scholarly journals A case for improved assessment of gut permeability: a meta-analysis quantifying the lactulose:mannitol ratio in coeliac and Crohn’s disease

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Jonathan Gan ◽  
Scarlet Nazarian ◽  
Julian Teare ◽  
Ara Darzi ◽  
Hutan Ashrafian ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Evidence ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Healthy Controls ◽  
Gut Permeability ◽  
Disease Outcomes ◽  
Standard Mean Difference

Abstract Background A widely used method in assessing small bowel permeability is the lactulose:mannitol test, where the lactulose:mannitol ratio (LMR) is measured. However, there is discrepancy in how the test is conducted and in the values of LMR obtained across studies. This meta-analysis aims to determine LMR in healthy subjects, coeliac and Crohn’s disease. Methods A literature search was performed using PRISMA guidance to identify studies assessing LMR in coeliac or Crohn’s disease. 19 studies included in the meta-analysis measured gut permeability in coeliac disease, 17 studies in Crohn’s disease. Outcomes of interest were LMR values and comparisons of standard mean difference (SMD) and weighted mean difference (WMD) in healthy controls, inactive Crohn’s, active Crohn’s, treated coeliac and untreated coeliac. Pooled estimates of differences in LMR were calculated using the random effects model. Results Pooled LMR in healthy controls was 0.014 (95% CI: 0.006–0.022) while pooled LMRs in untreated and treated coeliac were 0.133 (95% CI: 0.089–0.178) and 0.037 (95% CI: 0.019–0.055). In active and inactive Crohn’s disease, pooled LMRs were 0.093 (95% CI: 0.031–0.156) and 0.028 (95% CI: 0.015–0.041). Significant differences were observed in LMR between: (1) healthy controls and treated coeliacs (SMD = 0.409 95% CI 0.034 to 0.783, p = 0.032), (2) healthy controls and untreated coeliacs (SMD = 1.362 95% CI: 0.740 to 1.984, p < 0.001), (3) treated coeliacs and untreated coeliacs (SMD = 0.722 95% CI: 0.286 to 1.157, p = 0.001), (4) healthy controls and inactive Crohn’s (SMD = 1.265 95% CI: 0.845 to 1.686, p < 0.001), (5) healthy controls and active Crohn’s (SMD = 2.868 95% CI: 2.112 to 3.623, p < 0.001), and (6) active Crohn’s and inactive Crohn’s (SMD = 1.429 (95% CI: 0.580 to 2.278, p = 0.001). High heterogeneity was observed, which was attributed to variability in protocols used across different studies. Conclusion The use of gut permeability measurements in screening and monitoring of coeliac and Crohn’s disease is promising. LMR is useful in performing this function with significant limitations. More robust alternative tests with higher degrees of clinical evidence are needed if measurements of gut permeability are to find widespread clinical use.

scholarly journals A case for improved assessment of gut permeability – a meta-analysis quantifying the lactulose:mannitol ratio in coeliac and Crohn’s disease

2021 ◽  
Author(s):  
Jonathan Gan ◽  
Scarlet Nazarian ◽  
Julian Teare ◽  
Ara Darzi ◽  
Hutan Ashrafian ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Clinical Evidence ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Healthy Controls ◽  
Gut Permeability ◽  
Disease Outcomes ◽  
Standard Mean Difference

