Neurological Manifestations of Neuropathy and Ataxia in Celiac Disease: A Systematic Review

Celiac disease (CD) is an immune-mediated gastrointestinal disorder driven by innate and adaptive immune responses to gluten. Patients with CD are at an increased risk of several neurological manifestations, frequently peripheral neuropathy and gluten ataxia. A systematic literature review of the most commonly reported neurological manifestations (neuropathy and ataxia) associated with CD was performed. MEDLINE, Embase, the Cochrane Library, and conference proceedings were systematically searched from January 2007 through September 2018. Included studies evaluated patients with CD with at least one neurological manifestation of interest and reported prevalence, and/or incidence, and/or clinical outcomes. Sixteen studies were included describing the risk of gluten neuropathy and/or gluten ataxia in patients with CD. Gluten neuropathy was a neurological manifestation in CD (up to 39%) in 13 studies. Nine studies reported a lower risk and/or prevalence of gluten ataxia with a range of 0%–6%. Adherence to a gluten-free diet appeared to improve symptoms of both neuropathy and ataxia. The prevalence of gluten neuropathy and gluten ataxia in patients with CD varied in reported studies, but the increased risk supports the need for physicians to consider CD in patients with ataxia and neurological manifestations of unknown etiology.

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EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211004277 ◽

2021 ◽

pp. 174749302110042

Author(s):

Grace Mary Turner ◽

Christel McMullan ◽

Olalekan Lee Aiyegbusi ◽

Danai Bem ◽

Tom Marshall ◽

...

Keyword(s):

Systematic Review ◽

Stroke Risk ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Cochrane Library ◽

Control Group ◽

Large Sample Size ◽

Hazard Ratios ◽

Increased Risk ◽

The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

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The Prevalence of Anti-Zein Antibodies: A Comparative Study between Celiac Disease and Irritable Bowel Syndrome

Nutrients ◽

10.3390/nu13020649 ◽

2021 ◽

Vol 13 (2) ◽

pp. 649

Author(s):

Luis Alberto Sánchez-Vargas ◽

Karina Guadalupe Hernández-Flores ◽

Francisco Javier Cabrera-Jorge ◽

José María Remes-Troche ◽

Job Reyes-Huerta ◽

...

Keyword(s):

Irritable Bowel Syndrome ◽

Celiac Disease ◽

Gastrointestinal Disorder ◽

Newly Diagnosed ◽

Disease Group ◽

Immune Mediated ◽

Healthy Control ◽

Gliadin Peptides ◽

Irritable Bowel ◽

First Time

Celiac disease (CD) is a chronic immune-mediated enteropathy triggered by exposure to dietary gluten in genetically predisposed individuals. In contrast, irritable bowel syndrome (IBS) is a common functional gastrointestinal disorder affecting the large intestine, without an autoimmune component. Here, we evaluated the prevalence of IgA and IgG antibodies to maize zeins (AZA) in patients with CD and IBS. Using an in-house ELISA assay, the IgA and IgG anti-zein antibodies in the serum of 37 newly diagnosed CD (16 biopsy proved and 21 serological diagnosis) and 375 IBS patients or 302 healthy control (HC) subjects were measured. Elevated levels of IgA AZA were found in CD patients compared with IBS patients (p < 0.01) and HC (p < 0.05). CD patients had the highest prevalence (35.1%), followed by IBS (4.3%) and HCs (2.3%) (p < 0.0001). IgG AZA antibodies were not found in any CD patients, IBS patients, or HC subjects. A significant positive correlation was found between IgA AZA with IgA anti-gliadin (AGA, r = 0.34, p < 0.01) and IgA anti-deaminated gliadin peptides (DGP, r = 0.42, p < 0.001) in the celiac disease group. Taken together, our results show for the first time a higher prevalence of AZA IgA antibodies in newly diagnosed CD patients than in IBS patients, confirming a biased immune response to other gliadin-related prolamins such as maize zeins in genetically susceptible individuals.

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Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00322-3 ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Nikita Mohan ◽

Muhammad Ali Fayyaz ◽

Christopher del Rio ◽

Navpreet Kaur Rajinder Singh Khurana ◽

Sampada Sandip Vaidya ◽

...

Keyword(s):

Neurological Diseases ◽

Case Reports ◽

Healthcare Providers ◽

Case Series ◽

Altered Mental Status ◽

Common Finding ◽

Cochrane Library ◽

Neurological Manifestations ◽

The Cochrane Library ◽

Ct And Mri

Abstract Background The COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information. Objective To evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2. To identify neuro-invasive pathways of COVID infection. Methods Relevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020. Results Our review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases. Conclusion The information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.

