Gender differences in ischemic stroke intra-hospital mortality: a systematic review

The aim was to evaluate whether intra-hospital mortality from ischemic stroke is different in female patients. Methods. Studies were found in PubMed, Web of Science. We excluded 119 records because they did not include relevant reports or data. Studies were eligible for inclusion if enrolled adult patients with ischemic stroke and if the odds ratio (OR) of intra-hospital mortality in females compared to males is provided. Three retrospective cohort studies were eligible for inclusion criteria and so were included in the analysis. Findings: the random effect model showed a pooled significant higher risk of intra-hospital mortality [OR 1.34 (95% confidence interval 1.04, 1.74), P=0.026] in the female group compared to the male group. Our systematic review shows that intra-hospital mortality was significantly higher in female subjects compared to male.

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Effect of Hydroxychloroquine on QTc in Patients Diagnosed with COVID-19: A Systematic Review and Meta-Analysis

Journal of Cardiovascular Development and Disease ◽

10.3390/jcdd8050055 ◽

2021 ◽

Vol 8 (5) ◽

pp. 55

Author(s):

Angelos Arfaras-Melainis ◽

Andreas Tzoumas ◽

Damianos G. Kokkinidis ◽

Maria Salgado Guerrero ◽

Dimitrios Varrias ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Hospitalized Patients ◽

Qtc Interval ◽

Inclusion Criteria ◽

Qtc Prolongation ◽

Effect Model

Background: Hydroxychloroquine or chloroquine with or without the concomitant use of azithromycin have been widely used to treat patients with SARS-CoV-2 infection, based on early in vitro studies, despite their potential to prolong the QTc interval of patients. Objective: This is a systematic review and metanalysis designed to assess the effect of hydroxychloroquine with or without the addition of azithromycin on the QTc of hospitalized patients with COVID-19. Materials and methods: PubMed, Scopus, Cochrane and MedRxiv databases were reviewed. A random effect model meta-analysis was used, and I-square was used to assess the heterogeneity. The prespecified endpoints were ΔQTc, QTc prolongation > 500 ms and ΔQTc > 60 ms. Results: A total of 18 studies and 7179 patients met the inclusion criteria and were included in this systematic review and meta-analysis. The use of hydroxychloroquine with or without the addition of azithromycin was associated with increased QTc when used as part of the management of patients with SARS-CoV-2 infection. The combination therapy with hydroxychloroquine plus azithromycin was also associated with statistically significant increases in QTc. Moreover, the use of hydroxychloroquine alone, azithromycin alone, or the combination of the two was associated with increased numbers of patients that developed QTc prolongation > 500 ms. Conclusion: This systematic review and metanalysis revealed that the use of hydroxychloroquine alone or in conjunction with azithromycin was linked to an increase in the QTc interval of hospitalized patients with SARS-CoV-2 infection that received these agents.

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Aspirin Use is Associated with Decreased Mortality in Patients with COVID-19: A Systematic Review and Meta-analysis

10.1101/2021.07.08.21260236 ◽

2021 ◽

Author(s):

Pramod savarapu ◽

Nischit Baral ◽

Govinda Adhikari ◽

Maxwell Akanbi ◽

Basel Abdelazeem ◽

...

Keyword(s):

Hospital Mortality ◽

Virus Disease ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Inclusion Criteria ◽

