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Journal of Medical Virology Jun 2024Cervical cancer is the fourth most common cancer in women worldwide and is caused by persistent infection with high-risk types of human papillomavirus (HPV). HPV viral...
Cervical cancer is the fourth most common cancer in women worldwide and is caused by persistent infection with high-risk types of human papillomavirus (HPV). HPV viral load, the amount of HPV DNA in a sample, has been suggested to correlate with cervical disease severity, and with clinical outcome of cervical cancer. In this systematic review, we searched three databases (EMBASE, PubMed, Web of Science) to examine the current evidence on the association between HPV viral load in cervical samples and disease severity, as well as clinical outcome. After exclusion of articles not on HPV, cervical cancer, or containing clinical outcomes, 85 original studies involving 173 746 women were included. The vast majority (73/85 = 85.9%) reported that a higher viral load was correlated with higher disease severity or worse clinical outcome. Several studies reported either no correlation (3/85 = 3.5%), or the opposite correlation (9/85 = 10.6%); possible reasons being different categorization of HPV viral load levels, or the use of specific sampling methods. Despite variations in study design and populations, the above findings suggest that HPV viral load is correlated to clinical outcome, and may become an important biomarker for treatment selection and response monitoring for cervical cancer.
Topics: Humans; Viral Load; Female; Papillomavirus Infections; Papillomaviridae; Uterine Cervical Neoplasms; Severity of Illness Index; DNA, Viral; Uterine Cervical Diseases; Human Papillomavirus Viruses
PubMed: 38922964
DOI: 10.1002/jmv.29741 -
Veterinary Sciences Jun 2024Peste des petits ruminants (PPR) is an extremely transmissible viral disease caused by the PPR virus that impacts domestic small ruminants, namely sheep and goats. This... (Review)
Review
Peste des petits ruminants (PPR) is an extremely transmissible viral disease caused by the PPR virus that impacts domestic small ruminants, namely sheep and goats. This study aimed to employ a methodical approach to evaluate the regional occurrence of PPR in small ruminants in Pakistan and the contributing factors that influence its prevalence. A thorough search was performed in various databases to identify published research articles between January 2004 and August 2023 on PPR in small ruminants in Pakistan. Articles were chosen based on specific inclusion and exclusion criteria. A total of 25 articles were selected from 1275 studies gathered from different databases. The overall pooled prevalence in Pakistan was calculated to be 51% (95% CI: 42-60), with heterogeneity = 100%, 2 = 0.0495, and = 0. The data were summarized based on the division into five regions: Punjab, Baluchistan, KPK, Sindh, and GB and AJK. Among these, the pooled prevalence of PPR in Sindh was 61% (95% CI: 46-75), = 100%, 2 = 0.0485, and = 0, while in KPK, it was 44% (95% CI: 26-63), = 99%, 2 = 0.0506, and < 0.01. However, the prevalence of PPR in Baluchistan and Punjab was almost the same. Raising awareness, proper surveillance, and application of appropriate quarantine measures interprovincially and across borders must be maintained to contain the disease.
