scholarly journals Des-Gamma-Carboxy Prothrombin in Hepatocellular Cancer Patients Waiting for Liver Transplant: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 32 (4) ◽  
pp. 370-374 ◽  
Author(s):  
Quirino Lai ◽  
Samuele lesari ◽  
Giovanni Battista Levi Sandri ◽  
Jan Lerut
Keyword(s):  
Systematic Review ◽  
Liver Transplant ◽  
Living Donor ◽  
Meta Analysis ◽  
Hepatocellular Cancer ◽  
High Rate ◽  
Western World ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Japanese Studies

Background The use of des-gamma-carboxy prothrombin (DCP) as a predictor of the risk of recurrence of hepatocellular cancer (HCC) after liver transplant (LT) has recently gained interest, especially in view of the recent extension of the eligibility criteria of these patients for LT. The aim of the present study is to look into this important matter based on a systematic review and meta-analysis. Methods A systematic literature review about the role of DCP in the specific setting of LT for HCC has been conducted. Results Three selected studies, which showed a high rate of homogeneity (I2 = 0.0%), confirmed that the tumor marker DCP is a useful predictive factor, indicating a 5-fold increased risk for HCC recurrence after LT (p<0.001). Conclusions The meta-analysis enabled us to underline the importance of DCP in the refinement of the eligibility criteria of HCC patients for LT. This information, based on Japanese studies performed in the setting of living-donor LT only, needs further validation in the Western world both in the setting of post-mortem and living-donor LT.

scholarly journals Is a low Functional Movement Screen score (≤14/21) associated with injuries in sport? A systematic review and meta-analysis

2019 ◽  
Vol 5 (1) ◽  
pp. e000501 ◽  
Author(s):  
Manuel Trinidad-Fernandez ◽  
Manuel Gonzalez-Sanchez ◽  
Antonio I Cuesta-Vargas
Keyword(s):  
Systematic Review ◽  
Female Athletes ◽  
Meta Analysis ◽  
Functional Movement Screen ◽  
Eligibility Criteria ◽  
Functional Movement ◽  
Increased Risk ◽  
Registration Number ◽  
Definition Of ◽  
Evidence Database

ObjectiveTo assess whether Functional Movement Screen (FMS) score is associated with subsequent injuries in healthy sportspeople.DesignSystematic review and meta-analysis.Data sourcesThe following electronic databases were searched to December 2017: Medline, PubMed, PsycINFO, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature, Scopus, Embase, and Physiotherapy Evidence Database.Eligibility criteria for selecting studiesEligibility criteria included (1) prospective cohort studies that examined the association between FMS score (≤14/21) and subsequent injuries, (2) a sample of healthy and active participants without restrictions in gender or age, and (3) the OR was the effect size and the main outcome.ResultsThirteen studies met the criteria for the systematic review and 12 were included in the meta-analysis. In 5 of the 12 studies, and among female athletes in 1 study, FMS score ≤14 out of 21 points was associated with subsequent injuries. The overall OR of the selected studies in the meta-analysis was 1.86 (95% CI 1.32 to 2.61) and showed substantial heterogeneity (I2=70%).Summary/ConclusionWhether or not a low FMS score ≤14 out of 21 points is associated with increased risk of injury is unclear. The heterogeneity of the study populations (type of athletes, age and sport exposure) and the definition of injury used in the studies make it difficult to synthesise the evidence and draw definitive conclusions.Trial registration numberCRD42015015579.

Premorbid body mass and mortality in patients with hepatocellular cancer: A systematic review and meta-analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 477-477 ◽  
Author(s):  
Arjun Gupta ◽  
Avash Das ◽  
Nivedita Arora ◽  
Kaustav Majumder ◽  
Preet Paul Singh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Morbid Obesity ◽  
Body Mass ◽  
Meta Analysis ◽  
Hepatocellular Cancer ◽  
Dependent Manner ◽  
Increased Risk ◽  
Reported Data ◽  
Dose Dependent ◽  
Related Mortality

