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Clinical Nephrology Apr 2020The predictive value of Doppler-based renal resistive index (RRI) for acute kidney injury (AKI) has not been fully elucidated. The present meta-analysis was carried out... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The predictive value of Doppler-based renal resistive index (RRI) for acute kidney injury (AKI) has not been fully elucidated. The present meta-analysis was carried out to disclose the correlation between AKI and RRI, and to investigate the predictive value of RRI for the onset of AKI and its recovery.
MATERIALS AND METHODS
We searched PubMed, Embase, and Cochrane Library databases from inception to March 2019. The weighted mean difference (WMD) with a 95% confidence interval (CI) was used to assess the difference in RRIs between AKI and non-AKI patients. Moreover, the sensitivity and specificity were calculated, and summary receiver operating characteristic (SROC) curves were constructed. Meta-Disc and STATA were used for all statistical analyses.
RESULTS
A total of 20 studies (14 for prediction of the onset of AKI and 6 for prediction of AKI short-term non-recovery) were included in our meta-analysis. The values of RRI (WMD = 0.07; 95% CI: 0.05 - 0.09; p < 0.0001) were significantly higher in AKI patients compared with non-AKI patients. The overall sensitivity and specificity of RRI for prediction of the onset of AKI were 72% (95% CI, 64 - 80%) and 79% (95% CI, 71 - 85%), respectively. As for prediction of AKI short-term non-recovery, the pooled sensitivity was 81% (95% CI: 64 - 91), and the pooled specificity was 80% (95% CI: 72 - 85). For the onset of AKI, the best predictive performance was observed for the RRI measured immediately after major surgery, and a cut-off value ≥ 0.715 also achieved superior predictive value.
CONCLUSION
This study showed that the elevation of RRI may be related to the progression of AKI, and RRI could have good overall predictive value for the onset of AKI and its short-term non-recovery. Further studies in different clinical settings and patient groups are warranted before it could be widely used in clinical practice.
Topics: Acute Kidney Injury; Humans; Kidney; Predictive Value of Tests; Sensitivity and Specificity
PubMed: 32017700
DOI: 10.5414/CN109979 -
The Egyptian Heart Journal : (EHJ) :... Mar 2024The value of counting inflammatory cells and especially their counting ratio in predicting adverse clinical outcomes in patients with acute coronary syndrome (ACS)... (Review)
Review
The value of neutrophil-to-lymphocyte ratio in predicting severity of coronary involvement and long-term outcome of percutaneous coronary intervention in patients with acute coronary syndrome: a systematic review and meta-analysis.
BACKGROUND
The value of counting inflammatory cells and especially their counting ratio in predicting adverse clinical outcomes in patients with acute coronary syndrome (ACS) undergoing revascularization has been shown, but the results of studies have been very diverse and paradoxical. The aim of the current study was to systematically review the studies that investigated the role of increased neutrophil-to-lymphocyte ratio (NLR) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
METHODS
Data abstraction was independently performed by both un-blinded reviewers on deeply assessing Medline, Web of Knowledge, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials and using the relevant keywords. The risk of bias for each study was assessed using the criteria outlined in the Cochrane Handbook for Systematic Reviews of Interventions and the QUADAS-2 tool. Statistical analysis was performed using the Stata software. Overall, 14 articles published between 2010 and 2021 were eligible for the final analysis.
RESULTS
A total of 20,846 ACS patients undergoing PCI were included. Higher values of NLR were associated with higher numbers of involved coronaries (RR: 1.175, 95%CI 1.021-1.353, P = 0.024). Increasing the value of NLR was associated with a 3.4 times increase in long-term death (RR: 3.424, 95%CI 2.325-5.025, P = 0.001). Similarly, higher values of NLR were significantly associated with a higher likelihood of long-term MACE (RR: 2.604, 95%CI 1.736-3.906, P = 0.001).
CONCLUSIONS
NLR has a high value in predicting both the severity of coronary artery involvement and long-term adverse clinical outcomes following the PCI procedure.
