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Use of remdesivir in patients with COVID-19: a systematic review and meta-analysis

J Bras Pneumol. 2022 Feb 2;48(1):e20210393. doi: 10.36416/1806-3756/e20210393. eCollection 2022.

ABSTRACT

OBJECTIVE: Studies in the literature regarding the use of remdesivir to treat COVID-19 patients have shown conflicting results. This study sought to answer questions related to the use of remdesivir for the treatment of patients hospitalized with moderate to severe COVID-19.

METHODS: This was a systematic review and meta-analysis including phase 3 randomized clinical trials (RCTs) and observational cohort studies selected from various databases, comparing patients hospitalized with moderate to severe COVID-19 receiving remdesivir and controls.

RESULTS: A total of 207 studies were retrieved, 9 of which met the eligibility criteria and were included in the study. The meta-analysis using RCTs alone showed no statistically significant differences regarding mortality or use of mechanical ventilation/extracorporeal membrane oxygenation between remdesivir and control groups, and the quality of evidence was moderate and low, respectively. The use of remdesivir increased the recovery rate by 6% (95% CI, 3-9); p = 0.004) and the clinical improvement rate by 7% (95% CI, 1-14); p = 0.02). Additionally, no significant differences in mortality were found between remdesivir and control groups when the meta-analysis used observational cohort studies alone (risk difference = -0.01 (95% CI, -0.02 to 0.01; p = 0.32), the quality of evidence being moderate, and the risk of adverse events was 4% ([95% CI, -0.08 to 0.01]; p = 0.09).

CONCLUSIONS: The use of remdesivir for the treatment of patients with moderate to severe COVID-19 had no significant impact on clinically important outcomes.

PMID:35137874 | DOI:10.36416/1806-3756/e20210393

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Analysis of an outpatient child hearing health program: from screening to referral for rehabilitation

Codas. 2022 Feb 2;34(4):e20200403. doi: 10.1590/2317-1782/20212020403. eCollection 2022.

ABSTRACT

PURPOSE: To analyze the stages of a hearing health program, from screening to referral for rehabilitation, based on the quality indicators for neonatal screening programs.

METHODS: This is a cohort, observational, retrospective study encompassing all newborns included in the Municipal Information System of Mogi Mirim, São Paulo, from 2010 to 2016. Besides the data present in the Information System on Live Newborns, the newborn’s age at the first test, test and diagnosis results, and referrals for rehabilitation were analyzed, based on the quality indicator criteria recommended by the Neonatal Hearing Screening Care Guidelines, with a statistical program.

RESULTS: A total of 7,800 newborns participated. The following results were obtained in the analysis of the program quality indicators: 1) Neonatal hearing screening stage: 97% coverage in the first test; 91% of newborns by 30 days old; 2) Diagnosis stage: 0.24% referred after failing the second test; 94.73% adherence; 13.66% confirmed diagnosis by 3 months old; 3) Rehabilitation stage: 100% began speech-language-hearing therapy immediately after the diagnosis; 20% received the hearing aid within 1 month from diagnosis.

CONCLUSION: The program, conducted in an outpatient setting, met the recommendations of the guidelines presented by the Ministry of Health concerning the coverage and age at first examination, age at screening up to 1 month old, referral for diagnosis, and beginning the intervention. These results were obtained thanks to institutional support from the municipality.

PMID:35137893 | DOI:10.1590/2317-1782/20212020403

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Intra-breath oscillometry for the evaluation of lung function in children and adolescents with a history of preterm birth

J Bras Pneumol. 2022 Feb 2;48(1):e20210290. doi: 10.36416/1806-3756/e20210290. eCollection 2022.

ABSTRACT

OBJECTIVE: To assess respiratory system impedance (Zrs) and spirometric parameters in children and adolescents with and without a history of preterm birth.

METHODS: We evaluated a sample of 51 subjects between 11 and 14 years of age: 35 who had a history of preterm birth (preterm group) and 16 who had been born at term (full-term group). Lung function was measured by spirometry, spectral oscillometry, and intra-breath oscillometry.

