-
Pathogens (Basel, Switzerland) May 2022This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the... (Review)
Review
This systematic review and meta-analysis synthesized the evidence on the impacts of demographics and comorbidities on the clinical outcomes of COVID-19, as well as the sources of the heterogeneity and publication bias of the relevant studies. Two authors independently searched the literature from PubMed, Embase, Cochrane library, and CINAHL on 18 May 2021; removed duplicates; screened the titles, abstracts, and full texts by using criteria; and extracted data from the eligible articles. The variations among the studies were examined by using Cochrane, Q.; I, and meta-regression. Out of 11,975 articles that were obtained from the databases and screened, 559 studies were abstracted, and then, where appropriate, were analyzed by meta-analysis ( = 542). COVID-19-related severe illness, admission to the ICU, and death were significantly correlated with comorbidities, male sex, and an age older than 60 or 65 years, although high heterogeneity was present in the pooled estimates. The study design, the study country, the sample size, and the year of publication contributed to this. There was publication bias among the studies that compared the odds of COVID-19-related deaths, severe illness, and admission to the ICU on the basis of the comorbidity status. While an older age and chronic diseases were shown to increase the risk of developing severe illness, admission to the ICU, and death among the COVID-19 patients in our analysis, a marked heterogeneity was present when linking the specific risks with the outcomes.
PubMed: 35631084
DOI: 10.3390/pathogens11050563 -
Journal of Clinical Medicine Jul 2021Thirty-three years ago, pulsed lasers marked the beginning of a new era in endoscopic lithotripsy, and the one that was highlighted because of its potential was the... (Review)
Review
Thirty-three years ago, pulsed lasers marked the beginning of a new era in endoscopic lithotripsy, and the one that was highlighted because of its potential was the Holmium: YAG laser, which became and still is the gold standard in endourology. Recently, a new laser technology has been accepted for clinical use in lithotripsy: the thulium fiber laser (TFL), showing appealing characteristics not seen before in several preclinical studies. A review of the literature was performed and all relevant in vitro studies and clinical trials until April 2021 were selected. The search came back with 27 clinical experiences (7 full-text clinical trials and 20 peer-reviewed abstracts) and 33 laboratory studies (18 full-text articles and 15 peer-reviewed abstracts). The clinical experiences confirmed the clinical safety of using the wide parameter range of the TFL. This technology demonstrated the performance at a higher ablation speed, the higher ablation efficiency, and the better dust quality of the TFL, as well as reduced stone retropulsion, thus helping to maintain an optimal visibility. No thermal or radiation damage was found. Given the current evidence, we may be facing the future gold standard laser in endoscopic lithotripsy.
PubMed: 34362169
DOI: 10.3390/jcm10153390 -
Deutsches Arzteblatt International Oct 2017The number of homeless people in Germany is increasing. Studies from multiple countries have shown that most homeless people suffer from mental illnesses that require... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The number of homeless people in Germany is increasing. Studies from multiple countries have shown that most homeless people suffer from mental illnesses that require treatment. Accurate figures on the prevalence of mental illness among the homeless in Germany can help improve care structures for this vulnerable group.
METHODS
We carried out a systematic review and meta-analysis on the prevalence of mental illness among homeless people in Germany.
RESULTS
11 pertinent studies published from 1995 to 2013 were identified. The overall study population consisted of 1220 homeless people. The pooled prevalence of axis I disorders was 77.4%, with a 95% confidence interval [95% CI] of [71.3; 82.9]. Substance-related disorders were the most common type of disorder, with a pooled prevalence of 60.9% [53.1; 68.5]. The most common among these was alcoholism, with a prevalence of 55.4% [49.2; 61.5]. There was marked heterogeneity across studies.
CONCLUSION
In Germany, the rate of mental illness requiring treatment is higher among the homeless than in the general population. The development and implementation of suitable care models for this marginalized and vulnerable group is essential if their elevated morbidity and mortality are to be reduced.
Topics: Adult; Female; Germany; Ill-Housed Persons; Humans; Male; Mental Disorders; Prevalence; Quality of Life; Substance-Related Disorders
PubMed: 29070426
DOI: 10.3238/arztebl.2017.0665 -
Acta Ophthalmologica Jun 2015Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical... (Meta-Analysis)
Meta-Analysis Review
Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high-to-moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis.
Topics: Anterior Chamber; Anti-Bacterial Agents; Cataract Extraction; Endophthalmitis; Eye Infections, Bacterial; Humans; Postoperative Complications
PubMed: 25779209
DOI: 10.1111/aos.12684 -
Cancer Cell International 2019Mounting evidence has shown that long noncoding RNAs (lncRNAs) can play a substantial role in gallbladder cancer (GBC) development as tumor promotors or suppressors, and... (Review)
Review
BACKGROUND
Mounting evidence has shown that long noncoding RNAs (lncRNAs) can play a substantial role in gallbladder cancer (GBC) development as tumor promotors or suppressors, and their abnormal expression is relevant to GBC patient outcomes. We completed this systematic review and meta-analysis to explore the clinical significance and mechanisms of lncRNAs in GBC.
