Median Recovery Time Research Articles

Randomized double-blind placebo-controlled trial of Jingfang Granules in treatment of common cold(wind-cold syndrome)

Jingfang Granules have the effects of inducing sweating to releasing exterior, dispersing wind and dispelling dampness. Modern studies have demonstrated that it has antipyretic and antiviral activities. Therefore, this trial was conducted to evaluate the efficacy and safety of Jingfang Granules in the treatment of common cold(wind-cold syndrome). A total of 138 common cold(wind-cold syndrome) patients meeting the inclusion and exclusion criteria were randomly assigned into the experimental group(n=92) and the placebo group(n=46) at a ratio of 2∶1 and respectively received Jingfang Granules and Jingfang Granules simulation agent. The treatment lasted for 5 d, and the follow-up time was 8 d. Recovery time was employed as the main indicator of efficacy. The median reco-very time of the experimental group was 3.33 d, shorter than that 7.00 d of the placebo group. The efficacy of the experimental group was better than that of the placebo group(P<0.000 1). The major symptom severity score-time AUC of the experimental group was 489.90±206.95, which was smaller than that of the placebo group(763.50±339.53). The recovery rate and marked effective rate of the experimental group were higher than those of the placebo group, The above outcomes were statistically significant between the two groups(P<0.05). The disappearance time and rate of single symptoms including aversion to cold, nasal congestion, runny nose, cough, headache, pharyngeal itching/pain, white sputum, and somatalgia also had significant differences between the two groups(P<0.05), indicating that Jingfang Granules had good performance in alleviating the above symptoms. During the study period, one case of the experimental group had a slight increase in serum creatinine, which returned to the normal level after re-examination. The incidence of adverse reactions was 1.10%, and no serious adverse reaction was found. The two groups had no significant difference in the incidence of adverse reactions. In conclusion, Jingfang Granules can significantly shorten the course of common cold(wind-cold syndrome) and quickly alleviate the clinical symptoms, demonstrating good safety and clinical advantages.

Design of a novel smartphone-based photostress recovery time test for detecting abnormalities in the macula. A cross-sectional study

BackgroundThe study aims to present a new smartphone-based photostress recovery time test (K-PSRT test) that measures the stimulus-specific loss of visual sensitivity, as well as the differentiation between normal from abnormal macular function. This novel test defines a new standardized photostress application as an alternative tool for incorporation into clinical practice. Materials and methodsA total of 48 visually impaired eyes and 47 normal sighted age-matched controls eyes were enrolled in the study. The median age in subjects with impairment was 71.0 years, while the median age in normal subjects was 70.0 years. A light produced by the smartphone camera at approximately 5 cm distance, perpendicular to the eye up 10 s filled the pupil. The photostress recovery time was assessed immediately after the exposure by asking the subjects to read correctly at least three successive letters of size corresponding to the previous line of the BCVA line at a distance of 40 cm. The digital photostress testing was performed with the best-corrected visual acuity (BCVA). The patients were examined twice within 2 weeks. Correlations among the recovery times, the visual acuity, and the contrast sensitivity function as well as correlations concerning each specific ocular disease were also performed. Furthermore, correlations among technology, usability, and ease of performance in both groups were analyzed. ResultsThe initial median photostress recovery time in patients with impaired eyes was 83.5 (68.5, 126.0), while in the normal individuals was 39.0 (14.0, 43.0). The median visual acuity in individuals with impairment was 0.59 logMAR (0.40, 0.90), whereas in the normal individuals was −0,06 logMAR. Test-retest reliability study was performed on 26 eyes (16 males, 10 females) for visually impaired eyes as well as on 35 normal eyes (19 males, 16 females). Concerning the reliability, the average Intraclass Correlation Coefficients (with 95% confidence intervals) ICC (95% CI) = 0,99 (0,98–1,00), indicating significant correlation between them (p < 0.01). The coefficient of repeatability for eye measurements reaches clinically acceptable levels, which is demonstrated with increased repeatability and consistency. The recovery time in patients with diabetic retinopathy was statistically significantly lower than in those with dry age-related macular degeneration (p = 0.027) and those with wet age-related macular degeneration (p = 0.032). The patient group has lower scores concerning technology, usability, and ease of performance compared to the normal. ConclusionsThis new testing modality (K-Photostress Recovery time test), is designed to be an easily implemented measurement in ophthalmic practice, and it can expand our understanding of macular function. The above findings support the usefulness of a novel reproducible photostress application as an indicator of macular pathology.

