Search

Introduction: This study aimed to determine the efficacy of intravenous tranexamic acid (TXA) in change in hemoglobin levels and need of red blood cell (RCB) transfusion following total hip arthroplasty (THA) and total knee arthroplasty (TNA) when compared with non-tranexamic acid treatment. Material and methods: We retrospectively reviewed 33 hips and 44 knees between January 2023 and December 2023. Outcome measures were hemoglobin drop (among postoperative first day), need of RBC transfusion, number of RBC units, hemoglobin levels among preoperative, and postoperative 1, 2, and 5 day. Results: Among THA patients, use of TXA compared to the non-TXA group was associated with a reduced need for RBC transfusion (12.5% vs. 32.0%; p = 0.496). Drop in hemoglobin levels within the first postop- erative day was significantly greater in the non-TXA group (2.4 ± 1.12) compared to the TXA group (1.48 ± 0.53; p = 0.032). Among TKA patients, drop in hemoglobin levels on the first postoperative day was significantly smaller in the TXA group (1.05) than in the non-TXA group (2.31), with a significant p-value of < 0.001, with the need of RBC transfusion at 20% vs. 83.3%, respectively (p < 0.001). Conclusion: Our study supports the use of TXA as an effective measure to reduce the need for RBC transfusion in patients undergoing THA and TKA. The findings suggest that TXA may contribute to better postoperative outcomes by maintaining higher hemoglobin levels and reducing the need for transfusion. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has led to increased cases of out-of-hospital cardiac arrest (OHCA), impacting emergency medical services and necessitating changes in resuscitation protocols to protect healthcare workers from virus transmission. Amidst these challenges, there's a shift in prehospital airway management techniques, with a renewed focus on endotracheal intubation over supraglottic airway devices for better protection against aerosol spread during cardiopulmonary resuscitation. This systematic review and meta-analysis aimed to examine the influence of the COVID-19 pandemic on the use of SGA as a method of securing the airway during out-of-hospital cardiac arrest. Material and methods: PubMed Central, Scopus, EMBASE, and the Cochrane Library databases were systematically searched. English-language literature was searched up to December 5th, 2023. This search was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Fixed and random effects models were used to undertake the meta-analysis when appropriate. The risk of bias was assessed through the Newcastle-Ottawa Scale. Results: Fifteen studies met the inclusion criteria for the meta-analysis. Pooled analysis showed that SGAs were chosen as the method of airway protection in 46.3% and 49.8% of cases, pre- vs. during the COVID-19 pandemic (OR = 0.76; 95%CI: 0.65 to 0.90; p = 0.001). In the case of endotracheal intubation, statistically significant differences were also observed in the frequency of use during OHCA in the pre-pandemic period vs. during the COVID-19 pandemic period (19.0% vs. 14.2%, respectively; OR = 1.66; 95%CI: 1.20 to 2.28; p = 0.002). Conclusions: The study's conclusions indicate a significant increase in the use of supraglottic airway devices during the COVID-19 pandemic for out-of-hospital cardiac arrests. Additionally, a decrease in the use of endotracheal intubation was observed. Effective airway management correlates with better outcomes after cardiac arrests, although the specific impact of these techniques during the pandemic remains unclear. [ABSTRACT FROM AUTHOR]

Introduction: The influence of the COVID-19 pandemic on the incidence and effectiveness of dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) in the context of out-of-hospital cardiac arrests (OHCA) remains an area of ambiguity and requires further elucidation. The study aims to conduct a systematic review and meta-analysis of the DA-CPR among pre- vs. during COVID-19 periods. Material and methods: This search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic review of the current literature was performed to identify articles that evaluated the impact of the pandemic on DA-CPR. English-language literature was searched up to December 11, 2023, in three databases, including MEDLINE (via PubMed), Embase, and the Cochrane Library. Results: Six studies with 605,354 patients (431,308 patients with OHCA from before the pandemic period and 174,046 OHCA patients from the COVID-19 pandemic period) were included. Pooled analysis showed that DA-CPR before and during the COVID-19 period varied and amounted to 61.4% vs. 62.4%, respectively (OR = 0.94; 95% CI: 0.90 to 0.99; p = 0.02). Moreover, dispatchers recognized cardiac arrest by phone in 61.8% of cases in the pre-pandemic period as well as in the pandemic period (OR = 0.98; 95%CI: 0.95 to 1.01; p = 0.17). Conclusions: This systematic review and meta-analysis suggest the resilience and adaptability of emergency response systems in maintaining DA-CPR effectiveness despite the challenges posed by the pandemic. [ABSTRACT FROM AUTHOR]

