Intralymphatic immunotherapy for allergic rhinitis: A systematic review and meta-analysis

2021 ◽  
Vol 42 (4) ◽  
pp. 283-292 ◽  
Author(s):  
Michael T. Werner ◽  
John V. Bosso
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Adverse Event ◽  
Skin Prick Testing ◽  
Meta Analysis ◽  
Mean Difference ◽  
Random Effects Model ◽  
Nasal Provocation ◽  
Intralymphatic Immunotherapy ◽  
Standardized Mean Difference

Background: Only a fraction of patients with allergic rhinitis receive allergen-specific immunotherapy (AIT). AIT is most commonly delivered subcutaneously in a series of injections over 3‐5 years. Common obstacles to completing this therapy include cost and inconvenience. Intralymphatic immunotherapy (ILIT) has been proposed as a faster alternative, which requires as few as three injections spaced 4 weeks apart. Objective: This systematic review and meta-analysis evaluated the current evidence that supports the use of ILIT for allergic rhinitis. Methods: Clinical trials were identified in the published literature by using an electronic search strategy and were evaluated by using a risk of bias tool. Treatment outcome (symptom scores, medication scores, and combined symptom and medication scores) and provocation testing results (nasal provocation and skin-prick testing) were included in a meta-analysis of standardized mean difference with subgrouping by using a random-effects model. Overall adverse event rates were tabulated, and overall risk ratios were calculated by using a random-effects model. Results: We identified 17 clinical trials that met eligibility criteria. The standardized mean difference of ILIT on the symptom and medication score was ‐0.72 (95% confidence interval [CI], ‐0.98 to ‐0.46; p < 0.0001) (n = 10). The standardized mean difference of ILIT on nasal provocation and skin-prick testing was ‐1.00 (95% CI, ‐1.38 to ‐0.61; p < 0.0001) (n = 7) and ‐0.73 (95% CI, ‐0.99 to ‐0.47; p < 0.0001) (n = 7), respectively. No statistically significant heterogeneity was detected. The overall adverse event rate was 39.5% for ILIT and 23.5% for placebo. Also, 98.4% of adverse events were mild. Conclusion: Our meta-analysis demonstrated that ILIT was safe, conferred desensitization to seasonal and nonseasonal allergens, alleviated allergic rhinitis symptoms, and reduced medication use. A larger randomized, double-blind, placebo controlled trial will be necessary for wider adaptation of this form of AIT.

scholarly journals Efficacy and safety of intralymphatic immunotherapy in allergic rhinitis: A systematic review and meta‐analysis

2021 ◽  
Vol 11 (6) ◽  
Author(s):  
Nor Rahimah Aini ◽  
Norhayati Noor ◽  
Mohd Khairi Md Daud ◽  
Sarah K. Wise ◽  
Baharudin Abdullah
Keyword(s):  
Systematic Review ◽  
Allergic Rhinitis ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Intralymphatic Immunotherapy

scholarly journals The effect of unilateral and bilateral laparoscopic surgery for endometriosis on Anti-Mullerian Hormone (AMH) level after 3 and 6 months: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Anisodowleh Nankali ◽  
Mohsen Kazeminia ◽  
Parnian Kord Jamshidi ◽  
Shamarina Shohaimi ◽  
Nader Salari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Laparoscopic Surgery ◽  
Growth Factors ◽  
Web Of Science ◽  
Meta Analysis ◽  
Research Work ◽  
Mean Difference ◽  
Transient Growth ◽  
Common Causes ◽  
Standardized Mean Difference

Abstract Background Endometriosis is one of the most common causes of infertility. The causes of the disease and its definitive treatments are still unclear. Moreover, Anti-Mullerian Hormone (AMH) is a glycoprotein dimer that is a member of the transient growth factors family. This research work aimed to identify the effect of unilateral and bilateral laparoscopic surgery for endometriosis on AMH levels after 3 months, and 6 months, using meta-analysis. Methods In this study, the articles published in national and international databases of SID, MagIran, IranMedex, IranDoc, Cochrane, Embase, Science Direct, Scopus, PubMed, and Web of Science (ISI) were searched to find electronically published studies between 2010 and 2019. The heterogeneous index between studies was determined using the I2 index. Results In this meta-analysis and systematic review, 19 articles were eligible for inclusion in the study. The standardized mean difference was obtained in examining of unilateral laparoscopic surgery for endometriosis (before intervention 2.8 ± 0.11, and after 3 months 2.05 ± 0.13; and before intervention 3.1 ± 0.46 and after 6 months 2.08 ± 0.31), and in examining bilateral laparoscopic surgery for endometriosis examination (before intervention 2.0 ± 08.08, and after 3 months 1.1 ± 0.1; and before intervention 2.9 ± 0.23 and after 6 months 1.4 ± 0.19). Conclusion The results of this study demonstrate that unilateral and bilateral laparoscopic surgery for endometriosis is effective on AMH levels, and the level decreases in both comparisons.

