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International Journal of Public Health 2023We aimed to assess the association between rapid antigen detection tests and real-time reverse transcription-polymerase chain reaction assay for severe acute... (Meta-Analysis)
Meta-Analysis Review
Association Between Rapid Antigen Detection Tests and Real-Time Reverse Transcription-Polymerase Chain Reaction Assay for SARS-CoV-2: A Systematic Review and Meta-Analyses.
We aimed to assess the association between rapid antigen detection tests and real-time reverse transcription-polymerase chain reaction assay for severe acute respiratory syndrome coronavirus 2. We searched PubMed, Cochrane Library, EMBASE, and the Web of Science from their inception to 31 May 2023. A random-effects meta-analysis was used to estimate false positives in the RADTs group, relative to those in the RT-PCR group, and subgroup analyses were conducted based on the different Ct value cut-offs (<40 or ≥40). We performed this study in accordance with the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Fifty-one studies were included and considered to be of moderate quality. We found a satisfactory overall false positive rate (0.01, 95% CI: 0.00-0.01) for the RADTs compared to RT-PCR. In the stratified analysis, we also found that the false positive rates of the RADTs did not increase when Ct values of RT-PCR (Ct < 40, 0.01, 95% CI: 0.00-0.01; Ct ≥ 40, 0.01, 95% CI: 0.00-0.01). In conclusion, the best available evidence supports an association between RADTs and RT-PCR. When Ct-values were analyzed using cut-off <40 or ≥40, this resulted in an estimated false positive rate of only 1%.
Topics: Humans; Reverse Transcriptase Polymerase Chain Reaction; Reverse Transcription; SARS-CoV-2; COVID-19; COVID-19 Testing
PubMed: 37588042
DOI: 10.3389/ijph.2023.1605452 -
Otolaryngology--head and Neck Surgery :... Jun 2023In primary parotid gland malignancies, the incidence of level-specific cervical lymph node metastasis in clinically node-positive necks remains unclear. This study aimed... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
In primary parotid gland malignancies, the incidence of level-specific cervical lymph node metastasis in clinically node-positive necks remains unclear. This study aimed to determine the incidence of level-specific cervical node metastasis in clinically node-negative (cN0) and node-positive (cN+) patients who presented with primary parotid malignancies.
DATA SOURCES
Electronic databases (MEDLINE, EMBASE, PubMed, Cochrane).
REVIEW METHODS
Random-effects meta-analysis was used to calculate pooled estimate incidence of level-specific nodal metastasis for parotid malignancies with 95% confidence intervals (CIs). Subgroup analyses of cN0 and cN+ were performed.
RESULTS
Thirteen publications consisting of 818 patients were included. The overall incidence of cervical nodal involvement in all neck dissections was 47% (95% CI, 31%-63%). Among those who were cN+, the incidence of nodal positivity was 89% (95% CI, 75%-98%). Those who were cN0 had an incidence of 32% (95% CI, 14%-53%). In cN+ patients, the incidence of nodal metastasis was high at all levels (level I 33%, level II 73%, level III 48%, level IV 39%, and level V 37%). In cN0 patients, the incidence of nodal metastasis was highest at levels II (28%) and III (11%).
CONCLUSION
For primary parotid malignancies, the incidence of occult metastases was 32% compared to 89% in a clinically positive neck. It is recommended that individuals with a primary parotid malignancy requiring elective treatment of the neck have a selective neck dissection which involves levels II to III, with the inclusion of level IV based on clinical judgment. Those undergoing a therapeutic neck dissection should undergo a comprehensive neck dissection (levels I-V).
Topics: Humans; Parotid Neoplasms; Parotid Gland; Incidence; Retrospective Studies; Carcinoma; Neck Dissection; Lymph Nodes; Neoplasm Staging
PubMed: 36939620
DOI: 10.1002/ohn.207 -
Journal of Gastroenterology and... Apr 2022This study aims to systematically evaluate adherence to colonoscopy and related factors in cascade screening of colorectal cancer (CRC) among average-risk populations,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIM
This study aims to systematically evaluate adherence to colonoscopy and related factors in cascade screening of colorectal cancer (CRC) among average-risk populations, which is crucial to achieve the effectiveness of CRC screening.
