Meta-analysis of the efficacy of moxifloxacin in treating Mycoplasma genitalium infection

Mycoplasma genitalium is an important pathogen that is transmitted through sexual contact. For patients diagnosed with M. genitalium infection, the current guidelines recommend 1 g of azithromycin as the first-line treatment. Moxifloxacin is used as a second-line drug due to its remarkable efficacy; however, increased use of moxifloxacin to treat M. genitalium infections has caused the emergence of cases of moxifloxacin treatment failure. This meta-analysis aims to estimate the treatment efficacy of moxifloxacin for M. genitalium infection. Electronic databases were searched for articles published from 1983 to the end of May 2016 using the following search terms: ( Mycoplasma genitalium) AND (moxifloxacin OR 1-cyclopropyl–7-(2,8-diazabicyclo(4.3.0)non-8-yl)-6-fluoro-8-methoxy-1,4-dihydro-4-oxo-3-quinoline carboxylic acid OR Proflox OR moxifloxacin hydrochloride OR Octegra OR Avelox OR Avalox OR Izilox OR Actira OR [treatment efficacy]). All included studies were published in English; all participants were diagnosed with M. genitalium infection, and microbial cure times were measured within 12 months after treatment. Treatment efficacy was measured as microbial cure at the final follow-up after treatment. In total, 17 studies including 252 participants met the inclusion criteria. The majority of these studies were observational. The random-effects pooled microbial cure rate was 96% (95% confidence interval [CI], 90%–99%; I2 = 28.59%, P = 0.13). For studies with sample collection deadlines prior to 2010, the pooled microbial cure rate was 100% (95% CI, 99%–100%; I2 = 0.00%, P = 1.00). For studies with sample collection deadlines of 2010 and later, the pooled microbial cure rate was 89% (95% CI, 82%–94%; I2 = 0.00%, P = 0.59). The elimination rate of moxifloxacin for M. genitalium infection has decreased from 100% to 89% since 2010. This decline merits considerable attention. We suggest close follow-up to investigate the efficacy of moxifloxacin for treating M. genitalium infections. Additionally, sentinel points should be established to detect mutations in the gyrA/B and parC/E genes, which are associated with moxifloxacin resistance.

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P4414Effects of lorcaserin on the cardiometabolic risk factors in overweight or obese patients: a systematic review and meta-analysis

European Heart Journal ◽

10.1093/eurheartj/ehz745.0817 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

H H Kuo ◽

M E Liu ◽

P L Lin ◽

L.Y.-M Liu

Keyword(s):

Blood Pressure ◽

Heart Rate ◽

Meta Analysis ◽

Obese Patients ◽

Serotonin 2C Receptor ◽

Randomized Controlled Clinical Trials ◽

Randomized Controlled ◽

Search Terms

Abstract Introduction Lorcaserin is a selective serotonin 2c receptor agonist approved as an anti-obesity agent. The additional cardiometabolic benefits associated with lorcaserin have not been conclusively established. Purpose To examine the effects of lorcaserin on blood pressure, heart rate and other metabolic parameters in overweight or obese patients from randomized controlled clinical trials (RCTs). Methods A literature search was conducted on PubMed, EMBASE, and Cochrane Central using search terms: “lorcaserin”, “Belviq”, and “randomized controlled trials” without language restrictions. RCTs with a follow-up period of at least 24 weeks were included for the meta-analysis. Results Five studies with 9349 patients in the lorcaserin group and 9370 patients in the placebo group were included. Compared with placebo, lorcaserin not only reduced weight (mean difference [MD] = −3.03 kg, 95% CI: −3.42, −2.63, P<0.ehz745.08171, I2 =68%), waist circumference (MD=−2.27 cm, 95% CI: −2.71, −1.83, P<0.ehz745.08171, I2=57%) and BMI (MD=−1.11 kg/m2, 95% CI: −1.27, −0.96, P<0.ehz745.08171, I2=68%), but also improved SBP (MD=−0.75 mmHg, 95% CI: −1.12, −0.38, P<0.0001, I2=0%), DBP (MD=−0.70 mmHg, 95% CI: −0.93, −0.48, P<0.ehz745.08171, I2=0%), heart rate (MD=−0.94 bpm, 95% CI: −1.28, −0.60, P<0.ehz745.08171, I2=0%), LDL (MD=−1.47 mg/dL, 95% CI: −2.21, −0.74, P<0.0001, I2=0%), HDL (MD=0.55 mg/dL, 95% CI: 0.08, 1.01, P=0.02, I2=18%), triglycerides (MD=−8.71 mg/dL, 95% CI: −12.14, −5.28, P<0.ehz745.08171, I2=71%), and fasting plasma glucose (MD=−5.69 mg/L, 95% CI: −9.5, −1.87, P=0.003, I2=93%). Our findings support that lorcaserin has consistent and favourable effects on blood pressure, heart rate, and all criteria of metabolic syndrome. Summary of lorcaserin effects Conclusion Lorcaserin improved all cardiometabolic parameters modestly in addition to its weight loss effect in overweight or obese patients. More research is needed to determine its long-term cardiovascular benefits.

