Therapeutic Advances in Chronic Disease最新文献

{"title":"Comparative efficacy of different noninvasive brain stimulation therapies for recovery of global cognitive function, attention, memory, and executive function after stroke: a network meta-analysis of randomized controlled trials.","authors":"Yao Wang,&nbsp;Wan Liu,&nbsp;Jiu Chen,&nbsp;Jianling Bai,&nbsp;Hao Yu,&nbsp;Hongxia Ma,&nbsp;Jiang Rao,&nbsp;Guangxu Xu","doi":"10.1177/20406223231168754","DOIUrl":"https://doi.org/10.1177/20406223231168754","url":null,"abstract":"<p><strong>Background: </strong>Which noninvasive brain stimulation (NIBS) treatment - transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS) - is more beneficial for stroke patients' cognitive rehabilitation is still up for debate.</p><p><strong>Objectives: </strong>Our goal is to provide an overview of the research on the effectiveness and safety of various NIBS protocols.</p><p><strong>Design: </strong>Systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs).</p><p><strong>Methods: </strong>This NMA compared any active NIBS <i>versus</i> sham stimulation in adult stroke survivors to enhance cognitive function, with a focus on global cognitive function (GCF), attention, memory, and executive function (EF) using the databases MEDLINE, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. The NMA statistical approach was built on a frequency framework. The effect size was estimated by the standardized mean difference (SMD) and a 95% confidence interval (CI). We compiled a relative ranking of the competing interventions based on their surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>NMA showed that high-frequency repeated TMS (HF-rTMS) improved GCF compared with sham stimulation (SMD = 1.95; 95% CI: 0.47-3.43), while dual-tDCS improved memory performance <i>versus</i> sham stimulation significantly (SMD = 6.38; 95% CI: 3.51-9.25). However, various NIBS stimulation protocols revealed no significant impact on enhancing attention, executive function, or activities of daily living. There was no significant difference between the active stimulation protocols for TMS and tDCS and sham stimulation in terms of safety. Subgroup analysis demonstrated an effect favoring activation site of the left dorsolateral prefrontal cortex (DLPFC) (SUCRA = 89.1) for enhancing GCF and bilateral DLPFC (SUCRA = 99.9) stimulation for enhancing memory performance.</p><p><strong>Conclusion: </strong>The HF-rTMS over the left DLPFC appears to be the most promising NIBS therapeutic option for improving global cognitive performance after stroke, according to a comparison of numerous NIBS protocols. Furthermore, for patients with post-stroke memory impairment, dual-tDCS over bilateral DLPFC may be more advantageous than other NIBS protocols. Both tDCS and TMS are reasonably safe.</p><p><strong>Registration: </strong>PROSPERO ID: CRD42022304865.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231168754"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/9b/10.1177_20406223231168754.PMC10272674.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10301167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-normal free thyroxine level is related with decreased bone mineral density in nonobese male patients with type 2 diabetes over 50 years old.","authors":"Hanxin Zhao,&nbsp;Dike Shi,&nbsp;Guoxing Wang,&nbsp;Yu Ruan,&nbsp;Xiaocheng Feng,&nbsp;ChengFang Jia,&nbsp;Qingqing Wang,&nbsp;Xuehong Dong","doi":"10.1177/20406223231195627","DOIUrl":"https://doi.org/10.1177/20406223231195627","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of 'low bone mineral density (BMD)' in Type 2 diabetes (T2DM), especially stratified by body mass index, is seldom reported. The relation of the euthyroid range and low BMD in T2DM remains to be further elucidated.</p><p><strong>Objectives: </strong>We aim to investigate the thyroid hormones' impact on BMD among euthyroid patients with T2DM.</p><p><strong>Design and methods: </strong>A total of 1452 hospitalized T2DM patients with normal thyroid function (43.6% males aged over 50 and 56.4% postmenopausal females) were enrolled in this cross-sectional study. BMD was measured at lumbar spine by GE lunar dual-energy X-ray absorptiometry system, and 'low BMD' was defined as <i>T</i>-score <-1.0 SD. The prevalence of 'low BMD' was compared between obese and nonobese (body mass index < 25 kg/m²) groups for both sexes, and the relation of low BMD and free T4 quartiles was explored by multiple logistic regression.