Intravenous corticosteroid treatment in adult patients with sepsis defined by the Sepsis-3 criteria: a systematic review and meta-analysis

Objectives To summarize the effects of intravenous corticosteroid treatment for sepsis defined by the Sepsis-3 criteria in adult patients. Design Systematic review and meta-analysis. Methods We searched RCTs from PubMed, Embase, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, Web of Science, and International Clinical Trials Registry Platform from inception to July 12th, 2019 and updated on June 28th, 2020. Conference proceedings from relevant societies and the reference lists of previous reviews were manually screened. Abstract or full-text articles were screened by two independent investigators. We included RCTs where (1) the participants had infections and the baseline Sequential Organ Failure Assessment (SOFA) score ≥ 2 (the Sepsis-3 definitions) (2) the intervention involved any intravenous corticosteroids; (3) the control group received placebo or standard of care (4) the outcomes of interest included mortality or clinical recovery. We chose the 28-day mortality as the pre-specified primary outcome and risk ratio (RR) as the effect measure. We followed PRISMA guidelines and chose random-effects models for the pooled analyses. Results This study included 24 RCTs and 19 of them (7,115 participants) reported the 28-day mortality. Pooled analyses showed that intravenous corticosteroid treatment compared to placebo or standard of care was not associated with a lower risk of 28-day mortality (RR, 0.88; 95%CI, 0.73 to 1.05), but with a higher risk of hyperglycemia (RR, 1.16; 95%CI, 1.06 to 1.27). Sensitivity analysis of high-quality studies revealed a similar result for the 28-day mortality (RR, 0.95; 95%CI, 0.86 to 1.05). Conclusions Our findings suggested that intravenous corticosteroids compared to placebo or standard of care may not reduce the 28-day mortality in adult patients with sepsis defined by the Sepsis-3 criteria. Further studies are warranted to clarify the roles of disease severity and treatment timing in the effects of corticosteroid treatment in this population. PROSPERO registration number CRD4201914308

Factors that contribute to faecal cyclooxygenase-2 mRNA expression in subjects with colorectal cancer

浜松医科大学学位論文　医博第600号（平成23年3月16日

A Direct Method for β-Selective Glycosylation with an N-Acetylglucosamine Donor Armed by a 4-O-TBDMS Protecting Group

A new direct method for β-selective glycosylation with an N-acetylglucosamine (GlcNAc) donor was developed. This substrate, which can be readily prepared from commercially available GlcNAc in two steps, contains a 4-O-tert-butyldimethylsilyl (TBDMS) protecting group as a key component. We found that this functionality could have a favorable effect on the reactivity of the GlcNAc donor. Glycosylation with the armed donor using primary alcohols in the presence of a catalytic amount of trimethylsilyl trifluoromethanesulfonate (TMSOTf) in 1,2-dichloroethane smoothly gave the desired coupling products in good yields with complete β-selectivity, while sterically hindered acceptors were less efficient

Giant converse magnetoelectric effect in a multiferroic heterostructure with polycrystalline Co2FeSi

To overcome a bottleneck in spintronic applications such as those of ultralow-power magnetoresistive random-access memory devices, the electric-field control of magnetization vectors in ferromagnetic electrodes has shown much promise. Here, we show the giant converse magnetoelectric (CME) effect in a multiferroic heterostructure consisting of the ferromagnetic Heusler alloy Co2FeSi and ferroelectric-oxide Pb(Mg1/3Nb2/3)O3-PbTiO3 (PMN-PT) for electric-field control of magnetization vectors. Using an in-plane uniaxial magnetic anisotropy of polycrystalline Co2FeSi film grown on PMN-PT(011), the nonvolatile and repeatable magnetization vector switchings in remanent states are demonstrated. The CME coupling coefficient of the polycrystalline Co2FeSi/PMN-PT(011) is over 1.0 × 10−5s/m at room temperature, comparable to those of single-crystalline Fe1-xGax/PMN-PT systems. The giant CME effect has been demonstrated by the strain-induced variation in the magnetic anisotropy energy of Co2FeSi with an L21-ordered structure. This approach can lead to a new solution to the reduction in the write power in spintronic memory architectures at room temperature