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Wang L, Wang Y, Sun D, Wang J, Lee SJ, Viscarra Rossel RA, Gan Y. Soil carbon stocks in temperate grasslands reach equilibrium with grazing duration. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 949:175081. [PMID: 39069182 DOI: 10.1016/j.scitotenv.2024.175081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 07/13/2024] [Accepted: 07/25/2024] [Indexed: 07/30/2024]
Abstract
Lost soil organic carbon (SOC) in degraded grasslands can be restored via the 'grazing exclusion' practice, but it was unknown how long (# of years) the restoration process can take. A synthesis of four decades of studies revealed that grazing exclusion increased SOC stocks in the topsoil (0-0.30 m) by 14.8 % (±0.8 Std Err), on average, compared to moderate-to-heavy grazing (MtH); During which SOC stock increased steadily, peaked in Year 18.5, and then declined. At peak, SOC stock was 42.5 % greater under grazing exclusion than under MtH due to 100.4 ± 4.2 % increase in aboveground biomass and 80.3 ± 33.5 % increase in root biomass. Grazing exclusion also increased soil C:N ratio by 7.6 % while decreasing bulk density by 9.4 %. Grazing exclusion could be ceased 18.5 years after initiation of grazing exclusion as plant biomass input balances carbon decomposition and SOC equilibrium occurs then additional benefits start diminishing.
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Affiliation(s)
- Li Wang
- College of Life and Environmental Science, State & Local Joint Engineering Research Center for Ecological Treatment Technology of Urban Water Pollution, Zhejiang Provincial Key Lab for Water Environment and Marine Biological Resources Protection, Zhejiang Provincial Collaborative Innovation Center for Tideland Reclamation and Ecological Protection, Wenzhou University, Wenzhou, Zhejiang 325035, China
| | - Yijia Wang
- College of Life and Environmental Science, State & Local Joint Engineering Research Center for Ecological Treatment Technology of Urban Water Pollution, Zhejiang Provincial Key Lab for Water Environment and Marine Biological Resources Protection, Zhejiang Provincial Collaborative Innovation Center for Tideland Reclamation and Ecological Protection, Wenzhou University, Wenzhou, Zhejiang 325035, China
| | - Dandi Sun
- College of Life and Environmental Science, State & Local Joint Engineering Research Center for Ecological Treatment Technology of Urban Water Pollution, Zhejiang Provincial Key Lab for Water Environment and Marine Biological Resources Protection, Zhejiang Provincial Collaborative Innovation Center for Tideland Reclamation and Ecological Protection, Wenzhou University, Wenzhou, Zhejiang 325035, China
| | - Junying Wang
- College of Life and Environmental Science, State & Local Joint Engineering Research Center for Ecological Treatment Technology of Urban Water Pollution, Zhejiang Provincial Key Lab for Water Environment and Marine Biological Resources Protection, Zhejiang Provincial Collaborative Innovation Center for Tideland Reclamation and Ecological Protection, Wenzhou University, Wenzhou, Zhejiang 325035, China
| | - Soon-Jae Lee
- Department of Ecology and Evolution, University of Lausanne, Lausanne CH1015, Switzerland
| | | | - Yantai Gan
- College of Life and Environmental Science, State & Local Joint Engineering Research Center for Ecological Treatment Technology of Urban Water Pollution, Zhejiang Provincial Key Lab for Water Environment and Marine Biological Resources Protection, Zhejiang Provincial Collaborative Innovation Center for Tideland Reclamation and Ecological Protection, Wenzhou University, Wenzhou, Zhejiang 325035, China; Agroecosystems, The UBC-Soil Group, Tallus Heights, Kelowna, BC V4T 3M2, Canada.
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Harvey LA, Payne NL, Tan A, Zhang J, Lai YC, Taylor ME, Armstrong E, McVeigh C, Mikolaizak AS, Hairu R, Scott TA, Bishop M, Close J. Variation in mortality following hip fracture across the Asia Pacific region: Systematic review and proportional meta-analysis. Arch Gerontol Geriatr 2024; 126:105519. [PMID: 38941947 DOI: 10.1016/j.archger.2024.105519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/24/2024] [Accepted: 06/02/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To determine country/region-specific mortality (in-hospital, 30-day and 1-year) following hip fracture across the Asia Pacific region. METHODS Five databases MEDLINE, PUBMED, EMBASE, Web of Science and the Cochrane Library were searched to identify studies that reported mortality following hospitalisation for low-trauma hip fracture in adults aged ≥50 years with data from 2010 to 30 September 2021. There were no restrictions on study design or language. Pooled mortality estimates for countries/regions with ≥2 studies were calculated using random-effects models. RESULTS In total 244 studies were included in the meta-analysis. 123 studies (1,382,810 patients, 13 countries/regions) reported in-hospital mortality which ranged from 1.4 % in Japan [95 %CI 1.2-1.7], Singapore [95 %CI 1.0-1.6], China [95 %CI 0.8-2.3] and Hong Kong SAR [95 %CI 0.8-2.6] to 5.5 % [95 %CI 4.1-7.2] in New Zealand. 92 studies (628,450 patients, 13 countries/regions) reported 30-day mortality which ranged from 1.2 % in Japan [95 %CI 0.9-1.5] and Thailand [95 %CI 0.7-2.0] to 7.4 % [95 %CI 7.0-7.8] in Australia. 142 studies (1,139,752 patients, 14 countries/regions) reported 1-year mortality which ranged from 10.8 % [95 %CI 9.6-12.1] in Singapore to 23.3 % [95 %CI 22.3-24.5] in Australia and 23.8 % in New Zealand. CONCLUSION There is substantial variation in mortality across the Asia Pacific region. Short-term mortality rates in Asian countries, notably Japan and Singapore, are up to four-fold lower than for Australia and New Zealand. This difference, although less marked, is sustained at 1-year with a two-fold lower mortality rate in Asia. This meta-analysis is the first to delineate these differences, further studies are required to understand the reasons for this variation.
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Affiliation(s)
- L A Harvey
- Neuroscience Research Australia, Sydney, Australia; School of Population Health, UNSW Medicine & Health, UNSW, Sydney, Australia.
| | - N L Payne
- Neuroscience Research Australia, Sydney, Australia
| | - A Tan
- Nepean Hospital, Sydney, Australia
| | - J Zhang
- School of Population Health, UNSW Medicine & Health, UNSW, Sydney, Australia
| | - Y C Lai
- Khoo Teck Puat Hospital, Singapore
| | - M E Taylor
- Neuroscience Research Australia, Sydney, Australia; School of Population Health, UNSW Medicine & Health, UNSW, Sydney, Australia; Ageing Futures Institute, UNSW Sydney, Sydney, Australia
| | - E Armstrong
- Neuroscience Research Australia, Sydney, Australia; School of Population Health, UNSW Medicine & Health, UNSW, Sydney, Australia
| | - C McVeigh
- School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
| | | | - R Hairu
- Neuroscience Research Australia, Sydney, Australia; School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
| | - T A Scott
- Prince of Wales Hospital, Sydney, Australia
| | - M Bishop
- Concord Repatriation General Hospital, Sydney, Australia
| | - Jct Close
- Neuroscience Research Australia, Sydney, Australia; School of Clinical Medicine, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia
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van Roey VL, Ombashi S, Pleumeekers MM, Mathijssen IMJ, Mink van der Molen AB, Munill M, Versnel SL. Comparison of two surgical protocols for the treatment of unilateral cleft lip and palate: a multidisciplinary systematic review and meta-analysis. Int J Oral Maxillofac Surg 2024; 53:803-820. [PMID: 38664107 DOI: 10.1016/j.ijom.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 04/09/2024] [Accepted: 04/15/2024] [Indexed: 08/27/2024]
Abstract
There is still no unanimous agreement on the optimal surgical protocol(s) for the treatment of unilateral cleft lip and palate (UCLP), and a huge variety of protocols are employed by cleft centres across the world. The aim of this systematic review and meta-analysis was to compare reported patient outcomes of the Oslo protocol (and modifications) (OP) and delayed hard palate closure protocols (DHPCP) from a multidisciplinary perspective. A systematic search of multiple databases was conducted until September 2023. Studies reporting any patient outcomes of these protocols were included. Random-effects meta-analyses were performed for evidence synthesis, including comparisons of results between the types of protocol. The quality of evidence was evaluated using the ROBINS-I tool. In total, 62 articles (42 studies) reporting patients with UCLP were reviewed, involving 1281 patients following the OP and 655 following DHPCP. Equally poor long-term sagittal maxillofacial growth was found, and similar results for velopharyngeal insufficiency and nasolabial appearance. In contrast, OP was associated with a lower rate of oronasal fistulas. Disregarding the scarcity of comparable evidence for some domains, the results of this review, overall, favour OP over DHPCP. However, caution should be taken when interpreting the results on velopharyngeal insufficiency and oronasal fistulas, since the possibility of confounding and other biases remains.
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Affiliation(s)
- V L van Roey
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
| | - S Ombashi
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands
| | - M M Pleumeekers
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Dutch Craniofacial Centre, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - I M J Mathijssen
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Dutch Craniofacial Centre, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - A B Mink van der Molen
- Department of Plastic and Reconstructive Surgery, UMC Utrecht, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - M Munill
- Department of Maxillofacial Surgery, Hospital Vall d'Hebron, Barcelona, Spain
| | - S L Versnel
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, the Netherlands; Dutch Craniofacial Centre, Erasmus University Medical Centre, Rotterdam, the Netherlands
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Okoli GN, Neilson CJ, Grossman Moon A, Kimmel Supron H, Soos AE, Grewal A, Etsell K, Alessi-Severini S, Richardson C, Harper DM. Exploration of individual socioeconomic and health-related characteristics associated with human papillomavirus vaccination initiation and vaccination series completion among adult females: A comprehensive systematic evidence review with meta-analysis. Vaccine 2024; 42:125994. [PMID: 38796328 DOI: 10.1016/j.vaccine.2024.05.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/08/2024] [Accepted: 05/20/2024] [Indexed: 05/28/2024]
Abstract
INTRODUCTION Human papillomavirus (HPV) vaccination rates among females are lower than the World Health Organization target and vaccination rates specifically among adult females are even much lower. METHODS We systematically evaluated individual socioeconomic and health-related characteristics associated with HPV vaccination initiation and vaccination series completion among adult females (PROSPERO: CRD42023445721). We performed a literature search on December 14, 2022, and supplemented the search on August 1, 2023. We pooled appropriate multivariable-adjusted results using an inverse variance random-effects model and expressed the results as odds ratios with associated 95 % confidence intervals. A point pooled significantly increased/decreased odds of 30-69 % was regarded to be strongly associated, and ≥ 70 % was very strongly associated. RESULTS We included 63 cross-sectional studies. There were strongly increased odds of vaccination initiation among White women compared with Black or Asian women, and those with higher education, health insurance, a history of sexually transmitted infection (STI), receipt of influenza vaccination in the preceding year, not married/cohabiting, not smoking, using contraception, and having visited a healthcare provider in the preceding year. We observed very strongly increased odds of vaccination initiation among those younger and having been born in the country of study. Similarly, there were strongly increased odds of completing the vaccination series for the same variables as initiating vaccination, except for higher education, prior STI, smoking and contraception use. Additional variables associated with strongly increased odds of vaccination series completion not seen in initiation were higher annual household income, being lesbian/bisexual, and having a primary care physician. We observed very strongly increased odds of vaccination series completion similar to vaccination initiation but including for White compared with Black women, higher education, and prior cervical cancer screening. CONCLUSIONS These individual characteristics may be the key to identifying women at increased risk of not being vaccinated against HPV and could inform targeted messaging to drive HPV vaccination.
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Affiliation(s)
- George N Okoli
- Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
| | | | | | | | - Alexandra E Soos
- University of Michigan Medical School, University of Michigan, Michigan, USA
| | - Avneet Grewal
- University of Michigan Medical School, University of Michigan, Michigan, USA
| | - Katharine Etsell
- University of Michigan Medical School, University of Michigan, Michigan, USA
| | - Silvia Alessi-Severini
- College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Caroline Richardson
- The Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Diane M Harper
- Departments of Family Medicine and Obstetrics & Gynecology, University of Michigan, Michigan, USA
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Guimarães FS, Dal-Pizzol TDS, Silveira MPT, Bertoldi AD. Prevalence of systemic antibacterial use during pregnancy worldwide: A systematic review. PLoS One 2024; 19:e0309710. [PMID: 39240933 DOI: 10.1371/journal.pone.0309710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/18/2024] [Indexed: 09/08/2024] Open
Abstract
OBJECTIVES In this study, we aimed to systematically review the literature of the prevalence of systemic antibacterial use during pregnancy and to perform a descriptive analysis focused on methodological characteristics. MATERIALS AND METHODS This study was registered in PROSPERO under protocol number CRD42022376634. Medline, Embase, Scientific Electronic Library Online, Biblioteca Virtual em Saúde, Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases were searched (published studies until November 3rd, 2022). Selected studies were population-based cross-sectional or cohort, carried out with pregnant women, and providing information about the prevalence of systemic antibacterial use at least in one trimester of pregnancy. Reviewers conducted in pairs the title and abstract screening, eligibility criteria check, and data extraction of selected studies. Quality appraisal was performed with an adapted version of the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Data of included studies were pooled into a graphical and tabular summary. RESULTS A total of 16,251,280 pregnant women and 5,169,959 pregnancy registers were identified. The prevalence estimates of systemic antibacterial use during pregnancy ranged from 2.0% (95%CI 2.0-2.0) to 64.3% (95%CI not reported) in the 79 included studies. The majority were performed in high-income countries (91.5%). Overall, the studies revealed considerable prevalence heterogeneity in terms of study type and dataset used. The 95% confidence intervals were not reported in 41% of studies. CONCLUSION The disparities in the prevalence of systemic antibacterial use during pregnancy can be related to methodological issues and different health policies. Lack of uniform databases and changes in data collection methods over time should be taken into account in public health strategy planning. The scarce evidence in low- and middle-income settings hampers the comprehensiveness of the global prevalence of antibacterial use during pregnancy.
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Figueroa-Parra G, Cuéllar-Gutiérrez MC, González-Treviño M, Sanchez-Rodriguez A, Flores-Gouyonnet J, Meade-Aguilar JA, Prokop LJ, Murad MH, Dall'Era M, Rovin BH, Houssiau F, Tamirou F, Fervenza FC, Crowson CS, Putman MS, Duarte-García A. Impact of Glucocorticoid Dose on Complete Response, Serious Infections, and Mortality During the Initial Therapy of Lupus Nephritis: A Systematic Review and Meta-Analysis of the Control Arms of Randomized Controlled Trials. Arthritis Rheumatol 2024; 76:1408-1418. [PMID: 38766897 DOI: 10.1002/art.42920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 04/15/2024] [Accepted: 05/15/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE Our objective was to evaluate the effect of glucocorticoid regimens on renal response, infections, and mortality among patients with lupus nephritis (LN). METHODS We performed a systematic review and meta-analysis of the control arms of randomized clinical trials (RCTs). We included RCTs of biopsy-proven LN that used a protocolized regimen of glucocorticoids in combination with mycophenolic acid analogs or cyclophosphamide and reported the outcomes of complete response (CR), serious infections, and death. The starting dosage of glucocorticoids, tapering method, and administration of glucocorticoid pulses were abstracted. Meta-analysis of proportions, meta-regression, and subgroup meta-analysis were performed at 6 and 12 months for all outcomes. RESULTS Fifty RCT arms (3,231 patients with LN) were included. The predicted rates of CR, serious infections, and death when starting on oral prednisone at 25 mg/day without pulses were 19.5% (95% confidence interval [CI] 7.3-31.5), 3.2% (95% CI 2.4-4.0), and 0.2% (95% CI 0.0-0.4), respectively. Starting on prednisone at 60 mg/day (without pulses) increased the rates to 34.6% (95% CI 16.9-52.3), 12.1% (95% CI 9.3-14.9), and 2.7% (95% CI 0.0-5.3), respectively. Adding glucocorticoid pulses increased the rates of CR and death but not serious infections. We observed a dose-response gradient between the initial glucocorticoid dosage and all the outcomes at six months after accounting for the administration of glucocorticoid pulses, underlying immunosuppressant, and baseline proteinuria. CONCLUSION A higher exposure to glucocorticoids during the initial therapy of LN was associated with better renal outcomes at the cost of increased infections and death.
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Affiliation(s)
| | | | | | | | | | - José A Meade-Aguilar
- Mayo Clinic, Rochester, Minnesota, and Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | | | | | | | - Brad H Rovin
- Ohio State University Wexner Medical Center, Columbus
| | - Frédéric Houssiau
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Farah Tamirou
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
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Ali A, Huszti E, Noordin S, Ali U, Sale JEM. Examining treatment targets and equity in bone-active medication use within secondary fracture prevention: a systematic review and meta-analysis. Osteoporos Int 2024; 35:1497-1511. [PMID: 38740589 DOI: 10.1007/s00198-024-07078-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 03/27/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE This systematic review seeks to evaluate the proportion of fragility fracture patients screened in secondary fracture prevention programs who were indicated for pharmacological treatment, received prescriptions for bone-active medications, and initiated the prescribed medication. Additionally, the study aims to analyze equity in pharmacological treatment by examining equity-related variables including age, sex, gender, race, education, income, and geographic location. METHODS We conducted a systematic review to ascertain the proportion of fragility fracture patients indicated for treatment who received prescriptions and/or initiated bone-active medication through secondary fracture prevention programs. We also examined treatment indications reported in studies and eligibility criteria to confirm patients who were eligible for treatment. To compute the pooled proportions for medication prescription and initiation, we carried out a single group proportional meta-analysis. We also extracted the proportions of patients who received a prescription and/or began treatment based on age, sex, race, education, socioeconomic status, location, and chronic conditions. RESULTS This review included 122 studies covering 114 programs. The pooled prescription rate was 77%, and the estimated medication initiation rate was 71%. Subgroup analysis revealed no significant difference in treatment initiation between the Fracture Liaison Service and other programs. Across all studies, age, sex, and socioeconomic status were the only equity variables reported in relation to treatment outcomes. CONCLUSION Our systematic review emphasizes the need for standardized reporting guidelines in post-fracture interventions. Moreover, considering equity stratifiers in the analysis of health outcomes will help address inequities and improve the overall quality and reach of secondary fracture prevention programs.