Adolescents with Sport-Related Concussion Who Adhere to Aerobic Exercise Prescriptions Recover Faster.

There is growing evidence that subsymptom threshold aerobic exercise speeds recovery from sport-related concussion (SRC). It is not known whether there is a direct relationship between adherence to a personalized exercise prescription and recovery or if initial symptom burden affects adherence to the prescription. This study was a planned secondary analysis of one arm of a randomized controlled trial. Male and female adolescent athletes (age 13-18 yr) presenting within 10 d of SRC were given aerobic exercise prescriptions based on their heart rate threshold at the point of exercise intolerance on a graded treadmill test. Adherence was determined objectively with HR monitors and compared against time to recovery. Participants who completed at least two-thirds of their aerobic exercise prescription were considered to be adherent. Sixty-one percent of adolescents met the adherence criterion. Those who were adherent were more symptomatic and were more exercise intolerant at their initial visit, yet they recovered faster than those who were not adherent (median recovery time, 12 (interquartile range, 9-22) d vs 21.5 (interquartile range, 13-29.8) d; P = 0.016). On linear regression, adherence during week 1 was inversely related to recovery time ( β = -0.002 (-0.003, 0.0), P = 0.046) and to initial exercise tolerance ( β = -0.886 (-1.385, -0.387), P < 0.001), but not to initial symptom severity ( β = 0.545 (-0.232, 1.323), P = 0.146). No adverse events or near misses were reported. Adherence to individualized subsymptom threshold aerobic exercise within the first week of evaluation is associated with faster recovery from SRC. The data suggest that initial degree of exercise intolerance, but not initial symptom severity, affects adherence to aerobic exercise prescribed to adolescents within 10 d of SRC.

Assessment of Factors Affecting Time to Recovery from COVID-19: A Retrospective Study in Ethiopia

Background. The average duration of recovery from COVID-19 and influencing factors, which would help inform optimal control strategies, remain unclear. Moreover, studies regarding this issue are limited in Ethiopia, and no region-wise studies were conducted. Hence, this study aimed to investigate the median recovery time from COVID-19, and its predictors among patients admitted to Amhara regional state COVID-19 treatment centers, Ethiopia. Methods. A facility-based retrospective follow-up study was conducted at Amhara regional state COVID-19 treatment centers from 13 March 2020 through 30 March 2021. Data were entered using EpiData version 3.1, and STATA version 14 was used for analysis. A Kaplan–Meier curve was used to estimate survival time, and the Cox regression model was fitted to identify independent predictors. P value with 95% CI for the hazard ratio was used for testing the significance at alpha 0.05. Results. Six hundred twenty-two cases followed, and 540 observations developed an event at the end of the follow-up. The median time to recovery was 11 days with an interquartile range of 9–14 days. Most of the patients were recovered from COVID-19 between days seven and fourteen. In the first six days of admission, only 4.2% of cases had recovered, but by day 14, 73.8% had recovered. Patients without comorbid illness/s were faster to recover than their counterparts (AHR = 1.44 : 95% CI: 1.10, 1.91) and those who have signs and symptoms on admission (AHR = 0.42 : 95% CI: 0.30, 0.60) and old-aged (AHR = 0.988; 95% CI: 0.982, 0.994) took longer to recover. Conclusion. In conclusion, a relatively short median recovery time was found in this study. Significant predictors for delayed recovery from COVID-19 were older age, presence of symptoms at admission, and having at least one comorbid condition. These factors should be placed under consideration while developing a strategy for quarantining and treating COVID-19 patients.

Time to recovery and its predictors among children aged 6\u201359\u2009months with severe acute malnutrition admitted to outpatient therapeutic program in Southwest Ethiopia: retrospective cohort study

