ObjectivesAssess values, preferences and burden of treatment that patients with type 2 diabetes consider when initiating glucagon-like peptide-1 receptor agonists (GLP-1 RA) or sodium-glucose ...cotransporter-2 inhibitors (SGLT-2i) compared with other glucose-lowering options.MethodsPaired reviewers independently included studies reporting quantitative or qualitative methods to assess values, preferences and burden of treatment reported by patients with type 2 diabetes regarding the initiation of GLP-1 RA or SGLT-2i over other alternatives. A systematic search in MEDLINE, Scopus, EMBASE, Web of Science and Cochrane Central Register of Controlled Trials from inception until May 2020 was performed by an experienced librarian. Risk of bias was assessed with a specifically designed tool for values and preferences studies.Results17 studies (7296 patients) proved eligible. Studies fulfilling criteria for SGLT-2i were not identified. Five studies (2662 patients) evaluated preferences for GLP-1 RA compared with other glucose-lowering medications. 12 studies (4634 patients) evaluated preferences between, at least, two kinds of GLP-1 RA or their injection devices based on the following attributes: efficacy, dose, application frequency, device characteristics. Among studies comparing GLP-1 RA to other glucose-lowering medications, some preferences were observed for dypeptil peptidase-4 inhibitors compared with once daily liraglutide. Comparing different attributes of GLP-1 RA drugs and devices, cardiovascular risk reduction, glucose lowering potential, once weekly and simple administered regimens were the most preferred.ConclusionsAs no evidence for preferences on SGLT-2i was available, only preferences for GLP-1 RA were assessed; however, evidence is still limited for the latter. Studies comparing preferences for GLP1-RA to other glucose-lowering alternatives only included twice daily or once daily injection regimens of GLP-1 RA drugs. According to our findings, once weekly alternatives are widely preferred than the formers. The extent to which patients with type 2 diabetes value reduced adverse cardiovascular and kidney outcomes, weighed benefits against harms and burden of treatment is limited and with very low certainty.PROSPERO registration numberCRD42020159284.
This is the protocol for a Campbell systematic review. The objectives are as follows: to identify, describe, and summarize existing guidance and methods for multistakeholder engagement throughout the ...health guideline development process.
PETKOVIC et al Petkovic, Jennifer; Riddle, Alison; Lytvyn, Lyubov ...
Campbell systematic review,
06/2022, Letnik:
18, Številka:
2
Journal Article
Recenzirano
Odprti dostop
This is the protocol for a Campbell systematic review. The objectives are as follows: to identify, describe, and summarize existing guidance and methods for multistakeholder engagement throughout the ...health guideline development process.
The emergence of methicillin-resistant Staphylococcus aureus (MRSA) infections among previously healthy persons in community settings, without exposure to health care facilities, has been noted ...recently. Colonization rates of community-associated MRSA (CA-MRSA) have been reported to range from 0 to 9.2 percent. The nose and open skin areas are considered the most important sites for colonization. The aim of our study was to assess the prevalence and to describe the antibiotic susceptibility pattern of CA-MRSA among outpatient children.
We prospectively screened every third consecutive child presenting to our pediatric emergency department of King Saud Medical City, a 275 bed tertiary care teaching hospital in Riyadh, Saudi Arabia, from March through July 2015.
We analyzed a total of 830 screening results (n = 478 males, 57.6%). Most of the screened patients were from Riyadh (n = 824, 99.3%). A total of 164 (19.8%) were found to be colonized with S. aureus, and of these 38 (4.6%) with MRSA. Thus, the MRSA rate amongst all S. aureus carriers was 23.2%. All MRSA were susceptible to vancomycin, (94.7%) were susceptible to linezolid, (65.8%) to clindamycin, and (89.5%) to trimethoprim/sulfamethoxazole.
The rate of MRSA carriage among children in Riyadh province was within the range reported internationally. As the MRSA rate among S. aureus infected children was 23.2%, empirical MRSA coverage should be considered in children with suspected S. aureus infections.
ВІДНОСИНИ ВЛАСНОСТІ В УКРАЇНІ Григорук, Анатолій; Литвин, Любов
Ekonomìka ta suspìlʹstvo,
03/2021
25
Journal Article
Odprti dostop
У статті розглянуто відносини власності в контексті їх місця і ролі в економіці України. Визначено власність, як стержень економічної системи, безпосередньо впливає на процеси в ринковій економіці ...України. Зазначено, що відносини власності виникають внаслідок відносин між людьми, групами людей, державою тощо з приводу з приводу привласнення об’єктів власності й перш за все засобів виробництва та його результатів. Висвітлено так звану тріаду власності яка визначається трьома основними правочинностями – володіння, користування і розпорядження. Охарактеризовано сутність поняття «власність» з економічної та юридичної точки зору. Визначено власність як складну і багатогранну категорію. Висвітлено основні типи і форми власності в економіці України. Зазначено, що сьогодні в Україні відбуваються істотні перетворення у відносинах власності, а для стабільності економічної системи суспільства повинні бути присутні всі типи, види та форми власності.
