Variable Diagnostic Performance of Stool Xpert in Pediatric Tuberculosis: a systematic review and meta-analysis

Abstract Background Difficult specimen collection and low bacillary load makes microbiological confirmation of tuberculosis (TB) in children challenging. In this study, we conducted a systematic review and meta-analysis to assess diagnostic accuracy of Xpert on stool for pediatric tuberculosis. Methods Our search included studies from 2011 through 2019 and specific search terms were used to retrieve articles from Pubmed, EMBASE, BIOSIS, Clinical trials.gov and Google scholar. Risk of bias was assessed using QUADAS 2 tool. The protocol was registered in PROSPERO (CRD42018083637). Summary estimates of sensitivity and specificity were conducted using meta-disc Software assuming a random effects model. Results We identified 12 eligible studies which included data from 2177 children, of whom 295 (13.6%) had bacteriologically confirmed TB on respiratory specimens. The pooled sensitivity of xpert MTB/RIF on stool specimens compared to bacteriologically confirmed tuberculosis with respiratory specimens was 0.50 (95%CI 0.44-0.56) with I 2 of 86%, which was statistically significant (p<0.001). The pooled specificity was 0.99 (95% CI 0.98-0.99), I 2 of 0.0%, p=0.44. Conclusions Despite the observed heterogeneity, stool may be considered as an additional specimen to support diagnosis of pulmonary TB in children especially in settings where it is impossible to get respiratory samples. Further studies should evaluate its optimization as a diagnostic tool.

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Baduanjin Exercise for Adults Aged 65 Years and Older: A Systematic Review and Meta-Analysis of Randomized Controlled Studies

Journal of Applied Gerontology ◽

10.1177/07334648211059324 ◽

2021 ◽

pp. 073346482110593

Author(s):

Cindy Jones ◽

Meiling Qi ◽

Zihui Xie ◽

Wendy Moyle ◽

Benjamin Weeks ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Mainland China ◽

Walking Ability ◽

Search Terms ◽

Randomized Controlled Studies ◽

Chinese Studies ◽

Older Chinese

This study performed a systematic review and meta-analysis to evaluate the health effects of Baduanjin exercise on adults aged 65 years and older. Chinese and English databases were electronically searched using search terms related to the PICO model from inception through June 2021. The study quality assessment and meta-analysis were conducted using the PEDro scale and RevMan 5.4 software. Eleven included Chinese studies, published between 2015 and 2021, recruited participants from the mainland of China. The aggregated results showed significant benefits of Baduanjin on physical function, walking ability, balance, and anxiety. A long-term Baduanjin intervention could also improve quality of life and reduce falls and pain. Baduanjin appears to have the potential to improve the health of older adults, but conclusions are limited due to the lack of rigorous and robust studies within and outside of mainland China. Larger, well-designed RCTs are needed to confirm these findings.

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Abstract 16037: Hybrid Convergent Ablation for Atrial Fibrillation: Updated Systematic Review and Meta-analysis

Circulation ◽

10.1161/circ.142.suppl_3.16037 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

suvash shrestha ◽

David DeLurgio ◽

Andy Kiser ◽

Saumil Oza ◽

Yisachar Greenberg ◽

...

Keyword(s):

