scholarly journals Emerging data on the treatment of multiple sclerosis

2021 ◽  
Vol 20 (3) ◽  
pp. 283-287
Author(s):  
Andrei Ciuhan ◽  
◽  
Lăcrămioara Perju-Dumbravă ◽  
Nicoleta Tohănean ◽  
◽  
...  
Keyword(s):  
Therapeutic Agent ◽  
Green Light ◽  
Bayesian Hierarchical Model ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Third Place ◽  
Web Based ◽  
Bayesian Hierarchical ◽  
The Past ◽  
Meta Analyses

Background and objectives. In the past few years, a myriad of new studies were aimed to find better ways to manage MS. As a result, a bunch of new molecules were found to have good efficacy, therefore FDA and EMA approved a series of treatments in the last few years, the last one receiving green light from EMA on March 30th, 2021 (Ofatumumab – Kesimpta®). The aim of this study was to evaluate and classify three of the newest drugs approved by the FDA and EMA. Material and methods. All the studies were chosen on the basis of pre-determined inclusion criteria and in accordance with PRISMA guidelines. We searched Pubmed and Cochrane Library for all studies published up until the end of 2020. For the data analysis we used MetaInsight®, a statistical web-based tool for meta-analyses and NMAs performing both Frequentist and Bayesian hierarchical model analyses, each one being seen as a sensitivity check for the other. Outcomes. The best therapeutic agent in reported efficacy amongst the three analyzed was Ofatumumab, ranked first in hierarchy, Ozanimod and Cladribine following in the second and third place, respectively. Conclusions. According to ABN’s 2015 guidelines, Cladribine was ranked between the most effective medicines for the treatment of MS; given the results from this study, other two may be considered as high efficacy alongside Natalizumab, Alemtuzumab and Ocrelizumab.

Sensorineural hearing loss with macrolide antibiotics exposure: a meta-analysis of the association

2020 ◽  
Author(s):  
Yazed Saleh Alsowaida ◽  
Abdulaziz Saleh Almulhim ◽  
Mok Oh ◽  
Brian Erstad ◽  
Ivo Abraham
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Sensorineural Hearing ◽  
Cochrane Library ◽  
Macrolide Antibiotics ◽  
Random Effects Model ◽  
Inclusion Criteria ◽  
Meta Analyses

Abstract Objective Macrolide antibiotics are among the most commonly used antibiotics; the association of macrolide antibiotics exposure with sensorineural hearing loss (SNHL) has been hypothesized. A systematic search was conducted in PubMed, EMBASE and Cochrane Library from inception to 15 July 2019 to identify studies used macrolide antibiotics for any indication. The results were reported as odds ratio (OR) with 95% confidence interval (CI) using random-effects model to derive the association of macrolide antibiotics exposure with SNHL. The objective of this meta-analysis was to estimate the association of macrolide antibiotics exposure and SNHL from up-to-date evidence. Key findings Nine studies met the inclusion criteria. There was no statistically significant association between macrolide antibiotics exposure and SNHL; the OR was 1.20 (95% CI: 0.96 to 1.49). No significant association was found with any of the subgroup meta-analyses. Summary Whilst the frequency of SNHL was higher with macrolide antibiotics exposure compared with controls, overall, no association was found between macrolide antibiotics and SNHL.

Surgical Management of Bilateral Vocal Fold Paralysis in Children: A Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982094489
Author(s):  
Ryan Kendall Thorpe ◽  
Sohit Paul Kanotra
Keyword(s):  
Vocal Fold ◽  
Web Of Science ◽  
Surgical Intervention ◽  
Meta Analysis ◽  
Vocal Fold Paralysis ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Initial Management ◽  
Bilateral Vocal Fold Paralysis ◽  
Meta Analyses