</p><p><strong>Results: </strong>The general prevalence of 'low BMD' was 12.3% for male patients aged over 50 (15.5% in the nonobese group and 8.0% in the obese group) and 49.8% for postmenopausal females (56.7% in the nonobese group and 48.9% in the obese group). After adjustment in multiple linear regression, free T4 level remained significantly related to decreased BMD in nonobese male subgroup. Multiple logistic regression revealed that BMD of the highest free T4 quartile (1.12-1.48 ng/dL) decreased significantly than other three quartiles after adjusting for confounding factors including age, body mass index, serum calcium and creatinine level, fasting glucose, alkaline phosphatase, glycosylated hemoglobin, total cholesterol, and smoking history (OR = 2.724, 95% CI = 1.085-6.840, <i>p</i> = 0.033). No significant relation was found in obese male or postmenopausal female groups.</p><p><strong>Conclusion: </strong>High-normal free T4 is a potential independent risk factor for 'low BMD' in nonobese male T2DM patients aged over 50. Close attention should be paid to thyroid function profile, even within normal range, in nonobese men with underlying higher fracture risks on diabetes status.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231195627"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/72/f0/10.1177_20406223231195627.PMC10472831.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eosinophilia attention, diagnosis, treatment, and awareness in physicians: a cross-sectional survey.","authors":"Bigui Chen,&nbsp;Yu Fu,&nbsp;Zhufeng Wang,&nbsp;Qiuping Rong,&nbsp;Qingling Zhang,&nbsp;Jiaxing Xie,&nbsp;Xuetao Kong,&nbsp;Mei Jiang","doi":"10.1177/20406223221146938","DOIUrl":"https://doi.org/10.1177/20406223221146938","url":null,"abstract":"<p><strong>Background: </strong>Patients with incidental eosinophilia is becoming increasingly common in clinical practice. But it remains challenging to diagnose and treat owing to its complex etiology. The awareness of physicians and the strategies of diagnosis and treatment toward eosinophilia are still unclear.</p><p><strong>Objective: </strong>We aimed to evaluate attention, diagnosis, treatment, and awareness of eosinophilia among physicians, as well as factors influencing clinical practice, and to find ways to improve the efficacy of this disease.</p><p><strong>Design: </strong>This is a cross-sectional survey.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from 1 to 4 June 2021 in a tertiary hospital. Self-administered and validated electronic questionnaire was used to investigate the attention toward eosinophilia, the strategies of diagnosis and treatment, and the awareness in physicians.</p><p><strong>Results: </strong>A total of 607 valid questionnaires were collected, with a response rate of 84.5%. Among the responders, 65.4% of physicians claimed to be familiar with patients with eosinophilia but only 11.0% of them had read the relevant guidelines or expert consensus. Among 207 physicians who had ever diagnosed patients with eosinophilia, only 19.4% had performed detailed examinations. The accuracy of awareness questions was 1.6-53.5%, and only 26.5% of physicians had high levels of awareness. An increase in the awareness level of up to 2.82 folds was seen among physicians with factors such as job title, encountering patients with eosinophilia, linking patients' conditions to peripheral blood eosinophil count, and paying attention to guidelines.</p><p><strong>Conclusion: </strong>This study highlighted the importance of raising awareness and knowledge of eosinophilia among physicians in China. More works on education about eosinophilia guideline are needed, which may help physicians make decision with more benefits to patients.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223221146938"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3f/a2/10.1177_20406223221146938.PMC9880572.