Systematic Review ◽

Patient Monitoring ◽

Event Rate ◽

Meta Analysis ◽

Adverse Event Rate ◽

Likelihood Estimator ◽

Search Terms ◽

Limited Effectiveness ◽

One Year ◽

Meta Analyses

Introduction: Hybrid convergent epicardial/endocardial ablation was developed in response to the limited effectiveness of endocardial catheter ablation for persistent (PersAF) and longstanding PersAF (LSPAF). The objective of this study was to perform a systematic review and meta-analysis of reported safety and efficacy outcomes with convergent procedures. Methods: Predefined search terms were used in PubMed; the initial search was performed in June 2019 and updated in May 2020. Abstracts and full text in English were reviewed for peer-reviewed, primary clinical studies of hybrid convergent procedures in PersAF/LSPAF. Meta-analysis was performed with using a random effects model with a restricted maximum likelihood estimator and forest plots. Heterogeneity was tested using Cochran’s Q-test. Results: The updated search yielded 325 unique results. Two articles from meta-analyses were added. Nineteen articles met inclusion with safety and/or efficacy data. Three overlapping studies were excluded. Results from the randomized CONVERGE trial were added, for a total of 1084 patients in 17 studies; 94% had PersAF or LSPAF. The 30-day major adverse event rate was 3.1% (95% CI 1.9% - 4.3%; n=1084; 17 studies), excluding pericardial effusions (PE) (non-emergent inflammatory response) and 5.1% (95% CI 3.6% - 6.6%) overall. The PEs may be mitigated by anti-inflammatory prophylaxis, pericardial drainage and appropriate patient monitoring. Freedom from AF/atrial arrhythmia at one year or later was 75.0% (95% CI 66.0%-83.9%; n=805; 14 studies) regardless of anti-arrhythmic drugs (AAD) and 64.9% (95% CI 54.7%-75.1%; n=494; 8 studies) off AADs/ absent increased dosage of failed AADs. Heterogeneity across studies was detected for effectiveness (p<0.0001), but not for safety (p=0.12). Conclusions: This meta-analysis shows high efficacy of hybrid convergent ablation at one year, even off AADs, and a reasonable safety in mostly persistent or long-standing persistent AF.

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Sleep Deprivation and Oxidative Stress in Animal Models: A Systematic Review

Oxidative Medicine and Cellular Longevity ◽

10.1155/2015/234952 ◽

2015 ◽

Vol 2015 ◽

pp. 1-15 ◽

Cited By ~ 62

Author(s):

Gabriel Villafuerte ◽

Adán Miguel-Puga ◽

Eric Murillo Rodríguez ◽

Sergio Machado ◽

Elias Manjarrez ◽

...

Keyword(s):

Oxidative Stress ◽

Systematic Review ◽

Sleep Deprivation ◽

Meta Analysis ◽

Exclusion Criteria ◽

Antioxidative Properties ◽

Search Terms ◽

Antioxidant Function ◽

Basic Studies ◽

And Oxidative Stress

Because the function and mechanisms of sleep are partially clear, here we applied a meta-analysis to address the issue whether sleep function includes antioxidative properties in mice and rats. Given the expansion of the knowledge in the sleep field, it is indeed ambitious to describe all mammals, or other animals, in which sleep shows an antioxidant function. However, in this paper we reviewed the current understanding from basic studies in two species to drive the hypothesis that sleep is a dynamic-resting state with antioxidative properties. We performed a systematic review of articles cited in Medline, Scopus, and Web of Science until March 2015 using the following search terms:Sleep or sleep deprivation and oxidative stress, lipid peroxidation, glutathione, nitric oxide, catalase or superoxide dismutase. We found a total of 266 studies. After inclusion and exclusion criteria, 44 articles were included, which are presented and discussed in this study. The complex relationship between sleep duration and oxidative stress is discussed. Further studies should consider molecular and genetic approaches to determine whether disrupted sleep promotes oxidative stress.

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Nonoperative treatment for nonperforated appendicitis in children: a systematic review and meta-analysis

Pediatric Surgery International ◽

10.1007/s00383-019-04610-1 ◽

2019 ◽

Vol 36 (3) ◽

pp. 261-269 ◽

Cited By ~ 3

Author(s):

Sonia Maita ◽

Björn Andersson ◽

Jan F. Svensson ◽

Tomas Wester

Keyword(s):

Systematic Review ◽

Acute Appendicitis ◽

Hospital Stay ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Nonoperative Treatment ◽

Controlled Study ◽

Randomized Controlled ◽

Search Terms ◽

Initial Hospital

AbstractAcute appendicitis is the most common surgical emergency in children. Nonoperative treatment of nonperforated acute appendicitis in children is an alternative to appendectomy. The purpose of this systematic review and meta-analysis was to determine the outcomes of nonoperative treatment of nonperforated acute appendicitis in children in the literature. Databases were searched to identify abstracts, using predefined search terms. The abstracts were reviewed by two independent reviewers and articles were selected according to inclusion and exclusion criteria. Data were extracted by the two reviewers and analyzed. The literature search yielded 2743 abstracts. Twenty-one articles were selected for analysis. The study design was heterogenous, with only one randomized controlled study. The symptoms resolved in 92% [95% CI (88; 96)] of the nonoperatively treated patients. Meta-analysis showed that an additional 16% (95% CI 10; 22) of patients underwent appendectomy after discharge from initial hospital stay. Complications and length of hospital stay was not different among patients treated with antibiotics compared with those who underwent appendectomy. Nonoperative treatment of nonperforated acute appendicitis children is safe and efficient. There is a lack of large randomized controlled trials to compare outcomes of nonoperative treatment with appendectomy.

