scholarly journals Assessment of the Therapeutic Effect of Total Glucosides of Peony for Juvenile Idiopathic Arthritis: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Yongsong Cai ◽  
Qiling Yuan ◽  
Ke Xu ◽  
Jialin Zhu ◽  
Yuanbo Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Juvenile Idiopathic Arthritis ◽  
Meta Analysis ◽  
Final Analysis ◽  
Tender Joint Count ◽  
Therapeutic Effects ◽  
Tender Joint ◽  
Reactive Protein ◽  
Total Glucosides Of Peony

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children; some clinical trials have reported the effects of total glucosides of peony (TGP) in the treatment of JIA. However, no systematic review has yet been conducted. In this study, we assessed the efficacy and safety in patients with JIA enrolled in randomized controlled trials (RCTs) of TGP. We extracted data for studies searched from 8 electronic databases that were searched and also evaluated the methodological quality of the included studies. We assessed the following outcome measures: overall response rate, pain, tender joint count (TJC), swollen joint count (SJC), duration of morning stiffness (DMS), grip strength (GS), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and adverse effects (AEs) in short term (4–8 weeks), intermediate term (9–26 weeks), and long term (>26 weeks). The final analysis showed that TGP acted as a unique nonbiologic disease-modifying antirheumatic drug (nonbiologic DMARD), and its therapeutic effects were safe and efficacious for the treatment of JIA with few AEs. However, more high-quality RCTs are needed to confirm these therapeutic effects.

scholarly journals The Derivative of Tripterygium wilfordii Hook F—Kunxian Capsule, Attenuated Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Ya-Fei Liu ◽  
Zhe Zhang ◽  
Jun-Jun Zhang ◽  
Zhe Chen ◽  
Sheng-Hao Tu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systematic Review ◽  
Meta Analysis ◽  
Tender Joint ◽  
Tripterygium Wilfordii Hook F ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Tripterygium Wilfordii Hook ◽  
Mean Differences ◽  
Review Manager

The study aimed to explore the efficacy and safety of Kunxian Capsule (KXC) in the treatment of rheumatoid arthritis (RA). The randomized controlled trials (RCTs) comparing the effects of KXC in patients with RA were included in this study. Weighted mean differences (MDs) were calculated for net changes by employing Review Manager meta-analysis software. Nine RCTs were included in the systematic review with a total of 747 patients. The overall effects showed that KXC alone or combined with disease-modifying antirheumatic and drugs decreased tender joint counts (P=0.02, MD = −1.07, 95% CI: −1.95 to −0.18), shortened duration of morning stiffness (P<0.0001, MD = −9.01, 95% CI: −13.08 to −4.93), lowered erythrocyte sedimentation rate (P<0.00001, MD = −5.27, 95% CI: −6.78 to −3.77), and reduced C-reactive protein (P<0.0001, MD = −5.04, 95% CI: −7.28 to −2.80). The most common adverse events were gastrointestinal disturbances and abnormal liver function. These results suggest that KXC is likely to be a more effective and safe candidate for treating RA compared with conventional therapies.

C-reactive Protein, Infection, and Outcome After Acute Ischemic Stroke: A Registry and Systematic Review

2020 ◽  
Vol 16 (5) ◽  
pp. 405-415 ◽  
Author(s):  
Lu Wang ◽  
Yuxiao Li ◽  
Changyi Wang ◽  
Wen Guo ◽  
Ming Liu
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Meta Analysis ◽  
Reactive Protein ◽  
Poor Outcome ◽  
Pubmed Database ◽  
Scale Scores ◽  
The Impact

