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Frontiers in Immunology 2023JAK inhibitors treat various autoimmune diseases, but an updated systematic review in treating alopecia areata is currently lacking. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
JAK inhibitors treat various autoimmune diseases, but an updated systematic review in treating alopecia areata is currently lacking.
OBJECTIVE
Evaluate the specific efficacy and safety of JAK inhibitors in alopecia areata by systematic review and meta-analysis.
METHODS
Eligible studies in PubMed, Embase, Web of Science, and Clinical Trials up to May 30, 2022, were searched. We enrolled in randomized controlled trials and observational studies of applying JAK inhibitors in alopecia areata.
RESULTS
6 randomized controlled trials with 1455 patients exhibited SALT (odd ratio [OR], 5.08; 95% confidence interval [CI], 3.49-7.38), SALT (OR, 7.40; 95% CI, 4.34-12.67) and change in SALT score (weighted mean difference [WSD], 5.55; 95% CI, 2.60-8.50) compared to the placebo. The proportion of 26 observational studies with 563 patients of SALT was 0.71(95% CI, 0.65-0.78), SALT was 0.54(95% CI 0.46-0.63), SALT was 0.33(95% CI, 0.24-0.42), and SALT score (WSD, -2.18; 95% CI, -3.12 to -1.23) compared with baseline. Any adverse effects occurred in 921 of 1508 patients; a total of 30 patients discontinued the trial owing to adverse reactions.
LIMITATIONS
Few randomized controlled trials met the inclusion criteria and insufficiency of eligible data.
CONCLUSION
JAK inhibitors are effective in alopecia areata, although associated with an increased risk.
Topics: Humans; Janus Kinase Inhibitors; Alopecia Areata; Autoimmune Diseases; Odds Ratio
PubMed: 37334349
DOI: 10.3389/fimmu.2023.1195858 -
The Lancet. Global Health May 2016The risk factors contributing to maternal mortality from anaesthesia in low-income and middle-income countries and the burden of the problem have not been... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The risk factors contributing to maternal mortality from anaesthesia in low-income and middle-income countries and the burden of the problem have not been comprehensively studied up to now. We aimed to obtain precise estimates of anaesthesia-attributed deaths in pregnant women exposed to anaesthesia and to identify the factors linked to adverse outcomes in pregnant women exposed to anaesthesia in low-income and middle-income countries.
METHODS
In this systematic review and meta-analysis, we searched major electronic databases from inception until Oct 1, 2015, for studies reporting risks of maternal death from anaesthesia in low-income and middle-income countries. Studies were included if they assessed maternal and perinatal outcomes in pregnant women exposed to anaesthesia for an obstetric procedure in countries categorised as low-income or middle-income by the World Bank. We excluded studies in high-income countries, those involving non-pregnant women, case reports, and studies published before 1990 to ensure that the estimates reflect the current burden of the condition. Two independent reviewers undertook quality assessment and data extraction. We computed odds ratios for risk factors and anaesthesia-related complications, and pooled them using a random effects model. This study is registered with PROSPERO, number CRD42015015805.
FINDINGS
44 studies (632,556 pregnancies) reported risks of death from anaesthesia in women who had an obstetric surgical procedure; 95 (32,149,636 pregnancies and 36,144 deaths) provided rates of anaesthesia-attributed deaths as a proportion of maternal deaths. The risk of death from anaesthesia in women undergoing obstetric procedures was 1·2 per 1000 women undergoing obstetric procedures (95% CI 0·8-1·7, I(2)=83%). Anaesthesia accounted for 2·8% (2·4-3·4, I(2)=75%) of all maternal deaths, 3·5% (2·9-4·3, I(2)=79%) of direct maternal deaths (ie, those that resulted from obstetric complications), and 13·8% (9·0-20·7, I(2)=84%) of deaths after caesarean section. Exposure to general anaesthesia increased the odds of maternal (odds ratio [OR] 3·3, 95% CI 1·2-9·0, I(2)=58%), and perinatal deaths (2·3, 1·2-4·1, I(2)=73%) compared with neuraxial anaesthesia. The rate of any maternal death was 9·8 per 1000 anaesthetics (5·2-15·7, I(2)=92%) when managed by non-physician anaesthetists compared with 5·2 per 1000 (0·9-12·6, I(2)=95%) when managed by physician anaesthetists.
INTERPRETATION
The current international priority on strengthening health systems should address the risk factors such as general anaesthesia and rural setting for improving anaesthetic care in pregnant women.
