scholarly journals Clinical characteristics and outcome of hydrocephalus in neurosarcoidosis: a retrospective cohort study and review of the literature

2021 ◽  
Author(s):  
Leroy ten Dam ◽  
Diederik van de Beek ◽  
Matthijs C. Brouwer
Keyword(s):  
Clinical Characteristics ◽  
Obstructive Hydrocephalus ◽  
Meta Analysis ◽  
Age At Onset ◽  
Medical Emergency ◽  
Presenting Symptoms ◽  
Cerebral Herniation ◽  
Csf Shunting ◽  
Gait Abnormalities ◽  
Neurosurgical Intervention

AbstractHydrocephalus is reported in approximately one-tenth of neurosarcoidosis patients. However, data on clinical characteristics and outcome are lacking. In this retrospective study, we present 11 patients with neurosarcoidosis and hydrocephalus on neuroimaging. Median age was 52 years and seven were female (64%). Presenting symptoms consisted of headache in 8 out of 11 (73%), vertigo in 5 (46%), gait abnormalities in 4 (36%), diplopia in 2 (18%) and decreased visual acuity in 1 (9%). Cranial imaging showed obstructive hydrocephalus in 10 (91%) and non-obstructive hydrocephalus in 1 (9%) out of 11, obstruction occurred at the level of the fourth ventricle in 6 out of 10 (60%). Treatment consisted of glucocorticoids in all the patients with additional methotrexate or azathioprine in 6 (55%) and infliximab in 1 (9%) patient. Neurosurgical intervention was performed in 10 out of 11 (91%) patients. Treatment led to remission, improvement or stabilization of disease in 9 out of 10 (90%) of patients. One patient died due to cerebral herniation despite neurosurgical decompression and CSF shunting. Median modified Rankin scale score at last follow-up was 2 (range 0–6). A systematic review and meta-analysis of studies on hydrocephalus due to neurosarcoidosis identified 36 patients that compared to our patients had a lower median age at onset and a higher mortality. Acute obstructive hydrocephalus due to neurosarcoidosis is a potentially fatal medical emergency requiring neurosurgical intervention and initiation of immunosuppressive therapy. If patients survive the initial phase, the outcome is generally favorable.

scholarly journals Clinical Characteristics Associated With Stuttering Persistence: A Meta-Analysis

2020 ◽  
Vol 63 (9) ◽  
pp. 2995-3018
Author(s):  
Cara M. Singer ◽  
Alison Hessling ◽  
Ellen M. Kelly ◽  
Lisa Singer ◽  
Robin M. Jones
Keyword(s):  
Family History ◽  
Clinical Characteristics ◽  
Language Skills ◽  
Meta Analysis ◽  
Age At Onset ◽  
Speech Sound ◽  
Receptive Language ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
History Of

Purpose The purpose of this meta-analytic study was to identify clinical characteristics, defined as child factors that can be assessed by a speech-language pathologist as part of a routine speech-language evaluation that may differentiate children who persist in stuttering from children who eventually recover from stuttering. Clinical characteristics explored included sex, age at onset, family history of stuttering, stuttering frequency and severity, speech-language skills, and temperament. Method Studies were identified through electronic databases, journals, and reference lists of relevant reports (e.g., research articles). Eligible studies followed young children who stutter (i.e., under 6 years old) for at least 24 months, assessed a potential clinical marker at study entry, and determined talker group classification (i.e., persistent or recovered) at study completion. Sex and family history differences were estimated using risk ratios; all other differences were estimated using Hedges's g . Heterogeneity and methodological differences among studies were evaluated. Results Eleven studies (41 reports) met eligibility criteria. Persistent children were older at stuttering onset and exhibited higher frequencies of stuttering-like disfluencies, lower speech sound accuracy, and lower expressive and receptive language skills than recovered children. Males and children with a family history of stuttering were also more likely to persist. Conclusions Clinical characteristics were identified that are associated with increased risk for stuttering persistence. Future studies have the potential to translate these clinical characteristics into prognostic markers for stuttering persistence risk.