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Does Adenotonsillectomy Cure Pediatric Sleep Apnea?

Otolaryngology ◽

10.1016/j.otohns.2008.05.205 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P63-P64

Author(s):

Michael Friedman ◽

Rohit Soans ◽

Ziya Bozkurt ◽

Hsin-Ching Lin ◽

Ninos J Joseph

Keyword(s):

Sleep Apnea ◽

Meta Analysis ◽

Treatment Success ◽

Primary Treatment ◽

Inclusion Criteria ◽

Cure Rate ◽

Effect Measure ◽

Surgical Cure ◽

Pediatric Sleep

Objective 1) Perform an updated meta-analysis to determine the cure rate of adenotonsillectomy for pediatric sleep apnea. 2) Report the findings of 5 years of experience with standardized coblation intracapsular tonsillectomy for the treatment of pediatric sleep apnea. Methods A thorough literature search of multiple databases was performed. Inclusion criteria for studies were: 1) Adenotonsillectomy as the primary treatment of sleep apnea (age<18). 2) Pre-and postoperative polysomnography data was included. 20 studies fit the inclusion criteria and a metaanalysis was performed to determine the overall success. A 5–year retrospective analysis of coblation tonsillectomy performed by a single surgeon for sleep apnea was also performed. Results The meta-analysis included 904 subjects with average follow-up time of 21.6 weeks. The effect measure was the percentage of pediatric patients with OSAHS who were successfully treated (k= 20 studies) with T/A based on pre-and postoperative PSG data. Random-effects model estimated the treatment success of adenotonsillectomy was 61.1%. When “cure” was defined as an AHI of <1, the cure rate was 53.8%. 200 adenotonsillectomy cases performed with coblation technique were reviewed. The mean preoperative was AHI 28.3 and mean postoperative AHI was 3.8. Surgical cure, as defined as a postoperative AHI <1, was achieved in 51.7% of patients. Conclusions 1) Contrary to popular belief, meta-analysis of current literature and a review of 200 cases demonstrates that pediatric sleep apnea is often not cured by adenotonsillectomy. 2) Although complete resolution is not achieved in most cases, adenotonsillectomy still offers significant improvements in AHI.

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The epidemiology of tuberculosis-associated hyperglycemia in individuals newly screened for type 2 diabetes mellitus: systematic review and meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-020-05512-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sonia Menon ◽

Rodolfo Rossi ◽

Alfred Dusabimana ◽

Natasha Zdraveska ◽

Samit Bhattacharyya ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Meta Analysis ◽

