Meta-analysis of ICU Delirium Biomarkers and Their Alignment With the NIA-AA Research Framework

2021 ◽  
Vol 30 (4) ◽  
pp. 312-319
Author(s):  
Carol K. Chan ◽  
Yiqing Song ◽  
Ryan Greene ◽  
Heidi Lindroth ◽  
Sikandar Khan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Amyloid Β ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Amyloid Β Peptide ◽  
Care Providers ◽  
Research Framework ◽  
Standard Mean Difference ◽  
Icu Delirium ◽  
Underlying Mechanisms

Background Between 30% and 80% of survivors of critical illness experience cognitive impairment, but the underlying mechanisms remain unknown. Objective To determine whether intensive care unit (ICU) delirium biomarkers align with the National Institute on Aging–Alzheimer’s Association (NIA-AA) research framework for diagnostic biomarkers for Alzheimer disease and other related dementias (ADRD). Methods Ovid MEDLINE, PsycInfo, Embase, and the Cochrane Library were systematically searched for articles published between January 1, 2000, and February 20, 2020, on the relationship between delirium and biomarkers listed in the NIA-AA framework. Only studies that addressed delirium in the ICU setting and fluid biomarkers were included in these analyses. Results Of 61 256 records screened, 38 studies met inclusion criteria, 8 of which were suitable for meta-analysis. In pooled analysis, significant associations were found between ICU delirium and amyloid β-peptide 1-40 (standard mean difference [SMD], 0.42; 95% CI, 0.09-0.75), interleukin (IL)-1 receptor antagonist (SMD, 0.58; 95% CI, 0.21-0.94), and IL-6 (SMD, 0.31; 95% CI, 0.06-0.56). No significant association was observed in pooled analyses between ICU delirium and the other biomarkers. Few studies have examined ICU delirium and pathologic tau or neurodegeneration biomarkers. Conclusions Inflammatory biomarkers and amyloid β are associated with ICU delirium and point to potential overlapping mechanisms between delirium and ADRD. Critical care providers should consider integrating diagnostic approaches used in ADRD in their assessment of post–ICU cognitive dysfunction.

scholarly journals Effects of Cyclocarya paliurus Aqueous and Ethanol Extracts on Glucolipid Metabolism and the Underlying Mechanisms: A Meta-Analysis and Systematic Review

2020 ◽  
Vol 7 ◽  
Author(s):  
Wei Liu ◽  
You Wu ◽  
Yuli Hu ◽  
Shuai Qin ◽  
Xiaoyuan Guo ◽  
...  
Keyword(s):  
Animal Models ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Cochrane Library ◽  
Oral Glucose ◽  
Inflammatory Infiltration ◽  
Cyclocarya Paliurus ◽  
Standard Mean Difference ◽  
Underlying Mechanisms ◽  
Ethanol Extracts

Background and Aims:Cyclocarya paliurus (CP) has been used as an herbal tea to treat diabetes mellitus and obesity for hundreds of years. Previous research suggests that CP specifically restores glucolipid metabolic homeostasis, and the two most studied preparations are aqueous and ethanol extracts. In order to verify the effect of CP on glucolipid metabolism in animal models with metabolic syndrome, a meta-analysis was performed, and the active components and underlying mechanisms were systematically reviewed.Methods: Four databases: PubMed, Web of Science, Embase, and Cochrane Library were searched to identify potential literature. Data of blood glucose (BG) level, area under curve (AUC) of oral glucose tolerance test (OGTT), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) levels were extracted as indicators of the assessment of CP's effects. Follow-up analyses including subgroup analysis, meta-regressions, and publication bias were also conducted.Results: A total of 96 papers were identified from the databases and 11 papers including 31 data reports were involved in the meta-analysis. CP had a positive effect in down-regulating BG, AUC of OGTT, TC, TG, and LDL, and up-regulating HDL (P < 0.001, 95% confidence interval of standard mean difference did not incorporate the null value 0).Conclusion: CP showed definite activity of regulating glucolipid metabolism in animal models, and it exerted its function through multiple mechanisms including but not limited to: (1) improving insulin resistance; (2) protecting pancreatic β cells; (3) decreasing inflammatory infiltration; and (4) anti-oxidative stress.

