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Review Articles
Worldwide prevalence of fungal coinfections among COVID-19 patients: a comprehensive systematic review and meta-analysis
Saber Soltani, Milad Zandi, Samireh Faramarzi, Ramin Shahbahrami, Mohebat Vali, Sara Akhavan Rezayat, Reza Pakzad, Pooneh Malekifar, Iraj Pakzad, Neda Jahandoost, Jalal Moludi
Osong Public Health Res Perspect. 2022;13(1):15-23.   Published online February 8, 2022
DOI: https://doi.org/10.24171/j.phrp.2021.0293
  • 5,149 View
  • 82 Download
AbstractAbstract PDFSupplementary Material
Microbial coinfections can increase the morbidity and mortality rates of viral respiratory diseases. Therefore, this study aimed to determine the pooled prevalence of fungal coinfections in coronavirus disease 2019 (COVID-19) patients. Web of Science, Medline, Scopus, and Embase were searched without language restrictions to identify the related research on COVID-19 patients with fungal coinfections from December 1, 2019, to December 30, 2020. A random-effects model was used for analysis. The sample size included 2,246 patients from 8 studies. The pooled prevalence of fungal coinfections was 12.60%. The frequency of fungal subtype coinfections was 3.71% for Aspergillus, 2.39% for Candida, and 0.39% for other. The World Health Organization’s Regional Office for Europe and Regional Office for Southeast Asia had the highest (23.28%) and lowest (4.53%) estimated prevalence of fungal coinfection, respectively. Our findings showed a high prevalence of fungal coinfections in COVID-19 cases, which is a likely contributor to mortality in COVID-19 patients. Early identification of fungal pathogens in the laboratory for COVID-19 patients can lead to timely treatment and prevention of further damage by this hidden infection.
COVID-19 Patients: A Systematic Review and Meta-Analysis of Laboratory Findings, Comorbidities, and Clinical Outcomes Comparing Medical Staff versus the General Population
Mina Ebrahimi, Amal Saki Malehi, Fakher Rahim
Osong Public Health Res Perspect. 2020;11(5):269-279.   Published online October 22, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.5.02
  • 5,592 View
  • 113 Download
  • 9 Citations
AbstractAbstract PDFSupplementary Material

This review compared coronavirus disease 2019 (COVID-19) laboratory findings, comorbidities, and clinical outcomes in patients from the general population versus medical staff to aid diagnosis of COVID-19 in a more timely, efficient, and accurate way. Electronic databases were searched up to 23rd March, 2020. The initial search yielded 6,527 studies. Following screening, 24 studies were included [18 studies (11,564 cases) of confirmed COVID-19 cases in the general public, and 6 studies (394 cases) in medical staff] in this review. Significant differences were observed in white blood cell counts (p < 0.001), lymphocyte counts (p < 0.001), platelet counts (p = 0.04), procalcitonin levels (p < 0.001), lactate dehydrogenase levels (p < 0.001), and creatinine levels (p = 0.03) when comparing infected medical staff with the general public. The mortality rate was higher in the general population than in medical staff (8% versus 2%). This review showed that during the early stages of COVID-19, laboratory findings alone may not be significant predictors of infection and may just accompany increasing C-reactive protein levels, erythrocyte sedimentation rates, and lactate dehydrogenase levels. In the symptomatic stage, the lymphocyte and platelet counts tended to decrease. Elevated D-dimer fibrin degradation product was associated with poor prognosis.

Original Articles
Meta-Analysis of the Effects of Physical Modality Therapy and Exercise Therapy on Neck and Shoulder Myofascial Pain Syndrome
Chan-Myeong Kim, Ji-Won Park
Osong Public Health Res Perspect. 2020;11(4):251-258.   Published online August 31, 2020
DOI: https://doi.org/10.24171/j.phrp.2020.11.4.15
  • 3,629 View
  • 101 Download
  • 1 Citations
AbstractAbstract PDF
Objectives

The main purpose of this study was to identify the effects of physical therapy modalities and exercise therapy on myofascial pain syndrome by assessing the degree of effect size (ES) and related variables.

