scholarly journals Effect of aspirin in takotsubo syndrome: protocol of a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046727
Author(s):  
Jinhai Lin ◽  
Bingxin Wu ◽  
Luoqi Lin ◽  
Yining Ding ◽  
Biying Zhong ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Systemic Review ◽  
Cochrane Library ◽  
Takotsubo Syndrome ◽  
Coronary Syndrome ◽  
Study Results ◽  
Long Term Treatment ◽  
The Impact

IntroductionTakotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management.Methods and analysisAfter searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible.Ethics and disseminationEthics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020212729.

scholarly journals Prognostic impact of antiplatelet therapy in Takotsubo syndrome: a systematic review and meta-analysis of the literature

2021 ◽  
Author(s):  
Francesca Rizzetto ◽  
Micaela Lia ◽  
Maddalena Widmann ◽  
Domenico Tavella ◽  
Luisa Zanolla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Antiplatelet Therapy ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Prognostic Impact ◽  
Takotsubo Syndrome ◽  
Long Term Outcomes ◽  
Short Term ◽  
The Impact

AbstractWhile the most recent evidence suggests a lack of benefit, antithrombotic therapy is still extensively prescribed in patients with Takotsubo syndrome (TTS). The objective of this study was to determine whether patients with TTS benefit from anti-aggregation, in terms of either short-term or long-term outcomes. A systematic review and meta-analysis was conducted. A comprehensive search of the literature included MEDLINE, Cochrane Library, Clinicaltrials.gov, EU Clinical Trial Register, References, and contact with the authors. Methodological quality assessment and data extraction were systematically performed. The review adhered to the PRISMA framework guidelines. A total of 86 citations were identified, six being eligible for inclusion, for a total of 1997 patients. One of them considered both short-term and long-term outcomes. One reported outcomes during the index event, while the remaining four focused on potential long-term benefits. They were all retrospective cohort studies.Based on our data, the long-term use of antiplatelet therapy (AT) led to a significantly higher incidence of the composite outcome (OR: 1.54; 95% CI 1.09–2.17; p = 0.014) and overall mortality (OR 1.72; 95% CI 1.07–2.77; p = 0.027). The analysis did not show a statistically significant difference in TTS recurrences, stroke/TIA, and MI or CAD worsening with AT compared with no anti-aggregation. The AT in this settings did not show any clear benefit in improving the long-term outcomes, and it may be even detrimental and it may be detrimental. These results warrant further future research and the design of adequately powered randomized controlled trials focusing on the impact of aspirin on the outcomes in patients presenting with TTS.

scholarly journals Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

2020 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw
Keyword(s):  
East Africa ◽  
Associated Factors ◽  
Meta Analysis ◽  
Eastern Africa ◽  
Systemic Review ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
The Impact ◽  
National Prevalence

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

scholarly journals A systematic review and meta-analysis reveal that Campylobacter spp. and antibiotic resistance are widespread in humans in sub-Saharan Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245951
Author(s):  
Delfina F. Hlashwayo ◽  
Betuel Sigaúque ◽  
Emília V. Noormahomed ◽  
Sónia M. S. Afonso ◽  
Inácio M. Mandomando ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Meta Analysis ◽  
Random Effect ◽  
Research Priorities ◽  
Sub Saharan Africa ◽  
Cochrane Library ◽  
African Countries ◽  
Pooled Prevalence ◽  
Sub Saharan ◽  
The Impact

Introduction Campylobacter spp. are zoonotic bacteria that cause gastroenteritis in humans worldwide, whose main symptom is diarrhea. In certain cases, extra intestinal manifestations may occur, such as Guillain Barré syndrome. The bacteria cause severe diarrhea mostly in children and in immunocompromised individuals. This review aims to address the prevalence of Campylobacter spp. in humans in sub-Saharan Africa. It also aims to understand the impact of HIV in the prevalence, as well as to report data on antibiotic resistance and propose research priorities. Methods We followed PRISMA guidelines to find studies on the occurrence of Campylobacter spp. in humans in all countries from sub-Saharan Africa. Studies published between 2000 and 2020 were searched in PubMed, Cochrane Library, CINAHL, African Index Medicus, African Journals Online, Google Scholar and Science Direct. We have conducted a random-effect meta-analysis and calculated the proportion of resistant isolates to different antibiotics. Results and discussion We found 77 studies that described such occurrence in humans in 20 out of 53 sub-Saharan African countries. Campylobacter jejuni was the most prevalent species. Pooled prevalence was 9.9% (CI: 8.4%–11.6%). No major variations within the different sub-regions were found. Most studies reported Campylobacter spp. as the cause of diarrhea, mainly in children. Some studies reported the bacteria as a possible etiologic agent of acute flaccid paralysis and urinary tract infection. Campylobacter spp. presented a higher pooled prevalence in HIV infected patients, although not statistically significant. High proportions of resistant strains were reported for many antibiotics, including erythromycin and tetracycline. Conclusion Campylobacter spp. occur in sub-Saharan Africa, although information is scarce or inexistent for many countries. Research priorities should include investigation of the understudied species; extra intestinal manifestations; the impact of HIV infection and associated risk factors. Control strategies should be reinforced to contain the spread of this pathogen and drug resistance.

Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

2020 ◽  
Vol 35 (4) ◽  
pp. 372-381
Author(s):  
Junhong Wang ◽  
Hua Zhang ◽  
Zongxuan Zhao ◽  
Kaifeng Wen ◽  
Yaoke Xu ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Cardiopulmonary Resuscitation ◽  
Neurological Outcome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Significant Difference ◽  
Bystander Cardiopulmonary Resuscitation ◽  
The Impact ◽  
Hospital Cardiac Arrest

AbstractObjective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

scholarly journals Breast Cancer Risk in Rheumatoid Arthritis: An Update Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Guo Tian ◽  
Jia-Ning Liang ◽  
Zhuo-Yun Wang ◽  
Dian Zhou
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Number Of Patients ◽  
The Impact

Background. The incidence of breast cancer in RA patients remains controversial. Thus we performed a meta-analysis to investigate the impact of RA on breast cancer.Methods. Published literature was available from PubMed, Embase, and Cochrane Library. Pooled standardized incidence rate (SIR) was computed by random-effect model analysis.Results. We identified 16 separate studies in the present study, in which the number of patients ranged from 458 to 84,475. We did not find the increased cancer risk in RA patients (SIR=0.86, 95%CI=0.72–1.02). However, subgroup analysis showed that breast cancer risk in RA patients was positively different in Caucasians (SIR=0.82, 95%CI=0.73–0.93) and non-Caucasians (SIR=1.21, 95%CI=1.19–1.23), respectively. In subgroup analysis by style, a reduced incidence was found in hospital-based case subjects (SIR=0.82, 95%CI=0.69–0.97). Similarly, subgroup analysis for adjusted factors indicated that in A3 (age and sex) and A4 (age, sex, and race/ethnicity) the risk was decreased (SIR=0.87, 95%CI=0.76–0.99;SIR=0.63, 95%CI=0.59–0.67).Conclusions. The meta-analysis revealed no increased breast cancer risk in RA patients. However, in the subgroup analysis, the risk of breast cancer is increased in non-Caucasians patients with RA while it decreased in Caucasian population, hospital-based case subjects, and A3 group. Such relationship may provide preference for risk of breast cancer in different population.

scholarly journals Efficacy of Neoadjuvant Therapy in Improving Long-Term Survival of Patients With Resectable Rectal Cancer: A Meta-Analysis

2021 ◽  
Author(s):  
Xinlong Li ◽  
Xiangyuan Li ◽  
Rongrong Fu ◽  
Derry Minyao Ng ◽  
Tong Yang ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Meta Analysis ◽  
Low Rectal Cancer ◽  
Cochrane Library ◽  
Term Survival ◽  
Resectable Rectal Cancer ◽  
Long Term Prognosis ◽  
The Impact

Abstract Background: The impact of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer is controversial. This study aimed to explore the effect of neoadjuvant therapy on the long-term prognosis of patients with resectable rectal cancer. Methods: Four major databases (PubMed, Web of Science, Embase, Cochrane library) were searched to find relevant articles published between January 2000 and July 2020. The main outcome indicators were the 5-year overall survival (OS) and disease-free survival (DFS). Results: Compared with upfront surgery, our meta-analysis showed that 5-year OS (HR: 0.84, 95% Cl: 0.78-0.91) and DFS (HR: 0.91, 95% Cl: 0.87-0.95) were prolonged for patients with resectable rectal cancer after receiving neoadjuvant therapy. The results of subgroup analysis suggested that both neoadjuvant short-course radiotherapy (SCRT) and neoadjuvant chemo-radiotherapy (CRT) could improve the 5-year OS and DFS. The 5-year OS and DFS of patients with stage Ⅱ-Ⅲ rectal cancer increased significantly and the improvement of 5-year OS and DFS could also be observed in mid/low rectal cancer.Conclusion: Neoadjuvant therapy could improve the long-term survival of patients with mid/low rectal cancer in stage Ⅱ-Ⅲ. For the treatment, neoadjuvant SCRT and neoadjuvant CRT were recommended.

scholarly journals The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiao-Qing Quan ◽  
Run-Chang Wang ◽  
Qing Zhang ◽  
Cun-Tai Zhang ◽  
Lei Sun
Keyword(s):  
Systematic Review ◽  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Short Term ◽  
Coronary Syndrome ◽  
Lymphocyte To Monocyte Ratio ◽  
Short Term Mortality ◽  
Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis of patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS. Methods: A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus and Web of science. The association between LMR and mortality or MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and higher long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). According to our subgroup analysis, there is still has a statistical significance for LMR to predict long-term mortality/MACE in any subgroups. Conclusions: This study suggested that lower LMR value might be associated with higher short-term mortality/MACE and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

The impact of SLE on health-related quality of life assessed with SF-36: a systemic review and meta-analysis

