Current medical research and opinion
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The prognosis of COPD patients can be calculated using multidimensional indexes that improve the predictive capacity of the individual variables. The CODEX index can be calculated using iCODEX, a digital support tool available on the web and in an app. The aim of this study was to evaluate how the usefulness and applicability of iCODEX and its recommendations in routine clinical practice are perceived by specialists in internal medicine, pneumology, and primary care. ⋯ Our study shows that the iCODEX tool is easy for participating specialists to use and identifies the recommendations that have the greatest clinical impact in areas such as lung obstruction, severe exacerbations, exercise, smoking, and patient follow-up.
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Congenital cytomegalovirus (CMV) is a leading cause of non-genetic sensorineural hearing loss and neurodevelopmental disabilities among US children. Studies using administrative healthcare databases have identified infants with congenital CMV using diagnostic codes from the International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification. ⋯ During 2010-2017, 668 congenital CMV cases were identified among 7,517,207 infants with encounters within 21 days of life, or 0.89 cases per 10,000 infants. The sensitivity of CMV diagnostic codes assigned within 21 and 90 days of life was 10.3% (95% CI: 8.2-12.9) and 11.1% (95% CI: 8.9-13.7), respectively.
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As cerebral mucormycosis is devastating in nature, here we discuss possible use of the intranasal route, in comparison to or in addition to intravenous administration, as a therapeutic approach to manage cases of mucormycosis with central nervous system involvement.
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Meta Analysis
Conducting and critically appraising a high-quality systematic review and meta-analysis pertaining to COVID-19.
With constantly emerging new information regarding the epidemiology, pathogenesis, diagnosis and management of Coronavirus Disease 2019 (COVID-19), reviewing literature related to it has become increasingly complicated and resource-intensive. In the setting of this global pandemic, clinical decisions are being guided by the results of multiple pertinent studies; however, it has been observed that these studies are often heterogenous in design and population characteristics and results of initial trials may not be replicated in subsequent studies. The resulting clinical conundrum can be resolved by high-quality systematic review and meta-analysis with a robust and reliable methodology, encapsulating and critically appraising all the available literature relevant to the clinical scenario under scrutiny. ⋯ It can identify optimal diagnostic algorithms, assess efficacy of treatment strategies, and analyze inherent factors influencing the efficacy of treatment for COVID-19. The current review aims to provide a basic guide to plan and conduct a high-quality systematic review and meta-analysis pertaining to COVID-19, describing the main steps and addressing the pitfalls commonly encountered at each step. Knowledge of the basic steps would also allow the reader to critically appraise published systematic review and meta-analysis and the quality of evidence provided therein.