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European Review For Medical and... May 2021This systematic review and meta-analysis aimed to evaluate the association between the prealbumin and severity and mortality in COVID-19. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This systematic review and meta-analysis aimed to evaluate the association between the prealbumin and severity and mortality in COVID-19.
MATERIALS AND METHODS
We performed a systematic literature search from PubMed, Embase, and Scopus databases up until 2 February 2021. The primary outcome was the poor outcome, a composite of mortality and severity. Severe COVID-19 was defined as COVID-19 that fulfill the criteria for severe pneumonia or patients with acute respiratory distress syndrome/disease progression/need for intensive care unit or mechanical ventilation. The effect estimates were a mean difference between patients with and without a poor outcome in mg/dL and odds ratio (OR) per 1 mg/dL decrease in prealbumin level. The effect estimates were reported with their 95% confidence interval (95% CI).
RESULTS
Nine studies comprising of 2104 patients were included in this systematic review and meta-analysis. Patients with poor outcome have lower prealbumin level (mean difference -71.48 mg/dL [95% CI -93.74, -49.22], p<0.001; I2: 85.9%). Every 1 mg/dL decrease in prealbumin level was associated with 1% increase in poor outcome (OR 0.992 [0.987, 0.997], p=0.004, I2: 81.7%). Meta-regression analysis showed that the association between the prealbumin level and poor outcome varies with gender (male) (coefficient: 3.50, R2: 100%, p<0.001), but not age, diabetes, hypertension, and chronic kidney disease.
CONCLUSIONS
Low serum prealbumin was associated with poor outcomes in patients with COVID-19.
Topics: COVID-19; Humans; Odds Ratio; Prealbumin; SARS-CoV-2; Severity of Illness Index; Sex Factors
PubMed: 34109596
DOI: 10.26355/eurrev_202105_25955 -
Acta Obstetricia Et Gynecologica... Dec 2021Human papillomavirus (HPV), p16, and p53 have been investigated as prognostic markers in various HPV-related cancers. Within the field of vaginal cancer, however, the...
INTRODUCTION
Human papillomavirus (HPV), p16, and p53 have been investigated as prognostic markers in various HPV-related cancers. Within the field of vaginal cancer, however, the evidence remains sparse. In this systematic review, we have compiled the presently published studies on the prognostic significance of HPV and immunohistochemical expression of p16 and p53 among women with vaginal cancer.
MATERIAL AND METHODS
We conducted a systematic search of PubMed, Embase, and Cochrane Library to identify relevant studies published until April 2021. We included studies reporting survival after histologically verified vaginal cancers tested for HPV, p16, and/or p53. Survival outcomes included overall survival, disease-free survival, disease-specific survival, and progression-free survival.
RESULTS
We included a total of 12 studies. The vast majority of vaginal cancer cases included in each study were squamous cell carcinomas (84%-100%). Seven studies reported survival after vaginal cancer according to HPV status, and the majority of these studies found a tendency towards improved survival for women with HPV-positive vaginal cancer. Three out of four studies reporting survival according to p16 status found an improved survival among women with p16-positive vaginal cancer. For p53, only one of six studies reported an association between p53 expression and survival.
CONCLUSIONS
This systematic review suggests that women with HPV- and p16-positive vaginal cancer have an improved prognosis compared with those with HPV- or p16-negative vaginal cancer. Results for p53 were varied, and no conclusion could be reached. Only 12 studies could be included in the review, of which most were based on small populations. Hence, further and larger studies on the prognostic impact of HPV, p16, and p53 in vaginal cancer are warranted.
Topics: Alphapapillomavirus; Carcinoma, Squamous Cell; Cyclin-Dependent Kinase Inhibitor p16; Disease-Free Survival; Female; Humans; Prognosis; Tumor Suppressor Protein p53; Vaginal Neoplasms
PubMed: 34546565
DOI: 10.1111/aogs.14260 -
Journal of Dairy Science Feb 2016Bovine paratuberculosis is a disease characterized by chronic granulomatous enteritis causing protein-losing enteropathy. Adverse effects on animal productivity are key... (Meta-Analysis)
Meta-Analysis Review
Bovine paratuberculosis is a disease characterized by chronic granulomatous enteritis causing protein-losing enteropathy. Adverse effects on animal productivity are key drivers in the attempt to control paratuberculosis at the farm level. Economic models require an accurate estimation of the production effects associated with paratuberculosis. The aim of this study was to conduct a systematic review and meta-analysis to investigate the effect of paratuberculosis on milk production. A total of 20 effect estimates from 15 studies were included in the final meta-analysis. Substantial between-study heterogeneity was observed. Subgroup analysis by case definition and study design was carried out to investigate heterogeneity. The majority of between-study variation was attributed to studies that defined cases on serology. Calculation of a pooled effect estimate was only appropriate for studies that defined cases by organism detection. A reduction in milk yield, corrected for lactation number and herd of origin of 1.87 kg/d, equivalent to 5.9% of yield, was associated with fecal culture or PCR positivity in individual cows.
