scholarly journals Mixed Neuroendocrine Non-Neuroendocrine Neoplasms: A Systematic Review of a Controversial and Underestimated Diagnosis

2020 ◽  
Vol 9 (1) ◽  
pp. 273 ◽  
Author(s):  
Melissa Frizziero ◽  
Bipasha Chakrabarty ◽  
Bence Nagy ◽  
Angela Lamarca ◽  
Richard A. Hubner ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Molecular Genetic ◽  
Standard Of Care ◽  
Diagnostic Methods ◽  
Neuroendocrine Neoplasms ◽  
Biological Behaviour ◽  
Dismal Prognosis ◽  
Molecular Genetic Data ◽  
Molecular Aberrations

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) represent a rare diagnosis of the gastro-entero-pancreatic tract. Evidence from the current literature regarding their epidemiology, biology, and management is of variable quality and conflicting. Based on available data, the MiNEN has an aggressive biological behaviour, mostly driven by its (often high-grade) neuroendocrine component, and a dismal prognosis. In most cases, the non-neuroendocrine component is of adenocarcinoma histology. Due to limitations in diagnostic methods and poor awareness within the scientific community, the incidence of MiNENs may be underestimated. In the absence of data from clinical trials, MiNENs are commonly treated according to the standard of care for pure neuroendocrine carcinomas or adenocarcinomas from the same sites of origin, based on the assumption of a biological similarity to their pure counterparts. However, little is known about the molecular aberrations of MiNENs, and their pathogenesis remains controversial; molecular/genetic studies conducted so far point towards a common monoclonal origin of the two components. In addition, mutations in tumour-associated genes, including TP53, BRAF, and KRAS, and microsatellite instability have emerged as potential drivers of MiNENs. This systematic review (91 full manuscripts or abstracts in English language) summarises the current reported literature on clinical, pathological, survival, and molecular/genetic data on MiNENs.

scholarly journals Comparing The Efficacy of Anti-Infectious Drugs For The Treatment of Mild To Severe COVID-19 Patients: A Protocol For A Systematic Review And Network Meta-Analysis of Randomized Clinical Trials.

2021 ◽  
Author(s):  
Dejene Tolossa Debela ◽  
Kidist Digamo Heraro ◽  
Abebaw Fekadu ◽  
Merga Belina ◽  
Tsegahun Manyazewal
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Antiviral Drug ◽  
Standard Of Care ◽  
Randomized Controlled ◽  
Primary Endpoints ◽  
Independent Review

Abstract Background: COVID-19 is a viral infection spreading at a great speed and has quickly caused an extensive burden to individuals, families, countries, and the world. No intervention has yet been proven highly effective for the treatment of COVID-19. Different drugs were being evaluated and reported through randomized clinical trials, and more are currently under trial. This review aimed to compare the efficacy of anti-infectious drugs with a comparator of the standard of care or placebo in patients with COVID-19.Methods: Two independent review authors will extract data and assess a risk of bias using RoB2. Randomized controlled trials (RCT) that evaluate single and/or combined antiviral drugs recommended by WHO latest guideline for the treatment of COVID-19 will be included. We will search for Pub Med, the Cochrane Center for Clinical Trial database (CENTRAL), clinicaltrials.gov, etc. databases for articles published in the English language between December 2019 to April 2021. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) involving Network Meta-analysis guidelines to design and report of the results. The primary endpoints will be time to clinical recovery and time to RNA negativity. The certainty of evidence will be evaluated using the GRADE extension of NMA. Data analysis will be performed using the frequentist NMA approach with the netmeta package implemented in R.Discussion: This review will reveal the best antiviral drug treatment for covid-19 and show the hierarchy of those drugs.Systematic review registration: The protocol was registered on PROSPERO with ID number CRD42021230919

scholarly journals Comparing the efficacy of anti‐infectious drugs for the treatment of mild to severe COVID-19 patients: a protocol for a systematic review and network meta-analysis of randomized clinical trials