RESULTS: Neither spirometry nor spectral oscillometry revealed any statistically significant differences between the preterm and full-term groups. However, intra-breath oscillometry demonstrated significant differences between the two groups in terms of the change in resistance, reactance at end-inspiration, and the change in reactance (p < 0.05 for all).

CONCLUSIONS: Our findings suggest that abnormalities in Zrs persist in children and adolescents with a history of preterm birth and that intra-breath oscillometry is more sensitive than is spectral oscillometry. Larger studies are needed in order to validate these findings and to explore the impact that birth weight and gestational age at birth have on Zrs later in life.

PMID:35137869 | DOI:10.36416/1806-3756/e20210290

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Characterization of the Bipolaris maydis: symptoms and pathogenicity in popcorn genotypes (Zea mays L.)

Braz J Biol. 2022 Feb 2;84:e256799. doi: 10.1590/1519-6984.256799. eCollection 2022.

ABSTRACT

Southern corn leaf blight (SCLB) is one of the most important corn leaf diseases. Appropriate management strategies and the use of resistant cultivars allow disease control. Therefore, knowing the aspects related to the pathogen and the response of hosts makes it possible to design efficient strategies for selecting genotypes resistant to this disease. In this sense, the objective was to carry out the Bipolaris maydis isolate characterization, evaluating the pathogenicity in different popcorn lines and the symptoms generated in the host after inoculation. The isolate characterization consisted of the macromorphological evaluation of the colonies and the micromorphological evaluation of the conidia in the PDA medium. An experiment was carried out in a greenhouse to evaluate the pathogenicity of the isolate, using 20 inbred lines of popcorn in a randomized block design with four replicates. Inoculation was carried out by spraying leaves, with a suspension containing 1.0 x 104 conidia.ml-1 of the CF/UENF 501 isolate of B. maydis. An incidence assessment and three assessments of disease symptom severity were performed, with seven days intervals between evaluations. The morphological characterization data of the isolate were analyzed using descriptive statistics, and for disease severity, the linear regression model was applied the first-degree model. The variance analysis was performed for the linear and angular coefficients obtained for each treatment. When a difference was found, the Scott-Knott clustering algorithm at 5% significance was applied. The isolate had gray-green colonies, a cottony appearance, and an irregular shape. The lines L353, L354, and L624 show more resistance at the beginning and throughout the evaluations. The high virulence of the CF/UENF 501 isolate made it possible to differentiate the lines in terms of disease intensity and the pattern of symptoms presented.

PMID:35137841 | DOI:10.1590/1519-6984.256799

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Effects of Solanum lycopersicum L. (tomato) against isoniazid and rifampicin induced hepatotoxicity in wistar albino rats

Braz J Biol. 2022 Feb 7;84:e254552. doi: 10.1590/1519-6984.254552. eCollection 2022.

ABSTRACT

Anti-tuberculosis drugs are reported to cause hepatotoxicity, which varies from asymptomatic rise of the hepatic enzymes. Hepatoprotective plants plays important role to protect liver. This study investigated the hepatoprotective potential of the Solanum lycopersicum in rats intoxicated with Isoniazid and Rifampicin (INH+RIF) to induce hepatotoxicity. Thirty wistar albino rats were divided into five groups of six animals each. Group 1 rats were kept control while groups II, III, IV and V were administered with INH+RIF (75+150 mg/kg) orally, for seven consecutive days. For treatment, rats in group III received silymarin while animals in group IV and V were provided with 40 mg/kg and 80 mg/kg of Solanum lycopersicum extract, respectively. On day 0 and 8th blood samples were collected for the analysis of hepatic biomarkers. The data were subjected to one-way ANOVA and Bonferroni’s post hoc test for statistical analysis. Hepatotoxicity induced by INH+RIF resulted in significant elevation of serum hepatic enzymes including Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), Alkaline phosphatase (ALP), and total bilirubin while decreased the albumin level. The Solanum lycopersicum at dose of 80 mg/kg significantly reduced the hepatic enzymes AST, ALT, ALP and bilirubin while the albumin level was significantly increased. The treatment had non-significant effect on body and liver weight. Drug induced hepatotoxicity can be effectively treated with Solanum lycopersicum at 80 mg/kg dose.

