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2.
Auris Nasus Larynx ; 48(6): 1126-1134, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34112558

RESUMO

OBJECTIVE: Our aim was to investigate association between OSA and radiotherapy in head and neck cancer patients. METHODS: On 9th of September 2018, we have searched 12 electronic databases to retrieve relevant studies. All eligible studies that assessed association between OSA and radiotherapy in head and neck cancer patients were included in our meta-analysis. Quality assessment of included studies was done using the NIH tools for cohort, cross-sectional and case series studies. RESULTS: Fourteen studies met our study selection criteria, and six studies were eligible for our meta-analysis. There was no significant association between occurrence of OSA and radiotherapy in head and neck cancer patients (Odds ratio 1.54, 95% CI [0.66-3.60]; P  =  0.322). CONCLUSION: These findings point to no significant association between OSA risk and radiotherapy in head and neck cancer patients. We suggest more studies to be conducted to investigate any confounders that may influence the effect of radiotherapy on development of OSA in head and neck cancer patients.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Radioterapia/efeitos adversos , Apneia Obstrutiva do Sono/etiologia , Neoplasias de Cabeça e Pescoço/complicações , Humanos , Razão de Chances , Fatores de Risco
3.
PLoS Negl Trop Dis ; 15(10): e0009808, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34610027

RESUMO

BACKGROUND: Predictive markers represent a solution for the proactive management of severe dengue. Despite the low mortality rate resulting from severe cases, dengue requires constant examination and round-the-clock nursing care due to the unpredictable progression of complications, posing a burden on clinical triage and material resources. Accordingly, identifying markers that allow for predicting disease prognosis from the initial diagnosis is needed. Given the improved pathogenesis understanding, myriad candidates have been proposed to be associated with severe dengue progression. Thus, we aim to review the relationship between the available biomarkers and severe dengue. METHODOLOGY: We performed a systematic review and meta-analysis to compare the differences in host data collected within 72 hours of fever onset amongst the different disease severity levels. We searched nine bibliographic databases without restrictive criteria of language and publication date. We assessed risk of bias and graded robustness of evidence using NHLBI quality assessments and GRADE, respectively. This study protocol is registered in PROSPERO (CRD42018104495). PRINCIPAL FINDINGS: Of 4000 records found, 40 studies for qualitative synthesis, 19 for meta-analysis. We identified 108 host and viral markers collected within 72 hours of fever onset from 6160 laboratory-confirmed dengue cases, including hematopoietic parameters, biochemical substances, clinical symptoms, immune mediators, viral particles, and host genes. Overall, inconsistent case classifications explained substantial heterogeneity, and meta-analyses lacked statistical power. Still, moderate-certainty evidence indicated significantly lower platelet counts (SMD -0.65, 95% CI -0.97 to -0.32) and higher AST levels (SMD 0.87, 95% CI 0.36 to 1.38) in severe cases when compared to non-severe dengue during this time window. CONCLUSION: The findings suggest that alterations of platelet count and AST level-in the first 72 hours of fever onset-are independent markers predicting the development of severe dengue.


Assuntos
Biomarcadores/sangue , Dengue Grave/sangue , Dengue Grave/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Aspartato Aminotransferases/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas , Prognóstico , Dengue Grave/diagnóstico , Adulto Jovem
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