Abstract Background A widely used method in assessing small bowel permeability is the lactulose:mannitol test, where the lactulose:mannitol ratio (LMR) is measured. However, there is discrepancy in how the test is conducted and in the values of LMR obtained across studies. This meta-analysis aims to determine LMR in healthy subjects, coeliac and Crohn’s disease. Methods A literature search was performed using PRISMA guidance to identify studies assessing LMR in coeliac or Crohn’s disease. 19 studies included in the meta-analysis measured gut permeability in coeliac disease, 17 studies in Crohn’s disease. Outcomes of interest were LMR values and comparisons of standard mean difference (SMD) and weighted mean difference (WMD) in healthy controls, inactive Crohn’s, active Crohn’s, treated coeliac and untreated coeliac. Pooled estimates of differences in LMR were calculated using the random effects model. Results Pooled LMR in healthy controls was 0.014 (95% CI: 0.006–0.022) while pooled LMRs in untreated and treated coeliac were 0.133 (95% CI: 0.089–0.178) and 0.037 (95% CI: 0.019–0.055). In active and inactive Crohn’s disease, pooled LMRs were 0.093 (95% CI: 0.031–0.156) and 0.028 (95% CI: 0.015–0.041). Significant differences were observed in LMR between: (i) healthy controls and treated coeliacs (SMD = 0.409 95% CI 0.034 to 0.783, p = 0.032), (ii) healthy controls and untreated coeliacs (SMD = 1.362 95% CI: 0.740 to 1.984, p < 0.001), (iii) treated coeliacs and untreated coeliacs (SMD = 0.722 95% CI: 0.286 to 1.157, p = 0.001), (iv) healthy controls and inactive Crohns (SMD = 1.265 95% CI: 0.845 to 1.686, p < 0.001), (v) healthy controls and active Crohns (SMD = 2.868 95% CI: 2.112 to 3.623, p < 0.001), and (vi) active Crohns and inactive Crohns (SMD = 1.429 (95% CI: 0.580 to 2.278, p = 0.001). High heterogeneity was observed, which was attributed to variability in protocols used across different studies. Conclusion The use of gut permeability measurements in screening and monitoring of coeliac and Crohn’s disease is promising. LMR is useful in performing this function with significant limitations. More robust alternative tests with higher degrees of clinical evidence are needed if measurements of gut permeability are to find widespread clinical use. Trial Registration Not Applicable

scholarly journals Diagnostic Value of sST2 in Cardiovascular Diseases: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Tianyi Zhang ◽  
Chengyang Xu ◽  
Rui Zhao ◽  
Zhipeng Cao
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Troponin ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Mean Difference ◽  
Diagnostic Biomarker ◽  
Healthy Individuals ◽  
Weighted Mean ◽  
Standard Mean Difference

Biomarkers such as B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP), cardiac troponin (cTn), and CK-MB contribute significantly to the diagnosis of cardiovascular disease (CVD). Recent studies have demonstrated that suppression of tumorigenicity 2 (ST2) is associated with CVD, but a meta-analysis of ST2 levels in different CVDs has yet to be conducted. Therefore, the present study aimed to investigate soluble ST2 (sST2) levels in patients with ischemic heart disease (IHD), myocardial infarction (MI), and heart failure (HF). A total of 1,425 studies were searched across four databases, of which 16 studies were included in the meta-analysis. The Newcastle–Ottawa Quality Assessment Scale (NOS) values of all 16 studies were ≥7. The meta-analysis results indicated that the sST2 level was not correlated with IHD (standard mean difference [SMD] = 0.58, 95% confidence interval [95% CI] = 0.00 to 1.16, p = 0.05) or MI (weighted mean difference [WMD] = 0.17, 95% CI = −0.22 to 0.55, p = 0.40) but was significantly associated with HF (WMD = 0.21, 95% CI = 0.04 to 0.38, p = 0.02; I2 = 99%, p &lt; 0.00001). sST2 levels did not differ significantly between patients with IHD or MI and healthy individuals; however, we believe that ST2 could be used as an auxiliary diagnostic biomarker of HF.

scholarly journals A Meta-Analysis of Different Types of Cardiac Adipose Tissue in HIV Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Guang Song ◽  
Wei Qiao ◽  
Lu Sun ◽  
Xiaona Yu
Keyword(s):  
Adipose Tissue ◽  
Sequential Analysis ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Trial Sequential Analysis ◽  
Control Group ◽  
Hiv Patients ◽  
Standard Mean Difference ◽  
Different Types

