scholarly journals 1471Metadata on calprotectin, an emerging biomarker of interest in COVID-19

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Raphael Udeh

Abstract Background COVID-19 has been shown to present with a varied clinical course, hence the need for more specific diagnostic tools that could identify severe cases and predict outcomes during COVID-19 infection. Recent evidence has shown an expanded potential role for calprotectin, both as a diagnostic tool and as a stratifying tool in COVID-19 patients in terms of severity. Therefore, this systematic review and meta-analysis aims to evaluate the levels of calprotectin in severe and non-severe COVID-19 and also identify the implication of raised calprotectin levels. Methods Databases searched include MEDLINE, EMBASE, the Cochrane Library, Web of Science, and MedRxiv. Stata was employed in meta-analysis to compare the serum/faecal levels of calprotectin between severe and non-severe COVID-19 infections. Results A pooled analysis of data in the 8 quantitative studies from 613 patients who were RT-PCR positive for COVID-19 (average age = 55 years; 52% males) showed an overall estimate as 1.34 (95%CI: 0.77, 1.91). Stata was further employed to carry out an in-depth investigation of the in-between study heterogeneity. Conclusion In conclusion, calprotectin levels have been demonstrated to be significantly elevated in COVID-19 patients who develop the severe form of the disease, and it also has prognostic significance. Key message This is the first comprehensive metadata on calprotectin in COVID-19. And as a druggable target for tasquinimod, calprotectin potentially remains a key therapeutic intervention strategy in COVID-19 management.

2021 ◽  
Vol 10 (4) ◽  
pp. 775
Author(s):  
Raphael Udeh ◽  
Shailesh Advani ◽  
Luis García de Guadiana Romualdo ◽  
Xenia Dolja-Gore

COVID-19 has been shown to present with varied clinical course, necessitating a need for more specific diagnostic tools that could identify severe cases and predict outcomes during COVID-19 infection. Recent evidence has shown an expanded potential role for calprotectin, both as a diagnostic tool and also as a tool in stratifying COVID-19 patients in terms of severity. Therefore, this systematic review and meta-analysis aims to evaluate the levels of calprotectin in severe and non-severe COVID-19 and also identify the implication of raised calprotectin levels. MEDLINE, EMBASE, The Cochrane Library, Web of science and MedRxiv were searched. Meta-analysis was done to compare the serum/fecal levels of calprotectin between severe and non-severe COVID-19 infections. A total of ten studies included in the review (eight had quantitative data while two were qualitative). A pooled analysis of the eight studies from 613 patients who were RT-PCR positive for COVID-19 (average age = 55 years; 52% males) showed an overall estimate as 1.34 (95%CI: 0.77, 1.91). In conclusion, calprotectin levels have been demonstrated to be significantly elevated in COVID-19 patients who develop the severe form of the disease, and it also has prognostic importance.


2020 ◽  
Author(s):  
Yiding Li ◽  
Guiling Wu ◽  
Wanli Yang ◽  
Xiaoqian Wang ◽  
Lili Duan ◽  
...  

Abstract Background: Esophageal carcinoma (EC) is the seventh-most prevalent tumor in the world, which is still one of the primary causes of tumor-related death. Identifying noteworthy biomarkers for EC is particularly significant in guiding effective treatment. Recently, circulating tumor cells (CTCs) in peripheral blood (PB) were intensively discussed as prognostic markers in patients with EC. However, an ongoing controversy still exists regarding the prognostic significance of CTCs determined by the CellSearch system in EC sufferers. This meta-analysis was designed to approach this topic. Methods: We systematically conducted searches using PubMed, Medline, Web of Science and the Cochrane Library for relevant studies, which were published through February 20, 2020. Using the random-effects model, our study was performed in Review Manager software, with odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs) and 95% confidence intervals (CIs) as the effect values. Results: Totally 7 articles were finally included in this study. For clinicopathological characteristics, the pooled results on TNM stage indicated that the III/IV group had higher rate of CTCs compared with the I/II group (OR=1.36, 95% CI: 0.68-2.71, I2=0%). Incidence of CTCs was higher in patients with T3/T4 stage (OR=2.92, 95% CI: 1.31-6.51, I2=0%) and distant metastasis group (OR=5.18, 95% CI: 2.38-11.25, I2=0%) compared to patients with T1/T2 stage or non-metastatic group. The pooled analysis revealed that CTC positivity detected in EC patients was correlated with poor overall survival (OS) (HR=2.83, 95% CI:1.99-4.03, I2=0%) and relapse-free survival (RFS) (HR=4.71, 95% CI:2.73-8.13, I2=0%). When pooling the estimated RR, a poor therapeutic response to chemoradiotherapy was discovered in patients with CTC positivity (RR=1.99, 95% CI:1.73-2.29, I2=60%). Conclusions: In summary, our meta-analysis demonstrated that CTCs positivity determined by the CellSearch system are correlated with the prognosis of EC patients and might indicate a poor therapeutic response to chemotherapy in EC patients.


