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Seminars in Liver Disease Nov 2017The authors conducted a meta-analysis of the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with chronic liver disease (CLD) and controls. Using... (Meta-Analysis)
Meta-Analysis Review
The authors conducted a meta-analysis of the prevalence of small intestinal bacterial overgrowth (SIBO) in patients with chronic liver disease (CLD) and controls. Using the search terms "small intestinal bacterial overgrowth (SIBO)" and "chronic liver disease (CLD)" or "cirrhosis," 19 case-control studies were identified. Utilizing breath tests, the prevalence of SIBO in CLD was 35.80% (95% CI, 32.60-39.10) compared with 8.0% (95% CI, 5.70-11.00) in controls. Using culture techniques, the prevalence was 68.31% (95% CI, 59.62-76.00) in CLD patients as compared with 7.94% (95% CI, 3.44-12.73) in controls. No difference between cirrhotic and noncirrhotic patients was found. SIBO is significantly more frequent in CLD patients as compared with controls. The association of SIBO and CLD was not confined to patients with advanced CLD, suggesting that SIBO is not a consequence of advanced liver disease but may play a role in the progression of CLD.
Topics: Bacteria; Disease Progression; Dysbiosis; Gastrointestinal Microbiome; Host-Pathogen Interactions; Humans; Intestine, Small; Liver Diseases; Prevalence; Prognosis; Risk Factors
PubMed: 29272899
DOI: 10.1055/s-0037-1608832 -
European Journal of Clinical... May 2022Chronic kidney disease (CKD) which is a common cause of death has an increasing trend, but there is no established approach for predicting CKD progression yet.... (Review)
Review
INTRODUCTION
Chronic kidney disease (CKD) which is a common cause of death has an increasing trend, but there is no established approach for predicting CKD progression yet. Functional magnetic resonance imaging (fMRI) studies such as blood oxygenation level-dependent MRI (BOLD-MRI), diffusion-weighted MRI (DWI-MRI), diffusion-tensor MRI (DTI-MRI) and arterial spin labelling MRI (ASL-MRI) are rising methods for the assessment of kidney functions in native and transplanted kidneys as well as the estimation of CKD progression.
METHODS
Systematic literature review was performed through the Embase (Elsevier), Cochrane Central Register of Controlled Trials (Wiley), PubMed/Medline and Web of Science databases, and studies investigating the role of fMRI methods assessing kidney functions in native and transplanted kidneys, as well as the value of fMRI methods to predict CKD progression, were included. Working mechanisms, advantages and limitations of the fMRI modalities were reviewed, and three studies investigating the role of fMRI studies in kidney functions were analysed.
RESULTS AND CONCLUSION
BOLD-MRI signal was found to be inversely correlated with annual eGFR change, and DWI/ADC (apparent diffusion coefficient map) values were shown to be correlated with annual eGFR decline. fMRI methods which are currently used for other systems can be utilized to provide more detailed information about kidney functions, and doctors should be ready to interpret kidney MRIs.
Topics: Disease Progression; Glomerular Filtration Rate; Humans; Kidney; Magnetic Resonance Imaging; Renal Insufficiency, Chronic
PubMed: 35267195
DOI: 10.1111/eci.13765 -
Nephrology, Dialysis, Transplantation :... Mar 2011Proteinuria is a candidate surrogate end point for randomized controlled trials (RCTs) in chronic kidney disease (CKD). There is a reasonably sound biological basis for... (Review)
Review
BACKGROUND
Proteinuria is a candidate surrogate end point for randomized controlled trials (RCTs) in chronic kidney disease (CKD). There is a reasonably sound biological basis for this hypothesis, but only preliminary empirical evidence currently exists.
METHODS
A systematic review and creation of a patient-level dataset of randomized controlled trials (RCTs) in CKD that reported changes in proteinuria and assessed progression of kidney disease as defined by dialysis, transplantation, death, or changes in GFR or creatinine were performed.
RESULTS
Systematic review. Seventy RCTs met the eligibility criteria; 17 eligible RCTs contained analyses of proteinuria as a predictor of outcomes; 15 RCTs concluded that greater proteinuria was associated with adverse outcomes. A majority were studies of diabetic or hypertensive kidney disease and tested renin-angiotensin system blockade. Definitions of predictor and outcome variables were too variable to conduct a meta-analysis of group data. Database creation. Over 4 years was required to create the patient-level dataset. The final dataset included 34 studies and > 9000 patients with a variety of CKD types and interventions.
CONCLUSIONS
There are a relatively small number of RCTs designed to rigorously test therapies for kidney disease progression. Current analyses of change in proteinuria as a predictor of CKD progression are heterogeneous and incomplete, indicating further evaluation in a pooled individual patient-level database is necessary to advance knowledge in this field.
