Homocysteine, vitamin B12, and folate circulating levels in women with and without polycystic ovary syndrome: A systematic review and meta-analysis.

BACKGROUND: Some studies have reported that homocysteine, vitamin B12, and folic acid levels are associated with polycystic ovary syndrome (PCOS), whereas other studies yielded controversial results. OBJECTIVES: This study aimed to systematize the available evidence of homocysteine, vitamin B12, and folate levels in women with and without PCOS. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: A systematic search without language restrictions was performed on PubMed, Ovid/Medline, Scopus, Embase, and Web of Science. In addition, the reference lists of the selected studies were reviewed. The Newcastle-Ottawa Scale was employed to evaluate the quality of studies. The means and standard deviations of the outcomes were pooled as standardized mean differences (SMDs) with 95% confidence intervals (CI). Furthermore, the DerSimonian and Laird method was employed for the quantitative synthesis. RESULTS: A total of 75 studies met the eligibility criteria for at least one outcome. Patients with PCOS had higher circulating homocysteine levels than those without (SMD: 0.82; 95% CI: 0.62-1.02, n = 70 studies, p < 0.001). This trend remained in the sensitivity and subgroup analyses by world regions of studies, assay methods, and insulin resistance. No significant differences were observed in circulating vitamin B12 (SMD: -0.11; 95% CI: -0.25 to 0.03; n = 17 studies, p = 0.13) and folate levels (SMD: -0.2; 95% CI: -0.68 to 0.27; n = 17 studies, p = 0.41) between patients with and without PCOS. CONCLUSIONS: (i) Patients with PCOS exhibited significantly higher homocysteine levels than those without, and (ii) no significant differences were observed in both vitamin B12 and folate levels in women with and without PCOS. REGISTRATION: PROSPERO ID (CRD42023432883).

Colposcopy in the Primary Health Care: A Scoping Review.

AIM: Low- and middle-income countries represent nearly 85% of all cervical cancer cases worldwide; thereby, it is extremely important to identify methods to improve the screening process. Therefore, this study aimed to summarize the primary characteristics of studies on accessibility, coverage, patient preferences, and factors associated with patient satisfaction or acceptance of colposcopy in primary healthcare. METHODS: A search strategy, based on MeSH, Emtree, and free terms, was run through 5 databases (PubMed, Scopus, Embase, Ovid/Medline, and Web of Science). EndNote 20.1 © and Rayyan QCRI © were used for screening. A preset datasheet was used for data extraction. RESULTS: The systematic search retrieved 1127 references, and after removing duplicates, screening the titles and abstracts, and reviewing the full text, 7 studies were included. The interrater reliability was 77.73% (kappa statistic = 0.1842). Most studies estimated the proportion of women that sought for colposcopy after a previous screening test for human papilloma virus. One study identifies barriers to colposcopy examination in women at risk of developing cervical cancer. Three studies assessed the decentralization of colposcopy from a tertiary healthcare center to a primary care center. Pap smear was the most common first-line screening test, followed by liquid-based cytology sample and visual inspection with acetic acid. CONCLUSION: Only a few countries have investigated the use of colposcopy in primary care. Thus, barriers and the care structure for this implementation to be successful in reducing cervical cancer incidence and mortality should be identified.

Systemic Immune-Inflammation Index and Mortality in Testicular Cancer: A Systematic Review and Meta-Analysis.

The systemic immune-inflammation index (SIII) is a marker studied in multiple types of urologic cancer. This systematic review evaluates the association between SIII values with overall survival (OS) and progression-free survival (PFS) in testicular cancer. We searched observational studies in five databases. The quantitative synthesis was performed using a random-effects model. The risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The only measure of the effect was the hazard ratio (HR). A sensitivity analysis was performed according to the risk of bias in the studies. There were 833 participants in a total of 6 cohorts. We found that high SIII values were associated with worse OS (HR = 3.28; 95% CI 1.3-8.9; p < 0.001; I2 = 78) and PFS (HR = 3.9; 95% CI 2.53-6.02; p < 0.001; I2 = 0). No indication of small study effects was found in the association between SIII values and OS (p = 0.5301). High SIII values were associated with worse OS and PFS. However, further primary studies are suggested to enhance the effect of this marker in different outcomes of testicular cancer patients.

Lymphocyte-to-Monocyte Ratio and Clinical Outcomes in Cholangiocarcinoma: A Systematic Review and Meta-Analysis.