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Affiliation(s)
- Anum Ali
- Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor - 155 College Street, Toronto, ON, M5T 3M6, Canada.
| | - Ella Huszti
- Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor - 155 College Street, Toronto, ON, M5T 3M6, Canada
| | - Shahryar Noordin
- Department of Surgery, Aga Khan University, National Stadium Rd, P.O. Box 3500, Karachi City, Sindh, Pakistan
| | - Usman Ali
- Department of Surgery, Aga Khan University, National Stadium Rd, P.O. Box 3500, Karachi City, Sindh, Pakistan
| | - Joanna E M Sale
- Institute of Health Policy, Management and Evaluation, University of Toronto, 4th Floor - 155 College Street, Toronto, ON, M5T 3M6, Canada
- Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
- Department of Surgery, Temerty Faculty of Medicine, University of Toronto, 5th Floor - 149 College Street, Toronto, ON, M5B 1W8, Canada
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Kostares E, Kostares M, Kostare G, Kantzanou M. Prevalence of lingual sensory impairment following bilateral sagittal split osteotomy: a systematic review and meta-analysis. Oral Maxillofac Surg 2024; 28:1055-1062. [PMID: 38622272 PMCID: PMC11330379 DOI: 10.1007/s10006-024-01247-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/26/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE Our study aims to estimate the prevalence of lingual nerve injury following bilateral sagittal split osteotomy (BSSO). METHODS Two reviewers independently conducted a systematic literature search in the Medline and Scopus databases. The pooled prevalence with 95% confidence intervals (CI) was estimated, and quality assessment, outlier analysis, and influential analysis were performed. RESULTS In total, eleven eligible studies comprising a total of 1,882 participants were included in this meta-analysis. One study was identified as critically influential. The overall prevalence of lingual sensory impairment was estimated to be as high as 0.1% (95% CI 0.0%-0.6%) with moderate heterogeneity observed between studies. CONCLUSION It is important for healthcare professionals to be aware of this issue, despite the relatively low rate of lingual nerve deficit after BSSO. Additional research will provide a more comprehensive understanding of the underlying factors contributing to lingual nerve injury, leading to improved preventive measures and treatment strategies. Furthermore, insights gained from future studies will enable healthcare professionals to inform patients about the potential complications and manage their expectations before undergoing BSSO.
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Affiliation(s)
- Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece.
| | - Michael Kostares
- National and Kapodistrian University of Athens Faculty of Medicine: Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole, 115 27, Athens, Greece
| | - Georgia Kostare
- National and Kapodistrian University of Athens Faculty of Medicine: Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole, 115 27, Athens, Greece
| | - Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27, Athens, Greece
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Kostares E, Kostare G, Kostares M, Kantzanou M. Prevalence of fibrinolytic alveolitis following extraction of impacted mandibular third molars: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101810. [PMID: 38432484 DOI: 10.1016/j.jormas.2024.101810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/06/2024] [Accepted: 02/29/2024] [Indexed: 03/05/2024]
Abstract
Our research aims to assess the prevalence of alveolar osteitis (AO) following impacted mandibular third molar extractions and investigate the impact of potential moderating factors on this occurrence. Two independent reviewers conducted a comprehensive systematic literature search across Medline, Scopus, and Google Scholar databases. The pooled prevalence, accompanied by 95 % confidence intervals (CI), was calculated. Quality assessments, outlier and influential analyses were performed. Subgroup and meta-regression analysis were conducted in order the effect of categorical and continuous variables on the estimated prevalence to be investigated. Our meta-analysis included twenty-eight eligible studies, encompassing a total of 41,859 impacted mandibular third molar extractions. The overall prevalence of dry socket (DS) following impacted mandibular third molar extractions was estimated at 6.7 % (95 % CI 4.6-9.1 %), indicating considerable heterogeneity among the studies. No study was identified as critically influential, and meta-regression analysis did not pinpoint any potential sources of heterogeneity. This study highlights the imperative for future well-constructed prospective and retrospective investigations to deepen our understanding of the etiological nuances and refine management approaches for this prevalent postoperative complication.
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Affiliation(s)
- Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece.
| | - Georgia Kostare
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
| | - Michael Kostares
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
| | - Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens 115 27, Greece
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Vilela A, Quingalahua E, Vargas A, Hawa F, Shannon C, Carpenter ES, Shi J, Krishna SG, Lee UJ, Chalhoub JM, Machicado JD. Global Prevalence of Pancreatic Cystic Lesions in the General Population on Magnetic Resonance Imaging: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol 2024; 22:1798-1809.e6. [PMID: 38423346 PMCID: PMC11344691 DOI: 10.1016/j.cgh.2024.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND & AIMS Understanding the burden of pancreatic cystic lesions (PCLs) in the general population is important for clinicians and policymakers. In this systematic review, we sought to estimate the global prevalence of PCLs using magnetic resonance imaging (MRI) and to investigate factors that contribute to its variation. METHODS We searched MEDLINE, EMBASE, and Cochrane Central, from database inception through February 2023. We included full-text articles that reported the prevalence of PCLs using MRI in the general population. A proportional meta-analysis was performed, and the prevalence of PCLs was pooled using a random-effects model. RESULTS Fifteen studies with 65,607 subjects were identified. The pooled prevalence of PCLs was 16% (95% confidence interval [CI], 13%-18%; I2 = 99%), most of which were under 10 mm. Age-specific prevalence of PCLs increased from 9% (95% CI, 7%-12%) at 50 to 59 years, to 18% (95% CI, 14%-22%) at 60 to 69 years, 26% (95% CI, 20%-33%) at 70 to 79 years, and 38% at 80 years and above (95% CI, 25%-52%). There was no difference in prevalence between sexes. Subgroup analysis showed higher PCL prevalence when imaging findings were confirmed by independent radiologist(s) (25%; 95% CI, 16%-33%) than when chart review alone was used (5%; 95% CI, 4%-7%; P < .01). There was no independent association of PCL prevalence with geographic location (Europe, North America, or Asia), MRI indication (screening vs evaluation of non-pancreatic pathology), enrollment period, sample size, magnet strength (1.5 vs 3 tesla), and MRI sequence (magnetic resonance cholangiopancreatography vs no magnetic resonance cholangiopancreatography). CONCLUSION In this systematic review, the global prevalence of PCLs using a highly sensitive noninvasive imaging modality ranged between 13% and 18%.
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Affiliation(s)
- Ana Vilela
- Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia
| | - Elit Quingalahua
- Division of Hematology and Oncology, University of Michigan, Ann Arbor, Michigan
| | - Alejandra Vargas
- Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, Virginia
| | - Fadi Hawa
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
| | - Carol Shannon
- Taubman Health Sciences Library, University of Michigan, Ann Arbor, Michigan
| | - Eileen S Carpenter
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan
| | - Jiaqi Shi
- Department of Pathology & Clinical Labs, University of Michigan, Ann Arbor, Michigan
| | - Somashekar G Krishna
- Division of Gastroenterology and Hepatology, The Ohio State University Wexner Medical Center, Columbus, Ohio
| | - Un-Jung Lee
- Biostatistics Unit, Office of Academic Affairs, Northwell Health, Staten Island, New York
| | - Jean M Chalhoub
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Staten Island University Hospital, Northwell Health, Staten Island, New York
| | - Jorge D Machicado
- Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan.
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11
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Hao Y, Zhou X, Razman R, Peng S, Ahmad NS. Compliance with the 24-hour movement behaviour guidelines among children and adolescents with disabilities: a systematic review and meta-analysis. BMC Public Health 2024; 24:2357. [PMID: 39215263 PMCID: PMC11363391 DOI: 10.1186/s12889-024-19842-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Compliance with the 24-Hour Movement Guidelines (24-HMG: physical activity (PA), screen time (ST), and sleep) has been associated with numerous beneficial health outcomes among children and adolescents. However, there is a lack of consensus on the overall compliance with the 24-HMG specifically among children and adolescents with disabilities. Therefore, this systematic review and meta-analysis aimed to examine the extent to which children and adolescents with disabilities adhere to the 24-HMG globally. METHOD Quantitative studies published in English until May 2023 were sought by searching seven electronic databases: Web of Science, PubMed, SPORTDiscus, CINAHL, MEDLINE, Scopus, Psychology and Behavioural Sciences Collection. This review included studies that identified participants as individuals with disabilities and reported the overall (non) compliance with the 24-HMG among children and adolescents with disabilities. RESULTS A total of 13 studies, involving 21,101 individuals (65.95% males), aged 6 to 21 years from 9 countries, were included in the analysis. In general, 7% (95%CI: 0.05-0.09, p < 0.01) of children and adolescents with disabilities met all three 24-HMG, while 16% (95%CI: 0.13-020, p < 0.01) did not meet any of the three recommendations. Regarding adherence to individual 24-hour movement behaviour, the rates of compliance were 22% (95%CI: 0.18-0.25, p < 0.01) for PA, 49% (95%CI: 0.41-0.56, p < 0.01) for ST, and 59% (95%CI: 0.56-0.61, p < 0.01) sleep. In relation to numbers of those meeting the 24-HMG, 43% (95%CI: 0.41-0.45, p < 0.01) met one guideline, while 32% (95%CI: 0.28-0.36, p < 0.01) met two guidelines. CONCLUSION There is a notable percentage of children and adolescents with disabilities who do not meet the recommended the 24-HMG, which encompasses PA, ST, and sleep. This underscores the pressing requirement to create and execute evidence-based strategies that effectively encourage and assist these individuals with disabilities in adopting and maintaining these movement behaviours.
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Affiliation(s)
- Yaru Hao
- School of Sports Science, Changsha Normal University, Changsha, China
| | - Xiaogang Zhou
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Rizal Razman
- Faculty of Sports and Exercise Science, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Sanying Peng
- Department of Physical Education, Hohai University, Nanjing, China
| | - Nor Shafrin Ahmad
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
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12
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Papanastasiou CA, Bazmpani MA, Kampaktsis PN, Zegkos T, Gossios T, Parcharidou D, Kokkinidis DG, Tziatzios I, Economou FI, Nikolaidou C, Kamperidis V, Tsapas A, Ziakas A, Efthimiadis G, Karamitsos TD. Cardiac magnetic resonance for ventricular arrhythmias: a systematic review and meta-analysis. Heart 2024; 110:1113-1123. [PMID: 39084706 DOI: 10.1136/heartjnl-2024-324182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
BACKGROUND Cardiac magnetic resonance (CMR) allows comprehensive myocardial tissue characterisation, revealing areas of myocardial inflammation or fibrosis that may predispose to ventricular arrhythmias (VAs). With this study, we aimed to estimate the prevalence of structural heart disease (SHD) and decipher the prognostic implications of CMR in selected patients presenting with significant VAs. METHODS Electronic databases were searched for studies enrolling adult patients that underwent CMR for diagnostic or prognostic purposes in the setting of significant VAs. A random effects model meta-analysis of proportions was performed to estimate the prevalence of SHD. HRs were pooled together in order to evaluate the prognostic value of CMR. RESULTS The prevalence of SHD was reported in 18 studies. In all-comers with significant VAs, the pooled rate of SHD post-CMR evaluation was 39% (24% in the subgroup of premature ventricular contractions and/or non-sustained ventricular tachycardia vs 63% in the subgroup of more complex VAs). A change in diagnosis after use of CMR ranged from 21% to 66% with a pooled average of 35% (29%-41%). A non-ischaemic cardiomyopathy was the most frequently identified SHD (56%), followed by ischaemic heart disease (21%) and hypertrophic cardiomyopathy (5%). After pooling together data from six studies, we found that the presence of late gadolinium enhancement was associated with increased risk of major adverse outcomes in patients with significant VAs (pooled HR: 1.79; 95% CI 1.33 to 2.42). CONCLUSION CMR is a valuable tool in the diagnostic and prognostic evaluation of patients with VAs. CMR should be considered early after initial evaluation in the diagnostic algorithm for VAs of unclear aetiology as this strategy may also define prognosis and improve risk stratification.
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Affiliation(s)
- Christos A Papanastasiou
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
- Cardiology Department, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Maria-Anna Bazmpani
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Polydoros N Kampaktsis
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, New York City, New York, USA
| | - Thomas Zegkos
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Thomas Gossios
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Despoina Parcharidou
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Damianos G Kokkinidis
- Heart and Vascular Institute, L&M, Yale New Haven Health, New Haven, Connecticut, USA
| | - Ioannis Tziatzios
- Cardiology Department, 424 General Military Training Hospital, Thessaloniki, Greece
| | - Fotios I Economou
- Cardiology Department, 424 General Military Training Hospital, Thessaloniki, Greece
| | | | - Vasileios Kamperidis
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Apostolos Tsapas
- Center for Clinical Research and Evidence-Based Medicine, Aristotle University Thessaloniki, Thessaloniki, Greece
- Harris Manchester College, University of Oxford, Oxford, UK
| | - Antonios Ziakas
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Georgios Efthimiadis
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
| | - Theodoros D Karamitsos
- 1st Cardiology Department, University General Hospital of Thessaloniki AHEPA, Thessaloniki, Greece
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13
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Naing C, Aung HH, Aye SN, Poovorawan Y, Whittaker MA. CagA toxin and risk of Helicobacter pylori-infected gastric phenotype: A meta-analysis of observational studies. PLoS One 2024; 19:e0307172. [PMID: 39173001 PMCID: PMC11341061 DOI: 10.1371/journal.pone.0307172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 07/01/2024] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Helicobacter pylori (H. pylori) is frequently associated with non-cardia type gastric cancer, and it is designated as a group I carcinogen. This study aimed to systematically review and meta-analyze the evidence on the prevalence of CagA status in people with gastric disorders in the Indo-Pacific region, and to examine the association of CagA positive in the risk of gastric disorders. This study focused on the Indo-Pacific region owing to the high disability adjusted life-years related to these disorders, the accessibility of efficient treatments for this common bacterial infection, and the varying standard of care for these disorders, particularly among the elderly population in the region. METHODS Relevant studies were identified in the health-related electronic databases including PubMed, Ovid, Medline, Ovid Embase, Index Medicus, and Google Scholar that were published in English between 1 January 2000, and 18 November 2023. For pooled prevalence, meta-analysis of proportional studies was done, after Freeman-Tukey double arcsine transformation of data. A random-effect model was used to compute the pooled odds ratio (OR) and 95% confidence interval (CI) to investigate the relationship between CagA positivity and gastric disorders. RESULTS Twenty-four studies from eight Indo-Pacific countries (Bhutan, India, Indonesia, Malaysia, Myanmar, Singapore, Thailand, Vietnam) were included. Overall pooled prevalence of CagA positivity in H. pylori-infected gastric disorders was 83% (95%CI = 73-91%). Following stratification, the pooled prevalence of CagA positivity was 78% (95%CI = 67-90%) in H. pylori-infected gastritis, 86% (95%CI = 73-96%) in peptic ulcer disease, and 83% (95%CI = 51-100%) in gastric cancer. Geographic locations encountered variations in CagA prevalence. There was a greater risk of developing gastric cancer in those with CagA positivity compared with gastritis (OR = 2.53,95%CI = 1.15-5.55). CONCLUSION Findings suggest that the distribution of CagA in H. pylori-infected gastric disorders varies among different type of gastric disorders in the study countries, and CagA may play a role in the development of gastric cancer. It is important to provide a high standard of care for the management of gastric diseases, particularly in a region where the prevalence of these disorders is high. Better strategies for effective treatment for high-risk groups are required for health programs to revisit this often-neglected infectious disease.
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Affiliation(s)
- Cho Naing
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
| | - Htar Htar Aung
- School of Medicine, IMU University, Kuala Lumpur, Malaysia
| | - Saint Nway Aye
- School of Medicine, IMU University, Kuala Lumpur, Malaysia
| | - Yong Poovorawan
- Center of Excellence in Clinical Virology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Maxine A. Whittaker
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Queensland, Australia
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Hanai M, Amaral DC, Jacometti R, Aguiar EHC, Gomes FC, Cyrino LG, Alves MR, Monteiro MLR, Fuganti RM, Casella AMB, Louzada RN. Large macular hole and autologous retinal transplantation: a systematic review and meta-analysis. Int J Retina Vitreous 2024; 10:56. [PMID: 39175026 PMCID: PMC11340077 DOI: 10.1186/s40942-024-00573-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2024] [Accepted: 08/12/2024] [Indexed: 08/24/2024] Open
Abstract
INTRODUCTION Macular holes are breaks in the retinal tissue at the center of the macula, affecting central vision. The standard treatment involves vitrectomy with membrane peeling and gas tamponade. However, for larger or chronic holes, alternative techniques like autologous retinal graft have emerged. This meta-analysis evaluates the efficacy and safety of retinal transplantation in managing large macular holes. METHODS We conducted a systematic review and meta-analysis following PRISMA guidelines. The study was prospectively registered in PROSPERO (CRD42024504801). We searched PubMed, Web of Science, Cochrane, and Embase databases for observational studies including individuals with large macular holes with or without retinal detachments and retinal transplantation as the main therapy. We used a random-effects model to compute the mean difference with 95% confidence intervals and performed statistical analysis using R software. RESULTS We conducted a comprehensive analysis of 19 studies involving 322 patients diagnosed with various types of macular holes (MHs). These included cohorts with refractory MH, high myopia associated with MH, primary MH, and MH with retinal detachment (RD). The findings were promising, revealing an overall closure rate of 94% of cases (95% CI 88-98, I2 = 20%). Moreover, there was a significant improvement in postoperative visual acuity across all subgroups, averaging 0.45 (95% CI 0.33-0.58 ; I2 = 72%; p < 0.01) overall. However, complications occurred with an overall incidence rate of 15% (95% CI 7-25; I2 = 59%). CONCLUSION ART for large MH shows promising results, including significant improvements in visual acuity and a high rate of MH closure with low complication risks overall and for subgroups.
