scholarly journals Prognostic Value and Risk Factors of Treatment-Related Lymphopenia in Malignant Glioma Patients Treated With Chemoradiotherapy: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 12 ◽  
Author(s):  
Yongchao Zhang ◽  
Shichao Chen ◽  
Hualei Chen ◽  
Shanshan Chen ◽  
Zhen Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Checkpoint Inhibitors ◽  
Meta Analysis ◽  
Cancer Control ◽  
Cochrane Library ◽  
Poor Overall Survival ◽  
Lower Baseline ◽  
Circulating Lymphocytes ◽  
The Impact

Background: Immunotherapy has shown promising therapeutic efficacy in various cancers but not gliomas. Circulating lymphocytes play critical roles in cancer control and responses to immune checkpoint inhibitors. Treatment-related lymphopenia has been associated with poor survival in patients with various tumors. This meta-analysis evaluated the risk and impact of lymphopenia in patients with glioma.Methods: The PubMed, Embase, Web of Science, and Cochrane Library databases were comprehensively searched. Eligible studies were included if they reported the incidence and risk factors of lymphopenia and the impact of lymphopenia on survival. Stata 16.0 was used for this meta-analysis.Results: A total of 21 studies were included in the final systematic review and 20 were included in the quantitative analysis. The overall incidence of grade III/IV lymphopenia was 31.6% [95% confidence interval (CI), 22.3–40.8%]. Pooled results based on pathology of glioma revealed that the incidence in astrocytoma and astrocytoma oligodendroglioma patients was 20.2% (95% CI:5.9–34.4%), and the incidence in glioblastoma patients was 27.6% (95% CI:16.2–38.9%). Lymphopenia was associated with poor overall survival (hazard ratio, 1.99; 95% CI, 1.74–2.27; P< 0.001) compared to no lymphopenia. Brain receiving radiation dose of 20 or 25 Gy, female sex, older age, lower baseline lymphocyte count, and dexamethasone dose > 2 mg instead of baseline use were risk factors for lymphopenia.Conclusions: Treatment-related lymphopenia was associated with decreased survival in patients with glioma. Optimization of chemoradiation regimens, particularly in patients with concurrent risk factors, can reduce lymphopenia and potentially improve survival in the era of immunotherapy.

scholarly journals Risk factors for predicting progression from normal cognition to mild cognitive impairment: protocol for a systematic review and meta-analysis of cohort studies

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e027313 ◽  
Author(s):  
Jie Wang ◽  
Lina Wang ◽  
Xianglian Zhou ◽  
Xiaohong Wen ◽  
Xueting Zhen
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Primary Data ◽  
Cochrane Library ◽  
The Impact ◽  
Normal Cognition

IntroductionMild cognitive impairment (MCI) often represents the earliest stage of Alzheimer’s disease. There has been considerable research investigating specific risk factors regarding the progression from normal cognition to MCI. However, different studies have come to different conclusions on the impact of particular risk factors. Therefore, it is necessary to conduct a meta-analysis of the risk factors that predict cognitive disruption in individuals based on associations with MCI.Methods and analysisWe will search seven electronic databases without time limit, including MEDLINE, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, the Wan Fang Database and China Biology Medicine. Two researchers will independently screen for eligibility and perform data extraction. Data were extracted from cohort studies meeting the inclusive criteria according to the Newcastle Ottawa Scale (NOS) methods. A third member of the research team will be contacted when a consensus cannot be reached. Any disagreement will be settled by consensus. The NOS will be used to assess the quality of the studies. All analyses were performed using Stata V.15.1.Ethics and disseminationWe will report this review in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. We will disseminate our findings through a publication in a peer-reviewed journal. This systematic review does not require ethical approval as no primary data are collected.PROSPERO registration numberCRD42018109099.

scholarly journals Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044564
Author(s):  
Kaizhuang Huang ◽  
Jiaying Lu ◽  
Yaoli Zhu ◽  
Tao Cheng ◽  
Dahao Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Factor ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Cochrane Library ◽  
Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

Prevalence and Risk Factors of Relapse in Patients with ANCA-Associated Vasculitis Receiving Cyclophosphamide Induction: A Systematic Review and Meta-analysis of Large Observational Studies

Rheumatology ◽  
2020 ◽  
Author(s):  
Peng He ◽  
Jin-ping Hu ◽  
Xiu-juan Tian ◽  
Li-jie He ◽  
Shi-ren Sun ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Baseline Serum ◽  
Anca Associated Vasculitis ◽  
Hazard Ratios ◽  
Post Hoc ◽  
Cumulative Probabilities ◽  
Relapse Rates

