Global Prevalence of COVID-19-Associated Mucormycosis (CAM): Living Systematic Review and Meta-Analysis

Mucormycosis, a secondary fungal infection, gained much attention in the ongoing COVID-19 pandemic. This deadly infection has a high all-cause mortality rate and imposes a significant economic, epidemiological, and humanistic burden on the patients and healthcare system. Evidence from the published epidemiological studies showed the varying prevalence of COVID-19-associated mucormycosis (CAM). This study aims to compute the pooled prevalence of CAM and other associated clinical outcomes. MEDLINE, Embase, Cochrane COVID-19 Study Register, and WHO COVID-19 databases were scanned to retrieve the relevant articles until August 2021. All studies reporting the prevalence of mucormycosis among COVID-19 patients were eligible for inclusion. Two investigators independently screened the articles against the selection criteria, extracted the data, and performed the quality assessment using the JBI tool. The pooled prevalence of CAM was the primary outcome, and the pooled prevalence of diabetes, steroid exposure, and the mortality rate were the secondary outcomes of interest. Comprehensive Meta-Analysis software version 2 was used for performing the meta-analysis. This meta-analysis comprised six studies with a pooled sample size of 52,916 COVID-19 patients with a mean age of 62.12 ± 9.69 years. The mean duration of mucormycosis onset was 14.59 ± 6.88 days after the COVID-19 diagnosis. The pooled prevalence of CAM (seven cases per 1000 patients) was 50 times higher than the highest recorded background of mucormycosis (0.14 cases per 1000 patients). A high mortality rate was found among CAM patients with a pooled prevalence rate of 29.6% (95% CI: 17.2–45.9%). Optimal glycemic control and the judicious use of steroids should be the approach for tackling rising CAM cases.

Download Full-text

Prevalence of All-Cause Mortality and Suicide among Bariatric Surgery Cohorts: A Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph15071519 ◽

2018 ◽

Vol 15 (7) ◽

pp. 1519 ◽

Cited By ~ 12

Author(s):

Russell Lim ◽

Melvyn Zhang ◽

Roger Ho

Keyword(s):

Bariatric Surgery ◽

Analytical Study ◽

Meta Analysis ◽

Well Being ◽

Mortality Rates ◽

Pooled Prevalence ◽

All Cause Mortality ◽

Bariatric Patients ◽

Post Bariatric Surgery

Introduction: Prior meta-analysis has reported mortality rates among post-operative bariatric patients, but they have not considered psychiatric factors like suicide contributing to mortality. Objectives: The current meta-analysis aims to determine the pooled prevalence for mortality and suicide amongst cohorts using reported suicides post bariatric surgery. It is also the aim of the current meta-analytical study to determine moderators that could account for the heterogeneity found. Results: In our study, the pooled prevalence of mortality in the studies which reported suicidal mortality was 1.8% and the prevalence of suicide was 0.3%. Mean body mass index (BMI) and the duration of follow-up appear to be significant moderators. Conclusions: Given the prevalence of suicide post bariatric surgery, it is highly important for bariatric teams to consider both the medical and psychiatric well-being of individuals pre- and post-operatively.

Download Full-text

A systematic literature review and meta-analysis of characterization of canine parvoviruses 2 prevalent in mainland China

Virology Journal ◽

10.1186/s12985-020-01462-3 ◽

2020 ◽

Vol 17 (1) ◽

Author(s):

Bo Dong ◽

Gaoqiang Zhang ◽

Jiajia Zhang ◽

Junyu Bai ◽

Weiming Lin

Keyword(s):

English Literature ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Mainland China ◽