Topics: Biomarkers; Disease Progression; Humans; Kidney Diseases; Proteinuria; Randomized Controlled Trials as Topic
PubMed: 20817671
DOI: 10.1093/ndt/gfq525 -
Dermatology (Basel, Switzerland) 2022Hormones are thought to play a role in hidradenitis suppurativa (HS). However, data on the HS disease course during pregnancy and the postpartum period has not been well... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Hormones are thought to play a role in hidradenitis suppurativa (HS). However, data on the HS disease course during pregnancy and the postpartum period has not been well established. The objective of this study is to analyze the available literature to determine HS disease activity during pregnancy and the postpartum period.
METHODS
The PubMed and Embase databases were systematically searched for relevant articles from database inception until November 22, 2020. The inclusion criteria were a study population with the diagnosis of HS and discussion of pregnancy impact on the HS disease course or postpartum flare. Study characteristics, patient demographics, HS severity, and HS disease course during pregnancy and the postpartum period were extracted by 2 independent reviewers. The quality of included studies was assessed using the Newcastle-Ottawa Scale for observational studies. Heterogeneity was assessed using Cochran's Q statistic and I2 index. The random-effects meta-analytical model was used. The primary study outcome was the pooled odds ratio of improvement or of worsening of HS disease activity during pregnancy.
RESULTS
The systematic search identified 8 studies for analysis. There was a total of 672 cases for which data on the patient-reported HS disease course during pregnancy were available, and 164 cases for which data on patient-reported postpartum flare were available. In the meta-analyses, the rate of HS disease improvement was 24% (95% CI 0.13-0.40) and the rate of HS disease worsening was 20% (95% CI 0.11-0.34). Sixty percent (99/164) of patients experienced a postpartum flare.
CONCLUSION
While about a quarter of women will experience an improvement in HS during pregnancy, the majority will have a stable or worsened disease course, and over half of patients will experience a postpartum flare. Close monitoring of HS patients is needed during pregnancy and postpartum periods, as patients may need continued, or even escalated, disease management.
Topics: Disease Progression; Female; Hidradenitis Suppurativa; Humans; Odds Ratio; Pregnancy
PubMed: 34515085
DOI: 10.1159/000517283 -
International Journal of Clinical... Nov 2021Probiotics may have a promising role in chronic autoinflammatory diseases. The current systematic review and meta-analysis investigated the effects of probiotics on... (Meta-Analysis)
Meta-Analysis
Effect of probiotics supplementation on disease progression, depression, general health, and anthropometric measurements in relapsing-remitting multiple sclerosis patients: A systematic review and meta-analysis of clinical trials.
BACKGROUND
Probiotics may have a promising role in chronic autoinflammatory diseases. The current systematic review and meta-analysis investigated the effects of probiotics on disease progression, depression, general health, and anthropometric measurements in Relapsing-Remitting Multiple Sclerosis (RRMS) patients.
METHODS
The English literature search was performed using PubMed, Scopus, Web of Science, and the Central Cochrane Library through January 2021. Random effect models were used to synthesise quantitative data by STATA .
RESULTS
From a total of 152 identified entries, four trials were included in quantitative synthesis (n = 213; 106 as intervention, 107 as control). An additional six studies with the same structure and different markers were also systematically reviewed. The pooled effect size showed that Expanded Disability Status Scale (EDSS) (WMD = -0.43; 95% CI = -0.65, -0.20; P < .001), Beck Depression Inventory-Ⅱ (BDI-Ⅱ) (WMD = -3.22; 95% CI = -4.38, -2.06; P < .001) and General Health Questionnaire (GHQ) (WMD = -4.37; 95% CI = -6.43, -2.31; P < .001) were improved following probiotics supplementation. However, body weight and body mass index did not statistically change.
CONCLUSION
Our findings revealed that probiotics supplementation can improve disease progression, suppress depression, and general health in MS patients; although, further investigations may be needed.
Topics: Depression; Disease Progression; Humans; Multiple Sclerosis; Multiple Sclerosis, Relapsing-Remitting; Probiotics
PubMed: 34379879
DOI: 10.1111/ijcp.14724 -
Endocrine Apr 2020Inflammation plays an important role in the pathogenesis of diabetes complications. This study aims to assess the association between circulating inflammatory biomarkers... (Meta-Analysis)
Meta-Analysis
Circulating TNF receptors and risk of renal disease progression, cardiovascular disease events and mortality in patients with diabetes: a systematic review and meta-analysis.
PURPOSE
Inflammation plays an important role in the pathogenesis of diabetes complications. This study aims to assess the association between circulating inflammatory biomarkers TNF receptors (TNFRs) and the risk of renal disease progression, cardiovascular disease (CVD) events, and mortality in patients with diabetes.