scholarly journals Minimally invasive versus conventional surgery of the ascending aorta and root: a systematic review and meta-analysis

2019 ◽  
Vol 57 (1) ◽  
pp. 8-17 ◽  
Author(s):  
Tom A Rayner ◽  
Sean Harrison ◽  
Paul Rival ◽  
Dominic E Mahoney ◽  
Massimo Caputo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Renal Impairment ◽  
Minimally Invasive ◽  
Risk Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Ascending Aorta ◽  
Mean Difference ◽  
Standardized Mean Difference

Summary Limited uptake of minimally invasive surgery (MIS) of the aorta hinders assessment of its efficacy compared to median sternotomy (MS). The objective of this systematic review is to compare operative and perioperative outcomes for MIS versus MS. Online databases Medline, EMBASE, Cochrane Library and Web of Science were searched from inception until July 2018. Both randomized and observational studies of patients undergoing aortic root, ascending aorta or aortic arch surgery by MIS versus MS were eligible for inclusion. Primary outcomes were 30-day mortality, reoperation for bleeding, perioperative renal impairment and neurological events. Intraoperative and postoperative timing measures were also evaluated. Thirteen observational studies were included comparing 1101 MIS and 1405 MS patients. The overall quality of evidence was very low for all outcomes. Mortality and the incidence of stroke were similar between the 2 cohorts. Meta-analysis demonstrated increased length of cardiopulmonary bypass (CPB) time for patients undergoing MS [standardized mean difference 0.36, 95% confidence interval (CI) 0.15–0.58; P = 0.001]. Patients receiving MS spent more time in hospital (standardized mean difference 0.30, 95% CI 0.17–0.43; P &lt; 0.001) and intensive care (standardized mean difference 0.17, 95% CI 0.06–0.27; P &lt; 0.001). Reoperation for bleeding (risk ratio 1.51, 95% CI 1.06–2.17; P = 0.024) and renal impairment (risk ratio 1.97, 95% CI 1.12–3.46; P = 0.019) were also greater for MS patients. There was substantial heterogeneity in meta-analyses for CPB and aortic cross-clamp timing outcomes. MIS may be associated with improved early clinical outcomes compared to MS, but the quality of the evidence is very low. Randomized evidence is needed to confirm these findings.

scholarly journals Effect of Exercise and Meditation on Depression and Anxiety Reduction: A Systematic Review and Meta-analysis

2021 ◽  
Vol 27 (2) ◽  
pp. 144-161
Author(s):  
Saeed Mohammadi ◽  
◽  
Komeil Zahedi Tajrishi ◽  
Mojtaba Tashkeh ◽  
◽  
...  
Keyword(s):  
Systematic Review ◽  
Aerobic Exercise ◽  
Web Of Science ◽  
Meta Analysis ◽  
Female Gender ◽  
Anxiety Reduction ◽  
Control Group ◽  
Random Effects Model ◽  
Depression And Anxiety ◽  
Standardized Mean Difference

