The use of statins, angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin II receptor blockers (ARBs), and anticoagulants may be associated with fewer adverse outcomes in COVID-19 patients. Nested within a cohort of 800,913 patients diagnosed with COVID-19 between April 1, 2020 and June 24, 2021 from the Optum COVID-19 database, three case-control studies were conducted. Cases-defined as persons who: (1) were hospitalized within 30 days of COVID-19 diagnosis (n = 88,405); (2) were admitted to the intensive care unit (ICU)/received mechanical ventilation during COVID-19 hospitalization (n = 22,147); and (3) died during COVID-19 hospitalization (n = 2300)-were matched 1:1 using demographic/clinical factors with controls randomly selected from a pool of patients who did not experience the case definition/event. Medication use was based on prescription ≤90 days before COVID-19 diagnosis. Statin use was associated with decreased risk of hospitalization (adjusted odds ratio [aOR], 0.72; 95% confidence interval [95% CI], 0.69, 0.75) and ICU admission/mechanical ventilation (aOR, 0.90; 95% CI, 0.84, 0.97). ACEI/ARB use was associated with decreased risk of hospitalization (aOR, 0.67; 95% CI, 0.65, 0.70), ICU admission/mechanical ventilation (aOR, 0.92; 95% CI, 0.86, 0.99), and death (aOR, 0.60; 95% CI, 0.47, 0.78). Anticoagulant use was associated with decreased risk of hospitalization (aOR, 0.94; 95% CI, 0.89, 0.99) and death (aOR, 0.56; 95% CI, 0.41, 0.77). Interaction effects-in the model predicting hospitalization-were statistically significant for statins and ACEI/ARBs (P < .0001), statins and anticoagulants (P = .003), ACEI/ARBs and anticoagulants (P < .0001). An interaction effect-in the model predicting ventilator use/ICU-was statistically significant for statins and ACEI/ARBs (P = .002). Statins, ACEI/ARBs, and anticoagulants were associated with decreased risks of the adverse outcomes under study. These findings may provide clinically relevant information regarding potential treatment for patients with COVID-19.

INTRODUCTION: Irritable bowel syndrome (IBS) affects between 10% and 20% of the global population. The therapeutic effect of yoga on IBS symptoms has been investigated by several randomized controlled trials (RCTs) with inconsistent findings. We conducted this review to synthesize the current evidence on yoga's effect on IBS symptoms. METHODS: A systematic review and meta-analysis were performed through systematically searching PubMed, EMBASE, WOS, SCOPUS, and Cochrane through October 2024. Continuous variables were pooled using the standardized mean difference (SMD), with confidence intervals (CIs) using Stata MP version 17. We assessed heterogeneity using the χ ² test and I ² statistics. PROSPERO ID: CRD42024611633. RESULTS: Eleven RCTs with 535 patients were included. Seven RCTs included adults, 3 included pediatric or adolescent patients, and another included adolescents and young adults. The yoga intervention type varied among the included trials, with the program duration ranging from 6 weeks to 8 months and the session duration ranging from 40 to 90 minutes. There was no difference between yoga and control groups in alleviating the severity of gastrointestinal symptoms (SMD −0.66, with 95% CI −1.51 to 0.18, P = 0.12), anxiety (SMD −0.39, with 95% CI −0.85 to 0.06, P = 0.09), and depression (SMD −0.46, with 95% CI −1.15 to 0.22, P = 0.19) or improving quality of life (SMD 0.53, with 95% CI −0.38 to 1.44, P = 0.25). DISCUSSION: With uncertain evidence, yoga did not reduce the gastrointestinal severity of symptoms, anxiety, and depression or improve quality of life in patients with IBS. In light of the considerable methodological heterogeneity and the high risk of bias within the included RCTs, Yoga cannot be recommended as a treatment for IBS before conducting further large-scale RCTs to fill the current evidence gaps.