Epidemiological Studies ◽

Diagnostic Methods ◽

Forest Plot ◽

Pooled Prevalence ◽

Epidemiological Characteristics

Abstract Background Canine parvovirus 2 (CPV-2) is a pathogenic virus that infects dogs, causing a highly infectious disease. Monitoring CPV-2 spread is an important part of prevention; however, the prevalence and epidemiological characteristics of CPV-2 have not been systematically evaluated and analyzed in mainland China. Therefore, a systematic review and meta-analysis were performed to assess prevalence and epidemiological characteristics of CPV-2 in domestic dogs in mainland China. Methods In this study, Chinese and English literature on CPV-2 epidemiology published between January 2006 and December 2019 was evaluated. Regarding meta-analysis, the random-effect model was employed by forest plot with 95% of confidence interval. The number of CPV-2 infections was identified and the pooled prevalence of infection, as well as the epidemiological characteristics, was calculated using meta-analysis. Results A total of 39 studies (data from 137,844 dogs) met the evaluation criteria and were used in our study. The pooled prevalence of CPV-2 infection in mainland China was 36%. CPV-2 infection were associated with age, breed, sampling season and immunization status, but not with gender, publication time and diagnostic methods. Conclusions Our results indicated that CPV-2 is prevalent among dogs in China. It is therefore necessary to carry out continuous surveillance and epidemiological studies of CPV-2. In addition, accordingly, effective measures should be taken to prevent the transmission and spread of CPV-2 among the Chinese dog population.

Download Full-text

The Protection of the Person is Central in CIOMS International Ethical Guidelines

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v3i4.449 ◽

2014 ◽

Vol 3 (4) ◽

pp. 270-272

Author(s):

Michel Vallotton ◽

Sian Fluss ◽

Gian Sjolin Forsberg

Keyword(s):

Clinical Trials ◽

Selection Criteria ◽

Meta Analysis ◽

Epidemiological Studies ◽

Nongovernmental Organization ◽

Evidence Based ◽

Ethical Guidelines ◽

The Subject ◽

Based Medicine ◽

And Storage

In this brief article the authors report on the objectives of this nongovernmental organization and, most particularly, on the protection of the person in its International Ethical Guidelines for the fields of clinical trials and epidemiological studies. They emphasize the terminology used to describe the subjects or the populations involved in these studies. They discuss the possibility and nature of harm to persons involved in such studies, and justify the requirement for informed consent also for the persons involved in epidemiological studies. Finally, they consider the roles of such trials and studies as the basis for evidence-based medicine, including cases when their results are pooled in meta-analysis. This methodology is the subject of examination by a CIOMS Working Group of problems concerning identification and selection criteria, analysis and interpretation of results (including unpublished results), and storage of data.

Download Full-text

Mortality in American Veterans with the HLA-B27 Gene

The Journal of Rheumatology ◽

10.3899/jrheum.140675 ◽

2015 ◽

Vol 42 (4) ◽

pp. 638-644 ◽

Cited By ~ 4

Author(s):

Jessica A. Walsh ◽

Xi Zhou ◽

Daniel O. Clegg ◽

Chiachen Teng ◽

Grant W. Cannon ◽

...

Keyword(s):

Mortality Rate ◽

Primary Outcome ◽

Hla B27 ◽

Test Results ◽

Mortality Difference ◽

National Cohort ◽

Inflammatory Bowel ◽

The Mean ◽

Secondary Outcomes ◽

The Difference

Objective.To compare survival in American veterans with and without the HLA-B27 (B27) gene.Methods.Mortality was evaluated in a national cohort of veterans with clinically available B27 test results between October 1, 1999, and December 31, 2011. The primary outcome was the mortality difference between B27-positive and B27-negative veterans, adjusted for age, sex, race, and diagnoses codes for diseases that may have influenced both B27 testing and mortality, including psoriasis, inflammatory bowel disease, spondyloarthritis (SpA), and other types of inflammatory arthritis. The secondary outcomes were the adjusted mortality HR for B27+ and B27− veterans, in subgroups with and without SpA.Results.Among veterans with available B27 test results, 27,652 (84.7%) were B27− and 4978 (15.3%) were B27+. The mean followup time was 4.6 years. Mortality was higher in the B27+ group than in the B27− group (HR 1.15, 95% CI 1.03–1.27). Mortality was also higher in the B27+ subgroups with SpA (HR 1.35, 95% CI 1.06–1.72) and without SpA (HR 1.11, 95% CI 0.99–1.24), but the difference was significant only in the subgroup with SpA.Conclusion.B27 positivity was associated with an increased mortality rate in a cohort of veterans clinically selected for B27 testing, after adjustment for SpA. In the subgroup with SpA, the mortality rate was associated with B27 positivity, and in the subgroup without SpA, there was a nonsignificant association between B27+ and mortality.