BackgroundOutpatient therapeutic program (OTP) brings the services for the management of Severe Acute Malnutrition (SAM) closer to the community by making services available at decentralized treatment points within the primary health care setting. Despite the available interventions to tackle nutritional problems, there is scarce information on time to recovery and its predictors. Therefore, the aim of this study was to estimate time to recovery and identify its predictors among children aged 6–59 month with SAM admitted to OTP in Bench Sheko zone Southwest Ethiopia.MethodsA retrospective cohort study was conducted on 588 children who had been managed for SAM under OTP, from September 01, 2018, to August 30, 2019, in 4 public health centers in Bench Sheko zone. A total of 1301 children’s card were eligible from them 588 children’s cards were selected by simple random sampling methods. Data was entered into EPI- data version 4.4.2 and exported to SPSS version 20 for analysis. Kaplan Meir estimate median time to recovery and survival curve was used to compare the time to recovery using a log-rank test among different characteristics. Cox Proportional Hazard Model was used to identify significant predictors of time to recovery. Association was summarized by using adjusted hazard ratio (AHR) and statistical significance was declared at 95% CI, and P-value < 0.05.ResultRecovery rate was 54.4% with the median recovery time 49 days with an Interquartile range of 21 days. The independent predictors of nutritional recovery time were: newly admitted (AHR = 1.52, 95% CI: 1.17, 2.98),had no diarrhea (AHR = 1.9, 95% CI: 1.52, 2.42), had no cough (AHR = 1.4, 95% CI: 1.13, 1.74) had no blood stool (AHR = 1.55, 95% CI: 1.14, 2.10) had no malaria (AHR = 1.75, 95% CI: 1.32, 2.32), and took deworming (AHR = 1.4, 95% CI: 1.01–1.61).Conclusion and recommendationIn the current study recovery rate and the median time of recovery is by far below the standard. Cough, diarrhea, malaria, deworming and admission status were independently associated with recovery time. Health professionals should give attention for early detection and management of co-morbidities. Minster of health should give refreshment community based management of acute malnutrition training for health workers to follow the national guideline strictly.

A retrospective review of infections and outcomes within 100 days of hematopoietic stem cell transplantation: insights from a new transplant program in the Philippines

BackgroundFew hematopoietic stem cell transplantations (HSCT) are performed in lower-middle income countries. Only four institutions in the Philippines are able to perform transplants. This study describes the experience of a newly established program. MethodsThe charts of all adult patients who underwent HSCT at The Medical City from May 1, 2016 to December 31, 2019 were reviewed retrospectively. ResultsA total of 33 patients were included in the cohort, of whom 31 (93.9%) underwent autologous HSCT and only two (6.1%) underwent allogeneic HSCT. Most were female (21/33, 63%), and median age was 51 years (range 21–67 years). The primary indication for transplantation was multiple myeloma (n = 21), followed by diffuse B-cell lymphoma (n = 6). Fifteen of the 33 patients had a history of treated tuberculosis (TB) disease (n = 4) or latent TB infection (n = 11). The median time for neutrophil recovery was 7.4 days (range 4–13 days). Transplant complications included neutropenic fever (n = 33, 100%) and mucositis (n = 14, 42.4%). Bacterial infection was documented in 12 (36.4%) patients, with nine (24.2%) developing a bacterial blood stream infection of which seven were related to a central line. The overall mortality rate was at 6.1% (2/33) in the first 30 days post-transplant, with no additional mortality in the succeeding days until day 100. ConclusionsThis cohort with mostly autologous HSCT had favorable outcomes in the first 100 days. Rates of bacterial infection were high in the early post-transplant period. Latent TB infection was common, but no reactivation was observed. Longer-term follow-up of patients is needed to determine late post-transplant complications and outcomes.

EFFECTS OF TRICAINE METHANESULFONATE IN A MANAGED COLLECTION OF MOON JELLYFISH (AURELIA AURITA).

The moon jellyfish (Aurelia aurita) is a scyphozoan frequently maintained in public and private aquaria. Little research has been conducted to investigate the effects of various drugs, such as anesthetics, in this species. Tricaine methanesulfonate (MS-222), a common immersion anesthetic for fish and amphibians, was evaluated in a managed population of moon jellyfish. Twenty-four clinically healthy jellyfish were assigned into three groups of eight for trials of 0.3 g/L MS-222 (low concentration [LC]), 0.6 g/L MS-222 (high concentration [HC]), and a saltwater control. The goal was to evaluate the effects of MS-222 administration on moon jellyfish movement and response to stimuli. Movement and response to stimuli were measured via rocking and probe stimulus tests and observations of bell contraction quality and body tone. These tests were performed at baseline and throughout both drug exposure and recovery periods. A threshold drug effect was defined based on systematic scoring criteria. Additionally, elastomer tags were administered to four of eight animals in each MS-222 group to evaluate response to tag placement after drug exposure. Threshold drug effect was achieved in six of eight individuals in the LC group and eight of eight individuals in the HC group. The LC group had median threshold and recovery times of 12.2 and 10.1 min, respectively, while the HC group had median threshold and recovery times of 4.0 and 19.9 min, respectively. The HC group had significantly faster time to threshold drug effect (P < 0.001) and longer recovery times (P= 0.005) than the LC group. In both the LC and HC tagged group, three of four jellyfish had no reaction to tag placement. All animals recovered uneventfully, and there were no mortalities. MS-222 at 0.3 and 0.6 g/L decreased movement and response to stimuli in moon jellyfish.