2021 ◽  
Author(s):  
Dejene Tolossa Debela ◽  
Kidist Digamo Heraro
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
English Language ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Ethical Considerations ◽  
Primary Endpoints ◽  
Registration Number ◽  
Independent Review

Background: COVID-19 is a viral infection spreading at a great speed and has quickly caused an extensive burden to individuals, families, countries, and the world. No intervention has yet been proven highly effective for the treatment of COVID-19. Different drugs were being evaluated and reported through randomized clinical trials, and more are currently under trial. This review aimed to compare the efficacy of anti-infectious drugs with a comparator of the standard of care or placebo in patients with COVID-19. Methods and analysis: Two independent review authors will extract data and assess a risk of bias using RoB2. Randomized controlled trials (RCT) that evaluate single and/or combined antiviral drugs recommended by WHO latest guideline for the treatment of COVID-19 will be included. We will search for Pub Med, the Cochrane Center for Clinical Trial database (CENTRAL), clinicaltrials.gov, etc. databases for articles published in the English language between December 2019 to April 2021. We will follow the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) involving Network Meta-analysis guidelines for the design and reporting of the results. The primary endpoints will be time to clinical recovery and time to RNA negativity. The certainty of evidence will be evaluated using the GRADE extension of NMA. Data analysis will be performed using the frequentist NMA approach with a netmeta package implemented in R. Ethics and dissemination: There are no ethical considerations associated with this study as we will use publicly available data from previously published studies. We plan to publish results in open access peer-reviewed journals. PROSPERO registration number: ID=CRD42021230919.

scholarly journals A Systematic Review of Clinical Practice Guidelines’ Recommendations on Levothyroxine Therapy Alone versus Combination Therapy (LT4 plus LT3) for Hypothyroidism

2015 ◽  
Vol 38 (6) ◽  
pp. 305 ◽  
Author(s):  
Eyal Kraut ◽  
Pendar Farahani
Keyword(s):  
Systematic Review ◽  
Clinical Practice ◽  
Combination Therapy ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
English Language ◽  
Experimental Treatment ◽  
Standard Of Care ◽  
Mesh Terms ◽  
Pediatric Populations

Purpose: Patients with hypothyroidism are increasingly enquiring about the benefit of using combination therapy of levothyroxine (LT4) and liothyronine (LT3) as a potential treatment for hypothyroidism. Combination therapy, however, remains controversial. The purpose of this study was to systematically review available hypothyroidism treatment recommendations from clinical practice guidelines from around the world to identify the consensus regarding combination therapy. Source: Clinical practice guidelines were obtained from searches of PubMed, EMBASE, and MEDLINE, using several combinations of MeSH terms. The search was limited to clinical guidelines in English-language publications, published between January 1, 1990 and May 1, 2015. A quantitative approach was utilized for data synthesis. Principal Findings: Thirteen guidelines were identified, including three regarding pregnancy, two regarding pediatric populations and eight regarding adult populations. There were six guidelines from North America, four guidelines from Europe and three guidelines from South America. Twelve of the guidelines were published after 2010. Nine guidelines addressed combination therapy of LT4 plus LT3, and all nine concluded that LT4 therapy alone is the standard of care, with insufficient evidence to recommend widespread combination therapy. Only the 2012 ETA Guidelines and the 2015 BTA Guidelines concluded that combination therapy could be used, although only in certain circumstances and as an experimental treatment. Conclusion: This systematic review illustrates that clinical practice guidelines worldwide do not recommend and do not support routine use of combination LT4 and LT3 therapy to treat hypothyroidism.

scholarly journals Prognostic Indicators and Treatment Strategies for Diffuse Midline Glioma: a Systematic Review

2021 ◽  
Author(s):  
Michael Fiorino ◽  
Nathan Kostick ◽  
Caroline Baughn ◽  
Alexander Bolufer ◽  
Takuma Iwai ◽  
...  
Keyword(s):  
Systematic Review ◽  
English Language ◽  
Treatment Plan ◽  
Treatment Strategies ◽  
Prognostic Indicators ◽  
Search Term ◽  
Medical Subject Headings ◽  
Therapeutic Modalities ◽  
Dismal Prognosis ◽  
Diffuse Midline Glioma

