scholarly journals Molecular Alterations in Lung Adenocarcinoma With Ground-Glass Nodules: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Zihan Wei ◽  
Ziyang Wang ◽  
Yuntao Nie ◽  
Kai Zhang ◽  
Haifeng Shen ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Early Stage ◽  
Meta Analysis ◽  
Genetic Alterations ◽  
Ground Glass ◽  
Cochrane Library ◽  
Chi Square ◽  
Test Analysis ◽  
Molecular Alterations ◽  
Chi Square Test

Background and AimsNodular ground-glass lesions have become increasingly common with the increased use of computed tomography (CT), while the genomic features of ground-glass opacities (GGOs) remain unclear. This study aims to comprehensively investigate the molecular alterations of GGOs and their correlation with radiological progression.MethodsStudies from PubMed, Embase, Cochrane Library, and Web of Science, using PCR, targeted panel sequencing, whole exosome sequencing, and immunohistochemistry, and reporting genomic alterations or PD-L1 expressions in lung nodules presenting as GGOs until January 21, 2021 were included in this study. Chi-square test, random-effects model, and Z-test analysis were adopted to analyze the data.ResultsA total of 22 studies describing mutations in lung adenocarcinoma (LUAD) with GGOs were analyzed. EGFR was the most frequently mutative gene (51%, 95%CI 47%–56%), followed by TP53 (18%, 95%CI 6%–31%), HER2 (10%, 95%CI 0%–21%), ROS1 (6%, 95%CI 0%–18%), and KRAS (6%, 95%CI 3%–9%). The correlation between the frequency of EGFR mutation and radiological was observed and the differences were found to be not statistically significant in the subgroups, which are listed as below: radiological: gGGO 47.40%, 95%CI [38.48%; 56.40%]; sGGO 51.94%, 95%CI [45.15%; 58.69%]. The differences of the frequency of KRAS mutation in the different subgroups were also consistent with this conclusion, which are listed as: radiological gGGO 3.42, 95%CI [1.35%; 6.13%]; sGGO 12.27%, 95%CI [3.89%; 23.96%]. The pooled estimated rate of PD-L1 was 8.82%, 95%CI [5.20%–13.23%]. A total of 11.54% (3/26) of the SMGGNs were confirmed to be intrapulmonary spread by WES.ConclusionsSomatic genetic alterations are considered in early-stage GGO patients without distinct changes of the frequency following the progress of the tumor. This review sheds insight on molecular alterations in LUAD with GGOs.

scholarly journals Association of Plasma Thrombin-Antithrombin Complex and Ischemic Stroke: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Peipei Song ◽  
Jianqin Xie ◽  
Wei Li ◽  
Xinying Zhang ◽  
Zhipeng Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Meta Analysis ◽  
Cardioembolic Stroke ◽  
Current Evidence ◽  
Cochrane Library ◽  
Healthy Controls ◽  
Chi Square ◽  
Chi Square Test ◽  
The Relationship

Abstract Background and objectiveThrombin-antithrombin complex (TAT) is a prethrombotic marker, and its application in ischemic stroke is still uncertain. The purpose of this systematic review and meta-analysis is to evaluate the relationship between plasma TAT and ischemic stroke base on the current evidence.MethodsA systematic literature search was conducted for searching the relative studies that investigated the association of TAT and ischemic stroke in PubMed, EMBASE, and Cochrane library databases. Mean difference and 95% confidence interval as the effect sizes were synthesized by random effects model in Review Manager (RevMan) Version 5.4. Then, the heterogeneity was investigated using the Chi-square test and the possible sources of heterogeneity were explored by sensitivity analysis. The publication bias was estimated through Begg’s and Egger’s tests.ResultsA total of 12 eligible studies were included involving 1431 stroke cases and 532 healthy controls, of which six studies were eventually included in the meta-analysis. Plasma TAT in patients with ischemic stroke was significantly higher than that in healthy controls (MD 5.31, 95% CI =4.12-6.51, P<0.0001, I2=97.8 %). There is a difference of TAT level in the same period among cardioembolic, lacunar and atherothrombotic stroke (all P<0.0001), in which the cardioembolic stroke with the highest level. Meanwhile, it is significant of TAT levels among various phases of cardioembolic stroke and the acute phase are markedly elevated (MD 7.75, 95CI%, 6.07-9.43, P<0.001). However, no difference was found in the atherothrombotic (P=0.13) and lacunar stroke (P=0.34). Besides, the higher TAT level is closely related to the poor prognosis of patients with ischemic stroke, including higher recurrence, mortality, unfavorable recovery (modified Rankin scale >2), and poor revascularization.ConclusionsThis study suggested that plasma TAT levels are different in ischemic stroke subtypes, which are closely associated with the progression and might have an effect on the prognosis. PROSPERO CRD: 42021248787

