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Journal of Vascular Surgery Aug 2022Studies have investigated the effects of gender on vascular surgery care. However, to the best of our knowledge, no comprehensive synthesis of the literature has been... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Studies have investigated the effects of gender on vascular surgery care. However, to the best of our knowledge, no comprehensive synthesis of the literature has been performed on the presentation severity and postoperative outcomes for abdominal aortic aneurysms (AAAs), carotid artery stenosis (CAS), peripheral artery disease (PAD), and type B aortic dissection (TBAD). We conducted a systematic review and meta-analysis of the sex and gender differences in the presentation severity and outcomes for patients who had undergone major vascular surgery.
METHODS
The MEDLINE, Embase, and Cochrane CENTRAL databases were searched from their inception to December 2020. All observational studies and randomized controlled trials that had evaluated the gender differences in presentation severity or outcomes for patients who had undergone open or endovascular AAA or TBAD repair, carotid endarterectomy or stenting, or lower extremity bypass or angioplasty were included. The presentation severity was defined as follows: AAA (symptomatic or ruptured vs asymptomatic), carotid artery disease (symptomatic vs asymptomatic), PAD (chronic limb-threatening ischemia [CLTI] vs claudication), and TBAD (complicated vs uncomplicated). The postoperative outcomes included long-term mortality, stroke, amputation, revascularization, and graft and/or stent thrombosis. A random effects model was used to derive the odds ratios (ORs), risk ratios (RRs), and 95% confidence intervals (CIs).
RESULTS
A total of 236 studies met the inclusion criteria for our systematic review. Of the 236 studies, 86 (n = 2,099,534 patients), 62 (n = 2,300,888 patients), 28 (n = 2,394,143 patients), and 4 (n = 4525 patients) had evaluated the effects of gender on the outcomes for patients with AAA, CAS, PAD, and TBAD, respectively. The female patients were more likely to have presented with a ruptured AAA (OR, 1.18; 95% CI, 1.09-1.28) and CLTI (OR, 1.10; 95% CI, 1.02-1.19) than were the male patients. The all-cause mortality for those with an AAA (RR, 1.35; 95% CI, 1.20-1.52) and those with PAD (RR, 1.14; 95% CI, 1.05-1.23) was higher for the women. However, the female patients with CAS had had lower all-cause mortality (RR, 0.85; 95% CI, 0.76-0.94). No sex differences were found in the TBAD outcomes.
CONCLUSIONS
We found that female patients who had undergone vascular surgery were associated with more severe disease at presentation, with a greater proportion of ruptured AAAs and CLTI. This potentially contributes to the higher mortality rates for female patients with AAAs and PAD compared with male patients. Future studies are needed to evaluate the reasons for these disparities, and greater efforts are required to support women in receiving more timely vascular surgical care.
Topics: Aortic Aneurysm, Abdominal; Aortic Rupture; Carotid Stenosis; Endovascular Procedures; Female; Humans; Male; Peripheral Arterial Disease; Risk Factors; Sex Factors; Treatment Outcome
PubMed: 35257798
DOI: 10.1016/j.jvs.2022.02.030 -
Experimental and Therapeutic Medicine Feb 2022Neuroendocrine tumors (NETs) can have multiple localizations in the human body however, most often, it appears in the in thorax at tracheobronchial tree and the thymus.... (Review)
Review
Neuroendocrine tumors (NETs) can have multiple localizations in the human body however, most often, it appears in the in thorax at tracheobronchial tree and the thymus. NETs are a group of tumors with heterogenous malignancy that evolve from neuroendocrine cells, with the lung being the second target organ after the gastrointestinal tract. These rare tumors are usually asymptomatic and non-functional with little information regarding incidence in the specialty literature. The main purpose of this review, was the analysis of the available literature in all aspects while mainly focusing on molecular diagnosis data and secondly, by using this molecular landscape to establish a differentiation of lung neuroendocrine tumors (LNETs). By analyzing the literature, new data were revealed regarding histological evaluation, genetic aberrations, prognosis depending on the type of LNET and therapeutic options that derive from these. Efficient management of these tumors is essential in the handling of symptoms and increase in life expectancy, especially in patients with functional tumors. Histological differentiation of LNETs is important in establishing proper therapeutic options and prognosis. Combined types of LNETs remain a controversial topic of discussion regarding diagnosis and treatment, a topic on which further studies are required in order to improve diagnosis in this group of tumors with heterogenous malignancy.
