Edwardspetersson5598

Currently, the American Academy of Pediatrics guidelines recommend that children with Down syndrome undergo polysomnography by the age of 4 years. Our review supports the recommendation for routine screening of children with Down syndrome. However, results from our meta-analysis suggest a need for longitudinal screening to diagnose children who may develop SDB as they get older.Hypoxaemia from COVID-19 is likely a consequence of multiple causes https//bit.ly/3yXCJGZPatients with obesity may have different ventilatory phenotypes during exercise related to an interaction of expiratory flow limitation, mechanical constraints and adaptations of chemoreception and metabolic setpoints. https//bit.ly/3JBs86S

To assess experiences of and response to the COVID-19 pandemic at community pharmacies in Kenya.

This was a mixed-methods study conducted from November 2020 to April 2021, targeting service providers in three counties (Nairobi, Mombasa and Kisumu), selected purposively to represent the main urban centres; pharmacies were selected randomly from a list of licensed pharmacies.

Of 195 sampled pharmacies, 108 (55%) completed a questionnaire and 103 (53%) received a simulated client call; 18 service providers were interviewed. The initial weeks of the pandemic were characterised by fear and panic among service providers and a surge in client flow. Subsequently, 65 (60%) of 108 pharmacies experienced a dip in demand to below prepandemic levels and 34 (31%) reported challenges with unavailability, high price and poor quality of products. Almost all pharmacies were actively providing preventive materials and therapies; educating clients on prevention measures; counselling anxious clients; and handling and referrpandemic responses.

Private pharmacies in Kenya were actively contributing to the COVID-19 response, but more deliberate engagement, support and linkages are required. Notably, there is an urgent need to develop guidelines for pharmacy-based COVID-19 testing, a service that is clearly needed and which could greatly increase test coverage. Pharmacy-based COVID-19 programmes should be accompanied with implementation research to inform current and future pandemic responses.

Antipsychotic medications are commonly prescribed off-label in acutely ill patients for non-psychiatric clinical indications such as delirium or insomnia. New prescription initiation of antipsychotics in acute care settings increases the proportion of patients discharged home on antipsychotics without approved clinical indication. Long-term use of antipsychotics is associated with increased risk of sudden cardiac death, falls and cognitive impairment. An understanding of acute care off-label antipsychotic prescribing practices and healthcare professional, patient and family perceptions related to antipsychotic prescribing and deprescribing is necessary to facilitate in-hospital deprescribing initiatives.

We present the protocol for a scoping review following the methodology proposed by Arksey and O'Malley and the Scoping Review Methods Manual by the Joanna Briggs Institute. We will search five databases including MEDLINE, EMBASE, CINAHL, PsycINFO and Web of Science from inception to 3 July 2021 (ie, plannained by primary investigators will be retrieved and analysed. The results of this scoping review will inform integrated knowledge translation initiatives aimed at in-hospital antipsychotic medication deprescribing.

No ethical approval will be required for this study as only data from published studies in which informed consent was obtained by primary investigators will be retrieved and analysed. The results of this scoping review will inform integrated knowledge translation initiatives aimed at in-hospital antipsychotic medication deprescribing.

Malnutrition and weight loss are important risk factors for complications after lung surgery. However, it is uncertain whether modifying or optimising perioperative nutritional state with oral supplements results in a reduction in malnutrition, complications or quality of life.

A randomised, open label, controlled feasibility study was conducted to assess the feasibility of carrying out a large multicentre randomised trial of nutritional intervention. The intervention involved preoperative carbohydrate-loading drinks (4×200 mL evening before surgery and 2×200 mL the morning of surgery) and early postoperative nutritional protein supplement drinks two times per day for 14 days compared with the control group receiving an equivalent volume of water.

Single adult thoracic centre in the UK.

All adult patients admitted for major lung surgery. Patients were included if were able to take nutritional drinks prior to surgery and give written informed consent. TPCA-1 price Patients were excluded if they were likely unable tISRCTN16535341.

Gestational diabetes mellitus (GDM) is one of the most prevalent diseases during pregnancy, which is closely associated with many short-term and long-term maternal and neonatal complications and can incur heavy financial burden on both families and society. Web-based interventions have been used to manage GDM because of the advantages of high accessibility and flexibility, but their effectiveness has remained inconclusive. This systematic review and meta-analysis aims to comprehensively investigate the multidimensional effectiveness of web-based interventions for pregnant women with GDM, thereby aiding implementation decisions in clinical settings.

This systematic review protocol strictly adheres to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols guidelines. Six electronic databases (PubMed, Web of Science, Cochrane Central Register of Controlled Trials, Embase, CINAHL and PsycINFO) will be comprehensively searched from their inception to 26 January 2022 to identify randomilved. The results will be disseminated via a peer-reviewed journal or an academic conference.

CRD42022296625.

CRD42022296625.