2021 ◽  
Vol 11 ◽  
Author(s):  
Benjamin Bjørseth ◽  
Josefine Oudmayer Simensen ◽  
Aina Bjørnethun ◽  
Mark D. Griffiths ◽  
Eilin K. Erevik ◽  
...  

Pop-up messages utilized by gambling operators are normally presented to gamblers during gambling sessions in order to prevent excessive gambling and/or to help in the appraisal of maladaptive gambling cognitions. However, the effect of such messages on gambling behavior and gambling cognitions has not previously been synthesized quantitatively. Consequently, a meta-analysis estimating the efficacy of pop-up messages on gambling behavior and cognitions was conducted. A systematic literature search with no time constraints was performed on Web of Science, PsychInfo, Medline, PsychNET, and the Cochrane Library. Search terms included “gambling,” “pop-up,” “reminder,” “warning message,” and “dynamic message.” Studies based on randomized controlled trials, quasi-experimental designs and pre-post studies reporting both pre- and post-pop-up data were included. Two authors independently extracted data using pre-defined fields including quality assessment. A total of 18 studies were included and data were synthesized using a random effects model estimating Hedges' g. The effects of pop-ups were g = 0.413 for cognitive measures (95% CI = 0.115–0.707) and g = 0.505 for behavioral measures (95% CI = 0.256–0.746). For both outcomes there was significant between-study heterogeneity which could not be explained by setting (laboratory vs. naturalistic) or sample (gambler vs. non-gamblers). It is concluded that pop-up messages provide moderate effects on gambling behavior and cognitions in the short-term and that such messages play an important role in the gambling operators' portfolio of responsible gambling tools.


Author(s):  
Pingping Xu ◽  
Jiajia Lin ◽  
Qi Lin ◽  
Dexiang Zhu ◽  
Wentao Tang ◽  
...  

Previous studies on the prognostic impact of survivin expression in gastrointestinal (GI) cancer have yielded inconsistent results. This study was initiated to assess the relationship between survivin expression and overall survival (OS) or disease free survival (DFS) in GI cancer patients. We applied system literature searches on EMBASE, PubMed, Web of science, and the Cochrane library to conduct this up-to-date meta-analysis. Thirty studies with totally 3622 GI cancer patients were collected. The prevalence of high survivin expression in GI cancer was 0.57 (95% CI: 0.51-0.63). High survivin expression was significantly associated with shorter OS (HR 1.57, 95% CI: 1.42-1.74) and DFS (HR 1.38, 95% CI: 1.21-1.58). Subgroup analysis also showed significant association between high survivin expression and poorer OS or DFS in gastric cancer or colorectal cancer. In summary, our study indicated that high survivin expression was related to poor prognosis in GI cancer. Well-designed studies with large sample and more convincing data are needed to confirm our conclusion.


2020 ◽  
Author(s):  
Yiding Li ◽  
Guiling Wu ◽  
Wanli Yang ◽  
Xiaoqian Wang ◽  
Lili Duan ◽  
...  

Abstract Background: Esophageal carcinoma (EC) is the seventh-most prevalent tumour in the world, which is still the primary cause of tumour-related death. Identifying noteworthy biomarkers for EC is particularly significant in guiding active and effective treatment. Recently, circulating tumour cells (CTCs) in peripheral blood (PB) were intensively discussed as prognostic markers in patients with EC. However, an ongoing controversy still exists regarding the prognostic significance of CTCs determined using the CellSearch System in EC sufferers. This meta-analysis was designed to approach this topic. Methods: We systematically conducted searches using PubMed, Medline, Web of Science and the Cochrane Library for relevant studies, which were published through February 20, 2020. Using the random-effects model, our study was performed in Review Manager software, with odds ratios (ORs), risk ratios (RRs), hazard ratios (HRs) and 95% confidence intervals (CIs) as effect values. Results: In total, 7 articles were finally included in this study. For clinicopathological characteristics, the pooled results on TNM stage indicated that the III/IV group had higher incidence of CTCs compared with the I/II group (OR=1.36, 95% CI (0.68,2.71), I2=0%). Incidence of CTCs was higher among patients on T3/T4 stage (OR=2.92, 95% CI (1.31,6.51), I2=0%) and distant metastasis group (OR=5.18, 95% CI (2.38,11.25), I2=0%) compared to patients on T1/T2 stage or non-metastatic group. The pooled analysis revealed that CTC positivity detected in EC patients was correlated with poor overall survival (OS) (HR =2.83, 95% CI (1.99,4.03), I2=0%) and relapse-free survival (RFS) (HR =4.71, 95% CI (2.73,8.13), I2=0%). When pooling the estimated RR, a poor therapeutic response to chemoradiotherapy was discovered in patients with CTC positivity (RR =1.99, 95% CI (1.73,2.29), I2=60%). Conclusions: In summary, our meta-analysis demonstrated that CTCs from PB of EC patients determined using the CellSearch System are correlated with the prognosis of EC patients and might indicate a poor therapeutic response to chemotherapy in EC patients.