Clostridium difficile infection (CDI) prevention is of high priority. We reviewed clinical practice guidelines (CPGs), and conducted an individual participant data meta-analysis (IPMDA) of randomized ...controlled trials (RCTs) to assess effectiveness and safety of probiotic prophylaxis. ;
For CPGs, we rated quality, summarized recommendations with their strength and author-reported evidence, then re-evaluated evidence. For the IPDMA, we pooled RCTs investigating probiotics versus control for CDI prevention among antibiotic consumers, using generalized linear mixed models. Our outcomes were CDI and serious adverse events (SAEs). We adjusted for age, sex, hospitalization status, and exposure to high risk antibiotics. We assessed study risk of bias and confidence in estimates of effect. ;
Five international guidelines were evaluated, and all scored poorly for applicability, stakeholder involvement, and rigor of development. Recommendations were not always linked to evidence, and guideline authors were not transparent about how evidence limitations impacted their decisions. None of the guidelines recommended probiotics. ;
Fourteen studies contributed data, with one pending. Probiotics reduced CDI among all studies and the adjusted model. No covariates were significantly associated with CDI. Subgroups suggested that high incidence did not affect probiotic effectiveness, and high-dose, multi-strain probiotics were more beneficial. Our estimate was robust to sensitivity analyses. Probiotics did not significantly affect SAE odds among all studies and the adjusted model. Increasing age was a significantly associated with SAEs. No SAEs were reportedly probiotics-related. For both outcomes, estimates were similar from data of obtained and not obtained studies. Confidence in estimates was moderate for both outcomes, due to low event rates.;
Current guidelines on CDI prevention did not adhere well to validated standards for development and reporting, most notably due to insufficient links between recommendations and supporting evidence. Our preliminary analysis suggests that probiotic prophylaxis is useful and safe for CDI prevention.
Thesis
Master of Science (MSc)
Clostridium difficile infection (CDI) is a common hospital-associated infection, and prevention is of high priority. We reviewed clinical practice guidelines on CDI prevention to summarize their recommendations, and assess the quality of guideline development and reporting. Furthermore, we analysed patient data from randomized clinical trials to obtain an overall estimate (meta-analysis) of whether using a novel strategy, probiotic prophylaxis, is effective and safe. The guidelines had several limitations, importantly that authors were not transparent about how recommendation were developed, and recommendations were not always linked to evidence. Although no guideline recommended using probiotics to prevent CDI, our advanced analysis of previously conducted trials suggested that it was an effective intervention, reducing infections by approximately 76%, and was not associated with differences in serious adverse events compared to participants not receiving probiotics. In summary, guidelines on CDI prevention should be improved, and probiotics may be considered as an additional strategy.
•Magnetite nanoparticles were obtained in a NaCl matrix by electron beam method.•They were modified with polyvinylpyrrolidone and ethylmethylhydroxypyridine succinate.•These nanoparticles were not ...cytotoxic to erythrocytes up to 100 μg Fe/ml.•They caused pathology of the shape of red blood cells and hemolysis at 200 μg Fe/ml.•The cytotoxicity decreased when using the antioxidant as a modifying agent.
The synthesis of covered nanoparticles provides new properties to the materials for biomedical applications. This fully applies to iron oxide nanoparticles. The research aim was to study features of the magnetite nanoparticles synthesized by electron beam technology as well as to investigate their functionalization and cytotoxicity. Nanoparticle characteristics were determined by standard methods. Cytotoxiciy of nanoparticles was studied using erythrocyte model. It was shown that the original magnetite nanoparticles in the sodium chloride matrix can be functionalized with polyvinylpyrrolidone and ethylmethylhydroxypyridine succinate, an antioxidant. All investigated nanoparticles were non-toxic for erythrocytes at concentrations up to 100 μg Fe/ml. At 100-200 μg Fe/ml, they increased the amount of cells expressing phosphatidylserine on the outer membrane, the count of pathological forms of erythrocytes and hemolysis. These phenomena were less pronounced if the nanosystem included the antioxidant. Therefore, magnetite nanoparticles can be obtained by electron beam technology and functionalized to form non-toxic nanosystems.
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