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Scientific Reports Jul 2022The neutrophil-to-lymphocyte ratio (NLR) is used as biomarker in malignant diseases showing significant association with poor oncological outcomes. The main research... (Meta-Analysis)
Meta-Analysis
The neutrophil-to-lymphocyte ratio (NLR) is used as biomarker in malignant diseases showing significant association with poor oncological outcomes. The main research question of the present study was whether NLR has also prognostic value in cholangiocarcinoma patients (CCA). A systematic review was carried out to identify studies related to NLR and clinical outcomes in CCA evaluating the literature from 01/2000 to 09/2021. A random-effects model, pooled hazard ratios (HR) and 95% confidence interval (CI) were used to investigate the statistical association between NLR and overall survival (OS) as well as disease-free survival (DFS). Subgroup analyses, evaluation of sensitivity and risk of bias were further carried out. 32 studies comprising 8572 patients were eligible for this systematic review and meta-analysis. The pooled outcomes revealed that high NLR prior to treatment is prognostic for poor OS (HR 1.28, 95% CI 1.18-1.38, p < 0.01) and DFS (HR 1.39, 95% CI 1.17-1.66, p < 0.01) with meaningful HR values. Subgroup analysis revealed that this association is not significantly affected by the treatment modality (surgical vs. non-surgical), NLR cut-off values, age and sample size of the included studies. Given the likelihood of NLR to be prognostic for reduced OS and DFS, pre-treatment NLR might serve as a useful biomarker for poor prognosis in patients with CCA and therefore facilitate clinical management.
Topics: Bile Duct Neoplasms; Bile Ducts, Intrahepatic; Cholangiocarcinoma; Humans; Lymphocytes; Neutrophils; Prognosis
PubMed: 35879385
DOI: 10.1038/s41598-022-16727-w -
Infectious Diseases and Therapy Sep 2020The ability to predict likely prognosis and infectiousness for patients with COVID-19 would aid patient management decisions. Diagnosis is usually via real-time PCR, and... (Review)
Review
BACKGROUND
The ability to predict likely prognosis and infectiousness for patients with COVID-19 would aid patient management decisions. Diagnosis is usually via real-time PCR, and it is unclear whether the semi-quantitative capability of this method, determining viral load through cycle threshold (Ct) values, can be leveraged.
OBJECTIVES
We aim to review available knowledge on correlations between SARS-COV-2 Ct values and patient- or healthcare-related outcomes to determine whether Ct values provide useful clinical information.
SOURCES
A PubMed search was conducted on 1 June 2020 based on a search strategy of (Ct value OR viral load) AND SARS-CoV-2. Data were extracted from studies reporting on the presence or absence of an association between Ct values, or viral loads determined via Ct value, and clinical outcomes.
CONTENT
Data from 18 studies were relevant for inclusion. One study reported on the correlation between Ct values and mortality and one study reported on the correlation between Ct values and progression to severe disease; both reported a significant association (p < 0.001 and p = 0.008, respectively). Fourteen studies reported on the correlation between Ct value or viral loads determined via Ct value and disease severity, and an association was observed in eight (57%) studies. Studies reporting on the correlation of viral load with biochemical and haematological markers showed an association with at least one marker, including increased lactate dehydrogenase (n = 4), decreased lymphocytes (n = 3) and increased high-sensitivity troponin I (n = 2). Two studies reporting on the correlation with infectivity showed that lower Ct values were associated with higher viral culture positivity.
IMPLICATIONS
Data suggest that lower Ct values may be associated with worse outcomes and that Ct values may be useful in predicting the clinical course and prognosis of patients with COVID-19; however, further studies are warranted to confirm clinical value.
PubMed: 32725536
DOI: 10.1007/s40121-020-00324-3 -
Cancers Jun 2023Neutrophils are an important part of the tumor microenvironment, which stimulates inflammatory processes through phagocytosis, degranulation, release of small DNA... (Review)
Review
BACKGROUND
Neutrophils are an important part of the tumor microenvironment, which stimulates inflammatory processes through phagocytosis, degranulation, release of small DNA fragments (cell-free DNA), and presentation of antigens. Since neutrophils accumulate in peripheral blood in patients with advanced-stage cancer, a high neutrophil-to-lymphocyte ratio can be a biomarker of a poor prognosis in patients with glioblastoma. The present study aimed to explore the prognostic value of the preoperative levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), systemic inflammation response index (SIRI), and cell-free DNA (cfDNA) to better predict prognostic implications in the survival rate of glioblastoma patients.
METHODS
The meta-analysis was carried out according to the recommendations and standards established by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Databases of PubMed, EBSCO, and Medline were systematically searched to select all the relevant studies published up to December 2022.
