Risk factors associated with the development of oral mucositis in pediatric oncology patients: Systematic review and meta‐analysis

Oral Diseases ◽  
2021 ◽  
Author(s):  
Amanda de Farias Gabriel ◽  
Felipe Martins Silveira ◽  
Marina Curra ◽  
Lauren Frenzel Schuch ◽  
Vivian Petersen Wagner ◽  
...  
2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Shaoyu Zhu ◽  
N Patrik Brodin ◽  
Madhur K Garg ◽  
Patrick A LaSala ◽  
Wolfgang A Tomé

ABSTRACT BACKGROUND Intracranial arteriovenous malformation (AVM) is a congenital lesion that can potentially lead to devastating consequences if not treated. Many institutional cohort studies have reported on the outcomes after radiosurgery and factors associated with successful obliteration in the last few decades. OBJECTIVE To quantitatively assess the dose-response relationship and risk factors associated with AVM obliteration using a systematic review and meta-analysis approach. METHODS Data were extracted from reports published within the last 20 yr. The dose-response fit for obliteration as a function of marginal dose was performed using inverse-variance weighting. Risk factors for AVM obliteration were assessed by combining odds ratios from individual studies using inverse-variance weighting. RESULTS The logistic model fit showed a clear association between higher marginal dose and higher rates of obliteration. There appeared to be a difference in the steepness in dose-response when comparing studies with patients treated using Gamma Knife radiosurgery (Elekta), compared to linear accelerators (LINACs), and when stratifying studies based on the size of treated AVMs. In the risk-factor analysis, AVM obliteration rate decreases with larger AVM volume or AVM diameter, higher AVM score or Spetzler-Martin (SM) grade, and prior embolization, and increases with compact AVM nidus. No statistically significant associations were found between obliteration rate and age, sex, prior hemorrhage, prior aneurysm, and location eloquence. CONCLUSION A marginal dose above 18 Gy was generally associated with AVM obliteration rates greater than 60%, although lesion size, AVM score, SM grade, prior embolization, and nidus compactness all have significant impact on AVM obliteration rate.


Author(s):  
George Koulaouzidis ◽  
Amanda E. Yung ◽  
Diana E. Yung ◽  
Karolina Skonieczna-Żydecka ◽  
Wojciech Marlicz ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255488
Author(s):  
Ritbano Ahmed ◽  
Hassen Mosa ◽  
Mohammed Sultan ◽  
Shamill Eanga Helill ◽  
Biruk Assefa ◽  
...  

Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).


2018 ◽  
Vol 33 (4) ◽  
pp. 359-365 ◽  
Author(s):  
Veeravich Jaruvongvanich ◽  
Tomoki Sempokuya ◽  
Passisd Laoveeravat ◽  
Patompong Ungprasert

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S15-S16
Author(s):  
Miguel A Minero ◽  
Asia Castro ◽  
Martha Avilés-Robles

Abstract Background Infectious processes are frequent complications presented in pediatric patients with cancer. Currently, the indiscriminate use of antibiotics induces resistance to available treatments, creating the emergence of multi-drug-resistant organisms (MDROs). Due to the impact in morbidity and mortality secondary to MDRO infection, we aimed to identify risk factors associated with mortality in infections due to MDROs in pediatric patients with cancer. Methods Case–control study nested in a prospective cohort of pediatric oncology patients with febrile neutropenia (FN) at Hospital Infantil de México Federico Gómez (HIMFG) in Mexico City from March 2015 to September 2017. MDRO was defined as acquired non-susceptibility to at least one agent in three or more antimicrobial categories. Patients with FN episodes who died from an infection due to MDROs were defined as cases and patients with FN episodes of an infection due to MDROs who did not die were defined as controls. Mucositis, septic shock, PICU stay, and bacterial prophylaxis (Trimethoprim/Sulfamethoxazole) were compared between groups. Descriptive statistics was performed and Pearson χ 2 or Student’s t-test were used to compare risk factors between groups. Results A total of 929 FN episodes were documented, 44.4% episodes occurred in male patients, mean age was 7.9 years, with the population under 5 years being the most represented (68.2%). The most frequent diagnosis was acute lymphoblastic leukemia in 75% followed by rhabdomyosarcoma in 10.5% and acute myeloid leukemia in 9.6%. Prophylaxis (trimethoprim/sulfamethoxazole) was used in 86%, mucositis was present in 9.2% of episodes. 12.1% had septic shock and 4.7% were admitted to PICU. In 148 FN episodes (15.9%) a microorganism was identified, of these 50 (33.7%) were due to an MDROs. Urinary tract infection was the most frequent site (49%), followed by bloodstream infections (47%). K. pneumoniae was the most frequent MDRO in 22.8%, followed by E. coli in 19.2% and P. aeruginosa in 14%. Septic shock was presented in 26% of MDROs infections. Overall mortality was 1.94% and only 0.86% (8) were secondary to MDROs. Of patients with MDRO isolated mortality was 30% (15/50). Mortality associated with bloodstream infection due to MDROs was 25% compared with other source of MDROs infections (3%) (P = 0.01). Septic shock was present in 40% of patients with death due to MDROs infection (P = 0.001). Conclusions In our population of children with FN episodes who had an isolated microorganism, infection due to MDROs are high (33.7%) and MDROs infection-directed mortality was as high as 30%. Bloodstream infections and septic shock were risk factors associated with mortality due to MDROs.


