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Journal of Research in Health Sciences Dec 2023Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Different vaccines have so far been developed and approved to cope with COVID-19 in the world. The aim of this updated network meta-analysis (NMA) was to compare and rank all available vaccines in terms of efficacy and complications simultaneously. A systematic review.
METHODS
Three major international databases, including Web of Science, Medline via PubMed, and Scopus, were searched through September 2023. The transitivity assumption was evaluated qualitatively in terms of epidemiologic effect modifiers. The exposure of interest in this study was receiving any available COVID-19 vaccine, and the primary outcome of interest was the incidence of symptomatic COVID-19. In this NMA, the relative risk of symptomatic COVID-19 was used to summarize the efficacy of vaccines in preventing COVID-19. The data were analyzed using the frequentist-based approach, and the results were reported using a random-effects model. Finally, the vaccines were ranked using a P-score.
RESULTS
In total, 34 randomized controlled trials (RCTs) met the eligibility criteria for this systematic review and NMA out of 3682 retrieved references. Based on the results of the NMA, mRNA-1273 was the most effective vaccine in preventing COVID-19 and demonstrated the highest P-score (0.93). The relative risk (RR) for mRNA-1273 versus placebo was 0.07 (95% confidence interval [CI]: 0.03, 0.17). The second and third-ranked vaccines were BNT-162b2 (RR=0.08; 95% CI: 0.04, 0.15; P-score=0.93) and Gam-COVID-Vac (0.09; 95% CI: 0.03, 0.25; 0.88).
CONCLUSION
Based on the results of this NMA, it seems that all available vaccines were effective in COVID-19 prevention. However, the top three ranked vaccines were mRNA-1273, BNT-162b2, and Gam-COVID-Vac, respectively.
Topics: Humans; COVID-19 Vaccines; Network Meta-Analysis; 2019-nCoV Vaccine mRNA-1273; BNT162 Vaccine; COVID-19; Randomized Controlled Trials as Topic
PubMed: 38315908
DOI: 10.34172/jrhs.2023.128 -
Journal of Pediatric Orthopedics Sep 2023Surgical site infection (SSI) is a major potential complication following pediatric spinal deformity surgery that is associated with significant morbidity and increased...
Updating the Evidence: Systematic Literature Review of Risk Factors and Strategies for Prevention, Diagnosis, and Treatment of Surgical Site Infection After Pediatric Scoliosis Surgery.
BACKGROUND
Surgical site infection (SSI) is a major potential complication following pediatric spinal deformity surgery that is associated with significant morbidity and increased costs. Despite this, SSI rates remain high and variable across institutions, in part due to a lack of up-to-date, comprehensive prevention, and treatment protocols. Furthermore, few attempts have been made to review the optimal diagnostic modalities and treatment strategies for SSI following scoliosis surgery. The aim of this study was to systematically review current literature on risk factors for SSI in pediatric patients undergoing scoliosis surgery, as well as strategies for prevention, diagnosis, and treatment.
METHODS
On January 19, 2022, a systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies reporting risk factors for acute, deep SSI (<90 d) or strategies for prevention, diagnosis, or treatment of SSI following pediatric scoliosis surgery were included. Each included article was assigned a level of evidence rating based on study design and quality. Extracted findings were organized into risk factors, preventive strategies, diagnostic modalities, and treatment options and each piece of evidence was graded based on quality, quantity, and consistency of underlying data.
RESULTS
A total of 77 studies met the inclusion criteria and were included in this systematic review, of which 2 were categorized as Level I, 3 as Level II, 64 as Level III, and 8 as Level IV. From these studies, a total of 29 pieces of evidence (grade C or higher) regarding SSI risk factors, prevention, diagnosis, or treatment were synthesized.
CONCLUSIONS
We present an updated review of published evidence for defining high-risk patients and preventing, diagnosing, and treating SSI after pediatric scoliosis surgery. The collated evidence presented herein may help limit variability in practice and decrease the incidence of SSI in pediatric spine surgery.