Clinical Features and Time to Recovery of Admitted COVID-19 Cases at Dilla University Referral Hospital Treatment Center, South Ethiopia.

BackgroundSince coronavirus disease 2019 emergence, millions were infected and many were dying because of the virus. Clinical features and time to recovery of admitted clients vary across settings. Therefore showing clinical features and recovery time from COVID-19 in a different setting is necessary to design appropriate treatment and preventive measures. So, this study attempted to investigate the clinical features and time to recovery of admitted clients to Dilla University Referral Hospital treatment center, Ethiopia.MethodsA retrospective study design was conducted in 220 patients confirmed by real time polymerase chain reaction and admitted to Dilla University Referral Hospital treatment center from September 2020 to July 2021. Data were collected from the patients’ record. Data entry was done by an Epi-Info version 7.2.1.0 and analyzed by Statistical Package for the Social Sciences version 25 software. Descriptive statistics were used for clinical features, and median time to recovery was computed by using Kaplan–Meier.ResultsCommon clinical features were cough 209 (95%), shortness of breath 153 (69.5%), fever 133 (60.5%), headache 75 (34.1%), easy fatigue 68 (30.9%), joint pain 56 (25.5%), tachypnea 197 (89.5%), hypoxia 95 (43.2%), and tachycardia 83 (37.7%). The overall median recovery time for admitted cases was 5 days. There was significant difference between recovery probability of severe and moderate cases, severe and mild cases (p=0.00), who had normal body temperature and hypothermic (p=0.05), who had normal breathing rate and bradypnea patients (p= 0.014).ConclusionCOVID-19 patients frequently show cough, shortness of breath, fever, headache, easy fatigue and joint pain. Median time to recovery was 5 days. Having a normal body temperature, normal breathing rate, and severe disease status had statistically significant association with median recovery time. So, close follow up is required for client admitted with severe disease.

The respiratory consequences of COVID-19 lasted for a median of 4 months in a cohort of children aged 2-18 years of age.

AimWe focused on the clinical picture, severity and prognosis of children who experienced long‐term respiratory issues after COVID‐19.MethodsThis was a national Czech multicentre study of paediatric post‐COVID syndrome, which used a standard protocol to evaluate structural and functional anomalies and exclude alternative diagnoses. From 6 January to 30 June 2021, 11 paediatric pulmonologists enrolled all paediatric referrals aged 2–18 years with persistent respiratory symptoms more than 12 weeks after COVID‐19, namely cough, dyspnoea and chest pain. Medical histories were taken, and physical examinations, lung function testing, chest X‐ray and blood tests were performed.ResultsThe dominant symptoms in the 39 children (56.4% girls) were exertional dyspnoea (76.9%) and a chronic cough (48.7%), while dyspnoea at rest (30.8%) and chest pain (17.9%) were less prevalent. More than half (53.8%) reported more than 1 symptom, and 38.5% had abnormal results for 1 of the following tests: lung function, chest X‐ray or D‐dimers. The median age of the children was 13.5 years (interquartile range ±4.8 years), and the median recovery time was 4 months (range 1.5–8 months).ConclusionOur initial data suggest that the long‐term respiratory impact of COVID‐19 was relatively mild in our cohort, with a favourable prognosis.

Takotsubo syndrome associated with cardioversion: a systematic review

BackgroundDirect current cardioversion is a well-established and safe procedure to restore normal sinus rhythm for atrial and ventricular arrhythmias. Takotsubo syndrome has been rarely described with cardioversion. We reviewed the literature for descriptions of Takotsubo syndrome associated with the stress of cardioversion, to better understand its risks.MethodsWe queried MEDLINE, EMBASE, Google Scholar and Cochrane for cases of Takotsubo syndrome secondary to synchronized cardioversion as defined by Mayo Clinic Diagnostic Criteria.ResultsWe identified 11 cases of cardioversion-associated Takotsubo syndrome. Average age was 76 years (range: 61–87 years) and most (10 out of 11, 91%) were female. Diagnosis was made soon after cardioversion (median: 10 h, range: 0–48 h). Only 2 of 11 had ST elevations noted, while apical ballooning was noted in all cases. Pulmonary edema developed in 6 and cardiogenic shock developed in 5 patients. The median recovery time was 7 days (range: 3–11).ConclusionsCardioversion-associated TS has an overall favorable outcome with complete recovery in most cases. A higher risk of this complication may exist for elderly females undergoing synchronized cardioversion.

