comorbidities, treatment received and its association with admission to ICU or mortality (adverse outcome). Poisson regression with robust variance was used to calculate crude and adjusted relative risks (RR) with their 95% confidence intervals (95%CI). RESULTS.: A total of 348 medical records were analyzed. The median age in years was 42.5 (IQR: 30.0; 58.0); 38.2% were male, and 35.3% died or were admitted to the ICU. Those admitted with an oxygen saturation ≤ 75% were 2.79 times more likely to have the adverse outcome (p < 0.001), compared to those admitted with a saturation ≥ 85%; those admitted with a value between 75-79% were 2.92 times more likely to have the adverse outcome (p < 0.001); likewise, those admitted with saturation between 80-84% were 1.70 times more likely to have the adverse outcome; however, the difference was not statistically significant (p=0.066). In addition, male patients, RR= 1.75 (p<0.001); those aged > 40 years, RR 3.5 (p=0.001); those with tachypnea, RR=1.66 (p=0.010); or with diabetes, RR = 1.53 (p=0.011) had higher risk of presenting the adverse outcome. CONCLUSIONS.: The risk factors for ICU admission or mortality due to COVID-19 were male sex, age over 40 years, low saturation, diabetes and tachypnea.
OBJETIVO.: Determinar los factores de riesgo de ingreso a unidad de cuidados intensivos (UCI) o mortalidad en pacientes hospitalizados por COVID-19 en un hospital de Puno, Perú. MATERIALES Y MÉTODOS.: Estudio de cohorte retrospectivo en adultos hospitalizados entre abril y diciembre del 2020. Se evaluaron características sociodemográficas, funciones vitales, comorbilidades, tratamiento recibido y su asociación con el ingreso a UCI o mortalidad (desenlace adverso). Se utilizó regresión de Poisson con varianza robusta para calcular riesgos relativos (RR) crudos y ajustados con sus intervalos de confianza al 95% (IC95%). RESULTADOS.: Se analizaron 348 historias clínicas. La mediana de edad en años fue 42,5 (RIC: 30,0; 58,0); el 38,2% fueron varones, y el 35,3% falleció o ingresó a UCI. Los que ingresaron con una saturación de oxígeno ≤ 75%, tuvieron 2,79 veces la probabilidad de tener el desenlace adverso (p < 0,001), en comparación con los que ingresaron con una saturación ≥ 85%; los que ingresaron con un valor entre 75-79% tuvieron 2,92 veces la probabilidad de tener el desenlace adverso (p < 0,001); asimismo, los que ingresaron con saturación entre 80-84% tuvieron 1,70 veces la probabilidad de presentar el desenlace adverso; sin embargo la diferencia no fue estadísticamente significativa (p=0,066). Además, hubo mayor riesgo de desenlace adverso en pacientes de sexo masculino RR= 1,75 (p<0,001), edad > 40 años RR 3,5 (p=0,001), taquipnea RR=1,66 (p=0,010), o con diabetes, RR = 1,53 (p=0,011). CONCLUSIONES: . Los factores de riesgo para ingresar a UCI o mortalidad por COVID-19 fueron el sexo masculino, edad mayor de 40 años, saturación baja, diabetes y taquipnea.
Subject(s)
COVID-19 , Diabetes Mellitus , Humans , Male , Female , Retrospective Studies , Intensive Care Units , Risk FactorsABSTRACT
During the COVID-19 pandemic, the increase in reports of human monkeypox virus infection cases spreading in many countries outside Africa is a major cause for concern. Therefore, this study aimed to explore the evidence of antiviral pharmacotherapy available for the treatment of adult patients with monkeypox. A scoping review of the literature was conducted using PubMed, Scopus, Web of Science, Embase, and CENTRAL databases until 12 September 2022. The key search terms used were "monkeypox" and "treatment". A total of 1927 articles were retrieved using the search strategy. After removing duplicates (n = 1007) and examining by title, abstract, and full text, 11 studies reporting case reports of monkeypox with antiviral treatment were included, detailing the number of monkeypox cases, clinical manifestations, number of participants with antiviral treatment, history of sexually transmitted diseases, method of diagnosis, location of skin lesions, drugs used in antiviral treatment, route of administration, and outcome. A total of 1281 confirmed cases of monkeypox have been reported, of which 65 monkeypox cases had antiviral treatment distributed most frequently in the United States (n = 30), the United Kingdom (n = 6), and Spain (n = 6). Of the total cases, 1269 (99.1%) were male with an age range of 18 to 76 years, and 1226 (95.7%) had a sexual behavior of being men who have sex with men. All confirmed cases of monkeypox were diagnosed by reverse transcriptase polymerase chain reaction (RT-PCR). The most frequent clinical manifestations were skin lesions, fever, lymphadenopathy, headache, fatigue, and myalgia. The most frequent locations of the lesions were perianal, genital, facial, and upper and lower extremities. The most commonly used drugs for antiviral treatment of monkeypox were: tecovirimat, cidofovir, and brincidofovir. All patients had a complete recovery. According to current evidence, the efficacy and safety of antiviral drugs against monkeypox is of low quality and scarce.