LEVEL OF EVIDENCE
Level III-systematic review.
Topics: Child; Humans; Scoliosis; Surgical Wound Infection; Spine; Risk Factors; Incidence
PubMed: 37442780
DOI: 10.1097/BPO.0000000000002464 -
BMC Endocrine Disorders Sep 2023Concerning ascending trend in the prevalence of chronic type II diabetes, prevention and the development of an effective approach after the recognition of at-risk... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Concerning ascending trend in the prevalence of chronic type II diabetes, prevention and the development of an effective approach after the recognition of at-risk individuals is crucial. This study aims to investigate comparing the influence of lifestyle modification and metformin interventions in the prevention of type II diabetes developments.
METHOD
The search was conducted using PubMed, Google Scholar, Scopus and Web of Science databases. The inclusion criteria include randomized controlled trials (RCT) which studied both lifestyle modification and metformin interventions in the population above 18 years old without a history of any type of diabetes. After excluding studies with intervention time of fewer than 6 months, a systematic review and meta-analysis were performed to evaluate relative risk (RR) with a confidence interval (CI) of 95% of type II diabetes development.
RESULTS
Data from 5 studies were included in the meta-analysis. The population also consists of individuals with a mean age of 50 years old with BMI and FBS of 35.5 and 104.7 mg/dl respectively. Participants range of prevention years was between 2-3 years with a mean of 2.8 years. Lifestyle modification decreases the probability of the incidence of type II diabetes by 25.3% (RR: 0.747, 95% CI, 0.6-0.92) compared to the metformin intervention (p-value = 0.007). Our results indicate that long-term lifestyle modifications can prevent diabetes type II and decrease diabetes mellitus incidence down to one-quarter in comparison to metformin.
CONCLUSION
Lifestyle modification can be more efficacious than metformin in diminishing the incidence of type II diabetes. Therefore, lifestyle modification can be a therapeutic strategy for controlling type II diabetes incidence, especially in high-risk individuals.
Topics: Humans; Middle Aged; Adolescent; Metformin; Diabetes Mellitus, Type 2; Behavior Therapy; Life Style; Primary Prevention
PubMed: 37723440
DOI: 10.1186/s12902-023-01445-9 -
Molecular Nutrition & Food Research Jan 2024This study aims to systematically review observational studies investigating the relation between dietary (poly)phenol consumption and various cognitive outcomes. (Meta-Analysis)
Meta-Analysis
SCOPE
This study aims to systematically review observational studies investigating the relation between dietary (poly)phenol consumption and various cognitive outcomes.
METHODS AND RESULTS
Embase and PubMed databases are searched from inception to April 2023 for observational studies investigating the relation between dietary (poly)phenol intake and cognitive outcomes. For quantitative analyses, random effects models, subgroup analyses, and dose-response analyses are performed. A total of 37 studies are included in the systematic review. Among (poly)phenols, a higher intake of flavonoids is associated with better cognitive function and lower odds of cognitive decline (although with some exceptions). A quantitative meta-analysis shows an overall inverse association with cognitive impairment and reduced association with the incidence of dementia or related disorders for total flavonoids (relative risk (RR) = 0.83, 95% confidence interval (CI): 0.76, 0.89), anthocyanins (RR = 0.73, 95% CI: 0.60, 0.89), flavones (RR = 0.77, 95% CI: 0.63, 0.94), flavan-3-ols (RR = 0.86, 95% CI: 0.82, 0.91), and flavonols (RR = 0.88, 95% CI: 0.80, 0.96). Data on other (poly)phenolic compounds (i.e., phenolic acids) are promising but too preliminary.
CONCLUSION
Habitual inclusion of flavonoids in the diet may play a preventive role against cognitive disorders.
