Protective role of Bacillus Calmette-Guérin vaccine in Alzheimer's disease progression: A systematic review and meta-analysis.

Introduction: Alzheimer's disease (AD) represents a significant societal challenge, highlighting the need to explore effective prevention and treatment approaches. Recent literature has suggested that Bacillus Calmette-Guérin (BCG) vaccine may be a viable therapeutic option for immune disorders associated with AD due to its immunomodulatory properties and protection against various diseases. Methods: This systematic review aimed to evaluate the association of BCG vaccine in the prevention of AD using six medical-scientific databases. A meta-analytical approach was undertaken to estimate the risk of AD incidence in patients with and without BCG vaccine exposure, followed by subgroup analyses. A risk of bias (RoB) assessment was performed using the Newcastle-Ottawa Scale (NOS). Results: Six cohort studies meeting our inclusion criteria were included (47,947 participants) in the study. From our meta-analysis, intravesical BCG vaccine administration lowered the risk of incidence of AD by 26% in non-muscle-invasive bladder cancer (p < 0.00001). Subgroup analyses showed that BCG vaccination showed a potentially notable preventive effect on AD in older adults (>75 years) and female participants. Conversely, significant heterogeneity in results was observed among male participants and those aged <75 years. The RoB was low in three studies and unclear in the remaining studies. Conclusions: Although our results support the potential benefits of BCG vaccine in preventing AD in specific demographics, we remain cautious about interpreting such results. Further research examining the implications of BCG vaccination for prevention and possible treatment of AD should be undertaken in the future.

Prenatal diagnosis of well-developed fetus in fetu with spontaneous movement in a resource-limited setting: A case report.

Fetus in fetu (FIF) is a rare congenital anomaly characterized by the presence of a parasitic monozygotic twin encased within the body of its host twin. Because FIF is asymptomatic throughout pregnancy, it is mainly diagnosed in children with an abdominal mass after birth. In the case reported here, at 38-39 weeks of gestation, a 33-year-old woman (gravida 4, para 3) was referred for routine obstetric ultrasonography. Fluid accumulation was identified along with calcification resembling two well-developed legs and trunk with undifferentiated organs inside. Slight spontaneous movement of the legs was observed. The fetus was delivered based on the presumed diagnosis of FIF. Postnatal sonography and computed tomography (CT) supported the diagnosis. The neonate underwent surgical excision of the tumor and was discharged on the eighth postoperative day. Ultrasound can be used to provide accurate prenatal diagnosis of FIF. Early diagnosis is important to improve outcomes.

Efficacy and safety of medical cannabinoids in children with cerebral palsy: a systematic review.

INTRODUCTION: The increasing popularity of cannabinoids for treating numerous neurological disorders has been reported in various countries. Although it reduces tetrahydrocannabinol psychoactivity, it helps patients tolerate higher doses and complements the anti-spasmodic effects of tetrahydrocannabinol. One of the most important potential of cannabinoids are related to its potential to help children with cerebral palsy, a contributor of lifelong disability. Therefore, this systematic review aimed to assess the efficacy and safety of medical cannabinoids in children with cerebral palsy. METHODS: This review adhered to The Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 guidelines. Seven databases, namely, Scopus, PubMed, EBSCO Host, ProQuest, Google Scholar, Semantic Scholar, and JSTOR, were used to identify relevant studies. Studies examining pediatric patients with cerebral palsy and reporting the efficacy and safety of medical cannabinoids through clinical trials, observational cross-sectional studies, or cohort designs were included. The outcomes of the studies included the efficacy of medical cannabinoids administered for spasticity, motor components, pain control, sleep difficulties, adverse effects, and seizure control. RESULTS: Of 803 identified articles, only three met the inclusion criteria for data synthesis. One study exhibited a moderate risk-of-bias. A total of 133 respondents, mainly from Europe, were investigated. Overall effectiveness and safety were considered good. However, the results are inconsistent, especially regarding spasticity treatment variables. CONCLUSION: The anti-spasticity, anti-inflammatory, and anti-seizure properties of cannabinoids might be beneficial for patients with cerebral palsy, although their effectiveness has not been widely studied. Further studies with larger sample sizes and various ethnicities are warranted. Prospero database registration: (www.crd.york.ac.uk/prospero) under ID CRD42022358383.

