Academic literature on the topic 'Complications [Subheading]'

A review of: Golder, Su, Heather M. McIntosh, Steve Duffy, and Julie Glanville. “Developing Efficient Search Strategies to Identify Reports of Adverse Effects in MEDLINE and EMBASE.” Health Information & Libraries Journal 23.1 (Mar. 2006): 3-12. Objective – To assess the sensitivity and precision of various search strategies for retrieving adverse effects studies from the MEDLINE and EMBASE databases. Design – Analytical survey. Subjects – A case study using a recently published systematic review of the effectiveness and adverse effects of seven new anti-epileptic drugs. Setting – MEDLINE and EMBASE searches performed by researchers at the Centre for Reviews and Dissemination and the UK Cochrane Centre Search Filters Design Group at the University of York, UK. Methods – Five key approaches to searching were defined. The first approach used either text words or controlled vocabulary to search for specific adverse effects. The second used subheadings or qualifiers either attached to drug names found in the controlled vocabulary (approach 2a) or ‘floating’ without drug names (approach 2b). The third approach used text words as synonyms for the phrase ‘adverse effects.’ The fourth used controlled indexing terms for adverse effects. The fifth and final approach used two published search strategies incorporating study design (Badgett et al., Loke et al.). These five approaches were used to search for studies of the adverse effects of seven new anti-epileptic drugs. 5,011 unique papers were retrieved. Of these, 236 were judged potentially relevant and 225 full text articles were obtained. The inclusion criteria from a previously published systematic review (Wilby et al.) were applied to the papers, and 79 met the criteria. Five papers were added to the set after being identified from reference lists, clinical experts, and other sources. This new set of 84 studies was used as a quasi gold standard (QGS) against which more than 300 combinations of the five approaches could be tested. To create the set of possible approaches, the researchers combined search strategies one through four in all possible ways, and used all available subheading combinations from 2a and 2b. The Badgett and Loke searches were tested separately. Main Results – Sensitivity and precision were determined for each combination. Formulas used to calculate sensitivity and precision were provided. In MEDLINE, search strategies using floating subheadings achieved the highest sensitivity. The most useful single subheading in both MEDLINE and EMBASE was “adverse effects,” with 79.1% and 79.5% sensitivity respectively. Of the more than 300 combinations tested, the most sensitive combination in MEDLINE included specified adverse effects in combination with the floating subheadings “adverse effects,” “complications,” and “drug effects,” together with text words for adverse effects. This strategy had 97.0% sensitivity, but low precision at 2.8%. The highest precision was achieved by using subheadings attached to drug indexing terms. In EMBASE, the strategy of Loke et al. provided the highest sensitivity at 86.3% and precision of 2.0%. Since researchers are not likely to know in advance all of the reported adverse effects of a particular drug therapy, the most sensitive strategies without specific adverse events were also identified. The search with the highest sensitivity in MEDLINE had 95.5% sensitivity, and 97.3% sensitivity in EMBASE. Conclusion – Searching for adverse effects requires a combination of approaches in both MEDLINE and EMBASE. In MEDLINE, the most sensitive combination yielded 97.0% sensitivity. Regardless of the approach used, precision remains low. An effective generic search filter for adverse effects searches may not yet be feasible. More research is needed on search strategies, as well as more consistent methods of reporting and indexing adverse effects.

OBJECTIVE: To review the pharmacology and pharmacokinetics of intravenous, oral and intraocular ganciclovir, and to discuss the role of these various formulations in the management of cytomegalovirus (CMV) retinitis in AIDS patients.DATA SOURCES: A MEDLINE search (1987 through November 1995) of English-language literature using the main medical subject headings ‘ganciclovir’ and ‘cytomegalovirus’, and the subheading ‘acquired immunodeficiency syndrome’. Relevant articles were also selected from references of identified articles. Abstracts from recent medical conferences of infectious diseases, pharmacology and human immunodeficiency virus were screened for additional data.STUDY SELECTION AND DATA EXTRACTION: All articles and abstracts discussing the use of ganciclovir for the management or prophylaxis of CMV retinitis in AIDS patients were considered for inclusion. Pertinent information, as judged by the authors, was selected and synthesized for discussion.DATA SYNTHESIS: Ganciclovir has demonstrated virustatic activity against CMV, and is often administered 5 mg/kg intravenously every 12 h as first-line therapy for CMV retinitis. Intravenous maintenance therapy at 5 mg/kg daily is usually effective at delaying retinitis progression for approximately 60 to 70 days. Neutropenia and thrombocytopenia are observed frequently, often necessitating interruption or discontinuation of therapy. Local drug administration may delay disease progression even further, and may be considered for patients who are intolerant to or failing intravenous therapy. However, systemic ganciclovir should be encouraged to reduce the risk of developing contralateral eye or end-organ CMV disease. Oral ganciclovir at 1 g tid is almost as effective as intravenous ganciclovir 5 mg/kg/day in delaying retinitis progression and is associated with fewer line-related complications. Absorption, drug interactions, cost and compliance should also be considered.CONCLUSIONS: Until recently, ganciclovir was available only for intravenous use. Recent developments allow for intraocular and oral administration of this agent. A clear understanding of the advantages and disadvantages of these new formulations is required in order to select the most appropriate product for managing CMV retinitis in AIDS patients.