Background. Antiretroviral therapy transformed HIV infection into a chronic disease but accelerated cardiovascular disease (CVD). Both of epicardial adipose tissue (EAT) and pericardial fat (PCF) have close relationships with CVD. The associations between these two cardiac adipose tissue and HIV are unclear. Methods. Eligible studies were searched in PubMed, Embase, Web of Science, and Scopus from database inception to March 24, 2020. The summarized standard mean difference (SMD) or weighted mean difference (WMD) with 95% confidence intervals (CIs) was used to assess the association between EAT/PCF and HIV. Subgroup analysis was performed based on EAT types. Trial sequential analysis was conducted to estimate whether the evidence of the results is sufficient. Results. In total, 2561 HIV patients and 1767 non-HIV participants were included. Compared to the control group, EAT was significantly higher in the HIV overall group and subgroup with EAT thickness ( SMD = 0.59 , 95% CI: 0.24–0.95, P = 0.001 ; SMD = 1.10 , 95% CI: 0.41–1.79, P = 0.002 ); however, the EAT volume and PCF volume were unchanged in the HIV group ( SMD = 0.16 , 95% CI: -0.07–0.39, P = 0.169 ; WMD = 10.78 , 95% CI: -14.11–35.67, P = 0.396 ). Trial sequential analysis indicated that the available samples were sufficient in the HIV overall group and subgroup with EAT thickness, and more studies are needed for EAT volume and PCF volume. Conclusions. EAT thickness was significantly higher in patients with HIV. The association between EAT/PCF volume and HIV needs more studies to confirm.

scholarly journals Meta-analysis of the Efficacy of Hemoperfusion Combined With Hemodialysis in Treating Acute Severe Organophosphorus Pesticide Poisoning

2022 ◽  
Author(s):  
Siyao Zeng ◽  
Lei Ma ◽  
Xiaodong Hu ◽  
Cheng Wang ◽  
Yi Gou ◽  
...  
Keyword(s):  
Emergency Treatment ◽  
Large Scale ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Organophosphorus Pesticide ◽  
Mean Difference ◽  
Good Effect ◽  
Pesticide Poisoning ◽  
Cure Rate ◽  
Standard Mean Difference

Abstract BackgroundAcute severe organophosphorus pesticide poisoning (ASOPP) is a common severe emergency in developing countries. At present, the incidence of complications and mortality are still very high, and there are some difficulties in treatment. More and more studies have found that hemoperfusion combined with hemodialysis can improve the prognosis of patients based on conventional emergency treatment, but there is a lack of evidence-based medical evidence. Our meta-analysis is mainly to clarify the efficacy of hemoperfusion combined with hemodialysis on ASOPP.MethodsWe searched several databases. After formulating relevant inclusion and exclusion criteria, qualified studies were included and data were extracted. The outcome indicators were cure rate, efficacy, incidence of complications, time for cholinesterase level to return to normal, coma time, time of hospitalization and atropine dosage. Results were analyzed using risk ratios (RR), odds ratios (OR), weighted mean difference (WMD), standard mean difference (SMD), and 95% confidential interval (95% CI). The cochrane collaboration tool was used for the assessment of the risk of bias of every included studies. In terms of statistical methods, we used RevMan software (version 5.3) and Stata (version 14 and 16) for data analysis.ResultsWe included 35 RCTs, including 2650 participants. Compared with the emergency conventional treatment group, the use of hemoperfusion combined with hemodialysis to treat ASOPP patients based on conventional emergency treatment significantly increased the cure rate [RR=1.20, 95% CI (1.16, 1.25), p<0.00001], improved the efficacy [OR=2.76, 95% CI (2.07, 3.67), p=0.000], and reduced the incidence of complications [RR=0.26, 95% CI (0.20, 0.34), p<0.00001] and also reduced the patient's time for cholinesterase level to return to normal [WMD=-4.05, 95% CI (-4.40, -3.70), p<0.00001], coma time [SMD=-2.62, 95% CI (-3.08, -2.15), p<0.00001], time of hospitalization [WMD=-5.80, 95% CI (-6.57, -5.02), p<0.00001], and atropine dosage [WMD=-194.81, 95% CI (-223.55, -166.08), p<0.00001].ConclusionHemoperfusion combined with hemodialysis can apparently improve the prognosis of patients and has a good effect in the treatment of acute severe organophosphorus pesticide poisoning. In the future, more scientifically designed large-scale, high-quality, multi-center randomized controlled trials are needed to further illustrate the significance of this study.

