Mahmoudharrison2822

Despite the continuous improvement in modern medical treatment, stroke is still a leading cause of death and disability worldwide. How to effectively improve the survival rate and reduce disability in patients who had a stroke has become the focus of many investigations. Recent findings concerning the benefits of glibenclamide as a neuroprotective drug have initiated a new area for prospective studies on the effects of sulfonylureas. Given the high mortality and disability associated with stroke, it is essential to weigh the benefits of neuroprotective drugs against their safety. Therefore, the objective of the current study is to conduct a systematic review using meta-analysis to assess the benefits and safety of glibenclamide as a neuroprotective drug.

This study will analyse randomised clinical trials (RCTs) and observational studies published up to 31 December 2020 and include direct or indirect evidence. Studies will be retrieved by searching PubMed, EMBASE, Web of Science, the Cochrane Library and China National Knowledge Infrastructure (CNKI) and WanFang Databases. The outcomes of this study will be mortality, scores from the Modified Rankin Scale and the occurrence of hypoglycaemic events. The risk of bias will be assessed using the Cochrane risk of bias assessment instrument for RCTs. A random-effect/fixed-effect model will be used to summarise the estimates of the mean difference/risk ratio using a 95% CI.

This meta-analysis is a secondary research project, which is based on previously published data. Therefore, ethical approval and informed consent were not required for this meta-analysis. The results of this study will be submitted to a peer-reviewed journal for publication.

CRD42020144674.

CRD42020144674.

Stroke is a common cause of epilepsy that may be mediated via glutamate dysregulation. There is currently no evidence to support the use of antiseizure medications as primary prevention against poststroke epilepsy. Perampanel has a unique antiglutamatergic mechanism of action and may have antiepileptogenic properties. This study aims to evaluate the efficacy and safety of perampanel as an antiepileptogenic treatment in patients at high risk of poststroke epilepsy.

Up to 328 patients with cortical ischaemic stroke or lobar haemorrhage will be enrolled, and receive their first treatment within 7 days of stroke onset. Patients will be randomised (11) to receive perampanel (titrated to 6 mg daily over 4 weeks) or matching placebo, stratified by stroke subtype (ischaemic or haemorrhagic). Treatment will be continued for 12 weeks after titration. 7T MRI will be performed at baseline for quantification of cerebral glutamate by magnetic resonance spectroscopy and glutamate chemical exchange saturation transfer imaging. Blood will be collected for measurement of plasma glutamate levels. Participants will be followed up for 52 weeks after randomisation.The primary study outcome will be the proportion of participants in each group free of late (more than 7 days after stroke onset) poststroke seizures by the end of the 12-month study period, analysed by Fisher's exact test. Secondary outcomes will include time to first seizure, time to treatment withdrawal and 3-month modified Rankin Scale score. Quality of life, cognitive function, mood and adverse events will be assessed by standardised questionnaires. Exploratory outcomes will include correlation between cerebral and plasma glutamate concentration and stroke and seizure outcomes.

This study was approved by the Alfred Health Human Research Ethics Committee (HREC No 44366, Reference 287/18).

ACTRN12618001984280; Pre-results.

ACTRN12618001984280; Pre-results.

To determine reference ranges of circulating long-chain (LC) omega-3 fatty acids eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) in a nationally representative population of Americans. To provide context, serum concentrations of LC omega-3 were compared with concentrations associated with consuming the recommended amount of EPA and DHA by the Dietary Guidelines for Americans (DGA) and the Omega-3 Index (EPA+DHA).

Cross-sectional population-based study.

The National Health and Nutrition Examination Survey 2011-2012 cycle.

Participants with fatty acids measured in serum 945 children, age 3-19 years, and 1316 adults, age 20 and older.

Serum EPA, DPA, DHA and sum of LC omega-3 fatty acids expressed as per cent of total fatty acids.

Among children, mean (SE) serum concentrations of EPA, DHA and omega-3s were 0.28% (0.01), 1.07% (0.02) and 1.75% (0.03). Among adults, mean (SE) of EPA, DHA and omega-3s were 0.61% (0.02), 1.38% (0.05) and 2.43% (0.08), all of which mendations. Our findings show the need for continued emphasis on regular consumption of LC omega-3s among Americans, particularly considering the importance of LC omega-3s in cardiovascular health, brain health and development throughout life.

The SARS-CoV-2 pandemic has infected millions of people and has caused more than 2.30 million deaths worldwide to date. Several doubts arise about the role of asymptomatic carriers in virus transmission. During the first epidemic outbreak in Italy a large screening with nasopharyngeal swab (NS) was performed in those who were considered 'suspect' for infection.

To report the results of the SARS-CoV-2 screening in a province in Southern Italy and to provide data on the COVID-19 epidemic and the burden of asymptomatic subjects.

A retrospective cohort study was set up in all healthcare facilities of the province (12 hospitals and 13 sanitary districts primary, secondary and tertiary centres) with the aim to analyse the results of NS performed on all subjects suspected to be infected with SARS-CoV-2, either because they presented symptoms suggestive of SARS-CoV-2 infection, they were 'contacts' of positive subjects, they came from areas with high prevalence or they were healthcare workers. NS were performedh to limit the spread of the epidemic.