METHODS
We searched PubMed, Embase, Web of Science, and Cochrane Library for studies published in English up to October 16, 2020, and reporting the adherence to colonoscopy following positive results of initial screening tests. A random-effects meta-analysis was applied to estimate pooled adherence and 95% confidence intervals. Subgroup analysis and mixed-effects meta-regression analysis were performed to evaluate heterogeneous factors for adherence level.
RESULTS
A total of 245 observational and 97 experimental studies were included and generated a pooled adherence to colonoscopy of 76.6% (95% confidence interval: 74.1-78.9) and 80.4% (95% confidence interval: 77.2-83.1), respectively. The adherence varied substantially by calendar year of screening, continents, CRC incidence, socioeconomic status, recruitment methods, and type of initial screening tests, with the initial tests as the most modifiable heterogeneous factor for adherence across both observational (Q = 162.6, P < 0.001) and experimental studies (Q = 23.2, P < 0.001). The adherence to colonoscopy was at the highest level when using flexible sigmoidoscopy as an initial test, followed by using guaiac fecal occult blood test, quantitative or qualitative fecal immunochemical test, and risk assessment. The pooled estimate of adherence was positively associated with specificity and positive predictive value of initial screening tests, but negatively with sensitivity and positivity rate.
CONCLUSIONS
Colonoscopy adherence is at a low level and differs by study-level characteristics of programs and populations. Initial screening tests with high specificity or positive predictive value may be followed by a high adherence to colonoscopy.
Topics: Colonoscopy; Colorectal Neoplasms; Early Detection of Cancer; Humans; Mass Screening; Occult Blood; Sigmoidoscopy
PubMed: 34907588
DOI: 10.1111/jgh.15762 -
International Journal of Nursing Studies Dec 2022Prediction of suicide and suicide attempts is an aspirational goal for clinicians and policy makers. This requires scrutiny of various diagnostic accuracy measurements. (Review)
Review
BACKGROUND
Prediction of suicide and suicide attempts is an aspirational goal for clinicians and policy makers. This requires scrutiny of various diagnostic accuracy measurements.
OBJECTIVE
To evaluate the diagnostic accuracy of suicide risk scales in inpatient and emergency departments, and combined settings within hospitals, and consider the best scale in predicting suicide and suicide attempts in adults.
DESIGN
Systematic review of diagnostic accuracy.
SETTINGS
Inpatient and emergency rooms of acute hospitals.
METHODS
The searched databases included PubMed, Embase, ProQuest, MEDLINE, Web of Science, CINAHL, Cochrane, PsycINFO and Scopus. Grey literature databases (ProQuest Dissertations and Theses, Google Scholar and OpenSIGLE) and reference lists of all included studies were also searched. Eligibility criteria included prospective cohort studies of suicide or attempted suicide in adults. A narrative synthesis was done for true positives, true negatives, false positives and false negatives, and they were calculated for sensitivity, specificity, likelihood ratios, predictive values and diagnostic odds ratios.
RESULTS
The included 33 studies differed in the methodological characteristics and scales used. The sensitivity of scales, specificity, positive predictive value, and diagnostic odds ratios ranged from 17 to 100%, 11-93%, 0.43-40.9%, and 0.77-18.5, respectively.
CONCLUSION
The choice of scale for predicting suicide attempts in adults in hospitals depends on many factors. None of the scales evaluated produced accurate diagnostic measurements. The Manchester Self-Harm Rule and Suicide Crisis Syndrome should be used in the emergency department and inpatient setting, respectively, while the Suicide Intent Scale should be used in combined settings.
Topics: Adult; Humans; Suicide, Attempted; Prospective Studies; Self-Injurious Behavior; Emergency Service, Hospital; Hospitals; Sensitivity and Specificity
PubMed: 36209575
DOI: 10.1016/j.ijnurstu.2022.104361 -
Autoimmunity Reviews Oct 2022Microvascular renal lesions have been described in patients with antiphospholipid antibodies (aPL), however their association with aPL is inconsistent among studies.... (Meta-Analysis)
Meta-Analysis Review
Increased risk of acute and chronic microvascular renal lesions associated with antiphospholipid antibodies in patients with systemic lupus erythematosus: A systematic review and meta-analysis.