477 Background: Excess body weight is associated with increased risk of developing hepatocellular cancer (HCC), but its effect on HCC mortality remains unclear. We performed a systematic review and meta-analysis to assess the association between premorbid body mass index (BMI) and HCC mortality. Methods: Through a systematic search of major databases and conference proceedings, up to March 2016, we identified observational studies reporting the association between premorbid BMI, and HCC-related mortality. We estimated summary adjusted hazard ratio (aHR) with 95% confidence intervals (CI), comparing obese (BMI > 30 kg/m2) and overweight (BMI 25-29.9 kg/m2) categories with reference category using random effects model; heterogeneity was measured using the inconsistency index (I2). Results: 9 studies were included in which 6,052 HCC deaths occurred in 1,599,453 cancer-free individuals at cohort inception. 5 studies reported data as obese vs. overweight vs. normal BMI, and 4 reported data as obese + overweight combined (BMI > 25 kg/m2). On meta-analysis, pre-morbid obesity was associated with higher HCC-related mortality, as compared to individuals with normal BMI (obese: aHR, 1.96; 95% CI, 1.46-2.46, I2= 37%; overweight: aHR, 1.08; 95% CI, 0.97-1.21, I2= 0%), in dose-dependent manner. This effect was stronger in males [3 studies, aHR, 2.50; 95% CI, 2.02-3.09] vs. females [2 studies, aHR, 1.45; 95% CI, 1.08-1.97]. This effect was seen primarily in Western populations [4 studies, aHR, 2.10; 95% CI, 1.77-2.48], but not in Asian population [1 study, aHR, 1.10; 95% CI, 0.63-1.92]. Conclusions: In this meta-analysis, there was a dose-dependent increase in HCC-related mortality with pre-morbid obesity, particularly in men, and in Western populations. Strategies targeting obesity-induced metabolic abnormalities may provide novel pathways for HCC therapy.

scholarly journals The Association Between Asthma and Risk of Myasthenia Gravis: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Pitchaporn Yingchoncharoen ◽  
Nipith Charoenngam ◽  
Ben Ponvilawan ◽  
Jerapas Thongpiya ◽  
Thanat Chaikijurajai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Myasthenia Gravis ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Case Control ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Inverse Variance ◽  
Increased Risk ◽  
Independent Review

Abstract PurposeThis study aimed to investigate the association between asthma and risk of myasthenia gravis (MG) using the method of systematic review and meta-analysis.MethodsPotentially eligible studies were identified from Medline and EMBASE databases from inception to … using search strategy that comprised of terms for “Asthma” and “Myasthenia Gravis”. Eligible cohort study must consist of one cohort of individuals with asthma and another cohort of individuals without asthma. Then, the study must report relative risk (RR) with 95% confidence intervals (95% CIs) of incident MG between the groups. Eligible case-control studies must include cases with MG and controls without MG. Then, the study must explore their history of asthma. Odds ratio (OR) with 95% CIs of the association between asthma status and MG must be reported. Point estimates with standard errors were retrieved from each study and were combined together using the generic inverse variance method.ResultsA total of 6,835 articles were identified. After two rounds of independent review by five investigators, two cohort studies and three case-control studies met the eligibility criteria and were included into the meta-analysis. Pooled analysis showed that asthma was significantly associated with risk of MG with the pooled risk ratio of 1.38 (95%CI, 1.02 – 1.86). Funnel plot was symmetric.ConclusionThe current study found a significant association between asthma and increased risk of MG.

scholarly journals Association between Smoking and Risk of Primary Biliary Cholangitis: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 28 ◽  
pp. 197-203
Author(s):  
Karn Wijarnpreecha ◽  
Monia Werlang ◽  
Panadeekarn Panjawatanan ◽  
Paul T Kroner ◽  
Omar Y Mousa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Random Effect ◽  
Primary Biliary Cholangitis ◽  
Case Control Studies ◽  
Eligibility Criteria ◽  
Inverse Variance ◽  
Increased Risk ◽  
Former Smokers

Background & Aims: Studies have suggested that smokers may have a higher risk of primary biliary cholangitis (PBC) although the results have been inconsistent. This systematic review and meta-analysis aim to better characterize the risk of PBC among smokers by identifying all relevant studies and summarizing their results together. Methods: A comprehensive literature review was conducted using Embase and Pubmed/MEDLINE databases from inception to September 2018 to identify all studies which compared the risk of PBC among current, ever and former smokers to non-smokers. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: Nine case-control studies with 21,577 participants met the eligibility criteria and were included in the meta-analysis. The risk of PBC among ever smokers was significantly higher than non-smokers with the pooled odds ratio (OR) of 1.31 (95% CI, 1.03-1.67; I 2 89%). Subgroup analysis found that the risk was higher in both former smokers (pooled OR 1.36; 95% CI, 1.01-1.84; I 2 75%) and current smokers (pooled OR 1.18; 95% CI, 0.94-1.50; I 2 79%), although the latter did not reach statistical significance. Immunomodulatory and cytotoxic effect of cigarettes were the possible mechanisms behind this increased risk. Conclusions: A significantly increased risk of PBC among individuals who ever smoked was observed in this study, adding to the already long list of harmful health consequences of smoking.

