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Frontiers in Pediatrics 2024Acute upper respiratory tract infection (AURI) includes infections caused by a variety of pathogens and is one of the most common diseases in children. Traditional...
BACKGROUND
Acute upper respiratory tract infection (AURI) includes infections caused by a variety of pathogens and is one of the most common diseases in children. Traditional Chinese medicine (TCM) injections are widely used for treating AURI in clinical practice, but their efficacy is unclear because of the lack of clear evidence. In this study, a network meta-analysis (NMA) was used to evaluate the efficacy and safety of TCM injections in the treatment of AURI and to provide a reference for clinical treatment.
METHODS
Eight databases were searched, namely, PubMed, Embase, the Cochrane Library, Web of Science, SinoMed, China National Knowledge Infrastructure (CNKI), the Wanfang database, and the Chinese Scientific Journal database (VIP). The search time period was from 1 January 2013 to 1 November 2023. Randomized controlled trials of herbal injections for treating AURI were searched. The Cochrane Risk of Bias 2.0 tool was used to assess the quality of these studies. Review Manager 5.4 and Stata 15.0 were used for the NMA.
RESULTS
A total of 81 papers involving 11,736 patients were included. These involved five different TCM injections, namely, Xiyanping injection (XYPI), Qingkailing injection (QKLI), Reduning injection (RDNI), Yanhuning injection (YHNI), and Tanreqing injection (TRQI). QKLI was most effective in alleviating symptoms of fever and improving overall clinical effectiveness. TRQI was most effective in relieving cough symptoms. YHNI was most effective in alleviating sore throat, runny nose, and nasal congestion. The overall incidence of adverse effects of these herbal injections in the treatment of AURI was lower, and their safety profiles were better.
CONCLUSIONS
The herbal injections combined with ribavirin improved clinical outcomes, and were superior to ribavirin injection alone in alleviating clinical symptoms such as fever, cough, sore throat, runny nose, and nasal congestion, and have favorable safety profiles.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023484099, CRD42023484099.
PubMed: 38915872
DOI: 10.3389/fped.2024.1358639 -
Frontiers in Immunology 2024Immune checkpoint inhibitors (ICIs) are effective for non-small cell lung cancer (NSCLC) treatment, but the response rate remains low. Programmed cell death ligand 1... (Meta-Analysis)
Meta-Analysis
Prognostic significance of programmed cell death ligand 1 blood markers in non-small cell lung cancer treated with immune checkpoint inhibitors: a systematic review and meta-analysis.
BACKGROUND
Immune checkpoint inhibitors (ICIs) are effective for non-small cell lung cancer (NSCLC) treatment, but the response rate remains low. Programmed cell death ligand 1 (PD-L1) in peripheral blood, including soluble form (sPD-L1), expression on circulating tumor cells (CTCs PD-L1) and exosomes (exoPD-L1), are minimally invasive and promising markers for patient selection and management, but their prognostic significance remains inconclusive. Here, we performed a meta-analysis for the prognostic value of PD-L1 blood markers in NSCLC patients treated with ICIs.
METHODS
Eligible studies were obtained by searching PubMed, EMBAS, Web of Science, and Cochrane Library prior to November 30, 2023. The associations between pre-treatment, post-treatment and dynamic changes of blood PD-L1 levels and progression-free survival (PFS)/over survival (OS) were analyzed by estimating hazard ratio (HR) and 95% confidence interval (CI).
RESULTS
A total of 26 studies comprising 1606 patients were included. High pre- or post-treatment sPD-L1 levels were significantly associated with worse PFS (pre-treatment: HR=1.49, 95%CI 1.13-1.95; post-treatment: HR=2.09, 95%CI 1.40-3.12) and OS (pre-treatment: HR=1.83, 95%CI 1.25-2.67; post-treatment: HR=2.60, 95%CI 1.09-6.20, P=0.032). High pre-treatment exoPD-L1 levels predicted a worse PFS (HR=4.24, 95%CI 2.82-6.38, P<0.001). Pre-treatment PD-L1 CTCs tended to be correlated with prolonged PFS (HR=0.63, 95%CI 0.39-1.02) and OS (HR=0.58, 95%CI 0.36-0.93). Patients with up-regulated exoPD-L1 levels, but not sPD-L1, after ICIs treatment had significantly favorable PFS (HR=0.36, 95%CI 0.23-0.55) and OS (HR=0.24, 95%CI 0.08-0.68).