scholarly journals Accuracy of circulating microRNAs in diagnosis of sepsis: a systematic review and meta-analysis

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Xiaomin Shen ◽  
Jiajie Zhang ◽  
Yicheng Huang ◽  
Jiepeng Tong ◽  
Li Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Likelihood Ratios ◽  
Internal Reference ◽  
Chi Square ◽  
Circulating Micrornas ◽  
Chi Square Test

Abstract Objectives The aim of this study was to systematically assess the accuracy of circulating microRNAs (miRNAs) as a promising biomarker for sepsis via a meta-analysis. Methods PubMed, Cochrane Library, Embase, Web of Science, Scopus, and Ovid databases were searched up to April 3, 2020. The Quality in Prognostic Studies (QUADAS-2) tool was used to assess methodological quality. The pooled sensitivity (Sen), specificity (Spe), positive or negative likelihood ratios (PLR or NLR), diagnostic odds ratio (DOR), curve, and area under the curve (AUC) were calculated with 95% confidence interval (95% CI). The overall accuracy (OA) of miRNAs, procalcitonin (PCT), and C-reactive protein (CRP) was analyzed by the chi-square test. Results A total of 22 records were eligible for systematic review, including 2210 sepsis, 426 systemic inflammatory response syndrome (SIRS), and 1076 healthy controls (HC). The pooled Sen, Spe, and DOR of miRNAs were 0.80 (95% CI 0.75–0.83), 0.85 (95% CI 0.80–0.89), and 22 (15–32), respectively. The DOR of PCT and CRP were 17 (95% CI 4–68) and 7 (95% CI 1–48), respectively. The OA value of miRNAs (79.02%) and PCT (76.95%) were higher than CRP (61.22%) (P < 0.000). The subgroup analysis indicated that miRNAs in adults, serum type, downregulation of miRNA expression, criteria of Sepsis-3, internal reference of non-U6, and dysregulation expression of miR-223 had superior diagnostic accuracy. In addition, there was no significant publication bias among the included studies. Fagan’s nomogram showed valuable clinical utility. Conclusions Our meta-analysis indicated that the level of circulating miRNAs, particularly the miR-223, could be used as an indicator for sepsis.

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.

scholarly journals Comparison of the survival outcomes of laparoscopy versus laparotomy in treatment of early-stage ovarian cancer: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Qingduo Kong ◽  
Hongyi Wei ◽  
Jing Zhang ◽  
Yilin Li ◽  
Yongjun Wang
Keyword(s):  
Ovarian Cancer ◽  
Overall Survival ◽  
Early Stage ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Survival Outcomes ◽  
Free Survival ◽  
Review Manager ◽  
Early Stage Ovarian Cancer

