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Contact Dermatitis Nov 2023Parthenium dermatitis is the commonest form of plant dermatitis in India, caused by the plant Parthenium hysterophorus. Systemic immunosuppressives are commonly employed... (Meta-Analysis)
Meta-Analysis Review
Parthenium dermatitis is the commonest form of plant dermatitis in India, caused by the plant Parthenium hysterophorus. Systemic immunosuppressives are commonly employed in its treatment. However, there is a relative lack of comparative head-to-head trials. This study was done to assess the relative efficacy and safety of systemic treatments in Parthenium dermatitis. We systematically reviewed all the published studies investigating the safety and efficacy of systemic treatments for Parthenium dermatitis in the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, and clinical trial registries. Treatment benefit data were tabulated based on outcome measures of scoring systems. The quality of evidence for each outcome was assessed by Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria for meta-analysis. The pooled Standardized mean difference (SMD) for case series and comparative studies based on clinical severity score (CSS) for azathioprine was 4.007 (95% CI (Confidence interval): 3.141, 4.873) and 0.746 (95% CI: 0.139, 1.352), respectively. About 88.8% (95% CI: 76.8%, 100.8%, p = 0.076) of the patients had excellent or a good response to azathioprine. Our meta-analysis shows that azathioprine has the highest level of evidence in the treatment of Parthenium dermatitis.
Topics: Humans; Azathioprine; Dermatitis, Allergic Contact; Immunosuppressive Agents; Asteraceae; India
PubMed: 37634936
DOI: 10.1111/cod.14406 -
Childhood Obesity (Print) Aug 2017The growing prevalence of childhood obesity has become a serious health problem over the past decades. As the immune system is greatly affected by excess weight, in this... (Review)
Review
The growing prevalence of childhood obesity has become a serious health problem over the past decades. As the immune system is greatly affected by excess weight, in this review of reviews, we discuss the findings of review articles about the relationship between childhood/maternal obesity and children's immune system. We searched English-language articles in PubMed, Scopus, ISI Thomson Reuters, and Google Scholar databases. All relevant reviews, either systematic or narrative, were retrieved. Then their quality was assessed by using the Assessment of Multiple Systematic Reviews and International Narrative Systematic Assessment tools, respectively. In the final step, 26 reviews were included. Our review suggests that childhood obesity is associated with extensive changes in the serum levels of inflammatory and anti-inflammatory cytokines and proteins, as well as the number of immune cells and their behavior. Therefore, it might cause or exacerbate diseases such as asthma, allergy, atopic dermatitis (AD), and obstructive sleep apnea syndrome. Moreover, childhood obesity may reduce the immune system responsiveness to vaccines and microorganisms. Furthermore, studies suggest that maternal obesity increases the risk of asthma in offspring. Future studies are needed to determine different associations of childhood obesity with allergy, atophic dermatitis, and autoimmune diseases.
Topics: Adipokines; Adolescent; Animals; Anti-Inflammatory Agents; Asthma; Biomarkers; Child; Child, Preschool; Cytokines; Female; Humans; Hypersensitivity; Immune System; Infant; Infant, Newborn; Inflammation; Obesity; Pediatric Obesity; Pregnancy; Pregnancy Complications; Prenatal Exposure Delayed Effects; Risk Factors; Weight Gain
PubMed: 28604080
DOI: 10.1089/chi.2016.0176 -
Expert Review of Respiratory Medicine Oct 2016Sarcoidosis is a multisystemic inflammatory disorder with a great variety of symptoms, including fatigue, dyspnea, pain, reduced exercise tolerance and muscle strength.... (Review)
Review
INTRODUCTION
Sarcoidosis is a multisystemic inflammatory disorder with a great variety of symptoms, including fatigue, dyspnea, pain, reduced exercise tolerance and muscle strength. Physical training has the potential to improve exercise capacity and muscle strength, and reduce fatigue. The aim of this review and survey was to present information about the role of physical training in sarcoidosis and offer practical guidelines.
AREAS COVERED
A systematic literature review guided an international consensus effort among sarcoidosis experts to establish practice-basic recommendations for the implementation of exercise as treatment for patients with various manifestations of sarcoidosis. International sarcoidosis experts suggested considering physical training in symptomatic patients with sarcoidosis. Expert commentary: There is promising evidence of a positive effect of physical training. Recommendations were based on available data and expert consensus. However, the heterogeneity of these patients will require modification and program adjustment of the standard rehabilitation format for e.g. COPD or interstitial lung diseases. An optimal training program (types of exercise, intensities, frequency, duration) still needs to be defined to optimize training adjustments, especially reduction of fatigue. Further randomized controlled trials are needed to consolidate these findings and optimize the comprehensive care of sarcoidosis patients.