BACKGROUND
Microvascular renal lesions have been described in patients with antiphospholipid antibodies (aPL), however their association with aPL is inconsistent among studies. Therefore, our objective was to investigate associations between microvascular renal lesions and aPL among systemic lupus erythematosus (SLE) patients.
METHODS
Studies were selected if they included SLE patients with and without aPL positivity with a description of kidney biopsy identifying acute and/or chronic microvascular renal lesions as well as lupus nephritis. Data sources were Pubmed, Embase, Cochrane Library, hand search, congress abstracts, and reference lists of studies, without language restrictions. Risk estimates were independently extracted by 2 investigators. Pooled effect estimates were obtained by using the Mantel-Haenszel method (random effects).
RESULTS
Of 1860 identified records obtained between 1991 and 2021, 35 published studies (10 cohorts, 7 case-control, 18 cross-sectional) met inclusion criteria, including 3035 SLE patients according to American College of Rheumatology criteria and 454 cases of microvascular renal lesions. Frequency of microvascular renal lesions in aPL-positive vs. aPL-negative SLE patients was 31.3% vs. 10.4%, respectively. The overall pooled odds ratios (OR) for microvascular renal lesions in aPL-positive vs. aPL-negative SLE patients was 3.03 (95% confidence interval [CI], 2.25-4.09). The risk of microvascular renal lesions was the highest for lupus anticoagulant (OR = 4.84 [95% CI, 2.93 to 8.02]) and IgG anticardiolipin antibodies (OR = 3.12 [95% CI,1.08-9.02]) while the association with anti-β-glycoprotein I antibodies (OR = 1.88 [95% CI, 0.25-14.14]) did not reach statistical significance. Furthermore, aPL were not associated with any classes of lupus nephritis.
CONCLUSION
In SLE patients, aPL-positivity is associated with a significant 3- to 5-fold increased risk for specific microvascular renal lesions. This risk is mainly driven by lupus anticoagulant and IgG anticardiolipin antibodies. Our results support the inclusion of microvascular renal lesions as new criteria for definite antiphospholipid syndrome.
Topics: Antibodies, Anticardiolipin; Antibodies, Antiphospholipid; Antiphospholipid Syndrome; Cross-Sectional Studies; Glycoproteins; Humans; Immunoglobulin G; Kidney; Lupus Coagulation Inhibitor; Lupus Erythematosus, Systemic; Lupus Nephritis
PubMed: 35907609
DOI: 10.1016/j.autrev.2022.103158 -
Cancers Apr 2021The worldwide prevalence of Epstein-Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL) is undetermined. There is no clearly defined cut-off for EBV-encoded... (Review)
Review
The worldwide prevalence of Epstein-Barr virus-positive (EBV+) diffuse large B-cell lymphoma (DLBCL) is undetermined. There is no clearly defined cut-off for EBV-encoded RNA (EBER) positivity in tumor cells by in-situ hybridization. The purpose of this study was to establish the proportions of EBV+ DLBCL patients and influence of the different cut-offs for EBER positivity, geographical location, and age on the prevalence of EBV+ DLBCL. PubMed and EMBASE were searched for studies published up to May 28, 2020 that reported proportions of EBER positivity in immunocompetent and de novo DLBCL patients. The pooled proportions were computed by an inverse variance method for calculating the weights and the DerSimonian-Laird method. Multiple subgroup analyses were conducted to explore any heterogeneity. Thirty-one studies (8249 patients) were included. The pooled proportion of EBV+ DLBCL was 7.9% (95% CI, 6.2-10.0%) with significant heterogeneity among studies ( < 0.001). The prevalence of EBV+ DLBCL was significantly higher in Asia and South America compared with Western countries ( < 0.01). The cut-offs for EBER positivity (10%, 20%, 50%) and patients' age (≥50 years vs. <50 years) did not significantly affect the prevalence ( ≥ 0.10). EBV+ DLBCL is rare with a pooled proportion of 7.9% in patients with DLBCL and the geographic heterogeneity was confirmed.