FUNDING
Ammalife Charity and ELLY Appeal, Bart's Charity.
Topics: Anesthesia, General; Anesthesia, Obstetrical; Anesthesiologists; Cesarean Section; Developing Countries; Female; Humans; Infant, Newborn; Maternal Mortality; Nurse Anesthetists; Obstetric Surgical Procedures; Odds Ratio; Perinatal Death; Pregnancy; Risk Factors
PubMed: 27102195
DOI: 10.1016/S2214-109X(16)30003-1 -
Cancer Medicine Jul 2022Salivary diagnostics and their utility as a nonaggressive approach for breast cancer diagnosis have been extensively studied in recent years. This meta-analysis assesses... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Salivary diagnostics and their utility as a nonaggressive approach for breast cancer diagnosis have been extensively studied in recent years. This meta-analysis assesses the diagnostic value of salivary biomarkers in differentiating between patients with breast cancer and controls.
METHODS
We conducted a meta-analysis and systematic review of studies related to salivary diagnostics published in PubMed, EMBASE, Scopus, Ovid, Science Direct, Web of Science (WOS), and Google Scholar. The articles were chosen utilizing inclusion and exclusion criteria, as well as assessing their quality. Specificity and sensitivity, along with negative and positive likelihood ratios (NLR and PLR) and diagnostic odds ratio (DOR), were calculated based on random- or fixed-effects model. Area under the curve (AUC) and summary receiver-operating characteristic (SROC) were plotted and evaluated, and Fagan's Nomogram was evaluated for clinical utility.
RESULTS
Our systematic review and meta-analysis included 14 papers containing 121 study units with 8639 adult subjects (4149 breast cancer patients and 4490 controls without cancer). The pooled specificity and sensitivity were 0.727 (95% CI: 0.713-0.740) and 0.717 (95% CI: 0.703-0.730), respectively. The pooled NLR and PLR were 0.396 (95% CI: 0.364-0.432) and 2.597 (95% CI: 2.389-2.824), respectively. The pooled DOR was 7.837 (95% CI: 6.624-9.277), with the AUC equal to 0.801. The Fagan's nomogram showed post-test probabilities of 28% and 72% for negative and positive outcomes, respectively. We also conducted subgroup analyses to determine specificity, sensitivity, DOR, PLR, and NLR based on the mean age of patients (≤52 or >52 years old), saliva type (stimulated and unstimulated saliva), biomarker measurement method (mass spectrometry [MS] and non-MS measurement methods), sample size (≤55 or >55), biomarker type (proteomics, metabolomics, transcriptomics and proteomics, and reagent-free biophotonic), and nations.
CONCLUSION
Saliva, as a noninvasive biomarker, has the potential to accurately differentiate breast cancer patients from healthy controls.
Topics: Adult; Biomarkers; Breast Neoplasms; Female; Humans; Middle Aged; Odds Ratio; ROC Curve; Sensitivity and Specificity
PubMed: 35315584
DOI: 10.1002/cam4.4640 -
The Journal of Maternal-fetal &... Dec 2023The relationship between circulating miRNAs and neonatal sepsis and the mechanism of action are still unclear at this time. Therefore, the potential diagnostic role of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The relationship between circulating miRNAs and neonatal sepsis and the mechanism of action are still unclear at this time. Therefore, the potential diagnostic role of miRNAs in neonatal sepsis (NS) was studied through meta-analysis.
METHOD
Web of Science, Cochrane Library, PubMed, and Embase are retrieved, supplemented by manual search, and the search was conducted to find related studies without time limit until May 2022.The quality of the literature was assessed via QUADAS criteria and meta-analyzed via Stata 11.0 software, including the assessment of specificity, sensitivity, likelihood ratio and diagnostic odds ratio. Then, sensitivity analysis and heterogeneity testing were conducted, and finally, the summary receiver operating characteristics (SROC) curve was drawn.
RESULT
This study included 14 articles, including 20 miRNAs and 1597 newborns(control group: 727 and case group: 870). Among them, one article was of low quality, three articles were of high quality, and the rest were of medium quality. According to the results of random effects model analysis, the pooled specificity and sensitivity of miRNA for the diagnosis of NS were 0.83 (95%CI: 0.79-0.87) and 0.76 (95%CI: 0.72-0.80), respectively. And negative likelihood ratio, positive likelihood ratio, and diagnostic odds ratio were 0.29 (95%CI: 0.24-0.34), 4.51 (95%CI: 3.52-5.78), and 15.81 (95%CI: 10.71-23.35), respectively. The area under the SROC curve was 0.86, and there was no evidence publication bias detected in the funnel plot.
