Clopidogrel is a mainstay in the treatment of patients with acute coronary syndromes or those receiving endovascular prostheses.However,its efficacy has been challenged in the recent past by studies suggesting variabl...Clopidogrel is a mainstay in the treatment of patients with acute coronary syndromes or those receiving endovascular prostheses.However,its efficacy has been challenged in the recent past by studies suggesting variable individual responsiveness and by new,more potent competitors,such as prasugrel and ticagrelor. But what is the actual body of evidence in support of clopidogrel?Is there any dark side of the moon?What is the role of prasugrel,which has already been approved in Europe and in the United States?And what will be the future role of ticagrelor,when approved for routine clinical practice?We hereby concisely summarize the scope of this clinical choice,providing arguments in favor and against each of the three antiplatelet agents:clopidogrel,prasugrel,and ticagrelor.展开更多
Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity.The coexistence of a heart disease complicates the management of mental illness,can contribute to a reduced quality...Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity.The coexistence of a heart disease complicates the management of mental illness,can contribute to a reduced quality of life and a worse illness course.The co-occurrence of psychiatric disorders in cardiac patients might affect the clinical outcome and morbidity.Moreover,the complex underlying mechanism that links these two conditions remains unclear.This paper discusses the known cardiovascular complications of psychotropic drugs and analyzes the important implications of antidepressive treatment in patients with previous cardiac history.展开更多
Experiencing various forms of violence in either childhood or adulthood has been associated with cardiovascular disease,both shortly after the event and during follow-up,particularly in women.The coronavirus disease 2...Experiencing various forms of violence in either childhood or adulthood has been associated with cardiovascular disease,both shortly after the event and during follow-up,particularly in women.The coronavirus disease 2019 pandemic has heightened the risk of domestic violence with serious sequelae for mental and cardiovascular health in women,possibly due to several contributing factors,ranging from lockdown,stay at home regulations,job losses,anxiety,and stress.Accordingly,it remains paramount to enforce proactive preventive strategies,at both the family and individual level,maintain a high level of attention to recognize all forms of violence or abuse,and guarantee a multidisciplinary team approach for victims of interpersonal or domestic violence in order to address physical,sexual,and emotional domains and offer a personalized care.展开更多
AIM： To compare four methods to approximate mean and standard deviation （SD） when only medians and interquartile ranges are provided.METHODS： We performed simulated meta-analyses on six datasets of 15, 30, 50, 100...AIM： To compare four methods to approximate mean and standard deviation （SD） when only medians and interquartile ranges are provided.METHODS： We performed simulated meta-analyses on six datasets of 15, 30, 50, 100, 500, and 1000 trials, respectively. Subjects were iteratively generated from one of the following seven scenarios： five theoreti-cal continuous distributions [Normal, Normal （0, 1）, Gamma, Exponential, and Bimodal] and two real-life distributions of intensive care unit stay and hospital stay. For each simulation, we calculated the pooled estimates assembling the study-specific medians and SD approximations： Conservative SD, less conservativeSD, mean SD, or interquartile range. We provided a graphical evaluation of the standardized differences.To show which imputation method produced the best estimate, we ranked those differences and calculated the rate at which each estimate appeared as the best, second-best, third-best, or fourth-best.RESULTS： Our results demonstrated that the best pooled estimate for the overall mean and SD was provided by the median and interquartile range （mean standardized estimates： 4.5 ± 2.2, P = 0.14） or by the median and the SD conservative estimate （mean standardized estimates： 4.5 ± 3.5, P = 0.13）. The less conservative approximation of SD appeared to be the worst method, exhibiting a significant difference from the reference method at the 90% confidence level. The method that ranked first most frequently is the interquartile range method （23/42 = 55%）, particularly when data were generated according to the Standard Normal, Gamma, and Exponential distributions. The second-best is the conservative SD method （15/42 = 36%）, particularly for data from a bimodal distributionand for the intensive care unit stay variable. CONCLUSION： Meta-analytic estimates are not signi-fcantly affected by approximating the missing values ofmean and SD with the correspondent values for medianand interquartile range.展开更多
The exponential growth of scientific evidence(i.e., primary research) and the ongoing development of methods to summarize such evidence, such as meta-analyses and mixed treatment comparisons(i.e., secondary research),...The exponential growth of scientific evidence(i.e., primary research) and the ongoing development of methods to summarize such evidence, such as meta-analyses and mixed treatment comparisons(i.e., secondary research), make the worldwide dissemination of highquality meta-analyses and pertinent articles a key scientific priority. The World Journal of Meta-Analysis will apply an electronic open access publishing approach combined with a timely and thorough peer-review of submitted manuscripts, weighing more on quality than priority, in order to improve the dissemination of systematic reviews and meta-analyses, as well as novelties and advancements in methods related to them, focusing on clinical medicine, but spanning all biomedical, epidemiological, and psychological research fields.展开更多
文摘Clopidogrel is a mainstay in the treatment of patients with acute coronary syndromes or those receiving endovascular prostheses.However,its efficacy has been challenged in the recent past by studies suggesting variable individual responsiveness and by new,more potent competitors,such as prasugrel and ticagrelor. But what is the actual body of evidence in support of clopidogrel?Is there any dark side of the moon?What is the role of prasugrel,which has already been approved in Europe and in the United States?And what will be the future role of ticagrelor,when approved for routine clinical practice?We hereby concisely summarize the scope of this clinical choice,providing arguments in favor and against each of the three antiplatelet agents:clopidogrel,prasugrel,and ticagrelor.
