scholarly journals Immunoglobulin Response and Prognostic Factors in Repeated SARS-CoV-2 Positive Patients: A Systematic Review and Meta-Analysis

Viruses ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 809
Author(s):  
Fanni Dembrovszky ◽  
Szilárd Váncsa ◽  
Nelli Farkas ◽  
Bálint Erőss ◽  
Lajos Szakó ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Immunoglobulin M ◽  
First Episode ◽  
And Gender ◽  
Mean Differences ◽  
Immunoglobulin Response

With repeated positivity being an undiscovered and major concern, we aimed to evaluate which prognostic factors may impact repeated SARS-CoV-2 positivity (RSP) and their association with immunoglobulin detectability among recovered patients. A systematic literature search was performed on 5 April 2021. Cohort studies with risk factors for repeated RSP or information about the immunoglobulin response (immunoglobulin M (IgM) and/or immunoglobulin G (IgG)) were included in this analysis. The main examined risk factors were severity of the initial infection, body mass index (BMI), length of hospitalization (LOH), age, and gender, for which we pooled mean differences and odds ratios (ORs). Thirty-four cohort studies (N = 9269) were included in our analysis. We found that increased RSP rate might be associated with IgG positivity; IgG presence was higher in RSP patients (OR: 1.72, CI: 0.87–3.41, p = 0.117). Among the examined risk factors, only mild initial disease course showed a significant association with RSP (OR: 0.3, CI: 0.14–0.67, p = 0.003). Age, male gender, BMI, LOH, and severity of the first episode do not seem to be linked with repeated positivity. However, further prospective follow-up studies focusing on this topic are required.

scholarly journals Predictors of Post-Thrombotic Syndrome (PTS) in Pediatric Thrombosis: A Systematic Review and Meta-Analysis of the Literature

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3806-3806 ◽  
Author(s):  
Elissa Engel ◽  
Manuela Albisetti ◽  
Leonardo R. Brandao ◽  
Ernest Amankwah ◽  
Anthony Nguyen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Prognostic Factors ◽  
Prognostic Factor ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Factors Associated ◽  
Post Thrombotic Syndrome ◽  
Statistical Heterogeneity