Abstract Background Laparoscopy has been widely used for patients with early-stage epithelial ovarian cancer (eEOC). However, there is limited evidence regarding whether survival outcomes of laparoscopy are equivalent to those of laparotomy among patients with eEOC. The result of survival outcomes of laparoscopy is still controversial. The aim of this meta-analysis is to analyze the survival outcomes of laparoscopy versus laparotomy in the treatment of eEOC. Methods According to the keywords, Pubmed, Embase, Cochrane Library and Clinicaltrials.gov were searched for studies from January 1994 to January 2021. Studies comparing the efficacy and safety of laparoscopy versus laparotomy for patients with eEOC were assessed for eligibility. Only studies including outcomes of overall survival (OS) were enrolled. The meta-analysis was performed using Stata software (Version 12.0) and Review Manager (Version 5.2). Results A total of 6 retrospective non-random studies were included in this meta-analysis. The pooled results indicated that there was no difference between two approaches for patients with eEOC in OS (HR = 0.6, P = 0.446), progression-free survival (PFS) (HR = 0.6, P = 0.137) and upstaging rate (OR = 1.18, P = 0.54). But the recurrence rate of laparoscopic surgery was lower than that of laparotomic surgery (OR = 0.48, P = 0.008). Conclusions Laparoscopy and laparotomy appear to provide comparable overall survival and progression-free survival outcomes for patients with eEOC. Further high-quality studies are needed to enhance this statement.

scholarly journals The osseointegration and stability of dental implants with different surface treatments in animal models: a network meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chun-Ping Hao ◽  
Nan-Jue Cao ◽  
Yu-He Zhu ◽  
Wei Wang
Keyword(s):  
Dental Implants ◽  
Early Stage ◽  
Meta Analysis ◽  
Critical Role ◽  
Cochrane Library ◽  
Missing Teeth ◽  
Treatment Technology ◽  
Implant Surface ◽  
Randomized Controlled ◽  
Early Healing

AbstractDental implants are commonly used to repair missing teeth. The implant surface plays a critical role in promoting osseointegration and implant success. However, little information is available about which implant surface treatment technology best promotes osseointegration and implant stability. The aim of this network meta-analysis was to evaluate the osseointegration and stability of four commonly used dental implants (SLA, SLActive, TiUnite, and Osseotite). The protocol of the current meta-analysis is registered in PROSPERO (International Prospective Register of Systematic Reviews) under the code CRD42020190907 (https://www.crd.york.ac.uk). We conducted a systematic review following PRISMA and Cochrane Recommendations. Medline (PubMed), Cochrane Library, Embase, and the Web of Science databases were searched. Only randomized controlled trials were considered. Twelve studies were included in the current network meta-analysis, eleven studies were included concerning the osseointegration effect and five studies were included for stability analysis (four studies were used to assess both stability and osseointegration). Rank possibility shows that the SLActive surface best promoted bone formation at an early healing stage and TiUnite seemed to be the best surface for overall osseointegration. For stability, TiUnite seemed to be the best surface. The present network meta-analysis showed that the SLActive surface has the potential to promote osseointegration at an early stage. The TiUnite surface had the best effect on osseointegration regarding the overall healing period. The TiUnite surface also had the best effect in stability.

scholarly journals Specific immunotherapy using Hymenoptera venom: systematic review

2010 ◽  
Vol 128 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Alexandra Sayuri Watanabe ◽  
Luiz Augusto Marcondes Fonseca ◽  
Clóvis Eduardo Santos Galvão ◽  
Jorge Kalil ◽  
Fabio Fernandes Morato Castro
Keyword(s):  
Randomized Controlled Trials ◽  
Specific Immunotherapy ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Venom Immunotherapy ◽  
Chi Square ◽  
Skin Reactions ◽  
Randomized Controlled ◽  
Chi Square Test ◽  
Adults And Children