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9150268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A primer on common supplements and dietary measures used by patients with inflammatory bowel disease.","authors":"Hadi J Minhas,&nbsp;Konstantinos Papamichael,&nbsp;Adam S Cheifetz,&nbsp;Robert J Gianotti","doi":"10.1177/20406223231182367","DOIUrl":"https://doi.org/10.1177/20406223231182367","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a chronic disease of the intestines. The pathophysiology of IBD, namely Crohn's disease and ulcerative colitis, is a complex interplay between environmental, genetic, and immune factors. Physicians and patients often seek complementary and alternative medicines (CAMs) as primary and supplementary treatment modalities. CAMs in IBD span a wide range of plants, herbs, pre/probiotics, and include formulations, such as cannabis, curcumin, fish oil, and De Simone Formulation. Dietary measures are also used to improve symptoms by attempting to target trigger foods and reducing inflammation. Examples include the specific carbohydrate diet, the Mediterranean diet, and a diet low in fermentable oligo-, di- and monosaccharides as well as polyols (FODMAP). We examine and review the most common complementary supplements and diets used by patients with IBD.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231182367"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/45/10.1177_20406223231182367.PMC10328183.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9866306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hematological parameters and early-onset coronary artery disease: a retrospective case-control study based on 3366 participants.","authors":"Huan Wang,&nbsp;Hui Li,&nbsp;Yan Wang,&nbsp;Cong Zhao,&nbsp;Qing-Wu Tian,&nbsp;Qing Wang,&nbsp;Guo-Wei He,&nbsp;Li-Min Lun,&nbsp;Chao Xuan","doi":"10.1177/20406223221142670","DOIUrl":"https://doi.org/10.1177/20406223221142670","url":null,"abstract":"<p><strong>Background: </strong>Thrombosis and inflammation are crucial elements in the pathogenesis of cardiovascular disease. Hematological parameters elucidate information involving the inflammatory and blood coagulation processes.</p><p><strong>Objectives: </strong>The current study explored the association of hematological parameters with EOCAD to identify specific risk factors.</p><p><strong>Design: </strong>A single-center retrospective case-control study was conducted with 1693 coronary artery disease patients and 1693 controls.</p><p><strong>Methods: </strong>Hematological parameters were examined through an automated analyzer.</p><p><strong>Results: </strong>The basophil percentage was significantly reduced in EOCAD (0.43 ± 0.26, <i>p</i> < 0.001) and MI (0.33 ± 0.24, <i>p</i> < 0.001) groups compared with controls (0.54 ± 0.28). The eosinophil percentage was also significantly lower in EOCAD (2.21 ± 1.71, <i>p</i> < 0.001) and MI (1.71 ± 2.44, <i>p</i> < 0.001) groups compared with controls (2.41 ± 1.75). The lymphocyte percentage in patients of EOCAD and MI and controls was 31.65 ± 7.93, 25.48 ± 9.43, and 34.82 ± 7.28, respectively. A significant difference was observed among the groups (<i>p</i> < 0.001). Except for the mean corpuscular hemoglobin (MCH), other red blood cell (RBC) parameters significantly differed between EOCAD patients and controls. The red blood cell distribution width (RDW), hematocrit (HCT), RBC count, mean corpuscular hemoglobin concentration (MCHC), mean corpuscular volume (MCV), and hemoglobin level were associated with EOCAD prevalence after adjusting for baseline differences. Platelet volume distribution width (PDW) also correlated with EOCAD prevalence (OR_adjust = 1.087, 95% CI: 1.044-1.131).</p><p><strong>Conclusions: </strong>Hematological parameters are closely associated with EOCAD. Moreover, leukocyte parameters correlated with the presence and severity of the disease. In addition, erythrocyte parameters were associated with the disease presence but not with the disease severity. Among the platelet parameters, only PDW was related to the disease presence.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223221142670"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/46/f2/10.1177_20406223221142670.PMC9869207.