文摘Psychotropic drugs can produce cardiovascular side effects associated with a degree of cardiotoxicity.The coexistence of a heart disease complicates the management of mental illness,can contribute to a reduced quality of life and a worse illness course.The co-occurrence of psychiatric disorders in cardiac patients might affect the clinical outcome and morbidity.Moreover,the complex underlying mechanism that links these two conditions remains unclear.This paper discusses the known cardiovascular complications of psychotropic drugs and analyzes the important implications of antidepressive treatment in patients with previous cardiac history.
文摘Experiencing various forms of violence in either childhood or adulthood has been associated with cardiovascular disease,both shortly after the event and during follow-up,particularly in women.The coronavirus disease 2019 pandemic has heightened the risk of domestic violence with serious sequelae for mental and cardiovascular health in women,possibly due to several contributing factors,ranging from lockdown,stay at home regulations,job losses,anxiety,and stress.Accordingly,it remains paramount to enforce proactive preventive strategies,at both the family and individual level,maintain a high level of attention to recognize all forms of violence or abuse,and guarantee a multidisciplinary team approach for victims of interpersonal or domestic violence in order to address physical,sexual,and emotional domains and offer a personalized care.
文摘AIM： To compare four methods to approximate mean and standard deviation （SD） when only medians and interquartile ranges are provided.METHODS： We performed simulated meta-analyses on six datasets of 15, 30, 50, 100, 500, and 1000 trials, respectively. Subjects were iteratively generated from one of the following seven scenarios： five theoreti-cal continuous distributions [Normal, Normal （0, 1）, Gamma, Exponential, and Bimodal] and two real-life distributions of intensive care unit stay and hospital stay. For each simulation, we calculated the pooled estimates assembling the study-specific medians and SD approximations： Conservative SD, less conservativeSD, mean SD, or interquartile range. We provided a graphical evaluation of the standardized differences.To show which imputation method produced the best estimate, we ranked those differences and calculated the rate at which each estimate appeared as the best, second-best, third-best, or fourth-best.RESULTS： Our results demonstrated that the best pooled estimate for the overall mean and SD was provided by the median and interquartile range （mean standardized estimates： 4.5 ± 2.2, P = 0.14） or by the median and the SD conservative estimate （mean standardized estimates： 4.5 ± 3.5, P = 0.13）. The less conservative approximation of SD appeared to be the worst method, exhibiting a significant difference from the reference method at the 90% confidence level. The method that ranked first most frequently is the interquartile range method （23/42 = 55%）, particularly when data were generated according to the Standard Normal, Gamma, and Exponential distributions. The second-best is the conservative SD method （15/42 = 36%）, particularly for data from a bimodal distributionand for the intensive care unit stay variable. CONCLUSION： Meta-analytic estimates are not signi-fcantly affected by approximating the missing values ofmean and SD with the correspondent values for medianand interquartile range.
文摘The exponential growth of scientific evidence(i.e., primary research) and the ongoing development of methods to summarize such evidence, such as meta-analyses and mixed treatment comparisons(i.e., secondary research), make the worldwide dissemination of highquality meta-analyses and pertinent articles a key scientific priority. The World Journal of Meta-Analysis will apply an electronic open access publishing approach combined with a timely and thorough peer-review of submitted manuscripts, weighing more on quality than priority, in order to improve the dissemination of systematic reviews and meta-analyses, as well as novelties and advancements in methods related to them, focusing on clinical medicine, but spanning all biomedical, epidemiological, and psychological research fields.