CONTEXT AND OBJECTIVE: The only effective treatment for patients who have severe reactions after Hymenoptera stings is venom immunotherapy. The aim of this study was to review the literature to assess the effects of venom immunotherapy among patients presenting severe reactions after Hymenoptera stings. DESIGN AND SETTING: Randomized controlled trials in the worldwide literature were reviewed. The manuscript was produced in the Discipline of Allergy and Clinical Immunology, Universidade de São Paulo (USP). METHODS: Randomized controlled trials involving venom immunotherapy versus placebo or only patient follow-up were evaluated. The risk of systemic reactions after specific immunotherapy was evaluated by calculating odds ratios (OR) and their 95% confidence intervals. RESULTS: 2,273 abstracts were identified by the keywords search. Only four studies were included in this review. The chi-square test for heterogeneity showed that two studies were homogeneous and could be included in a meta-analysis. By combining the two studies, the odds ratio became significant: 0.29 (0.10-0.87). However, analysis on the severity of the reactions after immunotherapy showed that the benefits may not be so significant because the reactions were mostly similar to or milder than the original reaction. CONCLUSIONS: Specific immunotherapy should be recommended for adults and children with moderate to severe reactions, but there is no need to prescribe it for children with skin reactions alone, especially if the exposure is very sporadic. On the other hand, the risk-benefit relation should always be assessed in each case.

scholarly journals Efficacy and Safety of Artemether-Lumefantrine for Treatment of Uncomplicated P. Falciparum malaria in Ethiopia: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Abdulhakim Abamecha ◽  
Daniel Yilma ◽  
Wondimagegn Adissu ◽  
Delenasaw Yewhalaw ◽  
Alemseged Abdissa
Keyword(s):  
Systematic Review ◽  
Falciparum Malaria ◽  
Meta Analysis ◽  
Treatment Success ◽  
Uncomplicated Falciparum Malaria ◽  
Chi Square ◽  
Inverse Variance ◽  
Chi Square Test ◽  
Polymerase Chain ◽  
Variance Index

Abstract Background: Anti-malarial drug resistance, in particular resistance to Plasmodium falciparum, challenges the treatment and control of malaria. In Ethiopia, the first-line treatment of uncomplicated falciparum malaria has been changed from sulphadoxine-pyrimethamine (SP) to artemether-lumefantrine (AL) in 2004. To maximize efficacy of anti-malarial drugs and ensure adequate treatment outcomes; monitoring drug efficacy regularly is vital to establish rational malaria treatment guidelines. This systematic review and meta-analysis is performed to obtain an overall stronger evidence to guide management of uncomplicated falciparum malaria from the existing literature in Ethiopia after policy changes in 2004.Methods: A systematic literature search was performed using the preferred reporting items for systematic review and meta-analysis (PRISMA) from published therapeutic efficacy studies conducted in Ethiopia from 2004 to 2020. The search was performed from Pubmed, Google Scholar and Clinical trial registry databases to identify literature. Two reviewers independently assessed study eligibility and extracted data. While computing the efficacy of AL, polymerase chain reaction (PCR)-corrected cure rate (adequate clinical and parasitological response, ACPR) at 28th day was considered as the primary endpoint. Meta-analysis was computed using OpenMeta-Analysis software to calculate the pooled ACPR. Statistical heterogeneity was evaluated with the Cochran chi-square test (X2) test and inverse variance index (I2). Publication bias was analyzed using funnel plots and Egger’s test statistics. The review protocol is registered in PROSPERO, number CRD42020201859.Results: Out of studies screened, fifteen studies fulfilled the inclusion criteria, and were included in final analysis with a total number of 1523 participants. Treatment success of AL for uncomplicated falciparum malaria in all combined studies was 98.4% [(95% CI 97.6–99.1), P< 0.001]. Polymerase chain reaction (PCR)-corrected AL treatment success rate of 98.7% [(95% CI 97.7-99.6), P<0.001)]. The efficacy of AL with PCR-corrected cure rates ranging from 95.0 to 99.4% in per-protocol analysis, and 88.8 to 97.4% in intention-to-treat analysis. Based on the analysis, Cochrane chi-square test (X2) test and inverse variance index (I2) indicated that the included studies with heterogeneity (X2=20.48, (df=14), P=0.116 and I2=31.65%). The highest parasite positivity rate at day-3 was 5.7%. Adverse events ranged from mild to serious but were not directly attributed to the drug.Conclusion: The present review has shown that AL is efficacious and safe for treatment of uncomplicated malaria in Ethiopia. However, few therapeutic efficacy studies were conducted in Ethiopia after treatment guideline was revised in 2004. AL has been used more than a decade in the study population without other alternative artemisinin-based combination therapy in Ethiopia and considering that the potential evolution of drug resistance is of a great concern, regular and continuous monitoring of its efficacy is warranted.