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Assessment of the Ovarian Reserve by Serum Anti-Müllerian Hormone in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis

International Archives of Allergy and Immunology ◽

10.1159/000520133 ◽

2021 ◽

pp. 1-8

Author(s):

Xian-hui Zhang ◽

Ying-an Zhang ◽

Xin Chen ◽

Peng-yan Qiao ◽

Li-yun Zhang

Keyword(s):

Rheumatoid Arthritis ◽

Ovarian Reserve ◽

Meta Analysis ◽

Cochrane Library ◽

Dmard Treatment ◽

Standard Mean Difference ◽

Increased Risk ◽

Significant Difference ◽

Newcastle Ottawa Scale ◽

The Cochrane Library

Background: The ovarian reserve has been reported to be diminished in patients with rheumatoid arthritis. However, these results are still controversial. Anti-Müllerian hormone (AMH) is considered a reliable biomarker for the ovarian reserve. We thus performed a meta-analysis to evaluate the AMH levels and the effect of DMARDs on the ovarian reserve in rheumatoid arthritis patients. Methods: PubMed, EMBASE, the Cochrane Library, and 2 Chinese databases (CNKI and Wanfang database), up to September 2021, were searched for relevant studies. The Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies. Pooled standard mean difference (SMD) with 95% confidence intervals (CIs) were determined with the random-effects model. The heterogeneity was described by I2 statistic and p value from the Cochrane Q test. Results: Eight eligible studies (679 patients and 1,460 controls) were included in the meta-analysis. Compared with healthy control, the AMH levels in RA patients were significantly lower with the pooled SMD of −0.40 (95% CI: −0.66 to −0.14). However, in comparison of AMH with and without DMARD treatment, there was no significant difference with the pooled SMD of −0.1 (95% CI: −0.39 to 0.19). Conclusion: The results indicated that there was an increased risk of ovarian failure in RA patients and which is not related to DMARD treatment.

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Association between Atopic Dermatitis and the Metabolic Syndrome: A Systematic Review

Dermatology ◽

10.1159/000491593 ◽

2018 ◽

Vol 234 (3-4) ◽

pp. 79-85 ◽

Cited By ~ 10

Author(s):

Zarqa Ali ◽

Charlotte Suppli Ulrik ◽

Tove Agner ◽

Simon Francis Thomsen

Keyword(s):

Metabolic Syndrome ◽

Atopic Dermatitis ◽

Central Obesity ◽

Current Knowledge ◽

Positive Association ◽

Cochrane Library ◽

The Metabolic Syndrome ◽

Increased Risk ◽

Meta Analyses ◽

The Cochrane Library

Atopic dermatitis (AD) may be associated with the metabolic syndrome and by that carry an increased risk of cardiovascular disease. Our objective was to provide an update on current knowledge of the association between AD and metabolic syndrome, including each component of the metabolic syndrome. A systematic literature review was performed to identify studies investigating the association between metabolic syndrome and AD from PubMed, Embase, and the Cochrane Library in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. A total of 14 studies, investigating the association between AD and the metabolic syndrome or AD and components of metabolic syndrome fulfilled the inclusion criteria and were included. It seems unlikely that the association between AD and metabolic syndrome is causal. However, women with AD tended to have components of metabolic syndrome more often than women without AD. There was a positive association between AD and central obesity measured as waist circumference, and this association was stronger for women than men. Despite conflicting results regarding hypertension, the association between hypertension and AD also appeared stronger for women. On the other hand, the association between AD and hyperglycemia appears unlikely, and the association between AD and cholesterol levels was inconsistent. In conclusion, it remains unclear whether AD is a risk factor for metabolic syndrome and its components. However, data indicate that central obesity is associated with AD and that the association is stronger for women than men.

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Pre-operative denosumab is associated with higher risk of local recurrence in giant cell tumor of bone: a systematic review and meta-analysis

10.21203/rs.2.21735/v2 ◽

2020 ◽

Author(s):

Xi Chen ◽

Hairui Li ◽

Shibai Zhu ◽

Yiou Wang ◽

Wenwei Qian

Keyword(s):