Benign acute childhood myositis associated with influenza A/B in the paediatric emergency department and the efficacy of early-onset oseltamivir.

To investigate the association of benign acute childhood myositis (BACM) with respiratory viruses. Also, we aimed to assess the effect of antiviral treatment on the improvement and complications. This study was conducted at an urban-academic emergency department during four influenza-seasons (2016-2019), retrospectively. Demographics, clinical findings, laboratories, metabolic disease analyses and serological features were extracted from the medical records. Treatments, complications and outcomes were also recorded. A total of 114 children were included. The median age was 7.0 (min 1.25-max 17) years and 78.9% were male. The most common symptoms were leg pain (91.2%), anorexia (54.4%), fever (45.6%), sore throat (42.1%) and walking difficulty (32.5%). On admission, the median creatine phosphokinase level was 3332 IU/L (range, 1634-50 185), median aspartate aminotransferase 107 U/L (range, 38-1798). In the multiplex polymerase chain reaction analysis, 40.4% influenza B, 36.8% influenza A, 7.8% adenovirus, 7.8% parainfluenza virus, 5.3% rhinovirus, 5.3% respiratory syncytial virus and 1.8% Mycoplasma pneumoniae were detected. Rhabdomyolysis was developed in 6.7% and acute renal failure was seen in two patients. Oseltamivir was given in 44 (38.6%) patients who had influenza A/B. Metabolic disease screening tests were performed in 33.3% of patients and metabolic diseases were detected in 4 (3.5%) patients. The median recovery time was lower in patients with oseltamivir treatment (4 (min 2-max 5) - 5 (min 3-max 10) days) (P <0.001). Rhabdomyolysis is more common in BACM due to the influenza A virus. The early use of oseltamivir treatment was significantly associated with a shorter recovery time.

Incidence, risk and risk factors for acute kidney injury associated with the use of intravenous indomethacin in neonatal patent ductus arteriosus: A 16-year retrospective cohort study.

Background:Intravenous indomethacin has been used in infants for many years as the pharmacological closure of ductus arteriosus, but the incidence, risk, and risk factors of acute kidney injury (AKI) among infants treated with indomethacin, were still scarce.Objectives:To determine the incidence, risk, and risk factors of AKI among infants treated with indomethacin (exposed group) for patent ductus arteriosus (PDA) closure compared with the matched non-exposed infants.Methods:A matched retrospective cohort study of infants admitted to the neonatal intensive care unit of Songklanagarind Hospital from January 2003 to December 2018 was performed. All data were collected from computerized medical records. A non-exposed infant was matched (1:1) by gestational age and birth weight to each exposed infant. AKI, the outcome of interest, was diagnosed according to neonatal AKI definitions. The incidence (95% CI) of AKI was estimated for each group. Conditional logistic regression was used to estimate the odds ratio (OR) of developing AKI among those who received indomethacin compared with those who did not, adjusted for potential confounders (concomitantly used nephrotoxic potential medications including aminoglycosides, amphotericin B, vancomycin, furosemide, systemic corticosteroids, and systemic vasopressors and inotropes). Kaplan-Meier estimate was performed to examine probability of recovery from AKI after AKI events.Results:The matching resulted in 193 pairs of exposed and non-exposed infants. The incidences [95% CI] of AKI in the exposed and the non-exposed group, were 33.7% [27.0%:40.4%] and 15.5% [10.4%:20.7%], respectively. Indomethacin statistically increased the risk for developing AKI, crude OR 2.94[95%CI 1.77:4.90], McNemar’s chi square p<0.001, and adjusted OR 2.73 [95%CI 1.55:4.80], p=0.001. The risk of AKI associated with potentially nephrotoxic medications were inconclusive. Time to recovery from AKI was relatively rapid, median recovery time was 3 days in both groups and all infants who developed AKI recovered within 6 days.Conclusions:The incidence of AKI among infants treated with indomethacin for PDA closure were doubled that in the indomethacin-nonexposed infants. Indomethacin significantly increased the risk of AKI, while the risk associated with other concomitant nephrotoxic medications were inconclusive. Transient nephrotoxicity associated with indomethacin should be balanced with the risk associated with delayed PDA closure. All infants receiving indomethacin should be routinely monitored for serum creatinine and/or urine output, throughout the treatment and one to two weeks after treatment cessation. Alternatives with better renal safety profiles should be considered in the population with higher risk of AKI.