2021 ◽  
pp. 112070002110419
Author(s):  
Ahmed A Magan ◽  
Ganan T Radhakrishnan ◽  
Babar Kayani ◽  
Flaminia Ronca ◽  
Vikas Khanduja ◽  
...  

Introduction: Total Hip Arthroplasty (THA) is being increasingly undertaken in younger and more active patients, with many of these patients wanting to return to sport (RTS) after surgery. However, the percentage of patients RTS and time at which they are able to get back to sport following surgery remains unknown. The objective of this meta-analysis was to determine the time patients RTS after THA. Methods: A search was performed on PUBMED, MEDLINE, EMBASE, and the Cochrane Library for trials on THA and RTS, in the English language, published from the inception of the database to October 2020. All clinical trials reporting on to RTS following THA were included. Data relating to patient demographics, methodological quality, RTS, clinical outcomes and complications were recorded. The PRISMA guidelines were used to undertake this study. Results: The initial literature search identified 1720 studies. Of these, 11 studies with 2297 patients matched the inclusion criteria. 3 studies with 154 patients demonstrated an overall pooled proportion of 40.0% (95% CI, 32.5–47.9%) of patients RTS between 2 and 3 months after surgery. 4 studies with 242 patients demonstrated an overall pooled proportion of 76.9% (95% CI, 71.5–82.0) of patients RTS by 6 months after surgery. Pooled proportion analysis from 7 trials with 560 patients demonstrated 93.9% (95% CI, 82.7–99.5%) of patients RTS between 6 and 12 months after surgery. Conclusions: Pooled proportion analysis showed increasingly more patients were able to RTS after THA over the first 1 year after surgery. There remains marked inter and intra-study variations in time for RTS but the pooled analysis shows that over 90% of patients were able to RTS at 6–12 months after THA. These finding will enable more informed discussions between patients and healthcare professionals about time for RTS following THA.


2020 ◽  
Vol 54 (8) ◽  
pp. 750-756
Author(s):  
Kang Xiao ◽  
Fu-Zhen Li ◽  
Shen-Zhi Liang ◽  
Jiong Wang ◽  
Cheng Qian ◽  
...  

Background: Aflibercept has been widely used in treating diabetic macular edema (DME). However, the effect of aflibercept in treating DME refractory to bevacizumab or ranibizumab has not been well established. Objective: To assess the therapeutic effect of switching from bevacizumab or ranibizumab to aflibercept in the treatment of refractory DME. Methods: Relevant studies were searched from 3 databases: the Cochrane Library, PubMed, and Web of Science. Data on changes in best-corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events within the follow-up period were collected and pooled using weighted mean differences (WMDs) with corresponding 95% CIs in a random effects model. The between-study heterogeneity was tested using the χ2 test and the I2 statistic, and funnel plots were used to evaluate the publication bias. Results: A total of 11 nonrandomized trials met the inclusion criteria and were included in the meta-analysis. Our studies showed significant improvements in the BCVA (WMD = 100.55; 95% CI = 68.46 to 132.63; P < 0.01) and reduction in CMT (WMD = 0.09; 95% CI = 0.03 to 0.14; P < 0.01) after switching to aflibercept. Although a large amount of heterogeneity was detected in the CMT results among these studies, the sensitivity analyses showed the reliability and stability of our results. Conclusion and Relevance: There were significant improvements in both visual and anatomical outcomes after switching from bevacizumab or ranibizumab to aflibercept, without risk of adverse events. Thus, switching therapy may be a safe and effective treatment for patients with refractory DME.