Download Full-text

A Meta-Analysis on the Effect of Dexamethasone on the Sugammadex Reversal of Rocuronium-Induced Neuromuscular Block

Journal of Clinical Medicine ◽

10.3390/jcm9041240 ◽

2020 ◽

Vol 9 (4) ◽

pp. 1240

Author(s):

Chang-Hoon Koo ◽

Jin-Young Hwang ◽

Seong-Won Min ◽

Jung-Hee Ryu

Keyword(s):

General Anesthesia ◽

Neuromuscular Blockade ◽

Primary Outcome ◽

Elective Surgery ◽

Neuromuscular Block ◽

Meta Analysis ◽

Secondary Outcome ◽

Continuous Variables ◽

Train Of Four ◽

The Mean

Sugammadex reverses the rocuronium-induced neuromuscular block by trapping the cyclopentanoperhydrophenanthrene ring of rocuronium. Dexamethasone shares the same steroidal structure with rocuronium. The purpose of this study was to evaluate the influence of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. Electronic databases were searched to identify all trials investigating the effect of dexamethasone on neuromuscular reversal of sugammadex after general anesthesia. The primary outcome was time for neuromuscular reversal, defined as the time to reach a Train-of-Four (TOF) ratio of 0.9 after sugammadex administration. The secondary outcome was the time to extubation after sugammadex administration. The mean difference (MD) and 95% CI were used for these continuous variables. Six trials were identified; a total of 329 patients were included. The analyses indicated that dexamethasone did not influence the time for neuromuscular reversal of sugammadex (MD −3.28, 95% CI −36.56 to 29.99, p = 0.847) and time to extubation (MD 25.99, 95% CI −4.32 to 56.31, p = 0.093) after general anesthesia. The results indicate that dexamethasone did not influence the neuromuscular reversal of sugammadex in patients after general anesthesia. Therefore, the dexamethasone does not appear to interfere with reversal of neuromuscular blockade with sugammadex in patients undergoing general anesthesia for elective surgery.

Download Full-text

Associations of total nut and peanut intakes with all-cause and cause-specific mortality in a Japanese community: the Takayama study

British Journal Of Nutrition ◽

10.1017/s0007114521002257 ◽

2021 ◽

pp. 1-23

Author(s):

Michiyo Yamakawa ◽

Keiko Wada ◽

Sachi Koda ◽

Takahiro Uji ◽

Yuma Nakashima ◽

...

Keyword(s):

Epidemiological Studies ◽

Population Based ◽

Disease Mortality ◽

Risk Of Mortality ◽

All Cause Mortality ◽

Specific Mortality ◽

The Mean ◽

Nut Intake ◽

Reduced Risk

Abstract Numerous epidemiological studies have suggested that nut intake is associated with a reduced risk of mortality. Although diets and lifestyles differ by regions or races/ethnicities, few studies have investigated the associations among non-white, non-Western populations. We evaluated the associations of total nut and peanut intakes with all-cause and cause-specific mortality in a population-based prospective cohort in Japan. Participants (age: ≥35 years at baseline in 1992; n = 31,552) were followed up until death or the end of follow-up in 2008. Those with cancer, coronary heart disease, or stroke at baseline were excluded. Dietary intake was assessed only at baseline by using a validated food frequency questionnaire. In total, 2901 men died during 183,299 person-years and 2438 women died during 227,054 person-years. The mean intakes of total nuts were 1.8 and 1.4 g/day in men and women, respectively. Although peanut intake accounted for approximately 80% of the total nut intake, total nut and peanut intakes were inversely associated with all-cause mortality in men after adjusting for all potential confounders. For example, compared with the lowest quartile category, the adjusted hazard ratio (95% confidence interval) of total nut intake for all-cause mortality in men of the highest quartile category was 0.85 (0.75–0.96) (P for trend = 0.034). Peanut intake was inversely associated with digestive disease mortality in men and cardiovascular disease mortality in women. Total nut and peanut intakes, even in low amounts, were associated with a reduced risk of mortality particularly in men.