Multiple myeloma (MM) is an incurable malignant neoplasm that accounts for approximately 1% of all cancers and 10% of haematological malignancies. Bortezomib is one of the most commonly used medications in first-line treatment and subsequent relapses, either as a single agent or in combination with other therapies. This study aims to assess the effects of bortezomib on the overall survival (OS), progression-free survival, overall response rate, time to next treatment, health-related quality of life, compliance, adverse events and treatment-related death in patients with MM.

We have performed a systematic review and meta-analysis and will include both randomised and non-randomised controlled studies where the effect of bortezomib was compared in similar or dissimilar background therapies in each arm. General and adaptive search strategies have been created for the following electronic health databases Embase, Medline, LILACS and CENTRAL. Two reviewers have independently selected eligible studies, will assess the risk of bias, and will extract data from the included studies. Similar outcomes will be plotted in the meta-analysis using the Stata Statistical Software V.17. The relative risk will be calculated with a 95% CI as the effect size of bortezomib. For the OS and progression-free survival, we calculate the overall OR from the HRs of each included study. Peto's one-step OR will be calculated for event rates below 1%. We will use the Grading of Recommendations Assessment, Development and Evaluation system to evaluate the certainty of evidence.

As no primary data collection will be undertaken, formal ethical assessment is not required. We plan to present the results of this systematic review in a peer-reviewed scientific journal, conferences and popular press.

CRD42020151142.

CRD42020151142.

To identify the risk factors for diabetic kidney disease (DKD) development, especially the difference between patients with different courses.

791 patients were considered to be eligible and were enrolled in the cross-sectional study from Shanghai Tongren Hospital Inpatient Department. 36 variables were initially screened by univariate analysis. The risk factors affecting progression of DKD were determined by logistics regression analysis. Subgroups were grouped according to the course of diabetes disease, and multivariate logistics regression analysis was performed to find out the different risk factors in two subgroups. Finally, the receiver operating characteristics curve is used to verify the result.

The logistic regression model indicated age (OR=1.020, p=0.017, 95% CI 1.004 to 1.040), systolic blood pressure (OR=1.013, p=0.006, 95% CI 1.004 to 1.022), waist circumference (OR=1.021, p=0.015, 95% CI 1.004 to 1.038), white blood cells (WBC, OR=1.185, p=0.001, 95% CI 1.085 to 1.295) and triglycerides lammatory indicators might be considered as early warning factors for DKD in T2DM. Women should pay attention to controlling inflammation and TGs, and men should strictly control blood pressure. Avoiding abdominal obesity in both men and women will bring great benefits.

The focus of attention should especially be on patients with a prolonged course of T2DM, and those with comorbid hypertension and hypertriglyceridaemia waist phenotype. More potential clinical indexes such as thyroid function and inflammatory indicators might be considered as early warning factors for DKD in T2DM. Women should pay attention to controlling inflammation and TGs, and men should strictly control blood pressure. Avoiding abdominal obesity in both men and women will bring great benefits.

Intracoronary ECG (IC-ECG) recording has been shown to be sensitive and reliable for detecting myocardial viability and local myocardial ischaemia in some studies. But IC-ECG is neither widely used during percutaneous coronary intervention (PCI) nor recommended in guidelines. This up-to-date meta-analysis of published studies was conducted to evaluate the prognostic and diagnostic accuracy of IC-ECG recorded during PCI.

Relevant studies were identified by searches of MEDLINE until 19 June 2021. Observational and diagnostic studies which reported the prognostic or diagnostic accuracy of IC-ECG were included. Data were extracted independently by two authors. Summary estimates of clinical outcomes were obtained using a random effects model. Summary diagnostic accuracy was obtained by using a Bayesian bivariate random effects model.

Of the 12 included studies, 7 studies reported the clinical outcomes (821 patients) and 6 studies reported the diagnostic accuracy (485 patients) of IC-ECG. The pooled ORs with 95% CIs of ST-segment elevation recorded by IC-ECG were 4.65 (1.69 to 12.77), 5.08 (1.10 to 23.44), 4.53 (0.79 to 25.90) and 1.83 (0.93 to 3.62) for major adverse cardiac events, myocardial infarction, cardiac death and revascularisation, respectively. The weighted mean difference were 6.49 (95% CIs 3.84 to 9.14) for ejection fraction when ST-segment resolution was recorded, and 0.86 (95% CIs -8.55 to 10.26) when ST-segment elevation was recorded. The pooled sensitivity and specificity of ST-segment elevation were 0.78 (95% credibility intervals 0.64 to 0.89) and 0.87 (95% credibility intervals 0.75 to 0.94), respectively.

These findings provide quantitative data supporting that IC-ECG had promising diagnostic ability for local myocardial injury, and could predict clinical outcomes.

These findings provide quantitative data supporting that IC-ECG had promising diagnostic ability for local myocardial injury, and could predict clinical outcomes.