scholarly journals Protein Substitute Requirements of Patients with Phenylketonuria on BH4 Treatment: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1040
Author(s):  
Fatma Ilgaz ◽  
Cyril Marsaux ◽  
Alex Pinto ◽  
Rani Singh ◽  
Carmen Rohde ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Normal Growth ◽  
Pharmaceutical Treatment ◽  
Restricted Diet ◽  
Traditional Treatment ◽  
Nutritional Factors ◽  
Protein Substitute ◽  
Natural Protein ◽  
Meta Analyses

The traditional treatment for phenylketonuria (PKU) is a phenylalanine (Phe)-restricted diet, supplemented with a Phe-free/low-Phe protein substitute. Pharmaceutical treatment with synthetic tetrahydrobiopterin (BH4), an enzyme cofactor, allows a patient subgroup to relax their diet. However, dietary protocols guiding the adjustments of protein equivalent intake from protein substitute with BH4 treatment are lacking. We systematically reviewed protein substitute usage with long-term BH4 therapy. Electronic databases were searched for articles published between January 2000 and March 2020. Eighteen studies (306 PKU patients) were eligible. Meta-analyses demonstrated a significant increase in Phe and natural protein intakes and a significant decrease in protein equivalent intake from protein substitute with cofactor therapy. Protein substitute could be discontinued in 51% of responsive patients, but was still required in 49%, despite improvement in Phe tolerance. Normal growth was maintained, but micronutrient deficiency was observed with BH4 treatment. A systematic protocol to increase natural protein intake while reducing protein substitute dose should be followed to ensure protein and micronutrient requirements are met and sustained. We propose recommendations to guide healthcare professionals when adjusting dietary prescriptions of PKU patients on BH4. Studies investigating new therapeutic options in PKU should systematically collect data on protein substitute and natural protein intakes, as well as other nutritional factors.

scholarly journals More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sandra Lopez-Leon ◽  
Talia Wegman-Ostrosky ◽  
Carol Perelman ◽  
Rosalinda Sepulveda ◽  
Paulina A. Rebolledo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Management Strategies ◽  
Original Data ◽  
Long Term Effects ◽  
Pooled Prevalence ◽  
Attention Disorder ◽  
Initial Recovery ◽  
Meta Analyses

AbstractCOVID-19 can involve persistence, sequelae, and other medical complications that last weeks to months after initial recovery. This systematic review and meta-analysis aims to identify studies assessing the long-term effects of COVID-19. LitCOVID and Embase were searched to identify articles with original data published before the 1st of January 2021, with a minimum of 100 patients. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. PRISMA guidelines were followed. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included (age 17–87 years). The included studies defined long-COVID as ranging from 14 to 110 days post-viral infection. It was estimated that 80% of the infected patients with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). Multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

scholarly journals Comparison of the efficacy of hematopoietic stem cell mobilization regimens: a systematic review and network meta-analysis of preclinical studies

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Chengxin Luo ◽  
Li Wang ◽  
Guixian Wu ◽  
Xiangtao Huang ◽  
Yali Zhang ◽  
...  
Keyword(s):  
Standard Dose ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Preclinical Studies ◽  
Mice Model ◽  
Short Term ◽  
Hematopoietic Stem ◽  
Support Unit ◽  
Meta Analyses

