Preparation for Animal Models of Osteoporosis: a Systematic Review

Background: it is of great significance for clinical diagnosis, prevention and treatment of osteoporosis to deeply understand the pathogenesis and development process of osteoporosis through animal models of osteoporosis. This systematic review aim to summarize the modeling methods of osteoporosis, reveal the current situation and progress of animal models of osteoporosis, and compare the advantages and disadvantages of various modeling methods, so as to provide reference for clinical research.Methods: CNKI, CBM database, VIP database, Wanfang database, PubMed database and EMBASE database were searched by computer from the database establishment to December 2020 with the key words of "animal model; osteoporosis" in Chinese and English respectively. The literatures were screened according to inclusion and exclusion criteria. The methods of osteoporosis modeling, the improvement of the methods and the advantages and disadvantages of each method are summarized.Discussion: a total of 9303 related literatures were collected, and 112 eligible literatures were included. The establishment of an appropriate animal model is the key to the etiology, pathophysiology and drug therapy of osteoporosis. As the causes and pathophysiological changes of different types of OP have their own characteristics, the modeling methods are also different. Therefore, different modeling methods and experimental animals should be selected according to different experimental requirements.Systematic review registration: No

The economic impact of hypercholesterolemia and mixed dyslipidemia: A systematic review of cost of illness studies

Hypercholesterolemia is a clinically relevant condition with an ascertained role in atherogenesis. In particular, its presence directly correlates to the risk of atherosclerotic cardiovascular disease (ASCVD). As known, cardiovascular diseases pose a significant economic burden worldwide; however, a clear picture of the economic impact of ASCVD secondary to hypercholesterolemia is lacking. This study aiming at conducting a systematic review of the current literature to assess the economic impact of familial hypercholesterolemia (FH), non-familial hypercholesterolemia (non-FH) or mixed dyslipidemia. A literature search was performed in Medline/PubMed and Embase database up to September 1st, 2020, exploring evidence published from 2010. The literature review was conducted in accordance with PRISMA guidelines. To be included the studies must be conducted on people who have been diagnosed with familial hypercholesterolemia, non-familial hypercholesterolemia or mixed dyslipidemia, and report data/information on costs attributable to these conditions and their sequelae. A total of 1260 studies were retrieved. After reading the titles and abstract, 103 studies were selected for full reading and eight met the criteria for inclusion. All but one studies were published in the American continent, with the majority conducted in US. An observational design with a prevalence approach were used and all estimated the economic burden of CVD. Direct cost estimates as annual average health expenditure on all population, ranging from $17 to $259 million. Few studies assessing the economic impact of hypercholesterolemia are available in the literature and new researches are needed to provide a more updated and reliable picture. Despite this scarceness of evidence, this review adds important data for future discussion on the knowledge of the economic impact of hypercholesterolemia and costs of care associated to this condition, with important implication for public health researches and novel therapies implementation.

The Underutilization, Adverse Reactions and Efficacy of Statins after Liver Transplant: A Meta-Analysis and Systematic Review

(1) Background: Treatment of dyslipidemia via statin therapy in the non-liver transplant (LT) population is associated with a mortality benefit; however, the impact of statin therapy in post-LT population is not well-defined. This meta-analysis seeks to investigate the safety and efficacy of statin therapy in post-LT patients. (2) Methods: A systematic literature search on Medline and EMBASE database was conducted. A single-arm proportional meta-analysis and conventional pair-wise meta-analysis were performed to compare different outcomes with a random effects model. (3) Results: A total of 11 studies were included in this study, with 697 LT recipients identified to be on statin therapy. Statins were underutilized with only 32% (95% CI: 0.15–0.52) of 1094 post-LT patients on therapy. The incidence of adverse events of 14% (95% CI: 0.05–0.25) related to statin therapy was low. A significant mortality benefit was noted in patients on statin therapy with HR = 0.282 (95% CI: 0.154–0.517, p < 0.001), and improved lipid profiles post LT. The use of statins also significantly decreased odds of graft rejection (OR = 0.33; 95% CI: 0.15–0.73) and hepatocellular carcinoma (HCC) recurrence (HR = 0.32, 95% CI: 0.11–0.89). (4) Conclusions: Statin therapy is safe and efficacious in post-LT patients. Future studies to evaluate the effects of interactions between statins and immunosuppressant therapy are warranted.

