The difference of prognosis between gastric carcinoma with neuroendocrine components and pure gastric neuroendocrine carcinoma compared with gastric carcinoma: a meta-analysis

Background: We compared relapse-free survival (RFS) in gastric neuroendocrine carcinoma (WHO grade 3) and gastric carcinoma (GC). This is one of very few studies that compare the prognosis of poorly differentiated neuroendocrine carcinoma (WHO grade 3, G3 NEC) with that of GC. Methods: Between 1996 and 2014, 63 patients were diagnosed with G3 NEC of the stomach and 56 with gastric neuroendocrine tumors (NETs) with GC at Asan Medical Center in Seoul, Korea. We also randomly selected 762 patients diagnosed with GC between 1999 and 2008. Results: Patients with G3 NEC tumors that invaded the muscularis propria or shallower had poorer RFS than those with GC of the same type, while G3 NEC that invaded the subserosa or deeper had similar RFS to GC of that type. Patients diagnosed with G3 NEC with N0 or N2 had poorer RFS than the corresponding patients with GC, while those who had G3 NEC with N1 or N3 had similar RFS to the corresponding patients with GC. G3 NEC patients had poorer RFS than well-differentiated, moderately differentiated and poorly differentiated GC patients, while G3 NEC patients had similar RFS to that of those with signet ring cell carcinoma (SRC). In addition, patients with G3 NEC of stages I or IIa had poorer RFS than those with corresponding GC, while G3 NEC stage IIb or greater had similar RFS to the corresponding GC. Conclusions: Non-advanced G3 NEC showed poorer RFS than GC excluding SRC, while advanced G3 NEC has a similar RFS to that of GC without SRC. Therefore, we recommend that patients with non-advanced G3 NEC of the stomach be given a more aggressive treatment and surveillance than those with non-advanced GC excluding SRC.

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Relationship between total plasma homocysteine and the risk of aneurysms – a meta-analysis

VASA ◽

10.1024/0301-1526/a000891 ◽

2020 ◽

pp. 1-6

Author(s):

Hanji Zhang ◽

Dexin Yin ◽

Yue Zhao ◽

Yezhou Li ◽

Dejiang Yao ◽

...

Keyword(s):

Large Scale ◽

Meta Analysis ◽

Single Species ◽

Total Plasma ◽

Control Groups ◽

Randomized Controlled ◽

Randomized Controlled Studies ◽

The Difference ◽

The Relationship ◽

Healthy Participants

Summary: Our meta-analysis focused on the relationship between homocysteine (Hcy) level and the incidence of aneurysms and looked at the relationship between smoking, hypertension and aneurysms. A systematic literature search of Pubmed, Web of Science, and Embase databases (up to March 31, 2020) resulted in the identification of 19 studies, including 2,629 aneurysm patients and 6,497 healthy participants. Combined analysis of the included studies showed that number of smoking, hypertension and hyperhomocysteinemia (HHcy) in aneurysm patients was higher than that in the control groups, and the total plasma Hcy level in aneurysm patients was also higher. These findings suggest that smoking, hypertension and HHcy may be risk factors for the development and progression of aneurysms. Although the heterogeneity of meta-analysis was significant, it was found that the heterogeneity might come from the difference between race and disease species through subgroup analysis. Large-scale randomized controlled studies of single species and single disease species are needed in the future to supplement the accuracy of the results.

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Age Differences in Eye Movements During Reading: Degenerative Problems or Compensatory Strategy?

European Psychologist ◽

10.1027/1016-9040/a000344 ◽

2019 ◽

Vol 24 (4) ◽

pp. 297-311

Author(s):

José David Moreno ◽

José A. León ◽

Lorena A. M. Arnal ◽

Juan Botella

Keyword(s):

Eye Movements ◽

Eye Movement ◽

Meta Analysis ◽

Age Groups ◽

Behavioral Changes ◽

Aging Effects ◽

Movement Data ◽

Sentence Reading ◽

The Difference ◽

Eye Movements During Reading

Abstract. We report the results of a meta-analysis of 22 experiments comparing the eye movement data obtained from young ( Mage = 21 years) and old ( Mage = 73 years) readers. The data included six eye movement measures (mean gaze duration, mean fixation duration, total sentence reading time, mean number of fixations, mean number of regressions, and mean length of progressive saccade eye movements). Estimates were obtained of the typified mean difference, d, between the age groups in all six measures. The results showed positive combined effect size estimates in favor of the young adult group (between 0.54 and 3.66 in all measures), although the difference for the mean number of fixations was not significant. Young adults make in a systematic way, shorter gazes, fewer regressions, and shorter saccadic movements during reading than older adults, and they also read faster. The meta-analysis results confirm statistically the most common patterns observed in previous research; therefore, eye movements seem to be a useful tool to measure behavioral changes due to the aging process. Moreover, these results do not allow us to discard either of the two main hypotheses assessed for explaining the observed aging effects, namely neural degenerative problems and the adoption of compensatory strategies.

