Impact of achondroplasia on Latin American patients: a systematic review and meta-analysis of observational studies

Abstract Background Achondroplasia (ACH), the most common form of disproportionate short stature, is caused by a pathogenic variant in the fibroblast growth factor receptor 3 gene. Recent advances in drug therapy for ACH have highlighted the importance of elucidating the natural history and socioeconomic burden of this condition. Recognition that there are many potential issues for the patient with ACH is the first step in planning cost-effective interventions in Latin America (LATAM), a vast geographic territory comprising countries with multicultural characteristics and wide socioeconomic differences. We conducted a systematic literature review to characterize the impact of ACH on affected individuals and on healthcare resources in LATAM countries. Methods Searches of the global medical literature as well as regional and local medical literature up to August 2020. Observational studies on patients with ACH from any LATAM country. Pairs of reviewers independently screened eligible articles, extracted data from included studies, and assessed their risk of bias. Results Fifty-three unique studies (28 case series and cross-sectional studies and 25 case reports) including data on 1604 patients were eligible. Of these studies, 11 had data available for meta-analysis. Both premature mortality and all-cause mortality in the pooled studies was 15% [95% Confidence Interval (CI) 1.0E−3 to 0.47; I2 = 82.9%, p = 0.0029; three studies, n = 99 patients]. Frequency of cardio-respiratory-metabolic disorders was 17% [95% CI 0.04–0.37; I2 = 90.3%, p < 0.0001; four studies, n = 230 patients]; nervous system disorders was 18% [95% CI 0.07–0.33; I2 = 84.6%, p < 0.0001; six studies, n = 262 patients]; ear, nose, throat and speech disorders was 32% [95% CI 0.18–0.48; I2 = 73.4%, p = 0.0046; five studies, n = 183 patients]; and spinal issues including stenosis, compression and associated pain was 24% [95% CI 0.07–0.47; I2 = 91.3%, p < 0.0001; five studies, n = 235 patients]. Conclusions There is currently evidence of high clinical burden in ACH patients in LATAM countries. Establishing the impact of ACH provides the necessary foundation for planning tailored and effective public health interventions.

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Vertical Transmission of COVID-19: A Systematic Review

Archives of Pediatric Infectious Diseases ◽

10.5812/pedinfect.108769 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Tahereh Fathi Najafi ◽

Sareh Dashti ◽

Narjes Bahri

Keyword(s):

Vertical Transmission ◽

Search Strategy ◽

Retrospective Studies ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Bibliographic Databases ◽

Pcr Analysis ◽

Cross Sectional ◽

Polymerase Chain

Context: Evidence regarding the vertical transmission of COVID-19 from infected pregnant women to the fetus are not sufficient. Methods: The current study intended to systematically assess the possibility of vertical transmission of COVID-19 in published literature. We systematically searched international bibliographic databases, including PubMed, SCOPUS, and Google Scholar, to identify relevant studies from the time of inception of these databases until July 2020. The search strategy was finalized based on the results of the primary search in PubMed. All observational studies, including cross-sectional, cohort, case-control, case reports, and case series, published in peer-reviewed journals in any language. Editorials, commentaries, and letters to editors were excluded. Twenty articles (6 retrospective studies, 2 prospective, one cohort, 9 case reports, and 2 case series) with a total of 145 subjects were eligible for the review. Data were collected based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. Results: Methods of assessing COVID-19 included polymerase chain reaction (PCR) analysis of naso/oropharyngeal, vaginal, rectal, urine secretions and gastric and amniotic fluid samples, and serum immunoglobulin (Ig) assays. Vertical transmission was reported in 6 neonates (< 10%), based on PCR, and three were positive based on Ig assays. Conclusions: According to the evidence, the possibility for vertical transmission of COVID-19 is rare.

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625 EFFICACY OF MYOTOMY IN PATIENTS WITH SIGMOID MEGAESOPHAGUS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Diseases of the Esophagus ◽

10.1093/dote/doab052.625 ◽

2021 ◽

Vol 34 (Supplement_1) ◽

Author(s):

Marina Orlandini ◽

Maria Carolina Serafim ◽

Letícia Datrino ◽

Clara Santos ◽

Luca Tristão ◽

...