Topics: Animals; Cattle; Cattle Diseases; Feces; Female; Lactation; Milk; Mycobacterium avium subsp. paratuberculosis; Paratuberculosis
PubMed: 26686704
DOI: 10.3168/jds.2015-10156 -
Alimentary Pharmacology & Therapeutics Mar 2015Treatment for chronic hepatitis C (CH-C) is rapidly changing and moving away from an interferon and ribavirin-based therapy to interferon-free ribavirin-free all oral... (Review)
Review
BACKGROUND
Treatment for chronic hepatitis C (CH-C) is rapidly changing and moving away from an interferon and ribavirin-based therapy to interferon-free ribavirin-free all oral regimens. These regimens are simpler and shorter to administer with very high efficacy rates and better side effect profiles. As advances in the treatment of CH-C occur, it is imperative to capture both clinical outcomes (efficacy and safety) as well as patient-reported outcomes (PROs). In fact, PROs assesses and quantifies the impact of these regimens on patient experience. PROs assess patients' health-related quality of life (HRQOL) especially in the realms of fatigue and neuropsychiatric issues such as depression which can affect treatment adherence and work productivity.
AIM
To review the literature related to PRO's in HCV patients and summarise the impact of CH-C and its treatment on PROs.
METHODS
Databases Ovid MEDLINE and PubMed were searched from 1990 to October 2014 using a combination of MEsh, thesaurus terms and relevant text words: hepatitis C, CH-C, treatment, quality of life, health-related quality of life, fatigue, work productivity, adherence, patient-reported outcomes, direct acting anti-viral agents and second generation direct acting anti-viral agents. Each manuscript was assessed for pertinence to the issue of PROs in CH-C as well as the quality of study design and publications.
RESULTS
From the literature, it is evident that CH-C patients have baseline PRO impairment. Furthermore, treatment with interferon with or without ribavirin and first generation DAAs causes additional PRO burden which can negatively impact treatment adherence and indirectly, treatment efficacy and work productivity. The new treatment regimens with interferon- and ribavirin-free regimens not only have very high efficacy, but also result in the improvement of PRO scores as early as 2 weeks into treatment as well as possibly better adherence to treatment regimens.
CONCLUSIONS
CH-C and its treatment have been associated with patient-reported outcome impairment. The new IF-free and RBV-free regimens are associated with high efficacy and substantial improvement of patient-reported outcomes in clinical trial setting. Although very encouraging, more data are needed to assess patient-reported outcomes, adherence and work productivity of CH-C patients in the real world setting of clinical practice.
Topics: Antiviral Agents; Drug Therapy, Combination; Hepacivirus; Hepatitis C, Chronic; Humans; Interferons; Patient Outcome Assessment; Quality of Life; Ribavirin; Treatment Outcome
PubMed: 25616122
DOI: 10.1111/apt.13090 -
Viruses Feb 2021For over 100 years after the description of the first case of African swine fever (ASF) in Kenya, ASF virus (ASFV) cross-border spread in eastern and southern Africa has... (Meta-Analysis)
Meta-Analysis Review
For over 100 years after the description of the first case of African swine fever (ASF) in Kenya, ASF virus (ASFV) cross-border spread in eastern and southern Africa has not been fully investigated. In this manuscript, we reviewed systematically the available literature on molecular epidemiology of ASF in Tanzania and its eight neighboring countries in order to establish the transmission dynamics of ASFV between these countries. Data were retrieved from World Animal Health Information System (WAHIS), Google Scholar, PubMed, Scopus, and CrossRef databases, using the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and reviewed to document ASF outbreaks and ASFV genotypes distribution. Using phylogeographic approach applied to ASFV p72 sequence dataset, the evolutionary history and the dispersal pattern of the ASFV strains were assessed. From 2005 to 2019, a total of 1588 ASF outbreaks affecting 341,742 cases that led to 302,739 domestic pig deaths were reported. The case fatality rates (CFR) varied from 15.41% to 98.95% with an overall CFR of 88.58%. Fifteen different p72 ASFV genotypes were reported and the time to the most recent common ancestor (TMRCA) for ASFV strains dated back to 1652.233 (1626.473, 1667.735) with an evolutionary rate of 4.805 × 10 (2.5857 × 10, 9.7789 × 10). Phylogeographic dispersal analysis revealed several transboundary spread events of ASFV strains between these countries. These results suggest persistent circulation of ASFV in these countries and advocate for more research to improve our understanding of the transmission dynamics of the virus and for a regional approach to mitigate the spread of ASFV.