PubMed: 35069857
DOI: 10.3892/etm.2021.11099 -
Journal of Infection and Public Health Feb 2023Leishmaniasis is a highly prevalent neglected tropical disease. It mainly presents as two forms: cutaneous and visceral leishmaniasis, the latter being the most severe... (Review)
Review
BACKGROUND
Leishmaniasis is a highly prevalent neglected tropical disease. It mainly presents as two forms: cutaneous and visceral leishmaniasis, the latter being the most severe form. However, asymptomatic cases of Leishmania infection result in an increase in the underreporting and transmission of the protozoan OBJECTIVES: In this study, articles on the incidence of asymptomatic Leishmania infection were systematically reviewed.
METHODS
The publications identified in the Medline/PubMed and Science Direct databases included 4568 articles. Inclusion, exclusion, and eligibility criterion analysis resulted in 83 articles being retained. These studies were mostly performed in Brazil (n = 26) and India (n = 15).
RESULTS
Several detection techniques have been used for diagnosis. Among the species found were L. infantum and L. donovani, which result in visceral leishmaniasis, and L. amazonensis, L. braziliensis, and L. panamensis. The incidence rates varied between the analyzed locations, largely due to sampling and the presence or absence of endemism in the regions. The largest populations analyzed were in two studies performed in India and Nepal. One of these studies evaluated 32,529 people and the incidence rate was 8.3% (n = 2702), while the other study evaluated 21,267 people and the incidence rate was 1.76% (n = 375). Only 14.28% of the studies investigated leishmaniasis in blood donors. Preexisting diseases have also been reported.
CONCLUSION
The findings of this systematic review present the incidence of cases of asymptomatic Leishmania infection worldwide, in addition to detailing the studies and offering information for researchers and health authorities to seek alternatives to reduce the number of leishmaniasis cases.
Topics: Humans; Leishmaniasis, Visceral; Leishmania infantum; Leishmaniasis; Brazil; Blood Donors
PubMed: 36630836
DOI: 10.1016/j.jiph.2022.12.021 -
HSS Journal : the Musculoskeletal... May 2023Restoring lumbar lordosis is important for adult spinal deformity surgery. Several reports have suggested that lumbar lordosis distribution has a significant impact on... (Review)
Review
BACKGROUND
Restoring lumbar lordosis is important for adult spinal deformity surgery. Several reports have suggested that lumbar lordosis distribution has a significant impact on the outcome of surgery, including lumbar distribution index (LDI), proximal lumbar lordosis (PLL), and distal lumbar lordosis (DLL). The features of lumbar lordosis distribution are inconclusive in asymptomatic adults.
QUESTIONS/PURPOSES
We sought to evaluate the variation of lumbar lordosis distribution (LDI, PLL, and DLL) and to identify associated factors in asymptomatic adult volunteers.
METHODS
We performed a systematic review of the Embase and Medline databases to identify studies in asymptomatic adult volunteers to evaluate lumbar lordosis distribution including LDI, PLL, and DLL.
RESULTS
Twelve articles met eligibility criteria and were included in our review. The respective pooled estimates of mean and variance, respectively, were 65.10% (95% confidence interval [CI]: 62.61-67.58) and 13.70% in LDI, 16.51° (95% CI: 5.54-27.49) and 11.46° in PLL, and 35.47° (95% CI: 32.79-38.18) and 9.10° in DLL. Lumbar lordosis distribution was associated with race, age, sex, body mass index, pelvic incidence, and Roussouly classification.
