BACKGROUND: An inverse relationship between vitamin D supplementation and C-reactive protein (CRP) and hypertension has been reported, mostly through observational data. This inverse relationship, however, has not been confirmed in randomized controlled trials (RCTs). A meta-analysis of RCTs is needed to provide more robust evidence. OBJECTIVE: This systematic review of RCTs was conducted to assess the effect of vitamin D supplementation on CRP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in postmenopausal women. METHODS: Four databases (PubMed, Web of Science, Embase, and Scopus) were systemically searched to identify relevant RCTs published in international scientific journals up to January 2023. Changes from baseline and SDs of CRP, SBP, and DBP were compared between postmenopausal women who received vitamin D supplementation and those who did not (controls). These parameters were applied to compute the overall effect sizes using the random-effects model. Data were summarized as mean difference (MD) with 95% CI. Heterogeneity among arms was scrutinized using the Cochrane's Q test and I2 statistic. Publication bias was judged by means of funnel plots and Egger's test. RESULTS: Seven studies with 6 arms on CRP, 6 arms on SBP, and 6 arms on DBP were included in the meta-analysis. Combined effect sizes suggested a significant effect of vitamin D supplementation on CRP (MD = -0.65 mg/L; 95% CI -0.93 to -0.37 mg/L; P < .001). In addition, CRP concentrations were significantly reduced after vitamin D supplementation in studies with a duration of more than 3 months (MD = -0.91 mg/L; 95% CI -1.37 to -0.45 mg/L; P < .001) and studies involving doses of ≤1,000 IU/d (MD = -2.10 mg/L; 95% CI -2.51 to -1.68 mg/L; P < .001). Vitamin D supplementation did not reduce SBP significantly (MD = -1.06 mm Hg; 95% CI -2.43 to 0.30 mm Hg; P = .127) and DBP (MD = 0.003 mm Hg; 95% CI -0.86 to 0.86 mm Hg; P = .994) levels compared with control groups. CONCLUSIONS: This meta-analysis concluded that vitamin D supplementation is associated with reduced CRP concentrations among postmenopausal women.
Kontext: Termínem supraventrikulární tachykardie (SVT) se označuje abnormálně rychlý srdeční rytmus v důsledku poruchy elektrické aktivity v horních segmentech srdce. Akutní léčba dětských pacientů se SVT může představovat náročný úkol, protože přesný mechanismus vzniku tachykardie často není znám. Volba léčebné strategie závisí na projevech a na klinickém stavu pacienta. Metodologie: Byla provedena systematická rešerše literatury s cílem vyhledat a vybrat zprávy a články o originálním výzkumu na téma farmakologické léčby SVT u dětí a kojenců bez strukturálního onemocnění srdce (všichni od první hodiny života až do 17 let věku) v souladu s doporučenými postupy PRISMA. Údaje byly analyzovány s použitím softwaru Review Manager version 5.4. Statistická významnost rozdílů se vyjadřovala hodnotou p a heterogenita/homogenita analyzovaných studií indexem I2. Výsledky: Do přehledu bylo zařazeno 26 studií z celkem původně vybraných 65 studií hodnocených z hlediska vhodnosti a splnění zadaných kritérií. Údaje se týkaly 8 103 pacientů se SVT ze 13 zemí, léčených různými antiarytmiky včetně adenosinu a dexmedetomidinu v akutních případech, a podáváním amiodaronu, beta-blokátorů, flekainidu, digoxinu a ivabradinu pacientům sloužícím jako chronické kontroly. Byl nalezen statisticky významný rozdíl mezi pacienty užívajícími uvedená léčiva a pacienty, kteří na léčivo reagovali (p < 0,005 a I2 = 72 %). Závěr: V pediatrii neexistuje léčba SVT první nebo druhé linie a účinnost léčiv se může mezi jednotlivými pacienty značně lišit; pro léčbu je nutno zvážit všechny možnosti. Na rozdíl od podávání jednotlivých léčiv jsou jejich kombinace účinnější při menším počtu nežádoucích účinků. Podle tohoto přehledu závisí léčba SVT u kojenců na anamnéze pacienta; přitom je třeba mít na paměti možné nežádoucí účinky některých léčiv.
