scholarly journals Effect of Renin-Angiotensin-Aldosterone System inhibitors on outcomes of COVID-19 patients with hypertension: Systematic review and Meta-analysis

2020 ◽  
Author(s):  
Tamirat Bekele Beressa ◽  
Tamiru Sahilu ◽  
Serawit Deyno
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Random Effects Model ◽  
Renin Angiotensin Aldosterone System ◽  
Renin Angiotensin ◽  
Central Register ◽  
Raas Inhibitors

Objective: This research aimed to systematically review and summarize the influence of Renin-Angiotensin-Aldosterone System (RAAS) inhibitors on the outcome of COVID_19 patients with hypertension. Methods: Electronic databases; PubMed/Medline, CINAHL, the Cochrane Central Register of Controlled Trials, clinical trial.gov, and Google Scholar were searched from 2019 to June 1, 2020. Additionally, the references of identified articles were also searched. Results: A total of 9 articles comprising 3,823 patients were incorporated; 1416 patients on RAAS inhibitors and 3469 on non-RAAS inhibitors. The study demonstrated that the taking of RAAS inhibitors in COVID_19 patients with hypertension significantly reduced mortality where patients on RAAS inhibitors had a 27% decrease of mortality (RR= 0.73 [95% CI: 0.63- 0.85, p<0.0001, I2=0%, random-effects model]) compared to those not taking ACEI/ARB. No significant association were observed in disease severity (RR= 0.92 (95% CI: 0.74- 1.14) and hospitalization (WMD= -2.33[95% CI: -5.60, 0.75]), random-effects model. Conclusion: This study supports RAAS inhibitors safe use among COVID_19 patients with hypertension. Keywords: COVID_19, ACEI, ARB, Hypertension, Coronavirus

scholarly journals Effects of Tea Consumption on Anthropometric Parameters, Metabolic Indexes and Hormone Levels of Women with Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Wenjuan Shen ◽  
Yujia Pan ◽  
Bao Jin ◽  
Zongyu Zhang ◽  
Tianjiao You ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Randomized Controlled Trials ◽  
Green Tea ◽  
Random Effects ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Controlled Trials ◽  
Random Effects Model ◽  
Randomized Controlled

ObjectiveOur aim was to conduct a systematic review and meta-analysis to assess the effectiveness and safety of tea supplements for patients with polycystic ovary syndrome (PCOS).MethodsWe conducted searches of the published literature in PubMed, EMBASE, Cochrane Library, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure (CNKI), VIP database, and Wanfang Database in 1985 to September 2021. Data from randomized controlled trials (RCTs) were obtained to assess the effects of tea versus placebo in women with PCOS. Weighted mean differences (WMDs) were pooled using a random-effects model or risks ratios (RRs) using a random-effects model.ResultsSix RCTs (235 participants) were included in our systematic review. Tea supplements as adjuvant therapy led to greater improvement in body weight (WMD −2.71, 95% CI −4.95 to −0.46, P = 0.02, I2 = 0%), fasting blood glucose (FBG: WMD −0.40, 95% CI −0.59 to −0.20, P &lt; 0.0001, I2 = 0%) and fasting insulin (FINS: WMD −3.40, 95% CI −4.76 to −2.03, P &lt; 0.00001, I2 = 0%) when compared with placebo. There were no significant differences of body mass index, waist circumference, hip circumference, waist-to-hip ratio (WHR), body fat rate, total testosterone, free testosterone (FT), dehydroepiandrosterone, luteinizing hormone or follicular-stimulating hormone (FSH) between the two groups. In addition, subgroup analysis suggested that green tea was effective on body weight, FINS, FBG, FT, and FSH, and herbal tea can also reduce FT levels, tea supplements had a significant impact on FBG and FSH in trials with intervention duration ≥ 3 months, and intervention lasting less than 3 months can improve FINS. Tea had significant effect on reducing WHR, FBG and FSH in Asian PCOS patients, but not in Caucasians. And there was no statistically significant effect of tea on weight and FINS in Asians, but it was effective for Caucasian participants. Compared with placebo, tea supplements did not cause significant adverse reactions (RR 1.45, 95% CI 0.30 to 6.90, P = 0.65, I2 = 0%).ConclusionThis meta-analysis suggests that consumption of tea supplementation in women with PCOS could significantly decrease the levels of FBG and FINS as well as reduce body weight. Especially green tea, not only has the above effects, but also has a significant effect on improving a variety of reproductive hormone indexes. Furthermore, tea supplementation is a relatively safe therapy for PCOS patients. Systematic Review RegistrationPROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=212755, identifier CRD42021249196.