scholarly journals The Association betweenLRRK2G2385R and Phenotype of Parkinson’s Disease in Asian Population: A Meta-Analysis of Comparative Studies

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Di ◽  
Zhiyong Zeng ◽  
Jingyan Li ◽  
Xiaoling Liu ◽  
Minzhi Bo ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Family History ◽  
Clinical Characteristics ◽  
Disease Duration ◽  
Meta Analysis ◽  
Age At Onset ◽  
Asian Population ◽  
Related Case ◽  
Initial Symptoms

Numerous studies have investigated the relationship between theLRRK2G2385R variant and clinical characteristics in Parkinson’s disease (PD), but the results have been inconsistent. This study investigated whether theLRRK2G2385R variant was associated with a unique clinical phenotype of PD in the Asian population, using a meta-analysis. The PubMed, Web of Science, EMBASE, CNKI, and WANFANG databases were searched until September 2017. The strict selection criteria and exclusion criteria were determined, and mean differences (MD) or odds ratios (OR) with 95% confidence intervals (CI) were used to assess the strength of associations. Statistical analyses and graphics were performed using Review Manager 5.3. Sixteen related case-control studies were included in the meta-analysis. TheLRRK2G2385R carriers significantly more often presented a family history (OR: 1.98; 95% CI: 1.16−3.39;P=0.01) and had a longer disease duration (MD = 0.47, 95% CI: 0.01−0.93,P=0.04) and a higher MMSE score (MD = 1.02, 95% CI: 0.43–1.62P=0.0007) thanLRRK2G2385R noncarriers. There were no significant differences in sex distribution, age at onset, initial symptoms, motor symptoms, depression, levodopa-equivalent dose, and related complications betweenLRRK2G2385R-carrier andLRRK2G2385R-noncarrier PD patients. Our results suggested that most of the clinical characteristics of PD patients withLRRK2G2385R mutations are similar to those ofLRRK2G2385R noncarriers among Asian PD patients, except for the more common family history, relatively longer disease duration, and higher MMSE scores in the former group.

COVID-19 in Healthcare Workers: A Systematic Review and Meta-Analysis of Prevalence, Risk Factors, Clinical Characteristics, and Outcomes

2020 ◽  
Author(s):  
Sergio Alejandro Gómez-Ochoa ◽  
Oscar H. Franco ◽  
Lyda Z. Rojas ◽  
Sandra Lucrecia Romero Guevara ◽  
Luis Eduardo Echeverría ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Meta Analysis

scholarly journals Clinical features and outcomes of COVID-19 in older adults: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sunny Singhal ◽  
Pramod Kumar ◽  
Sumitabh Singh ◽  
Srishti Saha ◽  
Aparajit Ballav Dey
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Critically Ill ◽  
Clinical Features ◽  
Older Patients ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Severe Infection ◽  
Factors Affecting ◽  
Pooled Prevalence

Abstract Background Few studies have focused on exploring the clinical characteristics and outcomes of COVID-19 in older patients. We conducted this systematic review and meta-analysis to have a better understanding of the clinical characteristics of older COVID-19 patients. Methods A systematic search of PubMed and Scopus was performed from December 2019 to May 3rd, 2020. Observational studies including older adults (age ≥ 60 years) with COVID-19 infection and reporting clinical characteristics or outcome were included. Primary outcome was assessing weighted pooled prevalence (WPP) of severity and outcomes. Secondary outcomes were clinical features including comorbidities and need of respiratory support. Result Forty-six studies with 13,624 older patients were included. Severe infection was seen in 51% (95% CI– 36-65%, I2–95%) patients while 22% (95% CI– 16-28%, I2–88%) were critically ill. Overall, 11% (95% CI– 5-21%, I2–98%) patients died. The common comorbidities were hypertension (48, 95% CI– 36-60% I2–92%), diabetes mellitus (22, 95% CI– 13-32%, I2–86%) and cardiovascular disease (19, 95% CI – 11-28%, I2–85%). Common symptoms were fever (83, 95% CI– 66-97%, I2–91%), cough (60, 95% CI– 50-70%, I2–71%) and dyspnoea (42, 95% CI– 19-67%, I2–94%). Overall, 84% (95% CI– 60-100%, I2–81%) required oxygen support and 21% (95% CI– 0-49%, I2–91%) required mechanical ventilation. Majority of studies had medium to high risk of bias and overall quality of evidence was low for all outcomes. Conclusion Approximately half of older patients with COVID-19 have severe infection, one in five are critically ill and one in ten die. More high-quality evidence is needed to study outcomes in this vulnerable patient population and factors affecting these outcomes.