Inverse Variance ◽

Statistical Heterogeneity ◽

Retrospective Cohort Studies ◽

Aspirin Group

Background: Novel Corona Virus Disease 2019 (COVID-19) has resulted in more than three and half million deaths worldwide as of June 6, 2021. The role of aspirin in prevention of COVID-19 mortality has not been much studied. We aimed to study the relationship between aspirin use and covid-19 mortality. Methods: We searched PubMed, MEDLINE, EMBASE, and Cochrane database for studies from January 2019 till June 6, 2021 with inclusion criteria of RCT, Cohort study, studies reporting mortality, and comparison studies on aspirin versus non-aspirin. Statistical analysis was done with Review Manager 5.4 statistical software using the inverse variance method. We assessed the pooled hazard ratio (HR), and 95% confidence interval using the random effect model and I-squared test was used to determine statistical heterogeneity. Results: We included five retrospective cohort studies which met our inclusion criteria with total of 14065 participants in both groups. There were 6797 participants in the aspirin group and 7268 participants in the non-aspirin group. Our results show that the use of aspirin was associated with 53% decrease in mortality compared to non-aspirin in patients with COVID-19 (adjusted HR 0.47, 95% CI 0.35-0.63, P< 0.001, I2= 47%). In the analysis restricted to patients hospitalized for COVID-19, the use of aspirin was associated with a 49% reduction in the risk for in-hospital mortality (adjusted HR 0.51, 95% CI 0.33-0.80, P = 0.004, I2= 39%). Conclusions: Our results show that aspirin is associated with decrease in both overall mortality and in-hospital mortality in patients with COVID-19.

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Alteration of Postural Balance in Patients with Fibromyalgia Syndrome—A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11010127 ◽

2021 ◽

Vol 11 (1) ◽

pp. 127

Author(s):

David Núñez-Fuentes ◽

Esteban Obrero-Gaitán ◽

Noelia Zagalaz-Anula ◽

Alfonso Javier Ibáñez-Vera ◽

Alexander Achalandabaso-Ochoa ◽

...

Keyword(s):

Systematic Review ◽

Postural Balance ◽

Fibromyalgia Syndrome ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Healthy Controls ◽

Functional Balance ◽

Sensory Organization ◽

Effect Model

Balance problems are one of the most frequent symptoms in patients with Fibromyalgia Syndrome (FMS). However, the extent and nature of this balance disorder are not known. The objective of this work was to determine the best evidence for the alteration of postural balance in patients with FMS and analyze differences with healthy controls. To meet this objective, a systematic review with meta-analysis was performed. A bibliographical search was carried out in PubMed Medline, Scopus, Web of Science, CINAHL and SciELO. Observational studies that assessed postural balance in patients with FMS compared to healthy subjects in baseline conditions, were selected. In a random-effect model, the pooled effect was calculated with the Standardized Mean Difference (SMD) and its 95% confidence interval (CI). Nineteen studies reporting data of 2347 participants (95% female) were included. FMS patients showed poor balance with a large effect on static (SMD = 1.578; 95% CI = 1.164, 1.992), dynamic (SMD = 0.946; 95% CI = 0.598, 1.294), functional balance (SMD = 1.138; 95% CI = 0.689, 1.588) and on balance confidence (SMD = 1.194; 95% CI = 0.914, 1.473). Analysis of the Sensory Organization Test showed large alteration of vestibular (SMD = 1.631; 95% CI = 0.467, 2.795) and visual scores (SMD = 1.317; 95% CI = 0.153, 2.481) compared to healthy controls. Patients with FMS showed worse scores for different measures of postural balance compared to healthy controls. Concretely, FMS patients appear to have poor vestibular and visual scores with a possible somatosensory dependence.

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Magnitude and determinants of neural tube defect in Africa: a systematic review and meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03848-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Daniel Atlaw ◽

Yohannes Tekalegn ◽

Biniyam Sahiledengle ◽

Kenbon Seyoum ◽

Damtew Solomon ◽

...

Keyword(s):

Systematic Review ◽

Neural Tube ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Folic Acid Supplementation ◽

