Meta-Analysis

Meta 分析
  • 文章类型: Journal Article
    难民的健康状况已得到广泛记录,在整个移民过程中,从遭受暴力到移民拘留的影响,一系列因素的影响也是如此。本研究通过使用荟萃分析评估简短表格36(SF-36)健康调查所衡量的健康相关生活质量,从而增加了我们对难民和寻求庇护者健康相关生活质量的理解。本研究的目的是(1)提供与健康相关的生活质量的总结和概述(通过SF-36测量),(2)探讨影响难民和寻求庇护者与健康相关的生活质量(通过SF-36衡量)的因素。对MEDLINE进行了搜索,CINAHL,PSYCINFO和SCOPUS,返回3965个结果。如果对难民(或寻求庇护者或有类似难民经历的人)进行抽样,并使用SF-36(或其变体)作为结果衡量标准,则包括论文。使用随机效应模型汇集平均得分和标准偏差。合并的样本量为18,418。SF-36物理汇总测量的合并平均值为54.99(95%CI46.01-63.99),而心理健康汇总指标为52.39(95%CI43.35-61.43)。每个子量表的合并平均得分范围为49.6(活力)至65.54(身体功能)。在汇总测量和所有子量表之间发现高度异质性。与高收入和中等收入国家一般人群的SF-36结果相比,这些结果表明,难民的生活质量普遍较差。然而,这在研究之间有很大差异。本综述没有很好地阐明的一个问题是导致健康相关生活质量的因素。
    The health of refugees has been widely documented, as has the impact of a range of factors throughout the migration journey from being exposed to violence to the impacts of immigration detention. This study adds to our understanding of health-related quality of life amongst refugees and asylum seekers by evaluating health-related quality of life as measured by the Short-Form 36 (SF-36) Health Survey using meta-analysis. The aims of this study were to (1) provide a summary and overview of health-related quality of life (as measured by the SF-36), including the extent to which this varies and (2) explore the factors that influence health-related quality of life (as measured by the SF-36) amongst refugees and asylum seekers. A search was undertaken of MEDLINE, CINAHL, PSYCINFO and SCOPUS, returning 3965 results. Papers were included if they sampled refugees (or asylum seeker or those with refugee-like experiences) and used the SF-36 (or its variants) as an outcome measure. Mean scores and standard deviations were pooled using a random effects model. The pooled sample size was 18,418. The pooled mean scores for the SF-36 physical summary measures was 54.99 (95% CI 46.01-63.99), while the mental health summary measure was 52.39 (95% CI 43.35-61.43). The pooled mean scores for each of the sub-scales ranged from 49.6 (vitality) to 65.54 (physical functioning). High heterogeneity was found between both summary measures and all sub-scales. In comparison to SF-36 results from general populations in high and middle income countries, these results suggest that refugee quality of life is generally poorer. However, this varied substantially between studies. One issue that is not well clarified by this review are the factors that contributed to health-related quality of life.
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  • 文章类型: Journal Article
    Rabson-Mendenhall综合征(RMS)是一种罕见的常染色体,以胰岛素受体(INSR)基因突变导致的严重胰岛素抵抗为特征的隐性疾病。本研究旨在分析RMS的临床特征和基因突变,尚未被广泛研究。
    PubMed,Embase,中国国家知识基础设施,和万方搜索“拉布森-门登霍尔综合征”或“黑棘皮病多毛症胰岛素抵抗综合征”。\"
    共纳入33篇文章中的42例。体重指数为18.50~20.00kg/m2,平均16.00kg/m2。无超重(25.00~29.90kg/m2)或肥胖(≥30.00kg/m2)患者。棘皮病29例(29/42,69.05%);生长迟缓25例(25/42,59.52%);牙齿异常包括缺牙,拥挤,错牙合23例(23/42,54.76%);多毛17例(17/42,40.48%)。糖化血红蛋白平均为9.35%,平均空腹血糖为8.44mmol/L;平均空腹胰岛素为349.96μIU/mL,平均空腹C肽为6.00ng/mL。糖尿病25例(25/33,75.76%)均在23岁以前确诊。所有42例患者都有基因突变记录,其中22例(22/42,52.38%)具有≥2个突变,20例(20/42,47.62%)仅具有1个突变。不同突变患者的临床特征和实验室指标无统计学差异。
    该研究表明,高胰岛素血症的年轻患者应考虑RMS,低体重的高血糖症,黑棘皮病,生长迟缓,牙齿异常,和多毛症。
    UNASSIGNED: Rabson-Mendenhall syndrome (RMS) is a rare autosomal, recessive disorder characterized by severe insulin resistance due to mutations in the insulin receptor (INSR) gene. This study aims to analyze the clinical features and gene mutations in RMS, which have not been extensively studied.