World Health ◽

Tb Treatment ◽

Search Terms ◽

Total Burden ◽

Health Organization

Abstract Background There is scarce evidence that tuberculosis (TB) can cause diabetes in those not previously known to be diabetic. Whilst the World Health Organization (WHO) recommends screening for Diabetes Mellitus (DM) at the onset of TB treatment, nevertheless, it remains to be elucidated which patients with TB-associated hyperglycemia are at higher risk for developing DM and stand to benefit from a more regular follow-up. This review aims to firstly quantify the reduction of newly detected hyperglycemia burden in TB patients who are on treatment over time; secondly, determine the burden of TB-associated hyperglycemia after follow-up, and thirdly, synthesize literature on risk factors for unresolved TB-associated hyperglycemia in previously undiagnosed individuals. Methods We searched PUBMED, EMBASE, SCOPUS, and Global Health for articles on TB-associated hyperglycemia up to September 30th, 2019. Search terms included Tuberculosis and hyperglycemia/DM, and insulin resistance. We appraised studies, extracted data, and conducted a meta-analysis to assess the change of the burden of hyperglycemia in prospective studies. The review is registered in the PROSPERO database (CRD42019118173). Results Eleven studies were included in the meta-analysis yielding a total of 677 (27,3%) of patients with newly detected hyperglycemia at baseline. The mean quality score of eligible studies using the Newcastle-Ottawa Quality Assessment Scale was 7.1 out of 9 (range 6-9). The pooled unresolved new cases of hyperglycemia at the end of follow up was 50% (95% CI: 36–64%) and the total pooled burden of hyperglycemia at 3–6 months of follow up was 11% (95% CI: 7–16%), with both estimates displaying a high heterogeneity, which remained significant after performing a sub-analysis by DM diagnostic method and 3 months of follow up. As only 2 studies explored risk factors for unresolved hyperglycemia, no meta-analysis was performed on risk factors. Conclusion Our meta-analysis showed that although in half of the patients with newly observed hyperglycemia at baseline, it remained unresolved at a follow-up of 3 to 6 months, the total burden of hyperglycemia is slightly above 10%, 3 months after initiating TB treatment. Studies are warranted to assess whether risk factors including HIV positivity, smoking, and extensive pulmonary TB disease put patients at higher risk for DM.

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Suicide as an outcome for mental disorders

The British Journal of Psychiatry ◽

10.1192/bjp.170.3.205 ◽

1997 ◽

Vol 170 (3) ◽

pp. 205-228 ◽

Cited By ~ 1585

Author(s):

E. Clare Harris ◽

Brian Barraclough

Keyword(s):

Mental Disorders ◽

Suicide Risk ◽

English Language ◽

Common Mental Disorders ◽

Meta Analysis ◽

Strong Association ◽

Search Terms ◽

Increased Risk ◽

Mortality Ratio

BackgroundMental disorders have a strong association with suicide. This meta-analysis, or statistical overview, of the literature gives an estimate of the suicide risk of the common mental disorders.MethodWe searched the medical literature to find reports on the mortality of mental disorders. English language reports were located on MEDLINE (1966–1993) with the search terms mental disorders', ‘brain injury’, ‘eating disorders’, ‘epilepsy’, ‘suicide attempt’, ‘psychosurgery’, with ‘mortality’ and ‘follow-up studies’, and from the reference lists of these reports. We abstracted 249 reports with two years or more follow-up and less than 10% loss of subjects, and compared observed numbers of suicides with those expected. A standardised mortality ratio (SMR) was calculated for each disorder.ResultsOf 44 disorders considered, 36 have a significantly raised SMR for suicide, five have a raised SMR which fails to reach significance, one SMR is not raised and for two entries the SMR could not be calculated.ConclusionsIf these results can be generalised then virtually all mental disorders have an increased risk of suicide excepting mental retardation and dementia. The suicide risk is highest for functional and lowest for organic disorders with substance misuse disorders lying between. However, within these broad groupings the suicide risk varies widely.

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Urethral Lift as a Safe and Effective Procedure for Prostatic Hyplasia Population: A Systematic Review and Meta-Analysis

Frontiers in Surgery ◽

10.3389/fsurg.2020.598728 ◽

2020 ◽

Vol 7 ◽

Author(s):

Jibo Jing ◽

Yuqing Wu ◽

Mulong Du ◽

Nieke Zhang ◽

Meiling Wang ◽

...

