The precise impact of sex difference on in-hospital mortality in ST-elevation myocardial infarction (STEMI) patients are unclear, and the studies are no longer consistent. Therefore, we sought to ...evaluate the impact of sex differences in a cohort of STEMI patients.
We analyzed the data of 2647 STEMI patients enrolled in the Kermanshah STEMI Cohort from July 2017 to May 2020. To accurately clarify the relationship between sex and hospital mortality, propensity score matching (PSM) and causal mediation analysis was applied to the selected confounder and identified intermediate variables, respectively.
Before matching, the two groups differed on almost every baseline variable and in-hospital death. After matching with 30 selected variables, 574 male and female matched pairs were significantly different only for five baseline variables and women were no longer at greater risk of in-hospital mortality (10.63% vs. 9.76%, p = 0.626). Among the suspected mediating variables, creatinine clearance (CLCR) alone accounts for 74% (0.665/0.895) of the total effect equal to 0.895(95% CI: 0.464-1.332). In this milieu, the relationship between sex and in-hospital death was no longer significant and reversed -0.233(95% CI: -0.623-0.068), which shows the full mediating role of CLCR.
Our research could help address sex disparities in STEMI mortality and provide a consequence. Moreover, CLCR alone can fully explain this relationship, which can highlight the importance of CLCR in predicting the short-term outcomes of STEMI patients and provide a useful indicator for clinicians.
Although the main cause of appendicitis is unclear, infection with Enterobius vermicularis is suggested as a neglected risk factor. Since, there is no comprehensive analysis to estimate the ...prevalence of E. vermicularis in appendicitis; therefore, we conducted a global-scale systematic review and meta-analysis study to estimate the prevalence of E. vermicularis infection in appendicitis cases. PubMed, Scopus, Web of Science and Google Scholar databases were systematically searched for relevant studies published until 15 August 2019. Pooled prevalence of E. vermicularis infection was estimated using the random effects model. Data were classified based on the continents and countries. Moreover, subgroup analyses regarding the gender, the human development index (HDI), and income level of countries were also performed. Fifty-nine studies involving 103195 appendix tissue samples belonging to the individuals of appendicitis were included. The pooled prevalence of E. vermicularis infection was (4%, 95%CI, 2-6%), with the highest prevalence (8%, 95% CI: 0-36%) and lowest prevalence (2%, 95% CI: 1-4%) in Africa and Americas continents, respectively. With respect to countries, the lowest and highest prevalence rates were reported from Venezuela (<1%, 95% CI: 0-1%) and Nigeria (33%, 95% CI: 17-52%), respectively. Indeed, a higher prevalence was observed in females, as well as in countries with lower levels of income and HDI. Our findings indicate the relatively high burden of E. vermicularis infection in appendicitis cases. However, our findings suggest the great need for more epidemiological studies to depth understand overlaps between E. vermicularis infection and appendicitis in countries with lower HDI and income levels.
Background and Aim
Escherichia coli pathobionts and particularly the adherent‐invasive E. coli (AIEC) may play a putative role in initiating and maintaining the inflammatory process in the intestinal ...tissues of inflammatory bowel disease (IBD) patients, by providing stimulatory factors that trigger gut immune system activation. The aim of this study is to conduct a systematic review and meta‐analysis to determine the prevalence of AIEC among patients with Crohn's disease (CD) and ulcerative colitis (UC).
Methods
Electronic databases were searched up to February 2020 for relevant publications reporting the prevalence of AIEC in IBD patients. The prevalence rate of AIEC among CD and UC patients, the odds ratio (OR) and 95% confidence interval (CI) were calculated compared to non‐IBD controls.
Results
The final dataset included 12 studies, all investigating AIEC isolates from ileal/colonic specimens. The OR for prevalence of AIEC in CD patients was 3.27 (95% CI 1.79–5.9) compared with non‐IBD controls. The overall pooled prevalence of AIEC among CD patients was 29% (95% CI 0.17–0.45), whereas this prevalence was calculated to be 9% (95% CI 0.03–0.19) in controls. Moreover, the prevalence of AIEC in UC subjects was calculated 12% (95% CI 0.01–0.34), while AIEC showed a prevalence of 5% (95% CI 0.0–0.17) among the controls. The OR for prevalence of AIEC in UC patients was 2.82 (95% CI 1.11–7.14) compared with controls.
Conclusions
There is a substantial increase in the prevalence of AIEC in IBD patients compared with controls. This review supports the growing evidence that AIEC could be involved in both CD and UC pathogenesis.