    UNASSIGNED: PubMed, Embase, the China National Knowledge Infrastructure, and Wanfang were searched for \"Rabson-Mendenhall syndrome\" or \"Black acanthosis hirsutism insulin resistance syndrome.\"
    UNASSIGNED: A total of 42 cases from 33 articles were included. The body mass index ranged from 18.50 to 20.00 kg/m2 with an average of 16.00 kg/m2. There were no overweight (25.00∼29.90 kg/m2) or obese (≥30.00 kg/m2) patients. Acanthosis was present in 29 cases (29/42, 69.05%); growth retardation in 25 cases (25/42, 59.52%); dental anomalies including absence of teeth, crowding, and malocclusion in 23 cases (23/42, 54.76%); and hirsutism in 17 cases (17/42, 40.48%). The average glycosylated hemoglobin was 9.35%, and the average fasting blood-glucose was 8.44 mmol/L; the mean fasting insulin was 349.96 μIU/mL, and the average fasting C-peptide was 6.00 ng/mL. Diabetes was reported in 25 cases (25/33, 75.76%) all of which were diagnosed before 23 years old. All 42 patients had recorded gene mutations, with 22 patients (22/42, 52.38%) having ≥ 2 mutations and 20 cases (20/42, 47.62%) having only 1 mutation. No statistical differences were found in clinical features and laboratory parameters between patients with different mutations.
    UNASSIGNED: The study indicates that RMS should be considered in young patients with hyperinsulinemia, hyperglycemia with low weight, acanthosis nigricans, growth retardation, dental anomalies, and hirsutism.
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  • 文章类型: Journal Article
    越来越多的儿童心理实验正在使用在线平台进行,部分原因是COVID-19大流行。个人重复比较了在线和亲自进行的特定实验的结果,但是数据收集方法对从儿童收集的数据的总体影响仍然未知。因此,当前荟萃分析的目标是估计在线进行的发展研究与亲自进行的相同研究相比的效应大小的平均差异.我们预先注册的分析包括从30篇论文和3282名儿童中计算出的211个效应大小,年龄从四个月到六岁不等。在线进行的研究的估计效果大小略小于亲自进行的研究。差异为d=-.05,但这种差异并不显著,95%CI=[-.17,.07]。我们研究了在线测试效果的几个潜在调节因素,包括依赖性测量的作用(看与言语),在线学习方法(有节制与无节制),和年龄,但这些都不重要.因此,迄今为止的文献表明,平均而言,亲自实验和在线实验之间的结果差异很小。
    An increasing number of psychological experiments with children are being conducted using online platforms, in part due to the COVID-19 pandemic. Individual replications have compared the findings of particular experiments online and in-person, but the general effect of data collection method on data collected from children is still unknown. Therefore, the goal of the current meta-analysis is to estimate the average difference in effect size for developmental studies conducted online compared to the same studies conducted in-person. Our pre-registered analysis includes 211 effect sizes calculated from 30 papers with 3282 children, ranging in age from four months to six years. The estimated effect size for studies conducted online was slightly smaller than for their counterparts conducted in-person, a difference of d = -.05, but this difference was not significant, 95% CI = [-.17, .07]. We examined several potential moderators of the effect of online testing, including the role of dependent measure (looking vs verbal), online study method (moderated vs unmoderated), and age, but none of these were significant. The literature to date thus suggests-on average-small differences in results between in-person and online experimentation.
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  • 文章类型: Systematic Review
    糖尿病性胃轻瘫是糖尿病患者常见的并发症。饮食干预已广泛应用于糖尿病胃轻瘫的治疗。这项研究的目的是评估饮食在糖尿病性胃轻瘫治疗中的作用。
    这项系统评价是对截至2023年11月9日使用饮食干预治疗糖尿病性胃轻瘫的随机对照试验进行的全面搜索。主要结果是胃排空时间和临床效果,而空腹血糖,餐后2小时血糖和糖化血红蛋白是次要结局。数据分析采用RevMan5.4软件,发表偏倚检验使用Stata15.1软件进行.