PubMed: 38546902
DOI: 10.1186/s43044-024-00469-3 -
Animals : An Open Access Journal From... Oct 2022This study aims to model the relationship among performance, whole body composition, and processing yield through meta-regression. Scientific papers found in Scopus and... (Review)
Review
This study aims to model the relationship among performance, whole body composition, and processing yield through meta-regression. Scientific papers found in Scopus and Google Scholar were included if they reported results and variability values of an actual experiment in the three mentioned groups of variables using a single broiler genetic line. Weighted mean effect sizes were determined with a random model, the risk of bias was determined, and heterogeneity was considered an indicator of usefulness. Meta-regressions considered the effect sizes of the response variable and the percent change in one or more variables as predictors. A 78-row database was built from 14 papers, including nine factors tested on 22,256 broilers. No influencing bias was found, and the data was determined useful. Meta-regressions showed that the changes in body weight gain (BWG) are inversely related to the effects in feed conversion ratio (FCR) (p < 0.001) and that the changes in FCR and effects in protein-to-fat gain (PFG) are directly related (p < 0.001). The changes in PFG and the effects on carcass conformation or the market value of birds are directly related (p < 0.001). In conclusion, body composition predicts carcass conformation and its market value, supporting its use to predict the economic value of broilers.
PubMed: 36230447
DOI: 10.3390/ani12192706 -
Clinical Endocrinology Mar 2021Neutropenia, a low absolute neutrophil count (ANC), may be a sign of new-onset hyperthyroidism. The aim of this systematic review and meta-analysis was to provide the... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
Neutropenia, a low absolute neutrophil count (ANC), may be a sign of new-onset hyperthyroidism. The aim of this systematic review and meta-analysis was to provide the most reliable estimates of prevalence, degree and response to treatments of neutropenia in the pure hyperthyroidism setting.
METHODS
A comprehensive literature search was performed in PubMed and Scopus databases for retrieving articles in English and non-English languages reporting ANC values/neutropenic cases at presentation and after therapy in patients with hyperthyroidism. A proportion meta-analysis was performed with DerSimonian and Laird method (random-effects model). Pooled data were presented with 95% confidence intervals (95% CI) and displayed in a forest plot. I statistic index was used to quantify the heterogeneity among the studies. Sensitivity analyses for the prevalence of neutropenia and the mean of ANC in hyperthyroid patients were performed by excluding the studies without full details. Trim and fill analysis and Egger's linear regression test were carried out to evaluate the publication bias. A two-sided P-value of <.05 was regarded as significant for all analyses. The National Heart, Lung and Blood Institute Quality Assessment Tool was used to evaluate the quality of studies included.
RESULTS
The literature search yielded 1880 studies of which 13 studies were included for systematic review and meta-analysis. Results of the meta-analysis demonstrated that the prevalence of neutropenia in newly diagnosed and untreated patients with Graves' hyperthyroidism was 10% (CI 5%-19%, I 88.6%) and summary mean ANC value in neutropenic was 1.4 ± 0.3 × 10 /L. In all neutropenic patients under ATD therapy neutropenia resolved, thus without the worsening of the baseline ANC values or the development of agranulocytosis. The sensitivity analyses showed similar results as those of the main analyses. For all outcomes, the publication bias was not statistically significant or not calculable.
CONCLUSIONS
Graves' disease per se is associated with neutropenia in about 10% of cases. Neutropenia usually appears as a mild to moderate laboratory abnormality with no detectable consequences. Subnormal/mild neutropenia should not be regarded as a contraindication to use ATDs, and clinicians should know that treating hyperthyroidism they have a significant chance to normalize ANC too.
Topics: Graves Disease; Humans; Hyperthyroidism; Neutropenia; Neutrophils; Prevalence
PubMed: 32799342
DOI: 10.1111/cen.14313 -
Cancer Imaging : the Official... May 2022To systematically review and perform meta-analysis to evaluate the prognostic value of cervical nodal necrosis (CNN) on the staging computed tomography/magnetic... (Meta-Analysis)
Meta-Analysis Review
Prognostic value of cervical nodal necrosis on staging imaging of nasopharyngeal carcinoma in era of intensity-modulated radiotherapy: a systematic review and meta-analysis.
PURPOSES
To systematically review and perform meta-analysis to evaluate the prognostic value of cervical nodal necrosis (CNN) on the staging computed tomography/magnetic resonance imaging (MRI) of nasopharyngeal carcinoma (NPC) in era of intensity-modulated radiotherapy.
METHODS
Literature search through PubMed, EMBASE, and Cochrane Library was conducted. The hazard ratios (HRs) with 95% confidence intervals (CIs) of CNN for distant metastasis-free survival (DMFS), disease free survival (DFS) and overall survival (OS) were extracted from the eligible studies and meta-analysis was performed to evaluate the pooled HRs with 95%CI.