Abstract Background Mobilization failure may occur when the conventional hematopoietic stem cells (HSCs) mobilization agent granulocyte colony-stimulating factor (G-CSF) is used alone, new regimens were developed to improve mobilization efficacy. Multiple studies have been performed to investigate the efficacy of these regimens via animal models, but the results are inconsistent. We aim to compare the efficacy of different HSC mobilization regimens and identify new promising regimens with a network meta-analysis of preclinical studies. Methods We searched Medline and Embase databases for the eligible animal studies that compared the efficacy of different HSC mobilization regimens. Primary outcome is the number of total colony-forming cells (CFCs) in per milliliter of peripheral blood (/ml PB), and the secondary outcome is the number of Lin− Sca1+ Kit+ (LSK) cells/ml PB. Bayesian network meta-analyses were performed following the guidelines of the National Institute for Health and Care Excellence Decision Support Unit (NICE DSU) with WinBUGS version 1.4.3. G-CSF-based regimens were classified into the SD (standard dose, 200–250 μg/kg/day) group and the LD (low dose, 100–150 μg/kg/day) group based on doses, and were classified into the short-term (2–3 days) group and the long-term (4–5 days) group based on administration duration. Long-term SD G-CSF was chosen as the reference treatment. Results are presented as the mean differences (MD) with the associated 95% credibility interval (95% CrI) for each regimen. Results We included 95 eligible studies and reviewed the efficacy of 94 mobilization agents. Then 21 studies using the poor mobilizer mice model (C57BL/6 mice) to investigate the efficacy of different mobilization regimens were included for network meta-analysis. Network meta-analyses indicated that compared with long-term SD G-CSF alone, 14 regimens including long-term SD G-CSF + Me6, long-term SD G-CSF + AMD3100 + EP80031, long-term SD G-CSF + AMD3100 + FG-4497, long-term SD G-CSF + ML141, long-term SD G-CSF + desipramine, AMD3100 + meloxicam, long-term SD G-CSF + reboxetine, AMD3100 + VPC01091, long-term SD G-CSF + FG-4497, Me6, long-term SD G-CSF + EP80031, POL5551, long-term SD G-CSF + AMD3100, AMD1300 + EP80031 and long-term LD G-CSF + meloxicam significantly increased the collections of total CFCs. G-CSF + Me6 ranked first among these regimens in consideration of the number of harvested CFCs/ml PB (MD 2168.0, 95% CrI 2062.0−2272.0). In addition, 7 regimens including long-term SD G-CSF + AMD3100, AMD3100 + EP80031, long-term SD G-CSF + EP80031, short-term SD G-CSF + AMD3100 + IL-33, long-term SD G-CSF + ML141, short-term LD G-CSF + ARL67156, and long-term LD G-CSF + meloxicam significantly increased the collections of LSK cells compared with G-CSF alone. Long-term SD G-CSF + AMD3100 ranked first among these regimens in consideration of the number of harvested LSK cells/ml PB (MD 2577.0, 95% CrI 2422.0–2733.0). Conclusions Considering the number of CFC and LSK cells in PB as outcomes, G-CSF plus AMD3100, Me6, EP80031, ML141, FG-4497, IL-33, ARL67156, meloxicam, desipramine, and reboxetine are all promising mobilizing regimens for future investigation.

scholarly journals Fuke Qianjin Combined with Antibiotic Therapy for Pelvic Inflammatory Disease: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Yu Chen ◽  
Shaobin Wei ◽  
Li Huang ◽  
Mei Luo ◽  
Yang Wu ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Meta Analysis ◽  
Lower Abdominal Pain ◽  
Effective Rate ◽  
Chinese Patent ◽  
Meta Analyses

Background. Pelvic inflammatory disease (PID) without timely and proper treatment can cause long-term sequelae; meanwhile, patients will be confronted with the antimicrobial resistance and side effects. Chinese patent medicine as a supplement is used to treat PID with satisfactory clinical efficacy. This study evaluated the efficacy and safety of Fuke Qianjin (FKQJ) combined with antibiotics in the treatment of PID. Methods. Eight electronic databases and other resources were searched to make a collection of the randomized controlled trials (RCTs) from 1990 to 2019. The RCTs contrasting the effect of FKQJ combined with antibiotics regimens and antibiotics alone in reproductive women with PID were included. The antibiotics regimens are all recommended by the guidelines. Two reviewers independently screened the studies, extracted the data, and assessed the methodological quality of the included studies. Then, the meta-analyses were performed by RevMan 5. 3 software if appropriate. Results. Twenty-three RCTs (2527 women) were included in this review. The evidence showed that FKQJ combined with antibiotics improved the markedly effective rate compared to antibiotics alone group (RR = 1.38, 95% CI 1.27 to 1.49, I2 = 42%), shortened the improvement time of low abdominal pain (MD = −1.11, 95% CI −1.39 to −0.84, I2 = 38%), and increased the rate of lower abdominal pain improvement (RR = 1.35, 95% CI 1.19 to 1.55, I2 = 0). The implementation of adjuvant reduced the recurrent rate compared with antibiotics alone (RR = 0.27, 95% CI 0.13 to 0.56, I2 = 0%). Conclusions. Based on available evidence, FKQJ combined with antibiotics therapy have certain outcomes on increasing the markedly effective rate, decreasing the recurrent rate compared with antibiotics alone group. This therapy appears to improve lower abdominal pain and curtail the relief time. Due to the low quality and the risk of bias, any high-quality evidence or longer follow-up period should be advisable and necessary in the future.

