Association between circulating leptin levels and multiple sclerosis: a systematic review and meta-analysis

AimLeptin, synthesised by adipocytes, has been identified as a hormone that can influence inflammatory activity. Several studies have investigated leptin levels in patients with multiple sclerosis (MS), but the results are not consistent. This study aims to derive a more precise evaluation on the relationship between circulating leptin levels and MS.DesignA comprehensive literature searched up to July 2017 was conducted to evaluate the association of circulating leptin levels and MS. The random-effect model was applied to calculate pooled standardised mean difference (SMD) and its 95% CI.Main outcome measuresCirculating leptin levels of patients with MS and healthy controls.ResultsOf 2155 studies identified, 33 met eligibility criteria and 9 studies with 645 patients with MS and 586 controls were finally included in the meta-analysis. Meta-analysis revealed that, compared with the healthy control group, the MS group had significantly higher plasma/serum leptin levels, with the SMD of 0.70% and 95% CI (0.24 to 1.15). Subgroup analyses suggested that the leptin levels of patients with MS were associated with region, age, study sample size, measurement type, gender and blood sample type.ConclusionOverall, our study suggests that patients with MS have a significantly higher leptin level than in healthy controls. Further mechanism studies and longitudinal large cohort studies are still needed to further reveal the role of leptin in the pathogenesis of MS.

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Alteration of Postural Balance in Patients with Fibromyalgia Syndrome—A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11010127 ◽

2021 ◽

Vol 11 (1) ◽

pp. 127

Author(s):

David Núñez-Fuentes ◽

Esteban Obrero-Gaitán ◽

Noelia Zagalaz-Anula ◽

Alfonso Javier Ibáñez-Vera ◽

Alexander Achalandabaso-Ochoa ◽

...

Keyword(s):

Systematic Review ◽

Postural Balance ◽

Fibromyalgia Syndrome ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Healthy Controls ◽

Functional Balance ◽

Sensory Organization ◽

Effect Model

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.

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Assessment of the Clinical Trials Safety Profile of PD-1/PD-L1 Inhibitors Among Patients With Cancer: An Updated Systematic Review and Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.662392 ◽

2021 ◽

Vol 11 ◽

Author(s):

Yuan Tian ◽

Alan Huang ◽

Yue Yang ◽

Qi Dang ◽

Qing Wen ◽

...

Keyword(s):

Clinical Trials ◽

Adverse Events ◽

Safety Profile ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Group ◽

Risk Of Death ◽

Effect Model ◽

Newcastle Ottawa Scale

BackgroundUnderstanding the safety and adverse event profiles of PD-1/PD-L1 inhibitors is important in guiding cancer immunotherapy. Consequently, we designed this meta-analysis to evaluate the safety of PD-1/PD-L1 inhibitors in clinical trials involving cancer patients.MethodsFour safety indicators comprising treatment-related adverse events, death, discontinuation of therapy and grades 3–5 adverse events were evaluated using the random effect model. The quality of enrolled trials was assessed using the Newcastle Ottawa Scale (NOS).ResultsForty-four clinical trials were included in the final meta-analysis. Compared with chemotherapy, the risk of death due to the use of PD-1/PD-L1 inhibitors was much lower than that experienced in the control group (OR = 0.65, 95%CI: [0.47, 0.91], I2 = 0%, Z = 2.52 (P = 0.01)). Similar observations were apparent regarding the other three indicators of safety and also when the use of PD-1/PD-L1 inhibitors alone is compared with the combined use of PD-1/PD-L1 and CTLA-4. When used together with chemotherapy, PD-1/PD-L1 inhibitors increased the incidence of the adverse events as compared to the use of chemotherapy alone. Increased risks for adverse events were also noticed with the use of PD-1/PD-L1 inhibitors over the use of a placebo.ConclusionThe use of PD-1/PD-L1 inhibitors alone is associated with a better safety profile compared to either the use of chemotherapy or the use of PD-1/PD-L1 inhibitors with other anticancer regimens.