PubMed: 33917961
DOI: 10.3390/cancers13081785 -
Breastfeeding Medicine : the Official... Jun 2022CDC guidelines have recommended coronavirus disease-19 (COVID-19) vaccination for all people 5 years and older, including people who are breastfeeding. Breast milk has... (Meta-Analysis)
Meta-Analysis Review
CDC guidelines have recommended coronavirus disease-19 (COVID-19) vaccination for all people 5 years and older, including people who are breastfeeding. Breast milk has shown to be a valuable source of protection for immune-immature neonates. It has been shown that breast milk from mothers who have received vaccinations can transfer antibodies. This systematic review and meta-analysis investigate the presence of antibodies to SARS-CoV-2 in human breast milk after vaccination. Studies that evaluated immunoglobulins in breast milk of women receiving a SARS-CoV-2 vaccination were included. PubMed, Embase, Web of Science were searched for articles published between December 1, 2019 and September 30, 2021. Data from relevant articles were extracted manually or by WebPlotDigitizer version 4.1 to obtain the numeric values of antibody levels on peak days and the peak day then condensed into Excel. Additional raw data and information were supplied by corresponding authors. One hundred ninety-two articles were obtained from the search. After excluding duplicates, screening titles and abstracts, 18 cohort studies were identified. For the rate of SARS-CoV-2 antibodies in breast milk after the first vaccine dose but before the second vaccine dose, we found 64% (95% CI 51-78%) were positive for IgA and 30% (95% CI 13.1-46%) were positive for IgG. For the rate for SARS-CoV-2 antibodies in breast milk after the second vaccine dose, we found 70% (95% CI 55-86%) were positive for IgA and 91% (95% CI 80-103%) were positive for IgG. Our analysis of the data published worldwide showed high rates of positivity for antibodies in breast milk following COVID-19 immunizations. Further research is necessary to find if the rate of positivity of IgA and IgG against SARS-CoV-2 in breast milk persists months after the full immunization, and their impact on the prevention of SARS-CoV-2 infection in infants.
Topics: Antibodies, Viral; Breast Feeding; COVID-19; COVID-19 Vaccines; Female; Humans; Immunoglobulin A; Immunoglobulin G; Infant; Infant, Newborn; Milk, Human; SARS-CoV-2; Vaccination
PubMed: 35325550
DOI: 10.1089/bfm.2021.0353 -
International Journal of Molecular... Jun 2023Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma (NHL) characterized by a hallmark translocation of t (11; 14). CD10 negativity has been used to... (Meta-Analysis)
Meta-Analysis Review
Mantle cell lymphoma (MCL) is a type of non-Hodgkin lymphoma (NHL) characterized by a hallmark translocation of t (11; 14). CD10 negativity has been used to differentiate MCL from other NHL types; however, recently, there has been an increase in the number of reported cases of CD10-positive MCL. This warrants further investigation into this rarer immunophenotype and its clinical significance. BCL6, which is a master transcription factor for the regulation of cell proliferation and key oncogene in B cell lymphomagenesis, has been reported to have co-expression with CD10 in MCL. The clinical significance of this aberrant antigen expression remains unknown. We conducted a systematic review by searching four databases and selected five retrospective analyses and five case series. Two survival analyses were conducted to determine if BCL6 positivity conferred a survival difference: 1. BCL6+ vs. BCL6- MCL. 2. BCL6+/CD10+ vs. BCL6-/CD10+ MCL. Correlation analysis was conducted to determine if BCL6 positivity correlated with the Ki67 proliferation index (PI). Overall survival (OS) rates were performed by the Kaplan-Meier method and log-rank test. Our analyses revealed that BCL6+ MCL had significantly shorter overall survival (median OS: 14 months vs. 43 months; = 0.01), BCL6+/CD10+ MCL had an inferior outcome vs. BCL6+/CD10- MCL (median OS: 20 months vs. 55 months = 0.1828), BCL6+ MCL had significantly higher percentages of Ki67% (Ki67% difference: 24.29; = 0.0094), and BCL6 positivity had a positive correlation with CD10+ status with an odds ratio 5.11 (2.49, 10.46; = 0.0000286). Our analysis showed that BCL6 expression is correlated with CD10 positivity in MCL, and BCL6 expression demonstrated an inferior overall survival. The higher Ki67 PI in BCL6+ MCL compared to BCL6- MCL further supports the idea that the BCL6+ immunophenotype may have prognostic value in MCL. MCL management should consider incorporating prognostic scoring systems adjusted for BCL6 expression. Targeted therapies against BCL6 may offer potential therapeutic options for managing MCL with aberrant immunophenotypes.
