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KU Leuven (2)


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dissertation (2)


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English (2)


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2022 (1)

2018 (1)

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Dissertation
Transcatheter versus surgical aortic valve replacement in a low risk population, what's the evidence? A systematic review

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Abstract

Context: TAVR is currently an acceptable treatment option for patients with symptomatic aortic stenosis at very high, high and intermediate surgical risk but has been creeping into even lower risk patient population in the last years. Solid evidence is lacking to support TAVR in low-risk patients as alternative to SAVR as results have been equivocal. Objective: This systematic review aims to investigate current and updated evidence on TAVR vs. SAVR outcomes in low and intermediate surgical risk patient groups by analysing metaanalysis, observational studies and randomized controlled trials on this topic. Data Sources: PubMed, EMBASE, Cochrane, Web of Science and clinicaltrials.gov were systematically searched. Study Selection: One reviewer conducted the eligibility process in a systematic manner. A total of 14 meta-analysis were finally included along with 3 RCT and 9 observational studies. Data Extraction and Synthesis: Baseline characteristics and relevant outcomes were extracted systematically from all included studies. Data was then summarized and presented as HR, OR or RR on forest plots. Results and conclusions: No significant differences were found between SAVR and TAVR in lower risk patient groups in myocardial infarction, stroke or all-cause death. TAVR performed worse than SAVR in terms of paravalvular leak, pacemaker implantation, and re-intervention.

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Dissertation
Treatment modalities for COVID-19 associated olfactory dysfunction: a systematic review

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Objectives: The objective of this review is to summarise all current evidence on the treatment of COVID-19 associated olfactory dysfunction. Data resources: PubMed, Embase, Cochrane Library and Web of Science were systematically searched. Ongoing trials were searched in clinicaltrials.gov and ICTRP. Search terms used in all databases included “olfactory dysfunction”, “anosmia”, “hyposmia”, “parosmia”, “COVID-19”, “SARS-CoV-2” and variations on these key words. Study selection: RCT’s, pro- and retrospective cohorts, and case-control studies were eligible. There were no restrictions in type of intervention, duration of follow-up or measurement method of olfactory dysfunction applied. A baseline measurement of olfactory function was required for inclusion. Studies including more than 50% confirmed COVID-19 patients were included. Data extraction: Extraction of data was done by one researcher using predefined data fields, including study quality indicators. Data synthesis: Eight randomised controlled trials (RCTs), one non-randomised controlled trial and one prospective cohort study were retrieved. Treatment modalities in this review include the use of oral or intranasal corticosteroids, olfactory training, zinc supplementation, an insulin fast-dissolving film and a PEA/Luteolin supplement. Conclusions: Several treatment modalities have been suggested for COVID-19 associated olfactory dysfunction. There seems to be consensus about olfactory training as the corner stone of the first line treatment. For other treatment options, evidence remains mixed and larger randomised placebo-controlled trials with a longer follow-up are needed.

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