CONCLUSIONS
This systematic review found that despite a wide variation in LDI and PLL, DLL is maintained in a narrower range in asymptomatic adult volunteers, especially in white populations. Distal lumbar lordosis may be a more reliable radiographic parameter to restore the lumbar lordosis distribution in preoperative planning.
PubMed: 37065105
DOI: 10.1177/15563316221145156 -
Indian Journal of Cancer 2022Patients with ductal adenocarcinoma of the body and tail of the pancreas usually remain asymptomatic until late in the course of the disease, and the survival of such... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Patients with ductal adenocarcinoma of the body and tail of the pancreas usually remain asymptomatic until late in the course of the disease, and the survival of such patients depends on multiple factors, which may affect the therapeutic approach and patient survival. Hence, the aim of this study was to investigate such risk factors by pooling various available studies.
METHODS
A systematic review was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines between January 1, 2007, and December 31, 2016, using the following databases: Medline, Scopus, the Cochrane Library, and Google Scholar. Studies were selected according to the predesigned eligibility criteria, and information was extracted for demographics, clinical features, and survival outcomes. Data were pooled using fixed- or random-effects models.
RESULTS
Sixteen studies were included (5,660 patients) with a median age of 64.8 years and a median survival of 28.5 (range 13-38) months. Identified significant factors for overall survival were higher age (hazard ratio [HR] = 1.211), men (HR = 1.182), presence of lymph node metastasis (HR = 1.964), multivisceral resection (HR = 1.947), N stage (1 versus 0; HR = 1.601), surgical margin (R0 versus No R0; HR = 0.519) and tumor size (>3 cm; HR = 1.890).
CONCLUSION
The pooled results of this study revealed several risk factors for overall survival in patients with left-sided pancreatic cancer.
Topics: Male; Humans; Infant; Child, Preschool; Prognosis; Pancreatic Neoplasms; Margins of Excision; Lymphatic Metastasis
PubMed: 36412310
DOI: 10.4103/ijc.IJC_1150_20 -
Clinical Chemistry and Laboratory... Jul 2020Several studies have shown an inverse association between diabetes mellitus and prostate cancer (PCa). Some researchers suggest that this relationship is due to reduced... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Several studies have shown an inverse association between diabetes mellitus and prostate cancer (PCa). Some researchers suggest that this relationship is due to reduced PCa detection in diabetics due to lower prostate-specific antigen (PSA) levels compared to non-diabetics. Our objective is to analyze the impact of diabetes on PSA in asymptomatic men without known prostate pathology and without prior prostate intervention.
METHODS
We searched Medline (via PubMed), Embase and Scopus. We included studies that reported the relationship between serum PSA levels and diabetes or diabetes treatment in asymptomatic adult men without known prostate pathology, and without prior prostate intervention. Pooled mean differences were compared between diabetics and non-diabetics.
RESULTS
Of 2,392 screened abstracts, thirteen studies met the inclusion criteria and 8 (62%) reported appropriate measures that could be included in a meta-analysis. Eleven (85%) examined the influence of diabetes on PSA levels and 8 (62%) evaluated the influence of diabetes treatments on PSA levels. Overall diabetics had a significantly lower PSA level compared to non-diabetics (mean difference: -0.07 ng/mL; 95% CI -0.10, -0.04).
CONCLUSIONS
Diabetes and related factors (such as disease duration, severity and treatment) were significantly associated with lower PSA levels among asymptomatic men, yet differences were small and are unlikely to influence PCa detection in a screening setting.
Topics: Age Factors; Diabetes Mellitus; Humans; Prostate-Specific Antigen
PubMed: 32681769
DOI: 10.1515/cclm-2020-0145 -
Malaria Journal Dec 2022In the last decade Plasmodium knowlesi has been detected in humans throughout South East Asia. The highest risk groups for this infection are males, adults and those... (Review)
Review
BACKGROUND
In the last decade Plasmodium knowlesi has been detected in humans throughout South East Asia. The highest risk groups for this infection are males, adults and those performing forest-related work. Furthermore, asymptomatic cases of P. knowlesi malaria have been reported including among women and children.