scholarly journals Right versus left thoracic approach oesophagectomy for oesophageal cancer: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030157
Author(s):  
Tianci Chai ◽  
Zhimin Shen ◽  
Sui Chen ◽  
Yuhan Lin ◽  
Zhenyang Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Malignant Tumours ◽  
Central Register ◽  
Registration Number ◽  
Thoracic Approach ◽  
Randomised Controlled

IntroductionOesophageal cancer is one of the most common malignant tumours and has been identified as one of the leading causes of cancer death worldwide. Surgery is considered to be the optimal treatment for patients with resectable oesophageal cancer. Oesophagectomy for oesophageal cancer can significantly extend the survival period of patients and provide a potential opportunity for a cure. However, there is still controversy regarding which thoracic approach (right or left) during oesophagectomy for oesophageal cancer can lead to better surgical outcomes globally. This systematic review and meta-analysis will be performed to determine which thoracic approach during oesophagectomy will achieve longer patient survival and will be more beneficial for patients.Methods and analysisWe will search PubMed, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials and Google Scholar databases for relevant clinical trials published in any language before 1 October 2019. Randomised controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, tumour pathological stage and ethnicity will be performed.PROSPERO registration numberCRD42019124133.Ethics and disseminationBecause this study will be based on published or unpublished records and studies, there is no need for ethics approval. The results of the study will be published in a peer-reviewed journal.

Pharmacological prevention of fractures in patients undergoing glucocorticoid therapies: a systematic review and network meta-analysis

Rheumatology ◽  
2020 ◽  
Author(s):  
Jiawen Deng ◽  
Zachary Silver ◽  
Emma Huang ◽  
Elena Zheng ◽  
Kyra Kavanagh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Vertebral Fractures ◽  
Meta Analysis ◽  
Adult Patients ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Vitamin D Metabolites ◽  
Pharmacological Prevention ◽  
Central Register

Abstract Objective To perform a network meta-analysis (NMA) on the efficacy of antiosteoporotic interventions in the prevention of vertebral and non-vertebral fractures in adult patients taking glucocorticoids (GCs). Methods We performed NMAs based on a prospectively developed protocol. A librarian-assisted database search of MEDLINE, EMBASE, Web of Science, Cumulative Index of Nursing and Allied Health Literature (CINAHL), the Cochrane Central Register of Controlled Trials (CENTRAL) and Chinese databases was conducted for randomized controlled trials (RCTs) comparing antiosteoporotic interventions in adult patients taking GCs. Outcomes were vertebral and non-vertebral fracture incidences. Results We included 56 RCTs containing 6479 eligible patients in our analysis. We found that alendronate and teriparatide were associated with decreased odds of both vertebral and non-vertebral fractures. Denosumab and risedronate were associated with decreased odds of vertebral fractures, while etidronate, ibandronate and alfacalcidol were associated with decreased odds of non-vertebral fractures. We observed low network heterogeneity as indicated by the I2 statistic, and we did not detect evidence of publication bias. All outcomes were based on a moderate quality of evidence according to GRADE. Conclusion Bisphosphonates, teriparatide and denosumab are associated with decreased odds of fracture in patients undergoing GC therapy. Vitamin D metabolites and analogues (e.g. alfacalcidol) may have greater anti-fracture efficacy compared with plain vitamin D. Systematic Review Registration The International Prospective Register of Systematic Reviews (PROSPERO)—CRD42019127073