Maternal Exposure ◽

X Ray ◽

Effect Model ◽

Pooled Prevalence

Abstract Background Neural tube defects (NTDs) are a group of disorders that arise from the failure of the neural tube close between 21 and 28 days after conception. About 90% of neural tube defects and 95% of death due to these defects occurs in low-income countries. Since these NTDs cause considerable morbidity and mortality, this study aimed to determine the prevalence and associated factors of NTDs in Africa. Methods The protocol of this study was registered in the International Prospective Register of Systematic Reviews (PROSPERO number: CRD42020149356). All major databases such as PubMed/MEDLINE, EMBASE, CINAHL, Web of Science, African Journals Online (AJOL), and Google Scholar search engine were systematically searched. A random-effect model was used to estimate the pooled prevalence of NTDs in Africa, and Cochran’s Q-statistics and I2 tests were used to assess heterogeneity between included studies. Publication bias was assessed using Begg ’s tests, and the association between determinant factors and NTDs was estimated using a random-effect model. Results Of the total 2679 articles, 37 articles fulfilled the inclusion criteria and were included in this systematic review and meta-analysis. The pooled prevalence of NTDs in Africa was 50.71 per 10,000 births (95% CI: 48.03, 53.44). Folic acid supplementation (AOR: 0.40; 95% CI: 0.19–0.85), maternal exposure to pesticide (AOR: 3.29; 95% CI: 1.04–10.39), mothers with a previous history of stillbirth (AOR: 3.35, 95% CI: 1.99–5.65) and maternal exposure to x-ray radiation (AOR 2.34; 95% CI: 1.27–4.31) were found to be determinants of NTDs. Conclusions The pooled prevalence of NTDs in Africa was found to be high. Maternal exposure to pesticides and x-ray radiation were significantly associated with NTDs. Folic acid supplementation before and within the first month of pregnancy was found to be a protective factor for NTDs.

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Systematic Review and Meta-analysis of Pirfenidone, Nintedanib, and Pamrevlumab for the Treatment of Idiopathic Pulmonary Fibrosis

Annals of Pharmacotherapy ◽

10.1177/1060028020964451 ◽

2020 ◽

pp. 106002802096445

Author(s):

Enrica Di Martino ◽

Alessio Provenzani ◽

Patrizio Vitulo ◽

Piera Polidori

Keyword(s):

Systematic Review ◽

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

World Health ◽

Effect Model ◽

All Cause Mortality ◽

Positive Effect

Background: The comparative efficacy of pirfenidone, nintedanib, and pamrevlumab in slowing the rate of forced vital capacity (FVC) decline and mortality in patients with idiopathic pulmonary fibrosis (IPF) is unknown. Objective: To perform a systematic review and meta-analysis (MA) of these drugs for IPF. Methods: We searched CENTRAL, PubMed, EMBASE, ClincalTrials.gov, and the World Health Organization’s registry databases up to March 2020. Phase II/III randomized controlled trials in adults with IPF were eligible. The random-effect model was implemented calculating the effect size and respective 95% CI as Cohen’s d for change from baseline FVC (in percentage predicted and liters) and odds ratio (OR) for 10% reduction in FVC and all-cause mortality (ACM). Results: Six studies were included in the MA. For change from baseline in percentage predicted FVC, the MA indicated that the 3 drugs were more effective than placebo (pirfenidone: d=3.30%, 95% CI=2.15-4.45; nintedanib: d=3.15%, 95% CI=2.35-3.95; pamrevlumab: d=4.30%, 95% CI=0.45-8.15). These results are superimposable to those relating to change from baseline FVC in liters (pirfenidone: d=0.09L, 95% CI=0.04-0.14; nintedanib: d=0.13L, 95% CI=0.10-0.16; pamrevlumab: d=0.20L, 95% CI=0.05-0.35). Each drug had a positive effect on 10% reduction in FVC (pirfenidone: OR=0.57, 95% CI=0.45-0.74; nintedanib: OR=0.66, 95% CI=0.51-0.85; pamrevlumab: OR=0.24, 95% CI=0.08-0.73), but only pirfenidone showed an effect on ACM (OR=0.50; 95% CI=0.31-0.83). Conclusion and Relevance: This MA provided encouraging results on pamrevlumab efficacy in slowing the decline in FVC compared with pirfenidone and nintedanib. Actually, in phase 3, it could become a potential IPF treatment.

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Head Injury and Parkinson Disease: Updated Evidence from Meta-Analysis Studies

10.21203/rs.3.rs-31754/v1 ◽

2020 ◽

Author(s):

yanhu ji ◽

Junjun Xue ◽

Yuhuan Ling ◽

Chunhan Shen ◽

Niannian Li ◽

...