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Regional differences in mortality rates during the COVID-19 epidemic in Italy

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.486 ◽

2020 ◽

pp. 1-22

Author(s):

Danila Azzolina ◽

Giulia Lorenzoni ◽

Luciano Silvestri ◽

Ilaria Prosepe ◽

Paola Berchialla ◽

...

Keyword(s):

Regional Differences ◽

Southern Italy ◽

Meta Analysis ◽

Analysis Data ◽

Mortality Rates ◽

Northern Italy ◽

Admission Rates ◽

Considerable Impact ◽

The Difference ◽

Disease Diffusion

Abstract Objective The COVID-19 outbreak started in Italy on February 20th, 2020, and has resulted in many deaths and intensive care unit (ICU) admissions. This study aimed to illustrate the epidemic COVID-19 growth pattern in Italy by considering the regional differences in disease diffusion during the first three months of the epidemic. Study design and methods Official COVID-19 data were obtained from the Italian Civil Protection Department of the Council of Ministers Presidency. The mortality and ICU admission rates per 100 000 inhabitants were calculated at the regional level and summarized via a Bayesian multilevel meta-analysis. Data were retrieved until April 21st, 2020. Results The highest cumulative mortality rates per 100 000 inhabitants were observed in northern Italy, particularly in Lombardia (85.3, 95% credibility intervals [CI] 75.7–94.7). The difference in the mortality rates between northern and southern Italy increased over time, reaching a difference of 67.72 (95% CI = 66–67) cases on April 2nd. Conclusions Northern Italy showed higher and increasing mortality rates during the first three months of the epidemic. The uncontrolled virus circulation preceding the infection spreading in southern Italy had a considerable impact on system burnout. This experience demonstrates that preparedness against the pandemic is of crucial importance to contain its disruptive effects.

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Endothelial nitric oxide synthase polymorphism and venous thromboembolism: A meta-analysis of 9 studies involving 3993 subjects

Phlebology The Journal of Venous Disease ◽

10.1177/02683555211016626 ◽

2021 ◽

pp. 026835552110166

Author(s):

Guangbin Huang ◽

Xuejun Deng ◽

Yanan Xu ◽

Pan Wang ◽

Tao Li ◽

...

Keyword(s):

Nitric Oxide ◽

Venous Thromboembolism ◽

Nitric Oxide Synthase ◽

Endothelial Nitric Oxide Synthase ◽

Meta Analysis ◽

Enos Polymorphism ◽

The Difference ◽

Oxide Synthase ◽

Endothelial Nitric Oxide ◽

Intron 4

Background Endothelial nitric oxide synthase (eNOS) polymorphism may influence the risk of venous thromboembolism (VTE). However, data from published studies with low statistical power are inconclusive. The present meta-analysis aimed to assess the relationship between eNOS polymorphism and the risk of VTE. Method Case-control studies evaluating the association between the eNOS polymorphism and VTE were searched in PubMed, Embase, Web of Science, Google Scholar, Wanfang, Chinese National Knowledge Infrastructure (CNKI), the Chongqing VIP Chinese Science and Technology Periodical Database (VIP), and Chinese Biomedical Literature Database (CBM). Results A total of 1588 cases and 2405 controls from 9 studies were included in the analysis. The results showed that eNOS G894T polymorphism was related to VTE susceptibility and the difference was statistically significant [T vs G: OR = 1.41, 95% CI (1.13, 1.75), P = 0.002; TT + GG vs TG: OR = 0.71, 95% CI (0.60, 0.84), P = 0.000; TT + TG vs GG: OR = 1.45, 95% CI (1.23, 1.70), P = 0.000]. Additionally, eNOS Intron 4 VNTR polymorphism was related to VTE susceptibility and the difference was statistically significant [4b4b vs 4a4a + 4a4b: OR = 2.77, 95% CI (1.01, 7.61), P = 0.048]. Conclusion ENOS G894T and eNOS Intron 4 VNTR polymorphisms were associated with VTE susceptibility, especially in Asian populations. However, multicenter studies with larger samples should be conducted to further clarify this association and verify our findings.

