-
Clinical and Experimental Allergy :... Jan 2021Conduct a systematic review and meta-analysis examining the association between hypertensive disorders of pregnancy (HDP) and risk of asthma, eczema, food allergies and... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Conduct a systematic review and meta-analysis examining the association between hypertensive disorders of pregnancy (HDP) and risk of asthma, eczema, food allergies and allergic rhinitis in the offspring.
DESIGN
A systematic review and random-effects meta-analyses were used to synthesize the published literature. PRISMA guidelines were followed throughout. Two independent reviewers carried out data extraction and quality assessment of included studies. Grading of Recommendations Assessment, Development and Evaluation (GRADE) was used to assess certainty of findings.
DATA SOURCES
A systematic search of PubMed, Embase, Web of Science and CINAHL was performed from inception of databases-21 April 2020, supplemented by hand-searching reference lists of included articles.
ELIGIBILITY CRITERIA
Two reviewers independently reviewed titles, abstracts and full-text articles. English language, cohort, case-control and cross-sectional published studies examining the association between HDP (primary exposure: pre-eclampsia; secondary exposures: all other HDP) and asthma, eczema, food allergies and allergic rhinitis were included.
RESULTS
Of the 2833 studies retrieved, 14 studies met inclusion criteria. Of these, 11 studies reported evidence of association between HDP and atopic disorders. Thirteen studies reported estimates for asthma. Seven of these included adjusted estimates (including 3 645 773 participants) for a pre-eclampsia-asthma relationship resulting in a pooled odds ratio (OR) of 1.14 (95% CI: 1.04, 1.26) (I = 62%). However, this OR was reduced to 1.08 (95% CI: (0.78, 1.48) when the large registry-based cohort studies were excluded, and only studies using parent-reported measures to determine a diagnosis of asthma were included. Four studies included adjusted estimates (including 254 998 participants) for other HDP and asthma (pooled OR: 1.02, 95% CI: 0.96, 1.09) (I = 0%). Two studies provided adjusted estimates (including 1 699 663 participants) for a pre-eclampsia-eczema relationship (pooled OR: 1.06, 95% CI: 0.98, 1.14) (I = 0%). One study including pre-eclampsia-food allergies was identified (OR: 1.28, 95% CI: 1.11, 1.46). Three studies examined a HDP (including pre-eclampsia) and allergic rhinitis relationship, with effect estimates ranging from 1.14 to 2.10. Studies were classified as low or low-moderate risk of bias, while GRADE certainty of findings were low to very low.
CONCLUSIONS
While pre-eclampsia was associated with a possible increased risk of asthma in offspring, there was no evidence for a relationship between other HDP and asthma. There is a lack of published literature examining the association between HDP and eczema, food allergy and allergic rhinitis. Further primary research is warranted to gain a better understanding of the association between HDP and the risk of childhood atopic disease.
SYSTEMATIC REVIEW REGISTRATION
Review protocol in appendix.
Topics: Asthma; Dermatitis, Atopic; Female; Food Hypersensitivity; Humans; Hypersensitivity; Hypertension, Pregnancy-Induced; Pre-Eclampsia; Pregnancy; Prenatal Exposure Delayed Effects; Rhinitis, Allergic
PubMed: 33037716
DOI: 10.1111/cea.13754 -
Joint Bone Spine Dec 2020Sarcoidosis and spondyloarthritis (SpA) have been regularly associated. Bone iliac granulomas have also been described. We propose herein a systematic review of...
BACKGROUND
Sarcoidosis and spondyloarthritis (SpA) have been regularly associated. Bone iliac granulomas have also been described. We propose herein a systematic review of rheumatologic axial manifestations of sarcoidosis.
METHODS
PubMed and the Cochrane Library were used to conduct this systematic literature review. Case reports and cross-sectional studies were reviewed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines.