Keyword(s):

Systematic Review ◽

Heller Myotomy ◽

Selection Process ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Cochrane Library ◽

Cross Sectional ◽

Manual Search ◽

The Mean

Abstract Megaesophagus progress to sigmoid megaesophagus (SM) in 10–15% of patients, presenting tortuosity and sigmoid colon aspect. Esophagectomy is the choice treatment but is associated with high complications and mortality rates. To avoid the esophagectomy inherent morbidity, several authors recommend Heller myotomy (HM) with pull-down technique for SM, mainly for patients with comorbidities and the elderly. This systematic review and meta-analysis is the first to analyze the effectiveness of HM for treating SM. Methods A systematic review was conducted in PubMed, Embase, Cochrane Library Central, Lilacs (BVS), and manual search of references. Inclusion criteria were: a) clinical trials, cohort studies, case series; b) patients with SM and esophageal diameter ≥ 6 cm; and c) patients undergoing primary myotomy. The exclusion criteria were: a) reviews, case reports, cross-sectional studies, editorials, letters, congress abstracts, full-text unavailability; b) animal studies, c) previous surgical treatment for achalasia; and d) pediatric studies. There were no restrictions on language or date of publication, and no filters were applied for the selection process. Random model and a 95% confidence interval (CI) were used. Results Sixteen articles were selected, encompassing 231 patients. The mean age ranged from 36 to 61 years old, and the mean follow-up ranged from 16 to 109 months. The analyzed outcomes include mortality, complications (pneumonia, pneumothorax, gastroesophageal reflux), need for reintervention (remyotomy, dilation and esophagectomy), and results classified as ‘good’ and ‘excellent’. Mortality rate was 0.035 (CI: 0.017–0.07; p < 0.01). Complications rate was 0.08 (CI: 0.04–0.153; p = 0.01). Need for retreatment rate was 0.161 (CI: 0.053–0.399; p < 0.01). Probability of good or excellent outcomes after myotomy was 0.762 (CI: 0.693–0.819; p < 0,01). Conclusion Heller myotomy is an option for avoiding esophagectomy in achalasia, with a low morbimortality rate and good results. It is effective for most patients but will fail in a minority of patients and demand retreatment, be it a remyotomy, endoscopic treatment or esophagectomy.

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Assessment of the possibility of vertical transmission of COVID-19: A systematic review and meta-analysis protocol

10.21203/rs.3.rs-18035/v1 ◽

2020 ◽

Author(s):

Sareh Dashti ◽

Tahereh Fathi Najafi ◽

Hamid Reza Tohidinik ◽

Narjes Bahri

Keyword(s):

Systematic Review ◽

Pregnant Women ◽

Vertical Transmission ◽

Observational Studies ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

World Health ◽

Free Text ◽

Care Providers

Abstract BackgroundThe novel coronavirus 2019 (COVID-19) outbreak has put a great burden on global health and healthcare systems. One of the vulnerable groups to COVID-19 infection and complications is the pregnant women. There is controversy regarding the possibility of vertical transmission of COVID-19 from mother to infant. The aim of this systematic review and meta-analysis was to assess the possibility of vertical transmission of COVID-19 based on currently published literature including observational studies. All published articles including case reports, case series,MethodsThis study will be conducted on all published observational studies, including cross-sectional studies, cohort, case-control, case reports, and case series, in peer reviewed journals in any language until the end of March 2020. Editorials, commentaries and letter to editors will be excluded from the review. Search will be conducted in international bibliographic databases including PubMed, Embase, and Web of Science based on preferred reporting items for systematic reviews and meta-analysis (PRISMA) checklist. Primary search will be performed in PubMed and Embase using the Coronavirus 2019 and vertical transmission keywords based on medical subject heading (MeSH) terms along with free text searching in combination with Boolean operations. The search strategy will be improved and finalized based on the results of the primary search. The World Health Organization (WHO) and google scholar websites will be searched as grey literature. Articles will be reviewed by two authors independently for the relevance of titles and abstracts. Data extraction of the included articles will be performed by two researchers using the Zotero and review manager (revMan) software. Heterogeneity of the articles will be assessed using DerSimonian & Laird Q test and I 2 statistic. The pooled estimated prevalence of vertical transmission of COVID-19 will be performed using the Metaprop command. Publication bias will be assessed using the Begg's rank correlation and the Egger weighted regression methods.DiscussionThe findings of this systematic review and meta-analysis will help practitioners and health care providers in decision making for the care and management of COVID-19 infected pregnant women. Systematic review registration In process

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Incidence of acute pulmonary embolism among patients hospitalized with COVID-19: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.27425.2 ◽

2021 ◽

Vol 9 ◽

pp. 1489

Author(s):

Mohamed S. Munner ◽

Charles A. Ritchie ◽

Ibrahim H. Elkhidir ◽

Doaa T. Mohammadat ◽

Hussein J. Ahmed ◽

...