Evaluation of mid- and long-term impact of COVID-19 on male fertility through evaluating semen parameters.

BackgroundThe coronavirus disease 2019 (COVID-19) has spread worldwide with alarming levels of spread and severity. The distribution of angiotensin converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2) from bioinformatics evidence, the autopsy report for COVID-19 and the published study on sperm quality indicated COVID-19 could have a negative impact on male fertility. However, whether the negative impact of COVID-19 on male fertility is persistent remains unknown, which requires long-term follow-up investigation.MethodsSemen samples were collected from 36 male COVID-19 patients with a median recovery time of 177.5 days and 45 control subjects. Then, analysis of sperm quality and alterations of total sperm number with recovery time were performed.ResultsThere was no significant difference in semen parameters between male recovered patients and control subjects. And the comparisons of semen parameters between first follow-up and second follow-up revealed no significant difference. In addition, we explored the alterations of sperm count with recovery time. It showed that the group with recovery time of ≥120 and <150 days had a significantly lower total sperm number than controls while the other two groups with recovery time of ≥150 days displayed no significance with controls, and total sperm number showed a significant decline after a recovery time of 90 days and an improving trend after a recovery time of about 150 days.ConclusionsThe sperm quality of COVID-19 recovered patients improved after a recovery time of nearly half a year, while the total sperm number showed an improvement after a recovery time of about 150 days. COVID-19 patients should pay close attention to the quality of semen, and might be considered to be given medical interventions if necessary within about two months after recovery, in order to improve the fertility of male patients as soon as possible.

Determining The Recurrence of Diabetic Patients Recovery Time in BenishangulGumuz Hospitals, Ethiopia

Diabetes is a chronic, metabolic disease characterized by elevated levels of blood glucose (or blood sugar). About 90% of people with diabetes around the world have type II diabetes. It is the main global health issues and burden as well with serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. In middleand low-income countries the prevalence of diabetes has been rising more rapidly and needs great attention. The data from such case has been considered as recurrent event data and correlation between events should be taken into account in the analysis. Thus, the aim of the study was to identify risk factors for recurrence of diabetic patient’s recovery time in Benishangul-Gumuz hospitals (Assosa, Pawi and Wonbera hospital), Ethiopia. A retrospective study has been applied to obtain data on the recurrence of diabetic patient’s recovery time in Benishangul-Gumuz hospitals, Ethiopia, from September 1, 2019 to September 1, 2021. Kaplan-Meier plot (s) and Log-rank test were used for comparison of patient’s recovery time from diabetes; Standard Cox-PH and Shared Frailty model were used to identify factors significantly affect the recovery time of diabetic patients, using R version 4.1.1 for data analysis. Of the total diabetic patients in this study 61.87 % experienced recurrence of diabetic. The estimated median recovery time of diabetic patients was 6 months. The Shared Log-normal Frailty model was chosen to be best fit for this data set, based on Likelihood Cross-Validation value. Family history, other medical history and Systolic Blood Pressure of patients were significantly affected the recovery time of diabetic patient’s.

Comparable Outcomes in Acquired Severe Aplastic Anemia Patients With Haploidentical Donor or Matched Related Donor Transplantation: A Retrospective Single-Center Experience.

Clinical data of patients with severe aplastic anemia (SAA) were retrospectively analyzed to evaluate the outcomes of haploidentical hematopoietic stem cell transplantation (HID-HSCT) with matched related sibling hematopoietic stem cell transplantation (MSD-HSCT) in complications and survivals. Thirty consecutive patients were enrolled in the study with a median follow-up of 50 months (range 4, 141), and the median age of the patients was 21 years (range 3, 49). All the patients achieved myeloid engraftment in the two cohorts. The cumulative incidences of platelet engraftment were 95.5 and 100% in HID cohort and MSD cohort, respectively. The median time for neutrophil and platelet recovery was 11 (range 9, 19) and 15 (range 10, 25) days in HID cohort, and 12 (range 10, 19) and 14 (range 8, 25) days in MSD cohort. The cumulative incidences of grade II–IV and grade III–IV acute graft vs. host disease (aGvHD) in HID cohort and in MSD cohort were 18.9 vs. 14.3% (p = 0.77) and 10.5 vs. 0% (p = 0.42), respectively. The cumulative incidences of chronic graft vs. host disease (cGvHD) was 22.7% in HID cohort and 25.5% in MSD cohort (p = 0.868). The 5-year overall survival (OS) rates and 5-year failure-free survival (FFS) rates in HID cohort and MSD cohort were 85.1 vs. 87.5% (p = 0.858), 80.3 vs. 87.5% (p = 0.635), respectively. The median time to achieve engraftment, cumulative incidence of aGvHD and cGvHD, and the 5-year OS and FFS rates were not significantly different between the two cohorts. We suggest that HID-HSCT might be a safety and effective option for SAA patients without a matched donor.

