scholarly journals Effect of in utero exposure to HIV and antiretroviral drugs on growth in HIV-exposed uninfected children: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e023937 ◽  
Author(s):  
Gabriel L Ekali ◽  
Julie Jesson ◽  
Pascal B Enok ◽  
Valériane Leroy
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
In Utero ◽  
Antiretroviral Drugs ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Growth Disorders ◽  
Growth Impairment ◽  
Hiv Exposed ◽  
Exposed Uninfected

IntroductionHIV-exposed uninfected (HEU) children have higher morbidity and mortality compared with HIV unexposed uninfected children. Despite the fact that malnutrition contributes to about half of all infant deaths below 5 years of age in low-income and middle-income countries and that growth impairment has been reported in the HEU population, the spectrum of growth disorders associated with HIV and antiretroviral therapy (ART) exposure during the in utero and perinatal periods is yet to comprehensively summarised among the global HEU population. This protocol for a systematic review and meta-analysis aims to critically synthesise data concerning the prevalence of underweight, stunting and wasting at different ages in the global HEU population.Methods and analysisMedline, EMBASE, Cochrane Library, TOXLINE, WHO Global Index Medicus and the Web of Science will be searched for relevant articles published between 1 January 1989 and 1 December 2017 without language restriction. In addition, conference abstracts and reference lists of eligible papers and relevant review articles will be screened. Authors will screen and select studies, extract data, assess the risk of bias as well as studies individually for heterogeneity. Study-specific estimates will be pooled through a random-effects meta-analysis model for studies that are clinically homogeneous while funnel plots and Egger’s test will be used to detect publication bias. Results will be presented by ART availability period, country income levels and mode of breastfeeding.Ethics and disseminationEthical approval will not be required for this study because it will be based on published data. The final report of this study will be published in a peer-reviewed journal and presented at scientific conferences. This review will summarise the evidence and quantify the problem of growth impairment in HEU infants and so shed more light on our understanding of the higher morbidity and mortality in this growing population.PROSPERO registration numberCRD42018091762.

scholarly journals 17-Alpha-Hydroxyprogesterone vs. Placebo for Preventing of Recurrent Preterm Birth: A Systematic Review and Meta-Analysis of Randomized Trials

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdulaali R. Almutairi ◽  
Hadir I. Aljohani ◽  
Nouf S. Al-fadel
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Meta Analysis ◽  
Neonatal Morbidity ◽  
Neonatal Outcomes ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Relative Risk Ratio ◽  
Analysis Model ◽  
Clinical Trial Registries

Background: Preterm birth (PTB) is a leading cause of neonatal morbidity and mortality.Objective: To estimate the effect of 17-alpha-hydroxyprogesterone caproate (17-OHPC) compared to placebo in singleton gestations for reducing the risk of recurrent PTB and neonatal morbidity and mortality.Work Design: Systematic review and meta-analysis.Search Strategy: Searching MEDLINE, Embase, Web of Science, SCOPUS, Cochrane Library, and clinical trial registries.Selection Criteria: Randomized controlled trials of singleton gestations with a history of PTB and treated with a weekly intramuscular injection of 17-OHPC or placebo.Data Collection and Analysis: A random meta-analysis model was performed for the PTB outcomes (<32, <35, and <37 weeks) and neonatal outcomes (neonatal death, grade 3 or 4 intraventricular hemorrhage, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, and sepsis). Effect estimates were measured by relative risk ratio (RR) with a 95% confidence interval (CI).Main Results: Six works were included. There were no statistically significant reductions in the PTB risk following the use of 17-OHPC at <32 weeks (RR = 0.61, 95% CI: 0.13–2.77, and I2 = 39%), <35weeks (RR = 0.60, 95% CI: 0.10–3.67, and I2 = 51%), and <37 weeks (RR = 0.68, 95% CI: 0.46–1, and I2 = 75%). Furthermore, all the neonatal outcomes were statistically similar between the two groups.Conclusion: Treatment with 17-OHPC is not associated with reducing the risk of PTB or neonatal outcomes compared to placebo.

scholarly journals Incidence of uterine rupture and associated factors in Ethiopia: A systematic review and Meta-analysis

2020 ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Asres Nigussie ◽  
Biruk Ferede Zewdu
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Uterine Rupture ◽  
Associated Factors ◽  
Meta Analysis ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Prolonged Labour ◽  
Obstructed Labour ◽  
Life Threatening

