Postgraduate medicine
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Postgraduate medicine · Apr 2021
Review Meta AnalysisThe effect of prophylactic thoracic duct ligation during esophagectomy on the incidence of chylothorax and survival of the patients: an updated review.
The role of thoracic duct ligation (TDL) during esophagectomy remains controversial. This review aimed to elucidate the effect of TDL on chylothorax and survival of the patients after esophagectomy for cancer. ⋯ The present review provided updated evidence opposing prophylactic TDL during esophagectomy for lowering chylothorax. Considering the harmful effect of TDL on survival of the patients, further well-designed trials should be considered in selected cases under strict supervision.
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Postgraduate medicine · Nov 2020
Meta AnalysisCOVID-19 and comorbidities: A systematic review and meta-analysis.
SARS-CoV-2 has caused a worldwide pandemic that began with an outbreak of pneumonia cases in the Hubei province of China. Knowledge of those most at risk is integral for treatment, guideline implementation, and resource allocation. We conducted a systematic review and meta-analysis to evaluate comorbidities associated with severe and fatal cases of COVID-19. ⋯ Diabetes was more prevalent among fatal cases [24.89% (95%CI: 18.80%, 32.16%)] compared to total cases [9.65% (95%CI: 6.83%, 13.48%)]. Respiratory diseases had a higher prevalence in fatal cases [10.89% (95%CI: 7.57%, 15.43%)] in comparison to total cases [3.65% (95%CI: 2.16%, 6.1%)]. Studies assessing the mechanisms accounting for the associations between severe cases and hypertension, diabetes, and respiratory diseases are crucial in understanding this new disease, managing patients at risk, and developing policies and guidelines that will reduce future risk of severe COVID-19 disease.
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Postgraduate medicine · Aug 2019
Meta AnalysisSerum levels of YKL-40 are increased in patients with psoriasis: a meta-analysis.
Background: YKL-40, also named chitinase-3-like protein 1, has been confirmed as an inflammatory glycoprotein associated with cardiovascular disease, diabetes or metabolic syndrome which are common comorbidities in psoriasis. Growing evidence has demonstrated that serum levels of YKL-40 in psoriatic patients were increased, however the results were appearance contradictory among the current published studies. Methods: Research involved in serum levels of YKL-40 in psoriatic patients and healthy control individuals was searched in PUBMED, EMBASE, and The Cochrane Library databases (up to 31 December 2018). ⋯ Our meta-analysis revealed that psoriatic patients had a higher serum YKL-40 levels compared to the control group, with the WMD of 53.6 ng/ml (95% CI: 31.3 to 75.9, P< 0.001). Furthermore, results of meta-regression analysis and subgroup analysis revealed that the disease duration and the value of psoriasis area and severity index (PASI) were related to the observed YKL-40 differences between two groups. Conclusions: Our meta-analysis indicates that psoriatic patients have higher serum YKL-40 levels when compared to healthy control individuals, and the levels are significantly affected by the disease duration and PASI.
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Postgraduate medicine · Jun 2017
Meta AnalysisCalprotectin levels in rheumatoid arthritis and their correlation with disease activity: a meta-analysis.
We evaluated the relationship between calprotectin levels and rheumatoid arthritis (RA), and the correlation between plasma/serum calprotectin and RA activity. ⋯ Our meta-analysis demonstrates that circulating and synovial fluid calprotectin levels are high in patients with RA, and that circulating calprotectin levels positively correlate with RA activity.
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Postgraduate medicine · May 2017
Meta AnalysisSafety and efficacy of a glucagon-like peptide-1 receptor agonist added to basal insulin therapy versus basal insulin with or without a rapid-acting insulin in patients with type 2 diabetes: results of a meta-analysis.
To consolidate the evidence from randomized controlled trials evaluating the use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) as add-on to basal insulin therapy in type 2 diabetes (T2D) patients. ⋯ Addition of GLP-1 RA to basal insulin provided improved glycemic control, led to weight reduction and similar hypoglycemia rates versus an intensified insulin strategy; however, symptomatic hypoglycemia rates were significantly lower when compared with a basal insulin plus RAI.