Abstract Background Clinical relapses are common in patients with ANCA-associated vasculitis (AAV). The aim of this systematic review was to estimate time-point prevalence and risk factors of relapse. Methods We searched PubMed, Embase, and Cochrane Library databases from their inception to March 30, 2020. Cohorts and post-hoc studies were included for the estimation of summary cumulative relapse rates (CRRs) and adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs). Sensitivity and meta-regression analyses were also performed. Results Of the 42 eligible studies, 24 studies with 6236 participants were used for the pooled analyses of CRRs. The summary 1-year, 3-year, and 5-year CRRs were 0.12 (95% CI, 0.10–0.14), 0.33 (0.29–0.38), and 0.47 (0.42–0.52), respectively. In meta-regressions, the baseline age was positively associated with 1-year CRR. The proportion of granulomatosis with polyangiitis was positively associated with 5-year CRR. Twenty-eight studies with 5390 participants were used for the meta-analysis of risk factors for relapse, including a lower level of baseline serum creatine, proteinase 3 (PR3)-ANCA positivity at diagnosis, an ANCA rise, extrarenal organ involvement (including lung, cardiovascular, upper respiratory, and gastrointestinal involvement), intravenous (vs oral) cyclophosphamide induction, a shorter course of immunosuppressant maintenance, and maintenance with mycophenolate mofetil (vs azathioprine). Conclusions Our systematic review demonstrated that the 1-year, 3-year, and 5-year cumulative probabilities of relapse were ∼12%, 33%, and 47% in AAV patients receiving cyclophosphamide induction, respectively. Early identification of risk factors for relapse is helpful to the risk stratification of patients so as to achieve personalized treatment.

Impact of Treatment for Nasal Cavity Disorders on Sleep Quality: Systematic Review and Meta-analysis

2021 ◽  
pp. 019459982110295
Author(s):  
Jacob Fried ◽  
Erick Yuen ◽  
Kathy Zhang ◽  
Andraia Li ◽  
Nicholas R. Rowan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Nasal Obstruction ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Life Questionnaire ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
The Impact

Objective To determine the impact of treatment for patients with nasal obstruction secondary to allergic rhinitis (AR) and nasal septal deviation (NSD) on sleep quality. Data Sources Primary studies were identified though PubMed, Scopus, Cochrane Library, and Web of Science. Review Methods A systematic review was performed by querying databases for articles published through August 2020. Studies were included that reported on objective sleep parameters (apnea-hypopnea index) and sinonasal and sleep-specific patient-reported outcome measures: Rhinoconjunctivitis Quality of Life Questionnaire, Nasal Obstruction Symptom Evaluation, Epworth Sleepiness Scale (EpSS), and Pittsburgh Sleep Quality Index (PSQI). Results The database search yielded 1414 unique articles, of which 28 AR and 7 NSD studies were utilized for meta-analysis. A total of 9037 patients (8515 with AR, 522 with NSD) were identified with a mean age of 35.0 years (35.3 for AR, 34.0 for NSD). Treatment for AR and NSD significantly improved subjective sleep quality. For AR, the EpSS mean difference was −1.5 (95% CI, –2.4 to –0.5; P = .002) and for the PSQI, –1.7 (95% CI, –2.1 to –1.2; P < .00001). For NSD, the EpSS mean difference was −3.2 (95% CI, –4.2 to –2.2; P < .00001) and for the PSQI, –3.4 (95% CI, –6.1 to –0.6; P = .02). Conclusion Subjective sleep quality significantly improved following treatment for AR and NSD. There were insufficient data to demonstrate that objective metrics of sleep quality similarly improved.

scholarly journals Efficacy of hydrofibre dressing following total joint arthroplasty: a meta-analysis of randomised controlled trials

2021 ◽  
pp. 112070002110126
Author(s):  
Raman Mundi ◽  
Harman Chaudhry ◽  
Seper Ekhtiari ◽  
Prabjit Ajrawat ◽  
Daniel M Tushinski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Joint Infection ◽  
The United States ◽  
Joint Arthroplasty ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Observable Effect ◽  
The Impact

Introduction: In the United States, over 1,000,000 total joint arthroplasty (TJA) surgeries are performed annually and has been forecasted that this number will exceed 4,000,000 by the year 2030. Many different types of dressing exist for use in TJA surgery, and it is unclear if any of the newer, hydrofibre dressings are superior to traditional dressings at reducing rates of infections or improving wound healing. Thus, the aim of this systematic review and meta-analysis was to assess the impact of hydrofiber dressings on reducing complications. Methods: A systematic review and meta-analysis was performed using the online databases MEDLINE and the Cochrane Library. Randomized controlled trials (RCTs) comparing hydrofibre dressings to a standard dressing were included. Summary measures are reported as odds ratios (ORs) and mean differences (MDs) with 95% confidence intervals (CIs). Our primary outcome was prosthetic joint infection (PJI). Secondary outcomes included blisters, dressing changes and wound irritation. Results: 5 RCTs were included. Hydrofibre dressing had no observable effect on PJI or wound irritation (OR 0.53; 95% CI, 0.14–1.98; p = 0.35). Hydrofibre dressings reduced the rate of blisters (OR 0.36; 95% CI, 0.14–0.90; p = 0.03) and number of dressing changes (MD -1.89; 95% CI, -2.68 to -1.11). Conclusions: In conclusion, evidence suggests hydrofibre dressings have no observable effect on PJI and wound irritation. Evidence for reduction in blisters and number of dressings is modest given wide CIs and biased trial methodologies. Use of hydrofibre dressings should be considered inconclusive for mitigating major complications in light of current best evidence.