scholarly journals Age at onset of mental disorders worldwide: large-scale meta-analysis of 192 epidemiological studies

2021 ◽  
Author(s):  
Marco Solmi ◽  
Joaquim Radua ◽  
Miriam Olivola ◽  
Enrico Croce ◽  
Livia Soardo ◽  
...  
Keyword(s):  
Mental Health ◽  
Early Intervention ◽  
Mental Disorders ◽  
Meta Analysis ◽  
Age At Onset ◽  
Autism Spectrum ◽  
Stress Disorders ◽  
Obsessive Compulsive ◽  
Good Mental Health ◽  
Significant Difference

AbstractPromotion of good mental health, prevention, and early intervention before/at the onset of mental disorders improve outcomes. However, the range and peak ages at onset for mental disorders are not fully established. To provide robust, global epidemiological estimates of age at onset for mental disorders, we conducted a PRISMA/MOOSE-compliant systematic review with meta-analysis of birth cohort/cross-sectional/cohort studies, representative of the general population, reporting age at onset for any ICD/DSM-mental disorders, identified in PubMed/Web of Science (up to 16/05/2020) (PROSPERO:CRD42019143015). Co-primary outcomes were the proportion of individuals with onset of mental disorders before age 14, 18, 25, and peak age at onset, for any mental disorder and across International Classification of Diseases 11 diagnostic blocks. Median age at onset of specific disorders was additionally investigated. Across 192 studies (n = 708,561) included, the proportion of individuals with onset of any mental disorders before the ages of 14, 18, 25 were 34.6%, 48.4%, 62.5%, and peak age was 14.5 years (k = 14, median = 18, interquartile range (IQR) = 11–34). For diagnostic blocks, the proportion of individuals with onset of disorder before the age of 14, 18, 25 and peak age were as follows: neurodevelopmental disorders: 61.5%, 83.2%, 95.8%, 5.5 years (k = 21, median=12, IQR = 7–16), anxiety/fear-related disorders: 38.1%, 51.8%, 73.3%, 5.5 years (k = 73, median = 17, IQR = 9–25), obsessive-compulsive/related disorders: 24.6%, 45.1%, 64.0%, 14.5 years (k = 20, median = 19, IQR = 14–29), feeding/eating disorders/problems: 15.8%, 48.1%, 82.4%, 15.5 years (k = 11, median = 18, IQR = 15–23), conditions specifically associated with stress disorders: 16.9%, 27.6%, 43.1%, 15.5 years (k = 16, median = 30, IQR = 17–48), substance use disorders/addictive behaviours: 2.9%, 15.2%, 48.8%, 19.5 years (k = 58, median = 25, IQR = 20–41), schizophrenia-spectrum disorders/primary psychotic states: 3%, 12.3%, 47.8%, 20.5 years (k = 36, median = 25, IQR = 20–34), personality disorders/related traits: 1.9%, 9.6%, 47.7%, 20.5 years (k = 6, median = 25, IQR = 20–33), and mood disorders: 2.5%, 11.5%, 34.5%, 20.5 years (k = 79, median = 31, IQR = 21–46). No significant difference emerged by sex, or definition of age of onset. Median age at onset for specific mental disorders mapped on a time continuum, from phobias/separation anxiety/autism spectrum disorder/attention deficit hyperactivity disorder/social anxiety (8-13 years) to anorexia nervosa/bulimia nervosa/obsessive-compulsive/binge eating/cannabis use disorders (17-22 years), followed by schizophrenia, personality, panic and alcohol use disorders (25-27 years), and finally post-traumatic/depressive/generalized anxiety/bipolar/acute and transient psychotic disorders (30-35 years), with overlap among groups and no significant clustering. These results inform the timing of good mental health promotion/preventive/early intervention, updating the current mental health system structured around a child/adult service schism at age 18.