CONCLUSION
PD-L1 blood markers, including sPD-L1, CTCs PD-L1 and exoPD-L1, can effectively predict prognosis, and may be potentially utilized for patient selection and treatment management for NSCLC patients receiving ICIs.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Immune Checkpoint Inhibitors; Lung Neoplasms; B7-H1 Antigen; Biomarkers, Tumor; Prognosis
PubMed: 38915398
DOI: 10.3389/fimmu.2024.1400262 -
BMC Medicine Jun 2024To combat coronavirus disease 2019 (COVID-19), booster vaccination strategies are important. However, the optimal administration of booster vaccine platforms remains... (Meta-Analysis)
Meta-Analysis
BACKGROUND
To combat coronavirus disease 2019 (COVID-19), booster vaccination strategies are important. However, the optimal administration of booster vaccine platforms remains unclear. Herein, we aimed to assess the benefits and harms of three or four heterologous versus homologous booster regimens.
METHODS
From November 3 2022 to December 21, 2023, we searched five databases for randomised clinical trials (RCT). Reviewers screened, extracted data, and assessed bias risks independently with the Cochrane risk-of-bias 2 tool. We conducted meta-analyses and trial sequential analyses (TSA) on our primary (all-cause mortality; laboratory confirmed symptomatic and severe COVID-19; serious adverse events [SAE]) and secondary outcomes (quality of life [QoL]; adverse events [AE] considered non-serious). We assessed the evidence with the GRADE approach. Subgroup analyses were stratified for trials before and after 2023, three or four boosters, immunocompromised status, follow-up, risk of bias, heterologous booster vaccine platforms, and valency of booster.
RESULTS
We included 29 RCTs with 43 comparisons (12,538 participants). Heterologous booster regimens may not reduce the relative risk (RR) of all-cause mortality (11 trials; RR 0.86; 95% CI 0.33 to 2.26; I 0%; very low certainty evidence); laboratory-confirmed symptomatic COVID-19 (14 trials; RR 0.95; 95% CI 0.72 to 1.25; I 0%; very low certainty); or severe COVID-19 (10 trials; RR 0.51; 95% CI 0.20 to 1.33; I 0%; very low certainty). For safety outcomes, heterologous booster regimens may have no effect on SAE (27 trials; RR 1.15; 95% CI 0.68 to 1.95; I 0%; very low certainty) but may raise AE considered non-serious (20 trials; RR 1.19; 95% CI 1.08 to 1.32; I 64.4%; very low certainty). No data on QoL was available. Our TSAs showed that the cumulative Z curves did not reach futility for any outcome.
CONCLUSIONS
With our current sample sizes, we were not able to infer differences of effects for any outcomes, but heterologous booster regimens seem to cause more non-serious AE. Furthermore, more robust data are instrumental to update this review.
Topics: Humans; COVID-19 Vaccines; Immunization, Secondary; COVID-19; Randomized Controlled Trials as Topic; SARS-CoV-2; Adult; Quality of Life
PubMed: 38915011
DOI: 10.1186/s12916-024-03471-3 -
BMC Pulmonary Medicine Jun 2024The risk of asthma in patients with psoriasis has been identified in previous studies, but the bidirectional association between the two has not been fully explored. (Meta-Analysis)
Meta-Analysis
BACKGROUND
The risk of asthma in patients with psoriasis has been identified in previous studies, but the bidirectional association between the two has not been fully explored.
METHODS
We thoroughly searched PubMed, Embase, and the Cochrane Library to find relevant observational studies published from the inception of these databases to October 2023. All the risk and bias assessments were analyzed by STATA 16.0. Where the heterogeneity was less than 50%, the fixed effect model was utilized. While where the level of heterogeneity was more than 50%, the random effect model was applied. Moreover, to identify publication bias, a visual funnel chart, and Egger's test were applied.
RESULTS
A total of 12,396,911 participants from 16 studies, published between 2011 and 2023 were included in this meta-analysis. We found that psoriasis patients had a higher risk of developing asthma (OR = 1.48, 95%CI 1.28-1.68). Meanwhile, asthma patients also had a higher overall risk of developing psoriasis (OR = 1.33, 95%CI 1.23-1.44). In the subgroup analysis, we found that the type of study, age, and severity of the psoriasis were significant factors in the survey of asthma risk in psoriasis patients.