Durable outcomes of double cord blood transplantation in adults with acute lymphoblastic leukemia: high-risk features for early and long-term mortality.

Background:Cord blood transplantation (CBT) has been reported as an acceptable option with comparable outcomes to conventional donors in adults with acute lymphoblastic leukemia (ALL). We aimed to analyze the long-term CBT outcomes and risk factors for early and long-term mortalities.Methods:Between 2006 and 2020, 112 patients (median age: 35 years; 62 Ph-negative ALL and 50 Ph-positive ALL) were treated with double CBT. Conditioning regimen consisted of total body irradiation (12 Gy) plus cytarabine (9.0 g/m2) plus fludarabine (150 mg/ m2), and graft-versus-host disease (GVHD) prophylaxis was attempted by administering tacrolimus plus mycophenolate mofetil.Results:The median time for neutrophil and platelet recovery was 25 days (range: 5–59 days) and 34 days (range: 7–185 days), respectively. The cumulative incidence of acute GVHD at 1 year was 43.8%, and the incidence of acute GVHD with grades III–IV was 8.9%. The overall cumulative incidence of chronic GVHD was 22.0%, and the incidence of moderate to severe chronic GVHD was 8.5%. After a median follow-up of 60.1 months (range: 5.7–181.3 months), the 5-year cumulative incidence of relapse (CIR) and nonrelapse mortality (NRM) were 15.9% and 28.5% (9.7% and 27.2% for CR1), respectively, and the 5-year overall survival (OS) was 57.9% (66.5% for CR1). In multivariate analysis of 88 patients receiving double CBT in CR1, delayed CR1 was related to high CIR, and age older than 40 years was associated with high NRM and early mortality. Unexpectedly, Ph-positive ALL with MRD had a higher NRM and early mortality than Ph-negative ALL and Ph-positive ALL without MRD subgroups, possibly due to delayed neutrophil and platelet recovery.Conclusion:Our data suggest that double CBT for adult ALL in CR1 has a greater benefit in younger patients and in patients with Ph-positive ALL without MRD or Ph-negative ALL.

Predictors and time to recovery from COVID-19 among patients attended at the treatment centers in Ekiti State, South West, Nigeria.

Introductiontime to clinical recovery from COVID-19 infection and associated factors has not been explored in Nigeria. This study was conducted to assess the predictors and time to recovery from COVID-19 among patients attended to at the treatment centers in Ekiti State, South West.Methodsa facility-based retrospective cohort study was conducted between March 2020 to October 2021. Laboratory confirmed COVID-19 positive test result of 586 patients receiving treatment at the treatment centres in Ekiti were included. Data were extracted from COVID-19 intake forms and medical records of patients. Data were analysed using descriptive statistics and survival analysis methods including Cox proportional hazards regression model. Level of significance was set at 5%.Resultsthe mean age of the patients was 43.46 (SD 0.74) years. Forty-seven percent (47%) of the patients were aged 25-44 years, fifty-one percent (51%) were males. The median recovery time of COVID-19 patients was 21 days (IQR: 14-23). Being a male-patient (95% CI 20.46-21.54), older age (95% CI 20.14-21.86), not admitted in the hospital (95% CI 22.74-23.26), and associated multiple co-morbidities (95% CI 17.65-28.35) were associated with delayed recovery time. Predictors of recovery time of patients from COVID-19 infection were admission status (aHR: 0.71, 95%CI 0.56-0.88; p=0.002) and symptoms on admission (aHR: 0.81, 95%CI 0.66-0.99; p=0.020).Conclusionpatients with comorbidities, older and those not admitted were more likely to have a delayed clinical recovery from COVID-19. Knowledge of the predictors might help health professionals in risk stratification and better management of patients with COVID-19.

