scholarly journals Interleukin in endometriosis-associated infertility-pelvic pain: systematic review and meta-analysis

Reproduction ◽  
2019 ◽  
Vol 158 (1) ◽  
pp. 1-12 ◽  
Author(s):  
Helena Malvezzi ◽  
Camila Hernandes ◽  
Carla A Piccinato ◽  
Sérgio Podgaec
Keyword(s):  
Systematic Review ◽  
Pelvic Pain ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Elevated Serum ◽  
Poor Quality ◽  
Chronic Inflammatory Disease ◽  
Deep Endometriosis ◽  
Mediators Of Inflammation ◽  
Inflammatory Processes

The objective is to study the significance of altered interleukin levels in endometriosis-related infertility or pelvic pain. The present systematic review and meta-analysis includes a discussion on the roles of interleukin in the physiopathology of endometriosis-associated infertility and/or pelvic pain. We included all studies in which interleukins in peritoneal fluid, follicular fluid or serum from patients were measured and that correlated the findings with either peritoneal or deep endometriosis-associated infertility or pelvic pain. For the meta-analysis, we selected studies on the following cytokines: interleukin-1 (IL-1), interleukin-6 (IL-6) and interleukin-8 (IL-8). Endometriosis is a chronic inflammatory disease. Inflammatory processes clearly participate in the etiology of endometriosis. Cytokines are mediators of inflammation, and increase in their concentration in plasma or other body fluids signals the presence and extent of tissue lesions. A number of studies have reported on the association between higher cytokine levels and progression or maintenance of endometriosis and coexisting infertility or pelvic pain. The results of the analyses support that an association exists between elevated serum IL-6 and/or IL-8 concentrations and the occurrence of endometriosis-associated infertility. Such association was not found for endometriosis-associated pain. In spite of accumulated evidence on the association of pro-inflammatory cytokines and endometriosis, it still is not clear if and how these mediators participate in the physiopathology of endometriosis-associated infertility or pelvic pain, in part due to poor quality of the evidence established in the vast majority of interleukins and challenges in endometriosis research reproducibility. In summary, the results of the analyses support that an association exists between elevated serum IL-6 and/or IL-8 concentrations and the occurrence of endometriosis-associated infertility.

scholarly journals A Systematic Review and Meta-Analysis of Human Milk Feeding and Short-Term Growth in Preterm and Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2089
Author(s):  
Machiko Suganuma ◽  
Alice R. Rumbold ◽  
Jacqueline Miller ◽  
Yan Fong Chong ◽  
Carmel T. Collins
Keyword(s):  
Systematic Review ◽  
Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Meta Analysis ◽  
Poor Quality ◽  
Low Birth Weight Infants ◽  
Preterm Formula ◽  
Meta Analyses

Human milk (HM) is the gold standard for feeding infants but has been associated with slower growth in preterm infants compared with preterm formula. This systematic review and meta-analysis summarises the post-1990 literature to examine the effect of HM feeding on growth during the neonatal admission of preterm infants with birth weight ≤1500 g and/or born ≤28 weeks’ gestation. Medline, PubMed, CINAHL, and Scopus were searched, and comparisons were grouped as exclusive human milk (EHM) vs. exclusive preterm formula (EPTF), any HM vs. EPTF, and higher vs. lower doses of HM. We selected studies that used fortified HM and compared that with a PTF; studies comparing unfortified HM and term formula were excluded. Experimental and observational studies were pooled separately. The GRADE system was used to evaluate risk of bias and certainty of evidence. Forty-four studies were included with 37 (n = 9963 infants) included in the meta-analyses. In general, due to poor quality studies, evidence of the effect of any HM feeds or higher versus lower doses of HM was inconclusive. There was a possible effect that lower doses of HM compared with higher doses of HM improved weight gain during the hospital admission, and separately, a possible effect of increased head circumference growth in infants fed EPTF vs. any HM. The clinical significance of this is unclear. There was insufficient evidence to determine the effects of an exclusive HM diet on any outcomes.

scholarly journals Dienogest versus gonadotropin-releasing hormone analogue for the clinical treatment of endometriosis: a systematic review and meta-analysis

2017 ◽  
Vol 6 (9) ◽  
pp. 3712
Author(s):  
Sofia Andrade De Oliveira ◽  
Bárbara Souza Melo ◽  
Marina Fernandes Pereira
Keyword(s):  
Systematic Review ◽  
Pelvic Pain ◽  
Meta Analysis ◽  
Uterine Cavity ◽  
Lower Abdominal Pain ◽  
Gnrh Analogue ◽  
Hot Flushes ◽  
Gnrh Analogues ◽  
Great Loss ◽  
Pouch Of Douglas