Lupus ◽  
2019 ◽  
Vol 28 (3) ◽  
pp. 371-382 ◽  
Author(s):  
M Gu ◽  
Q Cheng ◽  
X Wang ◽  
F Yuan ◽  
NB Sam ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Meta Analysis ◽  
Random Effect ◽  
Systemic Review ◽  
Health Related Quality ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Objective To evaluate the impact of systemic lupus erythematosus (SLE) on health-related quality of life (HRQoL) assessed with SF-36 and explore factors associated with HRQoL in SLE patients. Methods A random-effect meta-analysis was performed to calculate extracted data. Sensitivity and subgroup analyses were performed to distinguish sources of heterogeneity. Results A total of 36 articles were finally included in this meta-analysis, including 6510 patients. The pooled mean scores of SF-36 physical component summary and mental component summary were 46.10 (95% confidence interval (CI): 43.09–49.10) and 50.37 (95% CI: 47.78–52.87), respectively. Spearman's correlation analysis found that mean age, proportion of female participants, and publication decades were negatively associated with some of the SF-36 domains. Sample size and SLEDAI were positively associated with some of the SF-36 domains. Patients with SLE have lower HRQoL in comparison to the general population. Conclusions SLE has a significant impact on HRQoL, which proves that the necessity of improving HRQoL in SLE patients cannot be ignored. Measuring HRQoL should be considered as an indispensable part of the overall evaluation of health conditions of SLE patients.

scholarly journals A Meta-Analysis of the Efficacy of Prokinetic Agents against Glycemic Control

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Yeon-Ji Kim ◽  
Woo Chul Chung ◽  
Seung Jae Lee
Keyword(s):  
Glycemic Control ◽  
Large Scale ◽  
Serum Insulin ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Random Effect ◽  
Systemic Review ◽  
Cochrane Library ◽  
Prokinetic Agents ◽  
Gi Symptoms

Background. Prokinetic agents are used in diabetic gastroparesis patients to improve gastric emptying and upper gastrointestinal (GI) symptoms. However, the efficacy of prokinetic agents against glycemic control is questionable. Therefore, we conducted a systemic review and meta-analysis to determine the efficacy of prokinetic agents against glycemic control. Methods. Randomized controlled trials (RCTs) evaluating the effect of prokinetics were identified by searching PubMed, Embase, and the Cochrane Library databases until April 2018. The primary outcome was changes in the mean value of glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), and fasting serum insulin (FINS). The pooled standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated by evaluating the strength of the association. We used the random effect models to analyze these markers. The effects of each component of the prokinetic agents on glycemic control were separately analyzed. Results. Five RCTs with 190 patients met the criteria and were included in the meta-analysis. There were statistically significant SMD between prokinetics and placebo-controlled groups with respect to the reduction of HbA1c (-1.141, 95% CI -1.843, -0.438; P<0.01). No statistically significant differences were noted between the two groups for FBS (-1.270, 95% CI -2.613, -0.074; P=0.06) and FINS (0.359, 95% CI -1.205~1.923; P=0.65). Conclusions. Prokinetics have a positive effect on glycemic control. Further large-scale prospective studies are needed.

Abstract 221: Prognostic Role of elevated Myeloperoxidase in Patients with Acute Coronary Syndrome: A Systemic Review and Meta-Analysis.

2014 ◽  
Vol 115 (suppl_1) ◽  
Author(s):  
Andrew R Kolodziej ◽  
Charles L Campbell ◽  
Richard Charnigo ◽  
Raphael Twerenbold ◽  
Christian Mueller ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Major Adverse Cardiovascular Events ◽  
Poor Prognostic Factor ◽  
Coronary Syndrome ◽  
Prospective Trials ◽  
Long Term Prognosis

BACKGROUND: It has been shown that Myeloperoxidase (MPO) is intimately involved in pathogenesis of atherosclerosis and Acute Coronary Syndrome (ACS). Small studies have shown that high levels of MPO are a poor prognostic factor in patients presenting with ACS. However, due to the small nature of these studies, the relationship between MPO and outcomes has not been confirmed. Here we aimed to examine the prognostic value of MPO in patients with ACS. METHODS: We performed a meta-analysis to compare the long-term prognosis of ACS patients with high MPO and low MPO levels. The literature was retrieved by formal searches of electronic databases (PubMed, EMBASE, Medline, OVID, and web of knowledge) from inception to November 2013. A total of 16 trials were included in this meta-analysis involving 10572 patients. Data were analyzed using random-effects model and study quality was assessed using appropriate scales. RESULTS: High MPO group was associated with overall worse outcomes than low MPO group in terms of recurrent myocardial infarction (9% [211 of 2336] vs. 7.7% [240 of 3101], odds ratio [OR] 1.4, 95% confidence interval [CI]: 0.92-2.15, p 0.11); all cause mortality (8% [236 of 2920] vs. 5% [209 of 4263], OR 1.83, 95% CI: 1.31-2.54, p <0.0004) and Major Adverse Cardiovascular Events (MACE) (24% [334 of 1400] vs. 14% [133 of 949], OR 2.04, 95% CI: 1.46-2.85, p< 0.0001) (Figure). CONCLUSIONS: In this meta-analysis examining the long-term outcomes in ACS patients, high MPO levels were associated with worse outcomes. These observations support prospective trials tailoring more aggressive therapy to patients with suspected worse prognosis.

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