scholarly journals Evaluation of the Effect of Limosilactobacillus fermentum CECT5716 on Gastrointestinal Infections in Infants: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 9 (7) ◽  
pp. 1412
Author(s):  
Belén Pastor-Villaescusa ◽  
Ruth Blanco-Rojo ◽  
Mónica Olivares
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Well Being ◽  
Preventive Therapy ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Gastrointestinal Infections ◽  
Early Stages ◽  
Central Register ◽  
Present Systematic Review

Reducing the incidence of gastrointestinal infections (GIs) that occur at early stages to mitigate hospitalizations and treatments with adverse effects is a promising strategy for providing well-being to infants and their families. This systematic review and meta-analysis explores whether the early administration of Limosilactobacillus fermentum CECT5716 might be effective as a preventive therapy for GIs. We reviewed the literature to identify randomized controlled trials (RCTs) investigating the effectiveness of milk formulas supplemented with L. fermentum CECT5716 administered to infants at early stages to reduce the incidence of GIs. The MEDLINE (via PubMed), Web of Science (WoS), and Cochrane Central Register of Controlled Trials (via CENTRAL) databases were searched up to 15 June 2021. GI data from the included studies were synthesized in a random-effects model. Three RCTs were finally selected including 435 infants. There was a significant reduction in the incidence rate of GIs for those receiving L. fermentum CECT5716 compared with those receiving placebo (IRR: 0.52, 95% CI: 0.36–0.74, p = 0.0004). Heterogeneity between studies was moderate (I2 = 54.5%). Based on the present systematic review and meta-analysis, the administration of L. fermentum CECT5716 at doses from 1 × 109 to 8.4 × 108 cfu/day in milk formulas may prevent GIs in infants up to 12 months old. Longer-term studies including a higher number of infants are needed to determine whether the use of this probiotic during the early stages of life is an efficient way to reduce the incidence of GIs.

scholarly journals Do Various Treatment Modalities of Vesicoureteral Reflux Have Any Adverse Effects in Pediatric Patients? A Meta-Analysis

2021 ◽  
pp. 1-9
Author(s):  
Min Xie ◽  
Xiaogai Xu ◽  
Zhenjie Cao ◽  
Huijie Xiao
Keyword(s):  
Vesicoureteral Reflux ◽  
Random Effects ◽  
Renal Scarring ◽  
Meta Analysis ◽  
Forest Plot ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Random Effects Model ◽  
Recurrent Utis ◽  
Tract Infections

<b><i>Purpose:</i></b> Vesicoureteral reflux (VUR) is a risk factor for various renal problems like recurrent urinary tract infections (UTIs), pyelonephritis, renal scarring, hypertension, and other renal parenchymal defects. The interventions followed by pediatricians include low-dose antibiotic treatment, surgical correction, and endoscopy. This meta-analysis aimed to assess the advantages and drawbacks of various primary VUR treatment options. <b><i>Search Strategy:</i></b> The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference lists of journals, and abstracts from conference proceedings were all used to find randomized controlled trials. The articles were retrieved from 1985 till 2020. Twenty articles were used for the data analysis. <b><i>Criteria for Selection:</i></b> Surgery, long-term antibiotic prophylaxis, noninvasive techniques, and any mix of therapies are also options for treating VUR. <b><i>Collection and Interpretation of Data:</i></b> Two authors searched the literature separately, determining research qualifications, assessing accuracy, and extracting and entering results. The odds ratio (OR) of these studies was used to construct the forest plot. The random-effects model was used to pool the data. Also, the random-effects model was used with statistical significance at a <i>p</i> value &#x3c; 0.05 to assess the difference in side effects after treatment of VUR using different modalities. <b><i>Results:</i></b> We found no statistically significant differences between surgery plus antibiotics and antibiotic alone-treated patients in terms of recurrent UTIs (OR = 0.581; 95% confidence interval [CI] 0.259–1.30), renal parenchymal defects (OR = 1.149; 95% CI 0.75–1.754), and renal scarring (OR = 1.042; 95% CI 0.72–1.50). However, the risk of developing pyelonephritis after surgical treatment of VUR was lesser than that in the conservative approach, that is, antibiotics (OR = 0.345; 95% CI 0.126–0.946.), positive urine culture (OR = 0.617; 95% CI 0.428–0.890), and recurrent UTIs were more common in the placebo group than in the antibiotic group (<i>p</i> &#x3c; 0.05; OR = 0.639; 95% CI 0.436–0.936) which is statistically significant. <b><i>Conclusion:</i></b> Based on current research, we recommend that a child with a UTI and significant VUR be treated conservatively at first, with surgical care reserved for children who have issues with antimicrobials or have clinically significant VUR that persists after several years of follow-up.