scholarly journals Several interventions to alleviate pain in male patients undergoing office-based flexible cystoscopy: a systematic review and meta-analysis

2021 ◽  
Keyword(s):  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Pooled Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Flexible Cystoscopy ◽  
Standard Mean Difference ◽  
Study Heterogeneity ◽  
Lower Pain ◽  
Male Patients

Background: The purpose of this study was to explore the ability of nonpharmacologic adjuvant interventions to alleviate pain in male patients during flexible cystoscopy (FC) under local anesthesia. Methods: Electronic databases including PubMed, the Cochrane Library, and Embase were searched to identify eligible clinical trials from inception to 31 December 2020, with no language restrictions. Two independent reviewers used Cochrane Collaboration tools to assess the selection criteria, methodological rigor and risk of bias. Statistical analyses were performed using STATA 14.2. Results: In total, 717 studies were initially identified, and fourteen randomized controlled trials were ultimately included. We observed that patients who underwent FC with higher irrigation pressures had significantly lower pain scores on the visual analog scale than their counterparts with lower irrigation pressure during FC (weight mean difference (WMD): −1.43; 95% confidence interval (CI): −1.72 to −1.14) with no between-study heterogeneity (p = 0.661). There were no significant differences in pain between immediate or delayed FC groups under the same local anesthetic (standard mean difference (SMD): −0.19; 95% CI: −0.39 to 0.01). A pooled analysis of three studies including 340 male patients showed that men who observed the cystoscopy on the monitor had significantly lower pain ratings compared to those who did not view the operation on the monitor (SMD: −0.64; 95% CI: −1.14 to −0.15). Two studies, including a total of 272 patients, assessed the influence of listening to music on pain and anxiety in male patients during FC. Our meta-analysis found that music significantly improved patient pain (WMD: −0.92; 95% CI: −1.29 to −0.54). Hand-holding and urination during FC also relieved pain and anxiety in male patients undergoing FC. Conclusions: We observed that elevated irrigation pressure, real-time cystoscopy visualization, and music therapy alleviated pain in male patients undergoing FC. Well-designed trials are needed to confirm our findings.

scholarly journals Systematic review with meta-analysis: effectiveness of hyperbaric oxygenation therapy for ulcerative colitis

2021 ◽  
Vol 14 ◽  
pp. 175628482110233
Author(s):  
Pingrun Chen ◽  
Yina Li ◽  
Xian Zhang ◽  
Yan Zhang
Keyword(s):  
Ulcerative Colitis ◽  
Combination Therapy ◽  
Hyperbaric Oxygen ◽  
Hyperbaric Oxygenation ◽  
Meta Analysis ◽  
Serum Levels ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Complementary Method ◽  
Standard Mean Difference

Background and aims: Hyperbaric oxygenation therapy has been used in the treatment of ulcerative colitis in the past few years. However, its efficacy still remains unclear. The aim of the study was to investigate the efficacy of hyperbaric oxygen combination therapy in patients with ulcerative colitis. Methods: We conducted a comprehensive study search up to September 2020, from the online databases Embase, PubMed, Cochrane Library, China National Knowledge Infrastructure, WanFang and VIP. Results: Thirteen studies comprising 780 patients were included. We found that compared with conventional therapy, hyperbaric oxygen combination therapy was superior in reaching clinical remission [risk ratio (RR)=1.62; 95% confidence interval (CI) 1.42 to 1.84; p < 0.001] and clinical response (RR=1.29; 95% CI 1.21 to 1.38; p < 0.001), with lower disease activity scores [standard mean difference (SMD)= −1.19; 95%CI −1.74 to −0.65; p < 0.001]. An obvious reduction of serum levels of tumor necrosis factor-α (SMD= −1.96; 95%CI −2.50 to −1.41; p < 0.001) and interleukin (IL)-6 (SMD= −2.49; 95% CI −2.84 to −2.15; p < 0.001), and elevation of IL-10 level (SMD=2.40; 95% CI 0.68 to 4.12; p = 0.006) were also observed. Conclusion: Hyperbaric oxygen combination therapy was effective in patients with ulcerative colitis, and has potential as a complementary method for its treatment.