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Effects of Dexmedetomidine as an Analgesic Adjuvant for Surgery of Femur Fracture: A Systematic Review and Meta-Analysis

Pharmacology ◽

10.1159/000515788 ◽

2021 ◽

pp. 1-9

Author(s):

Shan Deng ◽

Yonghao Yu

Keyword(s):

Femur Fracture ◽

Meta Analysis ◽

Sensory Block ◽

Cochrane Library ◽

Rescue Analgesia ◽

Block Level ◽

Block Time ◽

Sedation Scores ◽

The Difference ◽

The Cochrane Library

Patients who undergo surgery of femur fracture suffer the excruciating pain. Dexmedetomidine (DEX) is a unique α2-adrenergic receptor agonist with sedative and analgesic properties, whose efficacy and safety are still unclear for surgery of femur fracture. Randomized controlled trials comparing the effects of addition of DEX to general or local anesthesia in surgery of femur fracture were searched from MEDLINE, EMBASE, and the Cochrane Library database. Patients who received DEX infusion had a significant longer time to rescue analgesia compared with those without DEX coadministration. DEX treatment seemed to reduce the visual analog score; however, the significance did not reach any statistical difference. DEX as an analgesic adjuvant did not reduce the onset of sensory block time, shorten the time to achieve maximum sensory block level, and provide a longer duration of sensory block. The difference in mean sedation scores between 2 groups was not statistically significant. As for adverse effects, DEX therapy significantly increased the rate of hypotension. In conclusion, dexmedetomidine as a local anesthetic adjuvant in femur fracture surgery had a longer duration of rescue analgesia. However, the incidence of hypotension was markedly increased in these patients. It was worth noting that the evidence was of low to moderate quality.

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Differences in coagulopathy indices in patients with severe versus non-severe COVID-19: a meta-analysis of 35 studies and 6427 patients

Scientific Reports ◽

10.1038/s41598-021-89967-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Alberto Polimeni ◽

Isabella Leo ◽

Carmen Spaccarotella ◽

Annalisa Mongiardo ◽

Sabato Sorrentino ◽

...

Keyword(s):

Platelet Count ◽

Meta Analysis ◽

Severe Disease ◽

Coagulation Factors ◽

Primary Analysis ◽

Severe Group ◽

Intravascular Coagulopathy ◽

The Difference ◽

D Dimer

AbstractCoronavirus disease 2019 (COVID-19) is a highly contagious disease that appeared in China in December 2019 and spread rapidly around the world. Several patients with severe COVID-19 infection can develop a coagulopathy according to the ISTH criteria for disseminated intravascular coagulopathy (DIC) with fulminant activation of coagulation, resulting in widespread microvascular thrombosis and consumption of coagulation factors. We conducted a meta-analysis in order to explore differences in coagulopathy indices in patients with severe and non-severe COVID-19. An electronic search was performed within PubMed, Google Scholar and Scopus electronic databases between December 2019 (first confirmed Covid-19 case) up to April 6th, 2020. The primary endpoint was the difference of D-dimer values between Non-Severe vs Severe disease and Survivors vs Non-Survivors. Furthermore, results on additional coagulation parameters (platelet count, prothrombin time, activated partial thromboplastin time) were also analyzed. The primary analysis showed that mean d-dimer was significantly lower in COVID-19 patients with non-severe disease than in those with severe (SMD − 2.15 [− 2.73 to − 1.56], I2 98%, P < 0.0001). Similarly, we found a lower mean d-dimer in Survivors compared to Non-Survivors (SMD − 2.91 [− 3.87 to − 1.96], I2 98%, P < 0.0001). Additional analysis of platelet count showed higher levels of mean PLT in Non-Severe patients than those observed in the Severe group (SMD 0.77 [0.32 to 1.22], I2 96%, P < 0.001). Of note, a similar result was observed even when Survivors were compared to Non-Survivors (SMD 1.84 [1.16 to 2.53], I2 97%, P < 0.0001). Interestingly, shorter mean PT was found in both Non-Severe (SMD − 1.34 [− 2.06 to − 0.62], I2 98%, P < 0.0002) and Survivors groups (SMD − 1.61 [− 2.69 to − 0.54], I2 98%, P < 0.003) compared to Severe and Non-Survivor patients. In conclusion, the results of the present meta-analysis demonstrate that Severe COVID-19 infection is associated with higher D-dimer values, lower platelet count and prolonged PT. This data suggests a possible role of disseminated intravascular coagulation in the pathogenesis of COVID-19 disease complications.

