International journal of clinical practice
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Int. J. Clin. Pract. · Nov 2021
ReviewVitamin D recommendations in clinical guidelines: A systematic review, quality evaluation and analysis of potential predictors.
Vitamin D has been widely promoted for bone health through supplementation and fortification of the general adult population. However, there is growing evidence that does not support these strategies. Our aim is to review the quality and recommendations on vitamin D nutritional and clinical practice guidelines and to explore predictive factors for their direction and strength. ⋯ Policymakers, clinicians and patients should be aware that lower quality guidelines and those reporting conflicts of interest are more likely to promote vitamin D supplementation. Guideline organisations should improve the quality of their recommendations' development and the management of conflicts of interest. Users and editors should be aware of these findings when using and appraising guidelines.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisSleep-disordered breathing and risk of the breast cancer: a meta-analysis of cohort studies.
Sleep-disordered breathing (SDB) has been related to a higher risk of breast cancer whereas the results of previous studies are inconsistent. We, therefore, performed a meta-analysis to evaluate the association between SDB and subsequent risk of breast cancer in women. ⋯ SDB may be an independent risk factor for breast cancer in women, particularly in elderly females.
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Int. J. Clin. Pract. · Nov 2021
ReviewAA amyloidosis complicating monoclonal gammopathies, an unusual feature validating the concept of "monoclonal gammopathy of inflammatory significance"?
AL amyloidosis is caused by the proliferation of an immunoglobulin-secreting B cell clone. AA amyloidosis is a rare complication of chronic inflammation. However, some patients present with diseases combining monoclonal immunoglobulin production and chronic inflammation. The aim of this work was to describe cases of AA amyloidosis associated with monoclonal gammopathies. ⋯ Monoclonal gammopathies might be a rare and poorly known cause of AA amyloidosis. Such monoclonal gammopathies could be named "monoclonal gammopathies of inflammatory significance."
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Int. J. Clin. Pract. · Nov 2021
ReviewThe Role of Endotheliitis in COVID-19: Real-world Experience of 11,190 Patients and Literature Review for a Pathophysiological Map to Clinical Categorization.
COVID-19 may yield a variety of clinical pictures, differing from pneumonitis to Acute Respiratory Distress Syndrome along with vascular damage in the lung tissue, named endotheliitis. To date, no specific treatment strategy was approved for the prevention or treatment of COVID-19 in terms of endotheliitis-related comorbidities. Here, we presented our treatment strategies for 11 190 COVID-19 patients depending on categorisation by the severity of both the respiratory and vascular distress and presented the manifestations of endotheliitis in skin, lung and brain tissues according to the different phases of COVID-19. ⋯ Distinctive manifestations in each COVID-19 patient, including non-respiratory conditions in the acute phase and the emerging risk of long-lasting complications, suggest that COVID-19 has endotheliitis-centred thrombo-inflammatory pathophysiology. Daily evaluation of clinical, laboratory and radiological findings of patients and deciding appropriate pathophysiological treatment would help to reduce the mortality rate of COVID-19.
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Int. J. Clin. Pract. · Nov 2021
Meta AnalysisAssociation between elevated brain natriuretic peptide levels and weaning failure: a systematic review and meta-analysis.
Cardiovascular dysfunction has been reported as an important mechanism of weaning failure, and recent data suggest that elevated brain natriuretic peptide (BNP) levels is associated with an increased risk of weaning failure. Therefore, we performed this meta-analysis to evaluate the correlation between elevated BNP levels and weaning failure in critically ill patients subject to mechanical ventilation. ⋯ This meta-analysis showed that increased plasma BNP concentration was associated with weaning failure in ICU patients.