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  1. Article ; Online: Frailty in acute coronary syndromes. A systematic review and narrative synthesis of frailty assessment tools and interventions from randomised controlled trials.

    Chad, Thomas / Koulouroudias, Marinos / Layton, Georgia R / Fashina, Oluwatomini / Sze, Shirley / Roman, Marius / Murphy, Gavin J

    International journal of cardiology

    2024  Volume 399, Page(s) 131764

    Abstract: Aim: We aimed to review all randomised controlled trial (RCT) data to explore optimal identification and treatment strategies of frail patients with Acute Coronary Syndromes (ACS).: Methods: The protocol was preregistered (PROSPERO - CRD42021250235). ...

    Abstract Aim: We aimed to review all randomised controlled trial (RCT) data to explore optimal identification and treatment strategies of frail patients with Acute Coronary Syndromes (ACS).
    Methods: The protocol was preregistered (PROSPERO - CRD42021250235). We performed a systematic review including RCT's that 1; used at least one frailty assessment tool to assess frailty and its impact on outcomes in patients diagnosed with ACS and 2; used at least one intervention where change in frailty was measured in patients diagnosed with ACS. The Cochrane Central Register of Controlled Trials, MEDLINE and EMBASE were searched on the 1st April 2021 and updated on 4th July 2023. Owing to low search output results are presented as a narrative synthesis of available evidence.
    Results: A single RCT used a frailty assessment tool. A single RCT specifically targeted frailty with their intervention. This precluded further quantitative analysis. There was indication of selection bias against frail participants, and a signal of value for physical activity measurement in frail ACS patients. There was a high level of uncertainty and low level of robustness of this evidence.
    Conclusions: Data from RCT's alone is inadequate in answering the reviews question. Future RCT's need to address ways to incorporate frail participants, whilst mitigating selection biases. Physical performance aspects of the frailty syndrome appear to be high yield modifiable targets that improve outcomes. Intervention trials should consider using change in frailty status as an outcome measure. Any trials that include frail participants should present data specifically attributable to this group.
    MeSH term(s) Humans ; Frailty/diagnosis ; Frailty/therapy ; Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/therapy ; Outcome Assessment, Health Care ; Research Design ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2024-01-09
    Publishing country Netherlands
    Document type Systematic Review ; Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2024.131764
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Expedited Partner Therapy: A Multicomponent Initiative to Boost Provider Counseling.

    Markowitz, Melissa A / Ackerman-Banks, Christina M / Oliveira, Carlos R / Fashina, Oluwatomini / Pathy, Shefali R / Sheth, Sangini S

    Sexually transmitted diseases

    2023  Volume 51, Issue 1, Page(s) 15–21

    Abstract: Background: Expedited partner therapy prescription remains low and highly variable throughout the United States, leading to frequent reinfections with Chlamydia trachomatis and Neisseria gonorrhoeae . We examined provider counseling on expedited partner ...

    Abstract Background: Expedited partner therapy prescription remains low and highly variable throughout the United States, leading to frequent reinfections with Chlamydia trachomatis and Neisseria gonorrhoeae . We examined provider counseling on expedited partner therapy before and after an electronic smart tool-based initiative.
    Methods: In this quasi-experimental interrupted time-series study, we implemented an initiative of electronic smart tools and education for expedited partner therapy in March 2020. We reviewed the records of patients with chlamydia and/or gonorrhea at an urban, academic obstetrics and gynecology clinic in the preimplementation (March 2019-February 2020) and postimplementation (March 2020-February 2021) groups. Descriptive statistics and an interrupted time-series model were used to compare the percent of expedited partner therapy offered by clinicians to patients in each group.
    Results: A total of 287 patient encounters were analyzed, 155 preintervention and 132 postintervention. An increase in expedited partner therapy counseling of 13% (95% confidence interval [CI], 2%-24%) was observed before the intervention (27.1% [42 of 155]) versus after the intervention (40.2% [53 of 132]). Significant increases in provider counseling were seen for patients who were single (15%; 95% CI, 3%-26%), 25 years or older (21%; 95% CI, 6%-37%), receiving public insurance (15%; 95% CI, 3%-27%), seen by a registered nurse (18%; 95% CI, 4%-32%), or seen for an obstetrics indication (21%; 95% CI, 4%-39%). No difference was seen in patients' acceptance of expedited partner therapy ( P = 1.00).
    Conclusions: A multicomponent initiative focused on electronic smart tools is effective at increasing provider counseling on expedited partner therapy. Further research to understand patient perceptions and acceptance of expedited partner therapy is critical.
    MeSH term(s) Humans ; United States ; Chlamydia Infections/drug therapy ; Chlamydia Infections/prevention & control ; Chlamydia Infections/epidemiology ; Sexual Partners/psychology ; Contact Tracing ; Gonorrhea/drug therapy ; Gonorrhea/prevention & control ; Gonorrhea/epidemiology ; Chlamydia trachomatis ; Counseling
    Language English
    Publishing date 2023-10-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 435191-5
    ISSN 1537-4521 ; 0148-5717
    ISSN (online) 1537-4521
    ISSN 0148-5717
    DOI 10.1097/OLQ.0000000000001894
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Reporting conflicts of interest in randomised trials of patient blood management interventions in patients requiring major surgery: a systematic review and meta-analysis.