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Affiliation(s)
- Mário Hanai
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Dillan Cunha Amaral
- Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Raiza Jacometti
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Laura Goldfarb Cyrino
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Milton Ruiz Alves
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | - Mário Luiz Ribeiro Monteiro
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil
| | | | | | - Ricardo Noguera Louzada
- Division of Ophthalmology and the Laboratory for Investigation in Ophthalmology (LIM-33), Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
- Instituto de Olhos São Sebastião, Largo do Machado 54, 1208, Rio de Janeiro, RJ, 22221-020, Brazil.
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15
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Rezk A, Liu W, Nijs K, Lee JW, Rajaleelan W, Nakatani R, Al Azazi E, Englesakis M, Chowdhury T. Brain and Heart Interactions Delineating Cardiac Dysfunction in Four Common Neurological Disorders: A Systematic Review and Meta-analysis. J Neurosurg Anesthesiol 2024:00008506-990000000-00125. [PMID: 39171885 DOI: 10.1097/ana.0000000000000987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/25/2024] [Indexed: 08/23/2024]
Abstract
Neurological and cardiovascular disorders are the leading causes of morbidity and mortality worldwide. While the effects of cardiovascular disease (CD) on the nervous system are well understood, understanding of the reciprocal relationship has only recently become clearer. Based on disability-adjusted life years, this systematic review and meta-analysis present the pooled incidence and association of CD in 4 selected common, noncommunicable neurological disorders: (1) migraine, (2) Alzheimer disease and other dementias, (3) epilepsy, and (4) head injury. Sixty-five studies, including over 4 and a half million patients, were identified for inclusion in this review. Among the 4 neurological disorders, the majority of patients (89.4%) had epilepsy, 9.6% had migraine, and 0.97% had head injury. Alzheimer disease and other dementias were reported in only 0.02% of patients. The pooled effect estimates (incidence and association) of CD in the 4 neurological disorders was 10% (95% CI: 5.8%-16.9%; I2 = 99.94%). When stratified by the neurological disorder, head injury was associated with the highest incidence of CD (28%). The 4 neurological disorders were associated with a 2-fold increased odds for developing CD in comparison to patients without neurological disorders. Epilepsy was associated with the greatest increased odds of developing CD (odds ratio: 2.25; 95% CI: 1.82-2.79; P = 0.04). In studies that reported this variable, the pooled hazard ratio was 1.64 (95% CI: 1.38-1.94), with head injury having the highest hazard ratio (2.17; 95% CI: 1.30-3.61). Large prospective database studies are required to understand the long-term consequences of CD in patients with neurological disorders.
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Affiliation(s)
- Amal Rezk
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Winnie Liu
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Kristof Nijs
- Department of Anaesthesiology and Pain Medicine, Jessa Hospital, Hasselt, Belgium
| | - Jun Won Lee
- University of Saskatchewan School of Medicine, Saskatoon, Canada
| | - Wesley Rajaleelan
- Department of Anesthesia and Pain Medicine, University of Ottawa, Ottawa, Canada
| | - Rodrigo Nakatani
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Emad Al Azazi
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Marina Englesakis
- Library and Information Services, University Health Network, Toronto, Canada
| | - Tumul Chowdhury
- Department of Anesthesia and Pain Medicine, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
- University of Toronto, Toronto, ON, Canada
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16
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Nanah A, Abdeljaleel F, Matsubara JK, Garcia MVF. Outcomes and Practices of Endotracheal Intubation Using the Glasgow Coma Scale in Acute Non-Traumatic Poisoning: A Systematic Review and Meta-Analysis of Proportions. J Intensive Care Med 2024:8850666241275041. [PMID: 39150325 DOI: 10.1177/08850666241275041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
BACKGROUND Acute poisoning often results in decreased consciousness, necessitating airway assessment and management. Existing literature in the trauma setting suggests the importance of airway protection in unconscious patients to prevent complications, including aspiration. Practices for endotracheal intubation in non-traumatic acute poisoning are poorly described and variable, particularly regarding the use of a Glasgow Coma Scale (GCS) ≤ 8 threshold for intubation. METHODS A systematic review and meta-analysis of proportions was conducted to evaluate intubation rates and outcomes in patients presenting for acute non-traumatic poisoning. Studies were excluded if the primary indication for intubation was not airway protection. We analyzed rates of intubation, mortality, and aspiration by subgrouping patients into GCS ≤ 8, GCS 9-15, or mixed GCS. Common and random-effects analysis were used, supplemented by subgroup analyses. RESULTS 39 studies were included in the analysis, involving 15,959 patients. Random-effects pooled intubation rates varied significantly across GCS categories: GCS ≤ 8 (30.0%, I2 = 92%, p < 0.01), GCS 9-15 (1.0%, I2 = 0%, p = 0.91), and mixed GCS (11.0%, I2 = 94%, p < 0.01), p-value <0.01 for subgroup difference. Aspiration rates also varied: GCS ≤ 8 (19.0%, I2 = 84%, p < 0.01), GCS 9-15 (4.0%, I2 = 78%, p < 0.01), and mixed group (5.0%, I2 = 72%, p < 0.01), p-value <0.01 for subgroup difference. Mortality rates remained low across all groups: GCS ≤ 8 (1.0%, I2 = 0%, p = 0.62), GCS 9-15 (1.0%, I2 = 0%, p = 0.99), and mixed group (2.0%, I2 = 68%, p < 0.01). CONCLUSION The conventional "less than 8, intubate" approach may not be directly applicable to acute poisoning patients due to heterogeneity in patient presentation, intubation practices, and low mortality. Therefore, a nuanced approach is warranted to optimize airway management strategies tailored to individual patient needs.
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Affiliation(s)
- Abdelrahman Nanah
- Cleveland Clinic Foundation, Fairview Hospital, Cleveland, Ohio, USA
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17
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Alenazi AS, Obeid AA, Alderaywsh A, Alrabiah A, Alkaoud O, Ashoor M, Aldosari B, Alarfaj AM. Impact of Tranexamic Acid on Bleeding Outcomes and Complication Rates in Facelift: A Systematic Review and Meta-analysis. Aesthet Surg J 2024:sjae156. [PMID: 39141514 DOI: 10.1093/asj/sjae156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Rhytidectomy poses a significant risk of bleeding. Several studies have reported the safety profile and efficacy of tranexamic acid (TXA), an antifibrinolytic agent, in minimizing perioperative sequelae, particularly hematoma and bleeding. OBJECTIVES The aim of this systematic review was to analyze the effect of TXA administration in facelift surgery, its effect with different routes of administration, and to compare different administration routes in reducing intraoperative blood loss, postoperative edema, and ecchymosis in rhytidectomy. METHODS A systematic literature search was conducted to identify studies that reported on TXA in facelift surgery. The primary outcomes of interest were intraoperative blood loss, time to achieve hemostasis, operation duration, and postoperative hematoma, edema, ecchymosis, drain output, and major and minor complications. Meta-analyses of hematoma, operation duration, drain output, and major and minor complications were performed, and the risk of bias was assessed with ROBINS-I for nonrandomized studies, and Cochrane's RoB 2.0, a tool for randomized controlled trials. RESULTS In total, 104 articles were included in the initial screening. Out of 388 participants 170 patients were administered TXA, predominantly female (over 91%), with ages from the late 50s to mid-60s. TXA administration varied, with subcutaneous injection being the most common method. The meta-analysis revealed that the pooled prevalence of minor and major hematoma in TXA recipients was remarkably low, with a significant reduction in the risk of minor hematoma (odds ratio [OR] = 0.18, 95% CI 0.05-0.62, P < .001) and no significant difference in major hematoma risk. Interestingly, TXA significantly reduced postoperative drainage compared to the controls (mean difference = -25.59, 95% CI, -30.4--20.77, P < .01). Additionally, neither minor nor major complications were significantly different between the TXA recipients and controls. Specifically, the pooled odds for the incidence of major complications were not significantly different (OR = 1.47, 95% CI, 0.23-9.19, P = .68), and similar results were found for minor complications (OR = 0.59, 95% CI, 0.23-1.48, P = .26). CONCLUSIONS TXA significantly reduces postoperative drain output and minor hematomas in facelift surgery without increasing major complications. It also reduces edema, ecchymosis, and intraoperative blood loss. However, further studies are required to explore the efficacy of TXA with different dosages and administration routes. LEVEL OF EVIDENCE: 3
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Chandramohan D, Adisa O, Patel D, Ware E, Eleti N, Agarwal G. Outcomes of Kidney Transplantation in Highly HLA-Sensitized Patients Treated with Intravenous Immuno-Globulin, Plasmapheresis and Rituximab: A Meta-Analysis. Life (Basel) 2024; 14:998. [PMID: 39202740 PMCID: PMC11355159 DOI: 10.3390/life14080998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 07/30/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
(1) Background: We aimed to investigate the outcomes of human leukocyte antigen (HLA)-incompatible transplantation for patients who received desensitization with intravenous immunoglobulins (IVIg), plasmapheresis, and rituximab. (2) Methods: A comprehensive search of multiple electronic databases to identify studies that utilized desensitization was conducted. The random-effects model was used to calculate the pooled rates and the 95% confidence interval (CI). (3) Results: A total of 1517 studies were initially identified. From these, 16 studies met the inclusion criteria, encompassing 459 patients, with a mean age of 45 years, of whom 40.8% were male. CDC crossmatch was positive in 68.3% (95% CI: 43.5-85.8; I2 87%), and 89.4% (95% CI: 53.4-98.4%; I2 89.8%) underwent living-donor transplantation. The 1-year graft survival pooled rate was 88.9% (95% CI: 84.8-92; I2 0%) and the 5-year graft survival rate was 86.1% (95% CI: 81.2-89.9; I2 0%). The 1-year patient survival rate was 94.2% (95% CI: 91-96.3; I2 0%), and the 5-year patient survival rate was 88.9% (95% CI: 83.5-92.7%; I2 7.7%). The rate of antibody-mediated rejection was 37.7% (95% CI: 25-52.3; I2 80.3%), and the rate of acute cell-mediated rejection was 15.1% (95% CI: 9.1-24; I2 55%). (4) Conclusions: Graft and patient survival are favorable in highly sensitized patients who undergo desensitization using IVIg, plasmapheresis, and rituximab for HLA-incompatible transplantation.
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Affiliation(s)
- Deepak Chandramohan
- Department of Internal Medicine/Nephrology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (D.P.); (N.E.); (G.A.)
| | - Oluwadamilola Adisa
- Department of Internal Medicine, Louisiana State University, Shreveport, LA 71103, USA; (O.A.); (E.W.)
| | - Devansh Patel
- Department of Internal Medicine/Nephrology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (D.P.); (N.E.); (G.A.)
| | - Erin Ware
- Department of Internal Medicine, Louisiana State University, Shreveport, LA 71103, USA; (O.A.); (E.W.)
| | - Navya Eleti
- Department of Internal Medicine/Nephrology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (D.P.); (N.E.); (G.A.)
| | - Gaurav Agarwal
- Department of Internal Medicine/Nephrology, University of Alabama at Birmingham, Birmingham, AL 35233, USA; (D.P.); (N.E.); (G.A.)
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Cherri Z, Lau K, Nellums LB, Himmels J, Deal A, McGuire E, Mounier-Jack S, Norredam M, Crawshaw A, Carter J, Seedat F, Clemente NS, Bouaddi O, Friedland JS, Edelstein M, Hargreaves S. The immune status of migrant populations in Europe and implications for vaccine-preventable disease control: a systematic review and meta-analysis. J Travel Med 2024; 31:taae033. [PMID: 38423523 DOI: 10.1093/jtm/taae033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/10/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Ensuring vaccination coverage reaches established herd immunity thresholds (HITs) is the cornerstone of any vaccination programme. Diverse migrant populations in European countries have been associated with cases of vaccine-preventable diseases (VPDs) and outbreaks, yet it is not clear to what extent they are an under-immunized group. METHODS We did a systematic review and meta-analysis to synthesize peer-reviewed published primary research reporting data on the immune status of migrants in EU/EEA countries, the UK and Switzerland, calculating their pooled immunity coverage for measles, mumps, rubella and diphtheria using random-effects models. We searched on Web of Science, Embase, Global Health and MEDLINE (1 January 2000 to 10 June 2022), with no language restrictions. The protocol is registered with PROSPERO (CRD42018103666). FINDINGS Of 1103 abstracts screened, 62 met eligibility criteria, of which 39 were included in the meta-analysis. The meta-analysis included 75 089 migrants, predominantly from outside Europe. Pooled immunity coverage among migrant populations was well below the recommended HIT for diphtheria (n = 7, 57.4% [95% confidence interval (CI): 43.1-71.7%] I2 = 99% vs HIT 83-86%), measles (n = 21, 83.7% [95% CI: 79.2-88.2] I2 = 99% vs HIT 93-95%) and mumps (n = 8, 67.1% [95% CI: 50.6-83.6] I2 = 99% vs HIT 88-93%) and midway for rubella (n = 29, 85.6% [95% CI: 83.1-88.1%] I2 = 99% vs HIT 83-94%), with high heterogeneity across studies. INTERPRETATION Migrants in Europe are an under-immunized group for a range of important VPDs, with this study reinforcing the importance of engaging children, adolescents and adults in 'catch-up' vaccination initiatives on arrival for vaccines, doses and boosters they may have missed in their home countries. Co-designing strategies to strengthen catch-up vaccination across the life course in under-immunized groups is an important next step if we are to meet European and global targets for VPD elimination and control and ensure vaccine equity.
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Affiliation(s)
- Zeinab Cherri
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Karen Lau
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Lancet Migration European Regional Hub
| | - Laura B Nellums
- Faculty of Medicine and Heath Sciences, University of Nottingham, Nottingham, UK
| | - Jan Himmels
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Anna Deal
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Emma McGuire
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Sandra Mounier-Jack
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity and Health, Section of Health Services Research, Department of Public Health, University of Copenhagen, Denmark
- Department of Infectious Diseases, Hvidovre Hospital, University of Copenhagen, Denmark
| | - Alison Crawshaw
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Jessica Carter
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Farah Seedat
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Nuria Sanchez Clemente
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
| | - Oumnia Bouaddi
- Lancet Migration European Regional Hub
- International School of Public Health, Mohammed VI University of Sciences and Health, Casablanca, Morocco
- Mohammed VI Center for Research and Innovation, Rabat, Morocco
| | - Jon S Friedland
- Institute for Infection and Immunity, St Georges, University of London, London, UK
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St Georges, University of London, London, UK
- Lancet Migration European Regional Hub
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20
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Mino E, Pfeifer K, Hanson CL, Schuler M, Brandmeier A, Klamroth S, Naber I, Weissenfels A, McHale S, Abu-Omar K, Gelius P, Whiting S, Wickramasinghe K, Galea G, Geidl W. Are physical activity referral scheme components associated with increased physical activity, scheme uptake, and adherence rate? A meta-analysis and meta-regression. Int J Behav Nutr Phys Act 2024; 21:82. [PMID: 39095805 PMCID: PMC11295389 DOI: 10.1186/s12966-024-01623-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/29/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Physical activity referral schemes (PARS) are composed of various components, such as a written prescription or a person-centered approach. The role of these components in their effectiveness is yet to be understood. Therefore, we aimed to explore the relationships between PARS components and physical activity, scheme uptake, and adherence rate; and to estimate the effect of PARS. METHODS We searched Scopus, PubMed, Web of Science, CINAHL, ScienceDirect, SpringerLink, HTA, Wiley Online Library, SAGE Journals, Taylor & Francis, Google Scholar, OpenGrey, and CORE. Eligible studies were published between 1990 and November 2023 in English or German, investigated PARS with participants aged ≥ 16 years, and reported physical activity, scheme uptake, or scheme adherence. Separate random-effects meta-analysis by comparison group were conducted for physical activity. Scheme uptake and adherence rates were pooled using proportional meta-analysis. The components were analyzed via univariate meta-regression. We rated the risk of bias using RoB2 and ROBINS-I, and the certainty of evidence using GRADE. RESULTS Fifty-two studies were included. PARS were more effective in increasing physical activity than usual care (k = 11, n = 5046, Hedges' g = 0.18, 95%CI 0.12 to 0.25; high certainty of evidence). When PARS were compared with physical activity advice or enhanced scheme versions, the pooled Hedges' g values for physical activity were -0.06 (k = 5, n = 1082, 95%CI -0.21 to 0.10; low certainty of evidence), and 0.07 (k = 9, n = 2647, 95%CI -0.03 to 0.18; low certainty of evidence) respectively. Scheme uptake was 87% (95%CI 77% to 94%, k = 14, n = 5000) across experimental studies and 68% (95%CI 51% to 83%, k = 14, n = 25,048) across non-experimental studies. Pooled scheme adherence was 68% (95%CI 55% to 80%, k = 16, n = 3939) and 53% (95%CI 42% to 63%, k = 18, n = 14,605). The meta-regression did not detect any significant relationships between components and physical activity or scheme uptake. A person-centered approach, screening, and brief advice were positively associated with scheme adherence, while physical activity sessions were negatively associated. CONCLUSION PARS are more effective in increasing physical activity than usual care only. We did not identify any components as significant predictors of physical activity and scheme uptake. Four components predicted scheme adherence, indicating that the component-effectiveness relationship warrants further research.
