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Diagnostic accuracy of interleukin-2 receptor in sarcoidosis: a systematic review and meta-analysis.Expert Review of Respiratory Medicine 2023Soluble interleukin-2 receptor (sIL-2 R), a valuable diagnostic biomarker for sarcoidosis, has been reported with variable results. Based on the literatures currently... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Soluble interleukin-2 receptor (sIL-2 R), a valuable diagnostic biomarker for sarcoidosis, has been reported with variable results. Based on the literatures currently accessible, a systematic review and meta-analysis of the diagnostic performance of serum sIL-2 R for sarcoidosis were performed.
METHODS
Relevant studies investigating sIL-2 R for sarcoidosis diagnosis in several databases were searched and data on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were pooled by STATA 16.0 software. Overall test performance was assessed using summary receiver operating characteristic curves and the area under the curve (AUC). Potential publication bias was assessed by Deeks test.
RESULTS
We included eleven studies involving 1,424 subjects, with 1,099 cases of sarcoidosis and 325 of non-sarcoidosis. The pooled parameters of sIL-2 R in diagnosing sarcoidosis were summarized as follows: sensitivity, 0.85 (95% CI: 0.72-0.93); specificity, 0.88 (95% CI: 0.72-0.96); PLR, 7.3 (95% CI: 2.7-20.1); NLR, 0.17 (95% CI:0.08-0.36); DOR, 44 (95% CI: 8-231); and the AUC, 0.93 (95% CI: 0.90-0.95). No publication bias was identified ( = 0.64).
CONCLUSIONS
Evidence suggests sIL-2 R performs well in diagnosing sarcoidosis. Nevertheless, results of sIL-2 R assay should be interpreted with other diagnostic examinations.
Topics: Humans; Sensitivity and Specificity; ROC Curve; Receptors, Interleukin-2; Sarcoidosis
PubMed: 37334768
DOI: 10.1080/17476348.2023.2225772 -
Contact Dermatitis Sep 2022Evidence regarding the association between lifestyle factors and hand eczema is limited.To extensively investigate the association between lifestyle factors (smoking,... (Meta-Analysis)
Meta-Analysis Review
Evidence regarding the association between lifestyle factors and hand eczema is limited.To extensively investigate the association between lifestyle factors (smoking, alcohol consumption, stress, physical activity, body mass index, diet, and sleep) and the prevalence, incidence, subtype, severity, and prognosis of hand eczema, a systematic review and meta-analysis were conducted in accordance with the Meta-analysis Of Observational Studies in Epidemiology consensus statement. MEDLINE, Embase, and Web of Science were searched up to October 2021. The (modified) Newcastle-Ottawa Scale was used to judge risk of bias. Quality of the evidence was rated using the Grades of Recommendation, Assessment, Development and Evaluation approach. Eligibility and quality were blindly assessed by two independent investigators; disagreements were resolved by a third investigator. Data were pooled using a random-effects model, and when insufficient for a meta-analysis, evidence was narratively summarized. Fifty-five studies were included. The meta-analysis (17 studies) found very low quality evidence that smoking is associated with a higher prevalence of hand eczema (odds ratio 1.18, 95% confidence interval 1.09-1.26). No convincing evidence of associations for the other lifestyle factors with hand eczema were found, mostly due to heterogeneity, conflicting results, and/or the limited number of studies per outcome.
Topics: Dermatitis, Allergic Contact; Eczema; Humans; Life Style; Odds Ratio; Smoking
PubMed: 35277987
DOI: 10.1111/cod.14102 -
The Annals of Thoracic Surgery Jul 2022Endobronchial ultrasound (EBUS)-guided intranodal forceps biopsy (IFB) is considered complementary to EBUS-guided transbronchial needle aspiration (TBNA) (EBUS-TBNA) for... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Endobronchial ultrasound (EBUS)-guided intranodal forceps biopsy (IFB) is considered complementary to EBUS-guided transbronchial needle aspiration (TBNA) (EBUS-TBNA) for patients with intrathoracic lymphadenopathy either when additional tissue is requested for comprehensive molecular testing or for suspected lymphoma and sarcoidosis. This systematic review and meta-analysis investigated the diagnostic yield and complications of combined EBUS-IFB and EBUS-TBNA compared with EBUS-TBNA alone.
METHODS
A systematic search was performed of Medline, Embase, and Google Scholar for studies evaluating the use of EBUS-IFB for diagnosis of intrathoracic adenopathy, and the quality of each study was assessed using the Quality Assessment, Data abstraction and Synthesis-2 tool. Using inverse variance weighting, a meta-analysis of diagnostic yield estimations was performed. The complications related to the procedure were also reviewed.