MO501INCREASED ALBUMINURIA RISK IN CHRONIC KIDNEY DISEASE PATIENTS WHOSE WHITE COAT-, MASKED-, AND SUSTAINED HYPERTENSION: SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Boby Pratama Putra ◽  
Felix Nugraha Putra
Keyword(s):  
Meta Analysis ◽  
Blood Pressure Measurement ◽  
Target Organ Damage ◽  
Random Effect ◽  
White Coat ◽  
Cochrane Library ◽  
White Coat Hypertension ◽  
Masked Hypertension ◽  
Sustained Hypertension ◽  
Standard Mean Difference

Abstract Background and Aims Latest classification of hypertension based on ambulatory blood pressure measurement was normotension (NT), white coat hypertension (WCHT), masked hypertension (MHT), and sustained hypertension (SHT). Recent studies suggest that WCHT, MHT, and SHT increase risk of target organ damage, particularly albuminuria, although the results were still inconsistent. Albuminuria is not only the sign of early glomerular damage in CKD patients, but also the signs of hypertension progression and predictors for cardiovascular events mortality. This study aims to compare the albuminuria risk among NT and WCHT, MHT, also SHT in CKD patients. Method We searched the literature comprehensively in online databases of Pubmed, EMBASE, ScienceDirect, and Cochrane Library to include all relevant studies using predefined terms until December 2020. We included studies that analyzed the albuminuria risk and compared the log2 urinary albumin-to-creatinine ratio (ACR) among NT and WCHT, MHT, or SHT in CKD patients. We used the Newcastle-Ottawa Scale for Observational Study checklist for evaluating bias risks. Analysis of the studies was conducted to provide pooled Odds Ratio (OR) for albuminuria risk and standard mean difference (SMD) for log2 ACR comparison with 95% Confidence Interval (CI) with random-effect heterogeneity test. Results We included 7 observational studies met our inclusion criteria. WCHT increases albuminuria risk although not statistically significant (pooled OR = 1.72, 95%CI 0.97 to 3.07, p = 0.06, I2 = 75%), while MHT and SHT significantly increase albuminuria risk with pooled OR respectively 1.62 (95%CI 1.03 to 2.53, p = 0.04, I2 = 82%) and 3.17 (95%CI 1.66 to 6.05, p = 0.0005, I2 = 94%). Controlled hypertension significantly protects CKD patients against albuminuria risk based on log2 ACR comparison with WCHT (SMD = 0.52, 95%CI 0.38 to 0.67, p&lt;0.00001, I2 = 0%), MHT (SMD = 0.34, 95%CI 0.19 to 0.49, p&lt;0.0001, I2 = 39%), and SHT (SMD = 0.63, 95%CI 0.31 to 0.95, p=0.0001, I2 = 76%). Conclusion White coat hypertension, masked hypertension, and sustained hypertension increase albuminuria risks in CKD patients. However, further studies are needed to determine the causality.

scholarly journals Pooled analysis of T2 Candida for rapid diagnosis of candidiasis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong-Lan Tang ◽  
Xiao Chen ◽  
Chang-Guo Zhu ◽  
Zhong-wei Li ◽  
Yong Xia ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Web Of Science ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Pooled Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Research Subjects

Abstract Background The present meta-analysis examined the diagnostic accuracy of T2 Candida for candidiasis. Methods The literature databases, such as PubMed, Embase, DVIO, Cochrane library, Web of Science, and CNKI, were searched on T2 Candida detection. Results A total of 8 articles, comprising of 2717 research subjects, were included in the study. The pooled sensitivity and specificity were 0.91 (95% confidence interval (CI): 0.88–0.94) and 0.94 95% CI: 0.93–0.95), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 10.16 (95% CI: 2.75–37.50) and 0.08 (95% CI: 0.02–0.35), respectively. The combined diagnostic odds ratio is 133.65 95% CI: 17.21–1037.73), and the AUC of SROC is 0.9702 [(SE = 0.0235), Q* = 0.9201(SE = 0.0381)]. Conclusions The current evidence supported that T2 Candida has high accuracy and sensitivity and is of major clinical significance in the diagnosis of Candida infection.