CONCLUSIONS
In the present systematic review and meta-analysis, we found a bidirectional association between psoriasis and asthma with significantly increased risk. As a result, clinicians should make patients aware of the connection between the two, particularly adolescents or patients with moderate to severe psoriasis who need to be informed about the rising likelihood of developing asthma.
TRIAL REGISTRATION
Registration number CRD42023390111 .
Topics: Psoriasis; Humans; Asthma; Risk Factors
PubMed: 38914981
DOI: 10.1186/s12890-024-03078-7 -
Journal of Cardiothoracic Surgery Jun 2024The question of whether segmentectomy and lobectomy have similar survival outcomes for patients with early-stage non-small cell lung cancer (NSCLC) is a matter of debate. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The question of whether segmentectomy and lobectomy have similar survival outcomes for patients with early-stage non-small cell lung cancer (NSCLC) is a matter of debate.
METHODS
A cohort study and randomized controlled trial were included, comparing segmentectomy and lobectomy, by utilizing computerized access to the Pubmed, Web of Science, and Cochrane Library databases up until July 2022. The Cochrane Collaboration tool was used to evaluate the randomized controlled trials, while the Newcastle-Ottawa Scale (NOS) was used to evaluate the cohort studies. Sensitivity analyses were also carried out.
RESULTS
The analysis incorporated 17 literature studies, including one randomized controlled trial and 16 cohort studies, and was divided into a segmentectomy group (n = 2081) and a lobectomy group (n = 2395) based on the type of surgery the patient underwent. Each study was followed up from 27 months to 130.8 months after surgery. Over survival (OS): HR = 1.14, 95%CI(0.97,1.32), P = 0.10; disease-free survival (DFS): HR = 1.13, 95%CI(0.91,1.41), P = 0.27; recurrence-free survival (RFS): HR = 0.95, 95%CI(0.81,1.12), P = 0.54.
CONCLUSION
The results of the study suggest that the survival outcomes of the segmentectomy group were not inferior to that of the lobectomy group. Segmentectomy should therefore be considered as a treatment option for early stage NSCLC.
Topics: Humans; Carcinoma, Non-Small-Cell Lung; Lung Neoplasms; Pneumonectomy; Neoplasm Staging; Survival Rate
PubMed: 38909240
DOI: 10.1186/s13019-024-02832-6 -
PloS One 2024COVID-19 and its prevention measures have had a significant impact on patients with non-communicable diseases (NCDs) by disrupting routine healthcare service and...
BACKGROUND
COVID-19 and its prevention measures have had a significant impact on patients with non-communicable diseases (NCDs) by disrupting routine healthcare service and increasing risk factors. These challenges were expected to be more severe in sub-Saharan Africa due to the lack of physical infrastructure and inadequate resources. The quantity of studies conducted was limited, and there was a lack of published systematic reviews in the specified region. This systematic review aimed to assess the indirect impacts of the COVID-19 pandemic and associated lockdown measures on individuals with non-communicable diseases (NCDs) in sub-Saharan African countries.
METHOD
This systematic review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and is registered with PROSPERO (ID CRD42023387755). Extensive searches were conducted in MEDLINE, EMBASE, and CINAHL databases in December 2023, supplemented by a manual search of references, grey literature, and the WHO COVID-19 database. Inclusion criteria encompassed studies that reported on the impact of COVID-19 on NCD patients in sub-Saharan African countries, focusing on access to care, health outcomes, and factors related to NCDs. Critical appraisal of study quality was performed using the Joanna Briggs Institute (JBI) analytical cross-sectional studies critical appraisal tool. Data were extracted and synthesized, highlighting the main findings and relevant limitations.
FINDINGS
This review included 30 primary studies with a cumulative sample size of 25634 participants, conducted in seven sub-Saharan African countries. These studies demonstrated that the COVID-19 pandemic significantly disrupted regular NCD patient care provision, with regional variations. The studies also identified a reduction in patient health-seeking behavior and reduced medication adherence, leading to poor treatment outcome. Furthermore, the pandemic and related lockdowns have been implicated in the increased prevalence of substance use, decreased physical exercise, and increased mental health problems.