Emotional intelligence and entrepreneurial intentions: an exploratory meta-analysis

2018 ◽  
Vol 23 (5) ◽  
pp. 497-512 ◽  
Author(s):  
Chao Miao ◽  
Ronald H. Humphrey ◽  
Shanshan Qian ◽  
Jeffrey M. Pollack
Keyword(s):  
Emotional Intelligence ◽  
Positive Relationship ◽  
Meta Analysis ◽  
Power Distance ◽  
Entrepreneurial Intention ◽  
Uncertainty Avoidance ◽  
Entrepreneurial Intentions ◽  
Content Type ◽  
Meta Analyses

Purpose The topic of entrepreneurial intention, which refers to a person’s degree of interest in creating a new business venture, has received close scrutiny in the entrepreneurship literature. The empirical results regarding the relation between emotional intelligence (EI) and entrepreneurial intention were nevertheless mixed across studies. Based on fit theory and trait activation theory, the purpose of this paper is to explain the fundamental reason for the mixed findings in the extant literature thus far. Design/methodology/approach Random-effects meta-analyses, based on 12 studies (along with 12 effect sizes), were performed to not only investigate the overall relation between EI and entrepreneurial intention but also to examine the moderators (i.e. individualism (vs collectivism), masculinity (vs femininity), power distance, long-term orientation (vs short-term orientation), uncertainty avoidance, and indulgence (vs restraint)) that influence this relation. Findings The results of this meta-analysis demonstrated that EI is positively related to entrepreneurial intention; the positive relationship between EI and entrepreneurial intention is stronger in long-term-oriented cultures; and the positive relationship between EI and entrepreneurial intention does not significantly differ based on a culture’s level of collectivism, masculinity, power distance, uncertainty avoidance, and indulgence. Originality/value This meta-analysis advances the current understanding of the relation between EI and entrepreneurial intention from cross-cultural perspectives.

Creativity in the hospitality and tourism industry: a meta-analysis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Xi Ouyang ◽  
Zhiqiang Liu ◽  
Chenglin Gui
Keyword(s):  
Meta Analysis ◽  
Uncertainty Avoidance ◽  
Tourism Industry ◽  
Employee Creativity ◽  
Content Type ◽  
Cultural Elements ◽  
Hospitality And Tourism ◽  
Using Data ◽  
Meta Analyses

Purpose Underpinned by the ability–motivation–opportunity framework, this paper aims to establish a framework of employee creativity antecedents in the hospitality and tourism industries and meta-analytically examine the magnitude of effect sizes as well as the moderating effects of cultural factors. Design/methodology/approach A meta-analysis using data from 82 independent studies was conducted to explore the hypothesized relationships and verify how they were contingent on uncertainty avoidance and long-term orientation. Findings The results supported the majority of hypotheses about the relationships between antecedents and creativity. Furthermore, they showed that the effects of intrinsic motivation, positive affect and climate for innovation on creativity in the hospitality and tourism industries were significantly larger than those reported in previous meta-analyses. It also showed that uncertainty avoidance and long-term orientation could buffer or strengthen some associations. Practical implications This study generates some essential managerial suggestions for organizations in need of innovation. Managers can learn from the results so as to effectively promote the ability, motivation and opportunity for creativity and merge cultural elements with innovation strategy when they operate globally. Originality/value This study provides a theory-based explanation for how employee creativity can be activated. To the best of the authors’ knowledge, this study is a first attempt to meta-analytically test the underlying determinants of employee creativity in the hospitality and tourism industries. Additionally, the search for boundary conditions of the proposed relationships is likely to reconcile existing conflicts and inspire future studies.

Large-scale randomized evidence: Trials and meta-analyses of trials

2020 ◽  
pp. 51-66
Author(s):  
Colin Baigent ◽  
Richard Peto ◽  
Richard Gray ◽  
Natalie Staplin ◽  
Sarah Parish ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
False Negative ◽  
Premature Deaths ◽  
Common Causes ◽  
The Common ◽  
Meta Analyses ◽  
Positive Results

Clinical trials generally need to be able to detect or to refute realistically moderate (but still worthwhile) differences between treatments in long-term disease outcome. Large-scale randomized evidence should be able to detect such effects, but medium-sized trials or medium-sized meta-analyses can, and often do, yield false-negative or exaggeratedly positive results. Hundreds of thousands of premature deaths each year could be avoided by seeking appropriately large-scale randomized evidence about various widely practicable treatments for the common causes of death, and by disseminating this evidence appropriately. This chapter takes a look at the use of large-scale randomized evidence—produced from trials and meta-analysis of trials—and how this data should be handled in order to produce accurate result.

scholarly journals Ciclosporin or Infliximab as Rescue Therapy in Acute Glucorticosteroid-Refractory Ulcerative Colitis: Systematic Review and Network Meta-Analysis