In a large area in Southern Italy, 3.14% (638 of 20 325) of the total subjects tested were positive for SARS-CoV-2. Most of them were asymptomatic (470 of 624, 75.3%), and of these 91% (428 of 470) were 'close contacts' of symptomatic subjects. The combination of social distancing together with the systematic screening of close contacts of COVID-19-positive symptomatic subjects seems to be an efficacious approach to limit the spread of the epidemic.

Sleep disruption occurs frequently in hospitalised patients. Given the potential of music intervention as a non-pharmacological measure to improve sleep quality, we aimed to assess and quantify current literature on the effect of recorded music interventions on sleep quality and quantity in the adult critical care and surgical populations.

Systematic review and meta-analysis.

Embase, MEDLINE Ovid, Cochrane Central, Web of Science and Google Scholar.

Randomised controlled trials assessing the effect of music on sleep quality in critically ill and surgical patients.

The electronic databases were systematically searched from 1 January 1981 to 27 January 2020. Data were screened, extracted and appraised by two independent reviewers. Primary outcomes were sleep quality and quantity, assessed with validated tools. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Random effects meta-analysis was performed, and pooled standardised mean differences (SMDs) with RD42020167783.

To investigate current patterns of work-related injuries sustained by foreign workers in Singapore and compare them to a decade ago. Secondary aim to analyse usefulness of selected trauma scores in this context.

Retrospective review of trauma registry of a single centre, from 1 April to 30 June 2015. Data compared with those from similar study performed at same centre in 2004.

Emergency department (ED) of 1500-bedded acute urban public hospital in Singapore.

1094 foreign workers with work-related injuries were included. Tourists, foreign students, non-work-related injuries, re-attendances for the same condition were excluded.

Mean age of participants was 32.8 years (SD 7.8), 90.0% were men. ED attendance was lowest on Sundays. Mechanism of injury blunt (78.2%), penetrating (19.2%), burns (2.6%). Compared to 2004, 5% of foreign workers required admission (vs 19.6% in 2004, p≤0.0001), 8.0% underwent day or inpatient surgical procedures (vs 13.2% in 2004, p≤0.0001), 41.6% were referred to specialist outpatient clinics (vs 27.6% in 2004, p≤0.0001), 12.5% were referred to primary care follow-up (vs 29.9% in 2004, p≤0.0001). Mean duration of sick days was 4.3 (vs 5.1 in 2004, p≤0.0001). Of admitted patients, 49.1% had extremity injuries and 36.3% had head and neck injuries. Mean Injury Severity Score (ISS) for admitted patients was 3.64 (SD 3.1) (vs 4.3 (SD 5.5) in 2004, p=0.39). Mean Revised Trauma Score (RTS) for admitted patients was 7.74 (SD 0.39) (vs 7.8 (SD 0.2) in 2004, p=0.07). Rapamycin concentration Of discharged patients, 48.9% had extremity injuries and 48.9% had external injuries. There was no death.

Compared to 2004, there were fewer major/fatal work-related injuries and an increased proportion of minor injuries. ISS and RTSs were of limited use in this setting.

Compared to 2004, there were fewer major/fatal work-related injuries and an increased proportion of minor injuries. ISS and RTSs were of limited use in this setting.

The aim of this study was to determine the effect of treatment in geriatric fracture centres (GFC) on the incidence of major adverse events (MAEs) in patients with hip fractures compared with usual care centres (UCC). Secondary objectives included hospital-workflow and mobility-related outcomes.

Cohort study recruiting patients between June 2015 and January 2017. Follow-up was 1 year.

International (six countries, three continents) multicentre study.

281 patients aged ≥70 with operatively treated proximal femur fractures.

Treatment in UCCs (n=139) or GFCs (n=142), that is, interdisciplinary treatment including regular geriatric consultation and daily physiotherapy.

Primary outcome was occurrence of prespecified MAEs, including delirium. Secondary outcomes included any other adverse events, time to surgery, time in acute ward, 1-year mortality, mobility, and quality of life.

Patients treated in GFCs (n=142) had a mean age of 81.9 (SD, 6.6) years versus 83.9 (SD 6.9) years in patients (n=139) treated in UCCs (p=0.013) and a higher mean Charlson Comorbidity Index of 2.0 (SD, 2.1) versus 1.2 (SD, 1.5) in UCCs (p=0.001). More patients in GFCs (28.2%) experienced an MAE during the first year after surgery compared with UCCs (7.9%) with an OR of 4.56 (95% CI 2.23 to 9.34, p<0.001). Analysing individual MAEs, this was significant for pneumonia (GFC 9.2%; UCC 2.9%; OR, 3.40 (95% CI 1.08 to 10.70), p=0.027) and delirium (GFC 11.3%; UCC 2.2%, OR, 5.76 (95% CI 1.64 to 20.23), p=0.002).

Contrary to our study hypothesis, the rate of MAEs was higher in GFCs than in UCCs. Delirium was revealed as a main contributor. Most likely, this was based on improved detection rather than a truly elevated incidence, which we interpret as positive effect of geriatric comanagement.

ClinicalTrials.gov NCT02297581.

ClinicalTrials.gov NCT02297581.