Abstract BACKGROUND: Post-thrombotic syndrome (PTS) is the most common long-term complication in pediatric deep venous thrombosis (DVT), affecting approximately 25% of children with an extremity DVT. PTS leads to a high physical, psychological and financial burden in affected patients. Although several risk factors have been associated with the development of pediatric PTS, few of them have been validated in the pediatric literature. A better understanding of the prognostic factors leading to PTS is a vital step for early identification of those children at greatest risk in order to develop risk-stratified interventions aimed at preventing this complication. AIM: To perform a systematic review and meta-analysis of available published evidence from the pediatric literature on prognostic factors for pediatric PTS. METHODS: A systematic search of MEDLINE, EMBASE, and the Cochrane Library from 1960 to December 2017 was performed. MeSH terms and search strategy employed were as follows: "postthrombotic syndrome" OR "postphlebitic syndrome" AND "all child 0-18 years" AND "young adult 19-24 years". A study was eligible for inclusion if it evaluated the development of PTS in pediatric patients (<21 years of age) with a confirmed extremity DVT and reported on at least one prognostic factor for the development of PTS. Single case reports, narrative reviews, and commentaries were excluded. Studies assessing the efficacy/safety of thrombolysis, and studies including patients >21 years of age with outcomes not reported by age group, were also excluded. Two reviewers independently screened all studies and extracted the data of interest. Data were analyzed using STATA v.15 statistical software. Meta-analyses were conducted for risk factors reported in at least three studies. Summary odds ratios (ORs) and 95% confidence intervals (CI) were calculated from the effect estimates from the individual studies using a random effects model. Statistical heterogeneity was quantified by I2 statistic. RESULTS: A total of 12 studies met the final inclusion criteria (Figure 1), nine cohort studies, two cross-sectional studies, and one case-control study. These studies reported a total of 1,160 patients with venous thromboembolism (VTE), of whom 938 (81%) were assessed for PTS (Table 1). Median age across studies ranged from 0.02 - 15.5 years. VTE was considered provoked in nearly 80% of patients. The most common reported risk factor for VTE was the presence of a central venous catheter (CVC, 54%) followed by congenital heart disease (26%). PTS was diagnosed in 46% (n=434) of patients with an extremity DVT. The median time from DVT diagnosis to PTS diagnosis ranged from 12 to 33 months across studies. Among studies reporting this information, mild PTS was most frequently diagnosed, followed by moderate and severe PTS (35%, 5% and 0.6% of patients respectively). Most common prognostic factors associated with PTS in individual studies included patient characteristics: age and gender; and DVT characteristics: recurrent DVT, symptomatic DVT, DVT degree of occlusion, and time between DVT diagnosis and PTS assessment. Three studies investigated the association of elevated factor VIII and d-dimer levels with PTS. Elevated levels of these biomarkers were found to be associated with development of adverse VTE outcomes in one study but this finding was not confirmed in the other studies. Meta-analysis of reported prognostic factors identified the presence of a CVC and occlusive DVT as significant risk factors for the development of pediatric PTS (OR= 1.8, 95%CI=1.08-2.98, and OR=1.89, 95%CI=1.04-3.46 respectively; Figure 2). CONCLUSION: Among 12 studies evaluating prognostic factors for PTS in children and meeting criteria for this meta-analysis, CVC-related DVT and complete occlusion were associated with pediatric PTS. Overall, high-quality evidence on pediatric PTS is lacking. Collaborative prospective cohort studies and trials that use validated pediatric PTS measures and standardized prognostic factor definitions are needed to better understand the risk factors associated with PTS. Disclosures No relevant conflicts of interest to declare.

scholarly journals O9.6. SYSTEMATIC REVIEW AND META-ANALYSIS OF THE EFFECTS OF CANNABIS USE IN ADOLESCENCE ON IQ IN LONGITUDINAL STUDIES ACCOUNTING PRE-EXPOSURE BASELINE PERFORMANCE

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S23-S23
Author(s):  
Emmet Power ◽  
Sophie Sabherwal ◽  
Aisling O’Neill ◽  
Colm Healy ◽  
David Cotter ◽  
...  
Keyword(s):  
Young People ◽  
Cohort Studies ◽  
Longitudinal Studies ◽  
Drug Exposure ◽  
Meta Analysis ◽  
Cannabis Use ◽  
First Episode ◽  
Control Group ◽  
Case Group

Abstract Background Cannabis use in adolescence is a known risk factor for developing schizophrenia. Decline in intellectual functioning is a well-studied phenomenon of schizophrenia. Schizophrenia in its first classification was conceptualized as a dementia - ‘Dementia Praecox’ indicating a dominance of effect of cognitive symptoms on functioning at that time. First episode psychosis patients with histories of cannabis use compared to those without cannabis use have superior cognitive functioning suggesting different disease phenotypes. Our aim was to investigate whether cannabis had an effect on full scale IQ in general population samples to further inform understanding of this disease pathway. Methods We developed a search strategy through an iterative approach with a qualified information specialist. We searched three databases: Medline, Embase and PsychInfo. We included conference abstracts and full text publications in English. We contacted authors for additional information in cases where an effect size was not calculable. We included longitudinal studies of non-help-seeking young people in the community with a pre-drug exposure standardized measure of IQ prior to the age of 18 and a comparable measure at subsequent follow up. We defined the case group as individuals with a history of heavy cannabis use (more than 25 lifetime uses, at least weekly use for 6 months and/or meeting criteria for a cannabis use disorder) and the control group as similar young people who had no or very minimal experimental exposure to cannabis (&lt;5 lifetime uses). Two reviewers independently extracted the data and assessed for bias using the Newcastle-Ottawa risk of bias tool. We performed random effects meta-analysis in Stata version 14 given expected heterogeneity in measurement of cannabis use across studies. Results We identified 7 cohort studies detailed in 6 reports including over 650 subjects and 5600 controls. Study designs included twin cohorts, representative cluster sampled community cohorts and birth cohort studies. Range of follow up was between 2 and 23 years. All studies showed relative decline in IQ of which two were statistically significant. Our findings show that cannabis use in youth is associated with modest IQ differences that equate to approximately to a 2-point decrease in young cannabis users. Studies examining twin pairs showed that twins discordant for cannabis use did not have divergent cognitive trajectories, however these analyses were relatively underpowered to find an effect. Discussion Our findings demonstrate the harmful effects of cannabis use on brain development in young people. These findings are of public health importance and provide further evidence for the detrimental effects of early cannabis use on mental health and cognition.