CONCLUSION
Circulating miRNAs may be very useful in the development of early diagnostic strategies for neonatal sepsis.
Topics: Infant, Newborn; Humans; MicroRNAs; Neonatal Sepsis; Biomarkers; Dietary Supplements; Odds Ratio
PubMed: 37303196
DOI: 10.1080/14767058.2023.2217317 -
World Journal of Gastroenterology Mar 2015To investigate the association between cholecystectomy and gastro-intestinal tract (GIT) cancers. (Review)
Review
AIM
To investigate the association between cholecystectomy and gastro-intestinal tract (GIT) cancers.
METHODS
We conducted a systematic review according to the PRISMA guidelines. A MEDLINE search was performed with predefined search criteria for English Language articles on the association between cholecystectomy and GIT cancers. Additional articles were retrieved by manual search of references. All relevant articles were accessed in full text. Data on study type; cases; controls; country; effect estimate; adjustments for confounders and quality of publication were extracted. The quality of the publications were scored by adherence to the STROBE checklist. The data for each part of the GIT were presented in separate tables.
RESULTS
Seventy-five studies and 5 meta-analyses satisfied the predefined criteria for inclusion and were included in this review. There were inconsistent reports and no strong evidence of an association between cholecystectomy and cancers of the oesophagus (Adenocarcinoma), pancreas, small bowel and right-sided colon cancers. In squamous cancer of the oesophagus, cancers of the stomach, liver, bile ducts, small bowel and left sided colon cancers, good quality studies suggested a lack of association with cholecystectomy. Equally, distal colon and rectal cancers were found not to be associated with cholecystectomy. Several mechanisms for carcinogenesis/promotion of carcinogensis have been proposed. These have focused on a role for bile salts in carcinogenesis with several potential mutagenic molecular events and gut metabolic hormones signaling cell proliferation or initiation of carcinogenesis.
CONCLUSION
This is a comprehensive review of the association between GIT cancers and cholecystectomy. This review found no clear association between cholecystectomy and GIT cancers.
Topics: Cholecystectomy; Digestive System Neoplasms; Humans; Odds Ratio; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 25834337
DOI: 10.3748/wjg.v21.i12.3679 -
Journal of Orthopaedic Surgery (Hong... Jan 2017Rotator cuff tears (RCTs) occur commonly, especially among certain groups of individuals. In this meta-analysis, we aim to identify risk factors for RCTs. (Review)
Review
PURPOSE
Rotator cuff tears (RCTs) occur commonly, especially among certain groups of individuals. In this meta-analysis, we aim to identify risk factors for RCTs.
METHODS
We searched MEDLINE for 210 articles. Seventeen articles were selected for systematic review, of which 10 were eligible for meta-analysis. Data was analysed with Review Manager 5.3, using Mantel-Haenszel statistics and random effect models.
RESULTS
A total of 6653 individuals were analysed. The odds of sustaining a RCT on the dominant hand was 2.30 times more than the non-dominant hand (95% confidence interval (CI): 1.01-5.25, Z = 1.99, p = 0.05; Heterogenity: τ = 0.38, χ = 8.84, df = 2 ( p = 0.01), I = 77%). The odds of an individual aged 60 years and above sustaining a RCT was 5.07 times higher than an individual less than 60 years old (95% CI: 2.45-10.51, Z = 4.37, p < 0.001; Heterogenity: τ = 0.47, χ = 25.24, df = 3 ( p < 0.001), I = 88%). Female gender was not a significant association, with an odds ratio of 0.98 when compared to the male gender (95% CI: 0.66-1.45, Z = 0.09, p = 0.93; Heterogenity: τ = 0.20, χ = 44.24, df = 5 ( p < 0.001), I = 89%).
CONCLUSIONS
Hand dominance and older age are associated with RCTs. More studies are required for further assessment of associations and risk factors of RCTs.
Topics: Adult; Age Factors; Aged; Female; Humans; Male; Middle Aged; Odds Ratio; Risk Factors; Rotator Cuff Injuries; Sex Factors
PubMed: 28211286
DOI: 10.1177/2309499016684318 -
Caries Research 2022The aim of the study was to evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The aim of the study was to evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD by means of a systematic review and meta-analysis.