METHODS
Pubmed, Scopus and the Web of Science databases for literature describing asymptomatic P. knowlesi malaria published between 2010 and 2020 were searched. A systematic literature review was conducted to identify studies reporting the prevalence and incidence of laboratory confirmed asymptomatic P. knowlesi cases in humans, their clinical and demographic characteristics, and methods used to diagnose these cases.
RESULTS
By analysing over 102 papers, thirteen were eligible for this review. Asymptomatic P. knowlesi infections have been detected in 0.03%-4.0% of the population depending on region, and infections have been described in children as young as 2 years old. Various different diagnostic methods were used to detect P. knowlesi cases and there were differing definitions of asymptomatic cases in these studies. The literature indicates that regionally-differing immune-related mechanisms may play a part on the prevalence of asymptomatic P. knowlesi.
CONCLUSION
Differing epidemiological characteristics of asymptomatic P. knowlesi malaria in different regions reinforces the need to further investigate disease transmission mechanics. Effective public health responses to changes in P. knowlesi epidemiology require proactive intervention and multisectoral collaboration.
Topics: Child; Humans; Female; Child, Preschool; Plasmodium knowlesi; Communicable Diseases, Emerging
PubMed: 36474243
DOI: 10.1186/s12936-022-04339-8 -
Vaccines Jun 2022Background: Asymptomatic infections are potential sources of transmission for coronavirus disease 2019, especially during the epidemic of the SARS-CoV-2 Omicron variant.... (Review)
Review
Background: Asymptomatic infections are potential sources of transmission for coronavirus disease 2019, especially during the epidemic of the SARS-CoV-2 Omicron variant. We aimed to assess the percentage of asymptomatic infections among SARS-CoV-2 Omicron variant-positive individuals detected by gene sequencing or specific polymerase chain reaction (PCR). Methods: We searched PubMed, EMBASE, and Web of Science from 26 November 2021 to 13 April 2022. This meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered with PROSPERO (CRD42022327894). Three researchers independently extracted data and two researchers assessed quality using pre-specified criteria. The pooled percentage with 95% confidence interval (CI) of asymptomatic infections of SARS-CoV-2 Omicron was estimated using random-effects models. Results: Our meta-analysis included eight eligible studies, covering 7640 Omicron variant-positive individuals with 2190 asymptomatic infections. The pooled percentage of asymptomatic infections was 32.40% (95% CI: 25.30−39.51%) among SARS-CoV-2 Omicron variant-positive individuals, which was higher in the population in developing countries (38.93%; 95% CI: 19.75−58.11%), with vaccine coverage ≥ 80% (35.93%; 95% CI: 25.36−46.51%), with a travel history (40.05%; 95% CI: 7.59−72.51%), community infection (37.97%; 95% CI: 10.07−65.87%), and with a median age < 20 years (43.75%; 95% CI: 38.45−49.05%). Conclusion: In this systematic review and meta-analysis, the pooled percentage of asymptomatic infections was 32.40% among SARS-CoV-2 Omicron variant-positive individuals. The people who were vaccinated, young (median age < 20 years), had a travel history, and were infected outside of a clinical setting (community infection) had higher percentages of asymptomatic infections. Screening is required to prevent clustered epidemics or sustained community transmission caused by asymptomatic infections of Omicron variants, especially for countries and regions that have successfully controlled SARS-CoV-2.
PubMed: 35891214
DOI: 10.3390/vaccines10071049 -
Orthopaedic Journal of Sports Medicine Feb 2022Patients with borderline acetabular dysplasia are a controversial patient population in hip preservation, as some have primarily impingement-based symptoms and others... (Review)
Review
BACKGROUND
Patients with borderline acetabular dysplasia are a controversial patient population in hip preservation, as some have primarily impingement-based symptoms and others have instability-based symptoms. Borderline dysplasia is most commonly defined as a lateral center-edge angle (LCEA) of 20° to 25°. However, its prevalence has not been well established in the literature.