Study Design: Review article. Objectives: A review of literature on the epidemiology, diagnosis, and management of spinal tuberculosis (TB). Methods: A systematic computerized literature search was performed using Cochrane Database of Systematic Reviews, EMBASE, and PubMed. Studies published over the past 10 years were analyzed. The searches were performed using Medical Subject Headings terms, and the subheadings used were “spinal tuberculosis,” “diagnosis,” “epidemiology,” “etiology,” “management,” “surgery,” and “therapy.” Results: Tissue diagnosis remains the only foolproof investigation to confirm diagnosis. Magnetic resonance imaging and Gene Xpert help in early detection and treatment of spinal TB. Uncomplicated spinal TB has good response to appropriately dosed multimodal ambulant chemotherapy. Surgery is warranted only in cases of neurological complications, incapacitating deformity, and instability. Conclusions: The incidence of atypical clinicoradiological presentations of spinal TB is on the rise. Improper dosing, inadequate duration of treatment, and inappropriate selection of candidates for chemotherapy has not only resulted in the resurgence of TB but also led to the most dreadful consequence of multidrug resistant strains. In addition, global migration phenomenon has resulted in worldwide spread of spinal TB. The current consensus is to diagnose and treat spinal TB early, prevent complications, promote early mobilization, and restore the patient to his or her earlier functional status.

These guidelines on transjugular intrahepatic portosystemic stent-shunt (TIPSS) in the management of portal hypertension have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the Liver Section of the BSG. The guidelines are new and have been produced in collaboration with the British Society of Interventional Radiology (BSIR) and British Association of the Study of the Liver (BASL). The guidelines development group comprises elected members of the BSG Liver Section, representation from BASL, a nursing representative and two patient representatives. The quality of evidence and grading of recommendations was appraised using the GRADE system. These guidelines are aimed at healthcare professionals considering referring a patient for a TIPSS. They comprise the following subheadings: indications; patient selection; procedural details; complications; and research agenda. They are not designed to address: the management of the underlying liver disease; the role of TIPSS in children; or complex technical and procedural aspects of TIPSS.

Background. Diabetic nephropathy (DN) is one of the most common microvascular complications of diabetes mellitus (DM), but no bibliometric studies pertaining to DN have been published within the last 5 years. Objectives. Most prior studies have focused on specific problems in the DN field. This study attempts to sort out and visualize the knowledge framework in this research space from a holistic and highly generalized perspective. Readers can quickly understand and master the knowledge regarding DN research conducted from 2016 to 2020, in addition to predicting future research hotspots and possible directions for development in this field in a comprehensive and scientifically valid manner. Methods. Literature information, discourse matrices, and co-occurrence matrices were generated using BICOMB. gCLUTO was used for biclustering analyses and visualization. Strategic diagrams were generated using GraphPad Prism 5. The social network analysis (SNA) was analyzed and plotted using Ucinet 6.0 and Netdraw. Results. In total, 55 high-frequency MeSH terms/MeSH subheadings were selected and grouped into 5 clusters in a biclustering analysis. These analyses revealed that extensive studies of the etiology, diagnosis, and treatment of DN have been conducted over the last 5 years, while further research regarding DN-related single nucleotide polymorphisms, miRNAs, and signal transduction are warranted as these research areas remain relatively immature. Conclusion. Together, these results outline a robust knowledge structure pertaining to the field of DN-related research over the last 5 years, providing a valuable resource for readers by enabling the easy comprehension of relevant information. In addition, this analysis highlights predicted DN-related research directions and hotspots.