CONCLUSION
This systematic review identified the complex challenges faced by NCD patients in sub-Saharan Africa during the COVID-19 pandemic. It also underlines the need to consider the indirect impact on vulnerable populations while developing pandemic prevention and control strategies for the future. The current NCD management strategies should prioritize the restoration of access to essential healthcare services while considering the multifaceted risks posed by decreased physical activity, poor dietary practices, and increased substance use. The main limitation of this review was the study design and setting. All of the studies included in this review employed a cross-sectional design, which may result in a low quality of evidence. This study identified research conducted in only seven countries among the 46 UN-classified sub-Saharan nations, which may impair the generalizability of the result.
Topics: COVID-19; Humans; Africa South of the Sahara; Noncommunicable Diseases; SARS-CoV-2; Pandemics
PubMed: 38905254
DOI: 10.1371/journal.pone.0293376 -
Systematic Reviews Jun 2024Mindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on...
BACKGROUND
Mindfulness-based interventions (MBIs) appear to be effective for improving the mental health of healthcare professionals (HCPs). However, the effectiveness of MBIs on extreme psychological trauma caused by the coronavirus disease 2019 (COVID-19) pandemic is largely unknown. The aim of this paper was to systematically review empirical studies of MBIs for HCPs carried out during the COVID-19 pandemic, to evaluate them and their effectiveness in different areas of mental health.
METHODS
The electronic databases searched were Web of Science, Scopus, PubMed, and PsycINFO. The date when each database was last searched was September 15, 2023. Randomized controlled trials (RCTs), non-randomized controlled trials (NRCTs), and non-randomized non-controlled trials (NRNCTs) focused on MBIs for health care staff who were working in healthcare centers during the COVID-19 pandemic were included. All of them employed standardized measures of mental health. The review followed the best practices and reported using PRISMA guidelines. A data collection form, adapted from the Cochrane handbook for systematic reviews of interventions, was used to extract and synthesize the results. The methods used to assess the risk of bias in the included studies were the Cochrane Risk of Bias Tool and the ROBINS-I Tool.
RESULTS
Twenty-eight studies were included in the systematic review. Overall, the methodological quality of the studies was moderate. The results showed the effectiveness of MBIs in improving levels of stress, mindfulness, and mental well-being. However, no conclusive results were found regarding the effectiveness of MBIs in improving the levels of burnout, anxiety, depression, sleep quality, and resilience of HCPs.
CONCLUSIONS
The MBIs for HCPs carried out during the COVID-19 pandemic have mainly contributed to improving stress, mindfulness, and mental well-being at a time of serious health emergency. However, more robust studies at a methodological level would have been desirable.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42021267621.
Topics: Humans; Mindfulness; COVID-19; Health Personnel; Mental Health; SARS-CoV-2; Burnout, Professional; Pandemics
PubMed: 38902795
DOI: 10.1186/s13643-024-02574-5 -
BMC Public Health Jun 2024Although the COVID-19 pandemic claimed a great deal of lives, it is still unclear how it affected mortality in low- and lower-middle-income countries (LLMICs). This... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although the COVID-19 pandemic claimed a great deal of lives, it is still unclear how it affected mortality in low- and lower-middle-income countries (LLMICs). This review summarized the available literature on excess mortality during the COVID-19 pandemic in LLMICs, including methods, sources of data, and potential contributing factors that might have influenced excess mortality.
METHODS
We conducted a systematic review and meta-analysis on excess mortality during the COVID-19 pandemic in LLMICs in line with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020 guidelines We searched PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Scopus. We included studies published from 2019 onwards with a non-COVID-19 period of at least one year as a comparator. The meta-analysis included studies reporting data on population size, as well as observed and expected deaths. We used the Mantel-Haenszel method to estimate the pooled risk ratio with 95% confidence intervals. The protocol was registered in PROSPERO (ID: CRD42022378267).
RESULTS
The review covered 29 countries, with 10 countries included in the meta-analysis. The pooled meta-analysis included 1,405,128,717 individuals, for which 2,152,474 deaths were expected, and 3,555,880 deaths were reported. Calculated excess mortality was 100.3 deaths per 100,000 population per year, with an excess risk of death of 1.65 (95% CI: 1.649, 1.655, p < 0.001). The data sources used in the studies included civil registration systems, surveys, public cemeteries, funeral counts, obituary notifications, burial site imaging, and demographic surveillance systems. The primary techniques used to estimate excess mortality were statistical forecast modelling and geospatial analysis. One out of the 24 studies found higher excess mortality in urban settings.
