scholarly journals Evaluation of current medical approaches for COVID-19: a systematic review and meta-analysis

2020 ◽  
pp. bmjspcare-2020-002554 ◽  
Author(s):  
Meng Wang ◽  
Ting Wu ◽  
Zhihong Zuo ◽  
Yaxian You ◽  
Xinyuan Yang ◽  
...  
Keyword(s):  
Western Medicine ◽  
Conversion Rate ◽  
Large Scale ◽  
Clinical Symptoms ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Antiviral Agents ◽  
The Body ◽  
Online Databases ◽  
Negative Conversion

BackgroundBecause of the lack of vaccination, it is urgent to find effective antiviral agents for COVID-19 treatment.MethodOnline databases were searched for articles published before or on 22 June 2020. Studies reporting the effectiveness and safety of antiviral agents for COVID-19 were analysed.ResultsA total of 42 studies were included in this analysis. Hydroxychloroquine (HCQ) was not associated with the incidence of death (risk ratio (RR)=1.08; 95% CI 0.81 to 1.44) and severe cases (RR=1.05; 95% CI 0.61 to 1.81). Patients treated with HCQ obtained few benefits with respect to the clearance of viral RNA and were more likely to have adverse reactions. HCQ treatment could shorten the body temperature recovery time (weighted mean difference = −1.04; 95% CI −1.64 to −0.45). Lopinavir/ritonavir (LPV/r) (RR=0.90; 95% CI 0.76 to 1.07) and Arbidol (RR=1.09; 95% CI 0.92 to 1.29) were not associated with the negative conversion rate. Integrative Chinese-Western medicine alleviated clinical symptoms and decreased the incidence of severe cases (RR=0.38; 95% CI 0.25 to 0.59). Remdesivir treatment reduced the 14-day mortality rate of patients with severe COVID-19 (RR=0.64; 95% CI 0.44 to 0.94). Convalescent plasma (CP) tended to increase the negative conversion rate (RR=2.47; 95% CI 1.70 to 3.57).ConclusionHCQ, LPV/r and Arbidol bring little benefit in COVID-19 treatment. Integrative Chinese-Western medicine improved the clinical symptoms of patients with COVID-19. Remdesivir and CP might be the potential treatments for patients with severe COVID-19. However, large-scale clinical randomised trials are needed to validate our conclusions.

Effect of Probiotic Consumption on Immune Response in Athletes: A Meta-analysis

2021 ◽  
Author(s):  
Rahele Tavakoly ◽  
Amir Hadi ◽  
Nahid Rafie ◽  
Behrouz Talaei ◽  
Wolfgang Marx ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Monocyte Count ◽  
Randomized Controlled ◽  
Immunological Markers ◽  
Online Databases ◽  
Immunological Effects

AbstractThe possible effect of probiotic interventions on immunological markers in athletes is inconclusive. Therefore, to synthesize and quantitatively analyze the existing evidence on this topic, systematic literature searches of online databases PubMed, Scopus, Cochrane Library, and ISI Web of Sciences was carried out up to February 2021 to find all randomized controlled trials (RCTs) concerning the immunological effects of probiotics in athletes. In the random-effects model, weighted mean difference (WMD) and 95% confidence interval (CI) explained the net effect. The authors assessed the likelihood of publication bias via Egger’s and Begg’s statistics. A total of 13 RCTs (836 participants) were retrieved. Probiotic consumption reduced lymphocyte T cytotoxic count significantly (WMD=−0.08 cells×109/L; 95% CI: −0.15 to −0.01; p=0.022) with evidence of moderate heterogeneity (I 2=59.1%, p=0.044) and monocyte count when intervention duration was ≤ 4 weeks (WMD=−0.08 cells×109/L; 95% CI: −0.16 to −0.001; I 2=0.0%). Furthermore, leukocyte count was significantly elevated (WMD=0.48 cells×109/L; 95% CI: 0.02 to 0.93; I 2=0.0%) when multi-strain probiotics were used. Probiotic supplements may improve immunological markers, including lymphocyte T cytotoxic, monocyte, and leukocyte in athletes. Further randomized controlled trials using diverse strains of probiotics and consistent outcome measures are necessary to allow for evidence-based recommendations.

scholarly journals Prognostic and clinicopathological importance of microRNA-140 expression in cancer patients: a meta-analysis