2020 ◽  
Author(s):  
Brigida Barberio ◽  
Christopher J Black ◽  
Edoardo V Savarino ◽  
Alexander C Ford
Keyword(s):  
Ulcerative Colitis ◽  
Rescue Therapy ◽  
Meta Analysis ◽  
Previous Treatment ◽  
Response To Therapy ◽  
Cochrane Central Register ◽  
Serious Adverse Events ◽  
Central Register ◽  
Meta Analyses

Abstract Background Despite randomized controlled trials [RCTs] and trial-based meta-analyses, the optimal rescue therapy for patients with acute glucorticosteroid-refractory ulcerative colitis [UC], to avoid colectomy and improve long-term outcomes, remains unclear. We conducted a network meta-analysis examining this issue. Methods We searched MEDLINE, EMBASE, EMBASE Classic and the Cochrane central register up to June 2020. We included RCTs comparing ciclosporin and infliximab, either with each other or with placebo, in patients with glucorticosteroid-refractory UC. Results We identified seven RCTs containing 534 patients [415 in head-to-head trials of ciclosporin vs infliximab]. Risk of colectomy at ≤ 1 month was reduced significantly with both treatments, compared with placebo (relative risk [RR] of colectomy with infliximab vs placebo = 0.37; 95% confidence interval [CI] 0.21–0.65, RR with ciclosporin vs placebo = 0.40; 95% CI 0.21–0.77). In terms of colectomy between > 1 month and < 1 year, both drugs ranked equally [P-score 0.75]. Neither treatment was more effective than placebo in reducing the risk of colectomy at ≥ 1 year. Both ciclosporin and infliximab were significantly more efficacious than placebo in achieving a response. Neither treatment was more effective than placebo in inducing remission, nor more likely to cause serious adverse events than placebo. Conclusions Both ciclosporin and infliximab were superior to placebo in terms of response to therapy and avoiding colectomy up to 1 year, with no significant differences in efficacy or safety between the two. Ciclosporin remains a valid option to treat refractory UC patients, especially those who do not respond to previous treatment with infliximab, or as a bridge to other biological therapies.

scholarly journals Use of Platelet-Rich Plasma for the Improvement of Pain and Function in Rotator Cuff Tears: A Systematic Review and Meta-analysis With Bias Assessment

2019 ◽  
Vol 48 (8) ◽  
pp. 2028-2041 ◽  
Author(s):  
Xiao Chen ◽  
Ian A. Jones ◽  
Ryan Togashi ◽  
Caron Park ◽  
C. Thomas Vangsness
Keyword(s):  
Rotator Cuff ◽  
Functional Outcomes ◽  
Methodological Quality ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Short Term ◽  
Vas Scores ◽  
Level 1 ◽  
Meta Analyses

Background: Many clinical trials have investigated the use of platelet-rich plasma (PRP) to treat rotator cuff–related abnormalities. Several meta-analyses have been published, but none have focused exclusively on level 1 randomized controlled trials. Purpose: To assess the efficacy of PRP for rotator cuff–related abnormalities and evaluate how specific tendon involvement, the inclusion of leukocytes, and the use of gel/nongel formulations affect pain and functional outcomes. Study Design: Systematic review and meta-analysis. Methods: The literature was screened following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Baseline, short-term, and long-term data were extracted for the Constant score, University of California, Los Angeles (UCLA) score, visual analog scale (VAS) for pain, retear rate, Simple Shoulder Test (SST), and American Shoulder and Elbow Surgeons (ASES) score. The 100-point modified Coleman Methodology Score (CMS) was used to assess methodological quality. Funnel plots and the Egger test were used to screen for publication bias, and sensitivity analysis was performed to evaluate the effect of potential outliers. Results: A total of 18 level 1 studies were included in this review, 17 (1116 patients) of which could be included in quantitative analysis. The mean modified CMS was 79.4 ± 10.39. The Constant scores of patients who received PRP were significantly better short term (weighted mean difference [WMD], 2.89 [95% CI, 0.89-4.90]; P < .01) and long term (WMD, 2.66 [95% CI, 1.13-4.19]; P < .01). The VAS scores were significantly improved short term (WMD, –0.45 [95% CI, –0.75 to −0.15]; P < .01). Sugaya grade IV and V retears in PRP-treated patients were significantly reduced long term (odds ratio [OR], 0.34 [95% CI, 0.20-0.57]; P < .01). In PRP-treated patients with multiple tendons torn, there were reduced odds of retears (OR, 0.28 [95% CI, 0.13-0.60]; P < .01). Patients who received leukocyte-rich PRP had significantly better Constant scores compared with the leukocyte-poor PRP group, but there was no difference in VAS scores. Patients receiving PRP gel reported higher Constant scores compared with the controls, whereas those receiving nongel PRP treatments did not, although there was no difference in VAS scores. Long-term odds of retears were decreased, regardless of leukocyte content (leukocyte-poor PRP: OR, 0.36 [95% CI, 0.16-0.82]; leukocyte-rich PRP: OR, 0.32 [95% CI, 0.16-0.65]; all P < .05) or usage of gel (nongel: OR, 0.42 [95% CI, 0.23-0.76]; gel: OR, 0.17 [95% CI, 0.05-0.51]; all P < .01). Conclusion: Long-term retear rates were significantly decreased in patients with rotator cuff–related abnormalities who received PRP. Significant improvements in PRP-treated patients were noted for multiple functional outcomes, but none reached their respective minimal clinically important differences. Overall, our results suggest that PRP may positively affect clinical outcomes, but limited data, study heterogeneity, and poor methodological quality hinder firm conclusions.