    本综述共纳入15项随机对照试验,涉及1106名参与者。结果显示,糖尿病胃轻瘫患者受益于饮食干预(无论是单独个性化饮食护理还是个性化饮食护理+常规饮食护理)。与常规饮食护理相比,个性化饮食护理和个性化饮食护理+常规饮食护理可以缩短胃排空时间,提高临床疗效,降低空腹血糖水平,餐后2小时血糖和糖化血红蛋白。
    有限的证据表明,饮食干预可以促进糖尿病胃轻瘫患者的胃排空和稳定血糖控制。饮食干预在糖尿病性胃轻瘫的治疗中具有独特的潜力,需要更多高质量的随机对照试验来进一步验证我们的研究结果.
    https://www.crd.约克。AC.英国/普华永道/,标识符CRD42023481621。
    UNASSIGNED: Diabetic gastroparesis is a common complication in patient with diabetes. Dietary intervention has been widely used in the treatment of diabetic gastroparesis. The aim of this study is to evaluate the role of diet in the treatment of diabetic gastroparesis.
    UNASSIGNED: This systematic review was conducted a comprehensive search of randomized controlled trials using dietary interventions for the treatment of diabetic gastroparesis up to 9 November 2023. The primary outcomes were gastric emptying time and clinical effect, while fasting blood glucose, 2-hour postprandial blood glucose and glycosylated hemoglobin were secondary outcomes. Data analysis was performed using RevMan 5.4 software, and publication bias test was performed using Stata 15.1 software.
    UNASSIGNED: A total of 15 randomized controlled trials involving 1106 participants were included in this review. The results showed that patients with diabetic gastroparesis benefit from dietary interventions (whether personalized dietary care alone or personalized dietary care+routine dietary care). Compared with routine dietary care, personalized dietary care and personalized dietary care+routine dietary care can shorten the gastric emptying time, improve clinical efficacy, and reduce the level of fasting blood glucose, 2-hour postprandial blood glucose and glycosylated hemoglobin.
    UNASSIGNED: Limited evidence suggests that dietary intervention can promote gastric emptying and stabilize blood glucose control in patients with diabetic gastroparesis. Dietary intervention has unique potential in the treatment of diabetic gastroparesis, and more high-quality randomized controlled trials are needed to further validate our research results.
    UNASSIGNED: https://www.crd.york.ac.uk/prospero/, identifier CRD42023481621.
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  • 文章类型: Journal Article
    背景:天然产物广泛用于原发性失眠(PI)。这项带有试验序贯分析(TSA)的系统评价旨在总结有关枣仁安神(ZRAS)处方的有效性和安全性的证据,一种商业中草药制剂,用于治疗PI。方法:在2024年1月之前,在七个数据库中系统地搜索了评估ZRAS与对照或作为附加治疗的对照临床试验。采用CochraneROB2.0和ROBINS-I工具来确定偏倚风险。使用GRADE框架评估证据质量。结果:我们分析了22项研究,涉及2142名参与者。发现ZRAS在降低匹兹堡睡眠质量指数评分方面的效果与苯二氮卓类药物相当[MD=0.39,95CI(-0.12,0.91),p=0.13],优于Z-药物[MD=-1.31,95CI(-2.37,-0.24),p=0.02]。在催眠药中添加ZRAS可显着降低多导睡眠记录的睡眠发作潜伏期[MD=-4.44分钟,95CI(-7.98,-0.91),p=0.01]和觉醒次数[MD=-0.89次,95CI(-1.67,-0.10),p=0.03],总睡眠时间增加[MD=40.72分钟,95CI(25.14,56.30),p<0.01],与单独使用催眠药相比,不良事件更少。TSA验证了这些定量合成结果的稳健性。然而,证据质量从非常低到低不等。可用于随访的有限数据不支持荟萃合成。结论:虽然ZRAS方剂治疗PI具有良好的疗效,证据的整体质量是有限的。严格设计的随机对照试验有必要证实ZRAS的短期疗效,并探讨其中长期疗效。系统审查注册:(https://www。crd.约克。AC.uk/prospro/display_record.php?RecordID=471497),标识符(CRD42023471497)。
    Background: Natural products are widely used for primary insomnia (PI). This systematic review with trial sequential analysis (TSA) aimed to summarize evidence pertaining to the effectiveness and safety of Zao Ren An Shen (ZRAS) prescription, a commercial Chinese polyherbal preparation, for treating PI. Methods: Controlled clinical trials appraising ZRAS compared to controls or as an add-on treatment were systematically searched across seven databases until January 2024. Cochrane ROB 2.0 and ROBINS-I tools were adopted to determine