RESULTS
Six observational studies with 443 patients undergoing 467 biopsies were included in the final analysis. Meta-analysis yielded a pooled overall diagnostic yield of 67% (312 of 467) for EBUS-TBNA and 92% (428 of 467) for EBUS-TBNA in combination with EBUS-IFB, with an inverse variance-weighted odds ratio of 5.87 (95% confidence interval, 3081 to 9.04; P < .00001) and an I of 15%. The overall complications included pneumomediastinum (1%), bleeding (0.8%), and respiratory failure (0.6%). The funnel plot analysis illustrated no major publication bias. Subgroup analysis showed increased diagnostic yield for lymphoma (86% vs 30%; P = .03) and sarcoidosis (93% vs 58%; P < .00001).
CONCLUSIONS
The addition of EBUS-IFB to EBUS-TBNA improves the overall diagnostic yield of sampling intrathoracic adenopathy when compared with EBUS-TBNA alone. The complication rates of the combined approach are higher than with EBUS-TBNA, but they are reportedly lower than with transbronchial or surgical biopsies.
Topics: Bronchoscopy; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Humans; Lymph Nodes; Lymphadenopathy; Lymphoma; Sarcoidosis
PubMed: 33485918
DOI: 10.1016/j.athoracsur.2020.12.049 -
The Journal of Prosthetic Dentistry Dec 2022Type IV hypersensitivity reactions (Type IV HR) are immune responses mediated by antigen-specific effector T cells.
STATEMENT OF PROBLEM
Type IV hypersensitivity reactions (Type IV HR) are immune responses mediated by antigen-specific effector T cells.
PURPOSE
The purpose of this clinical report and systematic review was to report the clinicopathological features of Type IV HR in the oral mucosa and to present a systematic literature review of case reports and case series of individuals with Type IV HR in the oral mucosa related to contact with dental materials.
MATERIAL AND METHODS
The presented clinical lesions were melanotic macules with burning that affected the internal labial mucosa in contact with composite resin veneer crowns. Histopathological and immunohistochemical analysis of the lesion was performed. The systematic literature review was performed based on a search in 4 electronic databases (PubMed/MEDLINE, Scopus, Web of Science, and Ovid).
RESULTS
Immunohistochemistry showed positivity for CD4, CD8, CD20, CD3, tryptase, and CD117. After conservative treatment, the patient reported improvement of symptoms, and a decrease in the number of inflammatory cells was verified. Twenty-one articles were included in the review. Unlike the present patient, the authors of all the articles recommended radical treatment with the removal of the dental material.
CONCLUSIONS
Type IV HR in oral mucosa is rare, and the assessment of clinical and histopathological characteristics is essential to perform an accurate diagnosis and provide appropriate treatment.
Topics: Humans; Composite Resins; Crowns; Hypersensitivity, Delayed
PubMed: 33820631
DOI: 10.1016/j.prosdent.2021.01.034 -
The Ocular Surface Apr 2023Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the... (Review)
Review
Mycoplasma pneumoniae induced rash and mucositis (MIRM) is a relatively newly identified clinical entity which is characterized by mucocutaneous manifestations in the setting of Mycoplasma infection. Though a clinically distinct disease, MIRM exists on a diagnostic continuum with entities including erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, and the recently described reactive infectious mucocutaneous eruption (RIME). In this systematic review, we discuss published findings on the epidemiology, clinical manifestations, diagnosis, and management of MIRM, with an emphasis on ocular disease. Lastly, we discuss some of the most recent developments and challenges in characterizing MIRM with respect to the related diagnosis of RIME.