Objectives To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS. Data Sources PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) on September 9, 2019, with no date restriction. Review Methods Articles focusing on GWS or tracheostomy for initial management of BVFP were included. Articles describing patients who received no surgical intervention for BVFP were excluded. Results A total of 5989 articles were reviewed: 67 articles met inclusion criteria, and 240 patients were incorporated into the analysis. Patients who underwent primary GWS had an eventual tracheostomy rate of 6.0% (5/83). There were no statistically significant differences in the rate of tracheostomy, reoperation, or mortality among cricoid split, suture lateralization, and cordectomy/cordotomy. Patients who underwent primary tracheostomy failed to achieve decannulation in 36.9% (58/157) of cases. Decannulation was more likely in tracheostomized children who received GWS than those who did not (odds ratio, 6.336; P < .0001). Conclusions Most children who undergo primary GWS for BVFP avoid tracheostomy or reoperation. These data demonstrated no differences in surgical outcomes among the most common types of GWS for BVFP. For children who receive a tracheostomy as their first intervention for BVFP, GWS is associated with a significantly improved rate of decannulation.

scholarly journals Estimating autoantibody signatures to detect autoimmune disease patient subsets

Biostatistics ◽  
2017 ◽  
Vol 20 (1) ◽  
pp. 30-47 ◽  
Author(s):  
Zhenke Wu ◽  
Livia Casciola-Rosen ◽  
Ami A Shah ◽  
Antony Rosen ◽  
Scott L Zeger
Keyword(s):  
Immune Responses ◽  
Autoimmune Diseases ◽  
Gel Electrophoresis ◽  
Sodium Dodecyl ◽  
Disease Patient ◽  
Bayesian Hierarchical Model ◽  
Multiple Sources ◽  
Bayesian Hierarchical ◽  
The Past ◽  
Shrinkage Priors

Abstract Autoimmune diseases are characterized by highly specific immune responses against molecules in self-tissues. Different autoimmune diseases are characterized by distinct immune responses, making autoantibodies useful for diagnosis and prediction. In many diseases, the targets of autoantibodies are incompletely defined. Although the technologies for autoantibody discovery have advanced dramatically over the past decade, each of these techniques generates hundreds of possibilities, which are onerous and expensive to validate. We set out to establish a method to greatly simplify autoantibody discovery, using a pre-filtering step to define subgroups with similar specificities based on migration of radiolabeled, immunoprecipitated proteins on sodium dodecyl sulfate (SDS) gels and autoradiography [Gel Electrophoresis and band detection on Autoradiograms (GEA)]. Human recognition of patterns is not optimal when the patterns are complex or scattered across many samples. Multiple sources of errors—including irrelevant intensity differences and warping of gels—have challenged automation of pattern discovery from autoradiograms. In this article, we address these limitations using a Bayesian hierarchical model with shrinkage priors for pattern alignment and spatial dewarping. The Bayesian model combines information from multiple gel sets and corrects spatial warping for coherent estimation of autoantibody signatures defined by presence or absence of a grid of landmark proteins. We show the pre-processing creates more clearly separated clusters and improves the accuracy of autoantibody subset detection via hierarchical clustering. Finally, we demonstrate the utility of the proposed methods with GEA data from scleroderma patients.

scholarly journals Association of microRNAs genes polymorphisms with arthritis: a systematic review and meta-analysis

2019 ◽  
Vol 39 (7) ◽  
Author(s):  
Yingqi Xiao ◽  
Hui Liu ◽  
Li Chen ◽  
Yang Wang ◽  
Xiang Yao ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Case Control ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Inclusion Criteria ◽  
Case Control Studies ◽  
Effect Model ◽  
Meta Analyses

Abstract Objective: To investigate whether microRNAs genes’ polymorphisms are associated with arthritis. Methods: The PubMed, Cochrane Library et al. were systematically searched to identify case–control studies, systematic reviews and meta-analyses. A meta-analysis was performed to calculate odds ratios (ORs), and confidence intervals (CIs) at 95% using fixed-effect model or random-effects model. Results: Twenty-two case–control studies involving 10489 participants fulfilled the inclusion criteria. MiR-146a rs2910164 (G/C) was not significantly associated with the risk of rheumatoid arthritis (RA) in any model. Significant associations were found between miR-146a rs2910164 (G/C) and the risk of psoriatic arthritis (PsA) in the heterozygous model and the dominant model. The heterozygous model showed a significant association between the miR-146a rs2910164 (G/C) polymorphism and ankylosing spondylitis (AS). And there was no significant association of miR-146a rs2910164 (G/C) with risk of juvenile rheumatoid arthritis (JRA) at any model. Additionally, there was a significant association of miR-499 rs3746444 (T/C) with risk of RA at two genetic models, and with a moderate heterogeneity. When subgroup analysis by ethnicity, significant associations were almost found between miR-499 rs3746444 (T/C) and the risk of RA in any model in Caucasian populations, and there is no heterogeneity. Conclusions: The association of miR-146a rs2910164 (G/C) with RA was not found. And there was a significant association between miR-146a rs2910164(G/C) and PsA or AS. MiR-499 rs3746444 (T/C) was associated with RA in Caucasian populations. These findings did not support the genetic association between miR-146a rs2910164 (G/C) and JRA susceptibility, as well as the association of miR-196a-2 rs11614913 (C/T), miR-146a rs2431697, miR-146a rs57095329, miR-149 rs22928323 with arthritis.