RESULTS
A total of 41 articles were eligible. Three cross-sectional studies on the association between SpA and sarcoidosis showed a prevalence of sacroiliitis and SpA ranging from 12.9 to 44.8% and 12.9 to 48.3% in inflammatory back pain (IBP) subgroups, respectively. However, the IBP definitions and sacroiliac joint (SIJ) imaging modalities (X-rays or magnetic resonance imaging) were heterogeneous, and X-ray was mainly used for sacroiliitis diagnosis (in 78% of cases). Thirty-one case-report articles of the sarcoidosis-sacroiliitis association were identified, representing 35 patients. ASAS criteria for SpA were met in half of cases (16/32) and 46% (12/26) had HLA B27 positivity. Sarcoidosis occurred after sacroiliac symptoms in 47% of cases. In the seven case-report articles with granulomatous sacroiliac bone involvement, unilateral involvement seemed higher than in the sarcoidosis-sacroiliitis group.
CONCLUSION
Literature analysis found a good evidence of the association between SpA and sarcoidosis, and special attention should be given to patients reporting IBP. Unilateral sacroiliitis may raise suspicion of granulomatous bone involvement, distinct from sacroiliitis. Imaging modalities used to study the SIJ in patients with sarcoidosis have been heterogeneous and further investigation is needed.
Topics: Back Pain; Cross-Sectional Studies; Friends; Humans; Magnetic Resonance Imaging; Sacroiliac Joint; Sacroiliitis; Sarcoidosis; Spondylarthritis
PubMed: 32622038
DOI: 10.1016/j.jbspin.2020.06.011 -
Contact Dermatitis Apr 2023Vulvar allergic contact dermatitis (vACD) and irritant contact dermatitis (vICD) are common and accompanied by a great burden on the patient's life. We aimed to review... (Review)
Review
Vulvar allergic contact dermatitis (vACD) and irritant contact dermatitis (vICD) are common and accompanied by a great burden on the patient's life. We aimed to review the existing literature on vACD and vICD in order to provide a comprehensive reference list of potential vulvar allergens and irritants, as well as to establish the role of patch testing therein. A systematic search was performed in Medline, Embase and Web of Science using a search string based on the PICO-format. The study protocol was registered at PROSPERO (CRD42021239527). Multiple allergens were identified and included metals, topical drugs, fragrances, preservatives, cosmetic constituents and rubber components. Not all positive reactions were, however, considered to be relevant. Patch testing is the primary tool for the identification of the causal allergens. Testing with standard series alone was proven to be insufficient. Little information about irritants was found. In the future, additional series and late readings should be considered in standard practice. Studies on vICD are scarce and further research is necessary. More population-based research should be performed.
Topics: Female; Humans; Allergens; Irritants; Dermatitis, Allergic Contact; Patch Tests; Dermatitis, Irritant; Vulva
PubMed: 36458568
DOI: 10.1111/cod.14258 -
The Journal of Dermatological Treatment Feb 2022Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are blistering cutaneous disorders that often manifest with epidermal and mucosal necrosis. In... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are blistering cutaneous disorders that often manifest with epidermal and mucosal necrosis. In extreme cases, the upper or bronchial airways are threatened, necessitating intubation and mechanical ventilation. This systematic review and meta-analysis examines the prevalence of mechanical ventilation (MV) in patients with SJS or TENS, despite maximal medical therapy, and additionally aims to identify the risk factors associated with this requirement.
MATERIALS AND METHODS
A systematic review of the literature was performed using the PRISMA guidelines and meta-analysis of proportions.
RESULTS
Six articles were included, with pooled total of 18648 cases. The weighted prevalence of MV was 27.5% (95%CI 17.8-39.9%). The need for MV was more closely associated with TEN, compared to SJS (OR 4.40, 95%CI 2.73-7.10, =48%, <.00001.) Risk factors associated with the need for MV included bacteremia (OR 5.02, 95%CI 2.87-8.79, =0%, <.00001), shock/organ failure on admission (OR 261.99, 95%CI 21.88-3137, =71, <.0001), total body surface area (TBSA) >30% (OR 4.47, 95%CI 1.41-14.20, =71, =.01.).