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Characteristics of Viral Shedding Time in SARS-CoV-2 Infections: A Systematic Review and Meta-Analysis

Frontiers in Public Health ◽

10.3389/fpubh.2021.652842 ◽

2021 ◽

Vol 9 ◽

Author(s):

Danying Yan ◽

Xiaobao Zhang ◽

Can Chen ◽

Daixi Jiang ◽

Xiaoxiao Liu ◽

...

Keyword(s):

Systematic Review ◽

Chronic Diseases ◽

Clinical Characteristics ◽

Web Of Science ◽

Meta Analysis ◽

Corticosteroid Treatment ◽

Inclusion Criteria ◽

Viral Shedding ◽

Stool Specimens ◽

Asymptomatic Infections

Background: The viral shedding time (VST) of SARS-CoV-2 mainly determines its transmission and duration of infectiousness. However, it was heterogeneous in the existing studies. Here, we performed a meta-analysis to comprehensively summarize the VST of SARS-CoV-2.Methods: We searched PubMed, Web of Science, MedRxiv, BioRxiv, CNKI, CSTJ, and Wanfang up to October 25, 2020, for studies that reported VSTs of SARS-CoV-2. Pooled estimates and 95% CIs for the VSTs were calculated using log-transformed data. The VSTs in SARS-CoV-2 infections based on different demographic and clinical characteristics, treatments and specimens were stratified by subgroup analysis.Results: A total of 35 studies involving 3,385 participants met the inclusion criteria. The pooled mean VST was 16.8 days (95% CI: 14.8–19.4, I2 = 99.56%) in SARS-CoV-2 infections. The VST was significantly longer in symptomatic infections (19.7 days, 95% CI: 17.2–22.7, I2 = 99.34%) than in asymptomatic infections (10.9 days, 95% CI: 8.3–14.3, I2 = 98.89%) (P < 0.05). The VST was 23.2 days (95% CI: 19.0–28.4, I2 = 99.24%) in adults, which was significantly longer than that in children (9.9 days, 95% CI: 8.1–12.2, I2 = 85.74%) (P < 0.05). The VST was significantly longer in persons with chronic diseases (24.2 days, 95% CI: 19.2–30.2, I2 = 84.07%) than in those without chronic diseases (11.5 days, 95% CI: 5.3–25.0, I2 = 82.11%) (P < 0.05). Persons receiving corticosteroid treatment (28.3 days, 95% CI: 25.6–31.2, I2 = 0.00%) had a longer VST than those without corticosteroid treatment (16.2 days, 95% CI: 11.5–22.5, I2 = 92.27%) (P = 0.06). The VST was significantly longer in stool specimens (30.3 days, 95% CI: 23.1–39.2, I2 = 92.09%) than in respiratory tract specimens (17.5 days, 95% CI: 14.9–20.6, I2 = 99.67%) (P < 0.05).Conclusions: A longer VST was found in symptomatic infections, infected adults, persons with chronic diseases, and stool specimens.

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ECG-based Predictors of Re-infarction or Death on the Hospital Admission 12-Lead ECG among UA/NSTEMI Patients: A Protocol for a Systematic Review and Meta-Analysis

10.21203/rs.3.rs-33611/v1 ◽

2020 ◽

Author(s):

Dillon J Dzikowicz ◽

Darcey H. Mulligan ◽

Mary G. Carey

Keyword(s):