Topics: African Swine Fever; African Swine Fever Virus; Animals; Capsid Proteins; Disease Outbreaks; Female; Genotype; Kenya; Male; Molecular Epidemiology; Phylogeny; Sus scrofa; Swine; Tanzania
PubMed: 33672090
DOI: 10.3390/v13020306 -
Artificial Organs Dec 2021Coronavirus disease-19 (COVID-19) ranges from asymptomatic infection to severe cases requiring admission to the intensive care unit. Together with supportive therapies...
BACKGROUND
Coronavirus disease-19 (COVID-19) ranges from asymptomatic infection to severe cases requiring admission to the intensive care unit. Together with supportive therapies (ventilation in particular), the suppression of the pro-inflammatory state has been a hypothesized target. Pharmacological therapies with corticosteroids and interleukin-6 (IL-6) receptor antagonists have reduced mortality. The use of extracorporeal cytokine removal, also known as hemoperfusion (HP), could be a promising non-pharmacological approach to decrease the pro-inflammatory state in COVID-19.
METHODS
We conducted a systematic review of PubMed and EMBASE databases in order to summarize the evidence regarding HP therapy in COVID-19. We included original studies and case series enrolling at least five patients.
RESULTS
We included 11 articles and describe the characteristics of the populations studied from both clinical and biological perspectives. The methodological quality of the included studies was generally low. Only two studies had a control group, one of which included 101 patients in total. The remaining studies had a range between 10 and 50 patients included. There was large variability in the HP techniques implemented and in clinical and biological outcomes reported. Most studies described decreasing levels of IL-6 after HP treatment.
CONCLUSION
Our review does not support strong conclusions regarding the role of HP in COVID-19. Considering the very low level of clinical evidence detected, starting HP therapies in COVID-19 patients does not seem supported outside of clinical trials. Prospective randomized data are needed.
Topics: Adult; Aged; Biomarkers; COVID-19; Cytokines; Female; Hemoperfusion; Humans; Inflammation Mediators; Male; Middle Aged; Risk Factors; Treatment Outcome
PubMed: 34632596
DOI: 10.1111/aor.14078 -
BMC Infectious Diseases Jun 2021Increasing incidences of syphilis highlight the preoccupation with the occurrence of neurosyphilis. This study aimed to understand the current diagnostic tools and their...
PURPOSE
Increasing incidences of syphilis highlight the preoccupation with the occurrence of neurosyphilis. This study aimed to understand the current diagnostic tools and their performance to detect neurosyphilis, including new technologies and the variety of existing methods.
METHODS
We searched databases to select articles that reported neurosyphilis diagnostic methods and assessed their accuracy, presenting sensitivity and specificity values. Information was synthesized in tables. The risk of bias was examined using the Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy recommendations.
RESULTS
Fourteen studies were included. The main finding was a remarkable diversity of tests, which had varied purposes, techniques, and evaluation methodologies. There was no uniform criterion or gold standard to define neurosyphilis. The current basis for its diagnosis is clinical suspicion and cerebrospinal fluid analysis. There are new promising tests such as PCR tests and chemokine measurement assays.
CONCLUSIONS
The diagnosis of neurosyphilis is still a challenge, despite the variety of existing and developing tests. We believe that the multiplicity of reference standards adopted as criteria for diagnosis reveals the imprecision of the current definitions of neurosyphilis. An important next step for the scientific community is to create a universally accepted diagnostic definition for this disease.
Topics: Chemokines; Diagnostic Techniques and Procedures; Humans; Neurosyphilis; Polymerase Chain Reaction; Reference Standards; Sensitivity and Specificity; Treponema pallidum
PubMed: 34126948
DOI: 10.1186/s12879-021-06264-8 -
PLoS Neglected Tropical Diseases Dec 2016Dengue virus (DENV) infection is widespread and its disease burden has increased in past decades. However, little is known about the epidemiology of dengue in the Middle... (Review)
Review
BACKGROUND
Dengue virus (DENV) infection is widespread and its disease burden has increased in past decades. However, little is known about the epidemiology of dengue in the Middle East and North Africa (MENA).
METHODOLOGY / PRINCIPAL FINDINGS
Following Cochrane Collaboration guidelines and reporting our findings following PRISMA guidelines, we systematically reviewed available records across MENA describing dengue occurrence in humans (prevalence studies, incidence studies, and outbreak reports), occurrence of suitable vectors (Aedes aegypti and Aedes albopictus), and DENV vector infection rates. We identified 105 human prevalence measures in 13 of 24 MENA countries; 81 outbreaks reported from 9 countries from 1941-2015; and reports of Ae. aegypti and/or Ae. albopictus occurrence in 15 countries. The majority of seroprevalence studies were reported from the Red Sea region and Pakistan, with multiple studies indicating >20% DENV seroprevalence in general populations (median 25%, range 0-62%) in these subregions. Fifty percent of these studies were conducted prior to 1990. Multiple studies utilized assays susceptible to serologic cross-reactions and 5% of seroprevalence studies utilized viral neutralization testing. There was considerable heterogeneity in study design and outbreak reporting, as well as variability in subregional study coverage, study populations, and laboratory methods used for diagnosis.