Topics: Humans; Phenols; Anthocyanins; Phenol; Diet; Cognitive Dysfunction; Flavonoids; Risk Factors; Observational Studies as Topic
PubMed: 37888840
DOI: 10.1002/mnfr.202300472 -
Trauma, Violence & Abuse Oct 2023There is increasing evidence for the deleterious impact of emotional violence on children`s well-being and development. This systematic review focused on a) the... (Review)
Review
There is increasing evidence for the deleterious impact of emotional violence on children`s well-being and development. This systematic review focused on a) the prevalence and (b) correlates of emotional violence by teachers. A literature search of quantitative and peer-reviewed studies published in English between 1980 and April 2021 was conducted. Eighty-four studies met the inclusion criteria. Studies represented all geographical regions of the world, were predominantly cross-sectional and of moderate quality. Studies were heterogeneous in terms of their samples, conceptualization, and measurement of emotional violence. Results indicated that emotional violence by teachers is prevalent across cultural settings, although large variations within and between regions are noted. It is related to mental health, behavioral and academic problems of children above and beyond physical violence by teachers and victimization by peers and parents. Boys are at higher risk of experiencing emotional violence by teachers than girls. Family dysfunction, low socioeconomic status (of the family or the community), and violent school environments appear to increase risk as well. The observed patterns of co-occurrence of emotional violence with physical violence by teachers and victimization by peers as well as perpetration of violence against peers and teachers lend support to notions of poly-victimization and cycles of violence in the school settings. Future research should use representative surveys, examine antecedents, and consequences of emotional violence by teachers using longitudinal and experimental designs and evaluate interventions to prevent emotional violence by teachers.
Topics: Male; Child; Female; Humans; Prevalence; Cross-Sectional Studies; Violence; Crime Victims; Physical Abuse
PubMed: 35583121
DOI: 10.1177/15248380221102559 -
JAMA Aug 2023A 2019 review for the US Preventive Services Task Force (USPSTF) found oral preexposure prophylaxis (PrEP) associated with decreased HIV infection risk vs placebo or no...
IMPORTANCE
A 2019 review for the US Preventive Services Task Force (USPSTF) found oral preexposure prophylaxis (PrEP) associated with decreased HIV infection risk vs placebo or no PrEP in adults at increased HIV acquisition risk. Newer PrEP regimens are available.
OBJECTIVE
To update the 2019 review on PrEP, to inform the USPSTF.
DATA SOURCES
Ovid MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and Embase (January 2018 to May 16, 2022); surveillance through March 24, 2023.
STUDY SELECTION
Randomized clinical trials of PrEP vs placebo or no PrEP or newer vs older PrEP regimens and diagnostic accuracy studies of instruments for predicting incident HIV infection.
DATA EXTRACTION AND SYNTHESIS
Dual review of titles and abstracts, full-text articles, study quality, and data abstraction. Data were pooled using the DerSimonian and Laird random-effects model.
MAIN OUTCOMES AND MEASURES
HIV acquisition, mortality, and harms; and diagnostic test accuracy.
RESULTS
Thirty-two studies were included in the review (20 randomized clinical trials [N = 36 543] and 12 studies of diagnostic accuracy [N = 5 544 500]). Eleven trials in the 2019 review found oral PrEP associated with decreased HIV infection risk vs placebo or no PrEP (n = 18 172; relative risk [RR], 0.46 [95% CI, 0.33-0.66]). Higher adherence was associated with greater efficacy. One new trial (n = 5335) found oral tenofovir alafenamide/emtricitabine (TAF/FTC) to be noninferior to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in men who have sex with men (RR, 0.47 [95% CI, 0.19-1.14]). Two new trials found long-acting injectable cabotegravir associated with decreased risk of HIV infection vs oral TDF/FTC (RR, 0.33 [95% CI, 0.18-0.62] in cisgender men who have sex with men and transgender women [n = 4490] and RR, 0.11 [95% CI, 0.04-0.31] in cisgender women [n = 3178]). Discrimination of instruments for predicting incident HIV infection was moderate in men who have sex with men (5 studies; n = 25 488) and moderate to high in general populations of persons without HIV (2 studies; n = 5 477 291).