CONCLUSION
Limited published evidence with significant heterogeneity exists within the literature regarding the need for MV in SJS and TEN. Greater cutaneous involvement, and more critically unwell patients appear more likely to require MV.
Topics: Body Surface Area; Humans; Retrospective Studies; Risk Factors; Stevens-Johnson Syndrome
PubMed: 32412819
DOI: 10.1080/09546634.2020.1770173 -
Annali Di Igiene : Medicina Preventiva... 2020It is essential to make sure that vaccines are safe, effective, and of good quality. In the past years, there have been some reports of adverse effects regarding...
AIMS AND BACKGROUND
It is essential to make sure that vaccines are safe, effective, and of good quality. In the past years, there have been some reports of adverse effects regarding vaccination. One of these adverse effects is the development of Stevens-Johnson syndrome. Stevens-Johnson syndrome is a rare, severe, skin disorder, that usually occurs after medication. In Europe, its estimated incidence is of 2-3 cases/million population/year. Therefore, the aim of this study was to investigate, through a systematic review, the association between vaccination and the development of Stevens-Johnson syndrome.
MATERIALS AND METHODS
We performed a systematic review using PubMed, Scopus and Web of Science databases. We included studies dated between January 2000 and February 2018. The main selection criterion was the reporting of the disease, following vaccination.
RESULTS
Ten studies were selected, from a total of 391 studies. Of these, 5 were case reports, 3 were cohort studies and 2 were case-control. All the studies were regarding cases of Stevens-Johnson syndrome after vaccination. The selected studies reported cases following vaccines such as influenza vaccine, smallpox, anthrax and tetanus vaccine, MMR vaccine, varicella vaccine, DTaP-IPV vaccine or rabies vaccine. None of the cohort studies reported statistically significant associations between vaccination and the syndrome. In the case-control studies, it was not observed significant increased risk for the Stevens-Johnson syndrome following the administration of vaccines. Regarding the case reports, there was not sufficient evidence to form a positive association between these two factors, and more studies are needed.
CONCLUSIONS
In this review it was not possible to establish a positive relation between vaccination and the development of Stevens-Johnson syndrome.
Topics: Anthrax Vaccines; Case-Control Studies; Cohort Studies; Humans; Stevens-Johnson Syndrome; Vaccination; Viral Vaccines
PubMed: 31713580
DOI: 10.7416/ai.2020.2333 -
Occupational Medicine (Oxford, England) Oct 2012Firefighters are exposed to a number of different workplace hazards. As a result of this and the perception of increased ill-health symptoms, a systematic review was... (Review)
Review
BACKGROUND
Firefighters are exposed to a number of different workplace hazards. As a result of this and the perception of increased ill-health symptoms, a systematic review was carried out to identify significant associations.
AIMS
To carry out a systematic review of evidence relating to non-cancer occupational health risks in firefighters.
METHODS
Systematic literature searches were conducted using a predetermined search strategy that encompassed terms describing the population of interest and health outcomes. Titles and abstracts identified were subjected to an initial screening process using specified guidelines. Included papers were reviewed and data extracted. Additional material, in the form of papers cited by those selected for review, was also obtained and, where relevant, added to the review. Extracted data were then collated into evidence tables to support the narrative review.
RESULTS
Relatively few papers were identified that addressed forms of ill-health in firefighters other than cancer. Nine papers were considered covering each of coronary heart disease and respiratory health. Other ill-health outcomes studied were hearing loss (five studies); hip osteoarthritis (two studies); and sarcoidosis (two studies). None of these sets of papers provided conclusive evidence of a consistent relationship between the specified disease outcomes and the occupation as a firefighter; although, in some instances (hearing loss, respiratory health, and hip and knee osteoarthritis), there were limited indications of some effect.