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Mengxia Zheng ◽  
Jingting Liu ◽  
Chunyan Meng ◽  
Kaifeng Tang ◽  
Jianhua Liao
Keyword(s):  
Cancer Patient ◽  
Cancer Patients ◽  
English Literature ◽  
Meta Analysis ◽  
Positive Lymph Node ◽  
The Body ◽  
Cancer Prognosis ◽  
Online Databases ◽  
Hazard Ratios ◽  
Patient Prognosis

Abstract Background MicroRNA-140 (miR-140) is one of the most widely investigated miRNAs in cell carcinogenesis and cancer development. Despite present proposals of employing miR-140 as a candidate biomarker for cancer prognosis, its effectiveness in predicting patient survival and clinicopathological outcome is still under debate. Methods A systematic search for English literature using online databases was performed with pre-established criteria. Odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were collected to delineate the correlation between miR-140 levels and cancer patient prognosis. Results For this meta-analysis, we selected 12 papers for analysis, involving 1386 participants. Based on our analysis, high levels of miR-140 were strongly correlated with enhanced patient overall survival (OS) (HR = 0.728, 95% CI = 0.601-0.882, P = 0.001). In addition, we also observed that elevated miR-140 levels significantly led to better OS in patients with cancers in different parts of the body like digestive system (HR = 0.675, 95% CI = 0.538-0.848, P = 0.001), digestive tract (HR = 0.709, 95% CI = 0.565-0.889, P = 0.003), and head and neck (HR = 0.603, 95% CI = 0.456-0.797, P < 0.001). Additionally, we verified that the low miR-140 levels was related to advanced TNM stage (OR = 0.420, 95% CI = 0.299-0.590, P < 0.001), worse histologic grade (OR = 0.410, 95% CI = 0.261-0.643, P < 0.001), and positive lymph node metastasis status (OR = 0.341, 95% CI = 0.144-0.807, P = 0.014). Conclusions Taken together, our results suggest that elevated miR-140 levels can be employed as a favorable biomarker for cancer patient prognosis. This information can greatly benefit in the formation of an individualized therapeutic plan for the treatment of cancer patients.

scholarly journals Algorithm for dental caries risk assessment

2017 ◽  
Vol 63 (2) ◽  
pp. 57-60
Author(s):  
Cristian Funieru ◽  
Keyword(s):  
Risk Assessment ◽  
Dental Caries ◽  
Large Scale ◽  
Meta Analysis ◽  
Caries Risk ◽  
Caries Risk Assessment ◽  
Patient Centered ◽  
Mathematical Algorithm ◽  
Online Databases ◽  
Starting Point

Introduction. Caries risk assessment in individual patients is mandatory as it becomes a starting point for developing patient-centered preventive strategies. Any method designed for caries risk assessment should be based on the risk and protection factors involved. Material and method. The first part of this study consists of a fundamental research based on a meta-analysis style study of a number of 128 articles present in the main online databases. The other part of the study is dedicated to the development of a mathematical algorithm of dental caries risk. Results. The caries risk is based on the algorithm presented in this study which takes into account 8 risk or protection factors, their frequency and coefficients being found in the main publications flow and assigned according to an evaluation scale. Conclusions. Although at first glance it seems to be a simple and easy to apply mathematical formula, this algorithm must be validated in a future and specially designed study before it could be used on a large scale.

scholarly journals Chinese Herbal Extractions for Relieving Radiation Induced Lung Injury: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-16 ◽  
Author(s):  
Bo Deng ◽  
Chao Deng ◽  
Zhiqiang Cheng
Keyword(s):  
Lung Injury ◽  
Large Scale ◽  
Clinical Symptoms ◽  
Remission Rate ◽  
Meta Analysis ◽  
Thoracic Radiotherapy ◽  
Double Blind ◽  
Chinese Herbal ◽  
Radiation Induced ◽  
Symptoms And Signs