Objectives: Despite the studies that examined the effect of exercise and meditation on depression and anxiety, no meta-analysis has proved this effect so far. Also, the effect of these factors is unknown in terms of gender and aerobic exercise. This meta-analysis addressed these gaps. Methods: Major electronic databases, including PubMed, Web of Science, and Embase, were searched until July 2019. Studies addressing the effect of exercise and meditation on depression and anxiety were found. Q-test and I2 statistic investigated the heterogeneity across the studies. The probability of publication bias was explored using Begg's and Egger's tests. The results were expressed as the Standardized Mean Difference (SMD) with a 95% confidence interval using a random-effects model. Results: We identified a total of 10015 references and 51 studies involving 3594 participants. Compared with the control group, the SMD estimate of anxiety was -0.7 (-1.20, -0.19) for meditation, -0.9 (-1.24, -0.57) for aerobic, and -1.07 (-1.67, -0.46) for other exercises. Also, the SMD estimate of depression was-0.84 (-1.26, -0.42) for meditation, -0.44 (-0.72, -0.17) for aerobic, and -1.10 (-1.55, -0.65) for other exercises. Conclusion: Exercise and meditation had a significant effect on depression and anxiety. Furthermore, there was an effect of the exercise and meditation on depression and anxiety regarding the female gender and aerobic exercise.

scholarly journals A Systematic Review and Meta-Analysis of Seasonal Influenza Vaccination of Health Workers

Vaccines ◽  
2021 ◽  
Vol 9 (10) ◽  
pp. 1104
Author(s):  
Tingting Li ◽  
Xiaoling Qi ◽  
Qin Li ◽  
Wenge Tang ◽  
Kun Su ◽  
...  
Keyword(s):  
Systematic Review ◽  
Influenza Vaccination ◽  
Randomized Clinical Trials ◽  
Health Workers ◽  
Meta Analysis ◽  
Random Effect ◽  
Mean Difference ◽  
Sensitivity Analyses ◽  
Standardized Mean Difference ◽  
Influenza Vaccinations

A systematic review and meta-analysis was conducted to estimate the pooled effect of influenza vaccinations for health workers (HWs). Nine databases were screened to identify randomized clinical trials and comparative observational studies that reported the effect of influenza vaccination among HWs. The risk ratio (RR), standardized mean difference, and 95% confidence interval (CI) were employed to study the effect size using fixed/random-effect models. Subgroup analyses and sensitivity analyses were conducted accordingly. Publication bias was examined. Sixteen studies (involving 7971 HWs from nine countries) were included after a comprehensive literature search. The combined RR regarding the incidence of laboratory-confirmed influenza was 0.36 (95% CI: 0.25 to 0.54), the incidence of influenza-like illness (ILI) was 0.69 (95% CI: 0.45 to 1.06), the absenteeism rate was 0.63 (95% CI: 0.46 to 0.86), and the integrated standardized mean difference of workdays lost was −0.18 (95% CI: −0.28 to −0.07) days/person. The subgroup analysis indicated that vaccination significantly decreases the incidence of laboratory-confirmed influenza in different countries, study populations, and average-age vaccinated groups. Influenza vaccinations could effectively reduce the incidence of laboratory-confirmed influenza, absenteeism rates, and workdays lost among HWs. It is advisable, therefore, to improve the coverage and increase the influenza vaccination count among HWs, which may benefit both workers and medical institutions.

scholarly journals Oxygen Cost of Walking in People with Multiple Sclerosis and Its Association with Fatigue: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Scott Rooney ◽  
Gavin McWilliam ◽  
Leslie Wood ◽  
Fiona Moffat ◽  
Lorna Paul
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Energy Expenditure ◽  
Meta Analysis ◽  
Positive Association ◽  
Mean Difference ◽  
Oxygen Cost ◽  
Future Studies ◽  
Standardized Mean Difference ◽  
The Relationship

Abstract Background: This systematic review and meta-analysis aimed to compare the oxygen cost of walking in people with multiple sclerosis (MS) and controls and to assess the relationship between oxygen cost of walking and fatigue in people with MS. Methods: Four databases (CINAHL, MEDLINE, ProQuest, Web of Science) were searched up to September 2020. Studies were included if they recruited adults with MS and either compared oxygen cost of walking in those with MS and a control population or determined the relationship between oxygen cost of walking and fatigue. Meta-analysis of the standardized mean difference in oxygen cost of walking between people with MS and controls was performed. Results: Nine studies were included in this review, of which seven compared oxygen cost of walking in people with MS (n = 176) and controls (n = 142) and four investigated the relationship between oxygen cost of walking and fatigue. Meta-analysis revealed that people with MS (with predominantly mild-to-moderate disability) had a significantly higher oxygen cost of walking compared with controls (standardized mean difference = 2.21, 95% CI = 0.88 to 3.54, P = .001). In addition, three studies found a significant yet weak positive association between oxygen cost of walking and fatigue. Conclusions: People with MS expend more energy when walking compared with controls. This increase in energy expenditure may contribute to the development of fatigue, as some studies found that higher oxygen costs of walking were associated with greater fatigue. Future studies should investigate whether reducing energy expenditure during movement improves fatigue.