Aim of the study: The aim of our review is to indicate and discuss the impact of cardiovascular risk factors, such as obesity, diabetes, lipid profile, hypertension and smoking on the course and mortality of COVID-19 infection. Background: The coronavirus disease 2019 (COVID-19) pandemic is spreading around the world and becoming a major public health crisis. All coronaviruses are known to affect the cardiovascular system. There is a strong correlation between cardiovascular risk factors and severe clinical complications, including death in COVID-19 patients. All the above-mentioned risk factors are widespread and constitute a significant worldwide health problem. Some of them are modifiable and the awareness of their connection with the COVID-19 progress may have a crucial impact on the current and possible upcoming infection. Data collection: We searched for research papers describing the impact of selected cardiovascular risk factors on the course, severity, complications and mortality of COVID-19 infection form PubMed and Google Scholar databases. Using terms, for example: “COVID-19 cardiovascular disease mortality”, “COVID-19 hypertension/diabetes mellitus/obesity/dyslipidemia”, “cardiovascular risk factors COVID-19 mortality” and other related terms listed in each subtitle. The publications were selected according to the time of their publications between January 2020 and December 2021. From the PubMed database we obtain 1552 results. Further studies were sought by manually searching reference lists of the relevant articles. Relevant articles were selected based on their title, abstract or full text. Articles were excluded if they were clearly related to another subject matter or were not published in English. The types of articles are mainly randomized controlled trial and systematic review. An additional criterion used by researchers was co-morbidities and age of patients in study groups. From a review of the publications, 105 of them were selected for this work with all subheadings included. Findings and Results: The intention of this review was to summarize current knowledge about comorbidities and development of COVID-19 infection. We tried to focus on the course and mortality of the abovementioned virus disease in patients with concomitant CV risk factors. Unfortunately, we were unable to assess the quality of data in screened papers and studies we choose because of the heterogenicity of the groups. The conducted studies had different endpoints and included different groups of patients in terms of nationality, age, race and clinical status. We decide to divide the main subjects of the research into separately described subtitles such as obesity, lipid profile, hypertension, diabetes, smoking. We believe that the studies we included and gathered are very interesting and show modern and present-day clinical data and approaches to COVID-19 infection in specific divisions of patients.

Objective: To review rifabutin-associated uveitis and discuss the mechanism and potential role of drug interactions with clarithromycin and fluconazole in contributing to this adverse event. Data Sources: A MEDLINE search (1991 through September 1994) of English-language literature using the main MeSH headings “rifabutin” and “uveitis” and the subheadings “adverse effects” and “chemically induced.” Relevant articles also were selected from references of identified articles. Abstracts from recent medical conferences of infectious diseases, pharmacology, and HIV were screened for additional data. Study Selection and Data Extraction: All articles and abstracts reporting uveitis potentially related to rifabutin were considered for inclusion. Fifty-four cases were identified. Pertinent information from the case reports, as judged by the authors, was selected and synthesized for discussion. Data Synthesis: Rifabutin is being prescribed increasingly for the treatment and prophylaxis of Mycobacterium avium complex (MAC) infection in the HIV-infected population. Uveitis was initially thought to be a rare, dose-limited complication of rifabutin therapy. In an early dose-ranging tolerance study, uveitis was associated with daily doses of 1200 mg or more. Because this toxicity appeared to be dose-related, lower dosages (300–600 mg/d) of rifabutin were selected for study in subsequent clinical trials. More recent reports noting the association of uveitis with these lower dosages of rifabutin have raised concerns about the prevalence of this adverse event. In the 54 identified cases, patients presented with symptoms of unilateral or bilateral uveitis from 2 weeks to more than 7 months following initiation of rifabutin therapy. In all reported cases, patients were receiving concurrent therapy with clarithromycin and/or fluconazole, both of which have inhibitory effects on rifabutin metabolism. In most cases, uveitis resolved within 1–2 months following discontinuation of rifabutin with or without administration of topical corticosteroids. Conclusions: Rifabutin is prescribed frequently for the prophylaxis and treatment of MAC infection, especially in patients with HIV. Uveitis is a rare, dose-related toxicity of this therapy. The risk of rifabutin-associated uveitis may be increased in patients receiving concurrent therapy with clarithromycin or fluconazole because of drug interactions. Patients receiving therapy with combinations of any of these agents should be warned about signs and symptoms of uveitis and be monitored closely for the development of rifabutin toxicity. If uveitis develops, rifabutin therapy should be discontinued promptly.