Adverse Event Profile for Nanoparticle Albumin-Bound Paclitaxel Compared With Solvent-Based Taxanes in Solid-Organ Tumors: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Background:Nanoparticle albumin-bound paclitaxel (nab-paclitaxel) is an innovative form of taxane that has superior antitumor effects; however, the safety profile between nab-paclitaxel and traditional taxanes remains controversial.Objective:To determine the burden of adverse events (AEs) in patients with multiple malignancies receiving nab-paclitaxel compared with that in patients receiving traditional taxanes.Methods:Randomized clinical trials comparing nab-paclitaxel with traditional taxanes (solvent-based paclitaxel [sb-paclitaxel] or docetaxel) in the treatment of primary solid-organ malignancies were included if AEs were reported as an outcome. Statistical analyses were conducted to calculate the summary odds ratio (OR) of the relevant adverse outcomes related to nab-paclitaxel and traditional taxanes. Prespecified subgroup analyses based on intervention and doses, primary tumor sites, and different ethnic groups were also performed.Results:Twelve clinical trials were included in the meta-analysis. Grade 3/4 anemia, thrombocytopenia, and neurotoxicity were more frequent with nab-paclitaxel than with traditional taxanes. Nab-paclitaxel at 100 or 125 mg/m2/w dosage was associated with fewer or similar grade 3/4 specific AEs. Allergy was less common with nab-paclitaxel. The median recovery times of neurotoxicity were 25, 64, and 37 days in patients receiving nab-paclitaxel, sb-paclitaxel, and docetaxel, respectively. Elevated incidences of specific AEs were more common in breast cancer and non-Asian patients than in other malignancies and ethnic groups, respectively.Conclusion and Relevance:Nab-paclitaxel increased the risk of hematologic and non-hematologic AEs in general, but anaphylaxis was less common, and the recovery duration of neurotoxicity was shorter. Weekly administration of nab-paclitaxel at a lower dosage provided better tolerance.

Predicting Phrenic Nerve Palsy in Patients Undergoing Atrial Fibrillation Ablation With the Cryoballoon-Does Sex Matter?

Background: Phrenicus nerve palsy (PNP) is a typical complication during pulmonary vein isolation (PVI) using the cryoballoon with the ominous potential to counteract the clinical benefit of restored sinus rhythm. According to current evidence incidence of PNP is about 5–10% of patients undergoing Cryo-PVI and is more frequent during ablation of the RSPV compared to the RIPV. However, information on patient specific characteristics predicting PNP and long-term outcome of patients suffering from this adverse event is sparse.Aim of the Study: To evaluate procedural and clinical characteristics of AF patients with PNP during cryoballoon PVI compared to patients without PNP.Methods and Results: Between 2013 and 2019 we included 632 consecutive AF patients undergoing PVI with the cryoballoon in our study. 84/632 (13.3%) patients experienced a total number of 89 PNP during the ablation procedure. 75/89 (84%) cryothermal induced PNP recovered until the end of the procedure (transient PNP, tPNP), whereas 14/89 (16%) PNP hold beyond the end of the procedure (non-transient PNP, ntPNP). Using multivariate logistic regression, we found that sex and BMI are strong and independent predictors of cryothermal induced non-transient PNP during cryoballoon PVI with an odds ratio of 3.9 (CI: 95%, 1.1–14.8, p = 0.04) for female gender. Interestingly, all patients (14/14, 100%) with a non-transient PNP experienced complete PNP resolution after a mean recovery time of 68 ± 79 days.Conclusion: Our data indicate for the first time, that female sex and lower BMI are independent predictors for non-transient PNP caused by cryoballoon PVI. Fortunately, during follow up all PNP patients resolved completely with a median recovery time of 35 days.

Delayed recovery from severe acute respiratory syndrome coronavirus-2 related anosmia predicts incomplete olfactory restoration.

This study aimed to assess the olfactory recovery rates and patterns in a cohort of coronavirus disease 2019 positive patients, and to investigate the clinical predictors of poor long-term olfactory restoration. An observational retrospective study was conducted on 146 patients between September 2020 and January 2021 at a tertiary referral hospital. Coronavirus disease 2019 positive patients with olfactory dysfunction were sent a modified version of the COVID-19 Anosmia Reporting Tool for Clinicians via e-mail. The difference in median recovery time between complete recovery and incomplete or no recovery was statistically significant. On multivariate analysis, the only significant factor associated with incomplete or no recovery was anosmia duration. After a mean time of 5.6 months from severe acute respiratory syndrome coronavirus-2 infection, persistent olfactory disorders were self-reported in 36.7 per cent of patients. Complete recovery was more likely to occur within 15 days. Given the high prevalence of coronavirus disease 2019, a large number of patients are expected to suffer from long-term olfactory morbidity.