Background. Radiation induced lung injury (RILI) is one of the most common and severe side effects of thoracic radiotherapy. In this meta-analysis, the effects of Chinese herbal extractions (CHE) for preventing and treating RILI are evaluated. Methods. Randomized Controlled Trials (RCTs) from five databases were identified. Studies were evaluated and the relevant data were extracted by two authors independently. Differences were resolved by a third party. Meta-analysis was conducted using RevMan 5.0. Results. In total, 2734 participants receiving thoracic radiotherapy were included in 28 RCTs, and 16 CHE were evaluated. Meta-analysis showed that CHE intervention significantly reduced the incidence of acute radiation pneumonitis (RP) and radiation induced pulmonary fibrosis (RIPF). In CHE group, total effective rate and remission rate of RILI patients were significantly higher. Patient’s quality of life (Qol) and clinical symptoms and signs were improved significantly. Inflammatory cytokines decreased, and thymus dependent lymphocytes subgroups were improved. Conclusion. CHE intervention may have clinical effectiveness for relieving RILI and related symptoms and signs and lead to improvement of Qol. However, more double-blind, multicenter, large-scale RCTs are needed to support this theory. Trial Registration. PROSPERO International prospective register of systematic reviews has registration number CRD42016043538.

scholarly journals Analysis of Clinical Efficacy of Traditional Chinese Medicine in Recovery Stage of Stroke: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-35
Author(s):  
Xue Zhang ◽  
Xiao-Fei Zhang ◽  
Lin Wang ◽  
Dong-Yan Guo ◽  
Jia-Min Zhang ◽  
...  
Keyword(s):  
Large Scale ◽  
Clinical Symptoms ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Recovery Period ◽  
Small Sample ◽  
Comprehensive Treatment ◽  
Neural Function ◽  
Routine Treatment

Background. We provide an updated meta-analysis with detailed information on a combination of TCM and routine treatment. Methods. Retrieve appropriate articles with no language restrictions on keywords until 8 July 2019 in an electronic database. All trajectories are screened according to certain criteria. The quality of certified research was also evaluated. We made a detailed record of the results of the measurement. Meta-analysis was carried out by using the Revman 5.3 software. Results. Sixty-seven RCTs were included, and 6594 subjects were analyzed. Compared with routine treatment, the total effective rate (TER) of TCM combined with routine treatment was improved, and the recovery of stroke was also significantly accelerated. Regulation of blood lipids by notably shrinking the contents of TC, TG, and LDL and enhancing the levels of HDL. The levels of serum hs-CRP, WHV, and WLV decreased significantly, indicating that the expression of thrombomodulin was decreased after the comprehensive treatment of traditional Chinese medicines (TCMs). The combination of TCM treatment could enhance the protection of neural function by decreasing the NIHSS scoring while increasing the BI scoring. Paeoniae Radix Rubra, Angeticae Sinensis Radix, etc., can effectively improve the clinical symptoms of stroke convalescent patients and promote the recovery of neurological function. ACU of Baihui, Renzhong, etc., can improve the clinical rehabilitation effect of patients. However, our findings must be handled with care because of the small sample size and low quality of clinic trials cited. Other rigorous and large-scale RCTs are in need to confirm these results. Conclusion. A combination of TCM and routine treatment in the treatment of stroke could improve TER, and it is beneficial to the rehabilitation of patients in the recovery period of apoplexy. These effects can be mediated by a combination of several mechanisms. Nevertheless, due to the limitations of this study, these results should be handled with caution.

scholarly journals Potential Effectiveness and Safety of Antiviral Agents in Children with Coronavirus Disease 2019: A Rapid Review and Meta-Analysis

2020 ◽  
Author(s):  
Qianling Shi ◽  
Qi Zhou ◽  
Xia Wang ◽  
Jing Liao ◽  
Yang Yu ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Antiviral Agents ◽  
Indirect Evidence ◽  
Rapid Review ◽  
Controlled Trials ◽  
Potential Effectiveness ◽  
Life Threatening ◽  
Pcr Test