Topics: Humans; Adult; Lymphoma, Mantle-Cell; Neprilysin; Proto-Oncogene Proteins c-bcl-6; Retrospective Studies; Prognosis; Ki-67 Antigen
PubMed: 37373354
DOI: 10.3390/ijms241210207 -
Journal of Pediatric Gastroenterology... Nov 2022To explore the effect of Helicobacter pylori (Hp ) infection on zinc, copper, calcium, magnesium, phosphorus, and iodine status in the pediatric population. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To explore the effect of Helicobacter pylori (Hp ) infection on zinc, copper, calcium, magnesium, phosphorus, and iodine status in the pediatric population.
METHODS
A protocol was registered on PROSPERO. A literature search was conducted on Embase, PubMed MEDLINE, and Web of Science, from inception to September 2020, including all studies in English, Spanish, and Portuguese languages. Reference lists were manually searched. Primary studies describing at least one micronutrient status in Hp -positive and Hp -negative or control children were included. PRISMA recommendations were applied. Pooled mean differences (MDs) and 95% confidence intervals were estimated using a random-effects model. A total of 1011 citations were screened. Six cross- sectional studies were included. No publications regarding phosphorus and iodine were identified.
RESULTS
Included studies in meta-analyses comprised an overall age range of 4-18 years, with Hp positivity ranging between 29.5% and 72.3%. These meta-analyses demonstrated a lack of evidence of an association between Hp -positive and Hp -negative or control children regarding serum zinc (vs Hp -negative: MD -1.36 µg/dL; vs control: MD 326.22 µg/dL), copper (MD -0.83 µg/dL), and calcium (MD 0.09 mg/dL) status. Considerable heterogeneity was recognized, except for calcium analysis (I 2 = 0%). Meta-analysis for magnesium was not performed. Five studies presented a low risk of bias.
CONCLUSIONS
The study demonstrated a lack of evidence of an effect of Hp infection on serum zinc, copper, and calcium status. Studies concerning magnesium, phosphorus, and iodine status are warranted. Furthermore, larger and well-controlled studies are recommended.
Topics: Child; Humans; Child, Preschool; Adolescent; Helicobacter Infections; Helicobacter pylori; Trace Elements; Copper; Calcium; Iodine; Zinc; Phosphorus
PubMed: 35815889
DOI: 10.1097/MPG.0000000000003559 -
Journal of Affective Disorders Jun 2021Big Five personality traits correlate with affective disorders, with neuroticism considered a risk factor, and conscientiousness and extroversion considered protective... (Review)
Review
BACKGROUND
Big Five personality traits correlate with affective disorders, with neuroticism considered a risk factor, and conscientiousness and extroversion considered protective factors. However, the relationships between affective disorders and lower-order personality facets and aspects are less clear.
METHOD
A systematic review was carried out to identify studies measuring associations between lower-order personality constructs and affective disorders. Big Five facets were measured using the NEO-PI-R, and aspects using the BFAS. PsycINFO, EMBASE, MedLine and OpenGrey were searched from January 1, 1985 to June 30, 2020. Fifteen studies met criteria and reported a total of 408 associations. Data were analysed using best evidence synthesis.
RESULTS
Most facets of neuroticism were positively associated with affective disorders. Positive emotion in extroversion, and competence and self-discipline in conscientiousness, were negatively associated with affective disorders. Trust in agreeableness, and actions in openness, were negatively associated with anxiety disorders, whereas fantasy in openness was positively associated with anxiety disorders. At the aspect level, withdrawal in neuroticism was positively associated with MDD, whereas industriousness in conscientiousness was negatively associated with MDD.
LIMITATIONS
Due to the use the heterogenous measures between studies, a meta-analysis could not be performed. Only Big Five personality constructs were investigated, limited to BFAS personality aspects, and NEO-PI-R personality facets.
CONCLUSIONS
Neuroticism, positive emotion, competence and self-discipline correlate with various anxiety and depressive disorders. These facets may be endophenotypes for affective disorders in general. Future research is needed to investigate mediating pathways between personality facets and affective disorders.
Topics: Extraversion, Psychological; Humans; Mood Disorders; Neuroticism; Personality; Personality Inventory
PubMed: 33901698
DOI: 10.1016/j.jad.2021.03.061