Keyword(s):

Head Injury ◽

Web Of Science ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

The Unconscious ◽

Analysis Study ◽

Effect Model ◽

Increased Risk ◽

Unconscious State

Abstract Background Published studies on head injury and Parkinson's risk(PD) were inconsistent. We performed a meta-analysis study to explore the association.Methods We retrieved articles published in English from PubMed, Web of Science, Scopus and ScienceDirect between January 1, 1990 and December 31, 2019. The pooled effect of head injury and PD risk was calculated by a random effect model.Results In the meta-analysis, there were 21 studies, including 214763 individuals and 39209 PD patients. The pooled OR estimates(ORs) showed an increased risk of PD was correlated with head injury(OR = 1.46, 95% CI 1.29–1.66). Considering the unconscious state, head injury with LOC showed significant association with PD(OR = 1.49, 95%CI 1.28–1.74). However, head injury without LOC had no significant association with PD (OR = 0.57, 95% CI 0.29–1.12). Sensitivity analysis showed that, when any one study was excluded, the results did not change significantly.Conclusions Our research shows that head injury was associated with PD risk.This study provides a basis and reference for further study on head injury and PD.

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Semen parameters in men recovered from COVID-19: a systematic review and meta-analysis

10.21203/rs.3.rs-912054/v1 ◽

2021 ◽

Author(s):

Sagar Tiwari ◽

Niranjan KC ◽

Sajan Thapa ◽

Anuja Ghimire ◽

Sanjeev M Bijukchhe ◽

...

Keyword(s):

Systematic Review ◽

Sex Hormones ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Sperm Concentration ◽

Semen Parameters ◽

Sexual Hormones ◽

Effect Model ◽

Semen Volume

Abstract Background: The novel beta-coronavirus disease (COVID-19) has infected millions of people globally with high risk among male then female. However, the effect of COVID-19 andrology is still a subject of dispute. We planned to analyze the overall consequences of COVID-19 on semen parameters and male sex hormones.Main text: Systematic search was performed on MEDLINE and Scopus database until June 11 2021. We included observational studies, which reported mean ± standard deviation of the semen parameters and serum sex hormones of those reproductive-aged male recovered from COVID-19 and controls who did not suffered from COVID-19. We used Random-effect model to pool the studies, as heterogeneity was present. Heterogeneity was evaluated by Q test and I2. All studies were assessed with their quality and publication bias.We assessed 966 articles for eligibility and found 7 eligible studies meeting PICO criteria. This include 934 participants with mean age 37.34 ± 10.5. Random-effect model meta-analysis showed that men recovered form COVID-19 had semen parameters less than those who had not suffered from COVID-19. The overall mean difference (MD) [95% confidence interval (CI)] in semen volume, sperm concentration, sperm number, and progressive sperm motility was -0.20 (-0.45, 0.05), -16.59 (-34.82, 1.65), -45.44 (-84.56, -6.31), -1.73(-8.20, 4.75) respectively. Considering sex hormones; Luteinizing hormone and prolactin was found more among those recovered with the significant MD (95% CI) of 3.47 (1.59, 5.35) and 3.21 (1.71, 4.72) respectively.Conclusion: Both the semen parameters and sexual hormones were found to be affected after infected with COVID-19. However, the mechanism for testicular involvement remains doubtful.This systematic review and meta-analysis has been registered in PROSPERO (ID: CRD42021259445)

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Do Corticosteroids Affect Prenatal Biophysical Parameters? A Systematic Review and Meta-analysis

International Journal of Women s Health and Reproduction Sciences ◽

10.15296/ijwhr.2020.42 ◽

2020 ◽

Vol 8 (3) ◽

pp. 259-264

Author(s):

Sanaz Musavi ◽

Leila Nikniaz ◽

Hosein Hoseinifard ◽

Arezou Hamzehzadeh ◽

Shabnam Vazifekhah

Keyword(s):

Systematic Review ◽

Heart Rate ◽

Heart Rate Variability ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cochrane Library ◽