Topics: Exercise; Humans; Sarcoidosis
PubMed: 27552344
DOI: 10.1080/17476348.2016.1227244 -
Contact Dermatitis Dec 2022The use of masks for infection control was common in the COVID-19 pandemic. As numerous cross-sectional studies have suggested a link between the use of such masks and... (Meta-Analysis)
Meta-Analysis Review
The use of masks for infection control was common in the COVID-19 pandemic. As numerous cross-sectional studies have suggested a link between the use of such masks and various facial dermatoses, a systematic review and meta-analysis of published studies was conducted to evaluate this association, as well as potential risk factors for the development of such facial dermatoses. Observational studies were searched for in MEDLINE, EMBASE and the Cochrane Central Register. Thirty-seven observational studies with a total of 29 557 study participants were identified. This study was performed according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020 checklist and quality was assessed via the Newcastle-Ottawa Quality Assessment Scale., Overall prevalence of facial dermatoses was 55%. Individually, acne, facial dermatitis, itch and pressure injuries were consistently reported as facial dermatoses, with a pooled prevalence of 31%, 24%, 30% and 31%, respectively. Duration of mask-wear was the most significant risk factor for the development of facial dermatoses (95% CI: 1.31-1.54, p < 0.001). Overall, facial dermatoses associated with mask wear are common, and consist of distinct entities. They are related to duration of use. Appropriate and tailored treatment is important to improve the outcomes for these affected patients.
Topics: Humans; Masks; Pandemics; COVID-19; Cross-Sectional Studies; Dermatitis, Allergic Contact; Facial Dermatoses
PubMed: 35980367
DOI: 10.1111/cod.14203 -
Preventive Veterinary Medicine Mar 2018Brucellosis is a worldwide extended zoonosis with a heavy economic and public health impact. Cattle, sheep and goats are infected by smooth Brucella abortus and Brucella... (Review)
Review
Brucellosis is a worldwide extended zoonosis with a heavy economic and public health impact. Cattle, sheep and goats are infected by smooth Brucella abortus and Brucella melitensis, and represent a common source of the human disease. Brucellosis diagnosis in these animals is largely based on detection of a specific immunoresponse. We review here the immunological tests used for the diagnosis of cattle brucellosis. First, we discuss how the diagnostic sensitivity (DSe) and specificity (DSp), balance should be adjusted for brucellosis diagnosis, and the difficulties that brucellosis tests specifically present for the estimation of DSe/DSp in frequentistic (gold standard) and Bayesian analyses. Then, we present a systematic review (PubMed, GoogleScholar and CABdirect) of works (154 out of 991; years 1960-August 2017) identified (by title and Abstract content) as DSe and DSp studies of smooth lipopolysaccharide, O-polysaccharide-core, native hapten and protein diagnostic tests. We summarize data of gold standard studies (n = 23) complying with strict inclusion and exclusion criteria with regards to test methodology and definition of the animals studied (infected and S19 or RB51 vaccinated cattle, and Brucella-free cattle affected or not by false positive serological reactions). We also discuss some studies (smooth lipopolysaccharide tests, protein antibody and delayed type hypersensitivity [skin] tests) that do not meet the criteria and yet fill some of the gaps in information. We review Bayesian studies (n = 5) and report that in most cases priors and assumptions on conditional dependence/independence are not coherent with the variable serological picture of the disease in different epidemiological scenarios and the bases (antigen, isotype and immunoglobulin properties involved) of brucellosis tests, practical experience and the results of gold standard studies. We conclude that very useful lipopolysaccharide (buffered plate antigen and indirect ELISA) and native hapten polysaccharide and soluble protein tests exist, provided they are applied taking into account the means available and the epidemiological contexts of this disease: i) mass vaccination; ii) elimination based on vaccination combined with test-and-slaughter; and iii) surveillance and existence of false positive serological reactions. We also conclude that the insistence in recent literature on the lack of usefulness of all smooth lipopolysaccharide or native hapten polysaccharide tests in areas where S19 vaccination is implemented is a misinterpretation that overlooks scientific and practical evidence.