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Increased Neurotoxicity Due to Activated Immune-Inflammatory and Nitro-Oxidative Stress Pathways in Patients with Suicide Attempts: A Systematic Review and Meta-Analysis

10.20944/preprints202104.0479.v1 ◽

2021 ◽

Author(s):

Asara Vasupanrajit ◽

Ketsupar Jirakran ◽

Chavit Tunvirachaisakul ◽

Michael Maes

Keyword(s):

Oxidative Stress ◽

Immune Activation ◽

Suicide Attempts ◽

Psychiatric Patients ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Group ◽

Healthy Controls ◽

New Biomarkers

Background: Suicide attempts (SA) frequently occur in patients with mood disorders and schizophrenia, which are both accompanied by activated immune-inflammatory and nitro-oxidative (IO&NS) pathways. Methods: We searched PubMed, Google Scholar, and Web of Science, for articles published from inception until February 1, 2021. We included studies that compared blood biomarkers in psychiatric patients with (SA+) and without SA (SA-) and heathy controls and we combined different IO&NS biomarkers into immune, inflammatory, and neurotoxic profiles and used meta-analysis (random-effect model with restricted maximum-likelihood) to delineate effect sizes with 95% confidence interval (CI).Findings: Our search included 51 studies comprising 4.945 SA+ patients and 24.148 controls. We stratified the control group into healthy controls and SA- patients. SA+ patients showed significantly (p<0.001) increased immune activation (SMD: 1.044; CI: 0.599-1.489), inflammation (SMD: 1.109; CI: 0.505, 1.714), neurotoxicity (SMD: 0.879; CI: 0.465, 1.293), and lowered neuroprotection (SMD: 0.648; CI: 0.354, 0.941) as compared with healthy controls. When compared with SA- patients, those with SA+ showed significant (p<0.001) immune activation (SMD: 0.290; CI: 0.183, 0.397), inflammation (SMD: 0.311; CI: 0.191, 0.432), and neurotoxicity (SMD: 0.315; CI: 0.198, 0.432), and lowered neuroprotection (SMD: 0.341; CI: 0.167, 0.515). Patients with current, but not lifetime, SA showed significant (p<0.001) levels of inflammation and neurotoxicity as compared with controls. Conclusions: Patients with immune activation are at a higher risk of SA which may be explained by increased neurotoxicity due to inflammation and nitro-oxidative stress. This meta-analysis discovered new biomarkers of SA and therapeutic targets to treat individuals with SA.

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Effects of music therapy on depression: A meta-analysis of randomized controlled trials

PLoS ONE ◽

10.1371/journal.pone.0240862 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0240862

Author(s):

Qishou Tang ◽

Zhaohui Huang ◽

Huan Zhou ◽

Peijie Ye

Keyword(s):

Depressive Symptom ◽

Music Therapy ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Control Group ◽

Controlled Trials ◽

Cochrane Central Register ◽

Music Medicine ◽

Effect Model

Background We aimed to determine and compare the effects of music therapy and music medicine on depression, and explore the potential factors associated with the effect. Methods PubMed (MEDLINE), Ovid-Embase, the Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, and Clinical Evidence were searched to identify studies evaluating the effectiveness of music-based intervention on depression from inception to May 2020. Standardized mean differences (SMDs) were estimated with random-effect model and fixed-effect model. Results A total of 55 RCTs were included in our meta-analysis. Music therapy exhibited a significant reduction in depressive symptom (SMD = −0.66; 95% CI = -0.86 to -0.46; P<0.001) compared with the control group; while, music medicine exhibited a stronger effect in reducing depressive symptom (SMD = −1.33; 95% CI = -1.96 to -0.70; P<0.001). Among the specific music therapy methods, recreative music therapy (SMD = -1.41; 95% CI = -2.63 to -0.20; P<0.001), guided imagery and music (SMD = -1.08; 95% CI = -1.72 to -0.43; P<0.001), music-assisted relaxation (SMD = -0.81; 95% CI = -1.24 to -0.38; P<0.001), music and imagery (SMD = -0.38; 95% CI = -0.81 to 0.06; P = 0.312), improvisational music therapy (SMD = -0.27; 95% CI = -0.49 to -0.05; P = 0.001), music and discuss (SMD = -0.26; 95% CI = -1.12 to 0.60; P = 0.225) exhibited a different effect respectively. Music therapy and music medicine both exhibited a stronger effects of short and medium length compared with long intervention periods. Conclusions A different effect of music therapy and music medicine on depression was observed in our present meta-analysis, and the effect might be affected by the therapy process.