Topics: Humans; Mucositis; Mycoplasma pneumoniae; Stevens-Johnson Syndrome; Eye; Exanthema
PubMed: 36396020
DOI: 10.1016/j.jtos.2022.11.007 -
Radiology Apr 2023Background There is no consensus regarding the relative prognostic value of cardiac MRI and fluorodeoxyglucose (FDG) PET in cardiac sarcoidosis. Purpose To perform a... (Meta-Analysis)
Meta-Analysis
Background There is no consensus regarding the relative prognostic value of cardiac MRI and fluorodeoxyglucose (FDG) PET in cardiac sarcoidosis. Purpose To perform a systematic review and meta-analysis of the prognostic value of cardiac MRI and FDG PET for major adverse cardiac events (MACE) in cardiac sarcoidosis. Materials and Methods In this systematic review, MEDLINE, Ovid Epub, CENTRAL, Embase, Emcare, and Scopus were searched from inception until January 2022. Studies that evaluated the prognostic value of cardiac MRI or FDG PET in adults with cardiac sarcoidosis were included. The primary outcome of MACE was assessed as a composite including death, ventricular arrhythmia, and heart failure hospitalization. Summary metrics were obtained using random-effects meta-analysis. Meta-regression was used to assess covariates. Risk of bias was assessed using the Quality in Prognostic Studies, or QUIPS, tool. Results Thirty-seven studies were included (3489 patients with mean follow-up of 3.1 years ± 1.5 [SD]); 29 studies evaluated MRI (2931 patients) and 17 evaluated FDG PET (1243 patients). Five studies directly compared MRI and PET in the same patients (276 patients). Left ventricular late gadolinium enhancement (LGE) at MRI and FDG uptake at PET were both predictive of MACE (odds ratio [OR], 8.0 [95% CI: 4.3, 15.0] [ < .001] and 2.1 [95% CI: 1.4, 3.2] [ < .001], respectively). At meta-regression, results varied by modality ( = .006). LGE (OR, 10.4 [95% CI: 3.5, 30.5]; < .001) was also predictive of MACE when restricted to studies with direct comparison, whereas FDG uptake (OR, 1.9 [95% CI: 0.82, 4.4]; = .13) was not. Right ventricular LGE and FDG uptake were also associated with MACE (OR, 13.1 [95% CI: 5.2, 33] [ < .001] and 4.1 [95% CI: 1.9, 8.9] [ < .001], respectively). Thirty-two studies were at risk for bias. Conclusion Left and right ventricular late gadolinium enhancement at cardiac MRI and fluorodeoxyglucose uptake at PET were predictive of major adverse cardiac events in cardiac sarcoidosis. Limitations include few studies with direct comparison and risk of bias. Systematic review registration no. CRD42021214776 (PROSPERO) © RSNA, 2023 .
Topics: Adult; Humans; Fluorodeoxyglucose F18; Prognosis; Cardiomyopathies; Contrast Media; Gadolinium; Myocarditis; Magnetic Resonance Imaging; Sarcoidosis
PubMed: 36809215
DOI: 10.1148/radiol.222483 -
Contact Dermatitis Apr 2024Healthcare workers (HCWs) are considered a high-risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta-analyse... (Meta-Analysis)
Meta-Analysis Review
Healthcare workers (HCWs) are considered a high-risk group for developing hand eczema (HE), mainly owing to wet work and contact with allergens at work. To meta-analyse the prevalence and incidence of HE in HCWs, as well as mapping the prevalence of atopic dermatitis (AD) and HE severity in HCWs. A systematic review and meta-analysis was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. Published literature from 2000 to 2022 was eligible based on predefined inclusion and exclusion criteria. A total of 18 studies were included. Pooled life-time, 1-year and point prevalence of self-reported HE in HCWs was 33.4% (95% confidence interval [CI]: 28.3-38.6), 27.4% (95% CI: 19.3-36.5) and 13.5% (95% CI: 9.3-18.4), respectively. AD prevalence was 15.4% (95% CI: 11.3-19.9). Overall, the majority of HCWs reported mild HE. One included study assessed HE incidence reporting 34 cases/1000 person years. Most studies scored low-moderate using the New Ottawa Scale and the pooled point prevalence data showed broad CIs. In conclusion, the high prevalence of HE in HCWs underlines the increased risk and need for preventive measures for this professional group. There is, however, a need of further standardized high-quality studies.
Topics: Humans; Prevalence; Dermatitis, Allergic Contact; Incidence; Eczema; Dermatitis, Atopic; Health Personnel
PubMed: 38186085
DOI: 10.1111/cod.14489 -
Rheumatology International Dec 2022We aimed to summarise effects and use of non-pharmacological and pharmacological treatments for sarcoidosis with musculoskeletal manifestations. We systematically... (Review)
Review
We aimed to summarise effects and use of non-pharmacological and pharmacological treatments for sarcoidosis with musculoskeletal manifestations. We systematically searched the Cochrane Library, Ovid MEDLINE, Embase, CINAHL, AMED, Scopus, clinical.trials.gov, PROSPERO and PEDro for systematic reviews from 2014 to 2022 and for primary studies from date of inception to March 29, 2022, and studies with patients diagnosed with sarcoidosis with musculoskeletal manifestations. Inclusion criteria required that studies reported effects of non-pharmacological and/or pharmacological treatments or number of patients receiving these treatments. Results were reported narratively and in forest plots. Eleven studies were included. No systematic reviews fulfilled our inclusion criteria. None of the included studies had a control group. We found that between 23 and 100% received corticosteroids, 0-100% received NSAIDs, 5-100% received hydroxychloroquine, 12-100% received methotrexate, 0-100% received TNF inhibitors, and 3-4% received azathioprine. Only ten patients in one study had used non-pharmacological treatments, including occupational therapy, chiropractic and acupuncture. There are no controlled studies on treatment effects for patients with sarcoidosis with musculoskeletal manifestations. We found 11 studies reporting use of pharmacological treatments and only one study reporting use of non-pharmacological treatments. Our study identified major research gaps for pharmacological and non-pharmacological treatment in musculoskeletal sarcoidosis and warrant randomised clinical trials for both.