Effects of telehealth interventions for adolescent sexual health: A systematic review and meta-analysis of randomized controlled studies

2021 ◽  
pp. 1357633X2110477
Author(s):  
Ita Daryanti Saragih ◽  
Santo Imanuel Tonapa ◽  
Carolyn M. Porta ◽  
Bih-O Lee
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Sexual Health ◽  
Condom Use ◽  
Self Efficacy ◽  
Meta Analysis ◽  
Mean Difference ◽  
Adolescent Sexual Health ◽  
Randomized Controlled ◽  
Standardized Mean Difference

Introduction Telehealth interventions to advance adolescent sexual health have evolved and are being used to promote adolescent sexual health knowledge and healthy sexual behaviors. However, as this area of intervention modality expands, there is a need to pause and examine the effects of telehealth interventions on adolescent sexual health outcomes. Addressing this knowledge gap will inform researchers and practitioners on the current state of evidence of telehealth interventions and inform further intervention development and testing. This study aimed to explore the meta-effects of telehealth interventions on self-efficacy of using condoms, condom use practices, and sexually transmitted infection testing behaviors among adolescents. Methods A systematic review and meta-analysis of randomized controlled trials were conducted. Seven databases (Academic Search Complete, CINAHL, EMBASE, MEDLINE, PubMed, OVID (UpToDate), and Web of Science) were searched for relevant full-text articles from the inception to May 2021. The revised Cochrane risk-of-bias tool for randomized trials was used to assess the methodological quality of the included studies. A meta-analysis was performed using a random effects model to calculate the pooled effects of telehealth interventions for adolescents. Stata 16.0 was used for statistical analysis. Results A total of 15 studies ( N = 5499) that used telehealth interventions with adolescents were included in the analysis. Telehealth interventions were found to increase self-efficacy for condom use (standardized mean difference: 0.22; 95% confidence interval: 0.08–0.36), practice for condom use (standardized mean difference: 0.35; 95% confidence interval: 0.23–0.47), and being screened/tested for sexual transmitted infections (standardized mean difference: 0.61; 95% confidence interval: 0.31–0.92). Discussion Telehealth interventions show promise as effective intervention delivery solutions for improving self-efficacy and certain sexual health behaviors among adolescents. These telehealth strategies could be important alternatives to in-person visits to accessing sexual health information or services near where they live. Future research should consider testing telehealth strategies where there is evidence of impact to move the field forward.

scholarly journals Omalizumab for the treatment of allergic rhinitis: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
S. Tsabouri ◽  
G. Ntritsos ◽  
F. Koskeridis ◽  
E. Evangelou ◽  
P. Olsson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Allergic Rhinitis ◽  
Symptom Severity ◽  
Meta Analysis ◽  
Mean Difference ◽  
Efficacy And Safety ◽  
Symptom Severity Score ◽  
Large Heterogeneity ◽  
Standardized Mean Difference

Background: Allergic rhinitis (AR), an IgE mediated inflammatory disease, significantly impacts quality of life of a considerable proportion of the general population. Omalizumab, a humanized monoclonal antibody against IgE, has been evaluated for both seasonal and perennial AR. We aimed to assess the efficacy and safety of omalizumab in randomized controlled trials (RCTs) in inadequately controlled AR. Methods: We conducted a systematic literature search of RCTs evaluating the safety and efficacy of omalizumab in AR. We synthesized evidence for clinical improvement of AR symptoms, quality of life, reduction of the use of rescue medication, and adverse events. Results: The systematic search returned 289 articles, of which 12 RCTs were eligible for data extraction and meta-analysis. Omalizumab reduced the Daily Nasal Symptom Severity Score (DNSSS) by a summary standardized mean difference of -0.41 points with large heterogeneity; omalizumab significantly reduced the DNSSS both in the 3 cedar pollen-induced AR trials by -0.97 points and to a lower extent in the remaining five non-cedar trials by -0.19 points. Omalizumab also improved the Daily Ocular Symptom Severity Score (DOSSS) by a summary standardized mean difference of -0.30 points with large heterogeneity; the Rhino-conjunctivitis Quality of Life Questionnaire by a summary standardized mean difference of -0.45 points with no heterogeneity and the mean daily consumption of rescue antihistamines by a summary standardized mean difference of -0.21 with large heterogeneity. No statistically significant difference in the occurrence of adverse events was observed between omalizumab and placebo. Conclusion: Our findings further support the efficacy and safety of omalizumab in the management of patients with allergic rhinitis inadequately controlled with a conventional treatment.