CONCLUSIONS AND RELEVANCE
In adults at increased HIV acquisition risk, oral PrEP was associated with decreased risk of acquiring HIV infection compared with placebo or no PrEP. Oral TAF/FTC was noninferior to oral TDF/FTC, and injectable cabotegravir reduced the risk of HIV infection compared with oral TDF/FTC in the populations studied.
Topics: Adult; Female; Humans; Male; Administration, Oral; Anti-HIV Agents; Emtricitabine; HIV Infections; Homosexuality, Male; Injections; Practice Guidelines as Topic; Pre-Exposure Prophylaxis; Randomized Controlled Trials as Topic; Risk; Sexual and Gender Minorities; Tenofovir
PubMed: 37606667
DOI: 10.1001/jama.2023.9865 -
Journal of Orthopaedic Surgery and... Jul 2023Prevalence information is the first step in developing preventive procedures or health services. This study was conducted to systematically evaluate the epidemiology of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Prevalence information is the first step in developing preventive procedures or health services. This study was conducted to systematically evaluate the epidemiology of osteoporotic fractures in Chinese elderly aged ≥ 60 years and to provide evidence-based evidence for the prevention and treatment of osteoporotic fractures.
METHODS
We identified relevant studies by searching the literature published in PubMed, Web of Science, Cochrane Library, Embase, CNKI, Wanfang Data, and VIP databases from the establishment of the database until August 2022. We used a random-effects model to obtain prevalence estimates and identified sources of heterogeneity and comparisons of prevalence among different groups through subgroup analysis and sensitivity analysis.
RESULTS
A total of 29 articles were included in this study, and the prevalence of osteoporosis fractures in elderly Chinese was high (18.9%). The prevalence has increased significantly over the past decade (from 13.2% in 2000-2010 to 22.7% in 2012-2022). The prevalence of osteoporosis is higher in women than in men (18.5% vs 14.3%) and increases with age. The northern region was higher than the southern region (20.3% vs 18.9%), and the spine, hip, and distal forearm were the most common sites of fracture.
CONCLUSION
The prevalence of osteoporotic fractures in the Chinese elderly is 18.9%, and timely prevention and treatment are necessary.
Topics: Aged; Male; Humans; Female; Osteoporotic Fractures; Prevalence; Osteoporosis; China; Spine
PubMed: 37501170
DOI: 10.1186/s13018-023-04030-x -
Scientific Reports Nov 2023Anti-tuberculosis drug induced liver injury (Anti-TB DILI) is the most common adverse events (AEs) necessitating therapy interruption but there is no preventing regimen.... (Meta-Analysis)
Meta-Analysis
Anti-tuberculosis drug induced liver injury (Anti-TB DILI) is the most common adverse events (AEs) necessitating therapy interruption but there is no preventing regimen. This study aimed to examine the efficacy and safety of herbs/alternative medicines for preventing anti-TB DILI. Relevant articles were identified through a systematic search in 5 international databases from inception till March 2022. All randomized controlled trials (RCT) assessing the effects of herbal or alternative medicines against anti-TB DILI were included. The network meta-analysis (NMA) was used to synthesize the evidence for preventing hepatotoxicity using a random-effects model. A total of 3423 patients from 14 RCTs were included. The NMA indicated that supplementation of Turmeric plus Tinospora cordifolia (RR 0.07; 95% CI 0.02 to 0.28), and N-acetyl cysteine (NAC) (RR 0.09; 95% CI 0.01 to 0.75) significantly reduced the incidence of anti-TB DILI compared with placebo. In addition, poly herbal product significantly reduced alkaline phosphatase (ALP) (MD - 21.80; 95% CI - 33.80 to - 9.80) and total bilirubin (Tbil) compared with placebo (MD - 0.51; 95% CI - 0.76 to - 0.26). There was no statistically significant difference in the occurrence of AEs in any intervention. In conclusion, Turmeric plus Tinospora cordifolia, NAC and poly-herbal product may provide benefit for preventing anti-TB DILI in TB patients. However, these findings are based on a small number of studies. Additional studies are warranted to confirm the findings.