Topics: Animals; Bayes Theorem; Brucellosis, Bovine; Cattle; Immunologic Tests; Sensitivity and Specificity
PubMed: 29496108
DOI: 10.1016/j.prevetmed.2018.01.005 -
The European Respiratory Journal May 2022Cardiac sarcoidosis (CS) is a life-threatening condition in which clear recommendations are lacking. We aimed to systematically review the literature on cardiac... (Review)
Review
BACKGROUND
Cardiac sarcoidosis (CS) is a life-threatening condition in which clear recommendations are lacking. We aimed to systematically review the literature on cardiac sarcoidosis treated by corticosteroids and/or immunosuppressive agents in order to update the management of CS.
METHODS
Using PubMed, Embase and Cochrane Library databases, we found original articles on corticosteroid and standard immunosuppressive therapies for CS that provided at least a fair Scottish Intercollegiate Guidelines Network (SIGN) overall assessment of quality and we analysed the relapse rate, major cardiac adverse events (MACEs) and adverse events. We based our methods on the PRISMA statement and checklist.
RESULTS
We retrieved 21 studies. Mean quality provided by SIGN assessment was 6.8 out of 14 (range 5-9). Corticosteroids appeared to have a positive impact on left ventricular function, atrioventricular block and ventricular arrhythmias. For corticosteroids alone, nine studies (45%, n=351) provided data on relapses, representing an incidence of 34% (n=119). Three studies (14%, n=73) provided data on MACEs (n=33), representing 45% of MACEs in patients treated by corticosteroid alone. Nine studies provided data on adjunctive immunosuppressive therapy, of which four studies (n=78) provided data on CS relapse, representing an incidence of 33% (n=26). Limitations consisted of no randomised control trial retrieved and unclear data on MACEs in patients treated by combined immunosuppressive agents and corticosteroids.
CONCLUSION
Corticosteroids should be started early after diagnosis but the exact scheme is still unclear. Studies concerning adjunctive conventional immunosuppressive therapies are lacking and benefits of adjunctive immunosuppressive therapies are unclear. Homogenous data on CS long-term outcomes under corticosteroids, immunosuppressive therapies and other adjunctive therapies are lacking.
Topics: Adrenal Cortex Hormones; Humans; Immunosuppression Therapy; Immunosuppressive Agents; Recurrence; Sarcoidosis
PubMed: 34531273
DOI: 10.1183/13993003.00449-2021 -
The Journal of Dermatological Treatment Feb 2022Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are blistering cutaneous disorders that often manifest with epidermal and mucosal necrosis. In... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are blistering cutaneous disorders that often manifest with epidermal and mucosal necrosis. In extreme cases, the upper or bronchial airways are threatened, necessitating intubation and mechanical ventilation. This systematic review and meta-analysis examines the prevalence of mechanical ventilation (MV) in patients with SJS or TENS, despite maximal medical therapy, and additionally aims to identify the risk factors associated with this requirement.
MATERIALS AND METHODS
A systematic review of the literature was performed using the PRISMA guidelines and meta-analysis of proportions.
RESULTS
Six articles were included, with pooled total of 18648 cases. The weighted prevalence of MV was 27.5% (95%CI 17.8-39.9%). The need for MV was more closely associated with TEN, compared to SJS (OR 4.40, 95%CI 2.73-7.10, =48%, <.00001.) Risk factors associated with the need for MV included bacteremia (OR 5.02, 95%CI 2.87-8.79, =0%, <.00001), shock/organ failure on admission (OR 261.99, 95%CI 21.88-3137, =71, <.0001), total body surface area (TBSA) >30% (OR 4.47, 95%CI 1.41-14.20, =71, =.01.).
CONCLUSION
Limited published evidence with significant heterogeneity exists within the literature regarding the need for MV in SJS and TEN. Greater cutaneous involvement, and more critically unwell patients appear more likely to require MV.