Systematic Review ◽

Prognostic Value ◽

Meta Analysis ◽

Rapid Test ◽

Treatment Decisions ◽

Cardiac Conduction ◽

Hospital Death ◽

Search Terms ◽

St Elevation ◽

New Research

Abstract Background The incidence of unstable angina/ non-ST elevation MI (UA/NSTEMI) continues to rise. The electrocardiogram (ECG) remains the first-line assessment of cardiac conduction and myocardial ischemia, and is performed within the first 10-minutes of hospital presentation. Despite recent advances in treatment, in-hospital death and re-infarction continues as a result of delayed interventions. Since the ECG is a rapid test to guide treatment decisions, it is crucial emergency providers understand the prognostic value of characteristics on the admission 12-lead ECG to decide treatments which may reduce the risk of re-infarction and death. This is the first systematic review and meta-analysis to assess the significance of these ECG findings associated with in-hospital death and re-infarction. Methods A systematic review and meta-analysis will be conducted to comprehensively assess the prognostic value of specific characteristics on the admission 12-lead ECG associated with re-infarction and death. This is the protocol for such review and meta-analysis. Electronic databases and specific cardiovascular journals will be searched using predefined search terms to identify relevant studies. Eligible studies will be peer-reviewed research articles with empirical findings on the risk re-infarction and death based on characteristics on the admission 12-lead ECG. The methodological quality of the included studies will be assessed with the Newcastle-Ottawa Quality Assessment Scale and GRADE. Citations will be managed using EndNote X9. A random effects meta-analysis will be conducted with the Meta-Essentials package and STATA. Discussion This study will be among the first to systematically evaluate and quantitatively assess the evidence available on the prognostic value of characteristics on the admission 12-lead ECG for the risk of re-infarction and death. This study will inform clinicians about the significance of characteristics on the admission 12-lead ECG so better treatment decisions can be made, as well as inform new research opportunities in the field of cardiovascular risk stratification. Registration This systematic review and meta-analysis is registered with the International Prospective Register of Systematic Reviews (PROSPERO; ID CRD42020158491).

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HPV infection and endometriosis: a systematic review and meta-analysis

Jornal Brasileiro de Doenças Sexualmente Transmissíveis ◽

10.5327/dst-2177-8264-201931406 ◽

2019 ◽

Vol 31 (4) ◽

pp. 138-142

Author(s):

Geilson Gomes de Oliveira ◽

José Eleutério ◽

Renata Mírian Nunes Eleutério

Keyword(s):

Systematic Review ◽

Bacterial Infections ◽

Meta Analysis ◽

Hpv Infection ◽

Cochrane Library ◽

Sexually Transmitted ◽

Unexposed Control ◽

Relative Risks ◽

Search Terms

Introduction: Recent research has focused on the role of persistent ascending bacterial infections and sexually transmitted infections (STI) as a factor associated to endometriosis. Indeed, some studies investigated the possible role of HPV in endometriosis, but this topic remains inconclusive. Objective:The present study aims to meta-analyze research that assessed the presence of HPV infection in patients with endometriosis. Methods: MEDLINE, Embase, Scopus, LILACS, Cochrane Library, and OpenGrey were searched until February 10th, 2020. Search terms included “endometriosis” and “HPV” without language restrictions. The combined relative risks and 95% confidence interval (95%CI) were calculated, and heterogeneity was assessed with I-square (I2 ). Results: Meta-analysis with low heterogeneity found a relative risk of twice as much in women exposed to HPV in relation to the unexposed control. Conclusion: Results indicate that HPV could be a risk factor for developing endometriosis.

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Services and Interventions for People who are Homeless with Companion Animals (Pets)

Social Science Protocols ◽

10.7565/ssp.2020.2814 ◽

2020 ◽

Vol 3 ◽

pp. 1-12

Author(s):

Laura McCosker ◽

Martin J. Downes ◽

Annick Maujean ◽

Natalie Hill

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Companion Animals ◽

Pet Ownership ◽

Health And Wellbeing ◽

Search Terms ◽

Index Terms ◽

Multiple Challenges ◽

Future Work ◽

The Relationship

Background Many people who are homeless own a companion animal (a ‘pet’). Pet ownership has positive impacts on health and wellbeing. However, for people who are homeless, pet ownership also creates multiple challenges and may be a barrier to exiting homelessness. This systematic review will identify the types, and outcomes, of services and interventions to support people who are homeless with pets. Methods This review will be conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searches will be undertaken on five databases. Combinations of search terms and subject headings or index terms will be used. Citation chaining and citation tracking will also be undertaken. Literature will be screened for relevance in a two-step process. Each study will be quality assessed using an evidence-based tool relevant to its methods. Relevant data will be extracted and synthesised using a meta-analytic, or narrative, approach. Discussion This review will address an identified gap in the knowledge about the types, and outcomes, of services/interventions for people who are homeless with pets. The results may increase recognition about the importance of protecting and promoting the relationship between people who are homeless and their pets, and inform future work.

