Can Vaccination Trigger Autoimmune Disorders? A Meta-Analysis

Vaccination as an important tool in the fight against infections has been suggested as a possible trigger of autoimmunity over the last decades. To confirm or refute this assumption, a Meta-analysis of Autoimmune Disorders Association With Immunization (MADAWI) was conducted. Included in the meta-analysis were a total of 144 studies published in 1968–2019 that were available in six databases and identified by an extensive literature search conducted on 30 November 2019. The risk of bias classification of the studies was performed using the Newcastle–Ottawa Quality Assessment Scale. The strength of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation. While our primary analysis was conducted in terms of measures of association employed in studies with a low risk of bias, the robustness of the MADAWI outcome was tested using measures independent of each study risk of bias. Additionally, subgroup analyses were performed to determine the stability of the outcome. The pooled association of 0.99 (95% confidence interval, 0.97–1.02), based on a total of 364 published estimates, confirmed an equivalent occurrence of autoimmune disorders in vaccinated and unvaccinated persons. The same level of association reported by studies independently of the risk of bias was supported by a sufficient number of studies, and no serious limitation, inconsistency, indirectness, imprecision, and publication bias. A sensitivity analysis did not reveal any discrepancy in the primary result. Current common vaccination is not the cause of any of the examined autoimmune disorders in the medium and long terms.

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Platinum-based neoadjuvant chemotherapy for triple-negative breast cancer: a systematic review and meta-analysis

Journal of International Medical Research ◽

10.1177/0300060520964340 ◽

2020 ◽

Vol 48 (10) ◽

pp. 030006052096434

Author(s):

Zhen-Yu Li ◽

Zhen Zhang ◽

Xiao-Zhong Cao ◽

Yun Feng ◽

Sha-Sha Ren

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Meta Analysis ◽

Complete Response ◽

Extensive Literature ◽

Extensive Literature Search ◽

Positive Breast Cancer

Background Triple-negative breast cancer (TNBC) is associated with higher aggressiveness and mortality than hormone-positive breast cancer because of the lack of approved therapeutic targets. Patients with TNBC who attain a pathological complete response (pCR) after neoadjuvant chemotherapy have improved survival. Platinum-based agents show promising activity in TNBC; however, their use remains controversial. We conducted a meta-analysis to assess the role of platinum-based agents in neoadjuvant chemotherapy in patients with TNBC. Methods We performed an extensive literature search of the Pubmed, Embase, and Cochrane databases. We calculated pooled odds ratios (OR) with 95% confidence intervals (CI) for the identified studies. Results Eight randomized controlled trials with 1345 patients were included in the analysis. The addition of platinum-based agents improved pCR compared with neoadjuvant therapy based on anthracyclines, cyclophosphamide, taxanes, and fluorouracil (49.1% vs. 35.9%; OR: 1.87, 95% CI: 1.23–2.86). Hematological adverse events were similar in both groups, except for more thrombocytopenia in the platinum-based group (OR: 7.96, 95% CI: 3.18–19.93). Conclusion The addition of platinum-based agents to neoadjuvant chemotherapy improved pCR rates in patients with TNBC, with a slight increase in hematological toxicities. Platinum-based agents might thus be an accessible and economically viable option in patients with TNBC.

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Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9103179 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3179 ◽

Cited By ~ 1

Author(s):

Daniel Cabanillas-Balsera ◽

Juan J. Segura-Egea ◽

María C. Jiménez-Sánchez ◽

Victoria Areal-Quecuty ◽

Benito Sánchez-Domínguez ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Collaboration ◽

Risk Of Bias ◽

Smoking Habits ◽

Assessment Development ◽

Negative Prognostic Factor ◽

Reported Data ◽

Teeth Extraction

Aim: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. Material and Methods: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. Results: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17–10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. Conclusions: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution.

