METHODS: Databases were searched from January 2020 to September 2023 for randomized clinical trials (RCTs) that used mAbs for the treatment of COVID-19 regardless of disease severity. Study screening, data extraction and data analysis were performed independently by two reviewers. The Cochrane risk of bias 1.0 tool was used for methodological quality assessment.
RESULTS: Sixteen studies were identified for analysis with 9682 participants in the intervention arm and 10 115 participants in the control arm. Seven trials reported hepatoxicity and there was a statistically significant increase in the chance of hepatoxicity among patients treated with mAbs compared to those given standard of care (SoC) or placebo with risk ratio (RR) = 1.70, 95% confidence interval (CI) 1.29-2.24. Five trials reported for neutropenia and there was a statistically significant association of neutropenia with the use of mAbs compared to SoC or placebo with RR = 4.03, 95% CI 1.74-9.34. Ten trials reported any disease-related serious adverse events related to the disease and there was a reduction of risk compared to SoC/placebo, although this reduction was not statistically significant (RR = 0.88, 95% CI 0.70-1.11).
CONCLUSIONS: The use of mAbs was found to be associated with an increased risk of hepatoxicity and neutropenia compared to SoC/placebo among COVID-19 patients with moderate certainty of evidence. Long-term observational studies are recommended to observe post-COVID adverse events related to the use of mAbs.
METHODS: Insights were gathered through a questionnaire from breast surgeons, gynecologists, oncologists, and genetic clinicians in 10 Asian countries: Thailand, Hong Kong, South Korea, India, Vietnam, Malaysia, the Philippines, Taiwan, Singapore, and Indonesia. The questionnaire covered their knowledge, attitudes, and practices in GT and C for BRCA1/2 mutations, along with information on perceived gaps and unmet needs in the region.
RESULTS: A total of 61 specialists participated in the survey. GT and C for BRCA1/2 mutations were less frequently offered in Asia compared to Western countries. Among the guidelines used, the National Comprehensive Cancer Network (NCCN) guidelines alone or in combination with other guidelines (American Society of Clinical Oncology [ASCO], National Institute for Health and Clinical Excellence [NICE], and European Society for Medical Oncology [ESMO]) were preferred for both BC and OC. Limited access to genetic counselors posed a significant challenge, resulting in delayed or no GT. Pretest genetic counseling was provided by the respondents themselves. Germline testing was preferred for BC, whereas both germline and somatic testing were preferred for OC, with the most preferred option being a multipanel germline test.
CONCLUSION: Disparities exist in GT and C practices between Asian and Western countries. To address this, steps, such as patient and doctor education, increased accessibility and affordability of GT and C services, and improved infrastructure for identifying gene mutations, should be taken.
DATA SOURCES: An updated systematic search was performed in three databases until September 4, 2024. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and the protocol was preregistered in PROSPERO (CRD42024546387).
STUDY SELECTION: Randomized controlled trials that studied adult critically ill patients comparing protein doses delivered enterally and/or parenterally with similar energy delivery between groups were included.
DATA EXTRACTION: Data extraction was performed by two authors independently, using a predefined worksheet. The primary outcome was mortality. Posterior probabilities of any benefit (relative risk [RR] < 1.00) or harm (RR > 1.00) and other important beneficial and harmful effect size thresholds were estimated. Risk of bias assessment was performed using the risk of bias 2.0 tool. All analyses were performed using a Bayesian hierarchical random-effects models, under vague priors.
DATA SYNTHESIS: Twenty-two randomized trials ( n = 4164 patients) were included. The mean protein delivery in the higher and lower protein groups was 1.5 ± 0.6 vs. 0.9 ± 0.4 g/kg/d. The median RR for mortality was 1.01 (95% credible interval, 0.84-1.16). The posterior probability of any mortality benefit from higher protein delivery was 43.6%, while the probability of any harm was 56.4%. The probabilities of a 1% (RR < 0.99) and 5% (RR < 0.95) mortality reduction by higher protein delivery were 38.7% and 22.9%, respectively. Conversely, the probabilities of a 1% (RR > 1.01) and 5% (RR > 1.05) mortality increase were 51.5% and 32.4%, respectively.
CONCLUSIONS: There is a considerable probability of an increased mortality risk with higher protein delivery in critically ill patients, although a clinically beneficial effect cannot be completely eliminated based on the current data.
METHODS: Individuals from the HyperPATH cohort were assessed for blood pressure and hormone levels after controlled low and liberal sodium diets. Black and White individuals with genotype data for LSD1 (rs587168) and STRN diplotype (rs888083 and rs6744560) were included.
RESULTS: 127 Black individuals were categorized: 1) Higher Risk: individuals who carried 1 or 2 risk alleles from both LSD1 and STRN and 2) Lower Risk: individuals who did not meet these criteria. In multivariable analysis, SSBP was higher among the Higher Risk versus the Lower Risk groups (18.9 ± 1.8 mmHg vs 10.8 ± 1.6 mmHg, p-value < 0.0001). Among hypertensive individuals, SSBP was 22.9 ± 2.5 mmHg vs 12.9 ± 2.1 mmHg for the Higher Risk vs Lower Risk groups, respectively (p-value <0.0001). These results were confirmed in a second cohort of 37 Black individuals (p-value=0.029). In 396 White individuals, no differences were observed.
CONCLUSION: Black, but not White, individuals with risk alleles from both LSD1 and STRN (44% of subjects) exhibited a higher degree of SSBP. In light of the MR-related drivers of SSBP in this population, MR blockade may be particularly effective.
METHODS: The physicochemical stability of TI-AT at 5°C±3°C and 30°C±2°C in sterile low-density polyethylene bottles was studied. Samples were put in conditions of simulated use and analyzed weekly for stability parameters (visual inspection, turbidity, ultraviolet spectral absorption, osmolality, and pH) and culture growth. Insulin was quantified using the stability-indicating high-performance liquid chromatographic method with diode-array detection with RP-C18 column, o-nitrophenol as an internal standard, and ultraviolet detection at 214 nm. Stability was set according to British Pharmacopoeia with 90% to 110% of initial concentration (with 95% confidence interval) considered acceptable.
RESULTS: All tested physicochemical and sterility parameters remained stable for 1 month in both temperature conditions with stable TI concentrations.
CONCLUSION: Topical insulin-artificial tears is stable in both room temperature and refrigeration. Topical insulin-artificial tears can be prescribed with a 1-month shelf life.
OBJECTIVE: This study aims to investigate the expression level of HSP70 in response to indoor heat exposure among vulnerable populations in both urban and rural settings.
METHODS: A comparative cross-sectional was conducted among 108 participants from urban and rural areas in Klang Valley, Malaysia. The study included face-to-face interviews, indoor heat exposure monitoring, and thermal stress classification using the Universal Thermal Climate Index (UTCI). HSP70 gene and protein expressions were analyzed using reverse-transcription quantitative polymerase chain reaction (RT-qPCR) and HSP70 High Sensitivity Enzyme-linked Immunosorbent Assay (ELISA), respectively.
RESULTS: Urban areas experienced signficantly higher UTCI heat exposure levels than rural areas (p