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Affiliation(s)
- Eriselda Mino
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany.
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Coral L Hanson
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
| | - Michael Schuler
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Josef-Schneider-Str. 2/ D7, Würzburg, 97080, Germany
- Department of Applied Health Sciences, University of Applied Sciences, Bochum, Germany
| | - Anna Brandmeier
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Sarah Klamroth
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Inga Naber
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Anja Weissenfels
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Sheona McHale
- School of Health and Social Care, Edinburgh Napier University, Sighthill Campus, Edinburgh, EH11 4DN, UK
| | - Karim Abu-Omar
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
| | - Peter Gelius
- Institute of Sport Sciences, Université de Lausanne, Lausanne, Switzerland
| | - Stephen Whiting
- Special Initiative for Noncommunicable Diseases and Innovation (SNI), WHO Regional Office for Europe, Copenhagen, Denmark
| | - Kremlin Wickramasinghe
- Special Initiative for Noncommunicable Diseases and Innovation (SNI), WHO Regional Office for Europe, Copenhagen, Denmark
| | - Gauden Galea
- Special Initiative for Noncommunicable Diseases and Innovation (SNI), WHO Regional Office for Europe, Copenhagen, Denmark
| | - Wolfgang Geidl
- Department of Sport Science and Sport, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Gebbertstraße 123b, Erlangen, 91058, Germany
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21
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Tran LT, Wardle H, Colledge-Frisby S, Taylor S, Lynch M, Rehm J, Volberg R, Marionneau V, Saxena S, Bunn C, Farrell M, Degenhardt L. The prevalence of gambling and problematic gambling: a systematic review and meta-analysis. Lancet Public Health 2024; 9:e594-e613. [PMID: 39025095 DOI: 10.1016/s2468-2667(24)00126-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/28/2024] [Accepted: 06/07/2024] [Indexed: 07/20/2024]
Abstract
BACKGROUND Gambling behaviours have become of increased public health interest, but data on prevalence remain scarce. In this study, we aimed to estimate for adults and adolescents the prevalence of any gambling activity, the prevalence of engaging in specific gambling activities, the prevalence of any risk gambling and problematic gambling, and the prevalence of any risk and problematic gambling by gambling activity. METHODS We performed a systematic review and meta-analysis. We systematically searched for peer-reviewed literature (on MEDLINE, Embase, and PsycInfo) and grey literature to identify papers published between Jan 1, 2010, and March 4, 2024. We searched for any gambling, including engagement with individual gambling activities, and problematic gambling data among adults and adolescents. We included papers that reported the prevalence or proportion of a gambling outcome of interest. We excluded papers of non-original data or based on a biased sample. Data were extracted into a bespoke Microsoft Access database, with the Joanna Briggs Institute Critical Appraisal Tool used to identify the risk of bias for each sample. Representative population survey estimates were firstly meta-analysed into country-level prevalence estimates, using metaprop, of any gambling, any risk gambling, problematic gambling, and by gambling activity. Secondly, population-weighted regional-level and global estimates were generated for any gambling, any risk gambling, problematic gambling, and specific gambling activity. This review is registered on PROSPERO (CRD42021251835). FINDINGS We screened 3692 reports, with 380 representative unique samples, in 68 countries and territories. Overall, the included samples consisted of slightly more men or male individuals, with a mean age of 29·72 years, and most samples identified were from high-income countries. Of these samples, 366 were included in the meta-analysis. Globally, 46·2% (95% CI 41·7-50·8) of adults and 17·9% (14·8-21·2) of adolescents had gambled in the past 12 months. Rates of gambling were higher among men (49·1%; 45·5-52·6) than women (37·4%; 32·0-42·5). Among adults, 8·7% (6·6-11·3) were classified as engaging in any risk gambling, and 1·41% (1·06-1·84) were engaging in problematic gambling. Among adults, rates of problematic gambling were greatest among online casino or slots gambling (15·8%; 10·7-21·6). There were few data reported on any risk and problematic gambling among adolescent samples. INTERPRETATION Existing evidence suggests that gambling is prevalent globally, that a substantial proportion of the population engage in problematic gambling, and that rates of problematic gambling are greatest among those gambling on online formats. Given the growth of the online gambling industry and the association between gambling and a range of public health harms, governments need to give greater attention to the strict regulation and monitoring of gambling globally. FUNDING Australian National Health and Medical Research Council.
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Affiliation(s)
- Lucy T Tran
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
| | - Heather Wardle
- School of Social and Political Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Samantha Colledge-Frisby
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia; National Drug Research Institute Melbourne, Curtin University, Melbourne, VIC, Australia
| | - Sophia Taylor
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Michelle Lynch
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Jürgen Rehm
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Rachel Volberg
- School of Public Health and Health Science, University of Massachusetts, Amherst, MA, USA
| | - Virve Marionneau
- Centre for Research on Addiction, Control, and Governance, University of Helsinki, Helsinki, Finland
| | - Shekhar Saxena
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Christopher Bunn
- School of Social and Political Sciences, University of Glasgow, Glasgow, Scotland, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
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22
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Antequera A, Molin-Veglia AD, López-Alcalde J, Álvarez-Díaz N, Muriel A, Muñoz J. Reactivation of Trypanosoma cruzi infection in immunosuppressed patients: a systematic review and meta-analysis. Clin Microbiol Infect 2024; 30:980-988. [PMID: 38697392 DOI: 10.1016/j.cmi.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 04/12/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND The risk of Trypanosoma cruzi reactivation is poorly understood. Previous studies evaluating the risk of reactivation report imprecise findings, and recommendations for monitoring and management from clinical guidelines rely on consensus opinion. OBJECTIVES We conducted a systematic review and meta-analysis to estimate the cumulative T. cruzi reactivation incidence in immunosuppressed adults, summarize the available evidence on prognostic factors for reactivation, and examine its prognostic effect on mortality. DATA SOURCES MEDLINE, Embase, LILACS, Clinical Trials, and CENTRAL from inception to 4 July 2022. STUDY ELIGIBILITY CRITERIA Studies reporting the incidence of T. cruzi reactivation. PARTICIPANTS Immunosuppressed adults chronically infected by T. cruzi. METHODS Two authors independently extracted data (including, but not limited to, incidence data, reactivation definition, follow-up, treatment, monitoring schedule, examined prognostic factors) and evaluated the risk of bias. We pooled cumulative incidence using a random-effects model. RESULTS Twenty-two studies (806 participants) were included. The overall pooled incidence of T. cruzi reactivation was 27% (95% CI, 19-36), with the highest pooled proportion in the sub-group of transplant recipients (36%; 95% CI, 25-48). The highest risk period was in the first 6 months after transplant (32%; 95% CI, 17-58), decreasing drastically the number of new cases later. People living with HIV and patients with autoimmune diseases experienced significantly lower cumulative reactivation incidences (17%; 95% CI, 8-29 and 18%; 95% CI, 9-29, respectively). A single study explored the independent effect of benznidazole and found benefits for preventing reactivations. No studies evaluated the independent association between reactivation and mortality, while sensitivity analysis results using unadjusted estimates were inconclusive. The heterogeneity of diagnostic algorithms was substantial. CONCLUSIONS Reactivation occurs in three out of ten T. cruzi-seropositive immunosuppressed adults. These findings can assist clinicians and panel guidelines in tailoring monitoring schedules. There is a great need for an accurate definition of reactivation and targeted monitoring.
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Affiliation(s)
- Alba Antequera
- Barcelona Institute for Global Health, Hospital Clínic Universitat de Barcelona (UB), Barcelona, Spain.
| | - Agustina Dal Molin-Veglia
- Barcelona Institute for Global Health, Hospital Clínic Universitat de Barcelona (UB), Barcelona, Spain
| | - Jesús López-Alcalde
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Pozuelo de Alarcón, Spain; Clinical Biostatistics Unit, Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain; CIBERESP, Madrid, Spain; Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Zurich, Switzerland
| | - Noelia Álvarez-Díaz
- Medical Library, Hospital Universitario Ramon y Cajal, Irycis, Madrid, Spain
| | - Alfonso Muriel
- Clinical Biostatistics Unit, Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain; CIBERESP, Madrid, Spain; Department of Nursing and Physiotherapy, Universidad Alcalá de Henares, Alcalá de Henares, Spain
| | - José Muñoz
- Barcelona Institute for Global Health, Hospital Clínic Universitat de Barcelona (UB), Barcelona, Spain
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23
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Knoedler S, Knoedler L, Kauke-Navarro M, Alfertshofer M, Obed D, Broer N, Kim BS, Könneker S, Panayi AC, Hundeshagen G, Kneser U, Pomahac B, Haug V. Quality of life and satisfaction after breast augmentation: A systematic review and meta-analysis of Breast-Q patient-reported outcomes. J Plast Reconstr Aesthet Surg 2024; 95:300-318. [PMID: 38945110 DOI: 10.1016/j.bjps.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Breast augmentation ranks among the most popular plastic surgery procedures. Yet, reports on post-operative patient-reported quality of life (QoL) and satisfaction remain conflicting. METHODS A systematic review was conducted following the PRISMA guidelines. Three databases were searched for eligible studies that reported pre-and/or post-operative Breast-Q™ augmentation scores for patient QoL (psychosocial, sexual, and physical well-being) and/or satisfaction. RESULTS A total of 39 studies (53 patient cohorts and 18,322 patients) were included in the quantitative synthesis. The pairwise meta-analysis revealed significant improvements in patient-reported psychosocial (MD: +38.10) and sexual well-being (MD: +40.20) as well as satisfaction with breast (MD: +47.88) (all p < 0.00001). Physical well-being improved slightly after breast augmentation (MD: +6.97; p = 0.42). The single-arm meta-analysis yielded comparable results, with Breast-Q™ scores in psychosocial and sexual well-being as well as satisfaction with breast increasing from 37.2, 31.1, and 26.3 to 75.0, 70.6, and 72.7, respectively (all p < 0.00001). Physical well-being improved by 8.1 (75.8 pre-operatively to 83.9 post-operatively; p = 0.17). Subgroup analyses highlighted higher QoL and satisfaction following breast augmentation for purely esthetic purposes and alloplastic mammaplasty. Although patient-reported physical and sexual well-being increased in the long term, psychosocial well-being was the highest in the short term. CONCLUSION Patient satisfaction with breast, psychosocial, and sexual well-being increased significantly after breast augmentation. In contrast, patient-reported physical well-being yielded ambivalent results, varying by mammaplasty technique and post-operative follow-up time. Plastic surgeons should be sensitized about our findings to refine eligibility criteria and gain a deeper understanding of the patients' perceived surgical experience. PROSPERO TRIAL REGISTRATION NO CRD42023409605.
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Affiliation(s)
- Samuel Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA; Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Leonard Knoedler
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Martin Kauke-Navarro
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Michael Alfertshofer
- Department of Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Doha Obed
- Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Hannover Medical School, Hannover, Germany
| | - Niclas Broer
- Department of Plastic, Reconstructive, Hand and Burn Surgery, Bogenhausen Academic Teaching Hospital Munich, Munich, Germany
| | - Bong-Sung Kim
- Department of Plastic Surgery and Hand Surgery, University Hospital Zürich, Zurich, Switzerland
| | - Sören Könneker
- Department of Plastic Surgery and Hand Surgery, University Hospital Zürich, Zurich, Switzerland
| | - Adriana C Panayi
- Division of Plastic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Gabriel Hundeshagen
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Ulrich Kneser
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany
| | - Bohdan Pomahac
- Division of Plastic Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Valentin Haug
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwigshafen, Germany.
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24
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Bonilla-Aldana DK, Calle-Hernández DM, Ulloque-Badaracco JR, Alarcón-Braga EA, Hernández-Bustamante EA, Cabrera-Guzmán JC, Quispe-Vasquez SM, Huayta-Cortez MA, Benites-Zapata VA, Rodriguez-Morales AJ. Highly pathogenic avian influenza A(H5N1) in animals: A systematic review and meta-analysis. New Microbes New Infect 2024; 60-61:101439. [PMID: 38911488 PMCID: PMC11192795 DOI: 10.1016/j.nmni.2024.101439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 05/28/2024] [Accepted: 05/30/2024] [Indexed: 06/25/2024] Open
Abstract
Introduction Avian influenza A H5N1 is a significant global public health threat. Although relevant, systematic reviews about its prevalence in animals are lacking. Methods We performed a systematic literature review in bibliographic databases to assess the prevalence of H5N1 in animals. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95 % confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I2 test) were reported. Results The literature search yielded 1359 articles, of which 33 studies were fully valid for analysis, including 96,909 animals. The pooled prevalence for H5N1 in birds (n = 90,045, 24 studies) was 5.0 % (95%CI: 4.0-6.0 %; I2 = 99.21); in pigs (n = 3,178, 4 studies) was 1.0 % (95%CI: 0.0-1.0 %); in cats (n = 2,911, 4 studies) was 0.0 % (95%CI: 0.0-1.0 %); and in dogs (n = 479, 3 studies) was 0.0 % (95%CI: 0.0-2.0 %). Conclusions While the occurrence of H5N1 in animals might be comparatively limited compared to other influenza viruses, its impact on public health can be substantial when it transmits to humans. This virus can potentially induce severe illness and has been linked to previous outbreaks. Therefore, it is essential to closely monitor and comprehend the factors influencing the prevalence of H5N1 in both avian and human populations to develop effective disease control and prevention strategies.
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Affiliation(s)
| | | | | | | | - Enrique A. Hernández-Bustamante
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo, Peru
| | | | | | | | | | - Alfonso J. Rodriguez-Morales
- Faculty of Health Sciences, Universidad Cientifica del Sur, Lima, Peru
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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25
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Kim K, Hong CM, Ha M, Choi M, Bang JI, Park S, Seo Y, Chong A, Oh SW, Lee SW. Efficacy of Empirical 131 I Radioiodine Therapy in Well-Differentiated Thyroid Carcinoma Patients With Thyroglobulin-Elevated Negative Iodine Scintigraphy Syndrome : A Systematic Review and Meta-analysis. Clin Nucl Med 2024; 49:741-747. [PMID: 38861375 DOI: 10.1097/rlu.0000000000005250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
OBJECTIVES This study aimed to perform a systematic review and meta-analysis on the efficacy of empirical high-dose radioiodine therapy in treating differentiated thyroid cancer patients with thyroglobulin (Tg)-elevated negative iodine scintigraphy (TENIS) syndrome. METHODS We searched PubMed, EMBASE, and the Cochrane Library to identify relevant studies published until April 2022. This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist and registered in an international prospective register of systematic reviews (PROSPERO). Meta-analyses of proportions and odds ratios were performed to assess the beneficial effect of empirical high-dose radioiodine therapy in patients with TENIS syndrome. Subgroup analysis was also performed according to the presence of micrometastasis or macrometastasis. RESULTS We identified 14 studies including 690 patients who received empirical high-dose radioiodine therapy for TENIS syndrome. Those who had micrometastasis exhibited additional lesions not previously observed on diagnostic whole-body scan (prop = 0.64, 95% confidence interval [CI], 0.51-0.77) and had reduced serum Tg levels (prop = 0.69; 95% CI, 0.52-0.84) after empirical radioiodine treatment. No such findings were observed among patients with macrometastasis. Moreover, we found that the empirical radioiodine treatment group had lower serum Tg levels than did controls (odds ratio = 0.27; 95% CI, 0.09-0.87), which suggests a lower risk of disease progression. CONCLUSIONS Our findings indicate that empirical high-dose radioiodine therapy promoted beneficial effects and could be recommended for patients with TENIS syndrome, especially those with micrometastasis.