scholarly journals Malondialdehyde concentrations in obsessive–compulsive disorder: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Amir Hossein Mohammadi ◽  
Ebrahim Balandeh ◽  
Alireza Milajerdi
Keyword(s):  
Systematic Review ◽  
Obsessive Compulsive Disorder ◽  
Inflammatory Responses ◽  
Current Knowledge ◽  
Meta Analysis ◽  
Mean Difference ◽  
Healthy Controls ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Standard Mean Difference

Abstract Background This meta-analysis aimed to investigate serum and plasma malondialdehyde (MDA) levels in patients with obsessive–compulsive disorder (OCD) in comparison to healthy controls. Methods Following the PRISMA protocol, we searched for the relevant studies through the databases of Scopus, PubMed, Google Scholar, and web of science until September 2019 with no time restriction. Overall, nine studies were included in the current meta-analysis. Data were pooled using a random-effects model; in addition, standard mean difference (SMD) and/or weight mean difference (WMD) was calculated. Cochran’s Q test and I-square (I2) statistics were used to evaluate between-study heterogeneity. The Newcastle–Ottawa scale (NOS) was used to evaluate the quality of the included studies. Statistical analyses were done using the STATA version 14. Results Our systematic review included nine case–control studies (including 367 cases and 337 controls). Pooling findings from these studies showed a significantly higher MDA level in OCD patient compared to control groups (SMD = 1.62; 95% CI [0.53, 2.72]; I2 = 96.9%; Pheterogeneity (Ph) < 0.001). This finding remained unchanged among studies which reported MDA in the same unit (WMD = 1.93; 95% CI [0.27, 3.59]; I2 = 99.2%; Ph < 0.001). Subgroup analysis by the study location and sample size revealed findings that were also significant. Conclusion We found that MDA levels are higher in OCD patients than healthy controls. This finding highlights the importance of inflammatory responses in OCD patients that should be considered for future investigations. Further studies are recommended to expand current knowledge on this issue.

Puerarin for OVX-Induced Postmenopausal Osteoporosis in Murine Model: Systematic Review and Meta-Analysis

2020 ◽  
Vol 15 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Xiaobin Yang ◽  
Haishi Zheng ◽  
Yuan Liu ◽  
Dingjun Hao ◽  
Baorong He ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Mass ◽  
Postmenopausal Osteoporosis ◽  
Murine Model ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Mean Difference ◽  
Weighted Mean ◽  
Enhancing Effect ◽  
Searching Strategy

Aims/Background: Ovariectomy (OVX)-induced murine model is widely used for postmenopausal osteoporosis study. Our current study was conducted to systematically review and essentially quantified the bone mass enhancing effect of puerarin on treating OVX-induced postmenopausal osteoporosis in murine model. Methods: Literatures from PUBMED, EMBASE, and CNKI were involved in our searching strategy by limited the inception date to January 9th, 2019. Moreover, the enhancing effect of puerarin on bone mass compared to OVX-induced rats is evaluated by four independent reviewers. Finally, all the data were extracted, quantified and analyzed via RevMan, besides that in our current review study, we assessed the methodological quality for each involved study. Results: Based on the searching strategy, eight randomization studies were finally included in current meta-analysis and systematic review. According to the data analysis by RevMan, puerarin could improve bone mineral density (BMD); (eight studies, n=203; weighted mean difference, 0.05; 95% CI, 0.03-0.07; P<0.0001) using a random-effects model. There is no significant difference between puerarin and estrogen (seven studies, n=184; weighted mean difference, 0.00; 95% CI, -0.01 to 0.00; P=0.30). Conclusions: Puerarin showed upregulating effects on bone mass in OVX-induced postmenopausal osteoporosis in murine model. More studies of the effect of puerarin on bone density in OVX animals are needed.

scholarly journals Antimicrobial Efficacy of Propolis in Comparison to Chlorhexidine against Enterococcus faecalis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (8) ◽  
pp. 3469
Author(s):  
Khalid H. Almadi ◽  
Muhammad Adeel Ahmed ◽  
Tuba Ghazal ◽  
Rizwan Jouhar ◽  
Mazen F. Alkahtany ◽  
...  
Keyword(s):  
Enterococcus Faecalis ◽  
Meta Analysis ◽  
Mean Difference ◽  
Permanent Teeth ◽  
Antibacterial Efficacy ◽  
Chi Square ◽  
Reporting Standard ◽  
Standard Mean Difference ◽  
Significant Difference ◽  
Chi Square Test