Abstract P209: Heterogeneity of Absolute/Relative Measures of Cardiovascular Mortality Among Cohorts in an Individual Participant Data Meta-Analysis: An EPOCH-JAPAN Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Yoshitaka Murakami ◽  
Tomonori Okamura ◽  
Katsuyuki Miura ◽  
Hirotsugu Ueshima ◽  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cohort Studies ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Individual Participant Data ◽  
Individual Participant ◽  
Rate Ratios ◽  
Meta Analyses

Introduction: Individual participant data (IPD) meta-analyses involve participant-level data from multiple cohort studies. However, these cohorts have different periods (years) of follow-up, target regions, and distributions of risk factors (including patient age). It remains unclear if these variations affect the heterogeneity of absolute/relative measures of mortality in cardiovascular disease (CVD), stroke, and coronary heart disease (CHD) among cohorts. Hypothesis: There is diverse heterogeneity in absolute measures of mortality, but negligible heterogeneity in relative measures among cohorts in IPD meta-analyses. Methods: The Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) study is an IPD meta-analysis of cardiovascular epidemiology. This project comprises 14 cohort studies with 105,945 Japanese subjects (total CVD deaths: 5,314). First, we examined the correlation between the follow-up periods of the baseline surveys and multivariate-adjusted mortality rates (CVD, stroke, and CHD) among the cohorts. Next, we estimated the cohort-specific mortality rates that adjusted for the stated follow-up periods, regions, age, and other risk factors using Poisson regression. Finally, we explored the heterogeneity of multivariate-adjusted mortality rates, mortality rate ratios, and rate ratios of 10-mmHg increases in systolic blood pressure using Higgins’s I 2 , which measures heterogeneity in meta-analyses. Results: High correlations were observed between the stated follow-up periods of the cohorts and their mortality rates (CVD [men, -0.70; women, -0.79], stroke [men, -0.65; women, -0.73], CHD [men, -0.24; women, -0.89]). In the multivariate-adjusted mortality rates, we observed clear heterogeneity in mortality rates among the cohorts (CVD [I 2 : men, 98.6%; women, 99.3%], stroke [I 2 : men, 98.5%; women, 98.3%], and CHD [I 2 : men, 98.2%; women 92.4%]). In the rate ratio comparison of 10-mmHg increases in systolic blood pressure, no heterogeneity was detected among the cohorts (CVD [I 2 : men, 0.0%; women, 17.9%]). Our results indicated that the ratio measure, which shows the magnitude of each risk factor, was stable even in the heterogeneity of absolute measures. Conclusions: A clear heterogeneity in mortality was observed in absolute measures, but not in relative measures, among cohorts after adjusting for the periods of follow-up, regions, and other risk factors.

scholarly journals Predictors of lost to follow up from antiretroviral therapy among adults in sub-Saharan Africa: a systematic review and meta-analysis

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Hafte Kahsay Kebede ◽  
Lillian Mwanri ◽  
Paul Ward ◽  
Hailay Abrha Gesesew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Sub Saharan Africa ◽  
Hiv Care ◽  
Care Services ◽  
Validity Assessment ◽  
Sub Saharan ◽  
Lost To Follow Up