PubMed: 38922027
DOI: 10.3390/vetsci11060280 -
Epidemiologia (Basel, Switzerland) May 2024Respiratory diseases, including respiratory syncytial virus (RSV) infections, are common reasons for seeking healthcare among refugees and asylum seekers. A systematic... (Review)
Review
Respiratory diseases, including respiratory syncytial virus (RSV) infections, are common reasons for seeking healthcare among refugees and asylum seekers. A systematic review with meta-analysis was designed to appraise all the available evidence on RSV infections among individuals in refugee camps. Three medical databases (PubMed, Embase, and Scopus) as well as the preprint repository medRxiv.org were searched for eligible observational studies, and the collected cases were pooled in a random-effects meta-analysis model. Heterogeneity was assessed using the I statistics. Funnel plots and a regression analysis were calculated for analyzing reporting bias. Eventually, six studies were retrieved from three areas (Bangladesh, Thailand, and Kenya), with pooled estimates of 129.704 cases per 1000 samples (95% CI 66.393 to 237.986) for RSV compared to 110.287 per 1000 people for influenza A (95% CI 73.186 to 162.889), 136.398 cases per 1000 people (95% CI 84.510 to 212.741) for human adenovirus (HAdV), 69.553 per 1000 people (95% CI 49.802 to 96.343) for parainfluenzavirus (PIFV), and 60.338 per 1000 people (95% CI 31.933 to 111.109) for human metapneumovirus (hMPV). Using influenza A as a reference group, the risk for a positive specimen was greater for RSV (relative risk [RR] 1.514, 95% CI 1.396 to 1.641) and HAdV (RR 1.984, 95% CI 1.834 to 2.146) and lower for influenza B (RR 0.276, 95% CI: 0.239 to 0.319), PIFV (RR: 0.889, 95% CI 0.806 to 0.981), and hMPV (RR 0.594, 95% CI 0.534 to 0.662). In summary, high rates of RSV infections were documented among individuals sheltered in refugee camps, stressing the importance of specifically designed preventive strategies.
PubMed: 38920751
DOI: 10.3390/epidemiologia5020016 -
AIDS Research and Therapy Jun 2024Despite remarkable progress, HIV's influence on global health remains firm, demanding continued attention. Understanding the effectiveness of third-line antiretroviral... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Despite remarkable progress, HIV's influence on global health remains firm, demanding continued attention. Understanding the effectiveness of third-line antiretroviral therapy in individuals who do not respond to second-line drugs is crucial for improving treatment strategies. The virological outcomes of third-line antiretroviral therapy vary from study to study, highlighting the need for robust global estimates.
METHODS
A comprehensive search of databases including PubMed, MEDLINE, International Scientific Indexing, Web of Science, and Google Scholar, was conducted. STATA version 17 statistical software was used for analysis. A random-effects model was applied to compute the pooled estimates. Subgroup analysis, heterogeneity, publication bias, and sensitivity analysis were also performed. The prediction interval is computed to estimate the interval in which a future study will fall. The GRADE tool was also used to determine the quality of the evidence.
RESULTS
In this systematic review and meta-analysis, 15 studies involving 1768 HIV patients receiving third-line antiretroviral therapy were included. The pooled viral suppression of third-line antiretroviral therapy was 76.6% (95% CI: 71.5- 81.7%). The viral suppression rates at 6 and 12 months were 75.5% and 78.6%, respectively. Furthermore, third-line therapy effectively suppressed viral RNA copy numbers to ≤ 50 copies/mL, ≤ 200 copies/mL, and ≤ 400 copies/mL with rates of 70.7%, 85.4%, and 85.7%, respectively.
CONCLUSION
More than three-fourths of patients on third-line antiretroviral therapy achieve viral suppression. Consequently, improving access to and timely initiation of third-line therapy may positively impact the quality of life for those with second-line treatment failure.
Topics: Humans; Anti-HIV Agents; Antiretroviral Therapy, Highly Active; Global Health; HIV Infections; HIV-1; Treatment Outcome; Viral Load
PubMed: 38918866
DOI: 10.1186/s12981-024-00630-7 -
Frontiers in Physiology 2024This systematic review investigates the interplay between oxytocin and exercise; in terms of analgesic, anti-inflammatory, pro-regenerative, and cardioprotective...
INTRODUCTION
This systematic review investigates the interplay between oxytocin and exercise; in terms of analgesic, anti-inflammatory, pro-regenerative, and cardioprotective effects. Furthermore, by analyzing measurement methods, we aim to improve measurement validity and reliability.
METHODS
Utilizing PRISMA, GRADE, and MECIR protocols, we examined five databases with a modified SPIDER search. Including studies on healthy participants, published within the last 20 years, based on keywords "oxytocin," "exercise" and "measurement," 690 studies were retrieved initially (455 unique records). After excluding studies of clinically identifiable diseases, and unpublished and reproduction-focused studies, 175 studies qualified for the narrative cross-thematic and structural analysis.
