ORCID Profile
0000-0001-7913-9942
Current Organisations
Women's and Children's Hospital
,
Libbs Farmacêutica Ltda
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Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.AMJOTO.2022.103488
Abstract: The incidence of epistaxis-related admissions amongst elderly patients is rising due to the increasing use of anticoagulants and antiplatelet agents. This retrospective study evaluates the differences in outcomes for patients on warfarin, novel anticoagulants (NOACs) and antiplatelets over two different time periods. Retrospective case-control study with data from patients admitted with epistaxis through the Flinders Medical Centre Emergency Department in the first six months of 2013 and compared to the same period in 2018. The latter coincides with integration of NOACs into Australian prescribing practices. Included participants were ≥50 years with spontaneous epistaxis which coincides with peak incidence in adults. Exclusion criteria were epistaxis due to trauma, intrinsic coagulopathy, or recent post-surgery. Linear regression and binary logistic regression models were the statistical methods used. Data from 85 patients were analysed for length of stay (LOS), readmission rates and method of haemostasis. In 2013, 41 patients were included compared to 44 in 2018, suggesting a 7% increase in admissions rates but this was not statistically significant (p = 0.96). The proportion of patients admitted with epistaxis while taking an anticoagulant or antiplatelet agent increased from 66% in 2013 to 93% in 2018. Thirty six percent of patients in 2018 were taking NOACs, however, LOS was 2 times shorter (mean ratio = 2.08 days, 95% CI: 1.03, 4.19). Seven percent of patients in 2018 had bleeding requiring surgery or interventional radiology, compared to 12% in 2013, but this was not statistically significant. There was no statistically significant difference in readmission rates (p = 0.82) or intervention required (p = 0.74) between the two time periods. Epistaxis admissions at our institution have increased since the introduction of NOACs. However, most patients can be managed successfully with intranasal packing and cautery alone. NOACs are not associated with increased rated of invasive haemostatic measures and patients have a shorter LOS.
Publisher: SAGE Publications
Date: 04-01-2023
DOI: 10.1177/10556656221148368
Abstract: To compare the effectiveness of short-term ventilation tubes compared to surveillance on conductive hearing loss in children with non-syndromic orofacial clefting involving the muscular palate. Chronic otitis media with effusion is a common finding in children with cleft palate. The accepted convention is insertion of short-term ventilation tubes at the time of palate repair, but some centres are choosing conservative management. Each approach has its advantages but there is currently no consensus on the most appropriate management in children with non-syndromic cleft palate. Children years with cleft lip and palate, or isolated cleft palate, not associated with a genetic syndrome, who have been diagnosed with chronic otitis media with effusion. A systematic search of MEDLINE, CINAHL, Embase and Scopus databases was conducted. Grey literature searches were conducted through Central Register of Controlled Trials, Clinicaltrials.gov and ProQuest. Two reviewers screened the studies, conducted critical appraisal, assessed the methodological quality, and extracted the data. Where possible, studies were pooled in statistical meta-analysis with heterogeneity being assessed using the standard Chi-squared and I 2 tests. Four studies met the inclusion criteria but were of low quality with a moderate risk of bias. Only data on hearing thresholds could be pooled for analysis which found no statistically significant difference. Other outcomes were presented in narrative form. Certainty of evidence for all outcomes was deemed low to very low using GRADE criteria. No definitive conclusions can be drawn regarding most effective management at improving conductive hearing loss. Missing data and inconsistent reporting of outcomes limited capacity for pooled analysis.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 25-02-2022
Publisher: SAGE Publications
Date: 21-12-2023
DOI: 10.1177/26320843221148131
Abstract: To assess the reporting quality of observational studies included in a systematic review of the management of chronic otitis media with effusion in children with non-syndromic cleft lip and palate using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist. Medline, CINAHL, Scopus and Embase, were searched for studies comparing the use of ventilation tubes to surveillance. Two reviewers screened potential eligible articles, extracted data independently and assessed reporting quality using the STROBE checklist. The median compliance rate with in idual STROBE items was low at 25% (range:0-100%) with 11 of the 22 items not reported in any of the studies. Items reported inconsistently pertained to potential sources of bias, s le size calculations, how loss to follow-up was addressed and management of missing data. The development of this systematic review highlights the inadequate reporting standards in this field. Differences in the way the outcomes are defined, reported, and measured leads to variability in the observed intervention effects and difficulty in interpreting the true effect size. Future researchers are encouraged to use STROBE guidelines for the design and reporting of observational studies in this field.
Publisher: Bentham Science Publishers Ltd.
Date: 03-2009
DOI: 10.2174/138945009787581177
Abstract: Malaria and leishmaniasis are the most prevalent tropical diseases caused by protozoan parasites. Half of world's population is at risk of malaria and more than 2 million of new cases of leishmaniasis occur annually. There are no vaccines available for these diseases and current treatments suffer from several limitations. Therefore, novel drugs for malaria and leishmaniasis are much-needed. This article reviews the agents currently in use for treatment of these diseases, their known mechanisms of action and weaknesses. We present an overview of the main strategies for drug discovery and the relevance of these parasites genomics roteomics data for a rational search of molecular targets and matching leads. In this direction, we emphasize the importance of the highly integrated partnerships and networks between scientists in academic institutions and industry involving several countries that promise to increase the chances of success and enhance cost-effectiveness in drug discovery against these parasitic diseases. In addition, we approach the available assays for testing lead compounds in large scale and their limitations for they represent one of the bottlenecks in the pipeline for novel drug discovery. We conclude the article presenting a recent coordinated initiative (TDR Transfection Network) established to overcome some of these limitations by the generation of Plasmodium and Leishmania transgenic parasites better suited for HTS platforms.
Location: Brazil
Location: Brazil
Location: Spain
No related grants have been discovered for Grace Maina.