Background: Supraventricular tachycardia (SVT) is an abnormally rapid heart rhythm that results from improper electrical activity in the upper part of the heart. Acute management of children presenting with SVT may be a challenge, as the exact tachycardia mechanism is often unknown. The strategy for treatment depends on the presentation and clinical status of the patient. Methodology: A systematic literature review was conducted to identify and select original research reports on supraventricular tachycardia management drugs in children and infants with no structural heart disease (all children from 1 hour to 17 years of age) in accordance with the PRISMA guidelines. Data were analyzed with Review manager version 5.4. P-value and I2 were used to test the significance difference. Results: 26 studies out of 65 total studies assessed for eligibility were included in the review by fulfilling the inclusion criteria. There were 8103 patients from 13 countries with SVT who were treated with different antiarrhythmic drugs including (Adenosine, Dexmedetomidine) as acute management and (Amiodarone, Beta-Blockers, Flecainide, Digoxin and Ivabradine) as chronic control. There was a significant difference between the patients who took the drugs and the patients who responded to the drugs, with P-value <0.005 and I2 = 72%. Conclusion: There is not a first line treatment or second line treatment for SVT in pediatrics, and drug effecti- veness can vary greatly between patients; all choices should be considered during the treatment protocol. The combination of drugs, as opposed to a single drug, is more efficient with less side effects in these patients. According to this review, the management of SVT in infants is highly dependent on the history of the patient and the probable side effects of some treatments that must be avoided.
Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.
- MeSH
- dítě MeSH
- dospělí MeSH
- konsensus MeSH
- kyselina listová MeSH
- lidé MeSH
- methotrexát * MeSH
- průzkumy a dotazníky MeSH
- psoriáza * terapie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Publikační typ
- abstrakt z konference MeSH
- MeSH
- anální kanál MeSH
- gynekologie * MeSH
- lékaři * MeSH
- lidé MeSH
- porodnictví * MeSH
- těhotenství MeSH
- vakuová extrakce porodnická MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- dopisy MeSH
- komentáře MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
INTRODUCTION: Egypt adopted a comprehensive strategy to eliminate measles and rubella by conducting a catch up campaign (in 2008) targeting children and young adults in the age group 10-19 years. This study aimed to explore the seroprevalence of rubella among females aged 20 to 30 years in order to provide the Ministry of Health with information to develop future strategies for rubella supplemental immunization activities among women of childbearing age before marriage and conception. METHODS: A total of 339 females in the age group 20 to 30 were selected. The study group comprised women who attended the central laboratory of the Ministry of Health for checking up before travelling abroad as pre-travel requirements for visa application. The collected serum samples were tested for rubella-specific IgG antibodies. RESULTS: The overall prevalence of rubella antibodies in the study group was 88.2%. Around 5.0% of females, who reported that they had been vaccinated, were susceptible to rubella. Age, history of measles, mumps and rubella (MMR) vaccination and past history of rubella infection were considered factors associated with seropositivity for rubella. CONCLUSION: The seroprevalence rate of rubella antibodies among our female study group was considered low.
- MeSH
- dospělí MeSH
- lidé MeSH
- prevalence MeSH
- protilátky virové analýza MeSH
- séroepidemiologické studie MeSH
- socioekonomické faktory MeSH
- vakcína proti zarděnkám imunologie MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Egypt MeSH
Background: Surveillance of infectious disease markers in the blood donor population is important in recognizing trends in prevalence and incidence of transfusion related infections in asymptomatic volunteer blood donors. Subjects and Methods: It was a cross sectional study. Samples were collected from volunteer blood donors and questionnaire was designed to collect the risk factors data. The prevalence of hepatitis C antibodies among 1,000 apparently healthy blood donors were determined. Objective: To estimate the prevalence of virus C hepatic infection and to illustrate the various socio-economic, behavioural and medical factors related to infection with Hepatitis C (HCV) among apparently healthy individuals. It contributed to analysis of the particularities of Egyptian blood donors and helped to better understand the challenges and solutions of blood safety. Results: The prevalence of HCV was 16.8%. There was an association of positive anti-HCV test with socio-demographic, medical and behavioural risk factors. Conclusion: This study provided comprehensive and reliable information on the possible risk factors affecting spread of Hepatitis C in the area.
- MeSH
- chronická hepatitida C diagnóza epidemiologie MeSH
- dárci krve MeSH
- dospělí MeSH
- hepatitida C - protilátky krev MeSH
- hepatitida C epidemiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Geografické názvy
- Egypt MeSH