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Association of FOXP3 Polymorphisms with Susceptibility to Multiple Sclerosis: A Meta-Analysis on Genetic Association Studies

Current Pharmacogenomics and Personalized Medicine ◽

10.2174/1875692118666200122163559 ◽

2020 ◽

Vol 17 (2) ◽

pp. 94-103

Author(s):

Nazanin Mousavi ◽

Seyyed Amir Yasin Ahmadi ◽

Zahra Mahmoudi ◽

Reza Nekouian ◽

Bijan Ansari-moghaddam ◽

...

Keyword(s):

Multiple Sclerosis ◽

Risk Factor ◽

Genetic Association ◽

Association Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Genetic Association Studies ◽

Genotype Frequencies ◽

Effect Model

Objectives: OXP3 is a gene related to regulatory T cells existing on chromosome X. This meta-analysis, based on genetic association studies, was conducted to investigate the association of FOXP3 polymorphisms with susceptibility to multiple sclerosis (MS). Methods: All genetic association studies covering both FOXP3 and multiple sclerosis terms were searched in PubMed, Web of Science and Google Scholar. The information of genotype frequencies was summarized and results were synthesized through odds ratio (OR). Heterogeneity and publication bias were investigated using I2 scale and Begg's funnel plot, respectively. Results: For rs3761548 -3279 C/A polymorphism, AA/AY genotypes were a risk factor in comparison to CC/CY genotypes (P =0.022; OR =1.752; 95% confidence interval [CI] =1.084-2.830; random). AC genotype was a risk factor in comparison to CC/CY genotypes (P =0.004; OR =1.537; 95% CI =1.145-2.062; random) and homozygote genotypes (P =0.016; OR =1.216; 95% CI =1.038-1.426; fixed). For rs2232365 -924 G/A polymorphism, 2 significant associations were found according to a fixed effect model; of course, they did not remain significant in the random effect model. Conclusion: According to the collected populations, susceptibility to and protection from MS are associated with rs3761548 -3279 C/A upstream polymorphism. However, it should be regarded that this association is ethnicity dependent with low effect size.

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Influence of Hyaluronan Nasal Dressing on Clinical Outcome after Endoscopic Sinus Surgery: A Systematic Review and Meta-Analysis

American Journal of Rhinology and Allergy ◽

10.2500/ajra.2017.31.4438 ◽

2017 ◽

Vol 31 (4) ◽

pp. 256-259 ◽

Cited By ~ 1

Author(s):

Jianneng Chen ◽

Xuan Wang ◽

Luzan Chen ◽

Jie Liu

Keyword(s):

Systematic Review ◽

Clinical Outcome ◽

Endoscopic Sinus Surgery ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Sinus Surgery ◽