Assessment of the Ovarian Reserve by Serum Anti-Müllerian Hormone in Rheumatoid Arthritis Patients: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-8
Author(s):  
Xian-hui Zhang ◽  
Ying-an Zhang ◽  
Xin Chen ◽  
Peng-yan Qiao ◽  
Li-yun Zhang
Keyword(s):  
Rheumatoid Arthritis ◽  
Ovarian Reserve ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Dmard Treatment ◽  
Standard Mean Difference ◽  
Increased Risk ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
The Cochrane Library

<b><i>Background:</i></b> The ovarian reserve has been reported to be diminished in patients with rheumatoid arthritis. However, these results are still controversial. Anti-Müllerian hormone (AMH) is considered a reliable biomarker for the ovarian reserve. We thus performed a meta-analysis to evaluate the AMH levels and the effect of DMARDs on the ovarian reserve in rheumatoid arthritis patients. <b><i>Methods:</i></b> PubMed, EMBASE, the Cochrane Library, and 2 Chinese databases (CNKI and Wanfang database), up to September 2021, were searched for relevant studies. The Newcastle-Ottawa scale (NOS) was used to assess the quality of the included studies. Pooled standard mean difference (SMD) with 95% confidence intervals (CIs) were determined with the random-effects model. The heterogeneity was described by <i>I</i><sup><i>2</i></sup> statistic and <i>p</i> value from the Cochrane Q test. <b><i>Results:</i></b> Eight eligible studies (679 patients and 1,460 controls) were included in the meta-analysis. Compared with healthy control, the AMH levels in RA patients were significantly lower with the pooled SMD of −0.40 (95% CI: −0.66 to −0.14). However, in comparison of AMH with and without DMARD treatment, there was no significant difference with the pooled SMD of −0.1 (95% CI: −0.39 to 0.19). <b><i>Conclusion:</i></b> The results indicated that there was an increased risk of ovarian failure in RA patients and which is not related to DMARD treatment.

scholarly journals The Impact of Javanica Oil Emulsion Injection on Chemotherapy Efficacy and Cellular Immune Indicators in Patients with Advanced NSCLC: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-12
Author(s):  
Huilin Xu ◽  
Zhucheng Yin ◽  
Anbing He ◽  
Dedong Cao
Keyword(s):  
Advanced Nsclc ◽  
Karnofsky Performance Status ◽  
Meta Analysis ◽  
Objective Response ◽  
Cochrane Library ◽  
Combination Group ◽  
Control Group ◽  
Oil Emulsion ◽  
Standard Mean Difference ◽  
The Impact

Background. This meta-analysis aimed to evaluate the efficacy and safety of Javanica oil emulsion injection (JOI) combined with chemotherapy versus chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC). Methods. Electronic databases including EMBASE, PUBMED, the Cochrane library, and Chinese Biological Medical disc (CBM) were searched until May 2018. The clinical trials reporting efficacy and immune function of JOI combined with chemotherapy versus chemotherapy in advanced NSCLC were included according to the inclusion and exclusion criteria. Stata 11 and RevMan 5.3 were used for meta-analysis. Results. Twenty-four studies involving 2089 cases were included. The results of the meta-analysis showed that there were significant differences in objective response rate (risk ratio (RR) = 1.17; 95% confidence interval (CI): 1.05–1.29; P<0.05), improvement in Karnofsky Performance Status (standard mean difference (SMD) = 1.59; 95% CI: 1.41–1.77; P<0.01), incidence of adverse events (RR = 0.78; 95% CI: 0.7–0.87; P<0.05), percentage changes of CD3+ cells (SMD = 2.0; 95% CI: 1.49–2.50; P<0.01), CD4+ cells (SMD = 1.55; 95% CI, 1.2–1.9; P<0.01), natural killer cells (SMD = 1.98; 95% CI: 1.15–2.82; P<0.01), but not CD8+ (SMD = −1.44; 95% CI: −4.53–1.65; P=0.36), and value of CD4+/CD8+ (SMD = 0.32; 95% CI: 0.28–0.36; P<0.01) between the JOI combination group and control group. Funnel plot and Begg’s and Egger’s analysis indicated that there was no significant publication bias (P>0.05). Conclusions. JOI may be effective to improve the efficacy of chemotherapy in advanced NSCLC patients, accompanied with better levels of immune cells.