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Intra-articular corticosteroids for treatment of temporomandibular joint internal disorders: protocol for systematic review and network meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034327 ◽

2020 ◽

Vol 10 (9) ◽

pp. e034327

Author(s):

Daniela Torres ◽

Carlos Zaror ◽

Verónica Iturriaga ◽

Aurelio Tobias

Keyword(s):

Minimally Invasive ◽

Temporomandibular Joint ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Minimally Invasive Therapy ◽

Risk Of Bias ◽

The Body ◽

Cochrane Library ◽

Invasive Therapy ◽

Assessment Development

IntroductionInternal temporomandibular joint (TMJ) disorders are present in approximately 80% of patients with symptomatic temporomandibular disorders. Among the minimally invasive therapies, we find the intra-articular infiltration of substances, such as corticosteroids, hyaluronic acid or platelet-rich plasma accompanied or not by an arthrocentesis. There are several studies on minimally invasive therapy for internal TMJ disorders; however, none compares the effectiveness of the different intra-articular corticosteroids to each other.The purpose of this study is to evaluate the effectiveness of the different intra-articular corticosteroids for the treatment of internal disorders of the TMJ and compare them to each other or to other minimally invasive therapies.Methods and analysisA systematic search will be carried out up to December 2019 in the electronic databases: Medline, Cochrane Library, EMBASE, SCOPUS and LILACS.Randomised clinical trials evaluating patients with internal disorders of the TMJ, with intra-articular corticosteroid therapy and comparing these to each other and/or to other minimally invasive therapy will be included. The main outcomes will be pain and range of motion measured through validated scales.Two review authors will independently screen search results, extract data from included studies and assess the risk of bias in those studies using the Revised Cochrane Risk of Bias Tool (RoB 2.0). In the case of any discrepancy and failure to reach consensus, this will be resolved by a third reviewer.A network meta-analysis will be conducted based on direct comparisons to generate indirect comparisons of the different treatments. Data will be combined in a meta-analysis using a random effects model.The principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system will be used to assess the overall quality of the body of evidence associated with the main results.Ethics and disseminationThis protocol will not require ethical approval. The results of this review will be disseminated through peer-reviewed publications.Trial registration numberCRD42019129014.

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Association between a soy-based infant diet and the onset of puberty: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0251241 ◽

2021 ◽

Vol 16 (5) ◽

pp. e0251241

Author(s):

Flávia Ramos Kazan Oliveira ◽

Ana Flora Silva e Gustavo ◽

Renan Braga Gonçalves ◽

Fernanda Bolfi ◽

Adriana Lúcia Mendes ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Age At Menarche ◽

Random Effects Model ◽

Voice Change ◽

Assessment Development ◽

Infant Diet ◽

Age Range ◽

Menarche Age

The objective of this systematic review was to evaluate the association between a soy-based infant diet and the onset of puberty. We included studies in which children were fed a soy-based diet, and we compared them with those who were not. The primary outcomes were the onset of puberty in girls (thelarche, pubarche, and menarche age), boys (pubarche, voice change, testicular and penis enlargement age), and both (risk of delayed and precocious puberty [PP]). Search strategies were performed in PubMed, Embase, LILACS, and CENTRAL databases. Two reviewers selected eligible studies, assessed the risk of bias, and extracted data from the included studies. The odds ratio (OR) and mean difference (MD) were calculated with a 95% confidence interval (CI) as a measure of the association between soy consumption and outcomes. We used a random-effects model to pool results across studies and the Grading of Recommendations Assessment, Development, and Evaluation to evaluate the certainty of evidence. We included eight studies in which 598 children consumed a soy-based diet but 2957 did not. The primary outcomes that could be plotted in the meta-analysis were the risk of PP and age at menarche. There was no statistical difference between groups for PP (OR: 0.51, 95% CI: 0.09 to 2.94, 3 studies, 206 participants, low certainty of evidence). No between-group difference was observed in menarche age (MD 0.14 years, 95% CI -0.16 to 0.45, 3 studies, 605 children, low certainty of evidence). One study presented this outcome in terms of median and interquartile range, and although the onset of menarche was marginally increased in girls who received a soy-based diet, the reported age was within the normal age range for menarche. We did not find any association between a soy-based infant diet and the onset of puberty in boys or girls. Trial Registration: PROSPERO registration: CRD42018088902.

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Lisfranc injuries: fix or fuse?

Bone & Joint Open ◽

10.1302/2633-1462.210.bjo-2021-0127.r1 ◽

2021 ◽

Vol 2 (10) ◽

pp. 842-849

Author(s):

Noortje Anna Clasina van den Boom ◽

Guido A. N. L. Stollenwerck ◽

Laureanne Lodewijks ◽

Jeroen Bransen ◽

Silvia M. A. A. Evers ◽

...