risk of bias. Quality of evidence was assessed using the GRADE framework. Results: We analyzed 22 studies, involving 2,142 participants. The effect of ZRAS in reducing Pittsburgh Sleep Quality Index scores was found to be comparable to benzodiazepines [MD = 0.39, 95%CI (-0.12, 0.91), p = 0.13] and superior to Z-drugs [MD = -1.31, 95%CI (-2.37, -0.24), p = 0.02]. The addition of ZRAS to hypnotics more significantly reduced polysomnographically-recorded sleep onset latency [MD = -4.44 min, 95%CI (-7.98, -0.91), p = 0.01] and number of awakenings [MD = -0.89 times, 95%CI (-1.67, -0.10), p = 0.03], and increased total sleep time [MD = 40.72 min, 95%CI (25.14, 56.30), p < 0.01], with fewer adverse events than hypnotics alone. TSA validated the robustness of these quantitative synthesis results. However, the quality of evidence ranged from very low to low. The limited data available for follow-up did not support meta-synthesis. Conclusion: While ZRAS prescription shows promising effectiveness in treating PI, the overall quality of evidence is limited. Rigorously-designed randomized control trials are warranted to confirm the short-term efficacy of ZRAS and explore its medium-to-long-term efficacy. Systematic Review Registration: (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=471497), identifier (CRD42023471497).
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  • 文章类型: Journal Article
    尚未定量评估人工智能(AI)在预测口腔鳞状细胞癌(OSCC)患者淋巴结(LN)转移中的性能。这项研究的目的是对基于AI算法预测OSCC患者LN转移的CT和MRI诊断性能的已发表数据进行系统评价和荟萃分析。
    我们搜索了Embase,PubMed(Medline),WebofScience,和Cochrane数据库,用于研究AI在预测OSCC中LN转移中的应用。提取二元诊断准确性数据以获得感兴趣的结果,即,曲线下面积(AUC),灵敏度,和特异性,并将AI的诊断性能与放射科医生的诊断性能进行了比较。针对不同类型的AI算法和成像模式进行亚组分析。
    14项符合条件的研究纳入荟萃分析。AUC,灵敏度,诊断LN转移的AI模型的特异性为0.92(95%CI0.89-0.94),0.79(95%CI0.72-0.85),和0.90(95%CI0.86-0.93),分别。在基于算法类型[机器学习(ML)或深度学习(DL)]和成像模式(CT与MRI)。AI的合并诊断性能明显优于有经验的放射科医生。
    总而言之,基于CT和MRI成像的AI在预测OSCC患者LN转移方面具有良好的诊断准确性,具有临床应用潜力。
    https://www.crd.约克。AC.uk/PROSPERO/#recordDetails,PROSPERO(编号CRD42024506159)。
    UNASSIGNED: The performance of artificial intelligence (AI) in the prediction of lymph node (LN) metastasis in patients with oral squamous cell carcinoma (OSCC) has not been quantitatively evaluated. The purpose of this study was to conduct a systematic review and meta-analysis of published data on the diagnostic performance of CT and MRI based on AI algorithms for predicting LN metastases in patients with OSCC.
    UNASSIGNED: We searched the Embase, PubMed (Medline), Web of Science, and Cochrane databases for studies on the use of AI in predicting LN metastasis in OSCC. Binary diagnostic accuracy data were extracted to obtain the outcomes of interest, namely, the area under the curve (AUC), sensitivity, and specificity, and compared the diagnostic performance of AI with that of radiologists. Subgroup analyses were performed with regard to different types of AI algorithms and imaging modalities.
    UNASSIGNED: Fourteen eligible studies were included in the meta-analysis. The AUC, sensitivity, and specificity of the AI models for the diagnosis of LN metastases were 0.92 (95% CI 0.89-0.94), 0.79 (95% CI 0.72-0.85), and 0.90 (95% CI 0.86-0.93), respectively. Promising diagnostic performance was observed in the subgroup analyses based on algorithm types [machine learning (ML) or deep learning (DL)] and imaging modalities (CT vs. MRI). The pooled diagnostic performance of AI was significantly better than that of experienced radiologists.