Topics: Humans; Adrenal Cortex Hormones; Anti-Inflammatory Agents, Non-Steroidal; Azathioprine; Hydroxychloroquine; Methotrexate; Sarcoidosis; Tumor Necrosis Factor Inhibitors
PubMed: 35943526
DOI: 10.1007/s00296-022-05171-8 -
Frontiers in Immunology 2019Despite the large number of performed studies, the etiology and pathogenesis of sarcoidosis still remain unknown. Most researchers allude to the possible autoimmune or...
Despite the large number of performed studies, the etiology and pathogenesis of sarcoidosis still remain unknown. Most researchers allude to the possible autoimmune or immune-mediated genesis of the disease. This review attempts an integral analysis of currently available information suggesting an autoimmune genesis of sarcoidosis and is divided into four categories: the evaluation of clinical signs described both in patients with sarcoidosis and "classic" autoimmune diseases, the role of triggering factors in the development of sarcoidosis, the presence of immunogenic susceptibility in the development of the disease, and the analysis of cellular and humoral immune responses in sarcoidosis. Studying the etiology and pathogenesis of sarcoidosis will improve diagnostic procedures as well as the prognosis and patients' quality of life.
Topics: Animals; Autoimmune Diseases; Humans; Immunity, Cellular; Immunity, Humoral; Sarcoidosis
PubMed: 31969879
DOI: 10.3389/fimmu.2019.02933 -
Seizure Nov 2022Antiepileptic drugs (AEDs) are extensively used to manage epilepsy and other comorbidities associated with seizures. Human Leukocyte Antigen (HLA) has a strong... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Antiepileptic drugs (AEDs) are extensively used to manage epilepsy and other comorbidities associated with seizures. Human Leukocyte Antigen (HLA) has a strong association with AED-induced severe cutaneous adverse drug reactions.
OBJECTIVE
We aimed to perform a systematic review and meta-analysis to identify, critically evaluate, and synthesize the best possible evidence on HLA-associated AED-induced Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN).
METHODS
MEDLINE/PubMed, Scopus, and the Cochrane Library were searched for literature from inception up to July 2022. We included case control studies analyzing association between HLA and AED-induced SJS/TEN. We assessed the studies' risk of bias in using Quality of genetic studies (Q-genie) tool. Outcomes focused on association (risk) between HLA and AED-induced SJS/TEN. The estimated risk was presented in the form of odds ratio (OR).
RESULTS
We included 37 studies (51,422 participants; 7027 cases and 44,395 controls). There was a significantly higher risk of Carbamazepine-induced SJS/TEN with HLA-A (OR: 1.50; 95% CI: 1.03 to 2.17), HLA-B (OR: 1.94; 95% CI: 1.45 to 2.58), HLA-C (OR: 7.83; 95% CI: 4.72 to 12.98), and HLA-DRB1 (OR: 2.82; 95% CI: 1.94 to 4.12). Lamotrigine-induced SJS/TEN posed a higher risk with HLA-A (OR: 2.38; 95% CI: 1.26 to 4.46) and HLA-B (OR: 2.79; 95% CI: 1.75 to 4.46). Phenytoin-induced SJS/TEN showed a higher risk with HLA-A (OR: 3.47; 95% CI: 2.17 to 5.56), HLA-B (OR: 1.72; 95% CI: 1.38 to 2.15), and HLA-C (OR: 2.92; 95% CI: 1.77 to 4.83). Phenobarbital-induced SJS/TEN had a higher risk with HLA-A (OR: 6.98; 95% CI: 1.81 to 26.84), HLA-B (OR: 2.40; 95% CI: 1.39 to 4.17), and HLA-C (OR: 3.37; 95% CI: 1.03 to 11.01). Zonisamide-induced SJS/TEN was significantly associated with HLA-A*02:07 (OR: 9.77; 95% CI: 3.07 to 31.1), HLA-B*46:01 (OR: 6.73; 95% CI: 2.12 to 21.36), and HLA-DRB1×08:03 (OR: 3.78; 95% CI: 1.20 to 11.97). All other alleles of HLA were observed to have a non-significant association with AED-induced SJS/TEN. All included studies were of good quality, with a score of >50 and a mean score of 54.96 out of 77.
CONCLUSION
Our study showed a significant association between few variants of HLA alleles and AED-induced SJS/TEN. Evidences from our study could help in population-based studies and in implementation of individualized treatment regimens. These findings could be part of translational research helping in precision therapy.
Topics: Humans; Stevens-Johnson Syndrome; HLA-DRB1 Chains; HLA-C Antigens; Asian People; HLA-B Antigens; Anticonvulsants; HLA Antigens
PubMed: 36183454
DOI: 10.1016/j.seizure.2022.09.011