Keyword(s):

Meta Analysis ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Risk Of Bias ◽

Level Of Evidence ◽

Assessment Development ◽

Significant Difference ◽

Patient Reported ◽

Mean Differences ◽

Lisfranc Injuries

Aims This systematic review and meta-analysis was conducted to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA) in the treatment of Lisfranc injuries, regarding patient-reported outcome measures (PROMs), and risk of secondary surgery. The aim was to conclusively determine the best available treatment based on the most complete and recent evidence available. Methods A systematic search was conducted in PubMed, Cochrane Controlled Register of Trials (CENTRAL), EMBASE, CINAHL, PEDro, and SPORTDiscus. Additionally, ongoing trial registers and reference lists of included articles were screened. Risk of bias (RoB) and level of evidence were assessed using the Cochrane risk of bias tools and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The random and fixed-effect models were used for the statistical analysis. Results A total of 20 studies were selected for this review, of which 12 were comparative studies fit for meta-analysis, including three randomized controlled trials (RCTs). This resulted in a total analyzed population of 392 patients treated with ORIF and 249 patients treated with PA. The mean differences between the two groups in American Orthopedic Foot and Ankle Society (AOFAS), VAS, and SF-36 scores were -7.41 (95% confidence interval (CI) -13.31 to -1.51), 0.77 (95% CI -0.85 to 2.39), and -1.20 (95% CI -3.86 to 1.46), respectively. Conclusion This is the first study to find a statistically significant difference in PROMs, as measured by the AOFAS score, in favour of PA for the treatment of Lisfranc injuries. However, this difference may not be clinically relevant, and therefore drawing a definitive conclusion requires confirmation by a large prospective high-quality RCT. Such a study should also assess cost-effectiveness, as cost considerations might be decisive in decision-making. Level of Evidence: I Cite this article: Bone Jt Open 2021;2(10):842–849.

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Are polypropylene mesh implants associated with systemic autoimmune inflammatory syndromes? A systematic review

Hernia ◽

10.1007/s10029-021-02553-y ◽

2022 ◽

Author(s):

C. R. Kowalik ◽

S. E. Zwolsman ◽

A. Malekzadeh ◽

R. M. H. Roumen ◽

W. A. R. Zwaans ◽

...

Keyword(s):

Systematic Review ◽

Inguinal Hernia ◽

Pelvic Floor ◽

Meta Analysis ◽

Systemic Disease ◽

Autoimmune Disorders ◽

Risk Of Bias ◽

Autoimmune Response ◽

Cochrane Library ◽

Pelvic Floor Surgery

Abstract Purpose The surgical implantation of polypropylene (PP) meshes has been linked to the occurrence of systemic autoimmune disorders. We performed a systematic review to determine whether PP implants for inguinal, ventral hernia or pelvic floor surgery are associated with the development of systemic autoimmune syndromes. Methods We searched Embase, Medline, Web of Science, Scopus, Cochrane library, clinicaltrialsregister.eu, clinicaltrails.gov and WHO-ICTR platform. Last search was performed on November 24th 2021. All types of studies reporting systemic inflammatory/autoimmune response in patients having a PP implant for either pelvic floor surgery, ventral or inguinal hernia repair were included. Animal studies, case reports and articles without full text were excluded. We intended to perform a meta-analysis. The quality of evidence was assessed with the Newcastle–Ottawa Scale. This study was registered at Prospero (CRD42020220705). Results Of 2137 records identified, 4 were eligible. Two retrospective matched cohort studies focused on mesh surgery for vaginal prolapse or inguinal hernia compared to hysterectomy and colonoscopy, respectively. One cohort study compared the incidence of systemic conditions in women having urinary incontinence surgery with and without mesh. These reports had a low risk of bias. A meta-analysis showed no association when comparing systemic disease between mesh and control groups. Calculated risk ratio was 0.9 (95% CI 0.82–0.98). The fourth study was a case series with a high risk of bias, with a sample of 714 patients with systemic disease, 40 of whom had PP mesh implanted. Conclusion There is no evidence to suggest a causal relationship between being implanted with a PP mesh and the occurrence of autoimmune disorders.