Endometriosis is a chronic inflammatory disease, defined by the presence of endometrial tissue outside the uterine cavity. It causes symptoms such as dysmenorrhea, chronic pelvic pain, dyspareunia, infertility, with great loss of quality of life for the patient. The objective of the study was to compare, through a meta-analysis, GnRH analogues, which are considered clinical first line treatment for endometriosis, versus dienogest, a selective oral progestin in the treatment of endometriosis. A systematic review was conducted to select the studies. In total, 31 articles were found. Four studies met criteria, the following variables were analyzed: pelvic pain, dyspareunia and induration of the Pouch of Douglas after treatment and it was evaluated the presence of side effects during treatment: hot flushes, headache and BMD loss. There was no difference between the dienogest group and GnRH analogue group when it was evaluated maintenance of lower abdominal pain, dyspareunia, induration of the Pouch of Douglas after treatment and hot flushes during treatment. Besides those results, the dienogest group had a lower incidence of headache and less BMD loss. The treatment of endometriosis continues to be a challenge, even with new treatment options such as new drugs (dienogest) and surgical procedures. This meta-analysis provides evidence of the absence of dienogest inferiority compared with GnRH analogues with less BMD loss and less headache incidence.

scholarly journals The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4462
Author(s):  
Konstantinos G. Kyriakoulis ◽  
Anastasios Kollias ◽  
Garyphallia Poulakou ◽  
Ioannis G. Kyriakoulis ◽  
Ioannis P. Trontzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Severe Pneumonia ◽  
Hospitalized Patients ◽  
Current Evidence ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
The Impact

The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19.

scholarly journals Predictive Performance of Serum S100B Versus LDH in Melanoma Patients: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Eszter Anna Janka ◽  
Tünde Várvölgyi ◽  
Zoltán Sipos ◽  
Alexandra Soós ◽  
Péter Hegyi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Study Protocol ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Predictive Performance ◽  
Discriminative Ability ◽  
Serum S100b ◽  
Risk Of Death ◽  
Melanoma Patients

BackgroundCurrently, no consensus on the use of blood tests for monitoring disease recurrence in patients with resected melanoma exists. The only meta-analysis conducted in 2008 found that elevated serum S100B levels were associated with significantly worse survival in melanoma patients. Serum LDH is an established prognostic factor in patients with advanced melanoma.ObjectiveTo compare the discriminative and prognostic ability of serum S100B with that of serum LDH in patients with melanoma.MethodsThis systematic review and meta-analysis were reported in accordance with the PRISMA Statement. The study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42019137138).ResultsA quantitative analysis of data from 6 eligible studies included 1,033 patients with cutaneous melanoma. The discriminative ability of serum S100B at identifying disease relapse [pooled Area Under the ROC (AUROC) 78.64 (95% CI 70.28; 87.01)] was significantly greater than the discriminative ability of serum LDH [AUROC 64.41 (95% CI 56.05; 7278)] (p=0.013). Ten eligible studies with 1,987 patients were included in the risk of death analysis. The prognostic performance of serum S100B [pooled estimate of adjusted hazard ratio (HR) 1.78 (95% CI 1.38; 2.29)] was independent but not superior to that of serum LDH [HR 1.60 (95% CI 1.36; 2.29)].LimitationsA relatively small number of articles were eligible and there was considerable heterogeneity across the included studies.ConclusionsSerum biomarkers may provide relevant information on melanoma patient status and should be further researched. Serum S100B is a valid marker for diagnosis of melanoma recurrence.Systematic Review RegistrationThe study protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO; CRD42019137138).

Sacral neuromodulation treating chronic pelvic pain: a meta-analysis and systematic review of the literature

2019 ◽  
Vol 30 (7) ◽  
pp. 1023-1035 ◽  
Author(s):  
Amr Mahran ◽  
Gina Baaklini ◽  
Daisy Hassani ◽  
Hassan A. Abolella ◽  
Ahmed S. Safwat ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Sacral Neuromodulation ◽  
Meta Analysis ◽  
Review Of The Literature

scholarly journals Acupuncture Treatment for Chronic Pelvic Pain in Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Soo-Hyun Sung ◽  
Angela-Dong-Min Sung ◽  
Hyun-Kyung Sung ◽  
Tteul-E-Bom An ◽  
Kyeong Han Kim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Acupuncture Treatment ◽  
Meta Analysis ◽  
Modern Technology ◽  
Current Evidence ◽  
Controlled Trials ◽  
Randomized Controlled

Aim of the Study. This systematic review and meta-analysis aims to evaluate the current evidence from randomized controlled trials (RCTs) related to the effectiveness and safety of acupuncture treatment (AT), including electroacupuncture or thread-embedding therapy in combination with modern technology, for chronic pelvic pain (CPP) in women. Materials and Methods. We searched 12 electronic databases up to December 2017. All randomized controlled trials evaluating the effect of AT for CPP were considered. Results. Four RCTs with 474 participants were included. The methodological quality of included studies was generally low. The results of meta-analysis of two studies showed that AT combined with conventional treatment (CT) was associated with significantly reduced CPP, based on the total effectiveness rate (n=277, mean difference = 1.29, confidence interval = 1.13 to 1.47, P=0.0001, I2 = 0%). Conclusions. This review suggests the potential of AT combined with CT compared to CT alone for treating female CPP. However, there is insufficient evidence to conclude that AT can be recommended as a complementary and alternative (CAM) treatment for women with CPP. To draw a firm conclusion, future studies should require not only lager, more rigorously designed RCTs but also research on different AT types. Protocol Registration Number. This study is registered with PROSPERO 2018 (CRD42018088627).