Control Group ◽

Effect Model ◽

Control Intervention

Introduction Hyaluronan nasal dressing might be promising in promoting reepithelialization after endoscopic sinus surgery (ESS). However, the results remain controversial. We conducted a systematic review and meta-analysis to explore the effects of hyaluronan nasal dressing on clinical outcome after ESS. Methods Medical literature data bases were systematically searched. Randomized controlled trials (RCT) that assessed the effect of hyaluronan nasal dressing on the outcome after ESS were included. The results were searched and data were extracted and assessed for quality. The primary outcome was reepithelization. Meta-analysis was performed by using the random-effect model. Results Four RCTs, which involved 352 patients, were included in the meta-analysis. Overall, compared with control intervention, hyaluronan nasal dressing significantly promoted reepithelization (odds ratio [OR] 3.18 [95% confidence interval {CI}, 1.33-7.59]; p = 0.009) and reduced edema (OR 0.45 [95% CI, 0.23-0.89]; p = 0.02) after ESS. However, hyaluronan nasal dressing failed to reduce synechia (OR 0.45 [95% CI, 0.19-1.03]; p = 0.06), crust (OR 1.00 [95% CI, 0.20-5.09]; p = 1.00), and infection (OR 0.84 [95% CI, 0.46-1.53]; p = 0.56) compared with the control group in patients who underwent ESS. Conclusion Compared with “Control intervention” indicates standard nasal dressing without hyaluronan, resorbable hyaluronan nasal dressing could significantly improve reepithelization and decrease edema but had no influence on synechia, crust, and infection after ESS.

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Circulating Resistin Levels and Risk of Colorectal Cancer: A Meta-Analysis

BioMed Research International ◽

10.1155/2016/7367485 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 8

Author(s):

Gui Yang ◽

Wei Fan ◽

Baohong Luo ◽

Zhigao Xu ◽

Ping Wang ◽

...

Keyword(s):

Colorectal Cancer ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Sensitivity Analyses ◽

Published Data ◽

Significant Heterogeneity ◽

Sample Type ◽

Effect Model ◽

Mean Differences

Objectives. Published data on resistin levels in patients with colorectal cancer (CRC) were conflicting and heterogeneous. We conducted a meta-analysis of observational studies to examine the association of circulating resistin levels with carcinogenesis of the CRC.Methods. Potentially eligible studies published up to November 2015 were searched through MEDLINE, EMBASE, Science Citation Index Expanded database, CNKI, and WanFang database. The pooled weighted mean differences (WMDs) with 95% confidence intervals (CIs) calculated by fixed- or random-effect model were used to estimate the effects.Results. A total of 11 studies involving 965 patients were admitted in our meta-analysis. The pooled effects indicated that resistin levels were higher in CRC patients compared to healthy controls (WMD: 1.47 ng/mL; 95% CI: 0.78 to 2.16), with significant heterogeneity across the studies (I2=72%,p<0.0001). Subgroup analyses and sensitivity analyses revealed that study quality, design, sample type, and resistin assays may account for this heterogeneity. No publication bias was observed.Conclusions. Our meta-analysis suggests that increased circulating resistin levels are associated with greater risk of colorectal cancer. Given the limited number of available studies and significant heterogeneity, larger well-designed randomized studies are warranted.

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Respiratory Rehabilitation Does not Prevent Post-Pperative Pulmonary Complications, Morbidity and Mortality After Esophagectomy.- A Systematic Review and Meta-Analysis.

10.21203/rs.3.rs-1057801/v1 ◽

2021 ◽

Author(s):

BHAVIN VASAVADA ◽

Hardik patel

Keyword(s):

Pulmonary Rehabilitation ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Pulmonary Complications ◽