METHODS
PubMed and Embase databases were comprehensively searched up to March 2019. Data were extracted independently by two reviewers. A random effects model was performed for the pooled analyses.
RESULTS
Five studies in 3316 subjects assessed TNFRs with renal disease in patients with type 1 diabetes and showed both TNFR-1 and TNFR-2 were consistently associated with the renal outcomes. Fourteen studies in 7696 subjects evaluated TNFRs in patients with type 2 diabetes. The pooled risk ratio per doubling increase in TNFR-1 and TNFR-2 for renal disease progression was more than two (2.64 [1.98, 3.52] and 2.23 [1.69, 2.94]). The subgroup analyses and sensitivity analyses further illustrated these results of renal outcome and its robustness. Moreover, higher TNFR-1 and TNFR-2 was also significantly associated with CVD events and mortality in patients with type 2 diabetes.
CONCLUSIONS
Circulating TNFR-1 and TNFR-2 are independently associated with higher risk of renal disease progression, CVD events, and mortality in patients with diabetes and might contribute to the clinical risk assessment in the future.
Topics: Cardiovascular Diseases; Diabetes Mellitus, Type 2; Diabetic Nephropathies; Disease Progression; Humans; Receptors, Tumor Necrosis Factor
PubMed: 31813103
DOI: 10.1007/s12020-019-02153-y -
European Radiology Oct 2023High-resolution computed tomography (HRCT), as the main tool for monitoring idiopathic pulmonary fibrosis (IPF), is characterized by subjective variability among... (Review)
Review
BACKGROUND
High-resolution computed tomography (HRCT), as the main tool for monitoring idiopathic pulmonary fibrosis (IPF), is characterized by subjective variability among radiologists and insensitivity to subtle changes. Recently, a few studies have aimed to decrease subjective bias by assessing the severity of IPF using computer software, i.e., Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER). However, these studies had diverse research directions. In this review, we systematically assess the effect of CALIPER in the management of IPF.
METHODS
A systematic review was conducted through a search of published studies in PubMed, Web of Science, Cochrane, Embase, Scopus, and CNKI databases from database inception through February 28, 2022. The methodological quality would be evaluated by using Methodological Index for Non-Randomized Studies (MINORS). Narrative synthesis summarized findings by participant characteristics, study design, and associations with outcomes.
RESULTS
Ten studies were included. They evaluated the relationship between CALIPER-derived parameters and pulmonary function test (PFT) and mortality. CALIPER-derived parameters showed a significant correlation with PFT and mortality. Two studies reported that CALIPER could be used to stratify outcomes.
CONCLUSION
CALIPER-derived parameters can be used to evaluate prognosis and mortality. CALIPER-derived parameters combined with composite physiologic index (CPI) or Gender-Age-Physiology (GAP) could help clinicians implement targeted management by refining prognostic stratification. However, research has been constrained by small number of retrospective investigations and sample sizes. Therefore, it is essential to design prospective controlled studies and establish the staging system by CALIPER-derived parameters and combining them with CPI, FVC, or GAP.
CLINICAL RELEVANCE STATEMENT
It is beneficial for clinic to provide objective, sensitive, and accurate indicators of disease progression. It also helps the clinic to develop individualized treatment plans based on the stage of disease progression and provides evaluation of efficacy in drug trials.
KEY POINTS
• Computer-Aided Lung Informatics for Pathology Evaluation and Rating (CALIPER) is a quantitative CT analysis software that can be used to evaluate the progression of disease on CT. • The CALIPER-derived vessel-related structure shows great performance in the management of idiopathic pulmonary fibrosis. • CALIPER-derived parameters combined with composite physiologic index or Gender-Age-Physiology can be used to refine prognostic stratification.
Topics: Humans; Retrospective Studies; Prospective Studies; Lung; Idiopathic Pulmonary Fibrosis; Prognosis; Computers; Disease Progression
PubMed: 37528299
DOI: 10.1007/s00330-023-10010-w -
Journal of Neurologic Physical Therapy... Jun 2009Amyotrophic lateral sclerosis (ALS) is an idiopathic disease of adults affecting upper and lower motor neurons. In one to four years, progressive weakness, spasticity,... (Review)
Review
BACKGROUND AND PURPOSE
Amyotrophic lateral sclerosis (ALS) is an idiopathic disease of adults affecting upper and lower motor neurons. In one to four years, progressive weakness, spasticity, and respiratory insufficiency compromise independence and survival. Current medical treatment is limited to medication and supportive care. The benefit and harm of moderate physical exercise are controversial. This review examined current research related to moderate exercise for maintaining independence without accelerating disease progression in persons with ALS.
