38 research outputs found

    Prognostic models in COVID-19 infection that predict severity: a systematic review.

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    Current evidence on COVID-19 prognostic models is inconsistent and clinical applicability remains controversial. We performed a systematic review to summarize and critically appraise the available studies that have developed, assessed and/or validated prognostic models of COVID-19 predicting health outcomes. We searched six bibliographic databases to identify published articles that investigated univariable and multivariable prognostic models predicting adverse outcomes in adult COVID-19 patients, including intensive care unit (ICU) admission, intubation, high-flow nasal therapy (HFNT), extracorporeal membrane oxygenation (ECMO) and mortality. We identified and assessed 314 eligible articles from more than 40 countries, with 152 of these studies presenting mortality, 66 progression to severe or critical illness, 35 mortality and ICU admission combined, 17 ICU admission only, while the remaining 44 studies reported prediction models for mechanical ventilation (MV) or a combination of multiple outcomes. The sample size of included studies varied from 11 to 7,704,171 participants, with a mean age ranging from 18 to 93 years. There were 353 prognostic models investigated, with area under the curve (AUC) ranging from 0.44 to 0.99. A great proportion of studies (61.5%, 193 out of 314) performed internal or external validation or replication. In 312 (99.4%) studies, prognostic models were reported to be at high risk of bias due to uncertainties and challenges surrounding methodological rigor, sampling, handling of missing data, failure to deal with overfitting and heterogeneous definitions of COVID-19 and severity outcomes. While several clinical prognostic models for COVID-19 have been described in the literature, they are limited in generalizability and/or applicability due to deficiencies in addressing fundamental statistical and methodological concerns. Future large, multi-centric and well-designed prognostic prospective studies are needed to clarify remaining uncertainties

    A preliminary investigation on the estimation of the sustained-release of indomethacin from agar beads part I

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    In this study agar beads containing indomethacin were prepared at different polymer-drug ratios. It was found that the release rate of indomethacin from agar beads was inversely related to the drug content. Lactose was added to the formulations in order to investigate its effect on the release of indomethacin from agar beads. Lactose increased the release rate of indomethacin and in vitro release studies exhibited a ?t dependence indicating a diffusion controlled process from a matrix formulation. All of the prepared formulations gave prolonged release. The release profiles of the formulations were compared with Indocid-R available in the market. The release criteria of all the formulations and Indocid-R were examined according to USP criteria given for indomethacin and general release criteria. At the end of the study, the obtained data were evaluated mathematically. Two equations to be used in the preparation of agar-indomethacin beads with or without lactose for optimum formulation were estimated. It was found that the estimated equations were in good agreement with the observed release results. In addition, in this study the in vivo distribution of agar beads prepared with barium sulfate as a contrast substance in the gastro-intestinal tract was also examined

    Thermoanalytical studies on complexes of ketoconazole with cyclodextrin derivatives

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    The effect of sodium lauryl sulfate on the release of indomethacin from agar beads

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    In this study, agar beads containing indomethacin were prepared at 1:1 polymer-drug ratio and the release of the drug was investigated. Sodium lauryl sulfate was added to the formulation at different ratios. All the prepared formulations gave prolonged release. It was observed that sodium lauryl sulfate increased the release of drug considerably. In vitro release studies exhibited a ?t dependence indicating a diffusion controlled process from the matrix formulation. A desired release profile was obtained by adding sodium lauryl sulfate to the formulations

    Thermoanalytical studies on complexes of clotrimazole with cyclodextrins

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    ?-Cyclodextrin and dimethyl-ß-cyclodextrin were used as solubilizing agents for a very poorly water-soluble drug, an imidazole derivative antifungal agent, clotrimazole; with the aim of improving the physicochemical properties of the drug. Solid products were prepared by physical mixing, kneading, precipitation and spray-drying methods in 1:1 and 1:2 drug:cxyclodextrin molar ratios. Drug interactions were studied by thermoanalytical methods such as DSC, DTA, TG and DTG, X-ray diffractometry and Fourier transformation-infrared spectroscopy. The results demonstrated the formation of inclusion complexes in some products.Hungarian Scientific Research Fund: T 026579 T 03250/99This study was supported by the Hungarian National Science Fund (OTKA) (Project number: T 026579) and by the Health Science Council (Project number: T 03250/99). The authors would like to thank Dr. Cs. Novak for his kind contribution. -

    Automation tools to support undertaking scoping reviews

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    Objective This paper describes several automation tools and software that can be considered during evidence synthesis projects and provides guidance for their integration in the conduct of scoping reviews.Study design and setting The guidance presented in this work is adapted from the results of a scoping review and consultations with the JBI Scoping Review Methodology group. Results This paper describes several reliable, validated automation tools and software that can be used to enhance the conduct of scoping reviews. Developments in the automation of systematic reviews, and more recently scoping reviews, are continuously evolving. We detail several helpful tools in order of the key steps recommended by the JBI’s methodological guidance for undertaking scoping reviews including team establishment, protocol development, searching, de-duplication, screening titles and abstracts, data extraction, data charting, and report writing. While we include several reliable tools and software that can be used for the automation of scoping reviews, there are some limitations to the tools mentioned. For example, some are available in English only and their lack of integration with other tools results in limited interoperability.Conclusion This paper highlighted several useful automation tools and software programs to use in undertaking each step of a scoping review. This guidance has the potential to inform collaborative efforts aiming at the development of evidence informed, integrated automation tools and software packages for enhancing the conduct of high-quality scoping reviews
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