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Affiliation(s)
| | - Chae Moon Hong
- Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | | | - Miyoung Choi
- Division for Healthcare Technology Assessment Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, Korea
| | - Ji-In Bang
- Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Gyeonggi, Republic of Korea
| | - Sohyun Park
- Department of Nuclear Medicine, National Cancer Center Hospital, Gyeonggi, Republic of Korea
| | - Youngduk Seo
- Department of Nuclear Medicine, Chungnam National University Sejong Hospital, Sejong, Korea
| | - Ari Chong
- Department of Nuclear Medicine, College of Medicine, Chosun University, Gwangju, Korea
| | - So Won Oh
- Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University, School of Medicine and Chilgok Hospital, Daegu, Republic of Korea
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Abdallah M, Mohamed MFH, Abdalla AO, Jaber F, Baliss M, Ahmed K, Eckmann J, Bilal M, Shaukat A. Adenomas and Sessile Serrated Lesions in 45- to 49-Year-Old Individuals Undergoing Colonoscopy: A Systematic Review and Meta-Analysis. Am J Gastroenterol 2024; 119:1600-1606. [PMID: 38421004 DOI: 10.14309/ajg.0000000000002735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 02/22/2024] [Indexed: 03/02/2024]
Abstract
INTRODUCTION Colorectal cancer (CRC) screening is now recommended at the age of 45 years in the United States. However, information regarding the adenomas detection rate (ADR) and sessile serrated lesions (SSLs) in 45- to 49-year-old individuals is limited. In addition, the impact of lowering the screening age to 45 years on the ADR and the detection rate of SSLs is not well elucidated. This systematic review and meta-analysis aims to report the overall ADR and SSL detection rate in 45- to 49-year-old individuals undergoing colonoscopy. METHODS We searched MEDLINE, EMBASE, SCOPUS, Web of Science, ClinicalTrials.gov , and the Cochrane database from inception through October 2022 to identify studies reporting on ADR and SSL detection rates in 45- to 49-year-old individuals undergoing colonoscopies for all indications. This approach acknowledges the possibility of including individuals undergoing diagnostic colonoscopies or those with increased risk factors for CRC. We also conducted a separate analysis examining ADR in average-risk individuals undergoing screening colonoscopy. The pooled rates with their corresponding 95% confidence intervals (CIs) were generated using the fixed-effects model. I2 was used to adjudicate heterogeneity. RESULTS Sixteen studies met the inclusion criteria. All studies were retrospective except one; 3 had data from national/local registries. There were 41,709 adenomas detected across 150,436 colonoscopies. The pooled overall ADR was 23.1% (95% CI 19.7%-27.0%, I2 = 98.6%). The pooled ADR in individuals with average risk of CRC from 7 studies was 28.2% (95% CI 24.6%-32.0%, I2 = 96.5%). The pooled overall SSL detection rate from 6 studies was 6.3% (95% CI 3.8%-10.5%, I2 = 97%). The included studies were heterogeneous because of differences in the inclusion and exclusion criteria and patient population. DISCUSSION In 45- to 49-year-old individuals undergoing a colonoscopy for any indication, the ADR and SSL detection rates were 23.1% and 6.3%, respectively. We conclude that these outcomes in 45- to 49-year-olds are comparable with individuals aged 50-54 years.
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Affiliation(s)
- Mohamed Abdallah
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Mouhand F H Mohamed
- Department of Medicine, Brown University, Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Abubaker O Abdalla
- Division of Gastroenterology and Hepatology, Emory University, Atlanta, Georgia, USA
| | - Fouad Jaber
- Department of Medicine, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Michelle Baliss
- Division of Gastroenterology and Hepatology, Saint Louis University, St. Louis, Missouri, USA
| | - Khalid Ahmed
- Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jason Eckmann
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
| | - Mohammad Bilal
- Division of Gastroenterology and Hepatology, University of Minnesota Medical Center, Minneapolis, Minnesota, USA
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA
| | - Aasma Shaukat
- Division of Gastroenterology, Department of Medicine and Population Health, NYU Grossman School of Medicine, New York, New York, USA
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Wong ZY, Teo CY, Fiona Wong YQ, Ng KT, Lim SK. Immunosuppression for adult steroid-dependent or frequently relapsing nephrotic syndrome: A systematic review and meta-analysis. PLoS One 2024; 19:e0307981. [PMID: 39083488 PMCID: PMC11290670 DOI: 10.1371/journal.pone.0307981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 07/15/2024] [Indexed: 08/02/2024] Open
Abstract
OBJECTIVE There is limited evidence on which immunosuppressive agents produce the best outcomes for adult patients with steroid-dependent or frequently relapsing nephrotic syndrome (SDNS/FRNS). This review compares the remission rate and adverse effects of various immunosuppressants used. METHODS Studies of adult patients with biopsy-proven SDNS/FRNS, administered any immunosuppressive agents and reported complete remission results as one of the clinical outcomes were included. Articles were independently screened by two researchers. ROBINS-I was used for risk of bias assessment. Random-effects model was used for statistical analysis and corresponding 95% confidence intervals (CIs) were calculated. RESULTS 574 patients across 28 studies were included in the analysis. Patients receiving rituximab have a complete remission rate of 89% (95% CI = 83% to 94%; τ2 = 0.0070; I2 = 62%; overall p < 0.01, low certainty) and adverse event rate of 0.26, cyclosporine (CR 40%; 95% CI = 21% to 59%; τ2 = 0.0205; I2 = 55%; overall p = 0.08, low certainty), tacrolimus (CR 84%; 95% CI = 70% to 98%; τ2 = 0.0060; I2 = 33%; overall p = 0.21, moderate certainty), mycophenolate mofetil (CR 82%; 95% CI = 74% to 90%; τ2 < 0.0001; I2 = 15%; overall p = 0.32, moderate certainty) and cyclophosphamide (CR 79%; 95% CI = 69% to 89%; τ2 = 0; I2 = 0%; overall p = 0.52, moderate certainty). CONCLUSION Among the commonly used immunosuppressive agents, only rituximab has a statistically significant effect in achieving complete remission among patients with SDNS/FRNS and has a relatively good safety profile, but this is limited by low quality of evidence with high degree of heterogeneity causing a lack of statistical power.
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Affiliation(s)
- Zhi Yong Wong
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chiu Yee Teo
- Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Ka Ting Ng
- Faculty of Medicine, Department of Anesthesiology, University of Malaya, Kuala Lumpur, Malaysia
| | - Soo Kun Lim
- Faculty of Medicine, Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Kostares E, Kostare G, Kostares M, Tsakris A, Kantzanou M. Prevalence of surgical site infections following extraction of impacted mandibular third molars: A systematic review and meta-analysis. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101995. [PMID: 39084557 DOI: 10.1016/j.jormas.2024.101995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/20/2024] [Accepted: 07/28/2024] [Indexed: 08/02/2024]
Abstract
Our research aims to assess the prevalence of surgical site infections (SSI) following impacted mandibular third molar extractions. Two independent reviewers conducted a comprehensive systematic literature search across Medline, Scopus and Cochrane Central databases. The pooled prevalence, accompanied by 95% confidence intervals (CI), was calculated. Quality assessments, outlier and influential analyses were performed. Our meta-analysis included seventeen eligible studies, encompassing a total of 37,585 impacted mandibular third molar extractions. The overall prevalence of SSI following impacted mandibular third molar extractions was estimated at 1.7% (95% CI 1%-2.6%), indicating considerable heterogeneity among the studies. No study was identified as critically influential. This study highlights the imperative for future well-constructed prospective and retrospective investigations to deepen our understanding of the etiological nuances and refine management approaches for this prevalent postoperative complication.
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Affiliation(s)
- Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
| | - Georgia Kostare
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Michael Kostares
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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29
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Maklennan A, Borg-Bartolo R, Wierichs RJ, Esteves-Oliveira M, Campus G. A systematic review and meta-analysis on early-childhood-caries global data. BMC Oral Health 2024; 24:835. [PMID: 39049051 PMCID: PMC11267837 DOI: 10.1186/s12903-024-04605-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 07/15/2024] [Indexed: 07/27/2024] Open
Abstract
OBJECTIVES The present study systematically reviewed and provided a meta-analysis on early childhood caries (ECC) global prevalence and its association with socioeconomic indicators, both geographical and regarding unemployment rate, national income as well as income inequalities. METHODS Only cross-sectional or cohort studies covering ECC prevalence and experience in children younger than 71 months, reporting sample size, diagnostic criteria and conducted in urban and rural communities were considered. No language restriction was selected. Studies published from 2011 to 2022 available in PubMed, Web of Science, Embase and Open Grey literature were retrieved by ad hoc prepared search strings. The meta-analyses were conducted for both overall ECC prevalence and experience stratified by country of publication as well as measures of socioeconomic indicators using a random effects model using STATA 18®. RESULTS One hundred publications reporting ECC data from 49 countries (published from 2011 to 2022) were included and summarized by meta-analysis. The lowest prevalence was reported in Japan (20.6%) and Greece (19.3%). The global estimated random-effect pooled prevalence of ECC was 49% (95%CI: 0.44-0.55). The random-effect pooled caries prevalence (ECC) was 34% (95%CI: 02.20-0.48) (Central/South America), 36% (95%CI: 0.25-0.47) (Europe), 42% (95%CI: 0.32-0.53) (Africa), 52% (95%CI: 0.45-0.60) (Asia-Oceania), 57% (95%CI: 0.36-0.77) (North America) and 72% (95%CI: 0.58-0.85) (Middle East). When stratified by gross national income (GNI) the ECC prevalence ranged from 30% ($20,000-$39,999) to 57% in countries with the lowest GNI (<$5000). Stratification by inequality index (Gini index) resulted in an ECC prevalence range of 39% (low inequality) to 62% (no inequality), while for life expectancy the ECC prevalence ranged from 28% in countries with the highest life expectancy (< 80 years) to 62% in countries with 71-75 years life expectancy. DISCUSSION Within the limitations of this study (lack of certainty about the results as many countries are not represented and lack of uniformity in prevalence and experience data represented), results from 49 different countries reported a wide range of ECC prevalence. These reports indicated persisting high worldwide distribution of the disease. Both ECC prevalence and experience were associated with geographical areas and GNI. REGISTRATION PROSPERO: CRD-42,022,290,418.
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Affiliation(s)
- Anastasia Maklennan
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, 3010, Switzerland.
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland.
| | - R Borg-Bartolo
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, 3010, Switzerland
| | - R J Wierichs
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, 3010, Switzerland
| | - M Esteves-Oliveira
- Department of Conservative Dentistry, Periodontology and Endodontology, Oral Medicine and Maxillofacial Surgery, University Centre of Dentistry, University Hospital Tübingen, Tübingen, Germany
| | - G Campus
- Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Freiburgstrasse 7, Bern, 3010, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 3/c, Sassari, 07100, Italy
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Priantti JN, Vilbert M, de Moraes FCA, Madeira T, de Lima Santiago EM, Leighl NB, Cavalcante L, Karim NFA. Neurocognitive Adverse Events Related to Lorlatinib in Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:2611. [PMID: 39061249 PMCID: PMC11275246 DOI: 10.3390/cancers16142611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/14/2024] [Accepted: 07/17/2024] [Indexed: 07/28/2024] Open
Abstract
Lorlatinib has been FDA-approved as a systemic therapy for ALK/ROS1-positive non-small cell lung cancer (NSCLC) patients. However, it has been associated with an increased frequency of neurocognitive adverse events (NAEs). Therefore, we conducted a systematic review and meta-analysis to assess the NAEs related to lorlatinib therapy in NSCLC patients. PubMed, Scopus, the Cochrane Library, and prominent conference proceedings were searched for eligible studies of lorlatinib in NSCLC patients. NAEs included cognitive, mood, speech, and psychotic effects. A total of 1147 patients from 12 studies were included; 62% had brain metastases. A pooled analysis of NAEs showed frequencies of cognitive effects of 14.57% (95% CI, 8.37 to 24.14, I2 = 84%), mood effects of 11.17% (95% CI, 5.93 to 20.07, I2 = 84%), speech effects of 7.24% (95% CI, 3.39 to 15.20, I2 = 72%), and psychotic effects of 4.97% (95% CI, 3.27 to 7.49, I2 = 21%). Clinical trials reported a significantly higher frequency of mood effects than was indicated by real-world data. These results highlight the importance of educating patients and healthcare professionals about lorlatinib-related NAEs for early detection and management to improve NSCLC patients' quality of life.
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Affiliation(s)
- Jonathan N. Priantti
- School of Medicine, Federal University of Amazonas—UFAM, Manaus 69020-160, AM, Brazil;
| | - Maysa Vilbert
- Massachusetts General Hospital Cancer Center, Division of Hematology/Oncology, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | | | - Thiago Madeira
- School of Medicine, Federal University of Minas Gerais—UFMG, Belo Horizonte 30130-100, MG, Brazil
| | | | - Natasha B. Leighl
- Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada
| | - Ludimila Cavalcante
- Department of Medical Oncology and Hematology, University of Virginia Comprehensive Cancer Center, Charlottesville, VA 22903, USA
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Bizuayehu HM, Belachew SA, Jahan S, Diaz A, Baxi S, Griffiths K, Garvey G. Utilisation of endocrine therapy for cancer in Indigenous peoples: a systematic review and meta-analysis. BMC Cancer 2024; 24:882. [PMID: 39039483 PMCID: PMC11264465 DOI: 10.1186/s12885-024-12627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 07/10/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Indigenous peoples worldwide experience inequitable cancer outcomes, and it is unclear if this is underpinned by differences in or inadequate use of endocrine treatment (ET), often used in conjunction with other cancer treatments. Previous studies examining ET use in Indigenous peoples have predominately focused on the sub-national level, often resulting in small sample sizes with limited statistical power. This systematic review aimed to collate the findings ofarticles on ET utilisation for Indigenous cancer patients and describe relevant factors that may influence ET use. METHODS We conducted a systematic review and meta-analysis of studies reporting ET use for cancer among Indigenous populations worldwide. PubMed, Scopus, CINAHL, Web of Science, and Embase were searched for relevant articles. A random-effect meta-analysis was used to pool proportions of ET use. We also performed a subgroup analysis (such as with sample sizes) and a meta-regression to explore the potential sources of heterogeneity. A socio-ecological model was used to present relevant factors that could impact ET use. RESULTS Thirteen articles reported ET utilisation among Indigenous populations, yielding a pooled estimate of 67% (95% CI:54 - 80), which is comparable to that of Indigenous populations 67% (95% CI: 53 - 81). However, among studies with sufficiently sized study sample/cohorts (≥ 500), Indigenous populations had a 14% (62%; 95% CI:43 - 82) lower ET utilisation than non-Indigenous populations (76%; 95% CI: 60 - 92). The ET rate in Indigenous peoples of the USA (e.g., American Indian) and New Zealand (e.g., Māori) was 72% (95% CI:56-88) and 60% (95% CI:49-71), respectively. Compared to non-Indigenous populations, a higher proportion of Indigenous populations were diagnosed with advanced cancer, at younger age, had limited access to health services, lower socio-economic status, and a higher prevalence of comorbidities. CONCLUSIONS Indigenous cancer patients have lower ET utilisation than non-Indigenous cancer patients, despite the higher rate of advanced cancer at diagnosis. While reasons for these disparities are unclear, they are likely reflecting, at least to some degree, inequitable access to cancer treatment services. Strengthening the provision of and access to culturally appropriate cancer care and treatment services may enhance ET utilisation in Indigenous population. This study protocol was registered on Prospero (CRD42023403562).
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Affiliation(s)
- Habtamu Mellie Bizuayehu
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Sewunet Admasu Belachew
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia.
| | - Shafkat Jahan
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
| | - Abbey Diaz
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
- Menzies School of Health Research, Darwin, Australia
| | - Siddhartha Baxi
- GenesisCare Australia, Griffith University, Gold Coast, Australia
| | - Kalinda Griffiths
- Poche SA+NT, Flinders University, Darwin, Australia
- Menzies School of Health Research, Darwin, Australia
- Centre for Big Data Research in Health, UNSW, Sydney, Australia
| | - Gail Garvey
- First Nations Cancer and Wellbeing Research Program, School of Public Health, The University of Queensland, Brisbane, Australia
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Celis-Andrade M, Morales-González V, Rojas M, Monsalve DM, Acosta-Ampudia Y, Rodríguez-Jiménez M, Rodríguez Y, Ramírez-Santana C. Prevalence of latent and overt polyautoimmunity in type 1 diabetes: A systematic review and meta-analysis. Diabetes Metab Syndr 2024; 18:103087. [PMID: 39074403 DOI: 10.1016/j.dsx.2024.103087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/15/2024] [Accepted: 07/20/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND Patients afflicted by type 1 diabetes (T1D) exhibit polyautoimmunity (PolyA). However, the frequency and distribution of PolyA in T1D is still unknown. OBJECTIVE We conducted a systematic review and meta-analysis to define the prevalence of latent and overt PolyA in individuals with T1D. METHODS Following PRISMA guidelines, a comprehensive search across medical databases identified studies on latent and overt PolyA in T1D. Two researchers independently screened, extracted data, and assessed study quality. A random effects model was utilized to calculate the pooled prevalence, along with its corresponding 95 % confidence interval (CI), for latent PolyA and overt PolyA. Meta-regression analysis was conducted to study the effect of study designs, age, sex, and duration of disease on pooled prevalence. RESULTS A total of 158 articles, encompassing a diverse composition of study designs were scrutinized. The analysis included 270,890 individuals with a confirmed diagnosis of T1D. The gender was evenly distributed (50.30 % male). Notably, our analysis unveiled an overt PolyA prevalence rate of 8.50 % (95 % CI, 6.77 to 10.62), with North America having the highest rates (14.50 %, 95 % CI, 7.58 to 24.89). This PolyA profile was further characterized by a substantial incidence of concurrent autoimmune thyroid disease (7.44 %, 95 % CI, 5.65 to 9.74). Moreover, we identified a notable prevalence of latent PolyA in the T1D population, quantified at 14.45 % (95 % CI, 11.17 to 18.49) being most frequent in Asia (23.29 %, 95 % CI, 16.29 to 32.15) and Oceania (21.53 %, 95 % CI, 16.48 to 27.62). Remarkably, this latent PolyA phenomenon primarily featured an array of autoantibodies, including rheumatoid factor, followed by Ro52, thyroid peroxidase antibodies, and thyroglobulin antibodies. Duration of the disease was associated with a highest frequency of latent (β: 0.0456, P-value: 0.0140) and overt PolyA (β: 0.0373, P-value: 0.0152). No difference in the pooled prevalence by study design was observed. CONCLUSION This meta-analysis constitutes a substantial advancement in the realm of early detection of PolyA in the context of T1D. Individuals with T1D should regularly undergo assessments to identify potential concurrent autoimmune diseases, especially as they age.
