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1.
Curr Res Transl Med ; 71(1): 103363, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36427416

RESUMO

BACKGROUND: Hematopoietic Stem Cell Transplantation (HSCT), is performed to treat many malignancies such as autologous or allogenic. Despite the success of this method in treating patients, - sometimes some HSCT recipients face problems such as cardiovascular complications. Therefore, this systematic review and meta-analysis aimed to evaluate the prevalence of cardiovascular complications in post-transplant patients. METHOD: In order to review the published studies, we examined PubMed, MEDLINE, Cochrane Library, Scopus, and web of science databases from the beginning to the end of January 2022, and we used tools by the Newcastle-Ottawa Scale to evaluate the quality of the studies. RESULT: In this study, 37 articles were included in the meta-analysis and 30,957 patients were examined. Also, the mean age of patients was 35.37 years. Based on the results of the meta-analysis, the prevalence of cardiovascular disease (CVD), was 16.84%. In addition, other complications related to CVD which include Arrhythmias, Congestive Heart Failure (CHF), Hypertension, stroke, and mortality were examined in patients who had hematopoietic stem cell transplantation and the resulting amounts were 3.91%, 3.66, 17.71, 0.22%, and 1.53%, respectively. CONCLUSION: This study showed that the prevalence of cardiovascular disease after hematopoietic stem cell transplantation is high and needs special attention.


Assuntos
Doenças Cardiovasculares , Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Humanos , Adulto , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/complicações , Doença Enxerto-Hospedeiro/epidemiologia , Transplante de Células-Tronco Hematopoéticas/métodos
3.
J Affect Disord Rep ; 8: 100326, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35165672

RESUMO

BACKGROUND: This study was designed to conduct a systematic review and meta-analysis of existing literature examining the prevalence of depression among hospital staff and the impact of various factors with a view to organize related programs for reducing the complications of this mental disorder. METHOD: A total of 24 studies were extracted from a literature search conducted through electronic databases including PubMed, EMBASE, Scopus, and Web of Science from January 2019 to February 2021. FINDINGS: Following the extraction of data, the total number of hospital staff was reported to be 42,010. Based on the results, depression prevalence among them was 26% (95% Cl, 0.18-0.35). Furthermore correlation coefficients revealed a significant relationship between the rate of depression and variables including type of career, age, and gender (P-value < 0.05). The highest and lowest prevalence of depressive disorder among hospital staff was in Africa 82% (95% Cl, 0.35-0.97) and Asia 19% (95% Cl, 0.11-0.29). CONCLUSION: Our findings affirmed that female workers who aged between 29 and 35 and worked as administrative and support staff in hospitals were among the population being at higher risk of developing mental health problems during the COVID-19 pandemic.

4.
Int J Clin Pharm ; 43(1): 25-34, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32910372

RESUMO

Background Anthracycline based chemotherapy is commonly used in many malignancies. While life expectancy increases with the use of this medication, cardiac toxicity causes a risk for patients' health due to anthracyclines. Objective This systematic review and meta-analysis emphasizes on prevention of anthracycline-associated cardiotoxicity in breast cancer and lymphoma patients. Methods We conducted a systematic review of electronic databases including PubMed, Medline, EMBASE, ClinicalTrials.gov, Web of Science, and the Cochrane Library from inception to June 2019 collecting published articles on primary prevention of anthracycline-associated cardiotoxicity in breast cancer and lymphoma patients. We conducted a network meta-analysis and a pairwise meta-analysis in order to compare direct and indirect cardiac agents group with control group calculate left ventricular ejection fraction change. Primary studies results were pooled using random effects model, frequent network meta-analyses, and performed pairwise meta-analysis using netmeta and meta packages respectively in R software version 3.5.1. Results Twelve studies reported left ventricular ejection fraction outcome among 526 patients in the cardiac agent group and 508 in the control group. Based on Surface Under the Cumulative Ranking cure result, spironolactone was the best in left ventricular ejection fraction change and based on meta-analysis, cardiac group had 1.98 unit left ventricular ejection fraction more than the control group (MD = 1.98, 95% CI 0.15-3.81, p value = 0.03). Conclusions The amount of left ventricular ejection fraction used by cardiac agents in anthracycline-based chemotherapy was reduced to a lesser extent. The effective and ineffective drugs were spironolactone and metoprolol, respectively.


Assuntos
Antraciclinas , Neoplasias da Mama , Cardiotoxicidade , Linfoma , Antraciclinas/efeitos adversos , Neoplasias da Mama/tratamento farmacológico , Cardiotoxicidade/prevenção & controle , Feminino , Humanos , Linfoma/tratamento farmacológico , Metanálise em Rede , Volume Sistólico , Função Ventricular Esquerda
5.
Clin Rheumatol ; 39(11): 3261-3276, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32385757