Background: A number of studies have explored the prognostic role of CRP in patients with acute ischemic stroke, however, the results have been inconclusive. The aim of our study was to investigate the impact of infection on the association between CRP and 3-month functional outcome by performing a registry study and systematic review. Methods: Patients admitted within 24 hours of acute ischemic stroke onset and had CRP measured within 24 hours after admission were included. Patients admitted between June 2016 and December 2018 in Chengdu Stoke Registry were enrolled. The PubMed database was searched up to July 2019 to identify eligible studies. Poor outcome was defined as modified Rankin Scale scores at 3-month more than 3. Results: Totally, 368 patients in the registry and 18 studies involving 15238 patients in the systematic review were included. A statistically significant association between CRP values on admission and 3-month poor outcome in patients without infection was found, both in our registry (CRP per 1-mg/L increment, OR 1.04, 95% CI 1.01 to 1.07, p=0.008) and meta-analysis (CRP per 1-mg/dL increment, OR 1.66 [95% CI 1.37 to 2.01, p<0.001]). In patients with infection, CRP was not associated with a 3-month poor outcome according to registry data (OR 1.00, 95% CI 0.99 to 1.01, p=0.663) and meta-analysis (OR 1.01, 95% CI 0.99 to 1.01, p=0.128). Conclusion: High CRP value was independently associated with a 3-month poor outcome after stroke in patients without infection. Further studies are required to examine the value of infection on CRP measures and long-term functional outcomes.

Differences of energy expenditure while sitting versus standing: A systematic review and meta-analysis

2018 ◽  
Vol 25 (5) ◽  
pp. 522-538 ◽  
Author(s):  
Farzane Saeidifard ◽  
Jose R Medina-Inojosa ◽  
Marta Supervia ◽  
Thomas P Olson ◽  
Virend K Somers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Energy Expenditure ◽  
Energy Content ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Final Analysis ◽  
Ovid Medline ◽  
The Difference ◽  
Mean Differences

Background Replacing sitting with standing is one of several recommendations to decrease sedentary time and increase the daily energy expenditure, but the difference in energy expenditure between standing versus sitting has been controversial. This systematic review and meta-analysis aimed to determine this difference. Designs and methods We searched Ovid MEDLINE, Ovid Embase Scopus, Web of Science and Google Scholar for observational and experimental studies that compared the energy expenditure of standing versus sitting. We calculated mean differences and 95% confidence intervals using a random effects model. We conducted different predefined subgroup analyses based on characteristics of participants and study design. Results We identified 658 studies and included 46 studies with 1184 participants for the final analysis. The mean difference in energy expenditure between sitting and standing was 0.15 kcal/min (95% confidence interval (CI) 0.12–0.17). The difference among women was 0.1 kcal/min (95% CI 0.0–0.21), and was 0.19 kcal/min (95% CI 0.05–0.33) in men. Observational studies had a lower difference in energy expenditure (0.11 kcal/min, 95% CI 0.08–0.14) compared to randomised trials (0.2 kcal/min, 95% CI 0.12–0.28). By substituting sitting with standing for 6 hours/day, a 65 kg person will expend an additional 54 kcal/day. Assuming no increase in energy intake, this difference in energy expenditure would be translated into the energy content of about 2.5 kg of body fat mass in 1 year. Conclusions The substitution of sitting with standing could be a potential solution for a sedentary lifestyle to prevent weight gain in the long term. Future studies should aim to assess the effectiveness and feasibility of this strategy.

scholarly journals Modified Si-Miao Pill for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Hui Wang ◽  
Yao Huang ◽  
Pan Shen ◽  
Yu Wang ◽  
Kai Qin ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Western Medicine ◽  
Large Scale ◽  
Meta Analysis ◽  
Tender Joint Count ◽  
C Reactive Protein ◽  
Tender Joint ◽  
Reactive Protein ◽  
Randomized Controlled ◽  
Inflammatory Drugs

Objective. The aim of this review and meta-analysis was to assess the effects and safety of modified Si-Miao pill (mSMP) in treatment of rheumatoid arthritis. Design. A systematic literature search was carried out in eight databases from their available dates of inception to April 2020. After screening, fifteen randomized, controlled trials (RCTs) comparing the effects and safety of mSMP in combination with western medicine (including disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs)) in treating rheumatoid arthritis patients were included after screening. Results. In comparison with DMARDs, or coadministration of DMARDs and NSAIDs, mSMP in combination with western medicine significantly lowered erythrocyte sedimentation rate (mean difference (MD) = -10.61, 95% confidence interval (CI) [−12.19, −9.03]), C-reactive protein (MD = −6.50, 95% CI [−8.43, −4.56]), rheumatoid factors (MD = −17.31, 95% CI [−24.34, −10.27]), swollen joint count (MD = −1.63, 95% CI [−2.29, −0.97]), tender joint count (MD = −1.98, 95% CI [−2.34, −1.62]), and morning stiffness time (MD = −24.37, 95% CI [−29.41, 19.33]) and ameliorated the condition of patients (odds ratio (OR) = 3.69, 95% CI [2.64, 5.14]). Additionally, mSMP in combination with western medicine seemed safer (OR = 0.49, 95% CI [0.30, 0.81]). Conclusion. The results of the meta-analysis study have shown that mSMP in combination with western medicine therapies appears to be more effective and safer than western medicine alone in the treatment of rheumatoid arthritis including reducing inflammatory markers and adverse events and improving symptoms. Howbeit, more high-grade, large-scale RCTs of mSMP in various countries and regions are still needed.