scholarly journals Clinical and Demographic Predictors of Mortality due to COVID-19 Pandemic: A Retrospective Study

2021 ◽  
Vol 11 (5) ◽  
pp. 74-81
Author(s):  
Ayushi Rajkumar Jain ◽  
Doss Prakash ◽  
Sheetal Swamy
Keyword(s):  
Risk Factors ◽  
Mortality Rate ◽  
Early Stage ◽  
Major Complication ◽  
Respiratory Arrest ◽  
Chi Square ◽  
High Risk Factors ◽  
Demographic Predictors ◽  
Chi Square Test ◽  
The Common

The alarming statistics of COVID-19 surges up in 2021 throwing an enormous burden on the healthcare system across the world. According to WHO reports on 14th April 2021, globally 136,996,364 confirmed COVID-19 cases are reported across the continents, including 2,951,832 deaths. The state of Maharashtra reported the maximum number of cases of India including high mortality rate. This study was conducted to identify and describe the relation of different predictors (Age, gender, duration of hospital stay, presence of co morbidities) of mortality among the COVID-19 deceased patients by retrospectively analyzing the medical case records of 121 patients from a dedicated COVID hospital at Aurangabad from July 2020 to December 2020. Chi-square test was performed to assess the association between causes of death with different cluster of variables and their significance. This study helps us to identify risk factors that show association between various predictors and mortality rate in COVID-19 patients. Out of 121 deaths, 96 (79%) were male, 61 (49.6%) were in age group between 60-79 years, ARDS was one of the major complication in the deceased patients accounting 29.8% and cardio respiratory arrest was the common cause of death among the deceased patients with 85%. It was also observed that mortality rate was very higher in the initial five days of hospitalization with critical care support. Our result findings provide clinical inferences for physicians to identify high-risk factors with COVID-19 at a very early stage. Key words: COVID-19, Mortality rate, Demographic predictors, Co-morbidities, Cardio respiratory arrest.

scholarly journals Analysis of main risk factors contributing to obesity in the region of East Africa: meta-analysis

2020 ◽  
Vol 20 (1) ◽  
pp. 248-256
Author(s):  
Lenka Mařincová ◽  
Simona Šafaříková ◽  
Radka Cahlíková
Keyword(s):  
Risk Factors ◽  
East Africa ◽  
Meta Analysis ◽  
Obesity Prevalence ◽  
East African ◽  
African Region ◽  
African Countries ◽  
Chi Square ◽  
Chi Square Test ◽  
Risk Ratios

Background: Over a few decades obesity has become a major global health problem. Its prevalence worldwide has more than doubled since 1980. The situation is expected to worsen in the future, especially in the developing countries that experience nutrition transition due to economic growth. It contributes to reduction in malnutrition which supports an increase in obesity prevalence. Objectives: The aim of this study was to analyse the predictors of obesity in the region of East Africa. Methods: Meta-analysis of existing studies was used in order to find the different risk factors and their significance in obesity development. Data extracted from 16 published academic research articles described the situation in East African countries. The significance of the effect of each variable was tested by means of an asymptotic chi-square test, or Fisher's exact (factorial) test and the risk ratios were calculated. Results: Based on the chi-square test and the risk ratios of the aggregated data, three risk factors were found to be significant in the development of obesity – gender, type of residence and socio-economic status. In East African countries, women are significantly more likely to be obese. Living in an urban area and socioeconomic status are also positively associated with obesity. Because of insufficient data three other risk factors did not prove to be of any significance – alcohol consumption, smoking and education level. Conclusion: Conclusions of this meta-analysis confirm world trends but we also found results that are not in line with them (e.g. education). This meta-analysis confirms the huge existing research gap concerning obesity predictors in the East African region. Keywords: Obesity; meta-analysis; East Africa. 

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