scholarly journals Risk of malignancies in patients with spondyloarthritis treated with biologics compared with those treated with non-biologics: a systematic review and meta-analysis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2092569
Author(s):  
Yu Heng Kwan ◽  
Ka Keat Lim ◽  
Warren Fong ◽  
Hendra Goh ◽  
Linkai Ng ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Interleukin 17 ◽  
Randomized Controlled ◽  
Risk Of Malignancy ◽  
Meta Analyses ◽  
Analytical Approaches

Background: The aim of our study was to synthesize evidence on the occurrence of malignancy in spondyloarthritis (SpA), from randomized controlled trials (RCTs) comparing biologics with non-biologics and biologics to each other. Methods: We systematically searched Medline, Cochrane Library, EMBASE, Scopus and ClinicalTrials.gov from inception until 31 October 2018. RCTs with ⩾24-week follow-up were included. We extracted data using standardized forms and assessed the risk of bias using the Cochrane Risk of Bias Tool. We performed pair-wise meta-analyses and network meta-analyses to compare the risk of malignancy for each biologics class and SpA type. We reported the Peto odds ratio (OR) of any malignancy along with 95% confidence intervals (95% CI). Bayesian posterior probabilities comparing risk of malignancy of each biologic class with non-biologics were computed as supplementary measures. Results: Fifty-four trials were included; most (44/54) had follow-up <1 year. Among 14,245 patients, 63 developed a malignancy. While most Peto ORs were >1, they had wide 95% CI and p >0.05. The overall Peto OR comparing biologics with non-biologics was 1.42 (95% CI 0.80–2.53). Only interleukin-17 inhibitors in peripheral SpA had p <0.05 (Peto OR 2.77, 95% CI 1.07–7.13); the posterior probability that the risk was higher than non-biologics was 98%. Stratified analyses revealed no consistent trend by prior exposure to biologics, duration of follow-up, study quality, study-arm crossover, analytical approaches and type of malignancy. Conclusions: Our findings indicate no overall elevated risk of malignancy with biologics in SpA. As our meta-analyses are unable to conclude on the long-term risk, long-term pharmacovigilance of biologics in SpA may still be warranted.

scholarly journals What does the latest meta-analysis really tell us about antidepressants?

2018 ◽  
Vol 27 (5) ◽  
pp. 430-432 ◽  
Author(s):  
J. Moncrieff
Keyword(s):  
Meta Analysis ◽  
Term Treatment ◽  
Significant Other ◽  
Brain Abnormality ◽  
Antidepressant Effects ◽  
Long Term Treatment ◽  
Clinically Significant ◽  
Meta Analyses ◽  
Chemical Imbalance

A recent meta-analysis of antidepressant trials is the largest conducted to date. Although it claims to prove antidepressant effectiveness beyond dispute, the main outcome is response rates, which are derived from continuous data in a process that can inflate differences between groups. The standardised mean difference of 0.3 is in line with other meta-analyses that show small differences between antidepressants and placebo that are unlikely to be clinically significant. Other factors likely to exaggerate the effects are discussed, and evidence on associations between antidepressant effects and severity and outcomes of long-term treatment is considered. Clinicians need to have open discussions with patients about the limitations of antidepressant research, the lack of evidence that antidepressants correct a chemical imbalance or other brain abnormality, and the range of adverse effects and mental and physical alterations they can produce.

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