scholarly journals Predicting the risk of stroke among patients with type 2 diabetes: a systematic review and meta-analysis of C-statistics

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e025579 ◽  
Author(s):  
Mohammad Ziaul Islam Chowdhury ◽  
Fahmida Yeasmin ◽  
Doreen M Rabi ◽  
Paul E Ronksley ◽  
Tanvir C Turin
Keyword(s):  
Systematic Review ◽  
Prediction Models ◽  
Data Extraction ◽  
Meta Analysis ◽  
External Validation ◽  
Predictive Performance ◽  
Eligibility Criteria ◽  
C Statistic ◽  
Increased Risk ◽  
Patients With Diabetes

ObjectiveStroke is a major cause of disability and death worldwide. People with diabetes are at a twofold to fivefold increased risk for stroke compared with people without diabetes. This study systematically reviews the literature on available stroke prediction models specifically developed or validated in patients with diabetes and assesses their predictive performance through meta-analysis.DesignSystematic review and meta-analysis.Data sourcesA detailed search was performed in MEDLINE, PubMed and EMBASE (from inception to 22 April 2019) to identify studies describing stroke prediction models.Eligibility criteriaAll studies that developed stroke prediction models in populations with diabetes were included.Data extraction and synthesisTwo reviewers independently identified eligible articles and extracted data. Random effects meta-analysis was used to obtain a pooled C-statistic.ResultsOur search retrieved 26 202 relevant papers and finally yielded 38 stroke prediction models, of which 34 were specifically developed for patients with diabetes and 4 were developed in general populations but validated in patients with diabetes. Among the models developed in those with diabetes, 9 reported their outcome as stroke, 23 reported their outcome as composite cardiovascular disease (CVD) where stroke was a component of the outcome and 2 did not report stroke initially as their outcome but later were validated for stroke as the outcome in other studies. C-statistics varied from 0.60 to 0.92 with a median C-statistic of 0.71 (for stroke as the outcome) and 0.70 (for stroke as part of a composite CVD outcome). Seventeen models were externally validated in diabetes populations with a pooled C-statistic of 0.68.ConclusionsOverall, the performance of these diabetes-specific stroke prediction models was not satisfactory. Research is needed to identify and incorporate new risk factors into the model to improve models’ predictive ability and further external validation of the existing models in diverse population to improve generalisability.

scholarly journals Safety of furazolidone-containing regimen in Helicobacter pylori infection: a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e037375
Author(s):  
Chao-ran Ji ◽  
Jing Liu ◽  
Yue-yue Li ◽  
Chuan-guo Guo ◽  
Jun-yan Qu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Helicobacter Pylori ◽  
Data Extraction ◽  
Meta Analysis ◽  
Treatment Discontinuation ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Daily Dose ◽  
H Pylori

ObjectivesFurazolidone containing regimen is effectivefor Helicobacter pylori (H. pylori) infection, but its safetyremains controversial. To assess the safety of furazolidone containing regimenin H. pylori infection.DesignA systematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane Library, Web of Science and Scopus databases were systematically searched for eligible randomised controlled trials.Eligibility criteriaStudies comparing furazolidone with non-furazolidone-containing regimen, variable durations or doses of furazolidone were included.Data extraction and synthesisTwo reviewers independently selected studies and extracted data. Primary outcomes were the risk of total adverse events (AEs), serious AEs and severe AEs, expressed as relative risk (RR) with 95% CI. Secondary outcomes contained the incidence of individual adverse symptoms, AE-related treatment discontinuation and compliance.ResultsTwenty-six articles were identified from 2039 searched records, of which 14 studies (n=2540) compared furazolidone with other antibiotics. The eradication rates of furazolidone-containing regimen were higher than those of other antibiotics in both intention-to-treat (RR 1.06, 95% CI 1.01 to 1.12) and per-protocol analysis (RR 1.05, 95% CI 1.00 to 1.10). Only two serious AEs were reported in furazolidone group (2/1221, 0.16%). No significant increased risk was observed for the incidence of total AEs (RR 1.04, 95% CI 0.89 to 1.21) and severe AEs (RR 1.81, 95% CI 0.91 to 3.60). Twelve studies (n=3139) compared different durations of furazolidone, and four studies (n=343) assessed variable doses. Elevated risk of total AEs and severe AEs were only found in a high daily dose of furazolidone rather than prolonged duration. The incidence of AE-related treatment discontinuation and compliance of patients were all similar, irrespective of dose and duration adjustments.ConclusionFurazolidone-containing regimen has a similar risk of AEs and compliance as non-furazolidone-containing regimen. A low daily dose of 200 mg is well-tolerated for 14 day regimen and should be first considered.PROSPERO registration numberCRD42019137247