scholarly journals Influence ofDPYDGenetic Polymorphisms on 5-Fluorouracil Toxicities in Patients with Colorectal Cancer: A Meta-Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-11 ◽  
Author(s):  
Qiang Li ◽  
Ying Liu ◽  
Hong-Mei Zhang ◽  
Yin-Peng Huang ◽  
Tian-Yi Wang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Genetic Polymorphisms ◽  
Web Of Science ◽  
Meta Analysis ◽  
Dihydropyrimidine Dehydrogenase ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Meta Analyses ◽  
The Cochrane Library ◽  
Stratified Analysis

Our meta-analysis aggregated existing results from relevant studies to comprehensively investigate the correlations between genetic polymorphisms in dihydropyrimidine dehydrogenase (DPYD) gene and 5-fluorouracil (5-FU) toxicities in patients with colorectal cancer (CRC). The MEDLINE (1966∼2013), the Cochrane Library Database (Issue 12, 2013), EMBASE (1980∼2013), CINAHL (1982∼2013), Web of Science (1945∼2013), and the Chinese Biomedical Database (CBM) (1982∼2013) were searched without language restrictions. Meta-analyses were conducted with the use of STATA software (Version 12.0, Stata Corporation, College Station, TX, USA). Seven clinical cohort studies with a total of 946 CRC patients met our inclusion criteria, and NOS scores of each of the included studies were ≥5. Our findings showed thatDPYDgenetic polymorphisms were significantly correlated with high incidences of 5-FU-related toxicity in CRC patients. SNP-stratified analysis indicated that there were remarkable connections of IVS14+1G>A, 464T>A, and 2194G>A polymorphisms with the incidence of marrow suppression in CRC patients receiving 5-FU chemotherapy. Furthermore, we found that IVS14+1G>A, 496A>G, and 2194G>A polymorphisms were correlated with the incidence of gastrointestinal reaction. Ethnicity-stratified analysis also revealed thatDPYDgenetic polymorphisms might contribute to the development of marrow suppression and gastrointestinal reaction among Asians, but not among Caucasians. The present meta-analysis suggests thatDPYDgenetic polymorphisms may be correlated with the incidence of 5-FU-related toxicity in CRC patients.

scholarly journals A systematic review of the keystone design perforator island flap in the reconstruction of trunk defects

2020 ◽  
Vol 47 (6) ◽  
pp. 535-541
Author(s):  
Irena Sakura Rini ◽  
Alberta Jesslyn Gunardi ◽  
Renate Parlene Marsaulina ◽  
Teguh Aryandono ◽  
Ishandono Dachlan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Wound Dehiscence ◽  
Island Flap ◽  
Cochrane Library ◽  
Complication Rates ◽  
Inclusion Criteria ◽  
Pubmed Central ◽  
Study Selection ◽  
Delayed Healing ◽  
Meta Analyses

The keystone design perforator island flap can be utilized in the repair of trunk defects. A systematic review was carried out to identify the complication rates of the use of this flap to treat such defects. The MEDLINE, Embase, Cochrane Library, and PubMed Central databases were searched for articles published between January 2003 and December 2018 that reported the use of keystone design perforator island flaps in the repair of trunk defects. Study selection was conducted in alignment with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Eight articles involving a total of 54 flaps satisfied the inclusion criteria. The most frequently reported cause of trunk defects was oncologic resection (64.4%). The overall complication rate was 35.2%, and complications included infection (11.1%), wound dehiscence (7.4%), delayed healing (7.4%), and partial flap loss (1.9%). The keystone design perforator island flap is associated with a high success rate and low technical complexity. Despite minor complications, keystone design flaps could be a preferred choice for trunk reconstruction.