Keyword(s):

Systematic Review ◽

Pulmonary Embolism ◽

Assessment Tool ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Cross Sectional ◽

Incidence Data ◽

Study Heterogeneity ◽

Newcastle Ottawa Scale

Background: Coronavirus disease 2019 (COVID-19) is a global pandemic, which is associated with venous thromboembolism and pulmonary embolism (PE). This study aimed to estimate the pooled incidence of PE among patients hospitalized with COVID-19 within the published literature. Methods: This systematic review and meta-analysis was performed according to PRISMA guidelines. An electronic search using MEDLINE /PubMed, ScienceDirect, Cochrane, and OpenGray databases was conducted May 19th, 2020. Eligible studies included sufficient data to calculate the incidence of PE diagnosed during hospitalization in patients with COVID-19. Case reports were excluded. Quality was assessed using the Newcastle-Ottawa scale (observational cohort and case-control), AXIS tool (cross-sectional), and quality assessment tool (case series). Demographics and PE incidence data were extracted from the included studies and analyzed with R language. The pooled incidence of PE in patients hospitalized with COVID-19 was calculated. Results: The database search identified 128 records. Ten observational studies were eligible and were included in the meta-analysis with a total of 1722 patients (mean age= 63.36). .The incidence of PE was noted to be higher in males. The D-dimer levels were specified between PE group and non-PE group in only three studies, while the remaining either reported it improperly or had missing data.The pooled PE incidence in patients hospitalized with COVID-19 was 17% (95% CI: 0.1-0.26). There was a high degree of study heterogeneity (I2 = 94%, p<0.01). Conclusion: The pooled PE incidence in patients hospitalized with COVID-19 is 17%. This increased incidence is greater than that previously reported in the general population of non-COVID-19. Attention and further investigation of this risk is warranted.

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Vertical Transmission of COVID-19: A Systematic Review

Archives of Pediatric Infectious Diseases ◽

10.5812/pedinfect.101087 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Tahereh Fathi Najafi ◽

Sareh Dashti ◽

Narjes Bahri

Keyword(s):

Vertical Transmission ◽

Search Strategy ◽

Retrospective Studies ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Bibliographic Databases ◽

Pcr Analysis ◽

Cross Sectional ◽

Polymerase Chain

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Effectiveness and Safety of MSC Cell Therapies for Hospitalized Patients with COVID-19: A Systematic Review and Meta-analysis

10.1101/2021.10.05.21264559 ◽

2021 ◽

Author(s):

Wenchun Qu ◽

Zhen Wang ◽

Erica Engelberg Cook ◽

Abu Bakar Siddik ◽

Guojun Bu ◽

...

Keyword(s):

Adverse Events ◽

Cell Therapy ◽

Pulmonary Function ◽

Observational Studies ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Cell Therapies ◽

Significant Difference ◽

All Cause Mortality

ABSTRACT MSC (a.k.a. mesenchymal stem cell or medicinal signaling cell) cell therapies have shown promise in decreasing mortality in ARDS and suggest benefits in treatment of COVID-19 related ARDS. We performed a meta-analysis of published trials assessing the effectiveness and adverse events (AE) of MSC cell therapy in individuals hospitalized for COVID-19. Systematic searches were performed in multiple databases through April 8th, 2021. Reports in all languages including randomized clinical trials (RCTs), comparative observational studies, and case series/case reports were included. Random effects model was used to pool outcomes from RCTs and comparative observational studies. Outcome measures included all-cause mortality, serious adverse events (SAEs), AEs, pulmonary function, laboratory and imaging findings. A total of 413 patients were identified from 25 studies, which included 8 controlled trials (3 RCTs), 5 comparative observational studies, (n=300) and 17 case-series/case reports (n=113). The patients age was 60.5 years (mean), 33.7% were women. When compared with the control group, MSC cell therapy was associated with reduction in all-cause mortality (RR=0.31, 95% CI: 0.12 to 0.75, I2=0.0%; 3 RCTs and 5 comparative observational studies, 300 patients), reduction in SAEs (IRR=0.36, 95% CI: 0.14 to 0.90, I2=0.0%; 3 RCTs and 2 comparative studies, n=219), no significant difference in AE rate. A sub-group with pulmonary function studies suggested improvement in patients receiving MSC. These findings support the potential for MSC cell therapy to decrease all-cause mortality, reduce SAEs, and improve pulmonary function compared to conventional care. Large scale double-blinded, well-powered RCTs should be conducted to further explore these results.