Topics: Humans; Antitubercular Agents; Network Meta-Analysis; Chemical and Drug Induced Liver Injury
PubMed: 37963954
DOI: 10.1038/s41598-023-46565-3 -
Clinical Nutrition ESPEN Dec 2023Malnutrition is a common problem among patients with head and neck cancer and can have adverse effects on overall health and treatment outcomes. Nutritional and physical...
BACKGROUND/SCOPE
Malnutrition is a common problem among patients with head and neck cancer and can have adverse effects on overall health and treatment outcomes. Nutritional and physical prehabilitation are potential strategies to optimize the nutritional status of these patients. This systematic review aimed to identify and describe prehabilitative interventions that can promote an improvement in nutritional status.
METHODS
A systematic review of the literature was conducted in the databases PubMed/Medline, Embase, CINAHL, Scopus and on the platform Web of Science and in Cochrane Library. The selected studies concern adults with head and neck tumours, not malnourished at the time of diagnosis, who undergo nutritional or physical prehabilitation.
RESULTS
Out of 1369 results, 7 studies were included. Multimodal prehabilitation interventions that combine nutritional counseling, oral nutritional supplements, and swallowing exercises to prevent dysphagia have shown positive outcomes in maintaining caloric intake, body weight, swallowing ability, and a reduced incidence of fibrosis in the upper gastrointestinal tract, as well as improving quality of life.
CONCLUSION
Despite the limited number of clinical studies available in the literature, the results suggest that nutritional and physical prehabilitation interventions have a positive effect on the nutritional status and clinical outcomes of patients with head and neck cancer, helping mitigate the risk of malnutrition and improve general well-being.
Topics: Adult; Humans; Preoperative Exercise; Quality of Life; Nutritional Status; Malnutrition; Head and Neck Neoplasms
PubMed: 38057023
DOI: 10.1016/j.clnesp.2023.10.033 -
Heart Failure Reviews Nov 2023Anthracyclines and trastuzumab are widely used to treat breast cancer but increase the risk of cardiomyopathy and heart failure. With the use of trastuzumab and... (Meta-Analysis)
Meta-Analysis Review
Anthracyclines and trastuzumab are widely used to treat breast cancer but increase the risk of cardiomyopathy and heart failure. With the use of trastuzumab and anthracycline-containing medications, this study intends to evaluate the effectiveness and security of current treatments against cardiotoxicity. We conducted a systematic review of randomized controlled trials (RCTs), which used at least one angiotensin-converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), or beta-blocker (BB) to prevent cardiotoxicity of antineoplastic agents for breast cancer, in 4 databases (PubMed, Cochrane Library, EMBASE, Web of Science) from inception to 11 May 2022, without language restrictions. The outcome of interest was left ventricular ejection fraction (LVEF) and adverse events. Stata 15 and R software 4.2.1 were used to perform all statistical analyses. The Cochrane version 2 of the risk of bias tool was used to assess the risk of bias, and the grading of recommendations assessment, development, and evaluation (GRADE) assessment was used to appraise the quality of the evidence. Fifteen randomized clinical studies with a total of 1977 patients were included in the analysis. The included studies demonstrated statistically significant LVEF in the ACEI/ARB and BB treatment groups (χ = 184.75, I = 88.6%, p = 0.000; SMD 0.556, 95% CI 0.299 to 0.813). In an exploratory subgroup analysis, the benefit of experimental agents on LVEF, whether anthracyclines or trastuzumab, was prominent in patients treated with ACEIs, ARBs, and BBs. Compared to placebo, ACEI/ARB and BB treatments in breast cancer patients protect against cardiotoxicity after trastuzumab and anthracycline-containing medication treatment, indicating a benefit for both.
Topics: Humans; Female; Angiotensin-Converting Enzyme Inhibitors; Cardiotoxicity; Antineoplastic Agents; Breast Neoplasms; Trastuzumab; Angiotensin Receptor Antagonists; Antibiotics, Antineoplastic; Anthracyclines; Randomized Controlled Trials as Topic
PubMed: 37414918
DOI: 10.1007/s10741-023-10328-z