ABSTRACT
RESUMEN Objetivo. Determinar los factores de riesgo de ingreso a unidad de cuidados intensivos (UCI) o mortalidad en pacientes hospitalizados por COVID-19 en un hospital de Puno, Perú. Materiales y métodos. Estudio de cohorte retrospectivo en adultos hospitalizados entre abril y diciembre del 2020. Se evaluaron características sociodemográficas, funciones vitales, comorbilidades, tratamiento recibido y su asociación con el ingreso a UCI o mortalidad (desenlace adverso). Se utilizó regresión de Poisson con varianza robusta para calcular riesgos relativos (RR) crudos y ajustados con sus intervalos de confianza al 95% (IC95%). Resultados. Se analizaron 348 historias clínicas. La mediana de edad en años fue 42,5 (RIC: 30,0; 58,0); el 38,2% fueron varones, y el 35,3% falleció o ingresó a UCI. Los que ingresaron con una saturación de oxígeno ≤ 75%, tuvieron 2,79 veces la probabilidad de tener el desenlace adverso (p < 0,001), en comparación con los que ingresaron con una saturación ≥ 85%; los que ingresaron con un valor entre 75-79% tuvieron 2,92 veces la probabilidad de tener el desenlace adverso (p < 0,001); asimismo, los que ingresaron con saturación entre 80-84% tuvieron 1,70 veces la probabilidad de presentar el desenlace adverso; sin embargo la diferencia no fue estadísticamente significativa (p=0,066). Además, hubo mayor riesgo de desenlace adverso en pacientes de sexo masculino RR= 1,75 (p<0,001), edad > 40 años RR 3,5 (p=0,001), taquipnea RR=1,66 (p=0,010), o con diabetes, RR = 1,53 (p=0,011). Conclusiones . Los factores de riesgo para ingresar a UCI o mortalidad por COVID-19 fueron el sexo masculino, edad mayor de 40 años, saturación baja, diabetes y taquipnea.
ABSTRACT Objective. To determine the risk factors for admission to the intensive care unit (ICU) or mortality in patients hospitalized for COVID-19 in a hospital in Puno, Peru. Materials and methods. Retrospective cohort study in adults hospitalized between April and December 2020. We evaluated Sociodemographic characteristics, vital functions, comorbidities, treatment received and its association with admission to ICU or mortality (adverse outcome). Poisson regression with robust variance was used to calculate crude and adjusted relative risks (RR) with their 95% confidence intervals (95%CI). Results. A total of 348 medical records were analyzed. The median age in years was 42.5 (IQR: 30.0; 58.0); 38.2% were male, and 35.3% died or were admitted to the ICU. Those admitted with an oxygen saturation ≤ 75% were 2.79 times more likely to have the adverse outcome (p < 0.001), compared to those admitted with a saturation ≥ 85%; those admitted with a value between 75-79% were 2.92 times more likely to have the adverse outcome (p < 0.001); likewise, those admitted with saturation between 80-84% were 1.70 times more likely to have the adverse outcome; however, the difference was not statistically significant (p=0.066). In addition, male patients, RR= 1.75 (p<0.001); those aged > 40 years, RR 3.5 (p=0.001); those with tachypnea, RR=1.66 (p=0.010); or with diabetes, RR = 1.53 (p=0.011) had higher risk of presenting the adverse outcome. Conclusions. The risk factors for ICU admission or mortality due to COVID-19 were male sex, age over 40 years, low saturation, diabetes and tachypnea.