CONCLUSIONS / SIGNIFICANCE
DENV seroprevalence in the MENA is high among some populations in the Red Sea region and Pakistan, while recent outbreaks in these subregions suggest increasing incidence of DENV which may be driven by a variety of ecologic and social factors. However, there is insufficient study coverage to draw conclusions about Aedes or DENV presence in multiple MENA countries. These findings illustrate the epidemiology of DENV in the MENA while revealing priorities for DENV surveillance and Aedes control.
Topics: Aedes; Africa, Northern; Animals; Antibodies, Viral; Dengue; Dengue Virus; Humans; Insect Vectors; Seroepidemiologic Studies
PubMed: 27926925
DOI: 10.1371/journal.pntd.0005194 -
PloS One 2016Hepatitis E virus is one of new threats to blood safety which was usually considered to be transmitted via fecal-oral route. China is one of the hyperendemic regions... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Hepatitis E virus is one of new threats to blood safety which was usually considered to be transmitted via fecal-oral route. China is one of the hyperendemic regions where frequent outbreaks of hepatitis E are noted. However, the overall prevalence of HEV infection among mainland Chinese blood donors is not clear until now.
METHOD
The peer-reviewed literatures reporting the prevalence of HEV in Chinese blood donors were identified by systematic searching of five electronic databases. The systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement issued in 2009. Data manipulation and statistical analyses were performed by Stata 12.0.
RESULTS
Fourteen eligible articles involving 22 independent studies were included. Pooled prevalence of HEV infection biomarkers (anti-HEV IgG, anti-HEV IgM, RNA and antigen) among mainland Chinese blood donors were 29.2%, 1.1%, 0.1% and 0.1%, respectively which were higher than the data reported in other countries. The analysis of HEV genotypes indicated that the most prevalent strains in Chinese blood donors were genotype 1 and 4.
CONCLUSIONS
Mainland China is indicated with a relatively higher risk of transmission of hepatitis E through transfusion and the screening of blood donors for HEV RNA, especially in HEV-endemic areas, might reduce the potential risk of HEV infection via transfusion.
Topics: Biomarkers; Blood Donors; Blood Safety; China; Hepatitis Antibodies; Hepatitis E; Hepatitis E virus; Humans
PubMed: 27597991
DOI: 10.1371/journal.pone.0161089 -
Journal of Infection in Developing... Jul 2015The varieties of infections caused by Helicobacter pylori may be due to differences in bacterial genotypes and virulence factors as well as environmental and... (Meta-Analysis)
Meta-Analysis Review
The varieties of infections caused by Helicobacter pylori may be due to differences in bacterial genotypes and virulence factors as well as environmental and host-related factors. This study aimed to investigate the prevalence of cagA and vacA genes among H. pylori-infected patients in Iran and analyze their relevance to the disease status between two clinical groups via a meta-analysis method. Different databases including PubMed, ISI, Scopus, SID, Magiran, Science Direct, and Medlib were investigated, and 23 relevant articles from the period between 2001 and 2012 were finally analyzed. The relevant data obtained from these papers were analyzed by a random-effects model. Data were analyzed using R software and STATA. The prevalence of cagA and vacA genes among H. pylori-infected patients was 70% (95% CI, 64-75) and 41% (95% CI, 24.3-57.7), respectively. The prevalence of duodenal ulcers, peptic ulcers, and gastritis among cagA+ individuals was 53% (95% CI, 20-86), 65% (95% CI, 34-97), and 71% (95% CI, 59-84), respectively. Odds ratio (OR) between cagA-positive compared with cagA-negative patients showed a 1.89 (95% CI, 1.38-2.57) risk of ulcers. In conclusion, the frequency of cagA gene among H. pylori strains is elevated in Iran and it seems to be more frequently associated with gastritis. Therefore, any information about cagA and vacA prevalence among different H. pylori-infected clinical groups in the country can help public health authorities to plan preventive policies to reduce the prevalence of diseases associated with H. pylori infection.
Topics: Antigens, Bacterial; Bacterial Proteins; Gastritis; Genotype; Helicobacter Infections; Helicobacter pylori; Humans; Iran; Peptic Ulcer; Prevalence
PubMed: 26230117
DOI: 10.3855/jidc.5970