METHODS
We conducted a comprehensive literature search and selected eligible records according to the inclusion and exclusion criteria. Hazard ratios (HRs) and odds ratios (ORs) were extracted or calculated to estimate the relationships of high lncRNA expression with GBC patient survival and clinical outcomes.
RESULTS
Eighteen studies were identified as eligible for this systematic review and meta-analysis. Heterogeneity among HRs of overall survival (OS) was notably high (I = 86.2%, p < 0.001). Subgroup analysis suggested that overexpression of lncRNAs in a group that is upregulated in GBC showed a significant association with poor OS (HR = 2.454, 95% CI 2.004-3.004, I = 0%). Conversely, overexpression of lncRNAs in a downregulated group was markedly related to good OS (HR = 0.371, 95% CI 0.267-0.517, I = 0%). High expression levels of lncRNA AFAP1-AS1, MALAT1 and ROR were positively correlated with tumor size. Expression of lncRNA LET, LINC00152 and HEGBC exhibited a positive correlation with high T status. LncRNA LINC00152, HEGBC, MALAT1 and ROR showed a marked correlation with positive lymph node metastasis (LNM), while lncRNA GCASPC, MEG3, LET and UCA1 had the opposite effect. High expression levels of lncRNA HEGBC, PAGBC, PVT1 and UCA1 predicted high tumor node metastasis (TNM) stages, while lncRNA LET, GCASPC and MEG3 indicated low TNM stages. We also summarized the mechanisms of lncRNAs in GBC.
CONCLUSION
Aberrant expression of several lncRNAs was indicative of the prognosis of GBC patients, and lncRNAs showed promise as biomarkers and therapeutic targets for GBC.
PubMed: 31297033
DOI: 10.1186/s12935-019-0891-1 -
Addictive Behaviors Reports Jun 2024Food addiction (FA) is characterized by behavioral changes related to the consumption of palatable foods, marked by dependence, impulsivity, and compulsion. Children and... (Review)
Review
Food addiction (FA) is characterized by behavioral changes related to the consumption of palatable foods, marked by dependence, impulsivity, and compulsion. Children and adolescents are more vulnerable to FA owing to their significant consumption of ultra-processed foods. This review aims to investigate the differences in dietary intake in pediatric populations with and without FA. We conducted a systematic literature review. PubMed, ScienceDirect, and PsycINFO databases were searched up to July 2023. Potentially eligible studies were independently checked by two researchers. The methodological quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies. Of the 4868 articles identified, six studies were included. All the included studies had high methodological quality. High consumption of calories and fat was observed in children and adolescents with FA. A diet quality analysis showed that the consumption of ultra-processed foods, such as sugary drinks, sweets, and chips, was related to FA. Given these findings, we concluded that FA in childhood may be associated with higher energy consumption and, consequently, higher intake of macronutrients. Few studies have examined the relationship between FA and food intake in childhood, and more studies are required.
PubMed: 38322322
DOI: 10.1016/j.abrep.2024.100531 -
HIV Medicine Apr 2022Effective antiretroviral therapy (ART) has improved the life expectancy of women living with HIV (WLWH). This population is now experiencing age-related comorbidities....
OBJECTIVES
Effective antiretroviral therapy (ART) has improved the life expectancy of women living with HIV (WLWH). This population is now experiencing age-related comorbidities. This systematic review presents the current understanding of the prevalence and impact of comorbidities in WLWH in the modern ART era.
METHODS
MEDLINE and Embase were searched for studies (1 January 2010 to 1 September 2020) reporting the prevalence of cardiovascular, bone, renal and neurocognitive disease in WLWH aged > 18 years. Studies were included if at least 100 participants (or > 50%) were female and data analysis included prevalence by sex.
RESULTS
In all, 3050 articles were identified and screened; 153 full-text articles were assessed for eligibility and 38 were included in the final review. Significant gaps in the literature were identified, notably a lack of data on WLWH aged > 50 years. The data suggest a high burden of cardiovascular, bone, renal and neurocognitive disease in WLWH compared with HIV negative women. Traditional risk factors, such as hypertension, diabetes and dyslipidaemia, were common and often poorly managed. Generalizability of the results was limited, as many studies were conducted in the USA. Comparisons between WLWH and men with HIV were limited by marked differences in demographic and socioeconomic factors.
CONCLUSIONS
Women living with HIV experience a high burden of comorbid disease. Traditional risk factors are common and often poorly managed. This review also highlights the magnitude of differences between women and men living with HIV beyond the pathophysiological. Future research must unpick the complex drivers of morbidity in WLWH, to improve the holistic management of this population.
