Key Points
Question
Does prevalence of strongyloidiasis interact with the relative risk (RR) of mortality in ivermectin trials for the treatment of COVID-19?
Findings
In this meta-analysis of 12 randomized clinical trials involving 3901 patients, favorable mortality results were limited to trials in high-prevalence regions, with no evidence that ivermectin had a mortality benefit in low-prevalence regions. Meta-regression found an association between the regional prevalence of strongyloidiasis and risk of mortality, with a decrease in RR of 39% for each 5% increase in strongyloidiasis prevalence.
Meaning
Evidence supports that strongyloidiasis prevalence interacts with the RR of mortality in ivermectin trial results; no evidence was found to suggest ivermectin has any role in preventing mortality in patients with COVID-19 in regions where strongyloidiasis is not endemic.
Poisoning through pediatric skin leading to acute systemic symptoms is a relatively uncommonly reported phenomenon. Systemic toxicity through the skin typically occurs by direct contact between therapeutic or non-therapeutic topical agents and the skin. Though uncommon, poisoning through pediatric skin can have significant consequences and must be recognized so the offending agent may be discontinued and appropriate treatment initiated. We performed a literature search for all article types between 1950 and April 2016 to provide a single source of detectable cases of acute toxicity in pediatric patients due to percutaneous exposure. This literature review discusses relevant pediatric skin physiology along with reports of poisoning events that resulted in systemic signs and symptoms and even death to provide a comprehensive report on causes of pediatric poisoning through the skin.
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