Objective To review observational studies reporting medical device-related pressure injuries and to identify the medical devices commonly associated with pressure injuries. Design A systematic review of primary research was undertaken, according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Data sources A comprehensive electronic literature search of AMED, CINAHL, MEDLINE, PsycINFO, Web of Science, British Nursing Database and Google Scholar was conducted from inception to 31 st December 2018. Studies that reported the prevalence or incidence of medical device-related pressure injuries and published in English language were included in the review. Review methods The eligibility of studies was evaluated independently by three of the four authors and audited by an independent researcher. The titles and abstracts of all studies were screened to identify studies that met the inclusion criteria. Full-text articles of the remaining studies were obtained and screened against the inclusion criteria. Risk of bias was assessed using the Newcastle-Ottawa scale. Meta-analysis was conducted using the 'metaprop' routine, with estimates of medical device-related pressure injuries from the included studies pooled using DerSimonian-Laird random-effects model. Meta-regression analysis was also conducted to examine between-study heterogeneity. Results Twenty-nine studies (17 cross-sectional studies; 12 cohort studies) comprising data on 126,150 patients were eligible for inclusion in this review. The mean ages for patients were approximately 36.2 years (adults) and 5.9 years (children). The estimated pooled incidence and prevalence of medical device-related pressure injuries were 12% (95% CI 8-18) and 10% (95%
Owing to antiretroviral drug-induced endothelial dysfunction, HIV-infected patients on antiretroviral therapy (ART) may have elevated blood pressure. We conducted a systematic review and meta-analysis to estimate the effects of ART on blood pressure levels and hypertension risk among HIV-infected populations worldwide. We sought articles that compared the mean blood pressure measurements and hypertension prevalence between HIV-infected adults naive and exposed to ART. Thirty-nine studies comprising 44 903 participants met the inclusion criteria. Overall, systolic (mean difference (MD) 4.52 mm Hg, 95% confidence interval (CI) 2.65-6.39, I(2)=68.1%, 19 studies) and diastolic blood pressure levels (MD 3.17 mm Hg, 95% CI 1.71-4.64, I(2)=72.5%, 16 studies) were significantly higher among ART-exposed patients compared with treatment-naive patients. Similarly, the risk of hypertension was significantly higher among ART-exposed patients, such that among 28 908 ART-exposed patients, 4195 (14.5%) had hypertension compared with 950 of 9086 (10.5%) in those who were treatment-naive (odds ratio 1.68, 95% CI 1.35-2.10, I(2)=81.5%, 32 studies). In summary, exposure to ART is significantly associated with increased systolic and diastolic blood pressure levels, and increased risk of hypertension, regardless of study-level sociodemographic differences. This meta-analysis supports the need for population-based strategies to reduce the risk of high blood pressure among people living with HIV on ART.
Evidence suggests the demographic age structure of sub-Saharan Africa is the leading factor of the low morbidity and mortality of COVID-19 compared to other regions of the world. n Widespread social mitigation strategies, such as lockdowns, have resulted in severe economic and societal consequences in terms of food security, adolescent pregnancy, gender-based violence, and disruptions in treating other diseases.nIt is imperative to weigh the risks and benefits of social mitigation strategies for future waves.
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