2021 ◽  

Background: The purpose of this study was to explore the ability of nonpharmacologic adjuvant interventions to alleviate pain in male patients during flexible cystoscopy (FC) under local anesthesia. Methods: Electronic databases including PubMed, the Cochrane Library, and Embase were searched to identify eligible clinical trials from inception to 31 December 2020, with no language restrictions. Two independent reviewers used Cochrane Collaboration tools to assess the selection criteria, methodological rigor and risk of bias. Statistical analyses were performed using STATA 14.2. Results: In total, 717 studies were initially identified, and fourteen randomized controlled trials were ultimately included. We observed that patients who underwent FC with higher irrigation pressures had significantly lower pain scores on the visual analog scale than their counterparts with lower irrigation pressure during FC (weight mean difference (WMD): −1.43; 95% confidence interval (CI): −1.72 to −1.14) with no between-study heterogeneity (p = 0.661). There were no significant differences in pain between immediate or delayed FC groups under the same local anesthetic (standard mean difference (SMD): −0.19; 95% CI: −0.39 to 0.01). A pooled analysis of three studies including 340 male patients showed that men who observed the cystoscopy on the monitor had significantly lower pain ratings compared to those who did not view the operation on the monitor (SMD: −0.64; 95% CI: −1.14 to −0.15). Two studies, including a total of 272 patients, assessed the influence of listening to music on pain and anxiety in male patients during FC. Our meta-analysis found that music significantly improved patient pain (WMD: −0.92; 95% CI: −1.29 to −0.54). Hand-holding and urination during FC also relieved pain and anxiety in male patients undergoing FC. Conclusions: We observed that elevated irrigation pressure, real-time cystoscopy visualization, and music therapy alleviated pain in male patients undergoing FC. Well-designed trials are needed to confirm our findings.


Author(s):  
Ramsey Powell ◽  
Marc P. Pelletier ◽  
Michael W. A. Chu ◽  
Denis Bouchard ◽  
Kevin N. Melvin ◽  
...  

Surgical aortic valve replacement with a stented prosthesis has been the standard of care procedure for aortic stenosis. The Perceval (LivaNova, London, United Kingdom) is a sutureless aortic valve bioprosthesis currently implanted in more than 20,000 patients. The purpose of this article was to review the literature available after 9 years of clinical experience of the Perceval aortic valve. PubMED, Embase, and the Cochrane Library databases were searched. A meta-analysis of summary statistics from individual studies was conducted. A total of 333 studies were identified and 84 studies were included. Thirty-day mortality and 5-year survival ranged from 0% to 4.9% and 71.3% to 85.5%, respectively. Compared with stented prosthesis, pooled analysis demonstrated a statistically significant reduction in aortic cross-clamp and cardiopulmonary bypass times (minutes) with Perceval (38.6 vs 63.3 and 61.4 vs 84.9, P < 0.00001, respectively). Compared with transcatheter aortic valve implantation, pooled analysis demonstrated a statistically significant reduction with Perceval in paravalvular leakage (1.26% vs 14.31%) and early mortality (2.3% vs 6.9%). Favorable hemodynamics, acceptable valve durability, and ease of implantation in minimally invasive cases were reported as benefits. A trend toward increased rates of permanent pacemaker implantation and low postoperative platelet count were identified. Special use and off-label procedures described included bicuspid aortic valves, valve-in-valve for homo-graft and stentless prosthesis failure, concomitant valvular procedures, porcelain aorta, and endocarditis. The Perceval valve has shown safe clinical and hemodynamic outcomes. Outcomes support its continued usage and potential expansion.


2020 ◽  
Vol 14 (7) ◽  
pp. 599-609
Author(s):  
Xuejiao Shi ◽  
Renhua Zhou ◽  
Leizhen Zheng ◽  
Mawei Jiang

Aim: The clinicopathological and prognostic significance of C-MYC dysregulation (amplification or overexpression) in esophageal squamous cell carcinoma (ESCC) remains controversial. Therefore, we performed this meta-analysis to elucidate this relationship. Materials & methods: Available studies were retrieved from PubMed, Web of Science, EMBASE and the Cochrane Library, and ten studies with a total of 1432 patients were included in this meta-analysis. Results: Pooled results showed that C-MYC dysregulation was significantly associated with poor overall survival (hazard ratio: 1.405 [95% CI: 1.170–1.639]; p < 0.001) and lymph node metastasis (odds ratio: 1.798 [95% CI: 1.125–2.873]; p = 0.014). Subgroup analysis confirmed the results and more prominent predictive effects were observed in the C-MYC amplification group. Conclusion: C-MYC dysregulation is a promising biomarker for ESCC prognosis.


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