This systematic review and meta-analysis study was conducted to estimate the pooled prevalence of CD in low and high risk groups in this region. Following keywords were searched in the Medline, ...PubMed, Scopus, Web of Science and Cochrane database according to the MeSH terms; celiac disease, prevalence, high risk population and Asian-Pacific region. Prevalence studies published from January 1991 to March 2018 were selected. Prevalence of CD with 95% confidence interval (CI) was calculated using STATA software, version 14. The pooled sero-prevalence of CD among low risk group in Asia-Pacific region was 1.2% (95% CI 0.8-1.7%) in 96,099 individuals based on positive anti-tissue transglutaminase (anti-t-TG Ab) and/or anti-endomysial antibodies (EMA). The pooled prevalence of biopsy proven CD in Asia-Pacific among high and low risk groups was 4.3% (95% CI 3.3-5.5%) and 0.61% (95% CI 0.4-0.8%) in 10,719 and 70,344 subjects, respectively. In addition, the pooled sero-prevalence and prevalence of CD in general population was significantly higher in children compared with adults and it was significantly greater in female vs. male (P < 0.05). Our results suggest high risk individuals of CD are key group that should be specifically targeted for prevention and control measures, and screening may prove to have an optimal cost-benefit ratio.
Trichomoniasis is a sexually transmitted infection (STI), caused by the protozoan parasite,
Trichomonas vaginalis
. Female sex workers are intensely affected by the infection, since they have ...frequent direct physical contact. The current systematic review and meta-analysis represents the global prevalence of
T. vaginalis
in female sex workers. Five databases (Science Direct, Scopus, PubMed, Web of Science, and Google Scholar) were explored for literatures that published from July 1985 to June 2020. Totally, 85 studies (54,515 participants) from 46 countries met the inclusion criteria. The global pooled prevalence of
T. vaginalis
was 16% (95% CI 13–19%). The estimated pooled prevalence based on methods including wet mount, culture, and molecular techniques was 15% (95% CI 12–19%), 16% (95% CI 10–24%), and 22% (95% CI 13–32%), respectively. Moreover, the infection was most prevalent at the mean age of 30–36 (20%, 95% CI 11–30%). Regarding the World Health Organization (WHO) regions, the highest pooled prevalence was estimated to be in the African region (23%, 95% CI 7–46%). In addition, we indicated that countries with low-income level have the highest pooled prevalence (23%, 95% CI 14–34%). Our results revealed that the worldwide prevalence of
T. vaginalis
was significant in female sex workers. Therefore, considering a precise strategy such as a health education program with regard to safe intercourse is needed to increase knowledge and prevent
T. vaginalis
infection in sex workers.
Gluten proteins are known as immunological triggers for inflammation resulting in mucosal lesions in patients with coeliac disease (CD). Adherence to a strict gluten-free diet (GFD) is currently ...known as the only effective treatment for CD. In this study, we performed a systematic review and dose-response meta-analysis on data from previous studies to investigate the association between different gluten doses administered and the risk of CD relapse. Electronic databases were systematically searched to retrieve studies that investigated the response of CD patients to different amounts of gluten intake and evaluated the clinical, serologic, and/or histologic evidence to recognize disease relapse. Study-specific relative risks (RRs) were combined using a random effects model. A total of 440 identified published papers were screened, of which 7 records were selected following full-text reviewing and eligibility assessment for dose-response meta-analysis. According to our analysis, the risk of CD relapse is estimated to be 0.2% (RR: 1.002; 95% CI: 1.001 to 1.004) following the consumption of 6 mg gluten/day, which was increased to 7% (RR: 1.07; 95% CI: 1.03 to 1.10), 50% (RR: 1.50; 95% CI: 1.23 to 1.82), 80% (RR: 1.80; 95% CI: 1.36 to 2.38), and 100% (RR: 2.00; 95% CI: 1.43 to 2.78) by the daily intake of 150, 881, 1276, and 1505 mg gluten, respectively. Although good adherence to a GFD can adequately control CD-related symptoms, disease relapse might happen even with a very low dose of gluten, and the duration of exposure to gluten is also an important matter. The current literature has substantial limitations, such as relying on the data from just a few countries that were different in terms of the amount of gluten administered, the duration of the challenge, etc. Therefore, more randomized clinical trials using a standardized gluten challenge protocol are needed to confirm the findings of the present study.
Strongyloides stercoralis, a soil-transmitted helminth, occurs in humans, non-human primates, dogs, cats and wild canids. The zoonotic potential between these hosts is not well understood with data ...available on prevalence primarily focused on humans. To increase knowledge on prevalence, this review and meta-analysis was performed to estimate the global status of S. stercoralis infections in dogs.
Following the PRISMA guidelines, online literature published prior to November 2020 was obtained from multiple databases (Science Direct, Web of Science, PubMed, Scopus and Google Scholar). Prevalence was calculated on a global and country level, by country income and climate, and in stray/animal shelter dogs versus owned dogs. Statistical analyses were conducted using R-software (version 3.6.1).