Associations of Whole Grain and Refined Grain Consumption With Metabolic Syndrome. A Meta-Analysis of Observational Studies

Background: The associations of whole grain and refined grain consumption with metabolic syndrome (MetS) has been evaluated in several epidemiological studies with conflicting results. This meta-analysis was therefore employed to further investigate the above associations.Method: We searched the PubMed, Web of Science and Embase database until March 2021 (without restriction for inclusion time), for observational studies on the associations of whole grain and refined grain consumption with MetS. The pooled relative risk (RR) of MetS for the highest vs. lowest category of whole grain and refined grain consumption, as well as their corresponding 95% confidence interval (CI) were calculated.Results: A total of 14 observational studies, which involved seven cross-sectional and seven prospective cohort studies, were identified. Specifically, nine studies were related to whole grain consumption, and the overall multi-variable adjusted RR demonstrated that the whole grain consumption was inversely associated with MetS (RR = 0.80, 95%CI: 0.67–0.97; P = 0.021). With regard to refined grain consumption, 13 studies were included. The overall multi-variable adjusted RR indicated that refined grain consumption was positively associated with MetS (RR = 1.37, 95%CI: 1.02–1.84; P = 0.036).Conclusions: The existing evidence suggests that whole grain consumption is negatively associated with MetS, whereas refined grain consumption is positively associated with MetS. Our result might be helpful to better consider the diet effect on MetS. However, more well-designed prospective cohort studies are needed to elaborate the concerned issues further.

Potential Gene Association Studies of Chemotherapy-Induced Cardiotoxicity: A Systematic Review and Meta-Analysis

Chemotherapy is widely used in the treatment of cancer patients, but the cardiotoxicity induced by chemotherapy is still a major concern to most clinicians. Currently, genetic methods have been used to detect patients with high risk of chemotherapy-induced cardiotoxicity (CIC), and our study evaluated the correlation between genomic variants and CIC. The systematic literature search was performed in the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), China Biology Medicine disc (CBMdisc), the Embase database, China National Knowledge Internet (CNKI) and Wanfang database from inception until June 2020. Forty-one studies were identified that examined the relationship between genetic variations and CIC. And these studies examined 88 different genes and 154 single nucleotide polymorphisms (SNPs). Our study indicated 6 variants obviously associated with the increased risk for CIC, including CYBA rs4673 (pooled odds ratio, 1.93; 95% CI, 1.13–3.30), RAC2 rs13058338 (2.05; 1.11–3.78), CYP3A5 rs776746 (2.15; 1.00–4.62) ABCC1 rs45511401 (1.46; 1.05–2.01), ABCC2 rs8187710 (2.19; 1.38–3.48), and HER2-Ile655Val rs1136201 (2.48; 1.53–4.02). Although further studies are required to validate the diagnostic and prognostic roles of these 6 variants in predicting CIC, our study emphasizes the promising benefits of pharmacogenomic screening before chemotherapy to minimize the CIC.

Outcomes of laparoscopic cholecystectomy in rural hospitals – A systematic review

There are many studies on the laparoscopic cholecystectomy in rural hospitals. It is important to understand whether the advantages of the laparoscopic cholecystectomy are there in the rural hospital set up. The present systematic review of literature aims to find the various outcomes of laparoscopic cholecystectomy in rural hospitals. The study was conducted based on PRISMA guidelines for systematic reviews. The MEDLINE and EMBASE database were used the retrieve the articles. A detailed descriptive analysis was on the various outcomes of open and laparoscopic cholecystectomy. The present systematic review has identified that the laparoscopic cholecystectomy in rural hospitals is most preferred as that of urban setting. It not only provides less hospital stay, but also provides economical option for rural patients. However, there are some limitations in many rural settings like lack of instrumental facility and trained surgeon. The outcomes of the laparoscopic cholecystectomy in some rural hospitals are comparatively same as that of urban settings.

Low Serum 25-hydroxyvitamin D (Vitamin D) Level Is Associated With Susceptibility to COVID-19, Severity, and Mortality: A Systematic Review and Meta-Analysis

Background: This systematic review and meta-analysis aimed to assess whether low serum 25-hydroxyvitamin D (25-OHD) level is associated with susceptibility to COVID-19, severity, and mortality related to COVID-19.Methods: Systematic literature searches of PubMed, Scopus, and Embase database up until 9 December 2020. We include published observational prospective and retrospective studies with information on 25-OHD that reported main/secondary outcome. Low serum 25-OHD refers to participants with serum 25-OHD level below a cut-off point ranging from 20 to 30 ng/mL. Other cut-off values were excluded to reduce heterogeneity. The main outcome was mortality defined as non-survivor/death. The secondary outcome was susceptibility and severe COVID-19.Results: There were 14 studies comprising of 999,179 participants. Low serum 25-OHD was associated with higher rate of COVID-19 infection compared to the control group (OR = 2.71 [1.72, 4.29], p &lt; 0.001; I2: 92.6%). Higher rate of severe COVID-19 was observed in patients with low serum 25-OHD (OR = 1.90 [1.24, 2.93], p = 0.003; I2: 55.3%), with a sensitivity of 83%, specificity of 39%, PLR of 1.4, NLR of 0.43, and DOR of 3. Low serum 25-OHD was associated with higher mortality (OR = 3.08 [1.35, 7.00], p = 0.011; I2: 80.3%), with a sensitivity of 85%, specificity of 35%, PLR of 1.3, NLR of 0.44, and DOR of 3. Meta-regression analysis showed that the association between low serum 25-OHD and mortality was affected by male gender (OR = 1.22 [1.08, 1.39], p = 0.002), diabetes (OR = 0.88 [0.79, 0.98], p = 0.019).Conclusion: Low serum 25-OHD level was associated with COVID-19 infection, severe presentation, and mortality.