RESULTS
The analysis resulted in five categories showing the reciprocal impact of oxytocin and exercise: Exercise (50), Physiology (63), Environment (27), Social Context (65), and Stress (49). Exercise-induced oxytocin could promote tissue regeneration, with 32 studies showing its analgesic and anti-inflammatory effects, while 14 studies discussed memory and cognition. Furthermore, empathy-associated rs53576 polymorphism might influence team sports performance. Since dietary habits and substance abuse can impact oxytocin secretion too, combining self-report tests and repeated salivary measurements may help achieve precision.
DISCUSSION
Oxytocin's effect on fear extinction and social cognition might generate strategies for mental training, and technical, and tactical development in sports. Exercise-induced oxytocin can affect the amount of stress experienced by athletes, and their response to it. However, oxytocin levels could depend on the type of sport in means of contact level, exercise intensity, and duration. The influence of oxytocin on athletes' performance and recovery could have been exploited due to its short half-life. Examining oxytocin's complex interactions with exercise paves the way for future research and application in sports science, psychology, and medical disciplines.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=512184, identifier CRD42024512184.
PubMed: 38915776
DOI: 10.3389/fphys.2024.1393497 -
Annals of Surgery Open : Perspectives... Jun 2024The aim of this systematic review and meta-analysis is to identify current robotic assistance systems for percutaneous liver ablations, compare approaches, and determine...
OBJECTIVE
The aim of this systematic review and meta-analysis is to identify current robotic assistance systems for percutaneous liver ablations, compare approaches, and determine how to achieve standardization of procedural concepts for optimized ablation outcomes.
BACKGROUND
Image-guided surgical approaches are increasingly common. Assistance by navigation and robotic systems allows to optimize procedural accuracy, with the aim to consistently obtain adequate ablation volumes.
METHODS
Several databases (PubMed/MEDLINE, ProQuest, Science Direct, Research Rabbit, and IEEE Xplore) were systematically searched for robotic preclinical and clinical percutaneous liver ablation studies, and relevant original manuscripts were included according to the Preferred Reporting items for Systematic Reviews and Meta-Analyses guidelines. The endpoints were the type of device, insertion technique (freehand or robotic), planning, execution, and confirmation of the procedure. A meta-analysis was performed, including comparative studies of freehand and robotic techniques in terms of radiation dose, accuracy, and Euclidean error.
RESULTS
The inclusion criteria were met by 33/755 studies. There were 24 robotic devices reported for percutaneous liver surgery. The most used were the MAXIO robot (8/33; 24.2%), Zerobot, and AcuBot (each 2/33, 6.1%). The most common tracking system was optical (25/33, 75.8%). In the meta-analysis, the robotic approach was superior to the freehand technique in terms of individual radiation (0.5582, 95% confidence interval [CI] = 0.0167-1.0996, dose-length product range 79-2216 mGy.cm), accuracy (0.6260, 95% CI = 0.1423-1.1097), and Euclidean error (0.8189, 95% CI = -0.1020 to 1.7399).
CONCLUSIONS
Robotic assistance in percutaneous ablation for liver tumors achieves superior results and reduces errors compared with manual applicator insertion. Standardization of concepts and reporting is necessary and suggested to facilitate the comparison of the different parameters used to measure liver ablation results. The increasing use of image-guided surgery has encouraged robotic assistance for percutaneous liver ablations. This systematic review analyzed 33 studies and identified 24 robotic devices, with optical tracking prevailing. The meta-analysis favored robotic assessment, showing increased accuracy and reduced errors compared with freehand technique, emphasizing the need for conceptual standardization.