CONCLUSIONS
None of the sets of papers reviewed showed any consistent association between the occupation of firefighter and any of a number of non-cancer disease and ill-health outcomes.
Topics: Coronary Artery Disease; Female; Firefighters; Humans; Longitudinal Studies; Male; Occupational Exposure; Occupational Health; Odds Ratio; Osteoarthritis; Prevalence; Respiratory Tract Diseases; Risk Assessment; Sarcoidosis; Scotland; Surveys and Questionnaires
PubMed: 23034787
DOI: 10.1093/occmed/kqs116 -
AJR. American Journal of Roentgenology Mar 1985Thoracic sarcoidosis is a common disease, and its usual radiographic manifestations have been well described and are readily recognized. However, most physicians are not... (Review)
Review
Thoracic sarcoidosis is a common disease, and its usual radiographic manifestations have been well described and are readily recognized. However, most physicians are not familiar with the unusual and often confusing manifestations of thoracic sarcoid, which have been sporadically reported. Using information derived from a systematic review of the literature and clinical material from our own institutions, a classification has been developed of the unusual thoracic manifestations of sarcoidosis, and their relative incidence has been determined and tabulated. These include lesions of the osseous, pleural, mediastinal, hilar, bronchial, pulmonary parenchymal, vascular, and cardiac structures. The information presented in this review is intended to provide physicians with a single comprehensive source to assist them when atypical radiographic findings of thoracic sarcoidosis are a diagnostic consideration.
Topics: Bronchial Diseases; Bronchiectasis; Calcinosis; Cardiomegaly; Chylothorax; Constriction, Pathologic; Humans; Lymphatic Diseases; Mediastinal Emphysema; Pleura; Pleural Effusion; Pneumothorax; Pulmonary Atelectasis; Radiography; Ribs; Sarcoidosis; Sternum; Thoracic Diseases; Thoracic Vertebrae; Tracheal Diseases; Vascular Diseases
PubMed: 3155892
DOI: 10.2214/ajr.144.3.513 -
MCN. the American Journal of Maternal... 2017The purpose of this systematic review was to explore the association between timing of introduction of potentially allergenic foods to infants and development of food... (Review)
Review
PURPOSE
The purpose of this systematic review was to explore the association between timing of introduction of potentially allergenic foods to infants and development of food allergies.
METHODS
CINAHL, Medline, PubMed, Science Direct, and Web of Science were searched using the terms solid food, complementary food, or infant feeding combined with allergy or hypersensitivity for articles published in English in 2000 or later. Inclusion criteria were 1) primary research articles with 2) a focus on association between introduction of complementary foods including potentially allergenic foods into diets of infants less than 12 months of age and development of food allergies. Articles were excluded if they were 1) not primary research, 2) about complementary foods only (without specificity of allergenic foods), or 3) on allergic conditions other than food allergy (such as asthma or eczema).
RESULTS
The initial literature search yielded 533 articles; 14 articles met inclusion criteria. Level of evidence of each study was determined with the SORT criteria. Results found that delayed introduction of solid foods in general and allergenic foods in particular was not associated with decreased risk for allergic diseases among high and low-risk infants. Later introduction was associated with increased risk for allergy development.
CLINICAL IMPLICATIONS
For infants at low risk for development of food allergies, providers should advise caregivers to introduce potentially allergenic foods with other solid foods between 4 and 6 months of age when children show an interest in eating solids. Infants at high risk for peanut allergy, should be evaluated by an allergy specialist prior to introduction of peanuts and work with providers to create an individualized plan for introduction of peanuts and other allergenic foods as needed.