Abstract Background: Globally, maternal morbidity and mortality a major public health challenge. Uterine rupture is a life-threatening obstetrical emergency with life-threatening complications for both the mother and her infant. In developing countries, it is the leading cause of maternal and fetal morbidity and mortality. Therefore, this systematic review and meta-analysis aimed to assess the incidence of uterine rupture and its associated factors among mothers managed for obstetric cases in Ethiopia.Method: for this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed, Google Scholar, EMBASE, Cochrane Library, HINARI, WHO Afro Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access all the essential articles. This search included all published and unpublished observational studies written only in English language and conducted in Ethiopia. Microsoft Excel 16 was used for data entrance, and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) used for data analysis.Result: A total of 21 studies with 33,303 mothers managed for obstetric cases were included. The pooled incidence of uterine rupture among mothers managed for obstetric cases in Ethiopia was 3.25% (95%CI: 2.6–3.89, I2=97.4%, P<0.001). Rural residency (adjusted odds ratio (AOR):5.44; 95% confidence interval (CI): 95%CI: 3.17–9.34, I2 =59.5%, P=0.03), grand multiparty (AOR = 2.38; 95%CI: 1.32–4.29, I2=0.0%, p=0.002), not having antenatal care (AOR =4.05(; 95% CI: 1.90–8.64 I2=89.4%, P<0.001), having previous cesarean section scar (AOR =7.10; 95% CI: 5.40–9.34, I2=26.3%, P=0.254), having Prolonged labour (AOR=6.71; 95%CI: 4.04–11.15, I2=84.6%, P<0.001), having obstructed labour (AOR=7.22; 95%CI: 2.86–18.28, I2=97.4%, P<0.001), no partograph utilization for labour monitoring (AOR=3.43; 95%CI: 1.62–7.29, I2=66.6%, P=0.05) were the determinant factors for the incidence of uterine rupture in Ethiopia.Conclusion: This systematic review and meta-analysis showed that the incidence of uterine rupture was high in Ethiopia. Being from the rural area, prolonged labour, having cesarean section scar, not using partograph for labour monitoring, not having ante natal care, and obstructed labour increased the risk of uterine rupture.

scholarly journals Impact of short-term exposure to extreme temperatures on diabetes mellitus morbidity and mortality? A systematic review and meta-analysis

2021 ◽  
Author(s):  
Xuping Song ◽  
Liangzhen Jiang ◽  
Dongdong Zhang ◽  
Xinyi Wang ◽  
Yan Ma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Heat Exposure ◽  
The Elderly ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Extreme Temperatures ◽  
Short Term ◽  
Short Term Exposure

Abstract The relationship between diabetes mellitus and short-term exposure to extreme temperatures remains controversial. A systematic review and meta-analysis were performed to assess the association between extreme temperatures and diabetes mellitus morbidity and mortality. PubMed, Embase, the Cochrane Library, Web of Science and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched since inception to January 1, 2019, and updated on November 17, 2020. The results were combined using random effects model and reported as relative risk (RR) with 95% confidence interval (CI). 32 studies met the included criteria. (1) Both heat and cold exposures have impact on diabetes. (2) For heat exposure, the subgroup analysis revealed that the effect on diabetes mortality (RR = 1.139, 95% CI: 1.089–1.192) was higher than morbidity (RR = 1.012, 95% CI: 1.004–1.019). (3) With the increase of definition threshold, the impact of heat exposure on diabetes rised. (4) A stronger association between heat exposure and diabetes was observed in the elderly (≥ 60 years old) (RR = 1.040, 95% CI: 1.017–1.064). In conclusion, both short-term exposure to heat and cold temperatures have impact on diabetes. The elderly is the vulnerable population of diabetes exposure to heat temperature. Developing definitions of heatwaves at the regional level are suggested.

scholarly journals Sex differences in the efficacy of antihypertensive treatment in preventing cardiovascular outcomes and reducing blood pressure: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e036128
Author(s):  
Karina Gasbarrino ◽  
Christopher Labos ◽  
Victoria Mastropietro ◽  
Lindsay Hales ◽  
Nadia Khan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Sex Differences ◽  
Antihypertensive Treatment ◽  
Meta Analysis ◽  
Cardiovascular Morbidity ◽  
Morbidity And Mortality ◽  
Cochrane Library ◽  
Men And Women ◽  
Cardiovascular Morbidity And Mortality