RESULTS
Poorer prognoses were recorded in patients with a high NLR or PLR when compared with the patients with a low NLR or PLR (HR 1.51, 95% CI 1.24-1.83, < 0.0001 and HR 1.34, 95% CI 1.10-1.63, < 0.01, respectively). Similarly, a worse prognosis was reported for patients with a higher cfDNA (HR 2.35, 95% CI 1.27-4.36, < 0.01). The SII and SIRI values were not related to glioblastoma survival ( = 0.0533 and = 0.482, respectively).
CONCLUSIONS
Thus, NLR, PLR, and cfDNA, unlike SII and SIRI, appeared to be useful and convenient peripheral inflammatory markers to assess the prognosis in glioblastoma.
PubMed: 37444448
DOI: 10.3390/cancers15133339 -
Heart & Lung : the Journal of Critical... 2023Heart failure is a pathophysiological condition where decreased cardiac output is observed subsequent to any structural deformity or cessation of normal function.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Heart failure is a pathophysiological condition where decreased cardiac output is observed subsequent to any structural deformity or cessation of normal function. Thiamine deficiency is one of the risk factors responsible for causing HF; other risk factors include hypertension, smoking, and obesity.
OBJECTIVE
We conducted a systemic review and meta-analysis of RCTs to scrutinize whether the heart failure patients would benefit from thiamine supplementation or not when compared to placebo.
METHODS
We selected only those double-arm randomized controlled trials (RCTs) which included participants presenting with symptomatic heart failure. We excluded all the articles published in languages other than English Language. Furthermore, all the studies other than RCTs were also omitted. Articles yielded from the electronic search were exported to EndNote Reference Library software to remove any duplicates. Analyses were done using the Review manager 5.4 tool. Mean values and standard deviations were retrieved for the continuous outcomes given as raw data.
RESULTS
The 6 RCTs selected for the statistical analysis consisted of 298 participants (158 in the intervention group, 140 in the placebo group). The outcomes resulted to be non-significant with LVEF p-value= 0.08, NT-pro BNP p-value= 0.94, LVEDV p-value= 0.53, 6MWT p-value=0.59, mortality p-value= 0.61, hospitalization p-value= 0.53 and dyspnea p-value= 0.77. Heart rate is the only significant outcome with a p-value=0.04.
CONCLUSION
To conclude, except for heart rate, thiamine supplementation had no effect on the outcomes of heart failure patients.
Topics: Humans; Thiamine; Heart Failure; Research Design; Dietary Supplements
PubMed: 37126872
DOI: 10.1016/j.hrtlng.2023.04.011 -
Diabetes & Metabolic Syndrome 2020Low consumption of fruit and vegetables is associated with high prevalence of non-communicable diseases, especially among South Asians. The aim of our study was to... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIMS
Low consumption of fruit and vegetables is associated with high prevalence of non-communicable diseases, especially among South Asians. The aim of our study was to systematically review data published on fruit and vegetable intake among South Asian countries.
METHODS
This review included 43 studies conducted from December 1999 to 2019 among South Asians. Literature searching was undertaken in PubMed® database and World Health Organization website. The main outcomes were pooled using random effect meta-analysis.
RESULTS
The highest fruit consumption by both men and women (2.4 servings/day) was found in Bhutan (2004) while the lowest reports (0.43 servings/day) were from Sri Lanka (2011) and Bangladesh (2002). With regard to vegetable consumption, Indians (2007) had the lowest reported intake (0.9 servings/day), while the highest value, 3.8 servings/day, was reported in Bhutanese adults (2014). When both intakes were considered, the highest (4.28; 95% CI, 4.02 to 4.55; p=0.15; I=51%, p<0.001) and the lowest (1.83; 95% CI, 1.41 to 2.25; p<0.001; I=100%, p<0.001) pooled mean values, were attained for Bhutan and Bangladesh, respectively. The highest percentage of respondents (86.2%) achieved the World Health Organization recommendation of five fruit and vegetables (400 g) per day in Afghanistan (2013) whereas the lowest (0%) reported in Bangladesh (2005).
CONCLUSIONS
Residents of almost all South Asian countries appear to consume extremely low quantities of fruit and vegetables, lower than the World Health Organization recommendation. Hence, immediate initiatives should be implemented to enhance the intake of fruit and vegetables across the region.