Abstract Background It is known that ‘drop out’ from human immunodeficiency virus (HIV) treatment, the so called lost-to-follow-up (LTFU) occurs to persons enrolled in HIV care services. However, in sub-Saharan Africa (SSA), the risk factors for the LTFU are not well understood. Methods We performed a systematic review and meta-analysis of risk factors for LTFU among adults living with HIV in SSA. A systematic search of literature using identified keywords and index terms was conducted across five databases: MEDLINE, PubMed, CINAHL, Scopus, and Web of Science. We included quantitative studies published in English from 2002 to 2019. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was used for methodological validity assessment and data extraction. Mantel Haenszel method using Revman-5 software was used for meta-analysis. We demonstrated the meta-analytic measure of association using pooled odds ratio (OR), 95% confidence interval (CI) and heterogeneity using I2 tests. Results Thirty studies met the search criteria and were included in the meta-analysis. Predictors of LTFU were: demographic factors including being: (i) a male (OR = 1.2, 95% CI 1.1–1.3, I2 = 59%), (ii) between 15 and 35 years old (OR = 1.3, 95% CI 1.1–1.3, I2 = 0%), (iii) unmarried (OR = 1.2, 95% CI 1.2–1.3, I2 = 21%), (iv) a rural dweller (OR = 2.01, 95% CI 1.5–2.7, I2 = 40%), (v) unemployed (OR = 1.2, 95% CI 1.04–1.4, I2 = 58%); (vi) diagnosed with behavioral factors including illegal drug use(OR = 13.5, 95% CI 7.2–25.5, I2 = 60%), alcohol drinking (OR = 2.9, 95% CI 1.9–4.4, I2 = 39%), and tobacco smoking (OR = 2.6, 95% CI 1.6–4.3, I2 = 74%); and clinical diagnosis of mental illness (OR = 3.4, 95% CI 2.2–5.2, I2 = 1%), bed ridden or ambulatory functional status (OR = 2.2, 95% CI 1.5–3.1, I2 = 74%), low CD4 count in the last visit (OR = 1.4, 95% CI 1.1–1.9, I2 = 75%), tuberculosis co-infection (OR = 1.2, 95% CI 1.02–1.4, I2 = 66%) and a history of opportunistic infections (OR = 2.5, 95% CI 1.7–2.8, I2 = 75%). Conclusions The current review identifies demographic, behavioral and clinical factors to be determinants of LTFU. We recommend strengthening of HIV care services in SSA targeting the aforementioned group of patients. Trial registration Protocol: the PROSPERO Registration Number is CRD42018114418

“Outcome evaluation of fruit and vegetables distribution interventions in schools: A systematic review and meta-analysis”

2021 ◽  
pp. 1-34
Author(s):  
M. R. Ismail ◽  
J. A. Seabrook ◽  
J. A. Gilliland
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Population Based ◽  
Outcome Evaluation ◽  
Fruit And Vegetables ◽  
Post Intervention ◽  
Health Strategy ◽  
Rigorous Study ◽  
Mean Differences

Abstract Objective: Fruit and vegetables (FVs) distribution interventions have been implemented as a public health strategy to increase children’s intake of FVs at school settings. The purpose of this review was to examine whether snack-based FVs distribution interventions can improve school-aged children’s consumption of FVs. Design: Systematic Review and meta-analysis of articles published in English, in a peer-review journals were identified by searching six databases up to August 2020. Standardized Mean Differences (SMDs) and 95% Confidence Interval (CI) were calculated using a random effects model. Heterogeneity was quantified using I2 statistics. Setting: Population-based studies of interventions where the main focus was the effectiveness of distributed FVs as snacks to schoolchildren in North America, Europe and Pacific were included. Results: Forty-seven studies, reporting on 15 different interventions, were identified; 10 studies were included in the meta-analysis. All interventions were effective in increasing children’s consumption of FVs, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children’s consumption of FVs, particularly for multi-component interventions at post-intervention (SMD 0.20, CI 0.13, 0.27) and free distribution interventions at follow-up (SMD 0.19, CI 0.12, 0.27). Conclusions: Findings suggest that utilizing FV distribution interventions provide a promising avenue by which children’s consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration, and follow-up evaluation are needed to improve comparability across studies.