IntroductionHypertension is a leading cause of mortality worldwide and its prevalence is expected to rise over the next decade. Sex differences exist in the epidemiology and pathophysiology of hypertension. It is well established that antihypertensive treatment can significantly reduce the risk for stroke and other cardiovascular disease events. However, it remains unclear whether this effect is dependent on sex. In this protocol, we outlined a systematic review and meta-analysis to evaluate the effects of antihypertensive therapy in (1) reducing blood pressure and (2) preventing cardiovascular morbidity and mortality outcomes for each sex separately.Methods and analysisThe following electronic databases will be searched: Medline, Embase, The Cochrane Library, PubMed, Cumulative Index of Nursing and Allied Health Literature Plus, Web of Science, grey literature (Google Scholar) and several trial registries. Search strategies will be designed to identify human adult (≥18) randomised (and non-randomised) controlled trials, prospective and retrospective cohort studies, and case–control studies concerning ‘sex-specific differences associated with the efficacy of antihypertensive treatment’. A preliminary search strategy was developed for Medline (1946—16 September 2019). Two investigators will independently review each article included in the final analysis. Primary outcomes investigated are cardiovascular morbidity and mortality and systolic and diastolic blood pressure. Pooled analyses will be conducted using the random-effects model. Publication bias will be assessed by visual inspection of funnel plots and by Begg’s and Egger’s statistical tests. Between-studies heterogeneity will be measured using the I2test (p<0.10). Sources of heterogeneity will be explored by sensitivity, subgroup and metaregression analyses.Ethics and disseminationThis is the first meta-analysis that will comprehensively compare the efficacy of antihypertensive treatment regimens between men and women. Findings will be shared through scientific conferences and societies, social media and consumer advocacy groups. Results will be used to inform the current guidelines for management of hypertension in men and women by demonstrating the importance of implementing sex-specific recommendations. Ethical considerations are not applicable for this protocol.

scholarly journals Safety and Immunogenicity of Measles Vaccination in HIV-Infected and HIV-Exposed Uninfected Children: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 1 ◽  
pp. 28-42 ◽  
Author(s):  
Eleonora A.M.L. Mutsaerts ◽  
Marta C. Nunes ◽  
Martijn N. van Rijswijk ◽  
Kerstin Klipstein-Grobusch ◽  
Diederick E. Grobbee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Measles Vaccination ◽  
Hiv Exposed ◽  
Exposed Uninfected

scholarly journals Vaccination among HIV-infected, HIV-exposed uninfected and HIV-uninfected children: a systematic review and meta-analysis of evidence related to vaccine efficacy and effectiveness

2019 ◽  
Vol 15 (11) ◽  
pp. 2578-2589 ◽  
Author(s):  
Olatunji O. Adetokunboh ◽  
Duduzile Ndwandwe ◽  
Ajibola Awotiwon ◽  
Olalekan A. Uthman ◽  
Charles S. Wiysonge
Keyword(s):  
Systematic Review ◽  
Vaccine Efficacy ◽  
Meta Analysis ◽  
Hiv Exposed ◽  
Exposed Uninfected

Does non-institutionalized elders have a better oral health status compared to institutionalized ones? A systematic review and meta-analysis

2020 ◽  
Vol 25 (6) ◽  
pp. 2177-2192 ◽  
Author(s):  
Ilky Pollansky Silva e Farias ◽  
Simone Alves de Sousa ◽  
Leopoldina de Fátima Dantas de Almeida ◽  
Bianca Marques Santiago ◽  
Antonio Carlos Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Meta Analysis ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Caries Experience ◽  
Institutionalized Elderly ◽  
Periodontal Status

Abstract This systematic review compared the oral health status between institutionalized and non-institutionalized elders. The following electronic databases were searched: PubMed (Medline), Scopus, Web of Science, Lilacs and Cochrane Library, in a comprehensive and unrestricted manner. Electronic searches retrieved 1687 articles, which were analyzed with regards to respective eligibility criteria. After reading titles and abstracts, five studies were included and analyzed with respect their methodological quality. Oral status of institutionalized and non-institutionalized elderly was compared through meta-analysis. Included articles involved a cross-sectional design, which investigated 1936 individuals aged 60 years and over, being 999 Institutionalized and 937 non-institutionalized elders. Studies have investigated the prevalence of edentulous individuals, the dental caries experience and the periodontal status. Meta-analysis revealed that institutionalized elderly have greater prevalence of edentulous (OR = 2.28, 95%CI = 1.68-3.07) and higher number of decayed teeth (MD = 0.88, 95%CI = 0.71-1.05) and missed teeth (MD = 4.58, 95%CI = 1.89-7.27). Poor periodontal status did not differ significantly between groups. Compared to non-institutionalized, institutionalized elders have worse dental caries experience.

scholarly journals Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyune June Lee ◽  
Sung Min Kim ◽  
Ji Yean Kwon
Keyword(s):  
Systematic Review ◽  
Transcranial Magnetic Stimulation ◽  
Side Effects ◽  
Electroconvulsive Therapy ◽  
Effect Size ◽  
Magnetic Stimulation ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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