Topics: Feeding Behavior; Fruit; Humans; Noncommunicable Diseases; Vegetables; World Health Organization
PubMed: 32947110
DOI: 10.1016/j.dsx.2020.09.004 -
Food Chemistry Jun 2023Psidium guajava L. is one of the most pivotal members belong to the Myrtaceae family, and it is an important tropical fruit with highly nutritional, healthy, and... (Review)
Review
Psidium guajava L. is one of the most pivotal members belong to the Myrtaceae family, and it is an important tropical fruit with highly nutritional, healthy, and pharmacological values prevailing in worldwide for decades. The polysaccharides of P. guajava (PGPs) are served as one of the most active constituents, which possess a variety of biofunctionalities including anti-inflammatory, antidiarrheic, antihypertension, and antidiabetic properties. Hence, a systematic review aimed to comprehensively summarize the recent research advances of PGPs is necessary for facilitating their better understanding. The present review discussed current research progress on the PGPs, including extraction and purification methods, structural features, biological activities, and potential pharmacological mechanism. In addition, this review may also provide some valuable insights for further development and potential value in affording functionally useful agents in food industry or therapeutically effective medicine in the fields of P. guajava polysaccharides.
Topics: Psidium; Plant Extracts; Myrtaceae; Hypoglycemic Agents; Plant Leaves; Polysaccharides
PubMed: 36652884
DOI: 10.1016/j.foodchem.2023.135423 -
Laterality Sep 2019This study aims to determine whether breastfeeding duration affects the prevalence of nonrighthandedness in later life. A systematic search for studies on this topic was... (Meta-Analysis)
Meta-Analysis
This study aims to determine whether breastfeeding duration affects the prevalence of nonrighthandedness in later life. A systematic search for studies on this topic was completed in 2018, and risk of bias was assessed by means of the Newcastle-Ottawa scale. Seven national surveys in five countries with Individual Participant Data (IPD) were identified (= 62,129 mother-child dyads). These surveys had low risk of bias. An IPD meta-analysis showed that breastfeeding for < 1 month, 1 to 6 months, and > 6 months, when compared to bottle feeding, was associated with a 9%, 15% and 22% decreased prevalence of nonrighthandedness, respectively (Prevalence Ratio (PR) = 0.91, 95% confidence interval (ci): 0.83, 1.00; -value = 0.05, PR = 0.85, 95% CI: 0.79, 0.92; -value < 0.0001 and PR = 0.78; 95% CI: 0.71, 0.85; -value < 0.0001). This dose-response relationship was significant ( < 0.001). No significant heterogeneity across surveys was detected (-value > 0.54). Breastfeeding for longer than 9 months was not associated with further reductions in the prevalence for nonrighthandedness ( > 0.58). It is concluded that the critical age window for establishing hemispheric dominance in handedness includes the first 9 months of infancy and is in part determined by nurture.
Topics: Breast Feeding; Functional Laterality; Humans; Prevalence; Time Factors
PubMed: 30563409
DOI: 10.1080/1357650X.2018.1555254 -
Medical Education Apr 2022The prevalence of peer-assisted learning (PAL) featuring alongside the core medical curriculum is increasing; however, the evidence base for PAL's efficacy on academic... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The prevalence of peer-assisted learning (PAL) featuring alongside the core medical curriculum is increasing; however, the evidence base for PAL's efficacy on academic performance is limited. This systematic review of randomised studies of PAL in medical school sets out to assess the impact of PAL on academic outcomes in medical school and evaluate whether PAL confers a benefit in specific educational contexts.
METHODS
A literature search was conducted across MEDLINE, Ovid Embase, Web of Science and Education Research Complete. Titles and abstracts were screened, and records were selected following strict eligibility criteria. Following full-text assessment for eligibility, two reviewers independently extracted data from the final selection of records and a meta-analysis was performed. Studies were classified using a modified version of Kirkpatrick's levels of learning. Student test scores were standardised by calculating the standardised mean difference (SMD).
RESULTS
Twenty-seven randomised controlled trials were eligible for inclusion, and twenty-one provided sufficient and complete data to enable meta-analysis. There was a significant improvement in the academic performance of medical students who received PAL compared with those in the control group (SMD = 0.52 [95% confidence interval 0.18-0.85]; p = .003). The impact of PAL was greater amongst clinical medical students (SMD = 0.63; p = .02) than preclinical medical students (SMD = 0.39; p = .08) and when used for teaching practical skills (SMD = 0.69; p = .001) compared with theory (SMD = -0.11; p = .21). Students taught by PAL also achieved better results in assessments conducted more than four weeks after course completion (SMD = 1.20; p = .04). [Correction added on 8 November 2020 after first publication. The data values in the Results section have been corrected in this version.] CONCLUSIONS: Medical students experiencing PAL benefit in terms of academic performance, relative to those not receiving PAL. PAL is of greatest value in the clinical stages of training and for practical skills. The long-term outcomes of PAL remain a priority for future research.