PubMed: 38911657
DOI: 10.1097/AS9.0000000000000406 -
BMC Infectious Diseases Jun 2024Currently, several studies have observed that chronic hepatitis B virus infection is associated with the pathogenesis of kidney disease. However, the extent of the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Currently, several studies have observed that chronic hepatitis B virus infection is associated with the pathogenesis of kidney disease. However, the extent of the correlation between hepatitis B virus infection and the chronic kidney disease risk remains controversial.
METHODS
In the present study, we searched all eligible literature in seven databases in English and Chinese. The random effects model was used to conduct a meta-analysis. Quality of included studies was assessed using the Newcastle-Ottawa Quality Scale.
RESULTS
In this analysis, a total of 31 studies reporting the association between hepatitis B virus infection and chronic kidney disease risk were included. The results showed a significant positive association between hepatitis B virus infection and the risk of chronic kidney disease (pooled OR, 1.20; 95% CI, 1.12-1.29), which means that hepatitis B virus increases the risk of developing chronic kidney disease.
CONCLUSION
This study found that hepatitis B virus infection was associated with a significantly increased risk of chronic kidney disease. However, the current study still cannot directly determine this causal relationship. Thus, more comprehensive prospective longitudinal studies are needed in the future to provide further exploration and explanation of the association between hepatitis B virus and the risk of developing chronic kidney disease.
Topics: Humans; Renal Insufficiency, Chronic; Risk Factors; Hepatitis B, Chronic; Hepatitis B; Hepatitis B virus
PubMed: 38909191
DOI: 10.1186/s12879-024-09546-z -
International Journal of Antimicrobial... Jun 2024We systematically assessed benefits and harms of the use of ivermectin in non-hospitalized patients with early COVID-19. (Review)
Review
Efficacy and safety of ivermectin for treatment of non-hospitalized COVID-19 patients: a systematic review and meta-analysis of 12 randomized controlled trials with 7,035 participants.
INTRODUCTION
We systematically assessed benefits and harms of the use of ivermectin in non-hospitalized patients with early COVID-19.
METHODS
Five databases were searched until October 17, 2023, for randomized controlled trials (RCTs) in adult patients with COVID-19 treated with ivermectin against standard of care (SoC), placebo, or active drug. Primary outcomes were hospitalization, all-cause mortality, and adverse events (AEs). Secondary outcomes included mechanical ventilation (MV), clinical improvement, clinical worsening, viral clearance, and severe adverse events (SAEs). Random effects meta-analyses were performed, with quality of evidence (QoE) evaluated using GRADE methods. Pre-specified subgroup analyses (ivermectin dose, control type, risk of bias, follow-up, and country income) and trial sequential analysis (TSA) were performed.
RESULTS
Twelve RCTs (n=7,035) were included. The controls were placebo in nine RCTs, SoC in two RCTs, and placebo or active drug in one RCT. Ivermectin did not reduce hospitalization (relative risk [RR], 0.81, 95% confidence interval [95%CI] 0.64-1.03; 8 RCTs, low QoE), all-cause mortality (RR 0.98, 95%CI 0.73-1.33; 9 RCTs, low QoE), or AEs (RR 0.89, 95%CI 0.75-1.07; 9 RCTs, very low QoE) vs. controls. Ivermectin did not reduce MV, clinical worsening, or SAEs and did not increase clinical improvement and viral clearance vs. controls (very low QoE for secondary outcomes). Subgroup analyses were mostly consistent with main analyses, and TSA-adjusted risk for hospitalization was similar to main analysis.
CONCLUSIONS
In non-hospitalized COVID-19 patients, ivermectin did not have effect on clinical, non-clinical or safety outcomes versus controls. Ivermectin should not be recommended as treatment in non-hospitalized COVID-19 patients.
PubMed: 38908535
DOI: 10.1016/j.ijantimicag.2024.107248 -
European Journal of Clinical... Jun 2024This meta-analysis was dedicated to evaluating the effectiveness and safety of Atezolizumab plus Bevacizumab (Atez/Bev) and Lenvatinib (LEN) as first-line systematic... (Review)
Review
BACKGROUND
This meta-analysis was dedicated to evaluating the effectiveness and safety of Atezolizumab plus Bevacizumab (Atez/Bev) and Lenvatinib (LEN) as first-line systematic therapy for unresectable hepatocellular carcinoma (u-HCC).