Local Recurrence ◽

Giant Cell Tumor ◽

Giant Cell ◽

Meta Analysis ◽

Cell Tumor ◽

Cochrane Library ◽

Control Group ◽

Risk Of Recurrence ◽

Increased Risk ◽

The Cochrane Library

Abstract Background: In 2013, denosumab was introduced as peri-operative adjuvant treatment for giant cell tumor (GCT) of bone as it inhibits osteoclast activity. It is suggested that denosumab relives pain, facilitate curettage in lesions requiring resection initially. However, controversy remains whether denosumab increases the risk of local recurrence after surgery. Methods: Medline, Embase and the Cochrane Library were comprehensively searched in June 2019 to identify studies investigating the clinical outcome of GCT of bone with and without peri-operative denosumab after surgery. Data were gathered and a meta-analysis was conducted. Result: Ten studies with 1082 cases (169 in denosumab group, 913 in control group) were included. Overall, denosumab was associated with significantly higher risk of recurrence(P<0.02) and inferior 5 year recurrence free survival(P=0.000). Denosumab and curettage has a relatively higher risk of recurrence comparing to curettage alone(P=0.07). The risk of recurrence is not significantly increased if denosumab was administered both preoperatively and postoperatively(P=0.24). Conclusion: Administration of denosumab is associated with increased risk of recurrence due to a variety of reasons, though it is proven effective in relieving pain, enabling curettage and improved functional outcome. Post-operative denosumab is recommended as it continuously suppress/eliminate residue tumor cells.

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The relationship between Fas and Fas ligand gene polymorphism and preeclampsia risk

Bioscience Reports ◽

10.1042/bsr20181901 ◽

2019 ◽

Vol 39 (2) ◽

Cited By ~ 1

Author(s):

Tingting Wang ◽

Yunyun Lian

Keyword(s):

Fas Ligand ◽

Meta Analysis ◽

Cochrane Library ◽

Nucleotide Polymorphisms ◽

Multisystem Disorder ◽

Increased Risk ◽

Fasl Gene ◽

The Cochrane Library ◽

The Relationship ◽

Risk Of Preeclampsia

Abstract Preeclampsia is an idiopathic multisystem disorder with partial genetic and immunological etiology. Several studies investigated the association between various single-nucleotide polymorphisms (SNPs) in Fas and Fas ligand (FasL) genes and the risk of preeclampsia. However, they achieved inconsistent results. Therefore, we conducted a meta-analysis by systematically searching the Cochrane Library, PubMed and Embase databases and assessed this association by calculating pooled odds ratios with 95% confidence interval to reach a more trustworthy conclusion. Subgroup analyses by genotype methods and source of controls (SOC) were also conducted. Seven citations containing nine studies were included for four SNPs (Fas -670 A/G, FasL 124A/G, FasL -844C/T, Fas -1377 G/A) in this meta-analysis. Our data suggested the G allele and genotype GG of the Fas -670 A/G polymorphism, GG genotype of the FasL 124A/G polymorphism, and TT genotype of the FasL -844C/T polymorphism increased the risk of preeclampsia. Stratification analyses by genotype methods and SOC also indicated that Fas -670 A/G polymorphism was related to increased risk for preeclampsia. In conclusion, Fas and FasL gene polymorphisms play important roles in the development of preeclampsia. Further well-designed studies in other races are needed to confirm the findings of this meta-analysis.

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Differences in the roles of types 1 and 2 diabetes in the susceptibility to the risk of fracture: A systematic review and meta-analysis

10.21203/rs.3.rs-357493/v1 ◽

2021 ◽

Author(s):

Jiaqing Dou ◽

Jing Wang ◽

Qiu Zhang

Keyword(s):