scholarly journals Serum IL-37 Level Is Associated with Rheumatoid Arthritis and Disease Activity: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Shengnan Cao ◽  
Haojun Shi ◽  
Guodong Sun ◽  
Yuanzhen Chen ◽  
Guangjian Hou ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Disease Activity ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Tender Joint Count ◽  
Tender Joint ◽  
Reactive Protein ◽  
Cytokine Levels ◽  
Factor Α ◽  
The Relationship

Interleukin-37 (IL-37) inhibits the pathogenesis of rheumatoid arthritis (RA) via downregulating proinflammatory cytokines. Accordingly, we performed an analysis to accurately assess the relationship between serum IL-37 cytokine levels and disease activity of RA. Subgroup analysis and sensitivity analysis were applied to explore the sources of heterogeneity. Correlation coefficient ( r ) was utilized to evaluate the relationship between IL-37 and disease activity of RA patients. Ten studies were included into the research. Functional analysis revealed elevated serum IL-37 concentrations in RA patients ( SMD = 1.61 , P < 0.00001 ). The relationship between serum IL-37 levels and disease activity was statistically significant (C-reactive protein: r = 1.47 , P = 0.0002 ; erythrocyte sedimentation rate: r = 1.55 , P < 0.00001 ; rheumatoid factor: r = 1.40 , P = 0.004 ; tumor necrosis factor⁃α: r = 1.64 , P = 0.0003 ; Disease Activity Score for 28 joints: r = 1.63 , P < 0.00001 ; tender joint count: r = 1.48 , P < 0.00001 ; and swollen joint count: r = 1.52 , P = 0.0003 ), but anti-CCP was not significant (anti-CCP: r = 0.98 , P = 0.72 ). In summary, these data are suggesting that the elevated serum level of IL-37 in RA is positively correlated with the disease activity of RA, suggesting a role for IL-37in the pathogenesis of RA.

scholarly journals Influence of PM1 exposure on total and cause-specific respiratory diseases: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yaoyu Hu ◽  
Mengqiu Wu ◽  
Yutong Li ◽  
Xiangtong Liu
Keyword(s):  
Systematic Review ◽  
Respiratory Diseases ◽  
Meta Analysis ◽  
Final Analysis ◽  
Inclusion Criteria ◽  
Short Term ◽  
Full Inclusion ◽  
Short Term Exposure ◽  
Increased Risk

AbstractAn increasing number of studies examined the potential effects of PM1 (submicronic particulate matter with an aerodynamic diameter ≤ 1 μm) on the risk of respiratory diseases; however, the results have been inconclusive. This study aimed to determine the overall association between PM1 with total and cause-specific respiratory diseases. A systematic review and meta-analysis was conducted with 68 related articles retrieved, and six articles met the full inclusion criteria for the final analysis. For a 10 μg/m3 increase in PM1, the pooled odds ratio (OR) was 1.05 (95% CI 0.98–1.12) for total respiratory diseases, 1.25 (95% CI 1.00–1.56) for asthma, and 1.07 (95% CI 1.04–1.10) for pneumonia with the I2 value of 87%, 70%, and 0%, respectively. Subgroup analyses showed that long-term exposure to PM1 was associated with increased risk of asthma (OR 1.47, 95% CI 1.33–1.63) with an I2 value of 0%, while short-term exposure to PM1 was not associated with asthma (OR 1.07, 95% CI 0.89–1.27) with the I2 value of 0%. Egger’s test showed that publication bias existed (P = 0.041); however, the funnel plot was symmetrical with the inclusion of the moderator. In conclusion, elevated levels of PM1 may increase morbidity in total and cause-specific respiratory diseases in the population.