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Use of convalescent plasma in patients with coronavirus disease (Covid-19): Systematic review and meta-analysis

10.1101/2021.02.14.20246454 ◽

2021 ◽

Author(s):

Fernando Tortosa ◽

Gabriela Carrasco ◽

Martin Ragusa ◽

Pedro Haluska ◽

Ariel Izcovich

Keyword(s):

Systematic Review ◽

Randomized Clinical Trials ◽

Meta Analysis ◽

Invasive Mechanical Ventilation ◽

Standard Of Care ◽

Risk Of Bias ◽

Current Evidence ◽

Assessment Development ◽

Treatment Standard ◽

Study Selection

AbstractObjetivesTo assess the effects of convalescent plasma treatment in patients with coronavirus disease (COVID-19).Study designSystematic review and Meta-analysisData sourcesA systematic search was carried out on the L · OVE (Living OVerview of Evidence) platform for COVID-19 until October 31, 2020Study selectionRandomized clinical trials in which people with probable or confirmed COVID-19 were randomized to drug treatment, standard care, or placebo. Pairs of reviewers independently screened potentially eligible articles.MethodsThe PRISMA guidelines were followed for conducting a systematic review and meta-analysis. The risk of bias of the included studies was assessed using the Cochrane risk of bias tool 2.0, and the certainty of the evidence using the recommendation assessment, development and evaluation (GRADE) approach. For each outcome, the interventions were classified into groups, from most to least beneficial or harmful.ResultsWe identified 10 RCTs (randomized controlled trials) involving 11854 patients in which convalescent plasma was compared with standard of care or other treatments. The results of five RCTs that evaluated the use of convalescent plasma in patients with COVID-19 did not show significant differences in the effect on mortality and the need for invasive mechanical ventilation.ConclusionsCurrent evidence is insufficient to recommend the use of convalescent plasma in the treatment of moderate or severe COVID-19.Contribution of the authors

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Feeding in neonates with antenatal doppler abnormalities- a systematic review and meta-analysis

10.21203/rs.3.rs-1163424/v1 ◽

2021 ◽

Author(s):

Rajendra Prasad Anne ◽

Abhishek S Aradhya ◽

Srinivas Murki

Keyword(s):

Meta Analysis ◽

Risk Of Bias ◽

Preterm Neonates ◽

Study Objective ◽

Assessment Development ◽

Evaluation Approach ◽

Increased Risk ◽

Late Initiation ◽

Hospital Acquired ◽

The Impact

Abstract Preterm neonates with antenatal doppler abnormalities are at increased risk of necrotizing enterocolitis (NEC). In these neonates, we did a meta-analysis to compare the impact of early versus late initiation of feeding, and slow versus rapid feed advancement on the important neonatal outcomes. The databases of PubMed, Embase, Cochrane central, CINAHL and google scholar were searched on 6th September 2020. We included all randomized controlled trials addressing the study objective(s). The risk of bias was assessed using the Risk of Bias tool, version 2. Certainty of evidence was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Early feeding did not increase the incidence of NEC stage 2 or more (odds ratio/OR 1.27, 95% confidence interval/CI 0.83, 1.96; 6 studies, 772 participants) and mortality (OR 0.79, 95% CI 0.4, 1.57; 3 studies, 498 participants). A trend was noted towards an increased incidence of feeding intolerance (OR 1.37, 95% CI 0.98, 1.92). There was a significant reduction in time to reach full feeds, duration of total parental nutrition, duration of hospital stay, and rates of hospital-acquired infections. The time to regain birth weight was not different. Rapid feed advancement decreased the time to reach full feeds, without affecting other outcomes. The overall certainty of the evidence was rated low. Heterogeneity was not significant. Conclusion: There is low-certainty evidence to recommend early feed initiation in preterm neonates with antenatal doppler abnormalities. The data is insufficient to make a recommendation on the rapidity of feed advancement.