Lymphocyte-to-Monocyte ratio (LMR) has shown an association with survival outcomes in several oncological diseases. This study aimed to evaluate the association between LMR and clinical outcomes for cholangiocarcinoma patients. A systematic review and meta-analysis were performed to assess the association between LMR values and overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and time to recurrence (TTR) in cholangiocarcinoma patients. We used Hazard ratio (HR) and their 95% confidence interval (CI) as a measure of effect for the random effect model meta-analysis. The Newcastle-Ottawa Scale was used for quality assessment. The Egger test and funnel plot were developed for approaching publication bias. A total of 19 studies were included in this study (n = 3860). The meta-analysis showed that cholangiocarcinoma patients with low values of LMR were associated with worse OS (HR: 0.82; 95% CI: 0.71-0.96; I2 = 86%) and worse TTR (HR: 0.71; 95% CI: 0.58-0.86; I2 = 0%). DFS and RFS also were evaluated; however, they did not show statistically significant associations. Low LMR values were associated with a worse OS and TTR.

Prognostic value of apolipoproteins in COVID-19 patients: A systematic review and meta-analysis.

INTRODUCTION: Apolipoproteins are predictive biomarkers for cardiovascular, neoplasms and cerebrovascular diseases and are postulated as prognostic biomarkers in infectious diseases, as COVID-19. Thus, we assessed the prognosis value of apolipoproteins for COVID-19 severity and mortality. METHODS: We conducted a systematic review and meta-analysis using observational studies that reported the association between apolipoproteins and severity or mortality in COVID-19 patients. Newcastle-Ottawa was used for the quality assessment of included studies. Effects measurements were shown as odds ratios (ORs) with 95% confidence intervals (CIs), and Egger-test was developed for assessing the risk of bias publication. RESULTS: We analyzed 12 cohort studies (n = 3580). Patients with low ApoliproteinA1 (ApoA1) (OR 0.35; 95%CI 0.24 to 0.49; P < 0.001) and ApoliproteinB (ApoB) (OR = 0.78; 95%CI 0.69 to 0.87; P < 0.001) values had a higher risk of developing severe disease. ApoB/ApoA1 ratio showed no statistically significant association with higher odds of severity. Low ApoA1 levels were associated with higher odds of all-cause mortality (OR = 0.34; 95%CI 0.20 to 0.57; P < 0.001). ApoB values showed no statistically significant association with a high risk of all-cause mortality. CONCLUSION: We suggest that adequate levels of ApoA1 and ApoB can be a protective factor for severity in COVID-19, and ApoB/ApoA1 ratio did not show predictive utility for severity.

Prácticas de prevención y control frente a la infección por Sars-Cov2 en la población peruana / Prevention and control practices against Sars-Cov2 infection in the peruvian population

Objetivo: Describir las prácticas de prevención y control para la infección por SARS-CoV2 en la población peruana. Material y Métodos: Estudio observacional de tipo descriptivo. Se evaluó una muestra no probabilística de adultos residentes en algún departamento de Perú. Las prácticas preventivas fueron evaluadas en personas sin antecedente de COVID-19 y las prácticas de control en personas que lo habían padecido. Resultados: Se evaluó un total de 3630 peruanos (edad media 25,4 ± 9,5) de los cuales el 3231 no indicaban el antecedente de COVID-19 y 399 refirieron haberlo padecido. Las medidas de prevención y control que se realizaron a menudo o siempre con mayor frecuencia fueron el utilizar mascarilla al salir de casa (97,9% vs 87,7), cubrirse su nariz y boca al estornudar o toser (95,4% vs 89,9%), guardar distancia de los demás en la calle (91,4% vs 74,7%), realizar el lavado de manos con agua y jabón al volver a casa (92,5% vs 88,7%), y desinfectar las superficies de objetos y lugares personales (82,6% vs 77,4%). El 22,1% y 83,7%, el 59,7% y 80,2, y el 8,0% y 16,8% consumieron algún tipo de medicamento, planta medicinal y dióxido de cloro para la prevención y control de la infección de COVID-19, respectivamente. Conclusiones: En general, menos del 50% de los participantes realizaron prácticas de prevención y control frente a la COVID-19 a menudo o siempre.

Objective: To describe prevention and control practices for SARS-CoV2 infection in the Peruvian population. Material and Methods: Observational descriptive study. A non-probabilistic sample of adults residing in a Peruvian department was evaluated. Preventive practices were evaluated in people with no history of COVID-19 and control practices in people who had had COVID-19. Results: A total of 3630 Peruvians were evaluated (mean age 25.4 ± 9.5) of whom 3231 did not indicate a history of COVID-19 and 399 reported having suffered from it. The prevention and control measures most frequently or always performed were using a mask when leaving home (97.9% vs 87.7%), covering their nose and mouth when sneezing or coughing (95.4% vs 89.9%), keeping their distance from others in the street (91.4% vs 74.7%), washing hands with soap and water when returning home (92.5% vs 88.7%), and disinfecting surfaces of objects and personal places (82.6% vs 77.4%). 22.1% and 83.7%, 59.7% and 80.2, and 8.0% and 16.8% consumed some type of medication, medicinal plant, and chlorine dioxide for prevention and control of COVID-19 infection, respectively. Conclusions: Overall, less than 50% of the participants performed prevention and control practices against COVID-19 often or always.