Copyright of Epidemiological Review / Przegląd Epidemiologiczny is the property of National Institute of Public Health - National Institute of Hygiene and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction:The search for new ways to optimize the use of medications by patients has led the pharmaceutical community to promote the idea of introducing pictograms into routine practice. The main intention of pictograms is to ease patient adherence and to reduce potential risks or errors associated with the use of medications. Purpose: To evaluate a series of pharmaceutical pictograms for patient comprehension. Patients and methods: The study was conducted in community pharmacies within a European Union country that belongs to the professional research network. Structured interviews were used to evaluate the pictograms for patient comprehension. This consisted of an assessment of the following: the transparency and translucency of the pictograms, health literacy, and pictogram recall. Participants were also given the opportunity to provide feedback on how to improve the pictograms. The primary endpoint was pictogram comprehension. Secondary outcomes included recall of the pictograms and pictogram translucency. Results: The study included 68 patients with whom face-to-face interviews were performed. Low transparency results (≤25%) and extensive patient feedback in initial interviews led to the withdrawal of certain pictograms (n=15) from the evaluation. Among the pictograms included in the final stage of our research, 22 pictograms (62.8%) obtained an acceptable transparency level ≥66%. All pictograms passed the short-term recall test with positive results. Conclusion: A majority of the designed and modified pictograms reached satisfactory guessability scores. Feedback from patients enabled modification of the pictograms and proved that patients have an important voice in the discussion regarding the design of additional pictograms. [ABSTRACT FROM AUTHOR]

Background: Globally, diseases of the cardiovascular system stand as principal contributors to mortality and are expected to show an upward trajectory. The occurrence of acute coronary syndrome (ACS) has been linked to underlying inflammatory processes. The monocyte-to-high-density lipoprotein-cholesterol ratio (MHR) has garnered significant attention as a prognostic biomarker, encapsulating the synergistic roles of inflammation and lipid metabolism in the pathophysiology of cardiovascular diseases, including ACS., Aims: This meta-analysis examines the prognostic MHR ratio in ACS patients., Methods: We systematically searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library databases to identify the relevant meta-analyses published before February 26, 2024. The findings were aggregated into risk ratios with 95% confidence intervals., Results: Eleven studies, with 7421 patients, were included. Low MHR levels compared to high MHR levels were associated with statistically significantly lower in-hospital mortality (0.9% vs. 5.5%; respectively; P <0.001), 3-month mortality (4.4% vs. 11.2%; P = 0.02), 6-month follow-up mortality (4.0% vs. 10.2%; P = 0.03), 1-year mortality (4.2% vs. 10.2%; P <0.001), as well as long-term follow-up mortality (7.5% vs. 13.7%; P <0.001)., Conclusions: MHR has both good predictive properties for mortality and major adverse cardiovascular events (short- and long-term). Data indicate that MHR may improve in-hospital and long-term cardiovascular risk prediction. It may, therefore, be an effective tool for risk re-estimation and selection of patients for whom intensive lipid-lowering treatment may be particularly useful.

Background: Residual fatigue is a common and debilitating symptom in patients with unipolar and bipolar depression, even after achieving partial or full remission. It significantly impacts patients' quality of life and increases the risk of relapse. This systematic review aims to evaluate the prevalence and effectiveness of therapeutic options for residual fatigue in individuals with unipolar major depressive disorder (MDD) and bipolar disorder (BD)., Methods: A comprehensive search was conducted in the PubMed, SCOPUS, and Web of Science databases up to September 2024. The protocol for this systematic review was registered in PROSPERO. The search strategy included terms related to depression and residual fatigue. Studies were included if they provided data on adult patients diagnosed with MDD or BD, and if they measured the prevalence or treatment of residual fatigue. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for non-randomized studies., Results: Twenty studies were included in the review. The vast majority reported on MDD, and single papers investigated BD. Residual fatigue was reported by up to 83% of patients, and moderate to severe residual fatigue affected a smaller percentage. Pharmacological treatments, such as modafinil and to a lesser extent atomoxetine, demonstrated short-term reductions in residual fatigue., Conclusion: Residual fatigue remains a significant challenge in the treatment of depression, persisting in a large portion of patients despite remission. Pharmacological interventions like modafinil appear promising, but more research is needed, especially in BD. Standardized assessment tools and longer-term studies are essential to better understand and treat residual fatigue., Trial Registration: PROSPERO identifier: CRD42024543087., (© 2025 The Author(s). Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology.)

Introduction: The COVID-19 pandemic has proved that community pharmacies play a pivotal role in providing medicines, information and safety measures to prevent the spread of SARS-CoV-2., Purpose: The study aimed to get to know opinions of pharmacy staff and owners on the functioning of the community pharmacy during the outbreak of the COVID-19 pandemic., Materials and Methods: To collect opinions about functioning of the community pharmacy during the pandemic, we conducted cross-sectional study among pharmacy staff and owners of pharmacies., Results: The study group included 456 respondents mostly associated with independent pharmacies (55.7%), from cities less than 100,000 inhabitants (38.8%). The number of patients as well as filled prescriptions increased during the pandemic. Respondents provided patients with advice on cold (81.6%), sore throat (77.0%) and acherelated complaints (68.6%). Most of participants (64.5%) declared that they informed patients about COVID-19. The safety measures in community pharmacies included: a safety regulations poster during the pandemic (97.1%), handwashing in accordance with recommended guidelines (96.3%) and using protective gloves by the pharmacy staff (89.9%). According to 60.7% of participants, the community pharmacy was properly prepared for the pandemic by the owner, however, respondents from independent pharmacies indicate this more frequently (p=0.0001)., Conclusions: Respondents are aware of the role of community pharmacies in the healthcare system during the pandemic, nevertheless, more attention needs to be paid by public authorities and governmental institutions to patient safety in the community pharmacy., (© National Institute of Public Health – National Institute of Hygiene.)