scholarly journals The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohail Akhtar ◽  
Jamal Abdul Nasir ◽  
Amara Javed ◽  
Mariyam Saleem ◽  
Sundas Sajjad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Population Based ◽  
Included Study ◽  
Cochrane Library ◽  
Or Education ◽  
Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

scholarly journals The Use of Seton as a Bridge to Definitive Ligation of the Intersphincteric Fistula Tract Procedure for Fistula-in-ano: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Carlos Placer-Galán ◽  
Jose Mª Enriquez-Navascués ◽  
Tania Pastor-Bonel ◽  
Ignacio Aguirre-Allende ◽  
Yolanda Saralegui-Ansorena
Keyword(s):  
Systematic Review ◽  
Anal Fistula ◽  
Meta Analysis ◽  
Fistula Tract ◽  
Cochrane Library ◽  
Fistula In Ano ◽  
Intersphincteric Fistula ◽  
The Impact ◽  
Seton Placement ◽  
Primary Healing

Abstract Background There is still controversy over the usefulness of seton placement prior to the ligation of the intersphincteric fistula tract (LIFT) surgery in the management of anal fistula. Objective To evaluate the impact of preoperative seton placement on the outcomes of LIFT surgery for the management of fistula-in-ano. Design systematic review and meta-analysis. Data Sources A search was performed on the MEDLINE (PubMed), EMBASE, Scopus, Web of Science, Cochrane Library and Google Scholar databases. Study Selection Original studies without language restriction reporting the primary healing rates with and without seton placement as a bridge to definitive LIFT surgery were included. Intervention The intervention assessed was the LIFT with and without prior seton placement. Main Outcome Measures The main outcome was defined as the primary healing rate with and without the use of seton as a bridge to definitive LIFT surgery. Results Ten studies met the criteria for systematic review, all retrospective, with a pooled study population of 772 patients. There were no significant differences in the percentages of recurrence between patients with and without seton placement (odds ratio [OR] 1.02; 95% confidence interval [CI] 0.73–1.43: p = 0.35). The I2 value was 9%, which shows the homogeneity of the results among the analyzed studies. The 10 included studies demonstrated a weighted average overall recurrence of 38% (interquartile range [IQR] 27–42.7%), recurrence with the use of seton was 40% (IQR 26.6–51.2%), and without its use, the recurrence rate was 51.3% (IQR 31.3–51.3%) Limitations The levels of evidence found in the available literature were relatively fair, as indicated after qualitative evaluation using the Newcastle-Ottawa scale and the Attitude Heading Reference System (AHRS) evidence levels. Conclusions Our meta-analysis suggests that the placement of seton as a bridge treatment prior to LIFT surgery does not significantly improve long-term anal fistula healing outcomes. Ligation of the intersphincteric fistula tract surgery can be performed safely and effectively with no previous seton placement.International prospective register of systematic reviews—PROSPERO registration number: CDR42020149173.

Risk of nodal disease in patients with MRI-detected extramural vascular invasion in rectal cancer: a systematic review and meta-analysis

2020 ◽  
pp. 030089162097586
Author(s):  
Pratik Tripathi ◽  
Zhen Li ◽  
Yaqi Shen ◽  
Xuemei Hu ◽  
Daoyu Hu
Keyword(s):  
Systematic Review ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Vascular Invasion ◽  
Literature Search ◽  
Meta Analysis ◽  
Adjuvant Chemoradiotherapy ◽  
Cochrane Library ◽  
Nodal Disease ◽  
The Impact