DESIGN
Electronic searches were performed in 4 databases (PubMed, Embase, Scopus, and Web of Science) in July 2021. Grey literature search in OpenGrey, a search in Google Scholar, and searches in the reference list of included articles were also conducted. The eligibility criteria were observational studies in which children with ADHD were compared with children without ADHD with respect to the dental caries. Study selection, data extraction, and risk of bias assessment, applying the Joanna Briggs tool were performed by 2 reviewers independently. Meta-analysis and assessment of heterogeneity among studies were conducted with the meta-package of RStudio using the R programming language (R Core Team, Vienna, Austria). Results of meta-analysis were provided in mean difference (MD), odds ratio (OR), and confidence intervals (CIs). For assessment of heterogeneity, Baujat plot and influence analysis plot were obtained.
RESULTS
Thirteen studies were included and 10 were incorporated into meta-analyses. The meta-analysis showed that children with ADHD had a higher decayed, missing, and filled teeth (DMFT) index than their peers without ADHD (I2 = 42%; MD = 0.75 [0.38-1.13]). For decayed, missing, and filled surfaces (I2 = 0; MD = 0.39 [-0.02 to 0.80]) and decayed surfaces (ds) (I2 = 0%; MD = 0.35 [-0.63 to 1.33]), no difference between groups was observed. In addition, children with ADHD had higher odds of having dental caries than their healthy peers (OR = 3.31 [1.25, 8.73]; I2 = 0%). After assessment of heterogeneity among studies, sensitivity analysis was conducted for DMFT. One study was removed and the significant difference between groups remained. Children with ADHD had a significantly higher DMFT index than their peers without ADHD (MD = 0.98 [CI = 0.75, 1.20]; I2 = 0%) Risk of bias ranged from low to high.
CONCLUSION
The main shortcoming of the included studies is the high risk of bias regarding the strategies to deal with confounding factors. Within its limitations, this systematic review and meta-analysis demonstrated that children with ADHD were more likely to develop dental caries than their healthy counterparts.
FUNDING
No funding.
REGISTRATION
CRD42021238923.
Topics: Attention Deficit Disorder with Hyperactivity; Bias; Child; Dental Care; Dental Caries; Humans; Odds Ratio
PubMed: 34929707
DOI: 10.1159/000521142 -
Medicine Nov 2022Sarcopenia is a progressive generalized skeletal muscle disorder that causes the accelerated loss of muscle mass and function. Osteoporosis is a systemic condition of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Sarcopenia is a progressive generalized skeletal muscle disorder that causes the accelerated loss of muscle mass and function. Osteoporosis is a systemic condition of the skeleton that results in low bone mass and quality. Several studies have suggested that osteoporosis and sarcopenia are interrelated; however, a few studies indicate the lack of a significant association between sarcopenia and osteoporosis. We aimed to evaluate the association between sarcopenia and osteoporosis via a systematic review and pooled analysis.
METHODS
From the inception of the PubMed and Embase databases until September 2022, we conducted a systematic search for studies evaluating the relationship between sarcopenia and osteoporosis. Study appraisal and synthesis methods: We included observational studies that provided 95% confidence intervals (CIs) and risk estimates. Two reviewers independently extracted data and assessed the quality of the research. The random-effects model was applied to the pool analysis, and the odds ratios (ORs) and 95% CIs were finally calculated.
RESULTS
The primary statistic was the mutual risk between sarcopenia and osteoporosis. According to the inclusion criteria, 56 studies (796,914 participants) were finally included. Sarcopenia was significantly correlative to the risk of osteoporosis (OR, 3.06; 95% CI, 2.30-4.08), and each standard deviation increase in relative appendicular skeletal muscle mass was significantly related to a decreased risk of osteoporosis (OR, 0.65; 95% CI, 0.56-0.75). Osteoporosis observably referred to a higher risk of sarcopenia (OR, 2.63; 95% CI, 1.98-3.49).
CONCLUSION
Our research indicated that sarcopenia and osteoporosis are highly positively correlated. Osteoporosis is closely associated with the risk of sarcopenia. Our finding highlights the importance of sarcopenia screening for those at risk of osteoporosis, and vice versa. However, heterogeneity was noted among the studies, and this might have influenced the accuracy of the results. Therefore, the results of our study should be interpreted with caution.