    UNASSIGNED: In conclusion, AI based on CT and MRI imaging has good diagnostic accuracy in predicting LN metastasis in patients with OSCC and thus has the potential for clinical application.
    UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO/#recordDetails, PROSPERO (No. CRD42024506159).
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  • 文章类型: Journal Article
    睡眠时间被认为是一个潜在的和重要的可改变的危险因素。然而,其与亚洲成年人高血压的确切关系尚不清楚.这项荟萃分析旨在阐明亚洲成年人群中睡眠时间短对高血压风险的影响。对数据库的系统搜索,包括PubMed,Scopus,和科学直接,是为了确定截至2024年1月4日发表的相关研究。符合条件的研究包括观察性队列研究和横断面研究,这些研究比较了亚洲成年人中短睡眠持续时间与正常睡眠持续时间与高血压风险的关系。短期和正常睡眠持续时间的定义来自各自的研究。随机效应模型被用来汇集效应估计,所有统计分析均使用ReviewManager5.4软件(RevMan)(CochraneCollaboration,牛津,英国)。系统搜索的结果获得了七项评估亚洲人群睡眠持续时间和高血压风险的研究。基于对六项研究的荟萃分析,与正常睡眠时间相比,短睡眠时间与更高的高血压风险相关(OR:1.36;95%CI:1.13-1.64;p:0.0010;I2:75%).基于性别的亚组分析表明,男性(OR:1.12;95%CI:1.01-1.25;p:0.03;I2:64%)和女性(OR:1.22;95%CI:1.10-1.35;p:0.0003;I2:82%)之间的关联很明显。总之,根据分析的研究,睡眠时间短与较高的轻度高血压风险有关,不管性别。因此,短睡眠时间可能是一个可改变的危险因素,可以预防以降低高血压的风险。通过纳入睡眠卫生习惯和促进健康的睡眠习惯,可以显著改善心血管健康,特别是在人群水平的高血压风险中。应进一步研究不同年龄人群睡眠持续时间的影响,以确认睡眠持续时间短的影响。
    Sleep duration has been proposed as a potential and important modifiable risk factor, yet its precise relationship with hypertension among Asian adults remains unclear. This meta-analysis aims to elucidate the impact of short sleep duration on hypertension risk within the adult Asian population. A systematic search of databases, including PubMed, Scopus, and ScienceDirect, was conducted to identify relevant studies published up to January 4, 2024. Eligible studies comprised observational cohort studies and cross-sectional studies that compared short sleep duration to normal sleep duration in relation to hypertension risk among Asian adults. The definitions for short and normal sleep durations were derived from the respective studies. The random effects model was utilized to pool effect estimates, and all statistical analyses were conducted using Review Manager 5.4 software (RevMan) (Cochrane Collaboration, Oxford, UK). Results from a systematic search obtained seven studies assessing sleep duration and hypertension risk in Asian populations. Based on a meta-analysis of six studies, short sleep duration is associated with a higher hypertension risk when compared to normal sleep duration (OR: 1.36; 95% CI: 1.13-1.64; p: 0.0010; I2: 75%). Subgroup analysis based on sex showed that the association is evident across males (OR: 1.12; 95% CI: 1.01-1.25; p: 0.03; I2: 64%) and females (OR: 1.22; 95% CI: 1.10-1.35; p: 0.0003; I2: 82%). In conclusion, based on the analyzed studies, short sleep duration is associated with a higher mild risk of hypertension, irrespective of sex. Thus, short sleep duration can be a modifiable risk factor that can be prevented to reduce the risk of hypertension. By incorporating sleep hygiene practices and promoting healthy sleep habits, significant improvement in cardiovascular health can be made, especially in hypertension risk at a population level. Further studies on the effect of sleep duration in different age populations should be conducted to confirm the impact of short sleep duration.