From 9428 articles, 61 met the inclusion criteria. The estimated pooled global prevalence of S. stercoralis in dogs was 6% (95% CI 3-9%). Infection was found to be the most prevalent in low-income countries with pooled prevalence of 22% (95% CI 10-36%). The highest pooled prevalence of S. stercoralis in dogs was related to regions with average temperature of 10-20 °C (6%; 95% CI 3-11%), an annual rainfall of 1001-1500 mm (9%; 95% CI 4-15%) and humidity of 40-75% (8%; 95% CI 4-13%). Prevalence was higher in stray and shelter dogs (11%; 95% CI 1-26%) than in owned dogs (3%; 95% CI 1-7%).
As with S. stercoralis in humans, higher prevalence in dogs is found in subtropical and tropical regions and lower-income countries, locations which also can have high dog populations. While this study presents the first estimated global prevalence of S. stercoralis in dogs, it is potentially an underestimation with 15 of 61 studies relying on diagnostic methods of lower sensitivity and a paucity of data from most locations. Standardized protocols (e.g. quantity of feces and number of samples for a Baermann) in future studies could improve reliability of results. More prevalence studies and raising veterinary awareness of S. stercoralis are needed for a One Health approach to protect humans and dogs from the impact of the infection.
Co-infection of intestinal helminthic infections (IHIs) and tuberculosis (TB) has appeared as a public health issue, especially in developing countries. Some recent studies have been carried out on ...the possible relevance of IHIs to TB. The current systematic review and meta-analysis was conducted to assess the prevalence and odds ratio (OR) of IHIs among TB patients and clarify the relationship between IHIs and TB disease.
For the purpose of the study, five English databases including PubMed, Science Direct, Scopus, Web of Science (ISI), and Google scholar were searched (up to January 30, 2019) in order to find the related studies. Random-effects meta-analysis model was used to estimate the pooled prevalence, odds ratio (OR), and 95% confidence interval (CI). Inclusion and exclusion criteria were applied.
A total of 20 studies including 10 studies with case-control design (2217 patients and 2520 controls) and 10 studies with cross-sectional design (a total of 2415 participants) met the eligibility criteria. As shown by the random-effects model, the pooled prevalence of IHIs in TB patients was estimated to be 26% (95% CI, 17-35%; 1249/4632). The risk of IHI was higher in TB patients compared to controls but this was not statistically significant. However, according to genus/species, the pooled OR of Strongyloides stercoralis (S. stercoralis) (OR, 2.68; 95% CI, 1.59-4.54) had a significantly higher risk in TB patients compared to controls. Nevertheless, the results of random effects model showed no statistically significant association between overall pooled OR of IHIs in TB patients compared to controls in case-control studies (OR, 1; 95% CI, 0-1).
It is highly recommended that more precise studies should be carried out by researchers in order to better understand this association. Also, it is of great importance to include the periodic screenings for IHIs in the routine clinical care of these patients.
Trichomonas tenax (T. tenax) is a commensal flagellated protozoan found in periodontal microenvironment of the oral cavity, with a possible role in periodontal diseases. The purpose of the present ...systematic review and meta-analysis was to determine the worldwide prevalence of T. tenax infection and to show the neglected association of this parasitic infection with oral diseases.
To find literatures published until August 2020, five English databases (PubMed, Scopus, Science Direct, Web of Science and Google Scholar) were explored. Finally, 65 papers were qualified to be included in the current study.
Our results revealed a global pooled prevalence of 17% (95% CI 14-22%) for T. tenax infection. The highest prevalence was estimated at 56% (42-69%) in Chile, while the lowest prevalence was related to Kenya with 3% (1-6%). The age-based analysis found that the infection was most common in 46-55 mean age group with 15% (0-100%). The overall prevalence regarding culture method, molecular method and direct method was 21% (12-32%), 19% (8-35%) and 17% (12-23%), respectively. Moreover, the subgroup analysis showed the pooled prevalence in patient with candidiasis 22% (3-52%), gingivitis 21% (9-36%) and periodontitis 27% (10-48%).
Our study specified a connection between T. tenax protozoa and periodontitis disease. However, more epidemiological studies as well as clinical trials are needed to precisely identify this relation.
The projection studies are imperative to satisfy demands for health care systems and proper response to the public health problems such as inflammatory bowel disease (IBD).
To accomplish this, we ...established an illness-death model based on available data to project the future prevalence of IBD in Asia, Iran in particular, separately from 2017 to 2035. We applied two deterministic and stochastic approaches.
In 2035, as compared to 2020, we expected a 2.5-fold rise in prevalence for Iran with 69 thousand cases, a 2.3-fold increment for North Africa and the Middle East with 220 thousand cases, quadrupling of the prevalence for India with 2.2 million cases, a 1.5-fold increase for East Asia region with 4.5 million cases, and a 1.6-fold elevation in prevalence for high-income Asia-Pacific and Southeast Asia regions with 183 and 199 thousand cases respectively.
Our results showed an emerging epidemic for the prevalence of IBD in Asia regions and/or countries. Hence, we suggest the need for immediate action to control this increasing trend in Asia and Iran. However, we were virtually unable to use information about age groups, gender, and other factors influencing the evolution of IBD in our model due to lack of access to reliable data.
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