Download Full-text

Safety and efficacy of the European Society of Cardiology 0/1-hour algorithm for diagnosis of myocardial infarction: systematic review and meta-analysis

Heart ◽

10.1136/heartjnl-2019-316343 ◽

2020 ◽

Vol 106 (13) ◽

pp. 985-991 ◽

Cited By ~ 4

Author(s):

Cho-Han Chiang ◽

Cho-Hung Chiang ◽

Gin Hoong Lee ◽

Weng-Tein Gi ◽

Yuan-Kun Wu ◽

...

Keyword(s):

Myocardial Infarction ◽

Mortality Rate ◽

European Society ◽

Primary Outcome ◽

Meta Analysis ◽

High Sensitivity ◽

Secondary Outcome ◽

Cochrane Central Register ◽

Registration Number ◽

European Society Of Cardiology

ObjectiveThe European Society of Cardiology (ESC) 0/1 hour algorithm has been primarily validated in Europe, America and Australasia with less knowledge of its performance outside of these settings. We aim to evaluate the performance of the ESC 0/1 hour algorithm across different contexts.MethodsWe searched PubMed, Embase, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials for relevant studies published between 1 January 2008 and 31 May 2019. The primary outcome was index myocardial infarction and the secondary outcome was major adverse cardiac event or mortality. A bivariate random-effects meta-analysis was used to derive the pooled estimate of each outcome.ResultsA total of 11 014 patients from 10 cohorts were analysed for the primary outcome. The algorithm based on high-sensitivity cardiac troponin (hs-cTn)T (Roche), hs-cTnI (Abbott) and hs-cTnI (Siemens) had pooled sensitivity of 98.4% (95% CI=95.1% to 99.5%), 98.1% (95% CI=94.6% to 99.3%) and 98.7% (95% CI=97.3% to 99.3%), respectively. The algorithm based on hs-cTnT (Roche) and hs-cTnI (Siemens) had pooled specificity of 91.2% (95% CI=86.0% to 94.6%) and 95.9% (95% CI=94.1% to 97.2%), respectively. Among patients in the rule-out category, the pooled mortality rate at 30 days and at 1 year was 0.1% (95% CI=0.0% to 0.4%) and 0.8% (95% CI=0.5% to 1.2%), respectively. Among patients in the observation zone, the pooled mortality rate was 0.7% (95% CI=0.3% to 1.2%) at 30 days but increased to 8.1% (95% CI=6.1% to 10.4%) at 1 year, comparable to the mortality rate in the rule-in group.ConclusionThe ESC 0/1 hour algorithm has high diagnostic accuracy but may not be sufficiently safe if the 1% miss-rate for myocardial infarction is desired.PROSPERO registration numberCRD42019142280.

Download Full-text

Weekend effects of admission and surgery in acute aortic syndrome

10.22541/au.161012777.76373255/v1 ◽

2021 ◽

Author(s):

Chao Song ◽

YunLong Fan ◽

ShiXiong Wei ◽

Shengli Jiang

Keyword(s):

Primary Outcome ◽

Meta Analysis ◽

Mortality Rates ◽

Weekend Effect ◽

Acute Aortic Syndrome ◽

Random Effects Models ◽

Acute Aortic Syndromes ◽

Increased Risk ◽

Fixed And Random Effects ◽

All Cause Mortality

Background: The weekend effect is a phenomenon characterized by increased early all-cause mortality among patients hospitalized or undergoing surgery over the weekend for emergencies. Objectives: With this meta-analysis we aimed to determine whether weekend hospitalization/surgery due to acute aortic syndromes (AAS) is associated with increased early all-cause mortality. Methods：Major electronic databases were searched for studies published up to October 2020 reporting early all-cause mortality rates for admissions/operations on weekends versus weekdays. Data were pooled using fixed- and random-effects models. The primary outcome of the study was early all-cause mortality after weekend versus weekday. Results: All the included studies were retrospective, comparative or cohort studies enrolling patients admitted or underwent surgery for AAS and reported early all-cause mortality after weekend (including holiday) versus weekday. A total of 18 studies including a total of 252807 patients were identified. This meta-analysis showed a significant increase in the early all-cause mortality for patients admitted/conducted surgery for AAS on weekends compare with weekdays (fixed-effect: OR 1.1;95% CI 1.06-1.14;P＜0.00001). Conclusion: Weekend admission/surgery for AAS is associated with a increased risk of early all-cause mortality.