Global Longitudinal Strain Using Speckle-Tracking Echocardiography as a Mortality Predictor in Sepsis: A Systematic Review

2018 ◽  
Vol 34 (2) ◽  
pp. 87-93 ◽  
Author(s):  
Saraschandra Vallabhajosyula ◽  
Hamza A. Rayes ◽  
Ankit Sakhuja ◽  
Mohammad Hassan Murad ◽  
Jeffrey B. Geske ◽  
...  
Keyword(s):  
Systematic Review ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Meta Analysis ◽  
Global Longitudinal Strain ◽  
Final Analysis ◽  
Adults And Children ◽  
Sepsis And Septic Shock

The data on speckle-tracking echocardiography (STE) in patients with sepsis are limited. This systematic review from 1975 to 2016 included studies in adults and children evaluating cardiovascular dysfunction in sepsis, severe sepsis, and septic shock utilizing STE for systolic global longitudinal strain (GLS). The primary outcome was short- or long-term mortality. Given the significant methodological and statistical differences between published studies, combining the data using meta-analysis methods was not appropriate. A total of 120 studies were identified, with 5 studies (561 patients) included in the final analysis. All studies were prospective observational studies using the 2001 criteria for defining sepsis. Three studies demonstrated worse systolic GLS to be associated with higher mortality, whereas 2 did not show a statistically significant association. Various cutoffs between −10% and −17% were used to define abnormal GLS across studies. This systematic review revealed that STE may predict mortality in patients with sepsis; however, the strength of evidence is low due to heterogeneity in study populations, GLS technologies, cutoffs, and timing of STE. Further dedicated studies are needed to understand the optimal application of STE in patients with sepsis.

Mechanical thrombectomy in pediatric stroke: systematic review, individual patient data meta-analysis, and case series

2019 ◽  
Vol 24 (5) ◽  
pp. 558-571 ◽  
Author(s):  
Kartik Bhatia ◽  
Hans Kortman ◽  
Christopher Blair ◽  
Geoffrey Parker ◽  
David Brunacci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Neurological Outcomes

OBJECTIVEThe role of mechanical thrombectomy in pediatric acute ischemic stroke is uncertain, despite extensive evidence of benefit in adults. The existing literature consists of several recent small single-arm cohort studies, as well as multiple prior small case series and case reports. Published reports of pediatric cases have increased markedly since 2015, after the publication of the positive trials in adults. The recent AHA/ASA Scientific Statement on this issue was informed predominantly by pre-2015 case reports and identified several knowledge gaps, including how young a child may undergo thrombectomy. A repeat systematic review and meta-analysis is warranted to help guide therapeutic decisions and address gaps in knowledge.METHODSUsing PRISMA-IPD guidelines, the authors performed a systematic review of the literature from 1999 to April 2019 and individual patient data meta-analysis, with 2 independent reviewers. An additional series of 3 cases in adolescent males from one of the authors’ centers was also included. The primary outcomes were the rate of good long-term (mRS score 0–2 at final follow-up) and short-term (reduction in NIHSS score by ≥ 8 points or NIHSS score 0–1 at up to 24 hours post-thrombectomy) neurological outcomes following mechanical thrombectomy for acute ischemic stroke in patients < 18 years of age. The secondary outcome was the rate of successful angiographic recanalization (mTICI score 2b/3).RESULTSThe authors’ review yielded 113 cases of mechanical thrombectomy in 110 pediatric patients. Although complete follow-up data are not available for all patients, 87 of 96 (90.6%) had good long-term neurological outcomes (mRS score 0–2), 55 of 79 (69.6%) had good short-term neurological outcomes, and 86 of 98 (87.8%) had successful angiographic recanalization (mTICI score 2b/3). Death occurred in 2 patients and symptomatic intracranial hemorrhage in 1 patient. Sixteen published thrombectomy cases were identified in children < 5 years of age.CONCLUSIONSMechanical thrombectomy may be considered for acute ischemic stroke due to large vessel occlusion (ICA terminus, M1, basilar artery) in patients aged 1–18 years (Level C evidence; Class IIb recommendation). The existing evidence base is likely affected by selection and publication bias. A prospective multinational registry is recommended as the next investigative step.

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