scholarly journals Effect of Exercise and Meditation on Depression and Anxiety Reduction: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Saeed Mohammadi ◽  
◽  
Komeil Zahedi ◽  
Mojtaba Tashkeh ◽  
◽  
...  
Keyword(s):  
Systematic Review ◽  
Aerobic Exercise ◽  
Web Of Science ◽  
Meta Analysis ◽  
Female Gender ◽  
Anxiety Reduction ◽  
Control Group ◽  
Random Effects Model ◽  
Depression And Anxiety ◽  
Standardized Mean Difference

Objectives: Despite the existence of studies that associated effect of exercise and meditation on depression and anxiety, there was no meta-analysis to date, that can prove this effect definitely. Also, the effect of these factors by gender and aerobic exercise are unknown. This gap was addressed by this meta-analysis. Methods: Major electronic databases, including PubMed, Web of Science, and Embase were searched until July 2019. Studies addressing the effect of exercise and meditation on depression and anxiety were enrolled. The heterogeneity across studies was investigated by Q-test and I2 statistic. The probability of publication bias was explored using Beggchr('39')s and Eggerchr('39')s tests. The results were expressed as the standardized mean difference (SMD) with 95% confidence intervals (CI) using a random-effects model. Results: We identified a total of 10,015 references and included 51 studies involving 3,594 participants. Compared control group, the SMD estimate of anxiety was -0.7 (-1.20, -0.19) for meditation, -0.9 (-1.24, -0.57) for aerobic, -1.07 (-1.67, -0.46) for other exercise, and the SMD estimate of depression was-0.84 (-1.26, -0.42) for meditation, -0.44 (-0.72, -0.17) for aerobic, and -1.10 (-1.55, -0.65) for other exercise. Conclusions: Exercise and meditation had a significant effect on depression and anxiety. Furthermore, there was an effect of the exercise and meditation on depression and anxiety by female gender and aerobic exercise.

Muscle hypertrophy and strength gains after resistance training with different volume matched loads: a systematic review and meta-analysis.

2022 ◽  
Author(s):  
Leonardo Henrique Fernandes Carvalho ◽  
Roberto Moriggi Junior ◽  
Júlia Barreira ◽  
Brad Jon Schoenfeld ◽  
John Orazem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Resistance Training ◽  
Muscle Hypertrophy ◽  
Meta Analysis ◽  
Dynamic Strength ◽  
Pooled Analysis ◽  
High Load ◽  
Mean Difference ◽  
Volume Load ◽  
Standardized Mean Difference

The purpose of this paper was to conduct a systematic review and meta-analysis of studies that compared muscle hypertrophy and strength gains between resistance training protocols employing very low (VLL<30% of 1RM or >35 RM), low (LL30%-59% of 1RM, or 16–35 RM), moderate (ML60%-79% of 1RM, or 8 -15RM) and high load (HL≥80% of 1RM, or ≤7 RM) with matched volume loads (sets x reps x weight). A pooled analysis of the standardized mean difference for 1RM strength outcomes across the studies showed a benefit favoring HL vs. LL and vs. ML; and favoring ML vs. LL. Results from LL and VLL indicated little difference. A pooled analysis of the standardized mean difference for hypertrophy outcomes across all studies showed no differences between the training loads. Our findings indicate that, when volume load is equated between conditions, the highest loads induce superior dynamic strength gains. Alternatively, hypertrophic adaptations are similar irrespective of the magnitude of load. NOVELTY BULLETS: • Training with higher loads elicits greater gains in 1RM muscle strength when compared to lower loads, even when volume load is equated between conditions. • Muscle hypertrophy is similar irrespective of the magnitude of load, even when volume load is equated between conditions.

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