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Mild-to-moderate hyperhomocyst(e)inemia and risk of stroke. Result of a meta-analysis.

Stroke ◽

10.1161/str.32.suppl_1.366 ◽

2001 ◽

Vol 32 (suppl_1) ◽

pp. 366-366

Author(s):

Peter J Kelly ◽

Jonathan Rosand ◽

Androniki Plomaritoglou ◽

Yuchiao Chang ◽

J Philip Kistler ◽

...

Keyword(s):

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Epidemiological Studies ◽

Inclusion Criteria ◽

Cross Sectional ◽

Search Terms ◽

Study Heterogeneity ◽

Study Population ◽

Artery Disease

P148 Background: Severe hyperhomocyst(e)inemia is associated with premature atherothrombosis and stroke in children with homocystinuria. Epidemiological studies indicate that mild-to-moderate hyperhomocyst(e)inemia is an independent risk factor for coronary artery disease. However, data are conflicting concerning the risk of stroke associated with mild-to-moderate hyperhomocyst(e)inemia. Aim: To describe and quantify the risk of stroke associated with elevated plasma homocyst(e)ine by meta-analysis. Methods: Relevant articles were obtained by search of Medline, Science Citation Index, and abstracts of conference proceedings. Search terms were Homocysteine, stroke, genetics and MTHFR. Exposure was defined as hyper-homocyst(e)inemia, relative to control values in each study population. Outcome was defined as ischemic stroke confirmed by neuroimaging (NI), and stroke without NI. Inclusion criteria: (1) Case-control (C-C) studies with reported odds ratios (OR) (2) Cohort (COH) studies with reported risk ratios (RR). Exclusion criteria: (1) Studies without clearly-defined OR/RR (reviews, C-C without OR, cross-sectional studies, case series, case reports) (2) Studies which defined outcome as carotid atherosclerosis or intima-media thickening. Statistical analyses for between-study heterogeneity and pooled risk estimates were performed using Stata software©. Results: Of 35 studies analyzed in detail, 15 (2 COH, 13 C-C) met inclusion criteria. Of 13 C-C studies (1306 cases, 6793 controls), the adjusted OR ranged 0.99–4.7, two had adjusted OR <=1 and 5 had a lower confidence limit <1. A random-effects model estimated a weighted pooled adjusted OR of 1.69 (95% CI 1.3, 2.2) from the 13 C-C studies. Within the 2 cohort studies (2825 subjects), the average adjusted RR was 1.86 (upper vs lower quantiles) (95% CI 1.14, 3.03). Conclusions: On average, mild-moderate hyperhomocyst(e)inemia is independently associated with a 69% increase in the odds and 86% increase in the risk of stroke.

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Mode of delivery and outcomes of infants with gastroschisis: a meta-analysis of observational studies

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/archdischild-2016-312394 ◽

2017 ◽

Vol 103 (4) ◽

pp. F355-F363 ◽

Cited By ~ 12

Author(s):

Dina W Kirollos ◽

Mohamed E Abdel-Latif

Keyword(s):

Vaginal Delivery ◽

Observational Studies ◽

Meta Analysis ◽

Mode Of Delivery ◽

Case Series ◽

Sensitivity Analyses ◽

Short Gut Syndrome ◽

Significant Difference ◽

The Impact

BackgroundThere is controversy among the literature for electing caesarean section (CS) delivery for infants with gastroschisis in an attempt to reduce mortality and morbidity.ObjectiveThis meta-analysis investigates whether there is enough evidence to support CS delivery over vaginal delivery.Data sourcesWe conducted our search in April 2017. We searched Cochrane, Medline, Premedline, Embase, CINAHL, GoogleScholar and Web of Science. We also searched conferences for abstracts online. Additional studies were retrieved by reviewing reference lists.Study selectionObservational studies, excluding case series, were eligible if data compared relevant outcomes of infants with gastroschisis in relation to mode of delivery.Data extractionRelevant information were extracted and assessed the methodological quality of the retrieved records.ResultsThirty-eight studies were included. Evidence suggested that mode of delivery is not significantly associated with overall mortality (OR 0.82, 95% CI 0.57 to 1.18), primary repair (OR 0.82, 95% CI 0.57 to 1.18), neonatal mortality (OR 1.08, 95% CI 0.54 to 2.15), necrotising enterocolitis, secondary repair, sepsis, short gut syndrome, duration until enteral feeding and duration of hospital stay. Furthermore, sensitivity analyses based on economic status and quality of study showed no significant difference between the impact of mode of delivery for all investigated outcomes.LimitationsDue to uncontrolled variables between and within studies, particularly regarding characteristics of delivery and postdelivery care, it is difficult to extract meaningful results from the literature.ConclusionsThere is insufficient evidence to advocate the use of CS over vaginal delivery for infants with gastroschisis.