Topics: Food Hypersensitivity; Humans; Infant; Infant Food; Time Factors
PubMed: 27879501
DOI: 10.1097/NMC.0000000000000313 -
Expert Review of Respiratory Medicine Dec 2021: Sarcoidosis is multisystem inflammatory granulomatosis that can potentially affect any organ of the human body. We aimed to estimate the prevalence of diabetes... (Meta-Analysis)
Meta-Analysis
: Sarcoidosis is multisystem inflammatory granulomatosis that can potentially affect any organ of the human body. We aimed to estimate the prevalence of diabetes mellitus (DM) in sarcoidosis patients and determine the association between sarcoidosis and DM.: All relevant articles reporting the prevalence of DM in sarcoidosis published until September 19, 2020, were retrieved from ten electronic databases. We used the random effect model to perform the meta-analysis.: After screening 2,122 records, we included 19 studies (n = 18,686,162). The prevalence of DM in sarcoidosis patients was 12.7% (95% CI 10-16.1). The prevalence was highest in North America with 21.3% (13.5-31.8), followed by Europe 10.4 (7.9-13.7) and Asia 10% (1.8-39.7). Sarcoidosis patients had higher rates of DM compared to controls (OR 1.75; 95% CI 1.49-2.05). Sensitivity analysis, after removing the largest weighted study, did not reveal any effect on the significance of the results (OR 1.73; 95% CI 1.33-2.25).: The prevalence of DM in sarcoidosis is considerably high, with increased odds of DM in sarcoidosis compared to healthy controls. Further research with a wide range of confounders is required to confirm the association of sarcoidosis with DM.
Topics: Databases, Factual; Diabetes Mellitus; Europe; Humans; Prevalence; Sarcoidosis
PubMed: 34018900
DOI: 10.1080/17476348.2021.1932471 -
Journal of Nuclear Cardiology :... Aug 2023Fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) and cardiac magnetic resonance (CMR) are frequently used advanced cardiac imaging to diagnose... (Meta-Analysis)
Meta-Analysis Review
Comparison of cardiac magnetic resonance imaging and fluorodeoxyglucose positron emission tomography in the assessment of cardiac sarcoidosis: Meta-analysis and systematic review.
AIM
Fluorine-18 fluorodeoxyglucose-positron emission tomography (FDG-PET) and cardiac magnetic resonance (CMR) are frequently used advanced cardiac imaging to diagnose cardiac sarcoidosis (CS). We conducted a meta-analysis and systematic review to compare diagnostic parameters of FDG-PET and CMR in the diagnosis of cardiac sarcoidosis (CS).
METHODS
We searched PubMed, EMBASE, and Scopus databases from their inception to 9/30/2021 with search terms "cardiac sarcoidosis" AND "cardiac magnetic resonance imaging" AND "positronemission tomography". We extracted patient characteristics, results of the FDG-PET and CMR, and adverse outcomes from the included studies. Adverse outcomes served as a reference standard for the evaluation of FDG-PET and CMR.
RESULTS
We included 4 studies in the meta-analysis which provided adverse outcomes and all patients underwent FDG-PET and CMR. There were 237 patients, 60.3% male, and ages ranged from 50-53 years. There were 45 events in 237 patients from four studies included in the meta-analyses. The pooled sensitivity (95% confidence interval-CI) and specificity (CI) of CMR in predicting an adverse event were 0.94 (0.79-0.98) and 0.49 (0.40-0.59), respectively. The pooled sensitivity (CI) and specificity (CI) of FDG-PET in predicting an adverse event were 0.51 (0.26-0.75) and 0.60 (0.35-0.81), respectively.
CONCLUSION
CMR was more sensitive but less specific than FDG-PET in predicting adverse events; however, the study population and definition of a positive test need to be considered while interpreting the results.
Topics: Humans; Male; Middle Aged; Female; Fluorodeoxyglucose F18; Cardiomyopathies; Positron-Emission Tomography; Magnetic Resonance Imaging; Myocarditis; Sarcoidosis; Radiopharmaceuticals; Sensitivity and Specificity
PubMed: 36443587
DOI: 10.1007/s12350-022-03129-8