scholarly journals IgM ELISA for leptospirosis diagnosis: a systematic review and meta-analysis

2017 ◽  
Vol 22 (12) ◽  
pp. 4001-4012 ◽  
Author(s):  
Maria Ines Rosa ◽  
Maria Fernandes dos Reis ◽  
Carla Simon ◽  
Eduardo Dondossola ◽  
Maria Cecília Alexandre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Grey Literature ◽  
British Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Medical Subject Headings ◽  
Igm Elisa ◽  
Central Register

Abstract A systematic review with meta-analysis was performed to estimate the accuracy of IgM ELISA for Leptospirosis diagnosis. A search of Medline, Lilacs, Embase, Cochrane Central Register of Controlled Trials and Grey literature (Google Scholar and British Library) was conducted. The medical subject headings (MeSHs) and the words “leptospirosis”, “human leptospirosis” and “IgM ELISA” were used. Fifty-two studies were analyzed, which included 10,775 samples. The pooled sensitivity of all the studies was 86% (CI 95%, 85%-87%) and specificity was 90% (CI 95%, 89%-91%). In studies of the acute phase, the sensitivity and specificity were 84% (CI 95%, 82%-85%) and 91% (CI 95%, 90%-91%), respectively. In conclusion, IgM ELISA is sensitive for use as an initial screen for leptospiral infections.

scholarly journals Prevalence and Possible Role of Candida Species in Patients with Psoriasis: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Aldona Pietrzak ◽  
Ewelina Grywalska ◽  
Mateusz Socha ◽  
Jacek Roliński ◽  
Kinga Franciszkiewicz-Pietrzak ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Fungal Colonization ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Cross Sectional ◽  
Detection Rates ◽  
Central Register ◽  
Cross Sectional Studies

Although fungal colonization is implicated in the pathogenesis of psoriasis, its prevalence remains unclear. The aim of this systematic review and meta-analysis was to provide an overview on the prevalence of Candida species in patients with psoriasis. We searched databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and http://clinicaltrials.gov) to identify studies involving subjects of any age with an established diagnosis of psoriasis and healthy controls, who were tested for carriage of Candida spp. on the skin or mucosal membranes (or saliva and stool), or presented with clinical candidiasis with microbiologically confirmed etiology. We identified nine cross-sectional studies including a total of 1038 subjects with psoriasis (psoriatics) and 669 controls. We found Candida species detection rates for psoriatics were significantly higher than those in the controls, especially in the oral mucosa milieux. These results suggest psoriasis may be one of the systemic diseases that predispose to oral Candida spp. carriage and infection.

Immune-related adverse events and efficacy outcomes in patients treated with immunotherapy: A systematic review and meta-analysis.