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Impact of healthcare strikes on patient mortality: a protocol for a systematic review and meta-analysis of observational studies

BMJ Open ◽

10.1136/bmjopen-2021-050826 ◽

2021 ◽

Vol 11 (12) ◽

pp. e050826

Author(s):

Ryan Essex ◽

Sharon Marie Weldon ◽

Trevor Thompson ◽

Erika Kalocsanyiova ◽

Paul McCrone ◽

...

Keyword(s):

Observational Studies ◽

Healthcare Professionals ◽

Assessment Tool ◽

Meta Analysis ◽

Well Being ◽

Evidence Base ◽

Risk Of Bias ◽

Cross Sectional ◽

The Impact ◽

Hospital Clinic

IntroductionA strike is a collective, temporary and calculated action, which involves a temporary stoppage of work. For healthcare professionals strike action poses a unique dilemma. Perhaps most fundamentally, as strike action is designed to be disruptive it has the potential to impact the delivery of care and place patient well-being in jeopardy. The objective of this study is therefore to evaluate the impact of healthcare strike action on patient mortality outcomes globally using meta-analysis in order to provide a comprehensive evidence base that can advise healthcare professionals, governments and regulatory bodies on the impact that strike action has on patients.Methods and analysisA comprehensive literature search of major electronic databases (EMBASE, MEDLINE, CINAHL, BIOETHICSLINE, EconLit, WEB OF SCIENCE, OPEN GREY and SIGMA REPOSITORY) will be undertaken to identify observational studies of strike action among healthcare professionals where in-hospital/clinic and population/community mortality is examined, prestrike, during and poststrike. Meta-analysis will be performed to estimate in-hospital/clinic and population/community mortality during periods of strike action. The quality of evidence will be assessed using the National Institute of Health quality assessment tool for observational cohort and cross-sectional studies. Risk of bias will be assessed using the Cochrane Risk Of Bias In Non-Randomized Studies - of Interventions tool.Ethics and disseminationThis study does not require ethical approval. Findings will be submitted to an appropriate peer-reviewed journal.Trial registration numberCRD42021238879.

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Assessment of the Possibility of Vertical Transmission of COVID-19: A Systematic Review and Meta-analysis Protocol

Journal of Research and Health ◽

10.32598/jrh.11.2.72.3 ◽

2021 ◽

Vol 11 (2) ◽

pp. 71-76

Author(s):

Sareh Dashti ◽

◽

Tahereh Fathi Najafi ◽

Hamid Reza Tohidinik ◽

Narjes Bahri ◽

...

Keyword(s):

Systematic Review ◽

Vertical Transmission ◽

Health Care Providers ◽

Case Reports ◽

Meta Analysis ◽

Case Series ◽

Bibliographic Databases ◽

Care Providers ◽

Case Control Studies ◽

Cross Sectional

Background: The Coronavirus disease 2019 (COVID-19) outbreak has put a great burden on global health and healthcare systems. There is controversy regarding the possibility of vertical transmission of COVID-19. This proposed systematic review will be done to assess the possibility of vertical transmission of COVID-19 based on currently published literature. Methods: In this study, all published observational studies, including cross-sectional, cohort, and case-control studies, as well as case reports and case series, in peer-reviewed journals in any language until the end of July 2020 will be assessed. Editorials, commentaries, and letters to editors will be excluded from the review. Searching will be conducted using international bibliographic databases, including PubMed, Embase, and Web of Science based on Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) checklist. The search strategy will be improved and finalized based on the results of the primary search. Data extraction of the included articles will be performed by two researchers using the Zotero and review manager (revMan) software. The heterogeneity of the articles will be assessed using DerSimonian & Laird Q test and I2 statistic. The pooled estimated prevalence of vertical transmission of COVID-19 will be performed using the Metaprop command. Publication bias will be assessed using Begg’s rank correlation and the Egger weighted regression methods Results: Based on the reviewers comments the results section was deleted because this manuscript was a systematic review protocol. Conclusion: The findings of this study will help practitioners and health care providers in decision-making for the care and management of COVID-19-infected pregnant women.

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