Keyword(s):

Systematic Review ◽

Urinary Tract Obstruction ◽

Meta Analysis ◽

R Package ◽

Effective Procedure ◽

Invasive Treatment ◽

Search Terms ◽

Objective Indicators ◽

Time Point

Background: Prostatic urethral lift (PUL) is a relatively new minimally invasive treatment procedure for benign prostatic hyperplasia (BPH). In order to analyze the sustainability of this new protocol, a systematic review and meta-analysis is performed based on the published articles.Methods: We performed a critical review according to the preferred reporting items for systematic review and meta-analysis (PRISMA) and MOOSE guidelines. A total of 818 published articles matched our search terms, and 11 studies met the inclusion criteria. Data of each follow-up time point (1, 3, 6, 12, and 24 months) were analyzed in terms of baseline characteristics and functional and sexual health outcomes. The merged means of each time point were calculated using R package meta and shown in the tendency plot.Results: A total of 1,443 patients who underwent PUL are available for the research. At 24 months, the changes of the three indicators are statistically significant (IPSS 9.40 points, p < 0.001; Qmax 3.39 ml/s, p < 0.001; QoL 1.99 points, p < 0.001) but were not as effective as TURP (from literature). The trend plot shows that, as time goes on, the effect of PUL tends to increase first and then weaken. Three items fitted a meaningful curve: IPSS (slope = −1.378 t = −12.395, p < 0.001), Qmax (slope = −1.382 t = −6.429, p < 0.001), and QoL (slope = −0.218, t = −10.058, p < 0.001). Fitted curves of SHIM and PVR are not statistically significant. The regression reveals that IPSS, Qmax, and QoL could be predicted after accepting PUL.Conclusion: PUL appears to be a safe and effective procedure in selected patients with BPH and can improve the symptoms of urinary tract obstruction. However, it is not as effective as TURP and shows no influence to the objective indicators like PVR.

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Cadazolid vs Vancomycin for the Treatment of Clostridioides difficile Infection: Systematic Review with Meta-analysis

Current Clinical Pharmacology ◽

10.2174/1574884714666190802124301 ◽

2020 ◽

Vol 15 (1) ◽

pp. 4-10

Author(s):

Aziz Muhammad ◽

Weissman Simcha ◽

Fatima Rawish ◽

Rajani Sabih ◽

Eid Albert ◽

...

Keyword(s):

Clinical Cure ◽

Clinical Cure Rate ◽

Meta Analysis ◽

Cure Rate ◽

Promising Alternative ◽

Clostridioides Difficile ◽

Experimental Drug ◽

Clostridioides Difficile Infection ◽

Diverse Patient Population

Background:: Current guidelines recommend the use of vancomycin for the initial treatment of Clostridioides difficile Infection (CDI). Cadazolid, an experimental drug, has been utilized and compared in several studies with varying results. Methods:: A systematic literature search was performed using electronic databases [Medline, Google Scholar and Cochrane] for eligible studies. Randomized Controlled Trials (RCTs) comparing cadazolid with vancomycin for CDI treatment were included. Demographic variables and outcomes (CDI resolution, CDI recurrence, and adverse events) were collected. The primary outcome was clinical cure rate defined as the resolution of CDI at the end of a 10-day course. Results:: Two studies with three RCTs met the inclusion criteria with a total of 1283 patients with CDI who received either cadazolid 250 mg twice daily (624 patients) or vancomycin 125 mg four times daily (659 patients). Clinical cure rate at the end of the treatment was not statistically significant (pooled OR= 0.82; 95% CI = 0.61 to 1.11; p=0.20; I2= 0%). Sustained clinical response at clinical follow-up was also not significantly different (pooled OR = 1.14; 95% CI = 0.91 to 1.43; p=0.27; I2 = 0 %). Cadazolid had a lower recurrence rate than vancomycin (pooled OR = 0.71; 95% CI = 0.52 to 0.98; p=0.04; I2 = 13 %). Conclusion:: Cadazolid is non-inferior to vancomycin and offers a promising alternative for the treatment of CDI. More studies including RCTs and longitudinal studies with large and diverse patient population are needed to further confirm this. Furthermore, cadazolid should also be compared with fidaxomicin in a head-to-head trial to evaluate their efficacy for CDI.