METHODS
The prospective protocol for this study was registered with the PROSPERO (Registration number: CRD42022356874). Literature searches were conducted in PubMed, EMBASE database Cochrane Library, and Web Science to determine all clinical controlled studies that reported Atez/Bev and LEN for treating u-HCC. We. evaluated as primary end-point overall survival (OS) and progression-free survival (PFS), as well as other outcomes such as tumor response and adverse events (AEs).Quality assessment and data extraction of studies were conducted independently by three reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software.
RESULTS
12 retrospective cohort studies (RCSs) involving a total of 4948 patients were finally included. The results showed that compared with LEN, Atez/Bev can improve the patient's PFS (HR = 0.80, 95% CI: 0.72 ~ 0.88; p < 0.0001) and reduce the rate of overall AEs (OR = 0.46 95% CI: 0.38 ~ 0.55, p < 0.00001) and grade ≥ 3 AEs (OR = 0.43; 95% CI: 0.36 ~ 0.51, p < 0.00001), while there is no difference between OS and treatment responses rate (objective response rate, disease control rate, complete response, partial response, progressive disease, and stable disease) between two groups. In addition, the subgroup analysis shows that Atez/Bev can promote the OS of patients with viral hepatitis. (HR = 0.79, 95% CI: 0.67 ~ 0.95; p = 0.01), while LEN has an advantage in improving OS in patients with Child-Pugh grade B liver function (HR = 1.98, 95% CI: 1.50 ~ 2.63; p < 0.00001).
CONCLUSION
Current evidence shows that compared with LEN, Atez/Bev has more advantages in PFS and safety in treating u-HCC and can improve the OS of patients with viral. LEN has advantages in improving the OS of patients with grade B liver function. However, more multicenter randomized controlled experiments are needed in the future to verify our results.
PubMed: 38907884
DOI: 10.1007/s00228-024-03718-1 -
Value in Health : the Journal of the... Jun 2024Chronic viral hepatitis is associated with severe impairment and reduction in patient health-related quality of life (HRQoL), due to substantial morbidity associated... (Review)
Review
OBJECTIVES
Chronic viral hepatitis is associated with severe impairment and reduction in patient health-related quality of life (HRQoL), due to substantial morbidity associated with advanced liver disease. The aim of this study was to identify and synthesize utilities for chronic hepatitis B (cHBV), C (cHCV), and D (cHDV) through a systematic literature review (SLR) and meta-analyses.
METHODS
Electronic databases were searched from inception to May 2023 to identify primary studies reporting health state utilities in English in patients aged 18 years and over, with cHBV, cHCV or cHDV in the United States, the United Kingdom, Europe, Canada, Australia or New Zealand. Meta-analyses were conducted for studies reporting a measure of uncertainty; model selection (fixed and random) was based on the observed levels of heterogeneity among studies.
RESULTS
A total of 24 studies met the inclusion criteria and were included in the meta-analyses. More studies meeting the inclusion criteria reported utilities for cHCV (n=20) than for cHBV (n=8); no studies reported utility values for cHDV. While for any given health state, mean utilities were higher for cHBV than for cHCV, utilities decreased with disease progression towards cirrhosis health states. Meta-analyses in cHCV found a utility decrement of 0.1 and 0.03, based on progression from non-cirrhosis to compensated cirrhosis and for decompensation in established cirrhosis, respectively.
CONCLUSIONS
Chronic viral hepatitis is associated with considerable impairment in HRQoL. Despite our findings, there is a need for more evidence on the lived experience in patients living with chronic heptatitis, notably in cHBV and cHDV.
PubMed: 38906373
DOI: 10.1016/j.jval.2024.06.002