2021 ◽  
Vol 71 (9) ◽  
Author(s):  
Danish Abdul Aziz ◽  
Syeda Khadija Fatima ◽  
Hasan Nawaz Tahir

Objective: To ascertain major risk factors associated with pulmonary exacerbation and pulmonary function decline in cystic fibrosis. Method: The systematic review was conducted at Aga Khan University, Karachi, in September 2018, and comprised electronic search of PubMed, Ovid, Science Direct and Cumulative Index of Nursing and Allied Health Literature databases of studies conducted from January 1990 to September 2018 which were categorised into 3 sets; 1990-98, 1999-2007 and 2008-18. Studies included for review focussed on articles with pulmonary exacerbation as the health outcome indicator, and had diagnosis of cystic fibrosis as the inclusion criteria, while risk factors were the exposure terms used in the search process. References in bibliographies of the included studies were also systematically searched for relevant documents. Results: Of the 60 studies obtained, 31(51.7%) were selected; 2(6.45%) from 1990-98, 7(22.58%) from 1999-2007 and 22(70.96%) from 2008-18. Overall, 17(54.83%) were cohort studies, 7(22.5%) were cross-sectional studies, 3(9.6%) were case-control studies, 3(9.6%) were randomised controlled trials and 1(3.2%) was systematic review and meta-analysis. In terms of major risk factors, genetic mutations were cited by 4(12.9%) studies, infections and inflammatory biomarkers by 15(48.4%), nutritional deficiencies by 9(29%) and geographical and socioeconomic status by 3(9.6%) studies. Conclusion: Early identification and recognition of risk factors associated with pulmonary exacerbation can have an explicit impact on its management, leading to decreased morbidity and mortality burden in cystic fibrosis cases. Key Words: Pulmonary exacerbation, Cystic fibrosis, Risk factors, Systematic review. Continuous...


2019 ◽  
Vol 9 (8) ◽  
pp. 881-894 ◽  
Author(s):  
Andrew Jack ◽  
Wyatt L. Ramey ◽  
Joseph R. Dettori ◽  
Zane A. Tymchak ◽  
Rod J. Oskouian ◽  
...  

Study Design: Systematic review. Objectives: C5 palsy (C5P) is a not uncommon and disabling postoperative complication with a reported incidence varying between 0% and 30%. Among others, one explanation for its occurrence includes foraminal nerve root tethering. Although different risk factors have been reported, controversy about its causation and prevention persists. Inconsistent study findings contribute to the persistent ambiguity leading to an assumption of a multifactorial nature of the underlying C5P pathophysiology. Here, we report the results of a systematic review on C5P with narrow inclusion criteria in the hope of elucidating risk factors for C5P due to a common pathophysiological mechanism. Methods: Electronic databases from inception to March 9, 2019 and references of articles were searched. Narrow inclusion criteria were applied to identify studies investigating demographic, clinical, surgical, and radiographic factors associated with postoperative C5P. Results: Sixteen studies were included after initial screening of 122 studies. Eighty-four risk factors were analyzed; 27 in ≥2 studies and 57 in single studies. The pooled prevalence of C5P was 6.0% (range: 4.2%-24.1%) with no consistent evidence that C5P was associated with demographic, clinical, or specific surgical factors. Of the radiographic factors assessed, specifically decreased foraminal diameter and preoperative cord rotation were identified as risk factors for C5P. Conclusion: Although risk factors for C5P have been reported, ambiguity remains due to potentially multifactorial pathophysiology and study heterogeneity. We found foraminal diameter and cord rotation to be associated with postoperative C5P occurrence in our meta-analysis. These findings support the notion that factors contributing to, and acting synergistically with foraminal stenosis increase the risk of postoperative C5P.


Sign in / Sign up

Export Citation Format

Share Document