    Roman, Marius / Fashina, Oluwatomini / Tomassini, Sara / Abbasciano, Riccardo G / Lai, Florence / Richards, Toby / Murphy, Gavin

    BMJ open

    2022  Volume 12, Issue 8, Page(s) e054582

    Abstract: Objective: This study aimed to systematically review the effects of declared and undeclared conflicts of interest on randomised controlled trials (RCTs) of patient blood management (PBM) interventions.: Design: We performed a secondary analysis of a ... ...

    Abstract Objective: This study aimed to systematically review the effects of declared and undeclared conflicts of interest on randomised controlled trials (RCTs) of patient blood management (PBM) interventions.
    Design: We performed a secondary analysis of a recently published meta-analysis of RCTs evaluating five common PBM interventions in patients undergoing major surgery.
    Data sources: The databases searched by the original systematic reviews were searched using subject headings and Medical Subject Headings terms according to search strategies from the final search time-points until 1 June 2019.
    Eligibility criteria: RCTs on PBM irrespective of blinding, language, date of publication and sample size were included. Abstracts and unpublished trials were excluded. Conflicts of interest were defined as sponsorship, funding or authorship by industry, professional PBM advocacy groups or blood services.
    Data extraction and synthesis: Three independent reviewers extracted the data and assessed the risk of bias. Pooled treatment effect estimates were reported as risk ratios (RRs) or standardised mean difference with 95% CIs. Heterogeneity was quantified using the I
    Results: Three hundred and eighty-nine RCTs totalling 53 635 participants were included. Thirty-two trials (8%) were considered free from important sources of bias. There was reporting bias favouring PBM interventions on transfusion across all analyses. In trials with no declared author conflicts of interest, the treatment effect on mortality was RR 1.12 (0.86 to 1.45). In trials where author conflicts of interest were declared, the treatment effect on mortality was RR 0.84 (0.69 to 1.03), with significant reporting bias favouring PBM interventions. Trials with declared conflicts linked to professional PBM advocacy groups (five studies, n=977 patients) reported statistically significant reductions in mortality RR 0.40 (0.17 to 0.92), unlike other groups.
    Conclusions: Low certainty of the evidence that guides PBM implementation is confounded by evidence of reporting bias, and the effects of declared and undeclared conflicts of interest, favouring PBM on important trial outcomes.
    MeSH term(s) Conflict of Interest ; Humans ; Randomized Controlled Trials as Topic
    Language English
    Publishing date 2022-08-17
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Systematic Review ; Research Support, Non-U.S. Gov't
    ZDB-ID 2599832-8
    ISSN 2044-6055 ; 2044-6055
    ISSN (online) 2044-6055
    ISSN 2044-6055
    DOI 10.1136/bmjopen-2021-054582
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Large animal model of vein grafts intimal hyperplasia: A systematic review.

    Fashina, Oluwatomini / Abbasciano, Riccardo G / McQueen, Liam W / Ladak, Shameem / George, Sarah J / Suleiman, Sadeeh / Punjabi, Prakash P / Angelini, Gianni D / Zakkar, Mustafa

    Perfusion

    2022  Volume 38, Issue 5, Page(s) 894–930

    Abstract: Coronary artery bypass grafting remains the treatment of choice for a large cohort of patients with significant coronary disease. Despite the increased use of arterial grafts, the long saphenous vein remains the most commonly used conduit. Long-term ... ...

    Abstract Coronary artery bypass grafting remains the treatment of choice for a large cohort of patients with significant coronary disease. Despite the increased use of arterial grafts, the long saphenous vein remains the most commonly used conduit. Long-term graft patency continues to be the Achilles heel of saphenous vein grafts. This is due to the development of intimal hyperplasia, a chronic inflammatory disease that results in the narrowing and occlusion of a significant number of vein grafts. Research models for intimal hyperplasia are essential for a better understanding of pathophysiological processes of this condition. Large animal models resemble human anatomical structures and have been used as a surrogate to study disease development and prevention over the years. In this paper, we systematically review all published studies that utilized large animal models of vein graft disease with a focus on the type of model and any therapeutic intervention, specifically the use of external stents/mesh.
    MeSH term(s) Animals ; Humans ; Graft Occlusion, Vascular ; Vascular Patency/physiology ; Hyperplasia/pathology ; Coronary Artery Bypass/methods ; Saphenous Vein/surgery ; Models, Animal
    Language English
    Publishing date 2022-05-27
    Publishing country England
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 645038-6
    ISSN 1477-111X ; 0267-6591
    ISSN (online) 1477-111X
    ISSN 0267-6591
    DOI 10.1177/02676591221091200
    Database MEDical Literature Analysis and Retrieval System OnLINE

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