Background and Aims: The optimal perioperative management of patients chronically using renin-angiotensin system inhibitors (RASIs) is still uncertain. This study aims to compare the outcomes of withholding versus continuing RASIs before surgery, focusing on efficacy and safety. Methods: A systematic review and meta-analysis synthesising evidence from randomised controlled trials (RCTs) obtained from PubMed, CENTRAL, Scopus, and Web of Science until September 2024. Using Stata MP v. 17, we used the fixed-effects model to report dichotomous outcomes by using the risk ratio (RR) with a 95% confidence interval (CI). Results: Ten RCTs with 3,740 patients were included. There was no statistical difference between both groups regarding the incidence of major adverse cardiac events (MACE) [Risk ratio (RR): 0.99; 95% confidence interval (CI): 0.84, 1.16; P = 0.88], all-cause mortality (RR: 0.88; 95% CI: 0.44, 1.78; P = 0.72), myocardial infarction (MI) (RR: 1.67; 95% CI: 0.61, 4.58; P = 0.32), heart failure/acute pulmonary oedema (RR: 1.87; 95% CI: 0.51, 6.84; P = 0.34), stroke (RR: 1.22; 95% CI: 0.35, 4.24; P = 0.75), postoperative hypotension (RR: 0.85; 95% CI: 0.66, 1.10; P = 0.22), perioperative hypertension (RR: 1.21; 95% CI: 1.00, 1.46; P = 0.05), and acute kidney injury (AKI) (RR: 1.01; 95% CI: 0.80, 1.26; P = 0.97). However, withholding RASIs was significantly associated with a decreased incidence of intraoperative hypotension (RR: 0.82; 95% CI: 0.75, 0.89; P < 0.001). Conclusion: Stopping RASIs in patients undergoing surgery was not associated with a higher risk of postoperative complications, such as MACE, all-cause mortality, myocardial infarction, heart failure/acute pulmonary oedema, stroke, or AKI. Conversely, discontinuing RASIs notably reduced the incidence of intraoperative hypotension.

Publishing its first issue in 2018, The Journal of Scientific Innovation in Medicine is an open access, international, peer reviewed journal covering the range of transformative scientific developments from the bench, to the bedside, and to local and global communities with emphasis on new concepts and paradigms in the prevention and treatment of human disease and the creation of human health. The mission of this journal is twofold. First, we advance an understanding of how to apply new technology, scientific discovery and innovative solutions in order to expand the frontiers of medicine and health. The journal welcomes research pertaining to diagnostic and therapeutic discovery from clinicians, scientists and practitioners as they discover new ways to prevent and treat diseases and illnesses. The journal also welcomes research on the impact of scientific discovery on health care systems, public health and population health including costs, value, applicability and social determinants of health. In addition, the journal solicits original papers exploring attitudes towards health care innovation, exploring health technology assessment and the effect of new technology on patients and communities. Second, we provide a mentored learning environment in transformative and sustainable scholarly communication. We welcome submissions of papers from students, residents and fellows papers including those building on accepted conference abstracts. We encourage trainees to publish their work originating from evidence-based research to our constructive peer review process. Our editorial team blends students, trainees, librarians, and faculty with a wide range of authorship and editorial expertise in order that we provide mentored peer review learning opportunities. Supported by the Icahn School of Medicine at Mount Sinai and its Gustave L. and Janet W. Levy Library, the journal does not charge author submission/publication/processing fees and the content is open for all readers. To learn more about how to get involved with our open journals on the Levy Library Press, contact Kris Alpi, Associate Dean of Libraries & Information Sciences.

Background: Elevated lipoprotein(a) is a well-established cardiovascular risk factor with limited therapeutic options. Both PCSK9 inhibitors and GLP-1 receptor agonists are used in patients with elevated Lp(a), yet any observational comparison between these two drug classes is highly vulnerable to confounding by indication. Methods: We used the TriNetX U.S. Collaborative Network to identify adults with elevated Lp(a) (>125 nmol/L or >50 mg/dL) initiated on either a PCSK9 inhibitor (evolocumab, alirocumab, or inclisiran) or a GLP-1 receptor agonist within one year of diagnosis. After 1:1 propensity score matching, 1,594 patients were included in each cohort. One-year cardiovascular outcomes were compared using Cox proportional hazards regression. Results: After matching, MACE-3 occurred in 11.3% versus 9.1% of patients (HR 1.25, 95% CI 1.01–1.56). Numerically higher rates of MACE-4, incident ASCVD, and peripheral artery disease were also observed in the PCSK9 inhibitor arm. These associations ran opposite to randomized-trial evidence and occurred in the presence of residual imbalance on body-mass index (standardized difference 0.647), HbA1c, and total cholesterol. Conclusions: A naïve reading of these results would suggest GLP-1 receptor agonists outperform PCSK9 inhibitors. This interpretation is almost certainly an artifact of confounding by indication. Residual imbalance in body-mass index, the coherent excess of all atherosclerotic endpoints in the PCSK9 inhibitor arm, and lower statin initiation in that arm indicate that matching failed to equalize baseline cardiovascular severity. This analysis serves as a cautionary case: propensity-score matching on measured covariates cannot support causal comparison between drug classes with such divergent prescribing indications.