scholarly journals Disease stability and extended dosing under anti-VEGF treatment of exudative age-related macular degeneration (AMD) — a meta-analysis

2021 ◽  
Author(s):  
Justus G. Garweg ◽  
Christin Gerhardt
Keyword(s):  
Macular Degeneration ◽  
Meta Analysis ◽  
Subretinal Fluid ◽  
Age Related Macular Degeneration ◽  
Pubmed Central ◽  
Age Related ◽  
Interval Extension ◽  
Second Year ◽  
Mean Differences

Abstract Purpose To assess disease stability (absence of intra- and/or subretinal fluid) and the portion of eyes being capable to extend their treatment interval to ≥ 12 weeks in exudative age-related macular degeneration (AMD). Methods A systematic literature search was performed in NCBI, PubMed, CENTRAL, and ClinicalTrials.gov to identify clinical studies reporting treatment outcomes for ranibizumab, aflibercept, and brolucizumab in exudative AMD under a treat-and-extend protocol and a follow-up of ≥ 12 months. Weighted mean differences and subgroup comparisons were used to integrate the different studies. Results This meta-analysis refers to 29 published series, including 27 independent samples and 5629 patients. In the pooled group, disease stability was reported in 62.9% and 56.0%, respectively, after 12 and 24 months of treatment, whereas treatment intervals were extended to ≥ 12 weeks in 37.7% and 42.6%, respectively. Ranibizumab, aflibercept, and brolucizumab differed regarding their potential to achieve disease stability (56.3%, 64.5%, and 71.5% after 12, and 50.0%, 52.7% and 75.7% after 24 months; p = < 0.001) and to allow an interval extension to ≥ 12 weeks (28.6%, 34.2%, and 53.3% after 12, and 34.2%, 47.7%, and 41.7% after 24 months; p = < 0.001). Conclusion The portion of eyes achieving disease stability regressed in the second year, whereas the portion of eyes under a ≥ 12-week interval increased. This discrepancy may reflect the challenges in balancing between under-treatment and a reduced treatment burden.

Impact of the Bag Exchange Procedure on Risk of Peritonitis

2010 ◽  
Vol 30 (4) ◽  
pp. 440-447 ◽  
Author(s):  
Jie Dong ◽  
Yuan Chen
Keyword(s):  
Risk Factors ◽  
Peritoneal Dialysis ◽  
Cox Regression ◽  
Face Mask ◽  
First Episode ◽  
Independent Risk Factors ◽  
Randomized Control ◽  
The Relationship ◽  
Control Study

ObjectiveWe studied whether improper bag exchange predicts the first peritonitis episode in continuous ambulatory peritoneal dialysis (CAPD) patients.Patients and MethodsOur single-center prospective observational study of 130 incident urban CAPD patients who started peritoneal dialysis (PD) between March 2005 and August 2008 aimed to determine the relationship between bag exchange procedures examined at the 6th month of PD and risk for a first peritonitis episode. All patients were followed until a first peritonitis episode, censoring, or the end of the study.ResultsThese 130 patients experienced 22 first peritonitis episodes during the 14-month follow-up. During bag exchange evaluation, 51.5% of patients washed their hands improperly, 46.2% failed to check expiration date or bag leakage, and 11.5% forgot to wear a face mask and cap. Patients experiencing peritonitis were more likely to forget to wear a face mask and cap. In multivariate Cox regression model, not wearing a face mask and cap [hazard ratio (HR): 7.26; 95% confidence interval (CI): 2.6 to 20.1; p < 0.001] and having anemia (HR: 0.96; 95% CI: 0.94 to 0.99; p = 0.005) were independent risk factors for a first episode of peritonitis.ConclusionsNot wearing a face mask and cap and having anemia were independent risk factors for peritonitis. A further randomized control study needs to verify the correlation between improper bag exchange technique and peritonitis in PD patients.