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  • 文章类型: Journal Article
    背景:Evodiamine(EVO)是从Euodiarutaecarpa的干燥和接近成熟的果实中提取的生物碱,用作抗癌药物,抗炎和抗肥胖剂。然而,到目前为止,缺乏临床前实验的有力证据。因此,本文的目的是在动物实验中研究EVO联合其他治疗对肿瘤的影响。
    方法:进行系统评价和荟萃分析,以评估吴茱萸胺联合治疗的抗肿瘤作用。搜索引擎和电子数据库包括PubMed,Scopus,中国知识资源综合数据库(CNKI),还有SinoMed.研究方法基于PRISMA检查表。
    结果:共纳入7项研究和108只动物。因此,发现EVO联合治疗比EVO单药治疗更有效。肿瘤生长的SMD为-25.64(95%CI:-5.77-3.13)。肿瘤重量,SMD为-8.91(95%CI:-16.37,-1.44)。
    结论:EVO有可能减轻化疗药物的毒性,这增加了对临床情况的可译性。
    BACKGROUND: Evodiamine (EVO) is an alkaloid extracted from the dried and nearly ripe fruits of Euodia rutaecarpa and used as an anti-cancer, anti-inflammatory and anti-obesity agent. However, robust evidence of preclinical experiments has been lacking so far. Therefore, the purpose of this article was to investigate the effect of EVO in combination with other treatments on tumors in animal experiments.
    METHODS: A systematic review and meta-analysis were conducted to assess the anti-tumor effect of evodiamine-combined therapy. The search engine and electronic databases included PubMed, Scopus, China Knowledge Resource Integrated Database (CNKI), and SinoMed. The research method was based on the PRISMA checklist.
    RESULTS: A total of 7 studies and 108 animals were included. As a result, EVO combined therapy was found to be more effective than EVO monotherapy. The SMD was -25.64(95% CI: -5.77 -3.13) in tumor growth. In tumor weight, the SMD was -8.91(95% CI: -16.37, -1.44).
    CONCLUSIONS: EVO has the potential to alleviate the toxicity of chemotherapeutic agents, which increases the translatability to the clinical situation.
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  • 文章类型: Journal Article
    背景:耐多药或利福霉素的结核病(MDR/RR-TB)是重要的公共卫生问题,包括在艾滋病毒高流行的环境中。在一线TB治疗期间,TB耐药性可以直接传播或通过耐药性获得而产生。有限的证据表明,艾滋病毒感染者(PLHIV)可能会增加获得性利福霉素耐药性(ARR)的风险。
    方法:为了评估一线结核病治疗期间HIV作为ARR的危险因素,我们进行了系统评价和荟萃分析.ARR定义为治疗开始时的利福霉素敏感性,治疗期间或治疗结束时诊断为利福霉素耐药。或复发。PubMed/MEDLINE,CINAHL,科克伦图书馆,从成立到2024年5月23日,搜索了GoogleScholar数据库中的英文文章;从2004年到2021年还搜索了会议摘要。Mantel-Haenszel随机效应模型用于估计接受一线结核病治疗的个体中HIV和ARR之间任何关联的合并比值比。
    结果:确定了包含1990年至2014年收集的数据的10项研究:5项来自美国,两个来自南非,一个来自乌干达,印度和摩尔多瓦。所有研究共纳入97,564人,13,359(13.7%)感染艾滋病毒。总的来说,312(0.32%)获得利福霉素抗性,其中115人(36.9%)为PLHIV。与接受一线结核病治疗的HIV阴性个体相比,PLHIV的ARR加权几率为4.57(95%CI,2.01-10.42)倍。
    结论:现有数据,提示PLHIV在一线TB治疗期间有增加的ARR风险.需要进一步的研究来澄清具体的风险因素,包括晚期HIV疾病和结核病的严重程度。鉴于较短的引入,4个月利福霉素为基础的方案,迫切需要更多关于ARR的数据,特别是PLHIV。
    背景:PROSPEROCRD42022327337。
    BACKGROUND: Multi-drug or rifamycin-resistant tuberculosis (MDR/RR-TB) is an important public health concern, including in settings with high HIV prevalence. TB drug resistance can be directly transmitted or arise through resistance acquisition during first-line TB treatment. Limited evidence suggests that people living with HIV (PLHIV) might have an increased risk of acquired rifamycin-resistance (ARR).
    METHODS: To assess HIV as a risk factor for ARR during first-line TB treatment, a systematic review and meta-analysis was conducted. ARR was defined as rifamycin-susceptibility at treatment start with rifamycin-resistance diagnosed during or at the end of treatment, or at recurrence. PubMed/MEDLINE, CINAHL, Cochrane Library, and Google Scholar databases were searched from inception to 23 May 2024 for articles in English; conference abstracts were also searched from 2004 to 2021. The Mantel-Haenszel random-effects model was used to estimate the pooled odds ratio of any association between HIV and ARR among individuals receiving first-line TB treatment.