Abstract IntroductionDiffuse Midline Gliomas (DMGs) are a class of grade IV gliomas associated with a very dismal prognosis. Despite many decades of research, a cure for DMG has yet to be found. In this paper, we will review the drugs and therapeutic techniques published in the scientific literature for DMG.MethodsA comprehensive search of current literature was conducted in MEDLINE/PubMed. Relevant studies were identified among those in the English language published after 1990 to the present. The Medical Subject Headings (MeSH) search term consisted of the singular phrase “diffuse midline glioma”. Prior to completion of the full-text review, a total of 298 articles were identified as of 26 April 2021. For this systematic review, 20 studies were included after review.ResultsRecent genetic testing has identified a H3K27M mutation that is characteristic of DMGs. This finding has helped pave the way in developing new therapeutic agents and techniques for DMG. Although these newer drugs and therapeutic modalities have not been shown to cure DMG, some of them have been shown to increase overall survival and reduce symptom severity in select patients.ConclusionsAt this point in time, there is no best treatment agent/modality for patients with DMG; rather, the treatment plan should be tailored to the patient’s specific type of DMG. More research is needed to develop better therapeutics and provide improved outcomes to patients.

Liver embolisation for patients diagnosed with neuroendocrine neoplasms: systematic review and meta-analysis of the literature

2019 ◽  
Author(s):  
Rahul Kanabar ◽  
Jorge Barriuso ◽  
Mairead McNamara ◽  
Was Mansoor ◽  
Richard Hubner ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Neuroendocrine Neoplasms

Chasing the Anchor: A Systematic Review and Meta-analysis of Perceptual Anchoring Deficits in Developmental Dyslexia

2020 ◽  
Author(s):  
Kurt D Shulver ◽  
Nicholas A Badcock
Keyword(s):  
Systematic Review ◽  
Reading Ability ◽  
English Language ◽  
Prediction Interval ◽  
Meta Analysis ◽  
Visual Assessment ◽  
Individual Performance ◽  
Future Research ◽  
Significant Heterogeneity ◽  
Eligibility Criteria

We report the results of a systematic review and meta-analysis investigating the relationship between perceptual anchoring and dyslexia. Our goal was to assess the direction and degree of effect between perceptual anchoring and reading ability in typical and atypical (dyslexic) readers. We performed a literature search of experiments explicitly assessing perceptual anchoring and reading ability using PsycInfo (Ovid, 1860 to 2020), MEDLINE (Ovid, 1860 to 2019), EMBASE (Ovid, 1883 to 2019), and PubMed for all available years up to June (2020). Our eligibility criteria consisted of English-language articles and, at minimum, one experimental group identified as dyslexic - either by reading assessment at the time, or by previous diagnosis. We assessed for risk of bias using an adapted version of the Newcastle-Ottawa scale. Six studies were included in this review, but only five (n = 280 participants) were included in the meta-analysis (we were unable to access the necessary data for one study).The overall effect was negative, large and statistically significant; g = -0.87, 95% CI [-1.47, 0.27]: a negative effect size indicating less perceptual anchoring in dyslexic versus non-dyslexic groups. Visual assessment of funnel plot and Egger’s test suggest minimal bias but with significant heterogeneity; Q (4) = 9.70, PI (prediction interval) [-2.32, -0.58]. The primary limitation of the current review is the small number of included studies. We discuss methodological limitations, such as limited power, and how future research may redress these concerns. The variability of effect sizes appears consistent with the inherent variability within subtypes of dyslexia. This level of dispersion seems indicative of the how we define cut-off thresholds between typical reading and dyslexia populations, but also the methodological tools we use to investigate individual performance.

