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Aims/Introduction: An overrepresentation of epilepsy has been suggested in patients with type 1 diabetes (T1D). This meta-analysis was conducted to evaluate if type 1 diabetes is associated with a higher incidence of epilepsy. Materials and Methods: Longitudinal observational studies which are relevant to the purpose of the meta-analysis were screened and obtained by searching PubMed, Embase, and Web of Science databases. Random-effects models were used when significant heterogeneity was observed; otherwise, fixed-effects models were used. Results: Six observational studies involving 10 datasets of 8,001,899 participants were included, with six datasets including children and only one dataset including older people. Among them, 100,414 (1.25%) had type 1 diabetes. During the follow-up duration of 5.4-15.2 years (mean: 9.5 years), 98,644 cases (1.23%) of epilepsy were observed. Compared with participants with normoglycemia, those with type 1 diabetes were shown to have a higher incidence of epilepsy (risk ratio [RR]: 2.41, 95% confidence interval 1.69-3.44, P < 0.001; I2 = 95%) after adjustment of potential confounding variables including age and sex. Subgroup analysis showed consistent results in nested case-control and retrospective cohort studies, and in studies of children, non-elderly adult, and older participants (P for subgroup difference = 0.42 and 0.07). In addition, a stronger association of type 1 diabetes and epilepsy was suggested in studies with follow-up duration <10 years compared with those =10 years (RR: 3.34 vs 1.61, P for subgroup difference < 0.001). Conclusion: Patients with type 1 diabetes may have a higher risk of epilepsy, which was mainly driven by datasets including children. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the long‐term efficacy, safety, and cumulative retention rate of antitumor necrosis factor‐alpha (anti‐TNF‐α) therapy for patients with Behcet's uveitis (BU) using meta‐analysis. Methods: We searched the Web of Science and PubMed databases for eligible studies up to December 1, 2022. The quality of each identified study was assessed using the Joanna Briggs Institute's case series literature quality assessment tool. Statistical analysis was conducted using Stata 16.0 software with a random‐effects model. Results: Twelve studies comprising 1156 patients with BU were included in our analysis. We found that 85.0% of patients achieved ocular inflammation remission after receiving anti‐TNF‐α treatment, with a 95% confidence interval (CI) ranging from 78.7% to 90.5%. Additionally, 77.4% (95% CI: 57.5%–92.5%) experienced an improvement in visual acuity (VA). Moreover, the pooled dose reduction of glucocorticoids (GCs) was 11.08 mg (95% CI: −13.34 mg to −8.83 mg). Throughout the follow‐up period, the cumulative retention rate of the medication was 67.3% (95% CI: 53.7%–79.6%). Serious adverse events occurred in 5.8% (95% CI: 3.1%–8.9%) of cases, with the three most common types being severe infusion or injection reactions (2.7%; 95% CI: 0.8%–5.4%), tuberculosis (1.3%; 95% CI: 0.0%–3.9%), and bacterial pneumonia (1.3%; 95% CI: 0.1%–3.4%). Subgroup analysis revealed that ocular inflammation remission rates were 89.3% (95% CI: 81.2%–95.5%) for adalimumab treatment and 83.7% (95% CI: 75.3%–90.8%) for infliximab treatment. The drug retention rate after adalimumab therapy was 70.3% (95% CI: 62.0%–78.0%) compared to 66.4% (95% CI: 48.6%–82.2%) for infliximab treatment. Furthermore, the incidence of severe infusion or injection reactions was 2.2% (95% CI: 0.1%–5.8%) following adalimumab treatment and 3.5% (95% CI: 0.7%–7.7%) following infliximab treatment. Conclusions: Anti‐TNF‐α therapy represents an effective treatment for BU patients with favorable safety profile and high drug retention rate and a potential advantage of adalimumab over infliximab in terms of ocular inflammation remission, drug retention, and the incidence of severe infusion or injection reactions. [ABSTRACT FROM AUTHOR]

Summary: Polysomnographic studies have been performed to investigate the first‐night effect in insomnia disorder. However, these studies have revealed discrepant findings. This meta‐analysis aimed to summarise and quantify the characteristics of the first‐night effect in insomnia disorder. We performed a systematic search of the PubMed, Medline, EMBASE, Web of Science and PsycINFO databases to identify studies published through October 2019. A total of 11,862 articles were identified, and seven studies with eight independent populations were included in the meta‐analysis. A total of 639 patients with insomnia disorder and 171 healthy controls underwent more than 2 consecutive nights of in‐laboratory polysomnography. Pooled results demonstrated that both variables of sleep continuity and sleep architecture, other than slow‐wave sleep were significantly altered in the first‐night effect in insomnia disorder. Furthermore, the results indicated that patients with insomnia disorder had a disruption of sleep continuity in the first‐night effect, including increased sleep onset latency and reduced total sleep time, compared to healthy controls. Overall, the findings show that patients with insomnia disorder experience the first‐night effect, rather than reverse first‐night effect, and the profiles of the first‐night effect in patients with insomnia are different from healthy controls. These indicate that an adaptation night is necessary when sleep continuity and sleep architecture is to be studied in patients with insomnia disorder. More well‐designed studies with large samples are needed to confirm the results. [ABSTRACT FROM AUTHOR]

Background and Objective: Recently, vonoprazan‐amoxicillin (VA) dual therapy has been reported as a promising approach for Helicobacter pylori (H. pylori) eradication. However, the effects of VA therapy versus bismuth‐containing quadruple therapy (BQT) on H. pylori eradication remains unclear. The objective of this meta‐analysis was to compare the effects of VA dual therapy with BQT for H. pylori eradication. Methods: A comprehensive search of the literature was conducted from the beginning to September 2023, utilizing PubMed, Embase, the Cochrane Library and Web of Science database. A random‐effects model was used to perform a meta‐analysis to determine the pooled relative risk (RR) with 95% confidence intervals (CIs). Moreover, trial sequential analysis (TSA) was conducted to evaluate the conclusiveness of the H. pylori eradication rate. Results: Six randomized controlled trials (RCTs) with 1233 patients were included. The VA therapy has similar eradication rate (ITT analysis: 87% vs. 85.7%, RR = 1.01, 95% CI: 0.93–1.09, p = 0.84; PP analysis: 92.5% vs. 93.2%, RR = 1.00, 95% CI: 0.94–1.06, p = 0.97) and compliance (RR = 1.01, 95% CI: 0.99–1.03, p = 0.32) compared to BQT. The VA therapy group had a significantly lower incidence of total adverse events than the BQT group (16.3% vs. 40.0%, RR = 0.45, 95% CI: 0.37–0.55, p < 0.00001). The TSA result showed that the effect was conclusive. Conclusions: Current evidence indicated that VA therapy is just as successful as BQT in eliminating H. pylori, yet it has fewer adverse events and similar compliance. [ABSTRACT FROM AUTHOR]