Rehabilitation in Osteoporosis - therapeutic chalenge?

Introduction. Osteoporosis is a disease of the entire skeleton, characterized by decrease bone mass and microarhitectural alterations of bone tissue, which result in increased bone fragility and predisposition to bone fractures. Materials and methods. Accesing standard medical databases: Medline, Embase, Database, Pubmed and the Cochrane Register of Controled Studies to review new pharmacological studies and non-pharmacological terapies in osteoporosis. Statistical analysis performed from the data extracted from the observation sheets from June 2019 to December 2019 by Dr. Liliana Stanciu. Results and discussions. The complex balneo-physical-kinetic treatment is an important link in the treatment of the disabling pathology for the patient, with an important clinical resonance. Conclusion. Osteoporosis is a pathology that decreases the patient’s quality of life. There are complementary therapies to pharmacological treatment with immediate and long lasting results. Keywords: mud, osteoporosis, balneal, hormones,

Association of BMI and Obesity with Composite poor outcome in COVID-19 adult patients: A Systematic Review and Meta-Analysis

AimThis study aimed to evaluate the association between obesity and composite poor outcome in coronavirus disease 2019 (COVID-19) patients.MethodsWe conducted a systematic literature search from PubMed and Embase database. We included all original research articles in COVID-19 adult patients and obesity based on classification of Body Mass Index (BMI) and composite poor outcome which consist of mortality, morbidity, admission of Intensive Care Unit (ICU), mechanical ventilation, Acute Respiratory Distress Syndrome (ARDS), and severe COVID-19.ResultsNine studies were included in meta-analysis with 6 studies presented BMI as continuous outcome and 3 studies presented BMI as dichotomous outcome (obese and non-obese). Most studies were conducted in China (55.5%) with remaining studies from French, Germany, and United States (US). COVID-19 patients with composite poor outcome had higher BMI with mean difference 0.55 kg/m2 (95% CI 0.07–1.03, P=0.02). BMI ≥30 (obese) was associated with composite poor outcome with odds ratio 1.89 (95% CI 1.06–3.34, P=0.03). Multivariate meta-regression analysis by including three moderators: age, hypertension, and Diabetes Mellitus type 2 (DM type 2) showed the association between obesity and composite poor outcome was affected by age with regression coefficient =-0.06 and P=0.02. Subgroup analysis was not performed due to the limited number of studies for several outcomes.ConclusionObesity is a risk factor of composite poor outcome of COVID-19. On the other hand, COVID-19 patients with composite poor outcome have higher BMI. BMI is an important routine procedure that should be assessed in the management of COVID-19 patients and special attention should be given to patients with obesity.

Two SNPs rs1801133 and rs1801394 in folate pathway are associated with the risk of nonsyndromic cleft lip with or without cleft palate

Background Prenatal intake of folic acid is important for prevention of nonsyndromic cleft lip with or without cleft palate (NSCL/P), genes participant in folate pathway are crucial for preventing birth defects. The present study aims to investigate the associations between four single nucleotide polymorphisms (SNPs) in folate pathway genes and the risk of NSCL/P. Methods Prediction by bioinformatics was conducted to assess the function of genetic variation. The PubMed, Embase database and Google Scholar were searched by two researchers to identify all relevant studies. Stata 11.0 software was used to calculate the results. Subgroup analysis was conducted to assess the influence of the genetic background. Sensitivity analysis, regression analysis and publication analysis were conducted to improve the strength of the results. Results Two genetic variations rs1801394 in MTRR gene and rs1801133 in MTHFR were predicted damaging. A total of 34 publications were included in the present analysis. The results showed that there were a significant association between rs1801133 and NSCL/P risk in two genetic models TT allele vs CC allele (OR=1.333 95%CI=1.062-1.674, P=0.013) and recessive model (OR=1.325 95%CI=1.075-1.634, P=0.008) and there were a significant association between rs1801394 and NSCL/P risk in Asian (GG allele vs AA allele, OR=0.520 95%CI=0.321-0.841, P=0.008). Meta-regression, sensitivity analysis, and publication bias analysis confirmed that the results of the present study were statistically robust. Conclusions This present study suggests that rs1801133 of the MTHFR gene and rs1801394 of the MTRR gene are risk factors for NSCL/P. Additional, larger studies should be performed to confirm these findings.