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9915515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two-year real-world outcome data from a single tertiary centre shows reduced ustekinumab persistence in a non-bio-naïve Crohn's disease cohort with penetrating disease, -ostomies and sarcopenia.","authors":"Saskia Inniss,&nbsp;Konstantinos C Fragkos,&nbsp;Lisa Whitley,&nbsp;Rachel Wimpory,&nbsp;Eleanor Rebello,&nbsp;Ana Lisboa,&nbsp;Tanvi Khetan,&nbsp;Jasmine Hassan,&nbsp;Kate Simpson,&nbsp;Anisha Bhagwanani,&nbsp;Roser Vega,&nbsp;Ioanna Parisi,&nbsp;Paul Harrow,&nbsp;Edward Seward,&nbsp;Sara McCartney,&nbsp;Stuart Bloom,&nbsp;Andrew M Smith,&nbsp;Andrew Plumb,&nbsp;Farooq Z Rahman","doi":"10.1177/20406223231189072","DOIUrl":"https://doi.org/10.1177/20406223231189072","url":null,"abstract":"<p><strong>Background: </strong>Ustekinumab was approved in 2016 for the treatment of moderate-severe Crohn's disease (CD). Clinical trials and real-world studies have suggested ustekinumab to be a safe and effective treatment; however, studies to date infrequently use imaging techniques to predict response to biologics in CD.</p><p><strong>Objectives: </strong>We assessed the 2-year real-world effectiveness and safety of ustekinumab in a tertiary CD cohort with the use of novel imaging techniques.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Retrospective data were collected between 2016 and 2021. Study end points included ustekinumab persistence, biological and/or clinical response and remission at 12, 18 and 24 months. Statistical analysis included demographic and inferential analyses.</p><p><strong>Results: </strong>In all, 131 CD patients [57.3% female, median age of 26.0 (21.0-37.0)] were included. Patients were non-bio naïve, and the majority received ustekinumab as third- or fourth-line treatment. At 24 months, 61.0% (80/131) persisted with ustekinumab [52.7% (69/131) steroid free]. Clinical response was reported in 55.2% (37/67), clinical remission in 85.7% (57/67), biological response in 46.8% (22/47) and biological remission in 31.9% (15/47) of patients at 24 months. The low outcome numbers were attributable to missing data. Improvements in routine disease markers, including C-reactive protein and Harvey-Bradshaw Index, were also reflected in magnetic resonance imaging-derived disease scores. The presence of penetrating CD, an -ostomy and sarcopenia were all predictors of poorer ustekinumab outcomes (<i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Ustekinumab is effective in non-bio-naïve CD patients with non-stricturing, non-penetrating disease with an unremarkable safety profile but may be less effective in those with penetrating disease, -ostomies and sarcopenia.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231189072"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/23/c2/10.1177_20406223231189072.PMC10434845.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10052116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optical coherence tomography biomarkers as predictors of transition to chronic central serous chorioretinopathy after retinal laser photocoagulation.","authors":"Ying Huang,&nbsp;Weiwei Zheng,&nbsp;Zuhua Sun,&nbsp;Shenghai Huang,&nbsp;Bing Lin","doi":"10.1177/20406223221146721","DOIUrl":"https://doi.org/10.1177/20406223221146721","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the optical coherence tomography (OCT) biomarkers to predict the transition to chronic central serous chorioretinopathy (cCSC) after retinal laser photocoagulation.</p><p><strong>Methods: </strong>Patients enrolled in this study were from a 12-week clinical trial comparing the efficacy and safety of subthreshold micropulse laser (SML) with threshold conventional laser (TCL) for CSC and had extended follow-up for more than 1 year. They were divided into two groups, transited to cCSC group (cCSC group) and did not transited to cCSC group (non-cCSC group) according to fundus examination at the extended follow-up. Collect the best-corrected visual acuity (BCVA) and OCT characteristics of patients at baseline and 12 weeks after laser treatment.