CONCLUSION
Our findings demonstrate that excess mortality in LLMICs during the pandemic was substantial. However, estimates of excess mortality are uncertain due to relatively poor data. Understanding the drivers of excess mortality, will require more research using various techniques and data sources.
Topics: Humans; COVID-19; Developing Countries; Mortality; Pandemics; SARS-CoV-2
PubMed: 38902661
DOI: 10.1186/s12889-024-19154-w -
F1000Research 2024Interstitial Lung Disease (ILD) is a severe and rapidly progressing disease with a high fatality rate. Patient education (PE) has been demonstrated to promote long-term... (Review)
Review
OBJECTIVES
Interstitial Lung Disease (ILD) is a severe and rapidly progressing disease with a high fatality rate. Patient education (PE) has been demonstrated to promote long-term adherence to exercise and lifestyle improvements by assisting patients in developing self-management techniques. Our scoping review's goal was to chart out the prevailing level of research about the content, processes, and effectiveness of PE for patients with ILD.
METHODS
The relevant databases were searched using the rules provided by Arksey and O'Malley in 2005 and the Joanna Briggs Institute reviewers' manual 2015: an approach for JBI scoping reviews. Individuals with ILD, published in English between the years of inception and 2020, and describing PE administered by various healthcare practitioners were among the 355 studies found and reviewed. Thirteen studies met these criteria.
RESULTS
PE delivery process, delivery techniques, quality of life assessments, common PE themes, and healthcare professional participation were all recognized and cataloged.
CONCLUSION
Despite the fact that healthcare professionals (physicians, nurses, and physiotherapists) provide PE to patients with ILD regularly, the PE provided varies greatly (contents of PE, process of delivery and delivery techniques). During the scoping review, a significant variation in the themes was addressed. They could not provide any evidence-based specific recommendations for all healthcare practitioners due to the studies' heterogeneity and lack of effectiveness measures.
Topics: Lung Diseases, Interstitial; Humans; Patient Education as Topic; Quality of Life
PubMed: 38895701
DOI: 10.12688/f1000research.147340.1 -
Respiratory Research Jun 2024The term "post-COVID-19 condition" refers to the symptomatology that appears between four to twelve weeks after Covid-19 infection. These symptoms can persist for weeks... (Review)
Review
BACKGROUND
The term "post-COVID-19 condition" refers to the symptomatology that appears between four to twelve weeks after Covid-19 infection. These symptoms can persist for weeks or even months, significantly diminishing the quality of life for affected individuals. The primary objective of this study was to assess the effectiveness of pulmonary rehabilitation programs and/or respiratory muscle training on respiratory sequelae in patients with post-COVID condition.
METHODS
The literature search was conducted in the following databases: PubMed, PEDro, Embase, Cochrane, Scopus, and Web of Science. Randomized clinical trials were included in which participants were aged 18 years or older. Articles were excluded if at least one of the therapies did not involve pulmonary rehabilitation or respiratory muscle training, if the participants were COVID positive, if studies lacked results, and finally, if interventions were conducted without supervision or at home. This review only encompasses supervised non-virtual interventions. This study adheres to the PRISMA statement and has been registered in the PROSPERO database (CRD42023433843).
RESULTS
The outcomes obtained in the included studies are assessed across the following variables: Exercise capacity using the 6-minute walk test, Dyspnea, fatigue, Pulmonary function, Maximum inspiratory pressure, and Quality of life.
CONCLUSION
Despite the absence of a specific treatment at present, it was evident from this review that a well-structured pulmonary rehabilitation program that incorporates both aerobic and muscular strength exercises along with techniques and inspiratory muscle exercises was the most effective form of treatment.
Topics: Humans; COVID-19; Breathing Exercises; Treatment Outcome; Respiratory Muscles; Quality of Life; Randomized Controlled Trials as Topic; Exercise Tolerance; Post-Acute COVID-19 Syndrome
PubMed: 38890699
DOI: 10.1186/s12931-024-02857-4