scholarly journals Causes of Raynaud’s phenomenon and the predictive laboratory and capillaroscopy features for the evolution to a definite connective tissue disease

Rheumatology ◽  
2021 ◽  
Author(s):  
Saeedeh Shenavandeh ◽  
Mehrnoush Ajri ◽  
Sahand Hamidi
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Retrospective Cohort ◽  
Predictive Marker ◽  
Number Of Patients ◽  
Laboratory Results ◽  
Secondary Causes ◽  
Scleroderma Pattern

Abstract Objective In patients with RP, capillaroscopy is useful for discriminating primary from secondary causes. There are certain capillaroscopy and lab values as predictive factors leading to a known CTD. We conducted the present study to evaluate the causes of RP in our area and followed the studied subjects to find prognostic factors indicating a definite CTD or remaining a UCTD. Methods In this retrospective cohort study we included all adult patients with RP who were referred for capillaroscopy from 2010 to 2019. All the patients with primary and secondary RP with follow-up were evaluated for demography, laboratory results and capillaroscopy to find the risk factors of their progression to a CTD. Results A total of 760 of 776 patients were included, with 679 being female (89.3%) and 81 (10.7%) male. There were 660 subjects (90.8%) with secondary RP [mostly UCTD (48.2%) and then SSc (16.4%)] and 67 (9.2%) with primary RP; 109 patients were followed up and 42 (42%) of those with secondary RP developed a definite CTD. The scleroderma pattern and some capillary changes on capillaroscopy and/or positive ANA had statistically significant differences for CTD transition. Conclusion We had a small number of patients with primary RP. The most prevalent causes of secondary RP in our patients were UCTD and SSc. Some capillaroscopy and laboratory results alone or in combination could be used as a predictive marker for the transition of patients with UCTD to CTD.

scholarly journals Alcohol use and personality trait change: pooled analysis of six cohort studies

2018 ◽  
Vol 49 (2) ◽  
pp. 224-231 ◽  
Author(s):  
Christian Hakulinen ◽  
Markus Jokela
Keyword(s):  
Alcohol Use ◽  
Cohort Studies ◽  
Personality Traits ◽  
Personality Trait ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Emotional Stability ◽  
Risky Alcohol ◽  
Average Alcohol

AbstractBackgroundPersonality has been associated with alcohol use, but less is known about how alcohol use may influence long-term personality trait change.MethodsThe present study examines associations between alcohol use and change in the five major personality traits across two measurement occasions (mean follow-up of 5.6 years). A total of 39 722 participants (54% women) were pooled from six cohort studies for an individual-participant meta-analysis. Alcohol use was measured as (1) average alcohol consumption, (2) frequency of binge drinking, (3) symptoms of alcohol use disorder, and (4) a global indicator of risky alcohol use. Changes in the five major personality traits (extraversion, emotional stability, agreeableness, conscientiousness, and openness to experience) were used as outcomes.ResultsRisky alcohol use was associated with increasing extraversion [0.25 T-scores over the mean follow-up of 5.6 years; 95% confidence interval (CI) 0.07–0.44] and decreasing emotional stability (−0.28; 95% CI −0.48 to −0.08), agreeableness (−0.67; 95% CI −0.87 to −0.36), and conscientiousness (−0.58; 95% CI −0.79 to −0.38). Except the association between alcohol use and extraversion, these associations were consistent across cohort studies and across different measures of alcohol use.ConclusionsThese findings suggest that alcohol use is associated with personality trait changes in adulthood.

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