scholarly journals Probiotics as a Complementary Therapy for Management of Obesity: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Salman Shirvani-Rad ◽  
Ozra Tabatabaei-Malazy ◽  
Shahrzad Mohseni ◽  
Shirin Hasani-Ranjbar ◽  
Ahmad-Reza Soroush ◽  
...  
Keyword(s):  
Polycystic Ovary ◽  
Complementary Therapy ◽  
Cochrane Library ◽  
Controlled Trials ◽  
High Dose ◽  
Inclusion Criteria ◽  
Obese Adults ◽  
Nonalcoholic Fatty Liver ◽  
Meta Analyses ◽  
The Impact

Background. Considering the observed role of probiotics in modulating gut microbiome, probiotics are discussed to be one potential complementary therapy for obesity management in recent years. The aim of the present study was to systematically review the meta-analyses of controlled trials and investigate the effects of probiotics on obesity. Methods. A comprehensive search was conducted on PubMed, Web of Science, and Cochrane Library web databases up to May 2020. Inclusion criteria were meta-analyses of controlled trials which evaluated the impact of probiotics on obesity in English language. Meta-analyses done on pregnant women, children, animal studies, or the effect of prebiotics on anthropometric indices were excluded. Results. Within 325 recorded studies, 20 studies met the inclusion criteria consisting of 16676 overweight/obese adults with different underlying disorders such as nonalcoholic fatty liver disease (NAFLD), or polycystic ovary syndrome (PCOS). The length of intervention varied from 2 to 26 weeks. Results of meta-analyses have shown a moderate effect of probiotics on body weight in overweight/obese adults: from −0.526 kg/m2 (95% CI: −0.810, −0.247) to −0.25 kg/m2 (95% CI: −0.33, −0.17). Body mass index (BMI) was changed from −1.46 kg/m2 (95% CI: −2.44, −0.48) to −1.08 kg/m2 (95% CI: −2.05, −0.11) in NAFLD. Probiotics could reduce BMI from −0.36 kg/m2 (95% CI: −0.74, 0.02) to −0.29 kg/m2 (95% CI: −0.54, −0.03) in patients with PCOS. Conclusion. It seems that the probiotic products could have beneficial effects as an adjunct therapy for care and management of obesity when used in high dose. However, due to heterogeneity of included studies, it is required to confirm our results by more meta-analyses of clinical trials.

scholarly journals Estimating Autoantibody Signatures To Detect Autoimmune Disease Patient Subsets

2017 ◽  
Author(s):  
Zhenke Wu ◽  
Livia Casciola-Rosen ◽  
Ami A. Shah ◽  
Antony Rosen ◽  
Scott L. Zeger
Keyword(s):  
Immune Responses ◽  
Autoimmune Diseases ◽  
Bayesian Model ◽  
Sodium Dodecyl ◽  
Disease Patient ◽  
Bayesian Hierarchical Model ◽  
Multiple Sources ◽  
Bayesian Hierarchical ◽  
The Past ◽  
Shrinkage Priors

SummaryAutoimmune diseases are characterized by highly specific immune responses against molecules in self-tissues. Different autoimmune diseases are characterized by distinct immune responses, making autoantibodies useful for diagnosis and prediction. In many diseases, the targets of autoantibodies are incompletely defined. Although the technologies for autoantibody discovery have advanced dramatically over the past decade, each of these techniques generates hundreds of possibilities, which are onerous and expensive to validate. We set out to establish a method to greatly simplify autoantibody discovery, using a pre-filtering step to define subgroups with similar specificities based on migration of radiolabeled, immunoprecipitated proteins on sodium dodecyl sulfate (SDS) gels and autoradiography [Gel Electrophoresis and band detection on Autoradiograms (GEA)]. Human recognition of patterns is not optimal when the patterns are complex or scattered across many samples. Multiple sources of errors - including irrelevant intensity differences and warping of gels - have challenged automation of pattern discovery from autoradiograms.In this paper, we address these limitations using a Bayesian hierarchical model with shrinkage priors for pattern alignment and spatial dewarping. The Bayesian model combines information from multiple gel sets and corrects spatial warping for coherent estimation of autoantibody signatures defined by presence or absence of a grid of landmark proteins. We show the pre-processing creates more clearly separated clusters and improves the accuracy of autoantibody subset detection via hierarchical clustering. Finally, we demonstrate the utility of the proposed methods with GEA data from scleroderma patients.