Background: The impact of magnetic resonance imaging–detected extramural vascular invasion (mrEMVI) in distant metastasis is well known but its correlation with prevalence of lymph node metastasis is less studied. The aim of this systematic review and meta-analysis was to assess the prevalence of nodal disease in mrEMVI–positive and negative cases in rectal cancer. Methods: Following guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic literature search in PubMed, Web of Science, Cochrane Library, and EMBase was carried out to identify relevant studies published up to May 2019. Results: Our literature search generated 10 studies (863 and 1212 mrEMVI–positive and negative patients, respectively). The two groups (mrEMVI–positive and negative) were significantly different in terms of nodal disease status (odds ratio [OR] 3.15; 95% confidence interval [CI] 2.12–4.67; p < 0.001). The prevalence of nodal disease was 75.90% vs 52.56% in the positive mrEMVI vs negative mrEMVI group, respectively ( p < 0.001). The prevalence of positive lymph node in positive mrEMVI patients treated with neoadjuvant/adjuvant chemoradiotherapy (nCRT/CRT) (OR 2.47; 95% CI 1.65–3.69; p < 0.001) was less compared with the patients who underwent surgery alone (OR 6.25; 95% CI 3.74–10.44; p < 0.001). Conclusion: The probability of positive lymph nodes in cases of positive mrEMVI is distinctly greater compared with negative cases in rectal cancer. Positive mrEMVI indicates risk of nodal disease prevalence increased by threefold in rectal cancer.

scholarly journals Seroprevalence of SARS CoV-2 infection in Low and Middle-Income Countries and risk classification in the context of rolling out vaccine candidate across these countries : Protocol for a systematic review and meta-analysis

2021 ◽  
Author(s):  
Martin Ackah ◽  
Louise Ameyaw ◽  
Kwadwo Owusu Akuffo ◽  
Cynthia Osei Yeboah ◽  
Nana Esi Wood ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Vaccine Candidate ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Research Database ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
Low And Middle Income

Abstract Background Seroprevalence of SARS Cov-2 provides a good indication of the extent of exposure and spread in the population, as well as those likely to benefit from a vaccine candidate. To date, there is no published or ongoing systematic review on the seroprevalence of COVID-19 in Low- and Middle-Income Countries (LMICs). This systematic review and meta-analysis will estimate SARS Cov-2 seroprevalence and the risk factors for SARS Cov-2 infection in LMICs.Methods We will search PubMed, EMBASE, WHO COVID-19 Global research database, Google Scholar, the African Journals Online, LILAC, HINARI, medRxiv, bioRxiv and Cochrane Library for potentially useful studies on seroprevalence of COVID-19 in LMICs from December 2019 to December 2020 without language restriction. Two authors will independently screen all the articles, select studies based on pre-specified eligibility criteria and extract data using a pre-tested data extraction form. Any disagreements will be resolved through discussion between the authors. The pooled seroprevalence of SARS CoV-2 for people from LMICs will be calculated. Random effects model will be used in case of substantial heterogeneity in the included studies, otherwise fixed-effect model will be used. A planned subgroup, sensitivity and meta-regression analyses will be performed. For comparative studies, the analyses will be performed using Review Manager v 5.4; otherwise, STATA 16 will be used. All effect estimates will be presented with their confidence intervals.Discussion The study will explore and systematically review empirical evidence on SARS Cov-2 seroprevalence in LMICs, and to assess the risk factors for SARS Cov-2 infection in Low Middle Income Countries in the context of rolling out vaccines in these countries. Finally, explore risk classifications to help with the rolling out of vaccines in LMICs.Systematic review registration: The protocol for this review has been registered in PROSPERO (CRD422020221548).

scholarly journals Impact of eating disorders on paid or unpaid work participation and performance: a systematic review and meta-analysis protocol

2022 ◽  
Vol 10 (1) ◽  
Author(s):  
Fatima Safi ◽  
Anna M. Aniserowicz ◽  
Heather Colquhoun ◽  
Jill Stier ◽  
Behdin Nowrouzi-Kia
Keyword(s):  
Systematic Review ◽  
Eating Disorders ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Work Participation ◽  
Unpaid Work ◽  
Cochrane Library ◽  
And Performance ◽  
The Impact

Abstract Background Eating disorders (ED) can reduce quality of life by limiting participation and performance in social and occupational roles, including paid or unpaid work. The association between ED pathologies and work participation and performance must be well understood to strengthen vocational rehabilitation programmes and prevent occupational disruptions in the ED population. The aims of this study are: (1) to examine the degree of association between ED pathologies and work participation and performance in 15-year-olds and older; (2) to highlight the specific ED symptoms that are most correlated with changes in work performance and participation; (3) to compile the most common metrics and assessments used to measure work participation and performance with ED. Methods Medline, Embase, CINAHL, Web of Science, PsycINFO, and Cochrane Library will be searched for observational and experimental studies that meet the following criteria: (1) a clinical sample of typical or atypical ED; (2) paid or unpaid employment or training; (3) an association between ED pathologies and work participation or performance. Unpublished data will also be examined. Title and abstract, and full-text screening will be conducted in duplicate. Risk of bias and quality of evidence assessments will be completed. A random-effect meta-analysis will be performed. Discussion This synthesis can clarify knowledge and gaps around the impact of ED on work functioning, thereby allowing better evaluation, improvements and development of current workplace assessments, interventions, and policies. Trial registration The registration number for this systematic review on PROSPERO is CRD42021255055.

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