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A SYSTEMATIC REVIEW OF GROUP WALKING IN PHYSICALLY HEALTHY PEOPLE TO PROMOTE PHYSICAL ACTIVITY

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462317001088 ◽

2018 ◽

Vol 34 (1) ◽

pp. 27-37 ◽

Cited By ~ 6

Author(s):

Catherine Meads ◽

Josephine Exley

Keyword(s):

Quality Of Life ◽

Physical Activity ◽

Meta Analysis ◽

Healthy Adults ◽

Qualitative Synthesis ◽

Physical Activity Guidelines ◽

Meta Analyses ◽

Current Guidelines

Background: Walking is a good way to meet physical activity guidelines. We examined the effectiveness of walking in groups compared with walking alone or inactive controls in physically healthy adults on physical activity and quality of life. (PROSPERO CRD42016033752).Methods: We searched Medline, Embase, Cinahl, Web of Knowledge Science Citation Index, and Cochrane CENTRAL until March 2016, for any comparative studies, in physically healthy adults, of walking in groups compared with inactive controls or walking alone, reporting any measure of physical activity. We searched references from recent relevant systematic reviews. Two reviewers checked study eligibility and independently extracted data. Disagreements were resolved through discussion. Quality was assessed using likelihood of selection, performance, attrition, and detection biases. Meta-analysis was conducted using Review Manager 5.3.Results: From 1,404 citations, 18 studies were included in qualitative synthesis and 10 in meta-analyses. Fourteen compared group walking to inactive controls and four to walking alone. Eight reported more than one measure of physical activity, none reported according to current guidelines. Group walking compared with inactive controls increased follow-up physical activity (9 randomized controlled trials, standardized mean difference [SMD] 0.58 [95 percent confidence interval {CI}, 0.34–0.82] to SMD 0.43 [95 percent CI, 0.20–0.66]). Compared with walking alone, studies were too few and too heterogeneous to conduct meta-analysis, but the trend was improved physical activity at follow-up for group walking participants. Seven (all inactive control) reported quality-of-life: five showed statistically significantly improved scores.Discussion: Better evidence may encourage government policy to promote walking in groups. Standardized physical activity outcomes need to be reported in research.

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Confronting the practice of surgery on differentiated thyroid cancer with current guidelines in Germany

Nuklearmedizin ◽

10.1055/s-0038-1625203 ◽

2005 ◽

Vol 44 (05) ◽

pp. 185-191 ◽

Cited By ~ 4

Author(s):

H. Wieler ◽

S. Birtel ◽

E. Ostwald-Lenz ◽

K. P. Kaiser ◽

H. P. Becker ◽

...

Keyword(s):

Thyroid Cancer ◽

Differentiated Thyroid Cancer ◽

Survival Rates ◽

Perioperative Morbidity ◽

Referral Hospitals ◽

Principles Of Treatment ◽

Current Guidelines ◽

Papillary Microcarcinomas ◽

Retrospective Multicenter Study

Summary:Aim: For the surgical therapy of differentiated thyroid cancer precise guidelines are applied by the German medical societies. In a retrospective multicenter study, we investigated the following issues: Are the current guidelines respected?. Is there a difference concerning the surgical radicalism and the outcome?. Does the perioperative morbidity increase with the higher radicalism of the procedure?. Patients, methods: Data gained from 102 patients from 17 regional referral hospitals who underwent surgery for thyroid cancer and a following radioiodine treatment (mean follow up: 42.7 [24-79] months) were analyzed. At least 71 criterias were analyzed in a SPSS file. Results: 46.1% of carcinomas were incidentally detected during goiter surgery. The thyroid cancer (papillary n = 78; follicular n = 24) occurred in 87% unilateral and in 13% bilateral. Papillary carcinomas <1 cm were detected in 25 cases; in five of these cases (20%) contralateral carcinomas <1 cm were found. There were significant differences concerning the surgical radicalism: a range from hemithyroidectomy to radical thyroidectomy with lateral neck dissection. Analysis of the histopathologic reports revealed that lymph node dissection was not performed according to guidelines in 55% of all patients. The perioperative morbidity was lower in departments with a high case load. The postoperative dysfunction of the recurrent laryngeal nerve (mean: 7.9% total / 4.9% nerves at risk) variated highly, depending on differences in radicalism and hospitals. Up to now these variations in surgical treatment have shown no differences in their outcome and survival rates, when followed by radioiodine therapy. Conclusion: Current surgical regimes did not follow the guidelines in more than 50% of all cases. This low acceptance has to be discussed. The actual discussion about principles of treatment regarding, the socalled papillary microcarcinomas (old term) has to be respected within the current guidelines.

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