scholarly journals A systematic review and meta-analysis protocol examining the clinical characteristics and epidemiological features of olfactory dysfunction (OD) in coronavirus disease 2019 (COVID-19)

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Rosemond Qian-Xiu Tan ◽  
Wai Tak Victor Li ◽  
Wing-Zi Shum ◽  
Sheung Chit Chu ◽  
Hang-Long Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Data ◽  
Systematic Reviews ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Olfactory Dysfunction ◽  
Statistical Analyses ◽  
Human Populations ◽  
Meta Analyses ◽  
Analysis Protocol

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has caused recurring and major outbreaks in multiple human populations around the world. The plethora of clinical presentations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been described extensively, of which olfactory dysfunction (OD) was established as an important and common extrapulmonary manifestation of COVID-19 infection. The aim of this protocol is to conduct a systematic review and meta-analysis on peer-reviewed articles which described clinical data of OD in COVID-19 patients. Methods This research protocol has been prospectively registered with the Prospective Register of Systematic Reviews (PROSPERO; CRD42020196202). CINAHL, ClinicalTrials.gov, Cochrane Central, EMBASE, MEDLINE and PubMed, as well as Chinese medical databases China National Knowledge Infrastructure (CNKI), VIP and WANFANG, will be searched using keywords including ‘COVID-19’, ‘coronavirus disease’, ‘2019-nCoV’, ‘SARS-CoV-2’, ‘novel coronavirus’, ‘anosmia’, ‘hyposmia’, ‘loss of smell’, and ‘olfactory dysfunction’. Systematic review and meta-analysis will be conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines. Articles will be screened according to pre-specified inclusion and exclusion criteria to extract studies that include new clinical data investigating the effect of COVID-19 on olfactory dysfunction. Included articles will be reviewed in full; data including patient demographics, clinical characteristics of COVID-19-related OD, methods of olfactory assessment and relevant clinical outcomes will be extracted. Statistical analyses will be performed using the Comprehensive Meta-Analysis version 3. Discussion This systematic review and meta-analysis protocol will aim to collate and synthesise all available clinical evidence regarding COVID-19-related OD as an important neurosensory dysfunction of COVID-19 infection. A comprehensive search strategy and screening process will be conducted to incorporate broad clinical data for robust statistical analyses and representation. The outcome of the systematic review and meta-analysis will aim to improve our understanding of the symptomatology and clinical characteristics of COVID-19-related OD and identify knowledge gaps in its disease process, which will guide future research in this specific neurosensory defect. Systematic review registration PROSPERO registration number: CRD42020196202.

scholarly journals Toxoplasma gondii Infection and Clinical Characteristics of Patients With Schizophrenia: A Systematic Review and Meta-analysis

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Arjen L Sutterland ◽  
David A Mounir ◽  
Juul J Ribbens ◽  
Bouke Kuiper ◽  
Tom van Gool ◽  
...  
Keyword(s):  
Systematic Review ◽  
Toxoplasma Gondii ◽  
Publication Bias ◽  
Clinical Characteristics ◽  
Negative Symptoms ◽  
Age Of Onset ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Duration Of Illness ◽  
Toxoplasma Gondii Infection