scholarly journals COVID-19 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review of critically unwell children and the association with underlying comorbidities

2020 ◽  
Author(s):  
Nia Williams ◽  
Trisha Radia ◽  
Katharine Harman ◽  
Pankaj Agrawal ◽  
James Cook ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intensive Care ◽  
Medical History ◽  
Cardiac Disease ◽  
Severe Disease ◽  
Past Medical History ◽  
Inclusion Criteria ◽  
Number Of Children ◽  
The Past ◽  
Meta Analyses

Abstract Data show that children are less severely affected with SARS-Covid-19 than adults; however, there have been a small proportion of children who have been critically unwell. In this systematic review, we aimed to identify and describe which underlying comorbidities may be associated with severe SARS-CoV-2 disease and death. The study protocol was in keeping with Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A total of 1726 articles were identified of which 28 studies fulfilled the inclusion criteria. The 28 studies included 5686 participants with confirmed SARS-CoV-2 infection ranging from mild to severe disease. We focused on the 108 patients who suffered from severe/critical illness requiring ventilation, which included 17 deaths. Of the 108 children who were ventilated, the medical history was available for 48 patients. Thirty-six of the 48 patients (75%) had documented comorbidities of which 11/48 (23%) had pre-existing cardiac disease. Of the 17 patients who died, the past medical history was reported in 12 cases. Of those, 8/12 (75%) had comorbidities. Conclusion: Whilst only a small number of children suffer from COVID-19 disease compared to adults, children with comorbidities, particularly pre-existing cardiac conditions, represent a large proportion of those that became critically unwell. What is Known:• Children are less severely affected by SARS-CoV-2 than adults.• There are reports of children becoming critically unwell with SARS-CoV-2 and requiring intensive care. What is New:• The majority of children who required ventilation for SARS-CoV-2 infection had underlying comorbidities.• The commonest category of comorbidity in these patients was underlying cardiac disease.

Proportion of Individuals With Past-Year Suicidal Ideation Who Attempted Suicide Over the Past 10 Years in the United States, and the Influence of Age and Sex

Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Shannon Lange ◽  
Courtney Bagge ◽  
Charlotte Probst ◽  
Jürgen Rehm
Keyword(s):  
United States ◽  
Suicidal Ideation ◽  
Random Effects ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
The United States ◽  
Individual Level ◽  
The Past ◽  
Meta Analyses ◽  
Age Category

Abstract. Background: In recent years, the rate of death by suicide has been increasing disproportionately among females and young adults in the United States. Presumably this trend has been mirrored by the proportion of individuals with suicidal ideation who attempted suicide. Aim: We aimed to investigate whether the proportion of individuals in the United States with suicidal ideation who attempted suicide differed by age and/or sex, and whether this proportion has increased over time. Method: Individual-level data from the National Survey on Drug Use and Health (NSDUH), 2008–2017, were used to estimate the year-, age category-, and sex-specific proportion of individuals with past-year suicidal ideation who attempted suicide. We then determined whether this proportion differed by age category, sex, and across years using random-effects meta-regression. Overall, age category- and sex-specific proportions across survey years were estimated using random-effects meta-analyses. Results: Although the proportion was found to be significantly higher among females and those aged 18–25 years, it had not significantly increased over the past 10 years. Limitations: Data were self-reported and restricted to past-year suicidal ideation and suicide attempts. Conclusion: The increase in the death by suicide rate in the United States over the past 10 years was not mirrored by the proportion of individuals with past-year suicidal ideation who attempted suicide during this period.

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