    RESULTS: Ten studies that included data collected between 1990 and 2014 were identified: five from the United States, two from South Africa and one each from Uganda, India and Moldova. A total of 97,564 individuals were included across all studies, with 13,359 (13.7%) PLHIV. Overall, 312 (0.32%) acquired rifamycin-resistance, among whom 115 (36.9%) were PLHIV. The weighted odds of ARR were 4.57 (95% CI, 2.01-10.42) times higher among PLHIV compared to HIV-negative individuals receiving first-line TB treatment.
    CONCLUSIONS: The available data, suggest that PLHIV have an increased ARR risk during first-line TB treatment. Further research is needed to clarify specific risk factors, including advanced HIV disease and TB disease severity. Given the introduction of shorter, 4-month rifamycin-based regimens, there is an urgent need for additional data on ARR, particularly for PLHIV.
    BACKGROUND: PROSPERO CRD42022327337.
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  • 文章类型: Journal Article
    背景:指南推荐常规冷圈套器息肉切除术(C-CSP)治疗小体积和小体积结直肠息肉(≤10mm)。然而,目前尚不清楚CSP联合粘膜下注射(SI-CSP)治疗这些病变的疗效是否与C-CSP相当.这项研究比较了SI-CSP和C-CSP对小型和小型结直肠息肉患者的影响。
    方法:进行了电子文献检索,以检索比较SI-CSP和C-CSP在小型和小型结直肠息肉中的切除结果的文章(注册号INPLASY2023100096)。我们感兴趣的主要结果是完全切除率(CRR),并发症(即立即出血,延迟出血和穿孔)和息肉切除时间。连续变量采用95%置信区间(CI)的平均差,而以95%CI计算分类变量的比值比(OR).使用随机效应模型分析数据,并利用I2检验评估异质性。
    结果:我们的分析中纳入了8项研究,涉及1470例2223例息肉患者。SI-CSP组的CRR没有显著升高,OR为95%CI0.50(0.22,1.15)。两组的即时出血(OR95%CI0.60[0.26-1.40])和延迟出血(OR95%CI0.88[0.32-2.42])的发生率没有显着差异。平均而言,C-CSP组的平均息肉切除时间缩短了64.75秒(95%CI,-102.96~-26.53).值得注意的是,纳入的研究没有穿孔事件的报道.
    结论:SI-CSP在处理小型和小型结直肠息肉方面并不优于C-CSP,而且手术需要更多的时间。
    BACKGROUND: The guidelines recommend conventional cold snare polypectomy (C-CSP) for diminutive and small colorectal polyps (≤ 10 mm). However, it remains unclear whether CSP with sub-mucosal injection (SI-CSP) achieves comparable efficacy to C-CSP for managing these lesions. This study compares SI-CSP with C-CSP for patients with diminutive and small colorectal polyps.
    METHODS: An electronic literature search was conducted to retrieve articles comparing resection outcomes between SI-CSP and C-CSP in diminutive and small colorectal polyps (registration number INPLASY2023100096). Our primary outcomes of interest were the complete resection rate (CRR), complications (namely immediate bleeding, delayed bleeding and perforation) and polypectomy time. Mean differences with 95% confidence intervals (CI) were employed for continuous variables, while odds ratios (OR) with 95% CI were calculated for categorical variables. Data was analyzed using a random effects model and the I2 test was utilized to assess heterogeneity.
    RESULTS: Eight studies involving 1470 patients with 2223 polyps were included in our analysis. The CRR was not significantly higher in the SI-CSP group, with an OR of 95% CI 0.50 (0.22, 1.15). The incidences of immediate bleeding (OR 95% CI 0.60 [0.26-1.40]) and delayed bleeding (OR 95% CI 0.88 [0.32-2.42]) did not differ significantly between the two groups. On average, the mean polypectomy time was 64.75 seconds shorter in the C-CSP group (95% CI, - 102.96 to - 26.53). Notably, no perforation events were reported in the included studies.
    CONCLUSIONS: The use of SI-CSP was not superior to C-CSP in managing diminutive and small colorectal polyps and the procedure required significantly more time.
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