Internal medicine journal
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Internal medicine journal · Dec 2020
Meta AnalysisRenin-angiotensin system inhibition and risk of infection and mortality in COVID-19: a systematic review and meta-analysis.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, enters human cells by binding of its viral protein to the aminopeptidase angiotensin-converting enzyme 2 (ACE2). This has led to speculation whether treatment with renin-angiotensin system (RAS) inhibitors was associated with an increased likelihood of a positive test for COVID-19 and risk of mortality. ⋯ Use of ACEI or ARB was not associated with a heightened susceptibility for a positive diagnosis of COVID-19. Furthermore, they were not associated with increased illness severity or mortality due to COVID-19. Randomised controlled trials are needed to address definitively the potential benefits or harms of RAS inhibitors in patients with COVID-19.
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Internal medicine journal · Jul 2020
Meta AnalysisIncident atrial fibrillation in patients undergoing bariatric surgery: a systematic review and meta-analysis.
There are controversial data regarding the relationship between bariatric surgery and atrial fibrillation (AF). This meta-analysis was performed to evaluate (i) the incidence and (ii) the risk of AF in patients following bariatric surgery. ⋯ The overall estimated incidence of AF following bariatric surgery was 5.3%. Our study demonstrates a significant beneficial association between bariatric surgery and AF, with a 0.42-fold decreased risk of AF. Future large-scale studies are needed to confirm the potential benefits of bariatric surgery on risk of AF.
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Internal medicine journal · May 2020
Review Meta AnalysisEndovascular clot retrieval for M2 segment middle cerebral artery occlusion: a systematic review and meta-analysis.
Endovascular clot retrieval (ECR) is the standard of care for acute ischaemic stroke due to large vessel occlusion. However, isolated occlusion of the M2 segment of the middle cerebral artery (MCA) was underrepresented in the landmark trials. ⋯ The outcomes of ECR treatment of M2 occlusions are favourable, with good safety profile. Comparison to medical management from large registries or randomised controlled trials is warranted.
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Internal medicine journal · Feb 2020
Meta AnalysisExtended duration of thromboprophylaxis for medically ill patients: a systematic review and meta-analysis of randomised controlled trials.
The benefit of extended-duration thromboprophylaxis in patients hospitalised for acute medical illness beyond hospital stay remains controversial. ⋯ Among hospitalised medically ill patients, prolonging venous thromboprophylaxis was associated with a decreased risk of composite events of the primary efficacy outcome and increased risk of bleeding with no significant difference in VTE-related death.
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Internal medicine journal · Dec 2019
Meta AnalysisEfficacy and tolerability of duloxetine in patients with knee osteoarthritis: a meta-analysis of randomised controlled trials.
Knee osteoarthritis (OA) is one of the most common joint diseases, and pharmacotherapy is necessary to control its symptoms. ⋯ Duloxetine is effective in the management of chronic pain and loss of physical function in knee OA with acceptable adverse events despite having no advantage in treating joint stiffness. Future trials should focus on determining the optimal treatment regimen.