METHODS
An evidence-based search was conducted using keywords alone and in combination (ALS, exercise, Lou Gehrig's disease, physical therapy) to search PubMed, PEDro, Hooked on Evidence, Ovid, and Cochrane databases. Human and animal models were included and graded on level of evidence and strength of recommendations for developing guidelines to practice. A secondary reviewer evaluated all selected studies, and statistics were calculated.
RESULTS
The search yielded the following nine studies: four small clinical studies, one clinical systematic review, and four randomized, controlled trials based on animal models. In human studies, there were small to moderate effect sizes supporting the benefit of moderate exercise in persons with early-stage ALS, with no adverse affects on disease progression or survival time. In transgenic mice with superoxide dismutase-1 ALS, moderate exercise most often had a moderate effect size for increasing life span.
DISCUSSION AND CONCLUSION
Large randomized clinical trials are needed to develop specific exercise guidelines. However, evidence suggests that moderate exercise is not associated with adverse outcomes in persons with early-stage ALS. Moderate exercise programs can be safely adapted to abilities, interests, specific response to exercise, accessibility, and family support.
Topics: Amyotrophic Lateral Sclerosis; Animals; Disease Progression; Exercise Therapy; Humans
PubMed: 19556916
DOI: 10.1097/NPT.0b013e31819912d0 -
Journal of Psychosomatic Research Nov 2009The variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic... (Review)
Review
OBJECTIVE
The variability in the conceptualization and categorization of social support has resulted in mixed findings regarding its role in cancer progression. This systematic review identifies and summarizes the evidence for the significance of two important indices of social support in progression of different cancers.
METHOD
We used systematic and replicable methods to search, select, and evaluate findings.
RESULTS
Thirty-one longitudinal prospective findings (in 26 papers) which were selected for inclusion categorized social support into structural and functional support. The types of cancer included in these studies fell into three major categories: breast cancer (16), other cancer (10), and mixed cancers (5). Results suggest that the evidence for the relationship between social support and cancer progression is sufficiently strong for breast cancer as shown by five out of seven methodologically sound studies but consistently unconvincing for other types of cancer or in studies which combined different types of cancer. Structural support indices were found to be more frequently associated with disease progression than the indices of functional support in breast cancer. Disease-related variables such as severity, treatment, nodal status, and site of metastasis were found to be significant predictors of cancer progression, and it is suggested that these variables must be considered when conducting studies on the role of psychosocial factors in cancer-related outcomes including progression.
CONCLUSION
Methodological limitations of the studies and counterintuitive findings are discussed, and further conclusive research, particularly randomized controlled trials of social support interventions, is warranted to support the findings of this systematic review.
Topics: Breast Neoplasms; Disease Progression; Female; Humans; Longitudinal Studies; Male; Neoplasms; Prognosis; Prospective Studies; Social Support
PubMed: 19837203
DOI: 10.1016/j.jpsychores.2008.12.012 -
Retina (Philadelphia, Pa.) Jan 2024Retinitis pigmentosa GTPase regulator-associated X-linked retinitis pigmentosa ( RPGR -associated XLRP) is a rare and severe form of retinitis pigmentosa, resulting in...
PURPOSE
Retinitis pigmentosa GTPase regulator-associated X-linked retinitis pigmentosa ( RPGR -associated XLRP) is a rare and severe form of retinitis pigmentosa, resulting in progressive visual impairment; however, disease progression data are limited. A systematic literature review was conducted to assess available data on disease progression in RPGR -associated XLRP.
METHODS
PubMed, Embase, and select congress abstracts were evaluated through June 2022. Eligible studies included results specific to RPGR -associated XLRP or populations with ≥80% of patients with retinitis pigmentosa carrying disease-causing RPGR variants. End points of interest included visual acuity, visual field, ellipsoid zone width, progression to blindness, and patient-reported outcomes.
RESULTS
Fourteen studies met ≥1 end point of interest. Progressive declines in visual acuity, visual field, and ellipsoid zone width were reported across studies. Nearly all publications reported annual declines in visual acuity (3.5%-8.2%). Annual visual field declines ranged from 4.2% to 13.3%. Changes in retinal structure were also observed (ellipsoid zone width changes: -177 to -830 µ m/year). Most studies measured blindness using visual acuity; visual field-based definitions resulted in blindness by age ∼25 years. Patient-reported outcome data were limited.
CONCLUSION
Published evidence shows that patients with RPGR -associated XLRP experience progressive decline in visual acuity, visual field, and ellipsoid zone width, eventually resulting in blindness. Additional longitudinal data with standardized end points and expanded collection of patient-reported outcomes are needed to assess visual decline in RPGR -associated XLRP.
Topics: Humans; Adult; Eye Proteins; Mutation; Retinitis Pigmentosa; Blindness; Disease Progression
PubMed: 37683184
DOI: 10.1097/IAE.0000000000003920