scholarly journals Atrial High‐Rate Episode Duration Thresholds and Thromboembolic Risk: A Systematic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Dimitrios Sagris ◽  
Georgios Georgiopoulos ◽  
Konstantinos Pateras ◽  
Kalliopi Perlepe ◽  
Eleni Korompoki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Transient Ischemic Attack ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
High Rate ◽  
Systemic Embolism ◽  
Thromboembolic Risk ◽  
Increased Risk ◽  
Episode Duration ◽  
Ischemic Attack

Background Available evidence supports an association between atrial high‐rate episode (AHRE) burden and thromboembolic risk, but the necessary extent and duration of AHREs to increase the thromboembolic risk remain to be defined. The aim of this systematic review and meta‐analysis was to identify the thromboembolic risk associated with various AHRE thresholds. Methods and Results We searched PubMed and Scopus until January 9, 2020, for literature reporting AHRE duration and thromboembolic risk in patients with implantable electronic devices. The outcome assessed was stroke or systemic embolism. Risk estimates were reported as hazard ratio (HR) or relative risk alongside 95% CIs. We used the Paule‐Mandel estimator, and heterogeneity was calculated with I 2 index. Among 27 studies including 61 919 patients, 23 studies reported rates according to the duration of the longest AHRE and 4 studies reported rates according to the cumulative day‐level AHRE duration. In patients with cardiac implantable devices, AHREs lasting ≥30 seconds significantly increased the risk of stroke or systemic embolism (HR, 4.41; 95% CI, 2.32–8.39; I 2 , 5.5%), which remained consistent for the thresholds of 5 minutes and 6 and 24 hours. Patients with previous stroke or transient ischemic attack and AHREs lasting ≥2 minutes had a marginally increased risk of recurrent stroke or transient ischemic attack. The risk of stroke or systemic embolism was higher in patients with cumulative AHRE ≥24 hours compared with those of shorter duration or no AHRE (HR, 1.25; 95% CI, 1.04–1.52; I 2 , 0%). Conclusions This systematic review and meta‐analysis suggests that single AHRE episodes ≥30 seconds and cumulative AHRE duration ≥24 hours are associated with increased risk of stroke or systemic embolism.

scholarly journals Zidovudine/Lamivudine vs. Abacavir/Lamivudine vs. Tenofovir/Emtricitabine in fixed-dose combinations as initial treatment for HIV patients: a systematic review and network meta-analysis

2017 ◽  
pp. 70-81 ◽  
Author(s):  
Juan Carlos Alzate Angel ◽  
Marcela María Duque Molina ◽  
Héctor Iván García García
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Initial Treatment ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Fixed Dose ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Statistical Heterogeneity

Introduction: Initial treatment of the HIV is based on the use of three drugs, two of which are nucleoside analog reverse-transcriptase inhibitors. There are three combinations of these drugs which have been approved by different guidelines, each with divergent results in terms of efficacy and safety.Objective: To compare the efficacy and safety of these three combinations.Methods: Systematic review and network meta-analysis of randomized clinical trials comparing fixed doses of Tenofovir Disoproxil Fumarate / Emtricitabine (TDF/FTC), Abacavir / Lamivudine (ABC/3TC) and Zidovudine / Lamivudine (ZDV/3TC).Results: Seven clinical trials met the eligibility criteria. The results suggested higher efficacy with TDF/FTC vs. ABC/3TC at 96 weeks and vs. ZDV/3TC at 48 weeks. However, there is clinical and statistical heterogeneity. Subgroup analysis were performed by third drug and by level of viral load prior to treatment, and found no differences in virological control. Network meta-analysis could only be carried out with TDF/FTC vs. ZDV/3TC, and the proportion of patients with virological response, with no differences at 48 weeks nor at 96 weeks. Direct comparisons showed an increased risk of bone marrow suppression of ZDV/3TC vs. TDF/FTC and of ABC/3TC hypersensitivity reactions vs. ZDV/3TCConclusions: The results did not show differences in effectiveness among the interventions. However, due to the heterogeneity of the third drug and the follow-up time between the included studies, this result is not definitive. The results raise the need for further studies to help improve treatment recommendations in patients infected with HIV.