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Affiliation(s)
- Mariana Celis-Andrade
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia
| | - Victoria Morales-González
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia
| | - Manuel Rojas
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia; Division of Rheumatology, Allergy and Clinical Immunology, University of California, Davis, CA, 95616, USA
| | - Diana M Monsalve
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia
| | - Yeny Acosta-Ampudia
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia
| | - Mónica Rodríguez-Jiménez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia
| | - Yhojan Rodríguez
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia; Department of Internal Medicine, University Hospital, Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
| | - Carolina Ramírez-Santana
- Center for Autoimmune Diseases Research (CREA), School of Medicine and Health Sciences, Universidad Del Rosario, Bogotá D.C., Colombia.
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Zhang Q, Jiao L, Chen Q, Bulstra CA, Geldsetzer P, de Oliveira T, Yang J, Wang C, Bärnighausen T, Chen S. COVID-19 antibody responses in individuals with natural immunity and with vaccination-induced immunity: a systematic review and meta-analysis. Syst Rev 2024; 13:189. [PMID: 39030630 PMCID: PMC11264703 DOI: 10.1186/s13643-024-02597-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/26/2024] [Indexed: 07/21/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has caused a large mortality and morbidity burden globally. For individuals, a strong immune response is the most effective means to block SARS-CoV-2 infection. To inform clinical case management of COVID-19, development of improved vaccines, and public health policy, a better understanding of antibody response dynamics and duration following SARS-CoV-2 infection and after vaccination is imperatively needed. METHODS We systematically analyzed antibody response rates in naturally infected COVID-19 patients and vaccinated individuals. Specifically, we searched all published and pre-published literature between 1 December 2019 and 31 July 2023 using MeSH terms and "all field" terms comprising "COVID-19" or "SARS-CoV-2," and "antibody response" or "immunity response" or "humoral immune." We included experimental and observational studies that provided antibody positivity rates following natural COVID-19 infection or vaccination. A total of 44 studies reporting antibody positivity rate changes over time were included. RESULTS The meta-analysis showed that within the first week after COVID-19 symptom onset/diagnosis or vaccination, antibody response rates in vaccinated individuals were lower than those in infected patients (p < 0.01), but no significant difference was observed from the second week to the sixth month. IgG, IgA, and IgM positivity rates increased during the first 3 weeks; thereafter, IgG positivity rates were maintained at a relatively high level, while the IgM seroconversion rate dropped. CONCLUSIONS Antibody production following vaccination might not occur as quickly or strongly as after natural infection, and the IgM antibody response was less persistent than the IgG response.
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Affiliation(s)
- Qiuying Zhang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lirui Jiao
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Qiushi Chen
- The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA, USA
| | - Caroline A Bulstra
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Im Neuenheimer Feld 130/3, Heidelberg, 69120, Germany
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Health Systems Innovation Lab, Harvard T.H. Chan School of Public Health, Harvard University, Cambridge, USA
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Stanford University, Stanford, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA, USA
| | - Tulio de Oliveira
- KwaZulu-Natal Research Innovation and Sequencing Platform, University of KwaZulu-Natal, Durban, South Africa
- Center for the AIDS Program of Research in South Africa (CAPRISA), Durban, South Africa
| | - Juntao Yang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Im Neuenheimer Feld 130/3, Heidelberg, 69120, Germany
| | - Simiao Chen
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Im Neuenheimer Feld 130/3, Heidelberg, 69120, Germany.
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Kantzanou M, Kostares E, Kostare G, Papagiannopoulou E, Kostares M, Tsakris A. Prevalence of Leishmaniasis among Blood Donors: A Systematic Review and Meta-Analysis. Diseases 2024; 12:160. [PMID: 39057131 PMCID: PMC11276524 DOI: 10.3390/diseases12070160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/07/2024] [Accepted: 07/15/2024] [Indexed: 07/28/2024] Open
Abstract
Our study seeks to provide a comprehensive assessment of leishmaniasis prevalence among blood donors, employing rigorous methodologies to inform public health initiatives and transfusion safety measures. A thorough literature search was conducted using electronic databases (Medline, Scopus, Web of Science, and Google Scholar) to identify the relevant studies reporting the prevalence of leishmaniasis among blood donors, gathering a wide range of studies encompassing different geographic locations and time periods. The pooled prevalence with a 95% confidence interval (CI) was estimated, and quality assessment, outlier analysis, and influential analysis were performed to ensure the robustness and validity of the findings. Our search and subsequent analyses led to the inclusion of thirty-five studies in our review. Using molecular diagnostic methods, the prevalence was estimated at 2.3% (95% CI 1-3.9%), while serological diagnostic methods indicated a higher prevalence rate of 4.5% (95% CI 2.8-6.7%). Notably, we observed significant heterogeneity among the included studies for each analysis. The observed heterogeneity highlights the need for future research to delve into the factors influencing leishmaniasis prevalence, with prospective and retrospective studies addressing the limitations identified in this review.
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Affiliation(s)
- Maria Kantzanou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Evangelos Kostares
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Georgia Kostare
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Evangelia Papagiannopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Michael Kostares
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
| | - Athanasios Tsakris
- Department of Anatomy, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece
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Seedat F, Evangelidou S, Abdellatifi M, Bouaddi O, Cuxart-Graell A, Edries H, Elafef E, Maatoug T, Ouahchi A, Mathilde Pampiri L, Deal A, Arias S, Abdelkhalek A, Arisha AH, Assarag B, Bani IA, Chaoui A, Chemao-Elfihri W, Hassouni K, Hilali M, Khalis M, Mansour W, Mtiraoui A, Wickramage K, Zenner D, Requena-Mendez A, Hargreaves S, Migrant Health Working Group MENA, Abdelkhalek A, Adam A, Aissa ABH, Agyemang C, Altyib S, Ardalan A, Belgacem HB, Belkhammar I, Calvot T, Casamitjana N, Ceretti L, Chavassieux N, Chrifi H, Douagi M, Elnil A, Fanjul G, Fouad FM, Hamed A, Ito C, Khelifi A, Makhlouf L, Mokni M, Olchini D, Oufkir T, Park N, Raffa G, Saidi W, Santafé S, Sironi A, Temimi F, Turki Z. Defining indicators for disease burden, health outcomes, policies and barriers and facilitators to health services for migrant populations in the Middle East and North African region: a protocol for a suite of systematic reviews. BMJ Open 2024; 14:e083813. [PMID: 39002961 PMCID: PMC11255408 DOI: 10.1136/bmjopen-2023-083813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 06/11/2024] [Indexed: 07/15/2024] Open
Abstract
INTRODUCTION The Middle East and North African (MENA) region is characterised by high and complex migration flows, yet little is known about the health of migrant populations, their levels of underimmunisation and access to healthcare provision. Data are needed to support regional elimination and control targets for key diseases and the design and delivery of programmes to improve health outcomes in these groups. This protocol describes a suite of seven systematic reviews that aim to identify, appraise and synthesise the available evidence on the burden and health outcomes, policies and access (barriers and facilitators) related to these mobile populations in the region. METHODS Seven systematic reviews will cover three questions to explore the: (1) burden and health outcomes, (2) policies and (3) healthcare barriers and facilitators for the following seven disease areas in migrants in the MENA region: tuberculosis, HIV and hepatitis B and C, malaria and neglected tropical diseases, diabetes, mental health, maternal and neonatal health, and vaccine-preventable diseases. We will search electronic databases for studies in any language (year 2000-2023), reference-check relevant publications and cross-check included studies with experts. We will search for grey literature by hand searching key databases and websites (including regional organisations and MoH websites) for country-specific guidelines and talking to our network of experts for local and regional reports and key datasets. We will assess the studies and policies for their quality using appropriate tools. We will meta-analyse the data by disease outcome if they are of sufficient volume and similarity. Where meta-analysis is not possible and where data are on policy or access, we will narratively synthesise the evidence using summary tables, figures and text. DISSEMINATION We anticipate disseminating the findings through peer-reviewed publications, conferences and other formats relevant to all stakeholders. We are following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and protocols will be registered on International Prospective Register of Systematic Reviews.
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Affiliation(s)
- Farah Seedat
- St George's University of London Institute for Infection and Immunity, London, UK
| | | | - Moudrick Abdellatifi
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
| | - Oumnia Bouaddi
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
| | | | - Hassan Edries
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
| | - Eman Elafef
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
| | | | | | | | - Anna Deal
- St George's University of London Institute for Infection and Immunity, London, UK
- London School of Hygiene & Tropical Medicine, London, UK
| | - Sara Arias
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
| | | | | | | | | | | | | | - Kenza Hassouni
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
| | - Mahmoud Hilali
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
| | - Mohamed Khalis
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
| | | | | | | | | | - Ana Requena-Mendez
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Karolinska Institute, Stockholm, Sweden
| | - Sally Hargreaves
- St George's University of London Institute for Infection and Immunity, London, UK
| | | | - MENA Migrant Health Working Group
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Adel Abdelkhalek
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Asad Adam
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Adnene Ben Haj Aissa
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Charles Agyemang
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Salma Altyib
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Ali Ardalan
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Hanen Ben Belgacem
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Imane Belkhammar
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Thomas Calvot
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Nuria Casamitjana
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Luciana Ceretti
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Nelly Chavassieux
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Hassan Chrifi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Mohamed Douagi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Algdail Elnil
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Gonzalo Fanjul
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Fouad M Fouad
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Ahmed Hamed
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Chiaki Ito
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Abdedayem Khelifi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Lora Makhlouf
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Maissa Mokni
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Davide Olchini
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Tarik Oufkir
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Nasong Park
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Giuseppe Raffa
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Wafa Saidi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Sandra Santafé
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Alice Sironi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Fatma Temimi
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
| | - Zeineb Turki
- St George's University of London Institute for Infection and Immunity, London, UK
- Barcelona Institute for Global Health, Barcelona, Catalunya, Spain
- Université Mohammed VI des Sciences et de la Santé, Casablanca, Casablanca-Settat, Morocco
- University of Gezira, Wad Madani, Sudan
- Badr University in Cairo, Cairo, Egypt
- University of Sousse, Sousse, Tunisia
- London School of Hygiene & Tropical Medicine, London, UK
- Ecole Nationale de Santé Publique, Rabat, Morocco
- Ajman University, Ajman, UAE
- Ministère de la Santé, Rabat, Morocco
- Higher Institute of Nursing Professions and Health Techniques, Ministry of Health and Social Protection, Rabat, Morocco
- International Organization for Migration, Berlin, Germany
- Queen Mary University of London, London, UK
- Karolinska Institute, Stockholm, Sweden
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Mac Curtain BM, Qian W, O'Mahony A, Deshwal A, Mac Curtain RD, Temperley HC, Sullivan NO, Ng ZQ. "Textbook outcome(s)" in colorectal surgery: a systematic review and meta-analysis. Ir J Med Sci 2024:10.1007/s11845-024-03747-w. [PMID: 38985416 DOI: 10.1007/s11845-024-03747-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Textbook outcome (TO) is a composite measure used in surgery to evaluate post operative outcomes. No review has synthesised the evidence in relation to TO regarding the elements surgeons are utilising to inform their TO composite measure and the rates of TO achieved. METHODS Our systematic review and meta analysis was conducted in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) recommendations. PubMed, EMBASE, and Cochrane central registry of controlled trials were searched up to 8th November 2023. Pooled proportions of TO, clinical factors considered and risk factors in relation to TO are reported. RESULTS Fifteen studies with 301,502 patients were included in our systematic review while fourteen studies comprising of 247,843 patients were included in our meta-analysis. Pooled rates of TO achieved were 55% with a 95% confidence interval (95% CI) of 54-55%. When stratified by elective versus mixed case load, rates were 56% (95% CI 49-62) and 54% (95% CI 50-58), respectively. Studies reported differing definitions of TO. Reported predictors of achieving TO include age, left sided surgery and elective nature. CONCLUSIONS TO is achieved, on average in 55% of reported cases and it may predict short and long term post operative patient outcomes. This study did not detect a difference in rates between elective versus mixed case load TO proportions. There is no standardised definition in use of TO. Standardisation of the composite is likely required to enable meaning comparison using TO in the future and a Delphi consensus is warranted.
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Affiliation(s)
| | - Wanyang Qian
- Dept of General Surgery, St John of God Midland Hospital, Midland, WA, Australia
| | - Aaron O'Mahony
- Department of Surgery, University Hospital Limerick, Limerick, Ireland
| | - Avinash Deshwal
- Department of Surgery, Fiona Stanley Hospital, Perth, WA, Australia
| | | | - Hugo C Temperley
- Department of Surgery, St James' University Hospital, Dublin, Ireland
| | - Niall O Sullivan
- Department of Surgery, St James' University Hospital, Dublin, Ireland
| | - Zi Qin Ng
- Department of General Surgery, Royal Perth Hospital, Perth, WA, Australia
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Vesterager JD, Torngren H, Elsoe R, Larsen P. Complications following surgical treatment of patella fractures - a systematic review and proportional meta-analysis. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02592-x. [PMID: 38980395 DOI: 10.1007/s00068-024-02592-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Accepted: 06/18/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE The aim of this systematic review and proportional meta-analysis was to identify complications of surgical treatment of patella fractures and to estimate their incidence. We extended existing knowledge on this topic by including several more recent and large-scale studies. METHODS This systematic review and meta-analysis were performed in accordance with the Cochrane Handbook for systematic reviews of interventions. After searching in PubMed, MEDLINE, EMBASE, Cochrane Library, and OpenGrey, all studies after 2000, with study populations > 100 patients, including only patients > 18 years and follow-up > 30 days, were included. Two independent authors assessed the literature search and extracted the data. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. The meta-analysis was performed on complications pooled in infections, nonunion, symptomatic implant removal, and fixation failure. RESULTS The data on complications were available from 14 studies, including a pool of 5659 patients. The most common complication was symptomatic implant removal, affecting. CONCLUSION Surgically, treatment of patella fractures was associated with a high risk of complications. The most common complication was symptomatic implant removal, affecting 29.6% of patients. Other complications stated were fixation failure 5.2%, infections 3.1% and nonunion 1.7%.
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Affiliation(s)
- Jeppe Damgren Vesterager
- Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
- Department of Orthopedic Trauma Surgery, Aalborg University Hospital, 18-22 Hobrovej, Aalborg, DK-9000, Denmark.
| | - Hannes Torngren
- Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Rasmus Elsoe
- Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - Peter Larsen
- Department of Orthopedic Surgery, Aalborg University Hospital, Aalborg, Denmark
- Department of Physiotherapy, Aalborg University Hospital, Aalborg, Denmark
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Ottiger M, Poppele I, Sperling N, Schlesinger T, Müller K. Work ability and return-to-work of patients with post-COVID-19: a systematic review and meta-analysis. BMC Public Health 2024; 24:1811. [PMID: 38973011 PMCID: PMC11229229 DOI: 10.1186/s12889-024-19328-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 07/01/2024] [Indexed: 07/09/2024] Open
Abstract
BACKGROUND In addition to several sequelae of post-COVID-19, individuals also experience significant limitations in work ability, resulting in negative consequences for the return-to-work (RTW) process. This systematic review and meta-analysis were conducted to assess the impact of post-COVID-19 on work ability and RTW of individuals previously infected with SARS-CoV-2. METHODS Studies on the work ability and RTW of patients with post-COVID-19 (more than 12 weeks after an acute SARS-CoV-2 infection) were regarded eligible for inclusion. Systematic search of literature was performed up to March 2023 using five databases (MEDLINE, EMBASE, CINAHL, CENTRAL and WHO COVID 19). Study selection followed the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) Statement. A meta-analysis estimated the overall success rate of RTW. The risk of bias of the included studies was evaluated with the Newcastle Ottawa Scale (NOS). RESULTS 19 relevant studies, published between 2021 and 2023, were included in the systematic review, involving 21.155 patients from 14 different countries. The findings indicate that a significant proportion of individuals with post-COVID-19 experience persistent symptoms and functional impairments, with fatigue being the most prominent symptom. These persistent symptoms can have a considerable (negative) impact on individuals' physical and psychological capacity to participate in work-related activities, leading to lower work ability and increased absenteeism. The RTW for post-COVID-19 patients is complex, with approximately 60.9% of patients successfully returning to work after 12 or more weeks following SARS-CoV-2 infection. Among those who successfully returning to work, a considerable number need modifications in their work duties or hours to cope with residual impairments. Factors such as workplace accommodations, supportive policies, and occupational rehabilitation programs play a crucial role in facilitating successful RTW. CONCLUSIONS The systematic review underscores the substantial impact of post-COVID-19 on work-related outcomes. The implications of this research highlight the need for healthcare providers, employers, and policymakers to collaborate in creating inclusive work environments and implementing tailored rehabilitation programs to support individuals recovering from post-COVID-19. Further research should focus on long-term follow-up studies with mixed methods to gain a more comprehensive understanding of the long-term consequences of post-COVID-19 on work ability and RTW outcomes. PROSPERO REGISTRATION NUMBER CRD42023385436.