2020 ◽  
Vol 38 (5_suppl) ◽  
pp. 92-92
Author(s):  
Eric Druyts ◽  
Mark Boye ◽  
Himani Agg ◽  
Catherine Muehlenbein ◽  
Andrew Frederickson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck Cancer ◽  
Adverse Events ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Efficacy Data ◽  
Incidence Data ◽  
Randomized Controlled ◽  
Central Register

92 Background: Immunotherapy (IO) can lead to immune-related adverse events (irAEs). Evidence on the association of irAEs and efficacy is limited. Methods: We conducted a systematic review in MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (inception to July 1, 2019) to identify randomized controlled trials (RCTs) reporting irAEs, incidence and efficacy data for pembrolizumab (PEM), nivolumab (NIVO), ipilimumab (IPI), atezolizumab, avelumab, durvalumab, and aldesleukin in lung, renal, head and neck cancer, and melanomas. RCTs assessing IO monotherapy or IO combinations in at least one arm were included. Evaluated outcomes were 1) irAE incidence (rash, pruritis, diarrhea, colitis, hypothyroidism, hyperthyroidism, transaminitis, hypophysitis, pneumonitis, arthralgia, anemia, and hepatitis); and 2) efficacy (response and survival). irAE incidence data will be pooled and meta-analysis performed to assess the association of irAEs with efficacy; heterogeneity between RCTs will be evaluated. Results: Fifty RCTs were included: IOs were compared to chemotherapy or chemotherapy-combinations (19), to other interventions (8), to placebo (3), and head-to-head (20). irAE reporting and definitions were heterogeneous across RCTs. The most common all-grade irAEs were skin, GI, and endocrine. For skin irAEs, rash ranged from 0% (PEM 2 mg/kg, n = 6) to 73% (NIVO + IPI, n = 11); pruritus was from 1% (PEM 2 mg/kg, n = 89) to 50% (NIVO + IPI, n = 6). For GI irAEs, diarrhea ranged from 0% (PEM 2 mg/kg, n = 6) to 64% (NIVO + IPI, n = 11); colitis was from 0% (NIVO 3 mg/kg, n = 98) to 23% (NIVO + IPI, n = 94). For endocrine irAEs, hypothyroidism ranged from 0% (NIVO 3 mg/kg, n = 12) to 83% (NIVO + IPI, n = 6), hyperthyroidism was from 0% (PEM 2 mg/kg, n = 6 and IPI 3 mg/kg, n = 46) to 27% (NIVO + IPI, n = 11), and hypophysitis was from 0% (PEM 10 mg/kg, n = 84 and NIVO 3 mg/kg, n = 25) to 26% (NIVO + IPI, n = 35). Liver, pulmonary, and musculoskeletal irAEs, and anemia, were reported less frequently and with lower incidence. Conclusions: irAEs are increasingly reported in IO RCTs, but lack reporting and definition consistency. The meta-analysis results may provide clarity on irAEs incidence and association with efficacy.

scholarly journals Effect of Berry Polyphenols on Glucose Metabolism: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 4 (7) ◽  
Author(s):  
Theresa F Rambaran ◽  
Jonathan Bergman ◽  
Peter Nordström ◽  
Anna Nordström
Keyword(s):  
Systematic Review ◽  
Glucose Metabolism ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Randomized Controlled ◽  
Inverse Variance ◽  
Central Register ◽  
Mean Differences

ABSTRACT The effect of berry polyphenols on glucose metabolism has been evaluated in several studies; however, the results are conflicting. A systematic review and meta-analysis was therefore conducted to evaluate the effect of berry polyphenol consumption on glucose metabolism in adults with impaired glucose tolerance or insulin resistance. PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, CINAHL (EBSCO), and Scopus were searched for randomized controlled trials published by June 2019. Of the 3240 articles found, 21 met inclusion criteria. Study-specific effects were calculated as mean differences, which were pooled using fixed-effect, inverse-variance weighting. Overall, berry polyphenol consumption did not have a clear effect on biomarkers of glucose metabolism compared with placebo or no treatment. Although some analyses showed statistically significant effects, these effects were too small to be of clinical relevance. The review protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews as CRD42019130811.

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