PMID:35137848 | DOI:10.1590/1519-6984.254552

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Time trend estimation of food consumption in repeated studies with different versions of food questionnaire among Brazilian schoolchildren aged 7 to 11 years

Cien Saude Colet. 2022 Feb;27(2):665-676. doi: 10.1590/1413-81232022272.34942020. Epub 2021 Jan 9.

ABSTRACT

Longitudinal study, whose objective was to evaluate of the time trend in food consumption across the 2002-2015 period in schoolchildren aged 7 to 11 years, covered five food surveys in Florianopolis, southern Brazil. Methodological differences across the surveys (typical vs. previous day food consumption, pen-and-paper versus computer screen presentation) and some known risk factors, were adjusted for statistically. Offset by maximum food/beverage consumption per day allowed comparability of a varying number of food components in a food group over survey years. Significant reduction in some healthy (fruits and animal proteins) and unhealthy diet markers (sodas, sugary drinks, sweets) was observed over the 2013-2015 period compared with the 2002 and 2007 data. Computer screen presentation of the food questionnaire systematically reduced the reporting frequency compared to the pen-and-paper presentation. Converting frequency reports into rates and using contrast analysis allowed time trend estimation based on food questionnaires with different presentation modes, varying number of items within food group over survey years, and variations in probabilistic sampling procedures.

PMID:35137822 | DOI:10.1590/1413-81232022272.34942020

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Comparison between the Effects of Hymalaian Salt and Common Salt Intake on Urinary Sodium and Blood Pressure in Hypertensive Individuals

Arq Bras Cardiol. 2022 Feb 7:S0066-782X2022005001217. doi: 10.36660/abc.20210069. Online ahead of print.

ABSTRACT

BACKGROUND: The Himalayan salt (HS) has become a popular alternative for the traditional table salt (TS) due to its health benefit claims, particularly for individuals with arterial hypertension. However, despite the increase in HS consumption, there is still a lack of clinical evidence to support a recommendation for its consumption by health professionals.

OBJECTIVE: This cross-over study aimed to compare the impact of HS and TS intake on systolic blood pressure (SBP) and diastolic blood pressure (DBP), and urinary sodium concentration in individuals with arterial hypertension.

METHODS: This study recruited 17 female patients with arterial hypertension who ate out no more than once a week. Participants were randomized into two groups, to receive and consume either HS or TS. Before and after each intervention, participants had their blood pressure measured and urine collected for mineral analysis. A p-value < 0.05 was considered statistically significant.

RESULTS: There were no statistically significant differences before and after the HS intervention for DBP (70mmHg vs. 68.5mmHg; p=0.977), SBP (118.5 mmHg vs. 117.5 mmHg; p= 0.932) and sodium urinary concentration (151 mEq/24h vs. 159 mEq/24; p=0.875). Moreover, the between-group analysis showed no significant differences after the intervention regarding SBP (117mmHg vs 119 mmHg; p=0.908), DBP (68.5 mmHg vs. 71mmHg; p= 0,645) or sodium urinary concentration (159 mEq/24h vs. 155 mEq/24h; p=0.734).

CONCLUSION: This study suggests that there are no significant differences on the impact of HS consumption compared to TS on blood pressure and sodium urinary concentration in individuals with arterial hypertension.

PMID:35137791 | DOI:10.36660/abc.20210069

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Use of unprescribed hormones in the body modification of travestis and transsexual women in Salvador/Bahia, Brazil

Cien Saude Colet. 2022 Feb;27(2):503-514. doi: 10.1590/1413-81232022272.44342020. Epub 2020 Dec 11.

ABSTRACT

This article aims to analyze the use of non-prescribed hormones among travestis and transgender women (TrTGW) in Salvador, Bahia, Brazil. This cross-sectional study used the Respondent Driven Sampling (RDS) methodology to recruit TrTGW from 2014 to 2016 in Salvador and the Metropolitan Region. A comparative analysis was carried out between sociodemographic, behavioral, and gender declaration conditions using hormones. The RDS-II estimator weighted the data. Stata version 14 was used for statistical analyses. One hundred twenty-seven TrTGW were recruited. From the studied sample, 69.1% of participants used non-prescribed hormones, which was associated with industrial liquid silicone use and body satisfaction. The TrTGW who were comfortable with the penis and felt pleasure with the penis used hormone less. The seropositive participants reported a higher proportion of hormone use. The non-prescribed use of hormones was used by most TrTGW. This use is likely associated with better satisfaction with self-image and body among TrTGW. Elevated and exacerbated use of these hormones was identified, probably due to the rare access to public health services.

