Search

This meta-analysis aims to look at the impact of early intravenous Metoprolol in ST-segment elevation myocardial infarction (STEMI) before percutaneous coronary intervention (PCI) on infarct size, as measured by cardio magnetic resonance (CMR) and left ventricular ejection fraction.We searched the following databases: PubMed, Scopus, Cochrane library, and Web of Science. We included only randomized control trials that reported the use of early intravenous Metoprolol in STEMI before PCI on infarct size, as measured by CMR and left ventricular ejection fraction. RevMan software 5.4 was used for performing the analysis.Following a literature search, 340 publications were found. Finally, 18 studies were included for the systematic review, and 8 clinical trials were included in the meta-analysis after the full-text screening. At 6 months, the pooled effect revealed a statistically significant association between Metoprolol and increased left ventricular ejection fraction (LVEF) (%) compared to controls (mean difference [MD] = 3.57, [95% confidence interval [CI] = 2.22-4.92], p .00001), as well as decreased infarcted myocardium(g) compared to controls (MD = -3.84, [95% [CI] = -5.75 to -1.93], p .0001). At 1 week, the pooled effect revealed a statistically significant association between Metoprolol and increased LVEF (%) compared to controls (MD = 2.98, [95% CI = 1.26-4.69], p = .0007), as well as decreased infarcted myocardium(%) compared to controls (MD = -3.21, [95% CI = -5.24 to -1.18], p = .002).A significant decrease in myocardial infarction and increase in LVEF (%) was linked to receiving Metoprolol at 1 week and 6-month follow-up.

Our aim was to perform a meta-analysis to evaluate the possible link between diabetes and high levels of immunoglobulin M (IgM) antibodies against Gonadotropin-Releasing Hormone (GnRH). The search included PubMed, Web of Science, and Scopus databases. Inclusion criteria were any controlled clinical trials or observational studies that measured the level of IgM antibodies against GnRH hormone in diabetic patients, we excluded case reports, editorials, and animal studies. RevMan software, version 5.4 (The Cochrane Collaboration 2020) was used to perform the meta-analysis. Following the screening, three studies were included in the meta-analysis. The meta-analysis included 99 patients in the diabetes group and 318 healthy persons in the control group. The pooled effect showed no statistically significant association between diabetes and the prevalence of GnRH IgM antibodies compared with the control group (risk ratio {RR} = 1.64, 95% CI = 0.96 to 2.79, p-value = 0.03). The pooled effect showed a statistically significant association between diabetes and increased levels of GnRH IgM antibodies compared with the control group (mean difference {MD} = 2.13, 95% CI = 0.25 to 4.02, p-value = 0.03). Our study found a significant association between diabetes and increased levels of GnRH IgM antibodies. Therefore, GnRH IgM antibodies may play a role in the pathogenesis of diabetes or may be considered a unique immunological reaction in diabetic patients. More multicenter randomized studies are needed to support our results confirming the positive relationship between diabetes and high levels of IgM antibodies against GnRH hormone.

Background: Some studies reported a positive link between high levels of lipoprotein (a) and aortic valve calcification. The aim of this study is to perform a meta-analysis to find whether aortic valve calcification has a significant association with high levels of lipoprotein (a). Methods: We searched PUBMED, WOS and OVID databases. We included cohort studies or clinical trials that measured lipoprotein (a) levels in patients with aortic valve calcium and controls without aortic valve calcium. Case reports, editorials and animal studies were excluded. RevMan software (5.4) was used to perform the meta-analysis. Levels of lipoprotein (a) and number of patients with increased levels of lipoprotein (a) outcomes were presented as standardized mean difference (SMD) and Odds ratio (OR) with 95% confidence interval (CI). Results: After complete screening, 7 studies were included with a total number of 446179 patients included in the analysis. The pooled analysis showed a statistically significant association between incidence of aortic valve calcium and increased levels of lipoprotein (a) compared with controls (SMD = 1.71, 95% CI = 1.04 to 2.38, p-value < 0.00001). The pooled analysis showed a statistically significant association between incidence of aortic valve calcium and increased number of patients with high levels of lipoprotein (a) compared with controls (OR = 2.21, 95% CI = 1.26 to 3.87, p-value = 0.006). We observed a significant heterogeneity in both outcomes ( P < 0.00001) that was not solved by subgroup analysis or leave-one out test. Conclusion: This meta-analysis showed a statistically significant association between incidence of aortic valve calcium and increased levels of lipoprotein (a) compared with controls. Patients with high levels of lipoprotein (a) are at increased risk of developing aortic valve calcification. Medications targeting lipoprotein (a) in future clinical trials may be useful in primary prevention of aortic valve calcification in high risk patients.

Cardiopulmonary resuscitation (CPR) in full-coded patients requires effective chest compressions with minimal interruptions to maintain adequate perfusion to the brain and other vital organs. Many novel approaches have been proposed to attain better organ perfusion compared to traditional CPR techniques. The purpose of this review is to investigate the safety and efficacy of heads-up CPR versus supine CPR.We searched PubMed Central, SCOPUS, Web of Science, and Cochrane databases from 1990 to February 2021. After the full-text screening of 40 eligible studies, only seven studies were eligible for our meta-analysis. We used the RevMan software (5.4) to perform the meta-analysis.In survival outcome, the pooled analysis between heads-up and supine CPR was (risk ratio = 0.98, 95% confidence interval [CI] = 0.17-5.68,Our study suggests that heads-up CPR is associated with better cerebral and coronary perfusion compared to the conventional supine technique in pigs' models. However, more research is warranted to investigate the safety and efficacy of the heads-up technique on human beings and to determine the best angle for optimization of the technique results.

This paper aims to compare the effectiveness and safety of pembrolizumab and paclitaxel as a second line for patients with locally advanced gastroesophageal cancer.By searching PubMed, Scopus, Web of Science, and Ovid, any randomized clinical study comparing the effectiveness of paclitaxel and pembrolizumab as second-line therapy for advanced gastroesophageal cancer met the inclusion criteria. Only 3 of the 23 eligible studies that were fully reviewed were eligible for meta-analysis.The total number of patients included in the meta-analysis was 635 in the pembrolizumab group and 596 in the paclitaxel group. In terms of objective response rate, there was no statistically significant difference between pembrolizumab and paclitaxel (relative risk = 1.10, 95% CI = 0.80-1.50, P = .57). Furthermore, Pembrolizumab and paclitaxel did not differ in terms of the rate of partial response statistically significantly from one another, according to the overall analysis (relative risk = 0.93, 95% CI = 0.57-1.52, P-value = .78).There is no difference between pembrolizumab and paclitaxel in objective response rate. The objective response rate shows that doctors may consider either treatment for patients with advanced gastroesophageal cancer, given the time to response is comparable across therapies.