scholarly journals Systematic review and meta-analysis of the associations of vegan and vegetarian diets with inflammatory biomarkers

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Juliane Menzel ◽  
Afraa Jabakhanji ◽  
Ronald Biemann ◽  
Knut Mai ◽  
Klaus Abraham ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Mean Difference ◽  
Inflammatory Biomarkers ◽  
Vegan Diet ◽  
Intercellular Adhesion Molecule ◽  
Intercellular Adhesion Molecule 1 ◽  
Necrosis Factor Alpha ◽  
Cross Sectional

AbstractPlant-based diets like vegetarian or vegan diets might influence circulating levels of inflammatory biomarkers, thereby reducing the risk of chronic diseases. This systematic review and meta-analysis aimed to investigate the associations of veganism and vegetarianism with circulating inflammatory biomarkers in comparison to omnivores. Literature search was conducted in Pubmed and EMBASE until April 2020 and mean differences of biomarkers were assessed for: C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-18 (IL-18), interleukin-1 receptor antagonist (IL-1 RA), tumor necrosis factor-alpha (TNF-ɑ), E-selectin, intercellular adhesion molecule-1 (ICAM-1), monocyte chemoattractant protein-1 (MCP-1), adiponectin, omentin-1 and resistin. Of initially identified 1073 publications, 21 cross-sectional studies met the inclusion criteria and were included in the systematic review and meta-analysis. Vegan diet was associated with lower levels of CRP compared to omnivores [mean difference − 0.54 mg/l, 95%-CI: − 0.79 to − 0.28, p < 0.0001]. This association was less pronounced in vegetarians [mean difference − 0.25 mg/l, 95%-CI: − 0.49 to 0.00, p = 0.05]. In patients with impaired kidney function, the association between vegetarian nutrition and CRP was much stronger with − 3.91 mg/l (95%-CI: − 5.23 to − 2.60; p < 0.0001). No substantial effects were observed for all other inflammatory biomarkers. Despite strong associations between CRP and a vegan or vegetarian diet were seen, further research is needed, as most inflammatory biomarkers were investigated only in single studies so far.

scholarly journals Systematic Review and Meta-Analysis of the Tolerability and Hepatotoxicity of Antifungals in Empirical and Definitive Therapy for Invasive Fungal Infection

2010 ◽  
Vol 54 (6) ◽  
pp. 2409-2419 ◽  
Author(s):  
Jiun-Ling Wang ◽  
Chia-Hsuin Chang ◽  
Yinong Young-Xu ◽  
K. Arnold Chan
Keyword(s):  
Systematic Review ◽  
Liver Injury ◽  
Fungal Infection ◽  
Liver Enzyme ◽  
Antifungal Therapy ◽  
Invasive Fungal Infection ◽  
Adverse Reactions ◽  
Meta Analysis ◽  
Elevated Serum ◽  
Treatment Discontinuation

ABSTRACT To evaluate the tolerability and liver safety profiles of the systemic antifungal agents commonly used for the treatment of invasive fungal infection, we conducted a systematic review and meta-analysis of randomized controlled trials published before 31 August 2009. Two reviewers independently applied selection criteria, performed quality assessment, and extracted data. We used the beta-binomial model to account for variation across studies and the maximum likelihood method to estimate the pooled risks. We identified 39 studies with more than 8,000 enrolled patients for planned comparisons. The incidence rates of treatment discontinuation due to adverse reactions and liver injury associated with antifungal therapy ranged widely. The pooled risks of treatment discontinuation due to adverse reactions were above 10% for amphotericin B formulations and itraconazole, whereas they were 2.5% to 3.8% for fluconazole, caspofungin, and micafungin. We found that 1.5% of the patients stopped itraconazole treatment due to hepatotoxicity. Furthermore, 19.7% of voriconazole users and 17.4% of itraconazole users had elevated serum liver enzyme levels, although they did not require treatment discontinuation, whereas 2.0% or 9.3% of fluconazole and echinocandin users had elevated serum liver enzyme levels but did not require treatment discontinuation. The results were similar when we stratified the data by empirical or definitive antifungal therapy. Possible explanations for antifungal agent-related hepatotoxicity were confounded by antifungal prescription to patients with a high risk of liver injury, the increased chance of detection of hepatotoxicity due to prolonged treatment, or the pharmacological entity.

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