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Determining the Difference in Clinical and Radiologic Outcomes Between Expandable and Nonexpandable Titanium Cages in Cervical Fusion Procedures: A Systematic Review and Meta-Analysis

World Neurosurgery ◽

10.1016/j.wneu.2021.01.027 ◽

2021 ◽

Author(s):

Ronan J. Doherty ◽

Waseem Wahood ◽

Yagiz U. Yolcu ◽

Mohammed Ali Alvi ◽

Benjamin D. Elder ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cervical Fusion ◽

The Difference ◽

Titanium Cages

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The diagnostic value of EBV-DNA and EBV-related antibodies detection for nasopharyngeal carcinoma: a meta-analysis

Cancer Cell International ◽

10.1186/s12935-021-01862-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Weixing Liu ◽

Gui Chen ◽

Xin Gong ◽

Yingqi Wang ◽

Yaoming Zheng ◽

...

Keyword(s):

Nasopharyngeal Carcinoma ◽

Test Performance ◽

Meta Analysis ◽

Diagnostic Value ◽

Cochrane Library ◽

Control Group ◽

Summary Receiver Operating Characteristic ◽

Ebv Dna ◽

The Difference ◽

Sensitivity Specificity

Abstract Background Numerous individual studies have investigated the diagnostic value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection for nasopharyngeal carcinoma (NPC), but the conclusions remain controversial. This meta-analysis aimed to determine the value of EBV-DNA, EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG detection in the diagnosis of NPC. Methods PROSPERO registration number: CRD42019145532. PubMed, EMBASE, Cochrane Library, and Chinese data libraries (Wanfang, CNKI, and CBM) were searched up to January 2019. The pooled sensitivity, specificity, and positive likelihood, negative likelihood, and diagnostic odds ratios were conducted in this meta-analysis. Summary receiver operating characteristic curves evaluated the test-performance global summary. Publication bias was examined by Deek’s funnel plot asymmetry test. Results Forty-seven studies with 8382 NPC patients (NPC group) and 15,089 individuals without NPC (Control group) were included in this meta-analysis. The sensitivity, specificity, positive likelihood (+ LR), negative likelihood (-LR), DOR and AUC of EBV-DNA in diagnosis of NPC were: 0.76 (95% CI 0.73–0.77), 0.96 (95% CI 0.95–0.97), 14.66 (95% CI 9.97–21.55), 0.19 (95% CI 0.13–0.28), 84 (95% CI 50.45–139.88), 0.96 (SE: 0.001), and 0.55 (95% CI 0.54–0.57), 0.96 (95% CI 0.96–0.97), 12.91 (95% CI 9.55–17.45), 0.35 (95% CI 0.29–0.43), 39.57 (95% CI 26.44–59.23), 0.94 (SE: 0.002) for the EA-IgA, and 0.85 (95% CI 0.84–0.85), 0.89 (95% CI 0.88–0.89), 6.73 (95% CI5.38–8.43), 0.17 (95% CI 0.12–0.23), 43.03 (95% CI 31.51–58.76), 0.93 (SE: 0.007) for the VCA-IgA, and 0.86 (95% CI 0.85–0.88), 0.87 (95% CI 0.88–0.90), 7.55 (95% CI 5.79–9.87), 0.16 (95% CI 0.13–0.19), 50.95 (95% CI 34.35–75.57), 0.94 (SE: 0.008) for the EBNA1-IgA, and 0.70 (95% CI 0.69–0.71), 0.94 (95% CI 0.94–0.95), 9.84 (95% CI 8.40–11.54), 0.25 (95% CI 0.21–0.31), 40.59 (95% CI 32.09–51.35), 0.95 (SE: 0.005) for the Rta-IgG. The EBV-DNA had larger AUC compared with other EBV-based antibodies (P < 0.05), while the difference between EA-IgA, VCA-IgA, EBNA1-IgA and Rta-IgG was not statistically significant (P > 0.05). Conclusions EBV-DNA, VCA-IgA, EBNA1-IgA and Rta-IgG detection have high accuracy in early diagnosis NPC. In addition, EBV-DNA detection has the higher diagnosis accuracy in NPC. On the other hand, EA-IgA is suitable for the diagnosis but not NPC screening.

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