Propolis is proposed to possess antibacterial and anti-inflammatory properties, which can be used in endodontic applications. However, evidence on its efficacy in comparison to chlorhexidine against Enterococcus faecalis (E. faecalis) is controversial. The aim of the current study was to compare the antibacterial efficacy of Propolis and chlorhexidine as an intracanal medicament against E. faecalis in extracted human permanent teeth. The focused question was, “Does Propolis show better antibacterial efficacy than Chlorhexidine (CHX) as an intracanal medicament against E. faecalis in extracted human permanent teeth?”. Databases including PubMed/Medline, Scopus, EMBASE, ISI-Web of Science were searched from 1990 to August 2020 using different combinations of the following keywords: “Propolis”, “Intracanal medicament”, “E. faecalis”, “Antibacterial activity” and “Chlorhexidine”. Ten studies fulfilling inclusion criteria were considered for qualitative analysis, followed by quantitative analysis of eight studies. Heterogeneity was calculated for colony forming units (CFU) of E. Faecalis using the Chi-square test and I2 statistics. Forest plots were computed reporting standard mean difference (SMD) of outcomes and 95% confidence intervals. The overall mean difference for CFU of E. faecalis showed a statistically significant difference between the antibacterial efficacy of Propolis and CHX (SMD = 3.20 [1.70, 4.69] Z = 4.20; p < 0.001). CHX showed superior antibacterial efficacy against E. faecalis compared to Propolis.

Meta-analysis of enteral nutrition as a primary treatment of active crohn's disease

1995 ◽  
Vol 108 (4) ◽  
pp. 1056-1067 ◽  
Author(s):  
Anne M. Griffiths ◽  
Arne Ohlsson ◽  
Philip M. Sherman ◽  
Lloyd R. Sutherland
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Enteral Nutrition ◽  
Meta Analysis ◽  
Primary Treatment

scholarly journals A Meta-Analysis of the Efficacy of Hyaluronic Acid Eye Drops for the Treatment of Dry Eye Syndrome

2021 ◽  
Vol 18 (5) ◽  
pp. 2383
Author(s):  
Yun-Jung Yang ◽  
Won-Young Lee ◽  
Young-jin Kim ◽  
Yeon-pyo Hong
Keyword(s):  
Hyaluronic Acid ◽  
Confidence Interval ◽  
Dry Eye ◽  
Test Scores ◽  
Meta Analysis ◽  
Mean Difference ◽  
Dry Eye Syndrome ◽  
Eye Drops ◽  
Cochrane Central Register ◽  
Standard Mean Difference

Hyaluronic acid (HA) is commonly used for treating dry eye syndrome (DES). This meta-analysis was performed to compare the efficacies of HA- and non-HA-based eye drops, including saline and conventional artificial tears (ATs), for the treatment of dry eye disease. Eight databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, DBpia, KoreaMed, KMBASE, RISS, KISS) were searched for studies comparing the efficacies of HA- and non-HA-based ATs in patients with DES published up to September 2020. Two independent reviewers assessed the quality and extracted the relevant data. The mean differences of Schirmer’s (SH) test scores, tear breakup times (TBUT), corneal fluorescein staining scores (Oxford scale, 0–4), and ocular surface disease indexes were calculated. The standard mean difference and 95% confidence interval were calculated using a random effect model. Nineteen studies, including 2078 cases, were included. HA eye drops significantly improved tear production compared with non-HA-based eye drops (standard mean difference (SMD) 0.18; 95% confidence interval (CI) 0.03, 0.33). In a subgroup analysis, the SH test scores and TBUT values after using HA significantly increased compared to those measured after using saline (SMD 0.27; 95% CI 0.05, 0.49 and SMD 0.28; 95% CI 0.03, 0.52, respectively). Based on these results, HA eye drops may be superior to non-HA eye drops including normal saline and ATs. Further research is needed to assess the efficacies stratified by age, treatment duration, the severity of dry eye, and optimal dosages.

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