PMID:35137807 | DOI:10.1590/1413-81232022272.44342020

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Diagnostic Performance of Coronary Tomography Angiography and Serial Measurements of Sensitive Cardiac Troponin in Patients With Chest Pain and Intermediate Risk for Cardiovascular Events

Arq Bras Cardiol. 2022 Feb 7:S0066-782X2022005001216. doi: 10.36660/abc.20210006. Online ahead of print.

ABSTRACT

BACKGROUND: Coronary tomography angiography (CTA) has been mainly used for chest pain evaluation in low-risk patients, and few data exist regarding patients at intermediate risk.

OBJECTIVE: To evaluate the performance of serial measures of sensitive troponin and CTA in intermediate-risk patients.

METHODS: A total of 100 patients with chest pain, TIMI risk scores of 3 or 4, and negative troponin were prospectively included. All patients underwent CTA and those with coronary stenosis ≥ 50% were referred to invasive coronary angiography. Patients with coronary lesions <50% were discharged and contacted 30 days later by a telephone call to assess clinical outcomes. Outcomes were hospitalization, death, and myocardial infarction at 30 days. The comparison between methods was performed by Kappa agreement test. The performance of troponin measures and CTA for detecting significant coronary lesions and clinical outcomes was calculated. Results were considered statistically significant when p < 0.05.

RESULTS: Coronary stenosis ≥ 50% on CTA was found in 38% of patients and significant coronary lesions on coronary angiography were found in 31 patients. Two clinical events were observed. Kappa agreement analysis showed low agreement between troponin measures and CTA in the detection of significant coronary lesions (kappa = 0.022, p = 0.78). The performance of CTA for detecting significant coronary lesions on coronary angiography or for predicting clinical events at 30 days was better than sensitive troponin measures (accuracy of 91% versus 60%).

CONCLUSION: CTA performed better than sensitive troponin measures in the detection of significant coronary disease in patients with chest pain and intermediate risk for cardiovascular events.

PMID:35137790 | DOI:10.36660/abc.20210006

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Perceptions of Artificial Intelligence Integration into Dermatology Clinical Practice: A Cross-Sectional Survey Study

J Drugs Dermatol. 2022 Feb 1;21(2):135-140. doi: 10.36849/jdd.6398.

ABSTRACT

BACKGROUND: Artificial intelligence (AI) is a growing field in dermatology and has great potential for integration into clinical practice. Our objective was to assess the perceptions of artificial intelligence in dermatology practice.

METHODS: An IRB-approved 18-question online survey was distributed by email. Patients were stratified by age to assess for statistical differences among perceptions.

RESULTS: 90 respondents fully completed the survey. 54 (60.0%) respondents were slightly familiar with AI, and 73 (81.1%) respondents have not incorporated AI into their clinical practice. 27.8% of respondents perceived AI as superior to a human provider&rsquo;s experience some of the time. 94.4% of respondents would at least use AI for certain scenarios. 65.6% of respondents believed that AI would help patients with analyzing and managing electronic health records. 38.9% respondents predict that AI will not decrease or increase the need for dermatologists. 51.6% of respondents felt that AI will at least somewhat enhance the dermatologists&rsquo; ability to screen skin lesions. The three dermatology areas that AI was perceived to most beneficial were malignant skin lesions, benign skin lesions, and pigmentation disorders. Age of respondents did not have a significant impact on the perceptions of AI.

CONCLUSION: Our results show that dermatologists surveyed were generally positive toward embracing AI integration into clinical practice. Further studies should be conducted to confirm these findings. J Drugs Dermatol. 2022;21(2):135-140. doi:10.36849/JDD.6398.

PMID:35133109 | DOI:10.36849/jdd.6398