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Affiliation(s)
- Marcel Ottiger
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107, Chemnitz, Germany.
| | - Iris Poppele
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107, Chemnitz, Germany
| | - Naveen Sperling
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107, Chemnitz, Germany
| | - Torsten Schlesinger
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107, Chemnitz, Germany
| | - Katrin Müller
- Institute of Human Movement Science and Health, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, 09107, Chemnitz, Germany
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Hoff CO, Manzi J, Lazar Neto F, Ferrarotto R. Vascular Endothelial Growth Factor Receptor Inhibitors for Recurrent or Metastatic Adenoid Cystic Carcinoma: A Systematic Review and Meta-Analysis. JAMA Otolaryngol Head Neck Surg 2024; 150:587-597. [PMID: 38814585 PMCID: PMC11140580 DOI: 10.1001/jamaoto.2024.1177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/02/2024] [Indexed: 05/31/2024]
Abstract
Importance There is no systemic therapy for recurrent or metastatic adenoid cystic carcinoma (ACC) approved by the US Food and Drug Administration. Objective To examine the efficacy, safety, and tolerability of vascular endothelial growth factor receptor (VEGFR) inhibitors in recurrent or metastatic ACC. Data Sources PubMed, Embase, and Cochrane Library were systematically searched for studies of VEGFR inhibitors in recurrent or metastatic ACC from database inception to August 31, 2023. Study Selection Inclusion criteria were prospective clinical trials of recurrent or metastatic ACC treated with VEGFR inhibitors, reporting at least 1 outcome of interest specifically for ACC. Of 1963 identified studies, 17 (0.9%) met inclusion criteria. Data Extraction and Synthesis The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) reporting guideline was followed to extract data. Data were pooled using a random-effects generalized linear mixed model with 95% CIs. Main Outcomes and Measures The primary efficacy outcome was best overall response to VEGFR inhibitors, including objective response, stable disease, or progressive disease (PD). Safety and tolerability outcomes included incidence of grade 3 or higher adverse events, rates of exit from trial due to PD or drug-related toxic effects, and dose reduction rate (DRR). Results A total of 17 studies comprising 560 patients with recurrent or metastatic ACC treated with 10 VEGFR inhibitors were included. The objective response rate was 6% (95% CI, 3%-12%; I2 = 71%) and stable disease was the most frequent best overall response (82%; 95% CI, 74%-87%; I2 = 67%). The 6-month disease control (defined as objective response and stable disease) rate was 54% (95% CI, 45%-62%; I2 = 52%). The rate of grade 3 or higher adverse events was 53% (95% CI, 42%-64%; I2 = 81%) and of DRR was 59% (95% CI, 40%-76%). Most patients (57%; 95% CI, 44%-70%; I2 = 83%) continued therapy until PD; 21% (95% CI, 15%-28%; I2 = 62%) of patients suspended therapy for toxic effects. In subgroup analysis by specific VEGFR inhibitor, the objective response rate was 14% (95% CI, 7%-25%; I2 = 0%), stable disease rate was 76% (95% CI, 63%-85%; I2 = 0%), proportion treated until PD was 61% (95% CI, 14%-94%; I2 = 94%), and DRR was 78% (95% CI, 66%-87%; I2 = 39%) with lenvatinib. Corresponding axitinib results were objective response rate of 8% (95% CI, 4%-15%; I2 = 0%) and stable disease rate of 85% (95% CI, 72%-92%; I2 = 69%), with 73% (95% CI, 63%-82%; I2 = 0%) of patients treated until PD, and the DRR was 22% (95% CI, 12%-38%; I2 = 77%). Rivoceranib had the highest objective response rate (24%; 95% CI, 7%-57%) but high heterogeneity among studies (I2 = 95%) and the lowest rate of patients who continued therapy until PD (35%; 95% CI, 20%-55%; I2 = 90%). Conclusions and Relevance This systematic review and meta-analysis found that VEGFR inhibitors were associated with high rates of disease stabilization in recurrent or metastatic ACC. Of 10 included VEGFR inhibitors, lenvatinib and axitinib were associated with the best combined and consistent efficacy, safety, and tolerability profiles, substantiating their inclusion in treatment guidelines.
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Affiliation(s)
- Camilla O. Hoff
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
- School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Joao Manzi
- School of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Felippe Lazar Neto
- Instituto do Cancer do Estado de Sao Paulo, University of Sao Paulo, Sao Paulo, Brazil
| | - Renata Ferrarotto
- Department of Thoracic Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston
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Bonilla-Aldana DK, Bonilla-Aldana JL, Ulloque-Badaracco JR, Al-Kassab-Córdova A, Hernandez-Bustamante EA, Alarcon-Braga EA, Benites-Zapata VA, Copaja-Corzo C, Silva-Cajaleon K, Rodriguez-Morales AJ. Mpox infection in animals: A systematic review and meta-analysis. J Infect Public Health 2024; 17:102431. [PMID: 38820901 DOI: 10.1016/j.jiph.2024.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/26/2024] [Accepted: 04/17/2024] [Indexed: 06/02/2024] Open
Abstract
Mpox is a zoonotic disease that became epidemic in multiple countries in 2022. There is a lack of published systematic reviews on natural animal infection due to Mpox. We performed a systematic literature review with meta-analysis to assess animal Mpox prevalence. We performed a random-effects model meta-analysis to calculate the pooled prevalence and 95% confidence interval (95%CI) for prevalence studies. After the screening, 15 reports were selected for full-text assessment and included in qualitative and quantitative analyses. Ten reports assessed Mpox infection by molecular or serological tests (n = 2680), yielding a pooled prevalence of 16.0% (95%CI: 3.0-29.0%) for non-human primates; 8.0% (95%CI: 4.0-12.0%) for rodents and 1.0% (95%CI: 0.0-3.0%) for shrews. Further studies in other animals are required to define the extent and importance of natural infection due to Mpox. These findings have implications for public human and animal health. OneHealth approach is critical for prevention and control.
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Affiliation(s)
| | - Jorge Luis Bonilla-Aldana
- Grupo de Investigación en Ciencias Animales Macagual, Universidad de La Amazonia, Florencia, Caquetá 180002, Colombia
| | | | - Ali Al-Kassab-Córdova
- Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru
| | - Enrique A Hernandez-Bustamante
- Grupo Peruano de Investigación Epidemiológica, Unidad para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima 15012, Peru; Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, Trujillo 13011, Peru
| | | | | | - Cesar Copaja-Corzo
- Unidad de Investigación para la generación y síntesis de evidencias en salud, Universidad San Ignacio de Loyola, Lima 15012, Peru; Servicio de infectología, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima 15072, Peru
| | - Kenneth Silva-Cajaleon
- Faculties of Environmental and Health Sciences, Universidad Científica del Sur, Lima 4861, Peru
| | - Alfonso J Rodriguez-Morales
- Faculties of Environmental and Health Sciences, Universidad Científica del Sur, Lima 4861, Peru; Grupo de Investigación Biomedicina, Faculty of Medicine, Fundación Universitaria Autónoma de las Américas-Institución Universitaria Visión de las Américas, Pereira, 660003 Risaralda, Colombia; Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Beirut, Lebanon
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Sutton S, Finkelhor D. Perpetrators' Identity in Online Crimes Against Children: A Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2024; 25:1756-1768. [PMID: 37609835 DOI: 10.1177/15248380231194072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Public and police concern about internet crimes against children has been primarily typified as a stranger danger problem. However, existing research suggests a variety of perpetrator ages and relationships to the victim. A more accurate estimate will help inform prevention efforts. This study provides a meta-analysis examining the identity of perpetrators in internet crimes against children. Databases were searched for published and unpublished studies using a detailed search strategy. In total, 32 studies met full inclusion criteria. Inclusion criteria was the following: (1) the victim sample consisted of children under the age of 18 years or young adults (18-25) asked to respond retrospectively; (2) the study victims experienced abuse through the use of technology; (3) the study reported the identity of the perpetrator, either the relationship to the victim or the age of the perpetrator; (4) the study was available in English. The overall proportion of offenders under the age of 18 as a proportion of all identified offenders was 44% (95% CI: 0.28-0.60). The overall proportion of acquaintance and family offenders as a proportion of all identified offenders was 68% (95% CI: 0.62-0.75). Between study variability was explained by data source, with higher proportion of juvenile offenders in studies using survey data. This meta-analysis confirms that most perpetrators of online crimes against children are not strangers to their victims and a large portion of perpetrators are juveniles. Prevention education needs to focus more on inappropriate behavior from anyone in addition to the dangers about communicating with strangers.
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Abatzis-Papadopoulos M, Tigkiropoulos K, Nikas S, Sidiropoulou K, Alexou C, Kostopoulou O, Stavridis K, Karamanos D, Lazaridis I, Saratzis N. Endograft Anaconda in Endovascular Aneurysm Repair: A Systematic Review of Literature and Meta-Analysis. Ann Vasc Surg 2024; 104:93-109. [PMID: 37468059 DOI: 10.1016/j.avsg.2023.06.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 06/16/2023] [Accepted: 06/25/2023] [Indexed: 07/21/2023]
Abstract
BACKGOUND The number of endovascular abdominal aortic aneurysm repairs (EVARs) has surpassed the number of open surgical repair of AAAs worldwide with a great variety of endografts being available. The aim of this study is to conduct a systematic review of the literature and meta-analysis of studies reporting patients with infrarenal abdominal aortic aneurysm (AAA) subjected to EVAR with the Anaconda endograft. METHODS We performed a systematic review of multiple electronic databases for studies including patients with infrarenal AAA who were subjected to elective EVAR with Anaconda endograft exclusively. We conducted a proportional meta-analysis cumulating the results of the included studies. The endpoints were first month overall mortality, first and second-year survival after EVAR, AAA-related deaths, incidence of endoleaks, endograft migration, endograft occlusion, open conversion, and primary and secondary technical success. The mean value for each separate studied factor was calculated, and the respective percentage or incidence was extracted so that it can be compared to endograft outcome studies in the literature. We assessed the methodologic quality of studies by using the Briggs Institute critical appraisal tool. RESULTS Seven observational studies were found including 954 patients (males 91.9%, mean age 73.38 ± 6.97 years). The mean transverse diameter of AAAs was 56.83 ± 9.97 mm. The mean proximal aortic neck diameter and length were 23.06 ± 3.33 mm and 24.14 ± 12.16 mm, respectively. Increased aortic neck calcification and aortic neck thrombus were present in 12.5% of patients. The 30-day overall mortality post-EVAR was 1.3%, 1 and 2-year survival rates were 95.9% and 91.4%, respectively. The mean follow-up period in the studies was 46.59 ± 15.5 months. AAA-related mortality was 1.3%. Primary technical success was 97.9% and secondary success was 99.3%. Open conversion was required in 3.4% of all patients (0.6% during the primary operation [Prim. Op]). The most common endoleak was type II, reported in 17.4% of all patients. Early type Ia endoleak was reported in 1.5% of patients and late type Ia in 1.7%. Overall, 2 endoleaks type III and 1 type IV were reported. Endograft migration occurred in 1.7% of patients. Main body and/or one/both iliac legs thrombotic occlusion was found totally in 7.6% of patients (5 main body occlusions and 64 iliac leg occlusions). CONCLUSIONS The use of Anaconda endograft in electively treated patients with infrarenal AAAs presented good results with high technical success and low postoperative and mid-term complications, except for an increased incidence of stent-graft thrombosis, which seems to be the "Achilles heel" of the device.
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Affiliation(s)
- Manolis Abatzis-Papadopoulos
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece.
| | - Konstantinos Tigkiropoulos
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Spyridon Nikas
- Radiology Department, General Hospital of Veroia, Veroia, Greece
| | - Katerina Sidiropoulou
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Christina Alexou
- Department of Nursing (Thessaloniki), School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - Olympia Kostopoulou
- Internal Medicine Department, General Hospital of Katerini, Katerini, Greece
| | - Kyriakos Stavridis
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Dimitrios Karamanos
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Ioannis Lazaridis
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
| | - Nikolaos Saratzis
- Vascular Unit, 1st University Surgical Department, Papageorgiou General Hospital, Aristotle University, Thessaloniki, Greece
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Lari A, Esmaeil A, AlSalem Y, Alabbad F, Shahin M, Aoude A. Comparative Outcomes and Failure Rates of Total Femur Replacement in Oncologic and Nononcologic Indications: A Systematic Review and Meta-analysis. JBJS Rev 2024; 12:01874474-202407000-00001. [PMID: 38968379 PMCID: PMC11221795 DOI: 10.2106/jbjs.rvw.24.00022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/07/2024]
Abstract
BACKGROUND Total femur replacement (TFR) has become increasingly significant as a salvage procedure for both oncologic reconstruction and complex nononcologic conditions such as revision arthroplasty. Despite its effectiveness in limb salvage, TFR is associated with high complication and failure rates, which vary depending on the underlying indication. METHODS This systematic review and meta-analysis adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search of MEDLINE, EMBASE, Web of Science, and Cumulative Index to Nursing and Allied Health Literature databases was conducted, focusing on studies that reported outcomes of TFR in oncologic and nononcologic cases. Primary outcomes included failure mode and rates according to the Henderson classification, functional outcomes scores, and mobility status. Data were analyzed using random-effects models and generalized linear mixed models. RESULTS A total of 35 studies involving 1,002 patients were included. The majority of TFRs were performed for oncologic reasons (63.7%). The mean Musculoskeletal Tumor Society (MSTS) score was 66%, with a limb salvage rate of 89%. The meta-analysis revealed a combined failure rate of 34%. For type 4 failures (infection), nononcologic patients exhibited a significantly higher rate at 18% (95% confidence interval [CI], 12%-26%, I2 = 46%, p < 0.01) compared with 8% in oncologic patients (95% CI, 6%-12%, I2 = 0%). Regarding combined types 1 to 4 failures, oncologic patients had a rate of 20% (95% CI, 25%-52%, I2 = 60%), whereas nononcologic patients faced a higher rate of 37% (95% CI, 12%-26%, I2 = 63%) (p < 0.05), indicating a significant difference. There were no significant differences in the MSTS score. In addition, there were no notable differences when comparing failure modes 1, 2, and 3 independently. Mobility analysis showed that approximately 70% of patients required walking aids after surgery. CONCLUSION TFR offers a valuable limb salvage option in both oncologic and nononcologic scenarios, despite its high failure rates. Although functional outcomes were similar between groups, the higher failure rate in nononcologic cases and the poor overall quality of evidence warrant further comprehensive assessments into predictors of outcomes to optimize results. LEVEL OF EVIDENCE Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ali Lari
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Ali Esmaeil
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Yousef AlSalem
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Fahad Alabbad
- Department of Orthopedic Surgery, AlRazi National Orthopedic Hospital, Kuwait
| | - Maged Shahin
- Department of Orthopedic Surgery, AlFarwaniya Hospital, Kuwait
| | - Ahmed Aoude
- McGill University Health Centre, Montreal, Quebec, Canada
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Sheu JY, Chang LY, Chen JY, Chuang MH, Wu VC, Chueh JS. The Prevalence of Obstructive Sleep Apnea in Patients With Primary Aldosteronism. J Clin Endocrinol Metab 2024:dgae415. [PMID: 38941133 DOI: 10.1210/clinem/dgae415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Indexed: 06/29/2024]
Abstract
CONTEXT Investigating the co-occurrence of obstructive sleep apnea (OSA) and primary aldosteronism (PA) is crucial for understanding their interrelation. OBJECTIVE This work aimed to evaluate the prevalence of OSA in individuals diagnosed with PA and to assess the prevalence of PA within the OSA population, with a specific focus on hypertensive individuals. METHODS An exhaustive search was performed across PubMed, Embase, CINAHL, Scopus, and Web of Science up to September 2023, without restrictions on language or publication date. Studies were selected based on their focus on the prevalence of OSA in PA patients and vice versa, specifically in hypertensive individuals. Data were extracted using standard guidelines, focusing on patient characteristics, prevalence rates, and other relevant clinical parameters. RESULTS Proportional meta-analysis using a random-effects model revealed a 59.8% prevalence of OSA in hypertensive PA patients, with 45.4% exhibiting moderate-to-severe OSA. Meta-regression showed no significant effect of age, sex, body mass index, antihypertensive medication, systolic blood pressure, diastolic blood pressure, or serum potassium on OSA prevalence. However, a significant positive association was found with the glomerular filtration rate (GFR) (P < .001). Subgroup analysis also revealed that a hyperfiltration rate (GFR ≥ 100 mL/min per 1.73 m2) may be associated with a higher prevalence of OSA (71%, P value for interaction < .01). Among hypertensive OSA patients, 11.2% had PA. CONCLUSION A substantial prevalence of OSA in individuals with PA was identified, demonstrating a complex interplay between these conditions in hypertensive patients. Notably, the prevalence of OSA was significantly associated with kidney hyperfiltration.