RESULTS
Nine studies, which investigated the prognostic values of 6 CNN patterns on MRI were included. Six/9 studies were eligible for meta-analysis, which investigated the CNN presence/absence in any nodal group among 4359 patients. The pooled unadjusted HRs showed that the CNN presence predicted poor DMFS (HR =1.89, 95%CI =1.72-2.08), DFS (HR =1.57, 95%CI =1.08-2.26), and OS (HR =1.87, 95%CI =1.69-2.06). The pooled adjusted HRs also showed the consistent results for DMFS (HR =1.34, 95%CI =1.17-1.54), DFS (HR =1.30, 95%CI =1.08-1.56), and OS (HR =1.61, 95%CI =1.27-2.04). Results shown in the other studies analysing different CNN patterns indicated the high grade of CNN predicted poor outcome, but meta-analysis was unable to perform because of the heterogeneity of the analysed CNN patterns.
CONCLUSION
The CNN observed on the staging MRI is a negative factor for NPC outcome, suggesting that the inclusion of CNN is important in the future survival analysis. However, whether and how should CNN be included in the staging system warrant further evaluation.
Topics: Humans; Magnetic Resonance Imaging; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Necrosis; Neoplasm Staging; Prognosis; Radiotherapy, Intensity-Modulated; Retrospective Studies
PubMed: 35596198
DOI: 10.1186/s40644-022-00462-6 -
The Knee Oct 2023To critically evaluate the efficacy and safety of early versus delayed anterior cruciate ligament reconstruction (ACLR) for anterior cruciate ligament (ACL) injuries... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To critically evaluate the efficacy and safety of early versus delayed anterior cruciate ligament reconstruction (ACLR) for anterior cruciate ligament (ACL) injuries based on the different cut-off values of the timing of operation.
METHODS
PubMed, Medline, Embase, Cochrane library, China National Knowledge Infrastructure, Chinese Biomedical Literature, and Wanfang Digital Periodical database were searched from inception to November 2022 without language restrictions. Randomized controlled trials (RCTs) and cohort studies (CSs) comparing early ACLR with delayed ACLR for ACL injuries were included.
RESULTS
Twenty-four studies (10 RCTs and 14 CSs) were included. According to the information from included studies, 3 weeks, 4 weeks, 6 weeks, 6 months, and 12 months after ACL injuries were considered as the cut-off values of early and delayed ACLR. When 4 weeks were considered as the cut-off value, early ACLR could significantly improve Lysholm score, IKDC score and VAS score at 6 and 12 months postoperatively and decrease the incidence of adverse events compared with delayed ACLR (P < 0.05). However, no statistically significant difference in positive rate of Lachman test and incidence of meniscus injuries and chondral lesions between the two groups when 3 weeks, 6 weeks, 6 months or 12 months after ACL injuries were considered as the cut-off values of early and delayed ACLR (P > 0.05).
CONCLUSION
The present study suggests that early ACLR, especially conducted within 3-4 weeks after ACL injuries, may be more effective for improving knee function and relieving pain compared with delayed ACLR. More high-quality RCTs are warranted.
Topics: Humans; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Knee Joint; Meniscus; Randomized Controlled Trials as Topic
PubMed: 37517167
DOI: 10.1016/j.knee.2023.07.008 -
Translational Andrology and Urology Apr 2020The research of the prognostic and clinicopathologic values of programmed cell death ligand 1/2 (PD-L1/2) in renal cell carcinoma (RCC) patients has been mired by a...
The prevalence and prognostic and clinicopathological value of PD-L1 and PD-L2 in renal cell carcinoma patients: a systematic review and meta-analysis involving 3,389 patients.
BACKGROUND
The research of the prognostic and clinicopathologic values of programmed cell death ligand 1/2 (PD-L1/2) in renal cell carcinoma (RCC) patients has been mired by a dearth of studies and considerable controversy. We thus conducted a systematic review and meta-analysis to report the prevalence and prognostic and clinicopathological value of programmed cell death ligand 1 (PD-L1) and programmed cell death-legend 2 (PD-L2) in RCC patients.
METHODS
The PubMed, Cochrane Library, EMBASE databases were searched to find human studies limited to English language literature published through October 1, 2019. Using random or fixed effects models, hazard ratios (HRs) and 95% confidence intervals (CIs) were evaluated to explore the prognostic value of PD-Ls expression, while odds ratios (ORs) and 95% CIs were evaluated to investigate clinicopathological parameters. The protocol of the study was registered in PROSPERO (CRD42019135199).