Efficacy and safety of medical cannabinoids in children with cerebral palsy: a systematic review

ABSTRACT Introduction The increasing popularity of cannabinoids for treating numerous neurological disorders has been reported in various countries. Although it reduces tetrahydrocannabinol psychoactivity, it helps patients tolerate higher doses and complements the anti-spasmodic effects of tetrahydrocannabinol. One of the most important potential of cannabinoids are related to its potential to help children with cerebral palsy, a contributor of lifelong disability. Therefore, this systematic review aimed to assess the efficacy and safety of medical cannabinoids in children with cerebral palsy. Methods This review adhered to The Preferred Reporting Items for Systematic Reviews and Meta-analysis 2020 guidelines. Seven databases, namely, Scopus, PubMed, EBSCO Host, ProQuest, Google Scholar, Semantic Scholar, and JSTOR, were used to identify relevant studies. Studies examining pediatric patients with cerebral palsy and reporting the efficacy and safety of medical cannabinoids through clinical trials, observational cross-sectional studies, or cohort designs were included. The outcomes of the studies included the efficacy of medical cannabinoids administered for spasticity, motor components, pain control, sleep difficulties, adverse effects, and seizure control. Results Of 803 identified articles, only three met the inclusion criteria for data synthesis. One study exhibited a moderate risk-of-bias. A total of 133 respondents, mainly from Europe, were investigated. Overall effectiveness and safety were considered good. However, the results are inconsistent, especially regarding spasticity treatment variables. Conclusion The anti-spasticity, anti-inflammatory, and anti-seizure properties of cannabinoids might be beneficial for patients with cerebral palsy, although their effectiveness has not been widely studied. Further studies with larger sample sizes and various ethnicities are warranted. Prospero database registration: (www.crd.york.ac.uk/prospero) under ID CRD42022358383.

Routine laboratory tests: Potential practical parameters to detect coronavirus disease-2019 in resource-limited settings.

INTRODUCTION: The diagnosis of Coronavirus Disease-2019 (COVID-19), an ongoing global pandemic with more than 3 million cases worldwide both in developed and developing countries, requires molecular or serological tests that are not available in some settings. This systematic review provides further evidence to assess the diagnostic accuracy of routine laboratory tests to detect COVID-19 in suspected COVID-19 patients in resource-limited point of care and mobile laboratory. METHODOLOGY: Comprehensive and systematic literature search in electronic databases (PubMed, Cochrane, and Online Wiley Library) was conducted to retrieve studies published between December 2019 and April 2020 reporting the diagnostic value of routine laboratory tests in the diagnosis of COVID-19. The quality of each study was assessed using QUADAS2. Literature search and study selection were depicted in PRISMA 2009 Flow Diagram. RESULTS: Three studies were included in this review. Two studies reported poor accuracy (AUC 0.075 and 0.624) of lymphopenia to detect COVID-19. One study reports good accuracy (AUC 0.858) of neutrophilia to detect COVID-19 amongst suspected cases. One multi-gated cross-sectional study reports poor discriminatory ability (AUC 0.65) of neutrophilia to discriminate between COVID-19 and CAP. Because of its big variability between patients and poor diagnostic accuracy (AUC 0.112 and 0.624), leukocyte count should not be a single parameter to determine COVID-19 patient status. CONCLUSIONS: Neutrophil percentage might be helpful to determine COVID-19 status for suspected patients at the primary point of care or even in a mobile laboratory for countries with limited resources, but further study is needed to support this statement.