Topics: Curriculum; Education, Medical; Educational Status; Humans; Schools, Medical; Students, Medical
PubMed: 34595769
DOI: 10.1111/medu.14672 -
Journal of Plastic, Reconstructive &... Sep 2022A potentially fatal disease of breast angiosarcoma (AS) can occur after breast cancer treatments, and previous studies have revealed that lymphedema is a risk factor of... (Review)
Review
BACKGROUND
A potentially fatal disease of breast angiosarcoma (AS) can occur after breast cancer treatments, and previous studies have revealed that lymphedema is a risk factor of AS development. However, little is known, and there is no systematic review focusing on the relationship between lymphedema and breast AS. This systematic review aimed to evaluate all publications on breast AS after primary breast cancer surgery to identify prognostic factors and evaluate treatment modalities.
METHODS
Databases were searched for articles with published individual patient data on prognostic factors, treatment, and follow-up of patients with breast AS after primary breast cancer surgery. Statistical analysis was performed to test the prognostic values of age, gender, location, tumor-node-metastasis classification of primary breast cancer (tumor and node), stage of primary breast cancer, treatment for primary breast cancer, breast cancer recurrence, post-operative lymphedema, latent period from primary breast cancer to AS, treatment for AS, AS recurrence, and time until death or last follow-up.
RESULTS
Twenty articles were included, representing data on 41 patients. In these articles, 15 patients were referred to post-operative lymphedema. Eleven patients of them had post-operative lymphedema. As for this research, post-operative lymphedema was not a significant prognostic factor. AS recurrence was significant as a prognostic factor (P-value < 0.001) in univariate analysis for follow-up status; patients who had AS recurrence had a shorter time until death.
CONCLUSION
In this systematic review, AS recurrence was of prognostic value for breast AS patients after primary breast cancer surgery. There are only a few articles that refer post-operative breast lymphedema.
Topics: Breast Neoplasms; Female; Hemangiosarcoma; Humans; Lymph Node Excision; Lymphedema; Risk Factors
PubMed: 35907689
DOI: 10.1016/j.bjps.2022.06.046 -
Frontiers in Public Health 2022The association between environmental and socioeconomic risk factors and the occurrence of hepatocellular carcinoma (HCC) are still inconclusive. A meta-analysis was... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The association between environmental and socioeconomic risk factors and the occurrence of hepatocellular carcinoma (HCC) are still inconclusive. A meta-analysis was conducted to address this issue.
METHODS
We systematically searched the databases including PubMed, Web of Science, and Google Scholar and collected the related risk factors of HCC before March 6, 2020. Statistical analysis was performed on the odds ratio (OR) value and 95% CI of the correlation between environmental and socioeconomic factors and HCC. Begg's rank correlation test, Egger's linear regression test, and the funnel plot were employed for identification of the publication bias.
RESULTS
Out of 42 studies, a total of 57,892 participants were included. Environmental and socioeconomic risk factors including ever educated (illiteracy); race (Black, Hispanic, and Asian); medium and low incomes; occupations (farmer and labor); passive smoking; place of residence (rural); blood aflatoxin B1 (AFB1) adduct level; exposure of pesticide, etc., were statistically increased with the occurrence of HCC ( < 0.05) and OR values and 95% CIs were 1.37 (1.00, 1.89), 2.42 (1.10-5.31), 1.90 (0.87-4.17), 5.36 (0.72-40.14), 1.48 (1.11, 1.96), 1.74 (1.00-3.03), 1.49 (1.06-2.08), 1.52 (1.07-2.18), 1.43 (0.27, 7.51), 1.46 (1.09, 1.96), 2.58 (1.67-3.97), and 1.52 (0.95-2.42), respectively. We found 6-9, 9-12, and ≥12 years of education that statistically reduced the risk of the occurrence of HCC ( < 0.05) and OR values and 95% CIs were 0.70 (0.58, 0.86), 0.52 (0.40, 0.68), and 0.37 (0.23, 0.59), respectively. No significant associations ( > 0.05) were observed between race (Hispanic and Asian), passive smoking, marital status, place of birth, place of residence, and HCC. In stratified analysis, exposure of pesticide was statistically significant ( < 0.05), while race of black was on the contrary.
CONCLUSION
Environmental and socioeconomic risk factors have great impacts on the incidence rate of HCC. Improving national education and income levels can significantly reduce the risk of HCC.
PROSPERO REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier: CRD42020151710.
Topics: Carcinoma, Hepatocellular; Humans; Liver Neoplasms; Pesticides; Risk Factors; Socioeconomic Factors; Tobacco Smoke Pollution
PubMed: 35252078
DOI: 10.3389/fpubh.2022.741490