Medicina
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Review Meta Analysis
Anti-Platelet Therapy with Cangrelor in Cardiogenic Shock Patients: A Systematic Review and Single-Arm Meta-Analysis.
Background and Objectives: Percutaneous coronary intervention (PCI) is a proven therapy for acute myocardial infarction (AMI) cardiogenic shock (CS). Dual anti-platelet therapy (i.e., aspirin plus an oral P2Y12 inhibitor) is recommended in patients treated with PCI. However, CS patients present severe hemodynamic instability, deranged hemostatic balance, and the need for invasive mechanical circulatory support (MCS) alongside invasive procedures, resulting in an increased risk of both bleeding and thrombotic complications, leaving uncertainty about the best anti-thrombotic treatment. ⋯ Conclusions: Cangrelor administration in AMI-CS patients was feasible and safe with a low rate of thromboembolic complications. Haemorrhagic complications were more frequent than thrombotic events. Nevertheless, to date, the optimal dosage of cangrelor in this clinical context still remains not universally recognized.
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Review Meta Analysis
Effectiveness of Meditation Techniques in Treating Post-Traumatic Stress Disorder: A Systematic Review and Meta-Analysis.
Background and Objectives: Post-traumatic stress disorder (PTSD) is a debilitating condition worldwide. The limited effectiveness of current psychological and pharmacological treatments has motivated studies on meditation techniques. This study is a comprehensive, multiple-treatments meta-analysis comparing the effectiveness of different categories of meditation in treating PTSD. ⋯ Conclusions: All categories of meditation studied were helpful in mitigating symptoms of PTSD. TM produced clinically significant reductions in PTSD in all trauma groups. We recommend a multisite Phase 3 clinical trial to test TM's efficacy compared with standard treatment.
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Review Meta Analysis
Prevalence of Vitamin D Deficiency Among Adults in Kazakhstan: A Systematic Review and Meta-Analysis.
Background and Objectives: Despite frequent references to the high prevalence of vitamin D deficiency in Kazakhstan, a comprehensive synthesis of existing research on this issue among adults is lacking. This systematic review and meta-analysis aim to address this gap by determining the mean prevalence of vitamin D deficiency among adults in Kazakhstan. A secondary objective is to evaluate whether the prevalence differs between healthy adults and those with chronic conditions. ⋯ Overall, the pooled mean prevalence of vitamin D deficiency in the adult population was 57% (95% CI, 45-69%). Conclusions: This analysis indicates a high prevalence of vitamin D deficiency among adults in Kazakhstan, with 57% of the population affected. Addressing this issue requires a multifaceted approach, including policy reforms that consider the impact of time zone changes on sunlight exposure and the active involvement of nurse practitioners in preventive strategies.
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Review Meta Analysis
Clozapine and Pneumonia: Synthesizing the Link by Reviewing Existing Reports-A Systematic Review and Meta-Analysis.
Background and Objectives: Clozapine is a highly effective antipsychotic used for treating treatment-refractory psychotic and mood disorders. However, clozapine also has a serious risk of side effects leading to mortality, particularly its potentiated risk of leading to pneumonia. This review aims to overview the demographic and health-related risk factors leading to pneumonia to better inform risk assessment for clozapine users and to summarise current theories on the mechanisms for clozapine-associated pneumonia. ⋯ Key mechanisms for clozapine-associated pneumonia include clozapine-induced hyper sedation, sialorrhea and neutropoenia. Conclusions: While clozapine improves overall mortality for patients, our review confirms clozapine has the highest risk of pneumonia of all antipsychotics. The review also highlights the prevalent underuse of pneumococcal vaccines among clozapine users and the urgent need to increase uptake.
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Review Meta Analysis
Disabilities and Disparities in Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis in Saudi Arabia.
Background and Objectives: In Saudi Arabia, persons with disabilities (PWDs) face considerable oral health challenges, including a higher prevalence of dental caries and gingival inflammation, which adversely affects their oral health-related quality of life (OHRQoL). This population experiences distinct and substantial barriers in accessing adequate dental care. This systematic review and meta-analysis aims to quantify disparities in OHRQoL between PWDs and individuals without disabilities in Saudi Arabia, focusing on caries and gingivitis prevalence, and to identify specific areas for intervention. ⋯ These disparities were compounded by limited preventive care access and high unmet treatment needs, particularly among those with severe disabilities and limited caregiver support. Conclusions: PWDs in Saudi Arabia face marked oral health disparities, with notably higher rates of dental caries and gingivitis, severely impacting their quality of life. The findings underscore the need for targeted oral health policies and community-based interventions to enhance care accessibility, promote preventive measures, and address the unique needs of this vulnerable population.