</p><p><strong>Results: </strong>Twenty-seven patients were enrolled (42.6 ± 7.7 years old), and duration of follow-up was 178.9 ± 88.8 (57.0-312.0) weeks. Nine patients (33.3%) were assigned to cCSC group, and the other 18 patients (66.7%) were assigned to the non-cCSC group. Twelve weeks after the laser treatment, subretinal fluid (SRF) of 15 patients (83.3%) in non-cCSC group and 5 patients (55.6%) in cCSC group absorbed completely; the height of SRF had statistical difference between two groups (<i>p</i> = 0.035); rough RPE was less common in cCSC group (<i>p</i> = 0.030); hyper reflective mass (HRM) was more common in cCSC group (<i>p</i> = 0.024); more number of hyper reflective foci (HRF) in outer segment of photoreceptor layer were detected in cCSC group (<i>p</i> = 0.035). From baseline to 12 weeks after laser treatment, the number of HRF in outer segment photoreceptor layer did not change significantly in cCSC group (<i>p</i> = 0.665) but decreased significantly in non-cCSC group (<i>p</i> = 0.000). A total of five patients suffered binocular CSC, three of them in the non-cCSC group occurred later than the other two in the cCSC group (129.9-278.3 weeks <i>vs</i> 96.1-114.9 weeks after baseline).</p><p><strong>Conclusion: </strong>SRF, rough RPE, HRM, and number of HRF in outer segment photoreceptor layer 12 weeks after laser treatment, and change in the number of HRF in outer segment photoreceptor layer from baseline to 12 weeks after laser treatment may predict the transition to cCSC.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223221146721"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/31/0c/10.1177_20406223221146721.PMC9871971.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10625588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging roles of macrophages in heart failure and associated treatment approaches.","authors":"Lan Xie,&nbsp;Jinyong Chen,&nbsp;Yidong Wang,&nbsp;Chengjiang Jin,&nbsp;Yao Xie,&nbsp;Hong Ma,&nbsp;Meixiang Xiang","doi":"10.1177/20406223231168755","DOIUrl":"https://doi.org/10.1177/20406223231168755","url":null,"abstract":"<p><p>Heart failure is typically caused by different cardiovascular conditions and has a poor prognosis. Despite the advances in treatment in recent decades, heart failure has remained a major cause of morbidity and mortality worldwide. As revealed by <i>in vivo</i> and <i>in vitro</i> experiments, inflammation plays a crucial role in adverse cardiac remodeling, ultimately leading to heart failure. Macrophages are central to the innate immune system, and they are the most indispensable cell type for all cardiac injuries and remodeling stages. The immediate microenvironment regulates their polarization and secretion. In this review, we summarize the phenotypic heterogeneity and governing roles of macrophages in the infarcted, inflamed, and aging heart and assess their significance as potential therapeutic targets in heart failure. We also highlight the current missing links and major challenges in the field that remain to be addressed before macrophages can be exploited for therapeutic applications.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231168755"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bb/ea/10.1177_20406223231168755.PMC10155014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10662284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is <i>Helicobacter pylori</i> infection associated with pancreatic cancer? A systematic review and meta-analysis of observational studies.","authors":"Ben-Gang Zhou,&nbsp;Yu-Zhou Mei,&nbsp;Jing-Shu Wang,&nbsp;Jian-Lei Xia,&nbsp;Xin Jiang,&nbsp;Sheng-Yong Ju,&nbsp;Yan-Bing Ding","doi":"10.1177/20406223231155119","DOIUrl":"https://doi.org/10.1177/20406223231155119","url":null,"abstract":"<p><strong>Background and objectives: </strong>Recent observational studies have investigated the association between <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection and pancreatic cancer with conflicting data. Therefore, we conducted a systematic review and meta-analysis to assess the potential association.</p><p><strong>Design: </strong>This is a systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched three databases (PubMed, Embase, and Web of Science) from inception to 30 August 2022. The summary results as odds ratio (OR) or hazard ratio (HR) with 95% confidence interval (CI) were pooled by generic inverse variance method based on random-effects model.