Covid-19 and Autoimmune Diseases: A Systematic Review of Reported Cases

2020 ◽  
Vol 16 ◽  
Author(s):  
Mariam Ahmed Saad ◽  
Mostafa Alfishawy ◽  
Mahmoud Nassar ◽  
Mahmoud Mohamed ◽  
Ignatius N Esene ◽  
...  
Keyword(s):  
Systematic Review ◽  
Autoimmune Disease ◽  
Kawasaki Disease ◽  
Autoimmune Diseases ◽  
English Language ◽  
Clinical Evidence ◽  
Eligibility Criteria ◽  
Thrombocytopenic Purpura ◽  
Pubmed Database ◽  
Viral Illness

Introduction: Over 4.9 million cases of Coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide pandemic began. Since the emergence of COVID-19, a number of confirmed cases reported autoimmune manifestations. Herein, we reviewed the reported COVID-19 cases with associated autoimmune manifestations. Methods: We searched PubMed database using all available keyword for COVID-19. All related studies between January 1st, 2020 to May 22nd, 2020 were reviewed. Only studies published in English language were considered. Articles were screened based on titles and abstract. All reports of confirmed COVID-19 patients who have associated clinical evidence of autoimmune disease were selected. Results: Among 10006 articles, searches yielded, Thirty-two relevant articles for full-text assessment. Twenty studies meet the eligibility criteria. The twenty eligible articles reported 33 cases of confirmed COVID-19 diagnosis who developed an autoimmune disease after the onset of covid-19 symptoms. Ages of patients varied from a 6 months old infant to 89 years old female (Mean=53.9 years of 28 cases); five cases had no information regarding their age. The time between symptoms of viral illness and onset of autoimmune symptoms ranged from 2 days to 33 days (Mean of the 33 cases=9.8 days). Autoimmune diseases were one case of subacute thyroiditis (3%), two cases of Kawasaki Disease (6.1%), three cases of coagulopathy and antiphospholipid syndrome (9.1%), three cases of immune thrombocytopenic purpura (9.1%), eight cases of autoimmune hemolytic anemia (24.2%), and sixteen cases of Guillain–Barré syndrome (48.5%). Conclusions: COVID-19 has been implicated in the development in a range of autoimmune diseases which may shed a light on the association between autoimmune diseases and infections.

Effectiveness of mHealth Interventions on Physical Activity and Physical Fitness in Outpatient and Home-Based Cardiac Rehabilitation Programs: A Systematic Review (Preprint)

2019 ◽  
Author(s):  
Sheeba Nadarajah ◽  
Susan Buchholz ◽  
Kristen Dickins
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Physical Fitness ◽  
Cardiac Rehabilitation ◽  
Text Messaging ◽  
English Language ◽  
Rehabilitation Program ◽  
Cardiac Rehabilitation Program ◽  
Mixed Effect ◽  
Home Based

BACKGROUND Globally, cardiovascular disease is the leading cause of death. Cardiovascular mortality can be decreased by participation in cardiac rehabilitation. Researchers are exploring the use of mHealth technology in cardiac rehabilitation. OBJECTIVE The aim of this systematic review is to examine the effectiveness of randomized controlled trials that use a mHealth intervention as a part of an outpatient and/or home-based cardiac rehabilitation program on improving physical activity and physical fitness outcomes. METHODS For this systematic review, mHealth interventions were limited to text messaging, mobile apps, and use of a mobile phone network for data transmission, used to deliver cardiac rehabilitation program. Using six databases, the search strategy included published English language studies through 2016. Data was extracted independently by two reviewers, and then synthesized. RESULTS The initial search yielded 149 articles, of which 15 articles that represented nine studies met inclusion criteria. Articles were published from 2010 to 2016 and came from two continents. The majority (84%) of participants were male. Generally, the participant mean age was late 50s to early 60s. Text messaging was the most frequently used intervention. The results of the physical activity and physical fitness findings were mixed. Effect sizes for intervention as measured by the 6-minute walk test ranged from 0.46 to 0.58 and peak VO2 ranged from 0.03 to 1.35. CONCLUSIONS Globally, use of mHealth in outpatient and/or home-based cardiac rehabilitation is being studied with greater attention. However, these studies are limited by geography, gender, and age. Therefore, further research in the area of cardiac rehabilitation and mHealth is recommended, especially in developing countries, among women, and older adults.

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