scholarly journals Radiological Signs of Latent Tuberculosis on Chest Radiography: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Jonathan W Uzorka ◽  
Jacco Wallinga ◽  
Lucia J M Kroft ◽  
Tom H M Ottenhoff ◽  
Sandra M Arend
Keyword(s):  
Systematic Review ◽  
Chest Radiography ◽  
Meta Analysis ◽  
Latent Tuberculosis ◽  
Added Value ◽  
Interferon Gamma Release Assay ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Previous Infection ◽  
Release Assay

Abstract Objective Current guidelines recommend screening for latent tuberculosis infection (LTBI) with a tuberculin skin test (TST) or interferon gamma release assay (IGRA), or both. Many also recommend chest radiography (CXR), although its added value is uncertain. This systematic review assessed the prevalence of abnormalities suggestive of LTBI on CXR (LTBI-CXR lesions) and evaluated the strength of the association. Method We searched 4 databases up to September 2017 and systematically reviewed cross-sectional and cohort studies reporting LTBI-CXR lesions in individuals with a positive TST or IGRA, or both, result. Prevalence estimates were pooled using random effects models and odds ratios (ORs) were used to calculate risk estimates. Results In the 26 included studies, the pooled proportion of individuals with LTBI having LTBI-CXR lesions was 0.15 (95% confidence interval [CI], 0.12–0.18]. In 16 studies that reported on individuals with LTBI and uninfected controls, LTBI-CXR lesions were associated with a positive TST result ≥ 5 mm or ≥ 10 mm (OR, 2.45; 95% CI, 1.00–5.99; and OR, 2.06; 95% CI, 1.38–3.09, respectively) and with a positive QuantiFERON result (OR, 1.99; 95% CI, 1.17–3.39) compared to CXR in uninfected controls. Although few studies reported specified lesions, calcified nodules were most frequently reported in individuals with LTBI (proportion, 0.07; 95% CI, 0.02–0.11). Conclusions Lesions on CXR suggestive of previous infection with Mycobacterium tuberculosis were significantly associated with positive tests for LTBI, although the sensitivity was only 15%. This finding may have added value when detection of past LTBI is important but immunodiagnostic tests may be unreliable.

scholarly journals Prevalence of Depression among Healthcare Workers during the COVID-19 Outbreak: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (15) ◽  
pp. 3406
Author(s):  
Beatriz Olaya ◽  
María Pérez-Moreno ◽  
Juan Bueno-Notivol ◽  
Patricia Gracia-García ◽  
Isabel Lasheras ◽  
...  
Keyword(s):  
Systematic Review ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Meta Analysis ◽  
Medical Doctors ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Pooled Prevalence ◽  
Prevalence Of Depression ◽  
Common Mental Health Problems

Background: There is evidence of a high psychological toll from the COVID-19 pandemic in healthcare workers. This paper was aimed at conducting a systematic review and meta-analysis of studies reporting levels of depression among healthcare workers during the COVID-19 and estimating the pooled prevalence of depression. Methods: We searched for cross-sectional studies listed on PubMed from 1 December 2019 to 15 September 2020 that reported prevalence of depression in healthcare workers, nurses, medical doctors, and COVID-19 frontline professionals. The pooled proportions of depression were calculated with random effects models. Results: We identified 57 studies from seventeen countries. The pooled prevalence of depression in healthcare workers was 24% (95% CI: 20%−28%), 25% for nurses (95% CI: 18%−33%), 24% for medical doctors (95% CI: 16%−31%), and 43% for frontline professionals (95% CI: 28%−59%). Conclusions: The proportion of depression in nurses and medical doctors during the COVID-19 pandemic was similar to that found in the general population as previously reported in other meta-analyses conducted with smaller numbers of studies. Importantly, almost half of the frontline healthcare workers showed increased levels of depression. There is need for a comprehensive, international response to prevent and treat common mental health problems in healthcare workers.

scholarly journals Prevalence of Erectile Dysfunction in Male Cancer: a Systematic Review and Meta-Analysis of Cross-Sectional Studies

2020 ◽  
pp. bjgp20X714197
Author(s):  
Damiano Pizzol ◽  
Tao Xiao ◽  
Smith Lee ◽  
Guillermo Felipe López Sánchez ◽  
Andrea Garolla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Meta Analysis ◽  
Well Being ◽  
Fundamental Aspect ◽  
Forest Plot ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Oncologic Patients ◽  
Cross Sectional Studies

Abstract Background: Sexual function is a fundamental aspect of health, well being and quality of life. In oncological male patients sexuality and erectile dysfunction (ED) can be compromise by psychological, pharmacological or physical components. Aim: We conducted a meta-analysis to estimate the prevalence of ED in all types of cancer and identify characteristics associated with ED in cancer survivors. Design and Setting: Systematic review and meta-analysis of cross-sectional studies. Method: Random effects models were used to pool the prevalence of ED as absolute estimates at three different stages (i.e., healthy, at diagnosis, and after treatment stages). A univariate meta-analysis (MA) regression including the three-level group variable as the only independent variable was used to assess the difference of prevalence of ED across the three groups. Further MA were conducted for studies involving patients at diagnosis and after treatment. Graphical comparisons of the prevalence of ED across these two stages of cancer treatment were given by a classic forest plot. Results: We included 43 studies with a total of 19,329 participants. Overall the pooled data of the included studies showed an ED prevalence of 40.72% (95%CI: 31.80-50.29) in cancer patients, with prevalence of 28.60% (95%CI: 12.10%-53.83%) at time of diagnosis and 42.70% (95%CI: 32.97%-53.03%) after treatment, across cancer locations. Conclusion: ED is particularly high in oncologic patients and may be influenced by neurovascular damage associated with treatment, hormonal therapy systemic chemo- or radiation therapy, as well as by psychological factors such as depression, anxiety, low self-esteem or issues with body image.