</p><p><strong>Results: </strong>A total of 20 observational studies involving 67,718 participants were included in the meta-analysis. Meta-analysis of data from 12 case-control studies and 5 nested case-control studies showed that there was no significant association between <i>H. pylori</i> infection and the risk of pancreatic cancer (OR = 1.20, 95% CI = 0.95-1.51, <i>p</i> = 0.13). Similarly, we also did not find significant association between cytotoxin-associated gene A (CagA) positive strains, CagA negative strains, vacuolating cytotoxin gene A (VacA) positive strains <i>H. pylori</i> infection, and the risk of pancreatic cancer. Meta-analysis of data from three cohort studies showed that <i>H. pylori</i> infection was not significantly associated with an increased risk of incident pancreatic cancer (HR = 1.26, 95% CI = 0.65-2.42, <i>p</i> = 0.50).</p><p><strong>Conclusion: </strong>We found insufficient evidence to support the proposed association between <i>H. pylori</i> infection and increased risk of pancreatic cancer. To better understand any association, future evidence from large, well-designed, high-quality prospective cohort studies that accounts for diverse ethnic populations, certain <i>H. pylori</i> strains, and confounding factors would be useful to settle this controversy.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231155119"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4f/a4/10.1177_20406223231155119.PMC9986679.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9081328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of postoperative radiotherapy on survival in patients with completely resected and pathologically confirmed stage N2 non-small-cell lung cancer: a systematic review and meta-analysis.","authors":"Lin Wang,&nbsp;Wenyu Chen,&nbsp;Xiaofei Xu,&nbsp;Wenbo Chen,&nbsp;Derong Bao,&nbsp;Ye Zhang,&nbsp;Yufen Xu","doi":"10.1177/20406223231195622","DOIUrl":"https://doi.org/10.1177/20406223231195622","url":null,"abstract":"<p><strong>Background: </strong>The role of postoperative radiotherapy (PORT) for patients with completely resected stage N2 non-small-cell lung cancer (NSCLC) has been controversial. This study aimed to investigate the efficacy of PORT and prognosis in these patients.</p><p><strong>Objectives: </strong>An updated meta-analysis was conducted in this study to investigate the efficacy of PORT and prognosis in patients with completely resected and pathologically confirmed stage N2 NSCLC.</p><p><strong>Design: </strong>This study is a systematic review and meta-analysis.</p><p><strong>Data source and methods: </strong>Databases were searched up to 2 March 2022. All trials on patients with completely resected and pathologically confirmed stage N2 NSCLC undergoing PORT were screened, and data indicators in the PORT and non-PORT groups were extracted, respectively. The effect of PORT on overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) was estimated. Subgroup and sensitivity analyses were performed.</p><p><strong>Results: </strong>In all, 20 studies involving 6340 patients were finally included. The PORT significantly increased OS [hazard ratio (HR) = 0.77, 95% CI: 0.71-0.84, <i>p</i> < 0.001), LRFS (HR = 0.63, 95% CI: 0.52-0.76, <i>p</i> < 0.001), and DFS (HR = 0.72, 95% CI: 0.63-0.82, <i>p</i> < 0.001) while it showed no significant difference in improving DMFS (HR = 0.86, 95% CI: 0.71-1.05, <i>p</i> = 0.14).</p><p><strong>Conclusion: </strong>Our results suggest that in the postoperative treatment of patients with completely resected and pathologically confirmed stage N2 NSCLC, the addition of PORT provides better local recurrence control and survival benefit, but no benefit for distant metastases. The PORT may be incorporated into the postoperative treatment options for some patients with high-risk factors. However, it needs to be validated by more prospective studies in the future.</p><p><strong>Trail registration: </strong>CRD42022314095.</p>","PeriodicalId":22960,"journal":{"name":"Therapeutic Advances in Chronic Disease","volume":"14 ","pages":"20406223231195622"},"PeriodicalIF":3.5,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a3/e3/10.1177_20406223231195622.PMC10501070.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10672527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}