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Implementation of the WHO’s collaborative framework for the management of tuberculosis and diabetes: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-047342 ◽

2021 ◽

Vol 11 (11) ◽

pp. e047342

Author(s):

Rita Suhuyini Salifu ◽

Mbuzeleni Hlongwa ◽

Khumbulani Hlongwana

Keyword(s):

Scoping Review ◽

Meta Analysis ◽

Extensive Literature ◽

Joint Management ◽

Rural And Urban ◽

The Press ◽

Complete Health ◽

Extensive Literature Search ◽

Narrative Report ◽

Academic Search

ObjectiveTo map evidence on the implementation of the WHO’s collaborative framework for the management of tuberculosis (TB) and diabetes mellitus (DM) comorbidity, globally.DesignScoping review.MethodsGuided by Arksey and O’Malley’s scoping review framework, this review mapped literature on the global implementation of the framework for the management of TB and DM comorbidity, globally. An extensive literature search for peer-reviewed studies, theses, studies in the press and a list of references from the selected studies was conducted to source-eligible studies. PubMed, Google Scholar, Web of Science, Science Direct, the EBSCOhost platform (academic search complete, health source: nursing/academic edition, CINAHL with full text), Scopus and the WHO library were used to source the literature. We performed title screening of articles using keywords in the databases, after which two independent reviewers (RS and PV) screened abstracts and full articles. Studies from August 2011 to May 2021 were included in this review and the screening was guided by the inclusion and exclusion criteria. Findings were analysed using the thematic content analysis approach and results presented in the form of a narrative report. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension was used as a checklist and for explaining the scoping review process.ResultsThis review found evidence of the WHO TB-DM collaborative framework’s implementation in 35 countries across the globe. TB-DM comorbidity was identified in patients through bidirectional screening of both patients with TB and patients with DM in rural and urban settings.ConclusionDue to the paucity of evidence on mechanisms of collaboration, we recommend further research in other implementing countries to identify techniques used for diagnosis and integration of TB and DM services, in order to ensure that effective and joint management of TB-DM comorbidity in populations is achieved.

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Prognostic value of YKL-40 in solid tumors: a meta-analysis of 41 cohort studies

Cancer Cell International ◽

10.1186/s12935-019-0983-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Bingxian Bian ◽

Li Li ◽

Junyao Yang ◽

Yi Liu ◽

Guohua Xie ◽

...

Keyword(s):

Solid Tumors ◽

Fixed Effects ◽

Prognostic Value ◽

Meta Analysis ◽

Elevated Serum ◽

Tumor Development ◽

Extensive Literature ◽

Poor Survival ◽

Prognostic Effect ◽

Extensive Literature Search

Abstract Background Serum/plasma YKL-40 can be a useful index that is associated with tumor development. However, the prognostic value of serum/plasma YKL-40 in patients with solid tumors is still unclear. We aimed to utilize the existing literature to investigate the prognostic value of serum/plasma YKL-40 in solid tumors. Methods An extensive literature search for relevant studies was conducted with the Embase, Medline and Web of Science databases. The effect on survival was measured with the hazard ratio (HR). Then, pooled HRs and 95% confidence intervals (CIs) were calculated using the random and fixed-effects models according to the heterogeneity of the included studies. Results This meta-analysis was based on 41 publications and comprised a total of 7762 patients with solid tumors. The pooled HR showed that elevated serum/plasma YKL-40 was significantly associated with poor OS (HR, 1.44; 95% CI 1.33–1.56). We also found that elevated serum/plasma YKL-40 had significant prognostic effects on OS in various cancer subgroups such as gastrointestinal tumors (HR, 1.37; 95% CI 1.18–1.58), ovarian cancer (HR, 2.27; 95% CI 1.69–3.06), melanoma (HR, 1.77; 95% CI 1.18–2.67), lung cancer (HR, 1.73; 95% CI 1.35–2.23), urologic neoplasms (HR, 1.61; 95% CI 1.08–2.40) and glioblastoma (HR, 1.23; 95% CI 1.07–1.42); in contrast, the prognostic effect of serum/plasma YKL-40 was not statistically significant in breast cancer (HR, 1.07; 95% CI 0.98–1.17). Conclusions The available evidence supports the hypothesis that elevated serum/plasma YKL-40 is associated with poor survival in patients with solid tumors and that serum/plasma YKL-40 may serve as a novel prognostic biomarker.

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