RESULTS
After pooling all 16 eligible studies comprising 3,389 patients, we found that the overall prevalence of PD-L1 and PD-L2 in RCC patients was 27% and 39%, respectively. Furthermore, PD-L1 over-expression was a strong negative predictor for overall survival (OS), disease-free survival/progression-free survival (DFS/PFS), and cancer-specific survival (CSS) in renal cell carcinoma patients (HR =2.86, 95% CI: 1.83-4.47, P<0.001; HR =2.64, 95% CI: 1.99-3.52, P<0.001; HR =2.78, 95% CI: 2.17-3.56, P<0.001). Meanwhile, PD-L2 over-expression was only a weak negative predictor for CSS (HR =1.66, 95% CI: 1.05-2.65, P<0.05). Subgroup analysis showed that Caucasians had worse OS (HR =3.60, 95% CI: 1.77-7.33, P<0.001), PFS (HR =3.56, 95% CI: 2.44-5.18, P<0.001), and CSS (HR =3.13, 95% CI: 2.37-4.14, P<0.001) than Asians. PD-L1 was a strong indicator for worse prognosis (P<0.05 for all), while PD-L2 over-expression was only associated with sarcomatoid features (presence absence, OR =1.80, 95% CI: 1.13-2.86, P=0.014). Notably, PD-L1 overexpression was more prevalent in women (male female, OR =0.68, 95% CI: 0.51-0.90, P=0.006).
CONCLUSIONS
Higher PD-L1 expression is more closely associated with poor prognosis and more advanced clinicopathological features in RCC patients than PD-L2, especially in women and Caucasian patients. PD-L2 was a weak negative predictor of poor CSS of RCC and was not a prompt for the metastasis of RCC.
PubMed: 32420142
DOI: 10.21037/tau.2020.01.21 -
BMC Infectious Diseases Sep 2018Salmonella Typhi is a human pathogen that causes typhoid fever. It is a major cause of morbidity and mortality in developing countries and is responsible for several... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Salmonella Typhi is a human pathogen that causes typhoid fever. It is a major cause of morbidity and mortality in developing countries and is responsible for several outbreaks in developed countries. Studying certain parameters of the pathogen, such as the incubation period, provides a better understanding of its pathophysiology and its characteristics within a population. Outbreak investigations and human experimental studies provide an avenue to study these relevant parameters.
METHODS
In this study, the authors have undertaken a systematic review of outbreak investigation reports and experimental studies, extracted reported data, tested for heterogeneity, identified subgroups of studies with limited evidence of heterogeneity between them and identified factors that may contribute to the distribution of incubation period. Following identification of relevant studies, we extracted both raw and summary incubation data. We tested for heterogeneity by deriving the value of I and conducting a KS-test to compare the distribution between studies. We performed a linear regression analysis to identify the factors associated with incubation period and using the resulting p-values from the KS-test, we conducted a hierarchical cluster analysis to classify studies with limited evidence of heterogeneity into subgroups.
RESULTS
We identified thirteen studies to be included in the review and extracted raw incubation period data from eleven. The value of I was 84% and the proportion of KS test p-values that were less than 0.05 was 63.6% indicating high heterogeneity not due to chance. We identified vaccine history and attack rates as factors that may be associated with incubation period, although these were not significant in the multivariable analysis (p-value: 0.1). From the hierarchical clustering analysis, we classified the studies into five subgroups. The mean incubation period of the subgroups ranged from 9.7 days to 21.2 days. Outbreaks reporting cases with previous vaccination history were clustered in a single subgroup and reported the longest incubation period.
CONCLUSIONS
We identified attack rate and previous vaccination as possible associating factors, however further work involving analyses of individual patient data and developing mathematical models is needed to confirm these as well as examine additional factors that have not been included in our study.
Topics: Databases, Factual; Disease Outbreaks; Humans; Infectious Disease Incubation Period; Linear Models; Salmonella Infections; Salmonella typhi; Serogroup
PubMed: 30261843
DOI: 10.1186/s12879-018-3391-3 -
Phlebology Aug 2022This study examines the influence of Earth's gravity field on the prevalence of varicose veins in geophysical area.
AIM
This study examines the influence of Earth's gravity field on the prevalence of varicose veins in geophysical area.