AbstractBackgroundThe COVID-19 outbreak presents a new, life-threatening disease. Our aim was to assess the potential effectiveness and safety of antiviral agents for COVID-19 in children.MethodsElectronic databases from their inception to March, 31 2020 were searched for randomized controlled trials, clinical controlled trials and cohort studies of interventions with antiviral agents for children (less than 18 years of age) with COVID-19.ResultsA total of 23 studies of indirect evidence with 6008 patients were included. The risks of bias in all studies were moderate to high in general. The effectiveness and safety of antiviral agents for children with COVID-19 is uncertain: For adults with COVID-19, lopinavir/ritonavir had no effect on mortality (risk ratio [RR]= 0.77, 95% confidence interval [CI] 0.45 to 1.30) and probability of negative PCR test (RR=0.98, 95 CI% 0.82 to 1.18). Arbidol had no benefit on probability of negative PCR test (RR=1.27, 95% CI 0.93 to 1.73). Hydroxychloroquine was not associated with increasing the probability of negative PCR result (RR=0.93, 95% CI 0.73 to 1.18). For adults with SARS, interferon was associated with reduced corticosteroid dose (weighted mean difference [WMD]=-0.14 g, 95% CI -0.21 to -0.07) but had no effect on mortality (RR=0.72, 95% CI 0.28 to 1.88); ribavirin did not reduce mortality (RR=0.68, 95% CI % 0.43 to 1.06) and was associated with high risk of severe adverse reactions; and oseltamivir had no effect on mortality (RR=0.87, 95% CI 0.55 to 1.38). Ribavirin combined with interferon was also not effective in adults with MERS and associated with adverse reactions.ConclusionsThere is no evidence showing the effectiveness of antiviral agents for children with COVID-19, and the clinical efficacy of existing antiviral agents is still uncertain. We do not suggest clinical routine use of antivirals for COVID-19 in children, with the exception of clinical trials.

Somatic and obstetrical aspects of magnesium deficiency (Clinical lecture)

2016 ◽  
pp. 10-17
Author(s):  
S.A. Shurpyak ◽  
Keyword(s):  
Large Scale ◽  
Clinical Symptoms ◽  
Magnesium Deficiency ◽  
The Body ◽  
Advisory Council ◽  
Magnesium Homeostasis ◽  
Physiological Processes ◽  
Key Words Magnesium ◽  
Key Words Magnesium Deficiency ◽  
International Advisory

Homeostasis of magnesium in the body is a prerequisite for human health. As required macrocell for cells and tissues, magnesium is involved in many physiological processes, to ensure the normal functioning of the organism. At the same time a number of large-scale studies established a significant prevalence of magnesium deficiency, which is in the general population is 14.5%, and the suboptimal level observed in 33.7%. The resolution of the International Advisory Council for magnesium deficiency in obstetrics and gynecology noted urgency of the problem and the importance of correction of magnesium deficiency in pregnant and gynecological patients. The lecture covered various aspects of magnesium deficiency are considered violations of the pathophysiological mechanisms of magnesium homeostasis, Principles on the Use of magnesium products with preventive and curative purposes. Key words: magnesium deficiency, clinical symptoms of hypomagnesemia, pregnancy.

scholarly journals Modified Si-Miao Pill for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Hui Wang ◽  
Yao Huang ◽  
Pan Shen ◽  
Yu Wang ◽  
Kai Qin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Western Medicine ◽  
Large Scale ◽  
Meta Analysis ◽  
Tender Joint Count ◽  
C Reactive Protein ◽  
Tender Joint ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Inflammatory Drugs

Objective. The aim of this review and meta-analysis was to assess the effects and safety of modified Si-Miao pill (mSMP) in treatment of rheumatoid arthritis. Design. A systematic literature search was carried out in eight databases from their available dates of inception to April 2020. After screening, fifteen randomized, controlled trials (RCTs) comparing the effects and safety of mSMP in combination with western medicine (including disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs)) in treating rheumatoid arthritis patients were included after screening. Results. In comparison with DMARDs, or coadministration of DMARDs and NSAIDs, mSMP in combination with western medicine significantly lowered erythrocyte sedimentation rate (mean difference (MD) = -10.61, 95% confidence interval (CI) [−12.19, −9.03]), C-reactive protein (MD = −6.50, 95% CI [−8.43, −4.56]), rheumatoid factors (MD = −17.31, 95% CI [−24.34, −10.27]), swollen joint count (MD = −1.63, 95% CI [−2.29, −0.97]), tender joint count (MD = −1.98, 95% CI [−2.34, −1.62]), and morning stiffness time (MD = −24.37, 95% CI [−29.41, 19.33]) and ameliorated the condition of patients (odds ratio (OR) = 3.69, 95% CI [2.64, 5.14]). Additionally, mSMP in combination with western medicine seemed safer (OR = 0.49, 95% CI [0.30, 0.81]). Conclusion. The results of the meta-analysis study have shown that mSMP in combination with western medicine therapies appears to be more effective and safer than western medicine alone in the treatment of rheumatoid arthritis including reducing inflammatory markers and adverse events and improving symptoms. Howbeit, more high-grade, large-scale RCTs of mSMP in various countries and regions are still needed.