scholarly journals Effects of interpregnancy interval on pregnancy complications: protocol for systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e025008 ◽  
Author(s):  
Amanuel Tesfay Gebremedhin ◽  
Annette K Regan ◽  
Eva Malacova ◽  
M Luke Marinovich ◽  
Stephen Ball ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pregnancy Complications ◽  
English Language ◽  
Human Subjects ◽  
Meta Analysis ◽  
Primary Data ◽  
Interpregnancy Interval ◽  
Eligibility Criteria ◽  
Increased Risk ◽  
Adverse Pregnancy

IntroductionInterpregnancy interval (IPI) is the length of time between a birth and conception of the next pregnancy. Evidence suggests that both short and long IPIs are at increased risk of adverse pregnancy and perinatal outcomes. Relatively less attention has been directed towards investigating the effect of IPI on pregnancy complications, and the studies that have been conducted have shown mixed results.This systematic review will aim to provide an update to the most recent available evidence on the effect of IPI on pregnancy complications.Method and analysisWe will search electronic databases such as Ovid/MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and PubMed to identify peer-reviewed articles on the effects of IPI on pregnancy complications. We will include articles published from start of indexing until 12 February 2018 without any restriction to geographic setting. We will limit the search to literature published in English language and human subjects. Two independent reviewers will screen titles and abstracts and select full-text articles that meet the eligibility criteria. The Newcastle-Ottawa tool will be used to assess quality of observational studies. Where data permit, meta-analyses will be performed for individual pregnancy complications. A subgroup analyses by country categories (high-income vs low and middle-income countries) based on World Bank income group will be performed. Where meta-analysis is not possible, we will provide a description of data without further attempt to quantitatively pool results.Ethics and disseminationFormal ethical approval is not required as primary data will not be collected. The results will be published in peer-reviewed journals and presented at national and international conferences.PROSPERO registration numberCRD42018088578.

scholarly journals Risk of myocardial infarction among people living with HIV: an updated systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e025874 ◽  
Author(s):  
Oghenowede Eyawo ◽  
Gwenyth Brockman ◽  
Charles H Goldsmith ◽  
Mark W Hull ◽  
Scott A Lear ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Hiv Infection ◽  
Meta Analysis ◽  
Cumulative Exposure ◽  
People Living With Hiv ◽  
Cochrane Central Register ◽  
Cvd Risk ◽  
Eligibility Criteria ◽  
Increased Risk

ObjectiveCardiovascular disease (CVD) is one of the leading non-AIDS-defining causes of death among HIV-positive (HIV+) individuals. However, the evidence surrounding specific components of CVD risk remains inconclusive. We conducted a systematic review and meta-analysis to synthesise the available evidence and establish the risk of myocardial infarction (MI) among HIV+ compared with uninfected individuals. We also examined MI risk within subgroups of HIV+ individuals according to exposure to combination antiretroviral therapy (ART), ART class/regimen, CD4 cell count and plasma viral load (pVL) levels.DesignSystematic review and meta-analysis.Data sourcesWe searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews until 18 July 2018. Furthermore, we scanned recent HIV conference abstracts (CROI, IAS/AIDS) and bibliographies of relevant articles.Eligibility criteriaOriginal studies published after December 1999 and reporting comparative data relating to the rate of MI among HIV+ individuals were included.Data extraction and synthesisTwo reviewers working in duplicate, independently extracted data. Data were pooled using random-effects meta-analysis and reported as relative risk (RR) with 95% CI.ResultsThirty-two of the 8130 identified records were included in the review. The pooled RR suggests that HIV+ individuals have a greater risk of MI compared with uninfected individuals (RR: 1.73; 95% CI 1.44 to 2.08). Depending on risk stratification, there was moderate variation according to ART uptake (RR, ART-treated=1.80; 95% CI 1.17 to 2.77; ART-untreated HIV+ individuals: 1.25; 95% CI 0.93 to 1.67, both relative to uninfected individuals). We found low CD4 count, high pVL and certain ART characteristics including cumulative ART exposure, any/cumulative use of protease inhibitors as a class, and exposure to specific ART drugs (eg, abacavir) to be importantly associated with a greater MI risk.ConclusionsOur results indicate that HIV infection, low CD4, high pVL, cumulative ART use in general including certain exposure to specific ART class/regimen are associated with increased risk of MI. The association with cumulative ART may be an index of the duration of HIV infection with its attendant inflammation, and not entirely the effect of cumulative exposure to ART per se.PROSPERO registration numberCRD42014012977.

Sign in / Sign up

Export Citation Format

Share Document