Topics: Humans; Sarcopenia; Osteoporosis; Odds Ratio
PubMed: 36401390
DOI: 10.1097/MD.0000000000031692 -
American Journal of Obstetrics and... Oct 2022This study aimed to systematically assess the impact of cardiomyopathy on maternal pregnancy outcomes. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to systematically assess the impact of cardiomyopathy on maternal pregnancy outcomes.
DATA SOURCES
PubMed, Ovid Embase, Ovid MEDLINE, Cochrane Library, and ClinicalTrials.gov were systematically searched from inception to April 24, 2022.
STUDY ELIGIBILITY CRITERIA
Observational cohort, case-control, and case-cohort studies in human populations were included if they reported predefined maternal outcomes for pregnant women with cardiomyopathy (any subtype) and for an appropriate control population (pregnant women with no known heart disease or pregnant women with noncardiomyopathy heart disease).
METHODS
Two reviewers independently assessed the articles for eligibility and risk of bias, and conflicts were resolved by a third reviewer. Data were extracted and synthesized according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-Analyses of Observational Studies in Epidemiology guidelines.
RESULTS
A total of 14 studies (n=57,539,306 pregnancies) were eligible for inclusion. Women with cardiomyopathy were more likely to deliver by cesarean delivery than women with no heart disease (odds ratio, 2.96; 95% confidence interval, 2.47-3.55; I=95%; P≤.00001) or women with noncardiomyopathy heart disease (odds ratio, 1.90; 95% confidence interval, 1.62-2.22; I=91%; P<.00001). Having cardiomyopathy conferred a greater risk for experiencing severe maternal adverse cardiovascular events during pregnancy when compared with not having any heart disease (odds ratio, 206.64; 95% confidence interval, 192.09-222.28; I=73%; P<.0001) or having noncardiomyopathy heart disease (odds ratio, 7.09; 95% confidence interval; 6.08-8.27; I=88%; P<.00001). In-hospital mortality was significantly higher among women with cardiomyopathy than among women with no heart disease (odds ratio, 126.67; 95% confidence interval, 43.01-373.07; I=87%; P<.00001) or among women with noncardiomyopathy heart disease (odds ratio, 4.30; 95% confidence interval, 3.42-5.40; I=0%; P<.00001).
CONCLUSION
Pregnant women with cardiomyopathy have increased risks for adverse maternal outcomes, including maternal death, when compared with both women with no heart disease and women with noncardiomyopathy heart disease. Our results highlight the importance of preconception risk assessments to allow for informed decision-making before pregnancy. Pregnancies affected by cardiomyopathy are high risk and should be managed by expert, multidisciplinary obstetrical and cardiology teams.
Topics: Cardiomyopathies; Cesarean Section; Female; Humans; Odds Ratio; Pregnancy; Pregnancy Complications; Pregnancy Outcome
PubMed: 35609641
DOI: 10.1016/j.ajog.2022.05.039 -
International Journal of Molecular... Jul 2016Dietary patterns influence cancer risk. However, systematic reviews have not evaluated relationships between a priori defined diet quality scores and adult cancer risk... (Review)
Review
Dietary patterns influence cancer risk. However, systematic reviews have not evaluated relationships between a priori defined diet quality scores and adult cancer risk and mortality. The aims of this systematic review are to (1) describe diet quality scores used in cohort or cross-sectional research examining cancer outcomes; and (2) describe associations between diet quality scores and cancer risk and mortality. The protocol was registered in Prospero, and a systematic search using six electronic databases was conducted through to December 2014. Records were assessed for inclusion by two independent reviewers, and quality was evaluated using a validated tool. Sixty-four studies met inclusion criteria from which 55 different diet quality scores were identified. Of the 35 studies investigating diet quality and cancer risk, 60% (n = 21) found a positive relationship. Results suggest no relationship between diet quality scores and overall cancer risk. Inverse associations were found for diet quality scores and risk of postmenopausal breast, colorectal, head, and neck cancer. No consistent relationships between diet quality scores and cancer mortality were found. Diet quality appears to be related to site-specific adult cancer risk. The relationship with cancer mortality is less conclusive, suggesting additional factors impact overall cancer survival. Development of a cancer-specific diet quality score for application in prospective epidemiology and in public health is warranted.
Topics: Databases, Factual; Diet; Epidemiologic Studies; Humans; Neoplasms; Odds Ratio; Proportional Hazards Models; Risk Factors
PubMed: 27399671
DOI: 10.3390/ijms17071052