scholarly journals Enucleation versus hepatectomy for giant hepatic haemangiomas: a meta-analysis

2017 ◽  
Vol 99 (3) ◽  
pp. 237-241 ◽  
Author(s):  
WL Cheng ◽  
YQ Qi ◽  
B Wang ◽  
L Tian ◽  
W Huang ◽  
...  
Keyword(s):  
Blood Loss ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Operation Time ◽  
China National Knowledge Infrastructure ◽  
Liver Tumours ◽  
Inflow Occlusion ◽  
Occlusion Time ◽  
Online Databases ◽  
Transfusion Requirements

INTRODUCTION Hepatic haemangiomas are the most common benign liver tumours. They can be treated with surgical resection such as enucleation or hepatectomy if necessary. However, controversy remains over the clinical outcome and safety of these two methods. In this study, we performed a comprehensive meta-analysis to compare the efficacy of liver resection with enucleation for giant haemangiomas. METHODS The online databases PubMed, Embase and CNKI (China National Knowledge Infrastructure) were searched for relevant original articles. We compared operation time, blood loss, transfusion requirements, inflow occlusion time and postoperative complications between enucleation and hepatectomy. RESULTS Seven controlled clinical trials met the predefined inclusion criteria. Analysis indicated that the enucleation group had significantly shorter operation time (weighted mean difference, WMD –28.22, 95% confidence interval, CI, –54.82 to –1.62), less blood loss (WMD –395.92, 95% CI –521.25 to –270.58) and fewer complications (odds ratio, OR, 0.47, 95 % CI 0.34 to 0.65). There were no significant differences between enucleation and hepatectomy with regard to transfusion requirements (OR 0.61, 95% CI 0.22 to 1.68) and inflow occlusion time (WMD 7.91, 95% CI –5.62 to 21.44). CONCLUSIONS Enucleation has advantages over hepatectomy in relation to operation time, blood loss and complications. Enucleation is a safe and effective treatment for giant hepatic haemangioma.

scholarly journals White Matter Abnormalities in Patients With Parkinson's Disease: A Meta-Analysis of Diffusion Tensor Imaging Using Tract-Based Spatial Statistics

2021 ◽  
Vol 12 ◽  
Author(s):  
Xia Wei ◽  
Chunyan Luo ◽  
Qian Li ◽  
Na Hu ◽  
Yuan Xiao ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Spatial Statistics ◽  
Diffusion Tensor ◽  
Meta Analysis ◽  
The Body ◽  
Online Databases ◽  
Tract Based Spatial Statistics

Background: Tract-based spatial statistics (TBSS) studies based on diffusion tensor imaging (DTI) have revealed extensive abnormalities in white matter (WM) fibers of Parkinson's disease (PD); however, the results were inconsistent. Therefore, a meta-analytical approach was used in this study to find the most prominent and replicable WM abnormalities of PD.Methods: Online databases were systematically searched for all TBSS studies comparing fractional anisotropy (FA) between patients with PD and controls. Subsequently, we performed the meta-analysis using a coordinate-based meta-analytic software called seed-based d mapping. Meanwhile, meta-regression was performed to explore the potential correlation between the alteration of FA and the clinical characteristics of PD.Results: Out of a total of 1,701 studies that were identified, 23 studies were included. Thirty datasets, including 915 patients (543 men) with PD and 836 healthy controls (449 men), were included in the current study. FA reduction was identified in the body of the corpus callosum (CC; 245 voxels; z = −1.739; p &lt; 0.001) and the left inferior fronto-occipital fasciculus (IFOF) 118 voxels; z = −1.182; p &lt; 0.001). Both CC and IFOF maintained significance in the sensitivity analysis. No increase in FA was identified, but the percentage of male patients with PD was positively associated with the value of FA in the body of the CC.Conclusions: Although some limitations exist, DTI is regarded as a valid way to identify the pathophysiology of PD. It could be more beneficial to integrate DTI parameters with other MRI techniques to explore brain degeneration in PD.

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