PURPOSE
To (1) define the prevalence of borderline hip dysplasia in the general population as well as in populations presenting with hip pain using a systematic review and meta-analysis of the literature and (2) describe differences between male and female patients as well as differences in prevalence from that of classic acetabular dysplasia.
STUDY DESIGN
Systematic review; Level of evidence, 3.
METHODS
A systematic review of the literature was performed using search terms to capture borderline dysplasia, or studies reporting prevalence by LCEA. The search yielded 1932 results, of which 11 articles met inclusion criteria and were included in the final systematic review. Studies were grouped by patient cohort as (1) asymptomatic general population, (2) asymptomatic targeted population (eg, athletes in a specific sport), and (3) symptomatic hip pain population. The reporting of prevalence rates by subject or by hip was recorded. In a study, the rates of borderline dysplasia were compared with those of classic acetabular dysplasia (LCEA, <20°).
RESULTS
The 11 studies included 19,648 hips (11,754 patients). In the asymptomatic general population, the pooled estimate of the prevalence of borderline dysplasia was 19.8% by subject and 23.3% by hip (range, 16.7%-46.0%). The targeted subpopulation group included 236 athletes with subgroups in ballet, football, hockey, volleyball, soccer, and track and field with prevalence ranging from 17.8% to 51.1%. The prevalence of borderline dysplasia in groups presenting with hip pain was 12.8% (range, 12.6%-16.0%). Borderline acetabular dysplasia was 3.5 times more common than classic acetabular dysplasia in the asymptomatic general population.
CONCLUSION
This study demonstrated a prevalence of borderline dysplasia of 19.8% to 23.3% in the asymptomatic general population. Additionally, an estimated prevalence of 12.8% of hips in symptomatic patients highlights the common decision-making challenges in this population.
PubMed: 35155698
DOI: 10.1177/23259671211040455 -
Scientific Reports Jun 2023Asymptomatic Plasmodium infection raises a problem for the persistent transmission of malaria in low-endemic areas such as Asia. This systematic review was undertaken to... (Meta-Analysis)
Meta-Analysis
Asymptomatic Plasmodium infection raises a problem for the persistent transmission of malaria in low-endemic areas such as Asia. This systematic review was undertaken to estimate the prevalence and proportion of asymptomatic Plasmodium infection in Asia. The systematic review was registered at PROSPERO (ID: CRD42022373664). The research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. A comprehensive search of five databases, Ovid, Scopus, MEDLINE, PubMed, and Embase, was conducted to identify studies of asymptomatic Plasmodium infection in Asian countries. The pooled prevalence of asymptomatic Plasmodium infection, the pooled proportion of asymptomatic Plasmodium infection among all parasitised individuals, and the associated 95% confidence intervals were estimated using a random-effects model. A total of 916 articles were retrieved, and 87 articles that met the criteria were included in the systematic review. The pooled prevalence of asymptomatic Plasmodium infection among enrolled participants in Southeast Asia, South Asia, and Western Asia was 5.8%, 9.4%, and 8.4%, respectively. The pooled proportion of asymptomatic Plasmodium infection among all parasitised individuals in Southeast Asia, South Asia, and Western Asia was 89.3%, 87.2%, and 64.8%, respectively. There was a low prevalence of asymptomatic Plasmodium infection, but there was a high proportion of asymptomatic Plasmodium infection per all parasitised individuals in different parts of Asia. These results may support and facilitate elimination and control programs for asymptomatic Plasmodium infection in Asia.
Topics: Humans; Malaria, Falciparum; Prevalence; Malaria; Plasmodium; Asia; Asymptomatic Infections
PubMed: 37369862
DOI: 10.1038/s41598-023-37439-9