Abstract Schizophrenia is associated with an increased prevalence of IgG antibodies against Toxoplasma gondii (T. gondii seropositivity), whereby the infection seems to precede the disorder. However, it remains unclear whether a T. gondii infection affects clinical characteristics of schizophrenia. Therefore, a systematic review and meta-analysis was conducted following PRISMA guidelines examining the association between T. gondii seropositivity and severity of total, positive, or negative symptoms or age of onset in schizophrenia. PubMed, Embase, and PsycInfo were systematically searched up to June 23, 2019 (PROSPERO #CRD42018087766). Random-effects models were used for analysis. Furthermore, the influence of potential moderators was analyzed. Indications for publication bias were examined. From a total of 934 reports, 13 studies were included. No overall effect on severity of total, positive, or negative symptoms was found. However, in patients with a shorter duration of illness T. gondii seropositivity was associated with more severe positive symptoms (standardized mean difference [SMD] = 0.32; P < .001). Similar but smaller effects were seen for total symptoms, while it was absent for negative symptoms. Additionally, a significantly higher age of onset was found in those with T. gondii seropositivity (1.8 y, P = .015), although this last finding was probably influenced by publication bias and study quality. Taken together, these findings indicate that T. gondii infection has a modest effect on the severity of positive and total symptoms in schizophrenia among those in the early stages of the disorder. This supports the hypothesis that T. gondii infection is causally related to schizophrenia, although more research remains necessary.

scholarly journals Antimicrobial-impregnated and -coated shunt catheters for prevention of infections in patients with hydrocephalus: a systematic review and meta-analysis

2015 ◽  
Vol 122 (5) ◽  
pp. 1096-1112 ◽  
Author(s):  
Athanasios A. Konstantelias ◽  
Konstantinos Z. Vardakas ◽  
Konstantinos A. Polyzos ◽  
Giannoula S. Tansarli ◽  
Matthew E. Falagas
Keyword(s):  
De Novo ◽  
Meta Analysis ◽  
Ventricular Drainage ◽  
Gram Negative ◽  
Ventriculoperitoneal Shunting ◽  
Csf Shunting ◽  
Statistical Heterogeneity ◽  
Catheter Implantation ◽  
Prevention Of Infections ◽  
Definition Of

OBJECT The aim of this study was to evaluate the effectiveness of antimicrobial-impregnated and -coated shunt catheters (antimicrobial catheters) in reducing the risk of infection in patients undergoing CSF shunting or ventricular drainage. METHODS The PubMed and Scopus databases were searched. Catheter implantation was classified as either shunting (mainly ventriculoperitoneal shunting) or ventricular drainage (mainly external [EVD]). Studies evaluating antibioticimpregnated catheters (AICs), silver-coated catheters (SCCs), and hydrogel-coated catheters (HCCs) were included. A random effects model meta-analysis was performed. RESULTS Thirty-six studies (7 randomized and 29 nonrandomized, 16,796 procedures) were included. The majority of data derive from studies on the effectiveness of AICs, followed by studies on the effectiveness of SCCs. Statistical heterogeneity was observed in several analyses. Antimicrobial shunt catheters (AICs, SCCs) were associated with lower risk for CSF catheter–associated infections than conventional catheters (CCs) (RR 0.44, 95% CI 0.35–0.56). Fewer infections developed in the patients treated with antimicrobial catheters regardless of randomization, number of participating centers, funding, shunting or ventricular drainage, definition of infections, de novo implantation, and rate of infections in the study. There was no difference regarding gram-positive bacteria, all staphylococci, coagulase-negative streptococci, and Staphylococcus aureus, when analyzed separately. On the contrary, the risk for methicillin-resistant S. aureus (MRSA, RR 2.64, 95% CI 1.26–5.51), nonstaphylococcal (RR 1.75, 95% CI 1.22–2.52), and gram-negative bacterial (RR 2.13, 95% CI 1.33–3.43) infections increased with antimicrobial shunt catheters. CONCLUSIONS Based on data mainly from nonrandomized studies, AICs and SCCs reduce the risk for infection in patients undergoing CSF shunting. Future studies should evaluate the higher risk for MRSA and gram-negative infections. Additional trials are needed to investigate the comparative effectiveness of the different types of antimicrobial catheters.

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