Meta Analysis ◽

Indirect Comparison ◽

Excess Risk ◽

Cochrane Library ◽

Upper Arm ◽

Risk Of Fracture ◽

Comparison Results ◽

Increased Risk ◽

The Difference ◽

The Cochrane Library

Abstract Background: Diabetes mellitus (DM) causes excess risk of fracture at varied sites. Whereas, the difference between the roles of types 1 DM (T1DM) and 2 DM (T2DM) diabetes in the risk of fractures remains limited and inconclusive. We, therefore, conducted a meta-analysis to assess the differences for the associations of T1DM and T2DM with the risk of fractures.Methods: We systematically searched PubMed, Embase, and the Cochrane library for eligible studies until May 2021. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to calculate the pooled effect estimates for the associations of T1DM and T2DM with the risk of fractures using the random-effects model. An indirect comparison results for the ratio of OR (ROR) with 95% CI were also applied to assess the difference between T1DM and T2DM with the risk of fractures.Results: Twenty-two cohort studies involving a total of 6,484,851 individuals were selected for meta-analysis. We noted that T1DM was associated with an increased risk of all fractures (OR: 1.72; 95% CI: 1.36–2.19; P < 0.001), and fractures at the hip (OR: 4.01; 95% CI: 2.90–5.54; P < 0.001), upper arm (OR: 2.20; 95% CI: 1.61–3.00; P < 0.001), ankle (OR: 1.97; 95% CI: 1.24–3.14; P = 0.004), and vertebrae (OR: 2.18; 95% CI: 1.85–2.57; P < 0.001). Moreover, T2DM induced excess risk to all fractures (OR: 1.19; 95% CI: 1.09–1.31; P < 0.001), including fractures at the hip (OR: 1.25; 95% CI: 1.15–1.35; P < 0.001), upper arm (OR: 1.42; 95% CI: 1.20–1.67; P < 0.001), and ankle (OR: 1.15; 95% CI: 1.01–1.31; P = 0.029). Furthermore, we noted that T1DM versus T2DM was associated with greater risk to all fractures (ROR: 1.45; 95% CI: 1.12–1.87; P = 0.005), including fractures at the hip (ROR: 3.21; 95% CI: 2.30–4.48; P < 0.001), upper arm (ROR: 1.55; 95% CI: 1.09–2.20; P = 0.015), and ankle (ROR: 1.71; 95% CI: 1.06–2.78; P = 0.029).Conclusions: This study found that T1DM caused an excess risk to all fractures, including fractures at the hip, upper arm, and ankle than T2DM. Further studies should therefore be conducted to directly compare the differences between T1DM and T2DM with the risk of fractures at various sites.

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Tobacco and bone fractures

Bone and Joint Research ◽

10.1302/2046-3758.86.bjr-2018-0344.r1 ◽

2019 ◽

Vol 8 (6) ◽

pp. 255-265 ◽

Cited By ~ 10

Author(s):

J. Hernigou ◽

F. Schuind

Keyword(s):

Adverse Effects ◽

Animal Studies ◽

English Language ◽

Bone Fractures ◽

Cochrane Library ◽

Treatment And Prevention ◽

Increased Risk ◽

Negative Effect ◽

The Cochrane Library ◽

The Impact

Objectives The aim of this study was to review the impact of smoking tobacco on the musculoskeletal system, and on bone fractures in particular. Methods English-language publications of human and animal studies categorizing subjects into smokers and nonsmokers were sourced from MEDLINE, The Cochrane Library, and SCOPUS. This review specifically focused on the risk, surgical treatment, and prevention of fracture complications in smokers. Results Smokers have an increased risk of fracture and experience more complications with delayed bone healing, even if they have already stopped smoking, because some adverse effects persist for a prolonged period. Some risks can be reduced during and after surgery by local and general prevention, and smoking cessation is an important factor in lessening this risk. However, if a patient wants to stop smoking at the time of a fracture, the cessation strategies in reducing tobacco use are not easy to implement. The patient should also be warned that using e-cigarettes or other tobaccos does not appear to reduce adverse effects on health. Conclusion The evidence reviewed in this study shows that smoking has a negative effect in terms of the risk and treatment of fractures. Cite this article: J. Hernigou, F. Schuind. Tobacco and bone fractures: A review of the facts and issues that every orthopaedic surgeon should know. Bone Joint Res 2019;8:255–265. DOI: 10.1302/2046-3758.86.BJR-2018-0344.R1.

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Effect of Gastrointestinal Surgical Manipulation on Metabolic Syndrome: A Focus on Metabolic Surgery

Gastroenterology Research and Practice ◽

10.1155/2012/670418 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 6

Author(s):

Mario Rizzello ◽

Francesco De Angelis ◽

Fabio Cesare Campanile ◽

Gianfranco Silecchia

Keyword(s):

Bariatric Surgery ◽

Metabolic Syndrome ◽

Weight Loss ◽

Cochrane Library ◽

Increased Risk ◽

Effective Option ◽

Surgery Outcomes ◽

The Cochrane Library ◽

Surgical Manipulation ◽

Related Mortality

Metabolic syndrome is strictly associated with morbid obesity and leads to an increased risk of cardiovascular diseases and related mortality. Bariatric surgery is considered an effective option for the management of these patients. We searched MEDLINE, Current Contents, and the Cochrane Library for papers published on bariatric surgery outcomes in English from 1 January 1990 to 20 July 2012. We reported the effect of gastrointestinal manipulation on metabolic syndrome after bariatric surgery. Bariatric surgery determines an important resolution rate of major obesity-related comorbidities. Roux-en-Y gastric bypass and biliopancreatic diversion appear to be more effective than adjustable gastric banding in terms of weight loss and comorbidities resolution. However, the results obtained in terms of weight loss and resolution of comorbidities after a “new bariatric procedure” (sleeve gastrectomy) encouraged and stimulated the diffusion of this operation.

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