scholarly journals Prevalence of malaria and scrub typhus co-infection in febrile patients: a systematic review and meta-analysis

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Polrat Wilairatana ◽  
Saruda Kuraeiad ◽  
Pongruj Rattaprasert ◽  
Manas Kotepui
Keyword(s):  
Systematic Review ◽  
Scrub Typhus ◽  
Meta Analysis ◽  
Severe Disease ◽  
Forest Plot ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Pooled Prevalence ◽  
Study Results ◽  
Endemic Areas

Abstract Background Little information is available about malaria and scrub typhus co-infection. This study aimed to investigate the pooled prevalence of malaria and scrub typhus co-infection in febrile patients. Further, it aimed to estimate the prevalence of scrub typhus infection among patients with malaria and the odds of co-infection. This will aid the diagnosis and management of co-infected patients in endemic areas. Methods We searched for relevant studies in three databases: PubMed, Scopus, and Web of Science. We assessed the quality of the included studies using the Joanna Briggs Institute checklist for analytical cross-sectional studies. We estimated (1) the pooled prevalence of malaria and scrub typhus co-infection, (2) the pooled prevalence of scrub typhus infection in malaria-positive patients, and (3) the pooled odds of co-infection using the DerSimonian–Laird method for random-effects models. The study results and summary estimates were visualized on a forest plot as point estimates (effect size, prevalence) and 95% confidence intervals (CI). We assessed the heterogeneity of the studies by Cochrane Q or I2 statistics. We performed subgroup analyses of countries and scrub typhus diagnostic tests to explore the sources of heterogeneity of the included studies. We assessed publication bias if more than 10 studies were used to estimate the outcome. All data analyses were conducted using Stata version 14 (StataCorp, College Station, TX, USA). Results Of the 542 studies retrieved from three databases, we included 14 meeting the inclusion criteria in the systematic review and meta-analysis. The pooled prevalence of malaria and scrub typhus co-infection (56 cases) among febrile patients (7920 cases) was 1% (95% CI: 0–1%, I2: 78.28%), while the pooled prevalence of scrub typhus infection (321 cases) in patients with malaria (1418 cases) was 21% (95% CI: 12–30%, I2: 98.15%). Subgroup analysis showed that the pooled prevalence of scrub typhus infection among patients with malaria in India was 8% (95% CI: 4–13%, I2: 85.87%, nine studies with 59/794 cases), while the pooled prevalence of scrub typhus infection among patients with malaria in Thailand was 35% (95% CI: 7–64%, I2: 98.9%, four studies with 262/624 cases). The co-infections did not occur by chance (P = 0.013, odds: 0.43, 95% CI: 0.22–0.84%, I2: 60.9%). In the sensitivity analysis, the pooled prevalence of malaria and scrub typhus co-infection among febrile patients was 0% (95% CI: 0–1%, I2: 59.91%). Conclusions The present study showed the pooled prevalence and a significant association between malaria and scrub typhus. The results show the status of co-infection. Further research into co-infection in endemic areas is needed, in particular, to determine whether co-infection can accelerate disease progression or protect against severe disease. Graphical abstract

scholarly journals Association of diabetes with atrial fibrillation types: a systematic review and meta-analysis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Fadi Alijla ◽  
Chepkoech Buttia ◽  
Tobias Reichlin ◽  
Salman Razvi ◽  
Beatrice Minder ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Meta Analysis ◽  
Population Sample ◽  
Positive Association ◽  
Cross Sectional ◽  
Random Effects Models ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
The Impact

Abstract Background Atrial fibrillation (AF) is a common arrhythmia classified as paroxysmal and non-paroxysmal. Non-paroxysmal AF is associated with an increased risk of complications. Diabetes contributes to AF initiation, yet its role in AF maintenance is unclear. We conducted a systematic review and meta-analysis to summarize the evidence regarding the association of diabetes with AF types. Methods We searched 5 databases for observational studies investigating the association of diabetes with the likelihood of an AF type (vs another type) in humans. Study quality was evaluated using the Newcastle–Ottawa Scale. Studies classifying AF types as paroxysmal (reference) and non-paroxysmal were pooled in a meta-analysis using random effects models. Results Of 1997 articles we identified, 20 were included in our systematic review. The population sample size ranged from 64 to 9816 participants with mean age ranging from 40 to 75 years and percentage of women from 24.8 to 100%. The quality of studies varied from poor (60%) to fair (5%) to good (35%). In the systematic review, 8 studies among patients with AF investigated the cross-sectional association of diabetes with non-paroxysmal AF (vs paroxysmal) of which 6 showed a positive association and 2 showed no association. Fourteen studies investigated the longitudinal association of diabetes with “more sustained” AF types (vs “less sustained”) of which 2 showed a positive association and 12 showed no association. In the meta-analysis of cross-sectional studies, patients with AF and diabetes were 1.31-times more likely to have non-paroxysmal AF than those without diabetes [8 studies; pooled OR (95% CI), 1.31 (1.13–1.51), I2 = 82.6%]. The meta-analysis of longitudinal studies showed that for patients with paroxysmal AF, diabetes is associated with 1.32-times increased likelihood of progression to non-paroxysmal AF [five studies; pooled OR (95% CI), 1.32 (1.07–1.62); I2 = 0%]. Conclusions Our findings suggest that diabetes is associated with an increased likelihood of non-paroxysmal AF rather than paroxysmal AF. However, further high quality studies are needed to replicate these findings, adjust for potential confounders, elucidate mechanisms linking diabetes to non-paroxysmal AF, and assess the impact of antidiabetic medications on AF types. These strategies could eventually help decrease the risk of non-paroxysmal AF among patients with diabetes.

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