Effect Model ◽

Biophysical Profile ◽

Betamethasone And Dexamethasone

This systematic review and meta-analysis aimed to evaluate the effect of betamethasone and dexamethasone on biophysical profile (BPP) parameters. In addition, it was performed in 2017, using several databases such as PubMed/MEDLINE, Scopus, EMBASE, Cochrane library, ISI Web of science, Proquest, and Google scholar, along with Magiran SID and IranMedex. Eligible studies were selected by two reviewers and the outcomes of interest were extracted as well. Meta-analysis was done using the random effect model. Further, I-square statistic test was used for heterogeneity analysis and the presence of publication bias was also checked. At last, 12 studies were included and a random and fixed effect model was used for analysis. The pooled event rates were 4.5% (95% CI = 0.01-64.3, P=0.1), 76.8% (% 95 CI=33.5-95.6, P=0.21), 71.8% (% 95 CI=38.8-91.1, P=0.18), 70.9% (%95 CI=38.4-90.5, P=0.20), and 92.3% (%95 CI=76.0-97.8, P<0.001) for the reduced amniotic fluid volume, baseline fetal heart rate reactivity, fetal breathing, fetal movement, and heart rate variability, respectively. In summary, a significant decrease was observed in heart rate variability following betamethasone and dexamethasone administration. However, further systematic reviews are necessary to differentiate steroid induced changes in the fetal BPP from those due to fetal compromise

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The risk of smoking with stroke in Asia : meta-analysis

Jurnal Profesi Medika Jurnal Kedokteran dan Kesehatan ◽

10.33533/jpm.v14i1.1597 ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Fadhilatul Hasnah ◽

Yuniar Lestari ◽

Abdiana Abdiana

Keyword(s):

Ischemic Stroke ◽

Publication Bias ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Haemorrhagic Stroke ◽

Fixed Effect Model ◽

Stroke Subtype ◽

Effect Model ◽

Trim And Fill

This study uses a systematic method of review and meta-analysis to look at the risk of smoking with stroke in Asia. Further analysis based on the stroke subtype (ischemic stroke and haemorrhagic stroke was also carried out. Literature search was carried out in the PubMed, EBSCO and Google Scholar databases. Q tests were performed to determine the heterogeneity of included studies. Funnel plot, Egger regression test and trim and fill methods were used to identified publication bias and with the transformation of the model between the fixed effect model and the random effect model for sensitivity analysis A total of 12 articles were included consisting of 9 studies with case control design studies and 3 studies with cohort designs. The meta-analysis results showed that people who smoke have risks pooled OR 2.04 times (95% CI 1.57-2.65) for having a stroke Analysis of the type of stroke, smokers had 2.3 times the risk of having an ischemic stroke or 2.77 times for having a haemorrhagic stroke. Eggers test showed no influence of publication bias on the meta-analysis of smoking with stroke to. From this meta-analysis, it can be concluded that smoking increasing risk for stroke. This study found the risk of smokers to have a haemorrhagic stroke is higher than ischemic stroke.

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Regional and chronological differences in prevalences of olfactory and gustatory dysfunction in coronavirus disease (COVID-19): a systemic review and meta-analysis

10.21203/rs.3.rs-58460/v1 ◽

2020 ◽

Cited By ~ 1

Author(s):

Jeong-Whun Kim ◽

Seung Cheol Han ◽

Hyung Dong Jo ◽

Sung-Woo Cho ◽

Jin Youp Kim

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Olfactory Dysfunction ◽

Systemic Review ◽

Effect Model ◽

Geographical Regions ◽

Significant Difference ◽

Subgroup Analyses

Abstract Olfactory and gustatory dysfunction are frequently reported in patients with coronavirus disease (COVID-19). However, the reported prevalence of olfactory and/or gustatory dysfunction varies widely, and the reason for the inter-study differences is unclear. Hence, in this meta-analysis, we performed subgroup analyses to investigate the factors that contribute to the inter-study variability in the prevalence of olfactory and gustatory dysfunction. Out of 943 citations, we included 55 eligible studies with 13,527 patients with COVID-19 for a systematic review. The overall pooled prevalences of olfactory and gustatory dysfunction were 51.4% and 47.5%, respectively, in the random-effect model. In subgroup analyses, the prevalences of olfactory and gustatory dysfunction were significantly different among four geographical regions (both P < 0.001, respectively). Although the prevalences of olfactory and gustatory dysfunction did not significantly differ according to the time of enrollment, the subgroup analyses including only studies from the same geographical region (Europe) revealed a significant difference in olfactory dysfunction according to the time of enrollment. The regional and chronological differences in the prevalences of olfactory and gustatory dysfunctions partly explain the wide inter-study variability.

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