Topics: Adolescent; Comorbidity; Dyslipidemias; Female; HIV Infections; Humans; Male; Middle Aged; Prevalence; Risk Factors
PubMed: 35243744
DOI: 10.1111/hiv.13240 -
Sensors (Basel, Switzerland) Apr 2022Dementia is the most common neurodegenerative disorder globally. Disease progression is marked by declining cognitive function accompanied by changes in mobility.... (Review)
Review
Dementia is the most common neurodegenerative disorder globally. Disease progression is marked by declining cognitive function accompanied by changes in mobility. Increased sedentary behaviour and, conversely, wandering and becoming lost are common. Global positioning system (GPS) solutions are increasingly used by caregivers to locate missing people with dementia (PwD) but also offer a non-invasive means of monitoring mobility patterns in PwD. We performed a systematic search across five databases to identify papers published since 2000, where wearable or portable GPS was used to monitor mobility in patients with common dementias or mild cognitive impairment (MCI). Disease and GPS-specific vocabulary were searched singly, and then in combination, identifying 3004 papers. Following deduplication, we screened 1972 papers and retained 17 studies after a full-text review. Only 1/17 studies used a wrist-worn GPS solution, while all others were variously located on the patient. We characterised the studies using a conceptual framework, finding marked heterogeneity in the number and complexity of reported GPS-derived mobility outcomes. was the most frequently reported category of mobility reported (15/17), followed by (14/17), and and (both 10/17). Future research would benefit from greater standardisation and harmonisation of reporting which would enable GPS-derived measures of mobility to be incorporated more robustly into clinical trials.
Topics: Cognitive Dysfunction; Dementia; Disease Progression; Geographic Information Systems; Humans; Wearable Electronic Devices
PubMed: 35591026
DOI: 10.3390/s22093336 -
Sports Medicine (Auckland, N.Z.) Jul 2017Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to... (Review)
Review
BACKGROUND
Information on sleep quality and insomnia symptomatology among elite athletes remains poorly systematised in the sports science and medicine literature. The extent to which performance in elite sport represents a risk for chronic insomnia is unknown.
OBJECTIVES
The purpose of this systematic review was to profile the objective and experienced characteristics of sleep among elite athletes, and to consider relationships between elite sport and insomnia symptomatology.
METHODS
Studies relating to sleep involving participants described on a pre-defined continuum of 'eliteness' were located through a systematic search of four research databases: SPORTDiscus, PubMed, Science Direct and Google Scholar, up to April 2016. Once extracted, studies were categorised as (1) those mainly describing sleep structure/patterns, (2) those mainly describing sleep quality and insomnia symptomatology and (3) those exploring associations between aspects of elite sport and sleep outcomes.
RESULTS
The search returned 1676 records. Following screening against set criteria, a total of 37 studies were identified. The quality of evidence reviewed was generally low. Pooled sleep quality data revealed high levels of sleep complaints in elite athletes. Three risk factors for sleep disturbance were broadly identified: (1) training, (2) travel and (3) competition.
CONCLUSION
While acknowledging the limited number of high-quality evidence reviewed, athletes show a high overall prevalence of insomnia symptoms characterised by longer sleep latencies, greater sleep fragmentation, non-restorative sleep, and excessive daytime fatigue. These symptoms show marked inter-sport differences. Two underlying mechanisms are implicated in the mediation of sport-related insomnia symptoms: pre-sleep cognitive arousal and sleep restriction.
Topics: Athletes; Fatigue; Humans; Sleep; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Sports
PubMed: 27900583
DOI: 10.1007/s40279-016-0650-6 -
MedEdPublish (2016) 2017This article was migrated. The article was marked as recommended. Professionalism is a core competency and concern in all health professional education. Evidence from...
This article was migrated. The article was marked as recommended. Professionalism is a core competency and concern in all health professional education. Evidence from nursing and medicine suggests the evidence base for approaches to developing and assessing professionalism at undergraduate level is weak. In 2015, notifications, imposed sanctions, and in some cases de-registration against dental practitioners for reported incidences of breaches in infection control in New South Wales, Australia, have refreshed the essential need for dental practitioners to promote public safety and protection. To investigate the evidence for clinical education practice approaches to develop professionalism in dentistry. Relevant electronic databases were searched for full-text peer reviewed papers relating to dental practitioners published between 2000 and June 2016 in English. All research designs were included. Following initial and detailed screening, included papers were independently quality appraised and strength of evidence graded by two independent reviewers. Removal of duplicates resulted in 195 unique papers; following screening 34 full text articles were assessed for eligibility resulting in 15 papers evaluated in this review. Eight different clinical education approaches were identified. Most studies were of low quality and reported low levels of educational outcomes based on Kirkpatrick's Hierarchy. There is a lack of good quality evidence to support any one approach to develop professionalism in dentistry. What evidence there is focuses on low level educational outcomes such as learners experience. Low level outcomes is common in educational research and therefore unsurprising. More disappointing was failure to adequately justify the methodology and the absence on the definition of dental professionalism. The research findings is consistent with the evidence across other health professions internationally. There is scope for an inter-professional approach to tackle the challenge developing and subsequently assessing professionalism.
PubMed: 38406420
DOI: 10.15694/mep.2017.000085