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Affiliation(s)
- Jia-Yuh Sheu
- Department of Urology, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Li-Yang Chang
- College of Medicine, National Taiwan University, Taipei 106319, Taiwan
| | - Jui-Yi Chen
- Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan
- Department of Health and Nutrition, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Min-Hsiang Chuang
- Division of Nephrology, Department of Internal Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan
| | - Vin-Cent Wu
- Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
- Primary Aldosteronism Center of National Taiwan University Hospital, Taipei 100225, Taiwan
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Jeff S Chueh
- Department of Urology, National Taiwan University Hospital, Taipei 100225, Taiwan
- Primary Aldosteronism Center of National Taiwan University Hospital, Taipei 100225, Taiwan
- Taiwan Primary Aldosteronism Investigation (TAIPAI) Study Group, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
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Kungwengwe G, Gowthorpe C, Ali SR, Warren H, Drury DJ, Ang KL, Gibson JAG, Dobbs TD, Whitaker IS. Prevalence and odds of anxiety and depression in cutaneous malignant melanoma: a proportional meta-analysis and regression. Br J Dermatol 2024; 191:24-35. [PMID: 38197404 DOI: 10.1093/bjd/ljae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 01/04/2024] [Accepted: 01/05/2024] [Indexed: 01/11/2024]
Abstract
BACKGROUND The psychological burden of cutaneous malignant melanoma (CM) is all-encompassing, affecting treatment adherence, recurrence and mortality. However, the prevalence and risk factors of anxiety and depression in CM remain unclear. OBJECTIVES To establish a benchmark pooled prevalence of anxiety and depression in CM, to provide magnitudes of association for clinical, therapeutic and demographic correlates, and to elucidate temporal trends in anxiety and depression from the time of diagnosis. METHODS This review followed the MOOSE guidelines. MEDLINE, Embase, PsychINFO, Web of Science and the Cochrane Library were queried from database inception to 24 August 2023. Study selection, data extraction and quality assessment were performed by two independent authors, utilizing both the Joanna Briggs Institute (JBI) and National Institutes of Health risk-of-bias tools for the latter. The GRADE approach was used to rate the certainty of evidence. Prevalence rates, 95% confidence intervals (CIs) and prediction intervals (PIs) were derived using a random-effects model and estimating between- and within-study variance. RESULTS Nine longitudinal and 29 cross-sectional studies were included (7995 patients). Based on the JBI and NIH tools, respectively, quality assessment found 20 and 17 to be at low risk of bias, 12 and 15 to be at moderate risk and 6 and 5 to be at high risk of bias. The prevalence of anxiety [30.6% (95% CI 24.6-37.0; PI 18-47%)] and depression [18.4% (95% CI 13.4-23.9; PI 10-33%)] peaked during treatment, declining to pretreatment levels after 1 year [anxiety: 48% vs. 20% (P = 0.005); depression: 28% vs. 13% (P = 0.03)]. Female sex [odds ratio (OR) 1.8, 95% CI 1.4-2.3; P < 0.001], age < 60 years (OR 1.5, 95% CI 1.2-2.0; P = 0.002) and low educational level (OR 1.5, 95% CI 1.2-2.0; P < 0.001) were likely to result in a large increase in the odds of anxiety. Depression was 12.3% higher in those with stage IV vs. those with stage I CM (P = 0.05). Relative to immune checkpoint inhibition, the rates of depression were 22% (P = 0.002) and 34% (P < 0.001) higher among patients with advanced-stage CM receiving interferon-α and chemotherapy, respectively. A significant reduction in self-reported depression scores was demonstrated over time (P = 0.003). CONCLUSIONS Notably, anxiety and depression in CM affect women, those younger than 60 years of age and the less educated, with up to 80% higher odds of anxiety in these groups. Anxiety and depression surge during chemotherapy and interferon treatment, especially in advanced CM. Our findings facilitate risk stratification and underscore the need for multidisciplinary vigilance.
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Affiliation(s)
- Garikai Kungwengwe
- Chelsea and Westminster Hospital, Imperial College Healthcare Trust, London, UK
| | | | - Stephen R Ali
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | | | - Damien J Drury
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | | | - John A G Gibson
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - Thomas D Dobbs
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
| | - Iain S Whitaker
- Reconstructive Surgery and Regenerative Medicine Research Group, Swansea University, UK
- Welsh Centre for Burns and Plastic Surgery, Morriston Hospital, Swansea, UK
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Lari A, Esmaeil A, Marples M, Watts A, Pincher B, Sharma H. Single versus two-stage management of long-bone chronic osteomyelitis in adults: a systematic review and meta-analysis. J Orthop Surg Res 2024; 19:351. [PMID: 38877562 PMCID: PMC11177413 DOI: 10.1186/s13018-024-04832-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/02/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Chronic osteomyelitis is a debilitating bone infection, characterized by a persistent infection over months to years, poses diagnostic and therapeutic challenges due to its insidious nature and potential for severe bone and soft tissue destruction. This systematic review and meta-analysis aims to review the literature on the treatment of chronic osteomyelitis in long bones and assess cure rates in single versus two-stage surgery. METHODS Following the PRISMA guidelines and registered with PROSPERO (ID: CRD42021231237), this review included studies that reported on the management of chronic osteomyelitis in long bones using either a planned one-stage or two-stage surgical approach in adult patients. Databases searched included Medline, Embase, Web of Science, CINAHL, HMIC, and AMED, using keywords related to osteomyelitis, long bones, and surgical management. Eligibility criteria focused on adults with chronic osteomyelitis in long bones, with outcomes reported after a minimum follow-up of 12 months. The meta-analysis utilized the random-effects model to pool cure rates. RESULTS The analysis included 42 studies with a total of 1605 patients. The overall pooled cure rate was 91% (CI 95%) with no significant difference observed between single-stage and two-stage surgeries (X2 = 0.76, P > 0.05). Complications were reported in 26.6% of cases in single-stage procedures and 27.6% in two-stage procedures, with prolonged wound drainage noted as a common issue. Dead space management techniques varied across studies, with antibiotic-loaded calcium sulphate beads used in 30.4% of cases. CONCLUSION This meta-analysis reveals no significant difference in cure rates between single and two-stage surgical treatments for chronic osteomyelitis in long bones, supporting the efficacy of both approaches. The current treatment strategy should include a combination of debridement, dead space management using local and systematic antibiotics and soft tissue reconstruction if necessary.
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Affiliation(s)
- Ali Lari
- Al-Razi Orthopedic Hospital, Kuwait, Kuwait.
| | | | | | - Arun Watts
- Hull University Teaching Hospitals, Hull, UK
| | | | - Hemant Sharma
- Hull York Medical School, University of Hull, Hull Limb Reconstruction & Bone Infection Unit, Hull University Teaching Hospitals, Hull, UK
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Saatci D, Zhu C, Harnden A, Hippisley-Cox J. Presentation of B-cell lymphoma in childhood and adolescence: a systematic review and meta-analysis. BMC Cancer 2024; 24:718. [PMID: 38862882 PMCID: PMC11167855 DOI: 10.1186/s12885-024-12372-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/10/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND The diagnosis of B-cell lymphoma, one of the commonest cancers seen in childhood and adolescence, is challenging. There is a crucial need to identify and delineate the prevalence of associated symptoms in order to improve early diagnosis. AIMS To identify clinical presentations associated with childhood and adolescent B-cell lymphomas and estimate symptom prevalence. METHODS A systematic review of observational studies and meta-analysis of proportions was carried out. Medline and EMBASE were systematically searched, with no language restrictions, from inception to 1st August 2022. Observational studies with at least 10 participants, exploring clinical presentations of any childhood and adolescent lymphoma, were selected. Proportions from each study were inputted to determine the weighted average (pooled) proportion, through random-effects meta-analysis. RESULTS Studies reported on symptoms, signs and presentation sites at diagnosis of 12,207 children and adolescents up to the age of 20. Hodgkin's lymphoma most frequently presented with adenopathy in the head-and-neck region (79% [95% CI 58%-91%]), whilst non-Hodgkin's lymphoma presented abdominally (55% [95% CI 43%-68%]). Symptoms associated with lymphoma included cervical lymphadenopathy (48% [95% CI 20%-77%]), peripheral lymphadenopathy (51% [95% CI 37%-66%]), B-symptoms (40% [95% CI 34%-44%]), fever (43% [95% CI 34%-54%]), abdominal mass (46% [95% CI 29%-64%]), weight loss (53% [95% CI 39%-66%]), head-and-neck mass (21% [95% CI 6%-47%]), organomegaly (29% [95% CI 23%-37%]), night sweats (19% [95% CI 10%-32%]), abdominal pain (28% [95% CI 15%-47%]), bone pain (17% [95% CI 10%-28%]) and abnormal neurology (11% [95% CI 3%-28%]). CONCLUSION This systematic review and meta-analysis of proportions provides insight into the heterogeneous clinical presentations of B-cell lymphoma in childhood and adolescence and provides estimates of symptom prevalence. This information is likely to increase public and clinical awareness of lymphoma presentations and aid earlier diagnosis. This review further highlights the lack of studies exploring childhood and adolescent lymphoma presentations in primary care, where patients are likely to present at the earliest stages of their disease.
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Affiliation(s)
- Defne Saatci
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK.
| | - C Zhu
- UCL Cancer Institute, University College London, London, UK
| | - A Harnden
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
| | - J Hippisley-Cox
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford, OX2 6GG, UK
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Esene I, Tantengco OAG, Robertson FC, Still MEH, Ukachukwu AEK, Baticulon RE, Barthélemy EJ, Perez-Chadid D, Lippa L, Silva ACV, Jokonya L, Hassani FD, Nicolosi F, Takoutsing BD, Ntalaja J, Hoz SS, Kalangu KKN, Dechambenoit G, Servadei F, El Abbadi N, Park KB, Kolias A. A guide to interpreting systematic reviews and meta-analyses in neurosurgery and surgery. Acta Neurochir (Wien) 2024; 166:250. [PMID: 38833024 DOI: 10.1007/s00701-024-06133-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/15/2024] [Indexed: 06/06/2024]
Abstract
INTRODUCTION Systematic reviews (SRs) and meta-analyses (MAs) are methods of data analysis used to synthesize information presented in multiple publications on the same topic. A thorough understanding of the steps involved in conducting this type of research and approaches to data analysis is critical for appropriate understanding, interpretation, and application of the findings of these reviews. METHODS We reviewed reference texts in clinical neuroepidemiology, neurostatistics and research methods and other previously related articles on meta-analyses (MAs) in surgery. Based on existing theories and models and our cumulative years of expertise in conducting MAs, we have synthesized and presented a detailed pragmatic approach to interpreting MAs in Neurosurgery. RESULTS Herein we have briefly defined SRs sand MAs and related terminologies, succinctly outlined the essential steps to conduct and critically appraise SRs and MAs. A practical approach to interpreting MAs for neurosurgeons is described in details. Based on summary outcome measures, we have used hypothetical examples to illustrate the Interpretation of the three commonest types of MAs in neurosurgery: MAs of Binary Outcome Measures (Pairwise MAs), MAs of proportions and MAs of Continuous Variables. Furthermore, we have elucidated on the concepts of heterogeneity, modeling, certainty, and bias essential for the robust and transparent interpretation of MAs. The basics for the Interpretation of Forest plots, the preferred graphical display of data in MAs are summarized. Additionally, a condensation of the assessment of the overall quality of methodology and reporting of MA and the applicability of evidence to patient care is presented. CONCLUSION There is a paucity of pragmatic guides to appraise MAs for surgeons who are non-statisticians. This article serves as a detailed guide for the interpretation of systematic reviews and meta-analyses with examples of applications for clinical neurosurgeons.
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Affiliation(s)
- Ignatius Esene
- Neurosurgery Division, Faculty of Health Sciences, University of Bamenda, Bambili, Cameroon.
- Research Division, Winners Foundation, Yaounde, Cameroon.
| | - Ourlad Alzeus G Tantengco
- Department of Physiology, College of Medicine, University of the Philippines Manila, Manila, Philippines
| | - Faith C Robertson
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Megan E H Still
- Department of Neurosurgery, University of Florida, Gainesville, FL, USA
| | | | - Ronnie E Baticulon
- Division of Neurosurgery, Department of Neurosciences, Philippine General Hospital, University of the Philippines, Manila, Philippines
| | - Ernest J Barthélemy
- Global Neurosurgery Laboratory, Division of Neurosurgery, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | | | - Laura Lippa
- Department of Neurosurgery, ASST Ospedale Niguarda, Milan, Italy
| | - Ana Cristina Veiga Silva
- Neurosurgery Department of Post Graduation Program in Neuropsychiatry and Behavioral Sciences (PosNeuro), Federal University of Pernambuco, Recife, Brazil
| | - Luxwell Jokonya
- Department of Surgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Fahd D Hassani
- Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco
| | - Federico Nicolosi
- Department of Medicine and Surgery, Neurosurgery Unit, University of Milano-Bicocca, Milan, Italy
| | | | - Jeff Ntalaja
- Clinique Ngaliema, République Démocratique du Congo, Kinshasa, Congo
| | - Samer S Hoz
- Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kazadi K N Kalangu
- Department of Surgery, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Gilbert Dechambenoit
- Centre Medical Chirurgical Obstetrical Cote d'Opale, Saint Martin Boulogne, France
| | - Franco Servadei
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Najia El Abbadi
- Department of Neurosurgery, Cheikh Zaid International Hospital, Abulcasis International University of Health Sciences, Rabat, Morocco
| | - Kee B Park
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Angelos Kolias
- Division of Neurosurgery, Addenbrooke's Hospital, University of Cambridge, Cambridge, United Kingdom
- NIHR, Global Health Research Group on Acquired Brain and Spine Injury, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
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Boltena MT, Wolde M, Hailu B, El-Khatib Z, Steck V, Woldegerima S, Siraneh Y, Morankar S. Point prevalence of evidence-based antimicrobial use among hospitalized patients in sub-Saharan Africa: a systematic review and meta-analysis. Sci Rep 2024; 14:12652. [PMID: 38825623 PMCID: PMC11144712 DOI: 10.1038/s41598-024-62651-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/20/2024] [Indexed: 06/04/2024] Open
Abstract
Excessive and improper use of antibiotics causes antimicrobial resistance which is a major threat to global health security. Hospitals in sub-Saharan Africa (SSA) has the highest prevalence of antibiotic use. This systematic review and meta-analysis aimed to determine the pooled point prevalence (PPP) of evidence-based antimicrobial use among hospitalized patients in SSA. Literature was retrieved from CINAHL, EMBASE, Google Scholar, PubMed, Scopus, and Web of Science databases. Meta-analysis was conducted using STATA version 17. Forest plots using the random-effect model were used to present the findings. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test. The protocol was registered in PROSPERO with code CRD42023404075. The review was conducted according to PRISMA guidelines. A total of 26, 272 study participants reported by twenty-eight studies published from 10 countries in SSA were included. The pooled point prevalence of antimicrobial use in SSA were 64%. The pooled estimate of hospital wards with the highest antibiotic use were intensive care unit (89%). The pooled prevalence of the most common clinical indication for antibiotic use were community acquired infection (41%). The pooled point prevalence of antimicrobial use among hospitalized patients were higher in SSA. Higher use of antibiotics was recorded in intensive care units. Community acquired infection were most common clinical case among hospitalized patients. Health systems in SSA must design innovative digital health interventions to optimize clinicians adhere to evidence-based prescribing guidelines and improve antimicrobial stewardship.
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Affiliation(s)
- Minyahil Tadesse Boltena
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute's Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia.
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa, Ethiopia.
| | - Mirkuzie Wolde
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute's Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
- University of Technology Sydney, Sydney, Australia
| | - Belachew Hailu
- Armauer Hansen Research Institute, Ministry of Health, Addis Ababa, Ethiopia
| | - Ziad El-Khatib
- Global Public Health Department, Karolinska Institute, Solna, Sweden
| | - Veronika Steck
- Department of Pharmacology and Therapeutics, Faculty of Life Sciences, McGill University, Montreal, Canada
| | - Selam Woldegerima
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Yibeltal Siraneh
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute's Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Sudhakar Morankar
- Ethiopian Evidence Based Health Care Centre: A Joanna Briggs Institute's Center of Excellence, Faculty of Public Health, Institute of Health, Jimma University, Jimma, Ethiopia
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Singh S, Saini R, Mathur R, Sarkar S, Sagar R. The prevalence of depression in people following limb amputation: A systematic review and meta-analysis. J Psychosom Res 2024; 181:111677. [PMID: 38657566 DOI: 10.1016/j.jpsychores.2024.111677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 04/10/2024] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE To estimate the prevalence of depression in people with limb amputation. Additionally, factors affecting the prevalence or pattern of depression following limb amputation were explored. METHODS Systematic literature search to identify all relevant studies assessing prevalence of depression following limb amputations was conducted through following databases: PubMed/ MEDLINE, Scopus, Embase, and Web of Science. Search period was since inception of database till December 2021. Meta-analyses using random-effects model were conducted to estimate pooled prevalence of depression. RESULTS A total of 61 studies comprising 9852 limb amputees were included. Pooled prevalence of depression following limb amputations was 33.85% (95% CI: 27.15% to 40.54%), with significant heterogeneity (I2 = 98.57%; p < 0.001). Sub-group meta-analysis showed that pooled prevalence of depression was significantly higher in studies conducted from middle-income (45.31%, 95% CI: 28.92% to 61.70%) as compared high income countries (28.31%, 95% CI: 23.97% to 32.64%). Greater activity restriction, amputation-related body image disturbances, social discomfort, perceived vulnerability regarding disability, and avoidant coping style were commonly reported factors associated with greater depression symptomatology. Whereas, good perceived social support, and use of more active coping strategies were commonly reported protective factors. CONCLUSION About one-third of all limb amputees suffered from clinically significant depression. This emphasizes need to sensitize health care professionals involved in providing care to people following limb amputation regarding the importance of periodically screening this vulnerable group of patients for depression and liaising with psychiatrists. Further, addressing risk factors identified in this review could help in reducing the rates of depression post-amputation.
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Affiliation(s)
- Swarndeep Singh
- Assistant Professor, Department of Psychiatry, Vardhman Mahavir Medical College & Safdarjung Hospital, Delhi, India.
| | - Romil Saini
- Department of Psychiatry, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Rahul Mathur
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Siddharth Sarkar
- National Drug Dependence Treatment Centre & Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, Delhi, India
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