Background. In modern musicology, the issues of composer creativity for children are far from enough covered. This applies to both Ukrainian and foreign musicological literature. Aesthetic issues prevail in studies of children’s piano music, while the issues of composer and performing techniques related to the interpretation of such works become the object of study only occasionally. Still there aren’t special works devoted to piano music for children of Kharkiv authors, and information about this music is dispersed in publications of review or monographic plan, for example, such as the brochure by K. Heivandova (1981) about M. Karminskyi. This article proposes the consideration of the cycle (triptych) of children’s piano miniatures by Mark Karminskyi as a representative of the Kharkiv school from the point of view of the unity of composer and performing aspects and the specifics of their connection. The purpose of the article is to identify the features of embodiment the genre of children’s piano miniature in M. Karminskyi’s composer interpretation using the example of “Three Pieces in C Major”. The main objective of the study is to consider the genre stylistics of the pieces, reflected through the means of thematism, texture and harmony. In a methodological aspect, the article contains elements of a new scientific approach to the study of texture-harmonic complex as the main indicator of the style of children’s piano music, including in the aforementioned work of M. Karminskyi. From a practical point of view, the study can be of help to performers who turn both to the triptych of M. Karminskyi and to other works in the genre of children’s piano miniatures. The results of the study. Piano miniatures, including children’s ones, obey the laws of poetics of this genre, in which, according to E. Nazaikinskyi (2003), the principle of reflection of “big in small” is the main one. Among the other features of this genre, as the main one, we single out the desire of miniatures to unite into groups, cycles of a special kind in which the principle of “identity of the modus and the genre” operates (E. Nazaikinskyi, 2003, p. 372). This means the music pieces of same type follow each other without highlighting any special functions in the form-making. In children’s piano miniatures, such a grouping is normative. However, they also have their own specifics: the contrast, based on which any musical cycle is built, should be combined with the same type of pieces by genre signs and the presence of certain connecting moments, except for a common genre name. For example, the designation “Pieces” typical for cycles of children’s miniatures may have program subheadings aimed at deciphering the emotional and figurative content, which is especially important for children’s perception. In the cycle “Three Pieces in C Major” by M. Karminsky, almost all typical signs of children’s piano miniatures are presented. As a master, in whose work the theme of childhood and youth was one of the leading ones, M. Karminskyi worked intensively in the genres corresponding to her. These were songs and song collections, as well as three children’s piano cycles – the programmatic “Children’s Album”, “Three Pieces in C Major” (discussed here), as well as the cycle “27 plays in a triple meter”. In constructing a cycle of three plays, united by the key in C Major, the figurative and emotional content of each of the numbers is the main thing for the composer. The pieces have programmatic names: No. 1 – “Carelessness”; No. 2 – “Playfulness”; No. 3 –“Fervor”. These names actually correspond to the three main modes-states that are characteristic of the children’s psyche and behavioral reactions. Their reflection in the thematic complex, texture and form of each of the plays puts before the composer the task of harmonizing imagery with the writing technique. It seems that the method of realizing this task for M. Karminskyi is, first of all, the texture in its close connection with harmony – “texture-harmonic complex” (G. Ignatchenko, 1984). The textural-harmonic formulas used by the composer in each of the triptych’s numbers reflect not only their emotional and figurative content, but also belong to various “stylistic inclinations” (according to E. Nazaikinsky, 2003) that are accessible to children’s perception. First, this refers to the unifying moment – the key of C Major, which is presented differently in each of the plays, and these differences are directed towards complication. The same can be said about the texture, as well as the form of the parts of the triptych. With the external similarity and even the same type of compositional solutions (the basis of all the plays is a three-part model of the ABA type, but with different intonation content), individual numbers, as well as sections within them, differ in the features of textured techniques. This is connected, not least, with didactic tasks set by the author that gradually becoming more complicated. The composer sequentially acquaints young pianists with the features of the piano texture, using and combining elements of traditional homophony, various types of sub-voice polyphonic writing, contrasting and imitation polyphonic combinations. Such, at first glance, the “kaleidoscope” texture is ordered, however, by the criterion of ease of performing, which the author takes care of, even taking into account the peculiarities of children’s stretching of fingers in verticals: intervals and chords. Conclusions. The analysis of the plays of the cycle presented in the article proves that it is an original work intended, on the one hand, for performance by young pianists; on the other hand, M. Karminskyi’s triptych reflects the general tendencies of “adult” pianism in the genre of piano miniatures and the cycle of miniatures. According to the style of “Three Pieces in C Major”, they belong to the neoclassical trend, as evidenced by a complex of expressive means: tonality, harmony, texture, and performing attributes – dynamics, articulation, agogics. M. Karminskyi interprets C Major as the “starting point” of various modal and tonal transformations, from the major-minor variable modus in the first play to showing the twelve-tones version of this tonality in the finale piece. There is a similar tendency in the field of texture in the cycle: from stylization of “minuet” homophony in the first piece to polyphony on the constant bass in the second and “stratum” polyphonicity in the finale. The composer acquaints young musicians with the texture and harmony means of piano music from different eras, which makes this cycle a peculiar short textbook of pianistic formulas in their artisticfigurative embodiment. Prospects for further research on this topic lie in the coverage of a largerscale material relating to children’s piano music, not only M. Karminskyi, but also other composers of the Kharkiv school. We can also add the performing aspect: after all, children’s piano music is always updated in interpretations, often with an eye to a concrete performer or performers.