MATERIAL AND METHODS
We performed a systematic review (OVID and Google Scholar) of studies focusing on prevalence of varicose veins to determine the influence of Earth's gravity field-GRACE GGM05S gravity model-on the disease prevalence. PROSPERO: CRD42021279513.
RESULTS
81 studies met inclusion and quality criteria. Areas with stronger gravity have significantly higher prevalence of varicose veins with adjustment for age, gender and body mass index (BMI) (-values < 0.02). Adjusted for age, prevalence of varicose veins in areas with gravity field +20 mGal and more is 1.37 time higher than in areas with gravity field less than +20 mGal, -value 0.005 (95% CI: -12.5 to -2.4): mean disease prevalence for gravity field +20 mGal and more-27.5% (mean age, 40.1 years; mean gravity field, +27.1 mGal; 63.9% females, 37 studies, 123,164 participants) vs mean disease prevalence for gravity field less than +20 mGal - 20.1% (mean age, 42.2 years; mean gravity field, +5.7 mGal; 56.8% females, 44 studies, 205,925 participants). Older age is the main risk factor for varicose veins (-values < 0.005). Female gender and high BMI are insignificantly associated with high prevalence of varicose veins (-values > 0.4 for gender, -values > 0.2 for BMI).
CONCLUSION
Stronger gravity field is significantly associated with higher prevalence of varicose veins-risk factor. The potential mechanism of this phenomenon is that high gravity field alters systemic venous return, pooling blood and fluid in the peripheral, gravity-dependent regions of the body in upright humans constantly living in the defined geophysical area.
Topics: Adult; Body Mass Index; Chronic Disease; Female; Humans; Male; Prevalence; Risk Factors; Varicose Veins
PubMed: 35471106
DOI: 10.1177/02683555221090054 -
Annals of Translational Medicine Feb 2022To study the effect of Narcotrend monitoring on the incidence of early postoperative cognitive dysfunction (POCD) under different Bispectral Index (BIS) conditions and...
Systematic review and meta-analysis of the prognostic value of Narcotrend monitoring of different depths of anesthesia and different Bispectral Index (BIS) values for cognitive dysfunction after tumor surgery in elderly patients.
BACKGROUND
To study the effect of Narcotrend monitoring on the incidence of early postoperative cognitive dysfunction (POCD) under different Bispectral Index (BIS) conditions and the effect of different depths of anesthesia on the incidence of POCD.
METHODS
We performed a literature search of the PubMed, Embase, OVID (database system made by Ovid Technologies, USA), Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), VIP Chinese Sci-tech Journals Database, Wanfang Data, etc. from the date of establishment of the database until December 31, 2020.
RESULTS
In the end, eighty articles were included, with a total of 714 patients. The meta-analysis results showed that four articles (255 patients) compared the state of deep anesthesia (BIS 30-40) with conventional anesthesia (BIS 40-60 earlier) after POCD. Also, the incidence of POCD on the first day after deep anesthesia [Narcotrend stage (NTS): negative correlation is currently the most appropriate egg description; Nd can subdivide the original electroencephalogram (EEG) into six stages 15 levels (Nd Sg, NTS), or A (state of wakefulness), state B0-B2 (sedated state), state C0-C2 (light anesthetic state), state D0-D2 (general anesthesia), state E0-E2 (deep anesthesia state), and state F0-F2 (burst suppression state)] was significantly lower than that of conventional anesthesia (NTS D0-D1) [odds ratio (OR) =0.21, 95% confidence interval (CI): 0.13-0.35, P<0.00001]. Moreover, the incidence of POCD in deep anesthesia (NTS E1) at 7 days after surgery was significantly lower than that of conventional anesthesia (NTS D0) (OR =0.45, 95% CI: 0.23-0.91, P=0.03), while the incidence of POCD 7 days after NTS D2 in conventional anesthesia was significantly lower than that of NTS D0 (OR =0.42, 95% CI: 0.24-0.71, P=0.001).
DISCUSSIONS
POCDs are thought to be the result of a combination of physical defects and precipitating factors in patients with their own physical impairments, and despite potential adverse effects, there is currently no consensus on the incidence of POCDs in patients with tumor, current risk factors, causes, and prevention strategies. Moreover, the level of evidence is low, and the deviation between different studies cannot be ruled out.
PubMed: 35280411
DOI: 10.21037/atm-22-90