Topics: Body Surface Area; Humans; Retrospective Studies; Risk Factors; Stevens-Johnson Syndrome
PubMed: 32412819
DOI: 10.1080/09546634.2020.1770173 -
Application of E75 peptide vaccine in breast cancer patients: A systematic review and meta-analysis.European Journal of Pharmacology Jul 2018The E75 peptide vaccine, derived from tumor-associated antigen HER2, is the most frequently studied anti-HER2 vaccination strategy for the treatment of breast cancer... (Meta-Analysis)
Meta-Analysis Review
The E75 peptide vaccine, derived from tumor-associated antigen HER2, is the most frequently studied anti-HER2 vaccination strategy for the treatment of breast cancer patients. It has been investigated in the several phases Ι/Π of the clinical trials and is currently being evaluated in a randomized multicenter phase III clinical trial. We conducted a systematic review and meta-analysis to clarify the outcomes of the E75 peptide vaccine including the therapeutic efficacy, the disease recurrence, the survival rate, and the side effects. Three peer-reviewed literature databases including the PubMed, Web of Science, and Scopus were sought. Of 29 trials assessed for eligibility, 16 were considered based on our inclusion criteria. Statistical analyses were performed by The Excel and STATA v.11.0. Meta-analysis of delayed-type hypersensitivity)DTH( reactions and CD8-T cell levels, as immune responses, displayed the significant differences in the vaccinated groups compared to their non-vaccinated counterparts. In addition, the recurrence, and the overall and the disease-free survival were significantly different in the vaccinated subjects versus the control. Evaluation of the local and systemic toxicity of the E75 peptide vaccine demonstrated the minimal side effects. It seems that the E75 peptide vaccine is safe and effective, and can be used for further randomized clinical trials.
Topics: Breast Neoplasms; Cancer Vaccines; Disease Progression; Disease-Free Survival; Female; Humans; Neoplasm Recurrence, Local; Peptide Fragments; Receptor, ErbB-2; Time Factors; Treatment Outcome
PubMed: 29753042
DOI: 10.1016/j.ejphar.2018.05.010 -
Contact Dermatitis Oct 2016Food industry workers are at increased risk for occupational contact urticaria (CU). There are many foodstuffs that have been reported to cause occupational CU,... (Review)
Review
Food industry workers are at increased risk for occupational contact urticaria (CU). There are many foodstuffs that have been reported to cause occupational CU, including seafood, meat, vegetables, and fruits. The aim of this review is to summarize all reported occupational cases of CU in the food industry. This is a systematic review based on a MEDLINE search of articles in English and German and a manual search, between 1990 and 2014, to summarize the case reports and case series of occupational CU in the food industry. Many different foodstuffs have been implicated in CU. Occupational CU has been reported in many different occupations, mostly in individuals dealing with seafood, meat, vegetables, and fruits, such as chefs, cooks, bakers, butchers, slaughterhouse workers, and fish-factory workers. Foodstuffs that commonly induce occupational protein contact dermatitis include fish, seafood, meats, vegetables, and fruits. Food handlers may acquire CU resulting from occupational exposures. The prognosis varies widely. The diagnosis of immunological CU is based on the clinical history and on a positive prick test with the suspected substance and/or measurement of specific IgE.
Topics: Allergens; Beer; Cheese; Dermatitis, Allergic Contact; Dermatitis, Occupational; Food Handling; Food Hypersensitivity; Food-Processing Industry; Fruit; Humans; Meat; Patch Tests; Seafood; Skin Tests; Urticaria; Vegetables
PubMed: 27425004
DOI: 10.1111/cod.12653 -
Contact Dermatitis Apr 2022Hairdressers are commonly affected by hand eczema (HE) due to skin hazardous exposure such as irritants and allergens in the work environment. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Hairdressers are commonly affected by hand eczema (HE) due to skin hazardous exposure such as irritants and allergens in the work environment.
OBJECTIVE
To give an overview of the current prevalence, incidence, and severity, as well as the pattern of debut and the contribution of atopic dermatitis on HE in hairdressers.
METHODS
A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines was performed. Studies published from 2000 to April 2021 that fulfilled predefined eligibility criteria were retrieved.
RESULTS
A pooled lifetime prevalence of 38.2% (95% confidence interval [CI] 32.6-43.8), a pooled 1-year prevalence of 20.3% (95% CI 18.0-22.6), and a pooled point prevalence of 7.7% (95% CI 5.8-9.6) of HE was observed in hairdressers. The lifetime prevalence in fully trained hairdressers and hairdressing apprentices was almost identical. The pooled incidence rate of HE was 51.8 cases/1000 person-years (95% CI 42.6-61.0) and the pooled prevalence of atopic dermatitis was 18.1% (95% CI 13.6-22.5).
CONCLUSION
HE is common in hairdressers and most hairdressers have debut during apprenticeship. The prevalence of atopic dermatitis in hairdressers is comparable with estimates in the general population, indicating that occupational exposures are the main factor in the increased prevalence of HE in hairdressers. This warrants a strategic and collective effort to prevent HE in hairdressers.
Topics: Dermatitis, Allergic Contact; Dermatitis, Occupational; Eczema; Hand Dermatoses; Humans; Incidence; Occupational Exposure; Prevalence
PubMed: 35038179
DOI: 10.1111/cod.14048