Download Full-text

When More Means Less: The Prognosis of Recurrent Acute Myocardial Infarctions

Journal of Clinical Medicine ◽

10.3390/jcm10245889 ◽

2021 ◽

Vol 10 (24) ◽

pp. 5889

Author(s):

Ygal Plakht ◽

Harel Gilutz ◽

Arthur Shiyovich

Keyword(s):

Primary Outcome ◽

Risk Group ◽

High Risk Group ◽

Myocardial Infarctions ◽

Time Interval ◽

Post Discharge ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

The Mean

Recurrent acute myocardial infarctions (AMI) are common and associated with dismal outcomes. We evaluated the clinical characteristics and the prognosis of AMI survivors according to the number of recurrent AMIs (ReAMI) and the time interval of events (TI). A retrospective analysis of patients who survived following hospitalization with an AMI throughout 2002–2017 was conducted. The number of ReAMIs for each patient during the study period was recorded and classified based on following: 0 (no ReAMIs), 1, 2, ≥3. Primary outcome: all-cause mortality up to 10 years post-discharge from the last AMI. A total of 12,297 patients (15,697 AMI admissions) were analyzed (age: 66.1 ± 14.1 years, 68% males). The mean number of AMIs per patient was 1.28 ± 0.7; the rates of 0, 1, 2, ≥3 ReAMIs were 81%, 13.4%, 3.6% and 1.9%, respectively. The risk of mortality increased in patients with greater number of AMIs, HR = 1.666 (95% CI: 1.603–1.720, p < 0.001) for each additional event (study group), attenuated following adjustment for potential confounders, AdjHR = 1.135 (95% CI: 1.091–1.181, p < 0.001). Increased risk of mortality was found with short TI (<6-months), AdjHR = 2.205 (95% CI: 1.418–3.429, p < 0.001). The risk of mortality following AMI increased as the number of ReAMIs increased, and the TI between the events shortened. These findings should guide improved surveillance and management of this high-risk group of patients (i.e., ReAMI).

Download Full-text

Staphylococcus aureus

Microbiology Australia ◽

10.1071/ma08113 ◽

2008 ◽

Vol 29 (3) ◽

pp. 113

Author(s):

Graeme Nimmo ◽

Geoffrey W Coombs

Keyword(s):

Staphylococcus Aureus ◽

Mortality Rate ◽

Lower Respiratory Tract ◽

Meta Analysis ◽

Healthcare Setting ◽

Blood Stream ◽

Soft Tissue Infections ◽

Blood Stream Infections ◽

Invasive Infections ◽

The Mean

Staphylococcus aureus is one of the major bacterial pathogens of man, causing a variety of diseases from mild skin and soft-tissue infections to severe invasive infections with high mortality. In the healthcare setting it is the most frequent cause of surgical site, lower respiratory tract and cardiovascular infections and the second most common cause of blood stream infections and pneumonia. The ability of S. aureus to develop resistance to all classes of antimicrobials, in particular the �-lactams, has become a major global problem. In the pre-antibiotic era, the mortality rate for severe staphylococcal sepsis was as high as 90%. In a recent meta-analysis of nine studies of S. aureus bacteraemia in the antibiotic era, although the mean mortality rate due to methicillin-susceptible S. aureus (MSSA) was 12% (ranging from 0 to 38%), for methicillin-resistant S. aureus (MRSA) the mean was 29% (ranging from 8 to 50%). Whilst estimates vary, the mortality associated with MRSA is on average twice that with MSSA.

Download Full-text