Morbidity And Mortality ◽

Postoperative Pneumonia ◽

Control Group ◽

Effect Model ◽

Significant Difference

Abstract Aim: The analysis aimed to study the effect of preoperative pulmonary rehabilitation on post-operative pulmonary complications, overall morbidity, and mortality after esophagectomy.Methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement (2020) and MOOSE guidelines. The meta-analysis was done using Review Manager 5.4. We compared postoperative pneumonia, postoperative pulmonary complications, morbidity, and mortality between the preoperative respiratory group vs. no prehabilitation group. Heterogeneity was evaluated using the I2 test. The random-effect model was used with I2 was more than 25% otherwise fixed-effect model was used. I2 less than 25%, 25-50%, and more than 50% were taken as low, moderate, or high heterogeneity.Results: Seven studies consisting of. 606 patients were included in the analysis. 322 patients in the respiratory prehabilitation group and 284 in the control group. There was no statistically significant difference in postoperative pneumonia (p=0.11), post-operative pulmonary complications (p= 0.09), All cause morbidity and mortality. (p=0.98, and 0.30 respectively). However, heterogeneity was moderate to high in most analyses.Conclusion: There is no conclusive evidence as of now regarding the benefits of preoperative pulmonary rehabilitation in esophagectomy. However, further studies are needed to confirm it.

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The Efficacy of Flupentixol-Melitracen in the Adjuvant Therapy of Ulcerative Colitis in the Chinese Population: A Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2019/3480732 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Xiaoqian Zhou ◽

Lei Zhao ◽

Ping Yang ◽

Yaxi Chen ◽

Xiong Z. Ruan

Keyword(s):

Ulcerative Colitis ◽

Adjuvant Therapy ◽

Chinese Population ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Fixed Effect Model ◽

Treated Group ◽

Control Group ◽

Effect Model

Objectives. Our aim of this study is to compare the efficacy of flupentixol-melitracen in the adjuvant therapy of ulcerative colitis patients in the Chinese population. Methods. Both the RevMan 5.2 and the Stata 12.0 software are used in this study for analysis, and a fixed-effect model (the Mantel-Haenszel method) or a random-effect model (the DerSimonian and Laird method) is used to merge or aggregate the risk ratio (RR) and its 95% confidence intervals (CI) of included studies. Results. Eleven trials involving 654 ulcerative colitis patients (treated group: 328; control group: 326) were analyzed in this study. Significant differences (RR=1.29, 95% CI=1.20 to 1.40, P<0.001) between patients were observed between the two groups. Conclusions. Our results suggested that the efficacy of flupentixol-melitracen in the adjuvant therapy of ulcerative colitis is better than traditional drug treatments.

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Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0252461 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252461

Author(s):

Athira Balakrishnan ◽

Sandra Puthean ◽

Gautam Satheesh ◽

Unnikrishnan M. K. ◽

Muhammed Rashid ◽

...

Keyword(s):

Systematic Review ◽

Blended Learning ◽

Effect Size ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Pharmacy Education ◽

Cochrane Library ◽

Control Group ◽

Effect Model

Background & objective Though blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education. Methods PubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify published literature. The retrieved studies from databases were screened for its title and abstracts followed by the full-text in accordance with the pre-defined inclusion and exclusion criteria. Methodological quality was appraised by modified Ottawa scale. Random effect model used for statistical modelling. Key findings A total of 26 studies were included for systematic review. Out of which 20 studies with 4525 participants for meta-analysis which employed traditional teaching in control group. Results showed a statistically significant positive effect size on knowledge (standardized mean difference [SMD]: 1.35, 95% confidence interval [CI]: 0.91 to 1.78, p<0.00001) and skill (SMD: 0.68; 95% CI: 0.19 to 1.16; p = 0.006) using a random effect model. Subgroup analysis of cohort studies showed, studies from developed countries had a larger effect size (SMD: 1.54, 95% CI: 1.01 to 2.06), than studies from developing countries(SMD: 0.44, 95% CI: 0.23 to 0.65, studies with MCQ pattern as outcome assessment had larger effect size (SMD: 2.81, 95% CI: 1.76 to 3.85) than non-MCQs (SMD 0.53, 95% CI 0.33 to 0.74), and BL with case studies (SMD 2.72, 95% CI 1.86–3.59) showed better effect size than non-case-based studies (SMD: 0.22, CI: 0.02 to 0.41). Conclusion BL is associated with better academic performance and achievement than didactic teaching in pharmacy education.

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