RESUMO

Osteoporosis is a chronic skeletal disease with an increasing prevalence. Romosozumab, as a monoclonal anti-sclerostin antibody with a dual function, has been produced. In this meta-analysis, we aimed to examine the efficacy of Romosozumab in patients with low bone mineral density. A systematic search was conducted in the most important electronic search engines like Cochrane Library, PubMed, Web of Science, Scopus, Google Scholar, and ClinicalTrials.gov at the end of July 2019 to retrieve randomized controlled trials (RCTs), which evaluated the effect of Romosozumab in patients with osteoporosis and/or low bone mineral density. After evaluating the quality of articles with the Cochrane checklist, data related to the outcomes of bone mineral density (BMD) of lumbar spine, femoral neck, and total hip, risk of clinical, vertebral and non-vertebral fractures, and risk of adverse events were extracted. Quality of evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Heterogeneity between studies was evaluated by I2 and Q statistics. The meta-analysis was performed using CMA v.2.0 software. Of all the 671 initially retrieved articles, seven articles were entered into the meta-analysis after removing duplicates and reviewing papers with inclusion and exclusion criteria. The results of the meta-analysis showed that Romosozumab 210, 140, and 70 mg compared with Alendronate, Teriparatide, and placebo can increase the bone mineral density in the lumbar spine, femoral neck, and total hip. The risk of adverse events like adjudicated cardiovascular serious adverse events and adjudicated cardiovascular death was more in Romosozumab 210 mg in comparison with placebo. However, this difference was not statistically significant. Treatment with anti-sclerostin antibodies can be a proper therapeutic option in patients with osteoporosis and low bone mineral density. Based on the results of this meta-analysis, it seems that Romosozumab, with its dual function, has a positive role in the treatment of osteoporosis and low bone mineral density.


Assuntos
Anticorpos Monoclonais , Conservadores da Densidade Óssea , Anticorpos Monoclonais/efeitos adversos , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico , Humanos , Teriparatida
6.
J Cardiovasc Thorac Res ; 12(1): 1-9, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32211131

RESUMO

Introduction: Cardiac troponin is one of the heart biomarkers and its high levels correlates with a high risk of cardiomyocytes damage. This study aimed to compare sevoflurane and isoflurane effect on troponin levels in patients undergoing cardiac surgery. Methods: We systematically searched for RCTs which had been published in Cochrane library, PubMed, Web of science, CRD, Scopus, and Google Scholar by the end of February 30th, 2019. The quality of articles was evaluated with the Cochrane checklist. GRADE was used for quality of evidence for this meta-analysis. Meta-analysis was done based on random or fixed effect model. Results: Five studies with total of 190 (sevoflurane) and 191 (isoflurane) patients were included. The results showed that pooled mean difference of troponin levels between the two groups was significant at ICU admission time and 24 hours after entering. The comparison of troponin level changes between the two groups (baseline = at time ICU) in 24 and 48 hours after ICU admission was significant. Conclusion: This meta-analysis showed that blood troponin levels were significantly lower at the time of arrival in ICU with isoflurane and after 24 hours with sevoflurane. Generally, given the small mean difference between isoflurane and sevoflurane, it seems that none of the medications has a negative effect on the cardiac troponin level.

7.
J Anesth ; 33(3): 441-453, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30895376

RESUMO

Noninvasive hemoglobin (Hb)-monitoring devices are new inventions in pulse oximeter systems that show hemoglobin levels continuously. The aim of this systematic review and meta-analysis was to evaluate the accuracy and precision of noninvasive versus standard central laboratory Hb measurements in the operating room. We systematically searched multiple databases. Then, for the quality assessment of studies, we modified QUADAS-2 in the Revman 5.3 software. The GRADE approach was used to measure the quality of evidence (Grading of Recommendations Assessment, Development, and Evaluation). Data were analyzed using the meta-analysis method (random effect model) using STATA 11 software. A total of 28 studies on 2000 participants were included in the meta-analysis. Meta-analysis results of mean differences between noninvasive and the central laboratory Hb measurements in overall pooled random effects were - 0.27 (95% LoA (0.44, - 0.10); P value < 0.05). According to this meta-analysis, noninvasive hemoglobin measurement has acceptable accuracy in comparison with the standard invasive method.


Assuntos
Hemoglobinas/análise , Salas Cirúrgicas , Oximetria/métodos , Humanos
8.
Int J Clin Pharm ; 41(1): 22-29, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30659493

RESUMO

Background Patients with mitral valve stenosis have increased heart rate. HR reduction is known as an important treatment and therapy strategy for patients with mitral valve stenosis. Aim of the review The aim of this systematic review and meta-analysis was to compare the efficacy of ivabradine versus beta-blockers in patients with mitral stenosis in sinus rhythm. Methods Randomized controlled trials were searched in Cochrane Library, PubMed, Web of Science, CRD, Scopus, and Google Scholar with no start time limitation and ending June 2018. Risk of bias across was assessed by the Cochrane Risk of Bias Assessment tool. Fixed effects models were used to combine the results and the mean difference with a 95% confidence interval. This meta-analysis was performed using Meta Package in R software. Results Five studies entered meta-analysis. The total number of patients treated with ivabradine and beta-blockers was 178 and 178 respectively. The results showed that the mean of maximum HR and HR at rest was lower at about 5.03 units and upper 4.32 units respectively with use of ivabradine compared with the use of beta-blockers. These values were statistically significant. Conclusion It seems that the efficacy of ivabradine is good in comparison with betablockers, but it still requires more clinical trials.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Arritmias Cardíacas/tratamento farmacológico , Fármacos Cardiovasculares/uso terapêutico , Ivabradina/uso terapêutico , Estenose da Valva Mitral/tratamento farmacológico , Antagonistas Adrenérgicos beta/farmacologia , Arritmias Cardíacas/diagnóstico , Arritmias Cardíacas/epidemiologia , Fármacos Cardiovasculares/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Frequência Cardíaca/fisiologia , Humanos , Ivabradina/farmacologia , Estenose da Valva Mitral/diagnóstico , Estenose da Valva Mitral/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Resultado do Tratamento
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