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BACKGROUND: There were controversial findings in terms of the association between the incidence of Benign Paroxysmal Positional Vertigo (BPPV) and climate changes, so the current systematic review plus meta-analysis is designed to discover this possible relationship. METHODS: Web of science, PubMed, Scopus, Google Scholar, Embase, and Cochrane library were systematically searched up to August 2023. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. RESULTS: In total, 15 studies including 16144 patients met the inclusion criteria. Ten studies reported the relation of BPPV to monthly mean temperature, 7 to monthly average humidity, 4 to monthly average rainfall, 6 to monthly sunlight time, and 2 to average solar radiation. The incidence of BPPV was associated significantly with atmospheric pressure (P: 0.003) and rainfall (P: 0.017). However, there was not any statistically significant correlation between incidence of BPPV and humidity, sunlight time, temperature, and solar radiation level (P > 0.05). CONCLUSIONS: The incidence of BPPV was higher in cold months of a year in both northern hemisphere and southern hemisphere countries. Although it can be because of negative correlation with temperature, the current meta-analysis did not find any statistically significant negative correlation with temperature. In addition, the incidence of BPPV was associated significantly with atmospheric pressure (positive correlation) and rainfall (negative correlation).
Assuntos
Vertigem Posicional Paroxística Benigna , Mudança Climática , Humanos , Vertigem Posicional Paroxística Benigna/epidemiologia , IncidênciaRESUMO
Objectives: The role of uric acid in pathogenesis of benign paroxysmal positional vertigo (BPPV) is not fully understood. It is aimed to assess the serum uric acid levels in BPPV patients compared to healthy controls. Study design: Systematic review and meta-analysis. Methods: Web of science, PubMed, Scopus, Google Scholar, Embase, Medline, and Cochrane library were systematically searched. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Results: In total, 20 studies including 3967 participants met the inclusion criteria. Ten studies (50%) reported higher uric acid (UA) levels in BPPV patients, 4 studies (20%) indicated lower UA levels in BPPV patients, while 6 studies (30%) found no significant difference in UA levels between BPPV patients and healthy controls. The overall mean serum levels of UA (SMD: 0.265, [-0.163 to 0.693]) were higher in BPPV patients than control group. However, this difference was not statistically significant (P-value: .225). Conclusion: There is no significant difference in serum level of UA between BPPV patients and healthy controls. It means that serum level of UA (whether low or high) is not likely the underlying factor of development of BPPV.
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PURPOSE: Early diagnosis of Diabetes insipidus (DI), a complication following pituitary surgery, can avoid the catastrophic results such as lethargy or even death. Measurement of Arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of post-op DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role. METHODS: Google Scholar, PubMed, Scopus, Web of Science, Embase, and Cochrane library were systematically searched up to August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. A meta-analysis was conducted to assess the discriminative performance of copeptin. RESULTS: In total, 8 cohort studies including 1255 participants met the inclusion criteria. The median copeptin levels were significantly lower in DI groups compared to non-DI groups in all included studies (P < 0.005). Meta-analysis of AUCs demonstrated that early measurement of copeptin level had an accuracy of 0.791 (SE: 0.0198, 95% CI: 0.752 to 0.830), which was statistically significant (P < 0.001). CONCLUSION: Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation), of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude post-op DI.
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Background: A salutary effect of treatments for Gaucher disease (GD) has been a reduction in the incidence of avascular osteonecrosis (AVN). However, there are reports of AVN in patients receiving enzyme replacement therapy (ERT) , and it is not known whether it is related to individual treatments, GBA genotypes, phenotypes, biomarkers of residual disease activity, or anti-drug antibodies. Prompted by development of AVN in several patients receiving ERT, we aimed to delineate the determinants of AVN in patients receiving ERT or eliglustat substrate reduction therapy (SRT) during 20 years in a tertiary referral center. Methods: Longitudinal follow-ups of 155 GD patients between 2001 and 2021 were analyzed for episodes of AVN on therapy, type of therapy, GBA1 genotype, spleen status, biomarkers, and other disease indicators. We applied mixed-effects logistic model to delineate the independent correlates of AVN while receiving treatment. Results: The patients received cumulative 1382 years of treatment. There were 16 episodes of AVN in 14 patients, with two episodes, each occurring in two patients. Heteroallelic p.Asn409Ser GD1 patients were 10 times (95% CI, 1.5-67.2) more likely than p.Asn409Ser homozygous patients to develop osteonecrosis during treatment. History of AVN prior to treatment initiation was associated with 4.8-fold increased risk of AVN on treatment (95% CI, 1.5-15.2). The risk of AVN among patients receiving velaglucerase ERT was 4.68 times higher compared to patients receiving imiglucerase ERT (95% CI, 1.67-13). No patient receiving eliglustat SRT suffered AVN. There was a significant correlation between GlcSph levels and AVN. Together, these biomarkers reliably predicted risk of AVN during therapy (ROC AUC 0.894, p<0.001). Conclusions: There is a low, but significant risk of AVN in GD in the era of ERT/SRT. We found that increased risk of AVN was related to GBA genotype, history of AVN prior to treatment initiation, residual serum GlcSph level, and the type of ERT. No patient receiving SRT developed AVN. These findings exemplify a new approach to biomarker applications in a rare inborn error of metabolism to evaluate clinical outcomes in comprehensively followed patients and will aid identification of GD patients at higher risk of AVN who will benefit from closer monitoring and treatment optimization. Funding: LSD Training Fellowship from Sanofi to MB.