scholarly journals Prognostic role of pre-treatment C-reactive protein/albumin ratio in esophageal cancer: a meta-analysis

BMC Cancer ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhenhua Liu ◽  
Hongtai Shi ◽  
Longyun Chen
Keyword(s):  
Esophageal Cancer ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
C Reactive Protein ◽  
Albumin Ratio ◽  
Reactive Protein ◽  
Pre Treatment

Abstract Background In recent years, the role of pre-treatment C-reactive protein/albumin ratio (CAR) in prognosis of esophageal cancer (EC) has been investigated by several studies. This meta-analysis aimed to provide a more accurate and objective assessment of the prognostic value of pre-treatment CAR in EC. Methods Studies assessing the role of pre-treatment CAR in prognosis of EC were searched from PubMed, Embase and the Cochrane Library (last update by April 16, 2019). The hazard ratios (HRs) of CAR and the corresponding 95% CIs for overall survival (OS) or cancer-specific survival (CSS) in EC were extracted for pooled analysis. Results A total of eight observational studies including 2255 patients were collected. The pooled analysis showed that high CAR was related to worse OS in EC (pooled HR = 1.81; 95% CI = 1.40–2.35; P < 0.001). Subgroup analyses showed that the negative correlation between the CAR and OS was consistently demonstrated in subgroups stratified by country, pathological type, and cut-off value (P < 0.05). However, there was no relation between CAR and OS in subgroup of patients receiving neoadjuvant chemotherapy at a proportion of 100% (HR = 1.15, 95% CI = 0.56–2.69; P = 0.715). In addition, high CAR was also related to worse CSS in EC (pooled HR = 2.61; 95% CI = 1.67–4.06; P < 0.001). Conclusions High pre-treatment CAR was an adverse prognostic factor for EC patients. More large-sample clinical trials are still needed to verify the prognostic value of pre-treatment CAR in EC.

scholarly journals Serum Sclerostin Levels in Patients with Ankylosing Spondylitis and Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Jianfeng Shi ◽  
Haijian Ying ◽  
Juping Du ◽  
Bo Shen
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Ankylosing Spondylitis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Healthy Controls ◽  
Data Analyses ◽  
Standard Mean Difference ◽  
The Difference ◽  
Sclerostin Level

Objective. Current studies of serum sclerostin levels in AS and RA patients are inconsistent. This meta-analysis was performed to identify the association of serum sclerostin level with AS and RA patients. Methods. Embase, PubMed, MEDLINE, and Cochrane Library databases (up to 25 January 2017) were used to collect all relevant published articles. Studies were pooled and standard mean difference (SMD) with 95% confidence interval (CI) was calculated. All data analyses were performed using RevMan 5.3. Results. Totally eight studies of AS including 420 AS patients and 317 healthy controls (HC) and three studies of RA including 145 RA patients and 127 HC were finally included in this meta-analysis. The results revealed that the serum sclerostin levels in both AS patients (SMD=-0.14; 95% CI=[-0.39,0.11]; P=0.28) and RA patients (SMD=-0.10; 95% CI=[-0.34,0.15]; P=0.43) were not significantly different from those in HC. Conclusion. The difference of serum sclerostin levels in AS and RA patients was not significantly different from HC, indicating that the sclerostin may not associate with the development of AS and RA.

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