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Clinical outcomes of over-the-scope-clip system for the treatment of acute upper non-variceal gastrointestinal bleeding: a systematic review and meta-analysis

10.21203/rs.2.12780/v1 ◽

2019 ◽

Author(s):

Chunyu Zhong ◽

Shali Tan ◽

Yutang Ren ◽

MuHan Lü ◽

Yan Peng ◽

...

Keyword(s):

Systematic Review ◽

Gastrointestinal Bleeding ◽

Clinical Success ◽

Meta Analysis ◽

Cochrane Library ◽

Gi Bleeding ◽

Search Terms ◽

Over The Scope Clip ◽

Otsc System ◽

Upper Gastrointestinal

Abstract BackgroundConventional endoscopic treatments can’t control bleeding in as many as 20% of patients with non-variceal gastrointestinal (GI) bleeding. Recent studies have shown that over-the-scope-clip (OTSC) system allowed for effective hemostasis for refractory GI bleeding lesions. So we aimed to conduct a systematic review to evaluate the effectiveness and safety of the OTSC system for management of acute non-variceal upper GI bleeding.MethodA comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 2007 to May 2019. The search terms included “gastrointestinal bleeding” AND “OTSC OR over the scope clip”. The literature was selected independently by two reviewers according to the inclusion and exclusion criteria. The statistical analysis was carried out using Comprehensive Meta-Analysis software version 3.0.ResultsA total of 16 studies including 769 patients with 778 GI bleeding lesions were identified. Pooled technical success was achieved in 761 lesions [95.7%; 95% confidence interval (CI), 93.5%-97.2%], and the pooled clinical success was achieved in 666 lesions (84.2%; 95% CI, 77.4%-89.2%). The incidence of re-bleeding was reported in 81 patients and the post-procedure mortality was 10.9% (n=84). Only 2 (0.3%) patients occurred complications after OTSC system procedure.ConclusionsOur study demonstrated that the OTSC system was a technically feasible modality and highly efficacious in achieving hemostasis in acute non-variceal upper gastrointestinal bleeding.

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Effect of Multi-Modal Therapies for Kinesiophobia Caused by Musculoskeletal Disorders: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249439 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9439

Author(s):

Yining Xu ◽

Yang Song ◽

Dong Sun ◽

Gusztáv Fekete ◽

Yaodong Gu

Keyword(s):

Systematic Review ◽

Musculoskeletal Disorders ◽

Meta Analysis ◽

Psychological Therapy ◽

Mathematical Methods ◽

Eligibility Criteria ◽

Psychological Therapies ◽

Search Terms ◽

Large Heterogeneity ◽

Test Retest Reliability

This systematic review and meta-analysis aimed to identify the effect of multi-modal therapies that combined physical and psychological therapies for kinesiophobia caused by musculoskeletal disorders compared with uni-modal therapy of only phycological therapy or psychological therapy. The search terms and their logical connector were as following: (1) “kinesiophobia” at the title or abstract; and (2) “randomized” OR “randomized” at title or abstract; not (3) ”design” OR “protocol” at the title. They were typed into the databases of Medline (EBSCO), PubMed, and Ovid, following the different input rules of these databases. The eligibility criteria were: (1) Adults with musculoskeletal disorders or illness as patients; (2) Multi-modal therapies combined physical and psychological therapy as interventions; (3) Uni-modal therapy of only physical or psychological therapy as a comparison; (4) The scores of the 17-items version of the Tampa Scale of Kinesiophobia as the outcome; (5) Randomized controlled trials as study design. As a result, 12 studies were included with a statistically significant polled effect of 6.99 (95% CI 4.59 to 9.38). Despite a large heterogeneity within studies, multi-modal therapies might be more effective in reducing kinesiophobia than the unimodal of only physical or psychological therapy both in the total and subdivision analysis. The effect might decrease with age. What’s more, this review’s mathematical methods were feasible by taking test-retest reliability of the Tampa Scale of Kinesiophobia into consideration.

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