The purpose of this study was to evaluate the international scientific output on postpartum depression (PPD) research during 2000–2020 through a bibliometric analysis and to explore research hotspots, frontiers, and trends in the field of postpartum depression. We searched the Web of Science Core Collection for publications on postpartum depression published between 2000 and 2020. CiteSpace, gCluto, and other software applications were used to analyze the data by year, journal, and country. A total of 2,963 publications were retrieved and 96 countries or regions published related papers. The United States had the largest number of published papers and the highest betweenness centrality, which is the dominant position in the field of postpartum depression. A total of 717 journals published papers, with the Archives of Womens Mental Health ranked first in terms of volume and betweenness centrality. In this study, 31 high-frequency main MeSH terms/subheadings were selected. The high-frequency MeSH terms were clustered into six categories: an overview of depression-related research, diagnostic and screening scales for postpartum depression, epidemiological investigation into postpartum depression, treatment and drug selection for postpartum depression, psychological research on postpartum depression, and etiology, physiopathology, complications, genetics of postpartum depression. Finally, we used strategic diagram to analyze research trends in postpartum depression. This study has identified a continuous significant increase in the publication of PPD articles. Currently, the etiology, physiological pathology, intervention and treatment of complications on PPD are immature, which provides reference for the trend of obstetric psychology.

: Epidermolysis bullosa (EB) is a group of rare congenital genetic conditions that result in painful blistering of the skin and mucous membranes which occur with minor trauma or friction. There are many types and subtypes of EB that need to be distinguished, as the management and prognosis of each can vary significantly. We aim to perform an up-to-date literature review on congenital EB for healthcare providers in pediatrics. We performed a review of existing literature in the English language on EB via PubMed Clinical Queries, using keywords such as “epidermolysis bullosa”, “congenital” and “children”. We reviewed EB based on the following subheadings: epidemiology, diagnosis, therapy, prognosis, and clinical prediction guidelines. EB is due to mutation in a number of genes, and some types are autosomal dominant while others are autosomal recessive. The underlying mechanism is a defect in attachment between or within the epidermis and dermis of the skin. There are four main types: epidermolysis bullosa simplex, dystrophic epidermolysis bullosa, junctional epidermolysis bullosa, and Kindler syndrome. The diagnosis is suspected based on symptoms and confirmed by skin biopsy and definitive genetic testing. Severity of EB can range from mild to fatal. Severe complications may arise in some EB types and subtypes within the eye, ear, nose, upper airway, gastrointestinal and genitourinary tracts. There is no cure for the condition to date. Optimal management must be multidisciplinary and involves wound care, pain control, controlling infections, nutritional support, and prevention and treatment of complications. EB is present in different forms. Treatment is supportive. The prognosis of milder forms is good. Children severely affected with EB and their families live a miserable life with impaired quality of life. Health care workers must be aware of the suffering in these families and be proactively support them.