Methods

Related studies published between 1st January 2008 and 31st December 2019were retrieved from national [KCI, RISS, National Assembly Library and DBpia (n = 405)] and international [PubMed, Embase, Google Scholar and Cochrane library (n = 1,600)] databases. According to the selection criteria, 25 studies were selected for review.

Results

The degree of ES in the physical therapy and exercise therapy combined group (1.83) showed the largest mean ES. The size of the effect according to the number of people to be treated was 41 or more (1.64), and showed the largest mean ES. The size of the effect according to treatment period was 16 to 30 days (1.41). The size of the effect for 6 to 10 treatments (1.51) showed the largest mean ES. Trim and fill results showed that the calibration ES was 0.67.

Conclusion

Physical therapy modalities and exercise therapy had a great effect on myofascial pain syndrome in the neck and shoulders, and the effect differed according to the methods of intervention, and the methods of evaluation.

Therapeutic Intervention for Visuo-Spatial Neglect after Stroke: A Meta-Analysis of Randomized Controlled Trials
Jae-Sung Kwon
Osong Public Health Res Perspect. 2018;9(2):59-65.   Published online April 30, 2018
DOI: https://doi.org/10.24171/j.phrp.2018.9.2.04
  • 3,202 View
  • 66 Download
  • 5 Citations
AbstractAbstract PDF
Objectives

The aims of this meta-analysis were to examine intervention methods of qualitatively, well-designed studies from the past 10 years for treating visuo-spatial neglect (VSN) in patients who had suffered a stroke, and to evaluate the combined effects of intervention.

Methods

Studies published between 2008 and 2017 on the theme of VSN were collected from PubMed, CINAHL, and MEDLINE, representative academic databases and search engines. The PEDro scale was used for evaluating the quality of methodology. The sample size, mean, and standard deviation of identified studies were used for meta-analysis.

Results

Eight studies were selected for analysis. The PEDro scores of the selected studies were ≥ 7, with 237 subjects analyzed. The results of intervention were classified into “mental function” and “activity and participation” based on the International Classification of Functioning, Disability and Health. The analyzed effect sizes for combined outcomes, mental function and, activity and participation, were 0.728 (medium effect size), 0.850 (large effect size), and 0.536 (medium effect size), respectively.

Conclusion

Intervention methods for treating VSN had a short-term effect on cognitive function (visual perception). In particular, non-invasive brain stimulation therapy showed a large effect size for VSN treatment.

Estimating Tuberculin Skin Test Reactions among Children and Teenagers Who Received the Bacillus Calmette-Guerin Vaccination at Birth: A Meta-analysis
Mohammad Sadegh Rezai, Siavosh Abedi, Mahdi Afshari, Mahmood Moosazadeh
Osong Public Health Res Perspect. 2017;8(1):3-10.   Published online February 28, 2017
DOI: https://doi.org/10.24171/j.phrp.2017.8.1.02
  • 2,561 View
  • 24 Download
  • 2 Citations
AbstractAbstract PDF
Objectives

Tuberculin skin reaction size is one indicator of bacillus Calmette-Guérin (BCG) vaccine efficacy and a way to diagnose latent infection. Several primary studies have examined this issue. Combining the results of these studies using a meta-analysis will provide reliable evidence regarding this indicator for policymakers. This study aimed to estimate the total frequency of different tuberculin skin test reactions among Iranian children and teenagers who received the BCG vaccination at birth.

Methods

National and international databanks were searched using relevant keywords. After the search strategy was restricted and duplicates were excluded, the titles and abstracts of the remaining papers were screened. All included studies included healthy children who received the BCG vaccine without confirmed tuberculosis exposure. Heterogeneity of the results was assessed using the Cochrane test and I2 index showed the random effects model as the best model for estimating the pooled results.

Results

We combined the results of 14 primary studies including purified protein derivative reaction test measures of 26,281 Iranian children. The frequencies (95% confidence intervals) of the reactions were 8.5% (6.2–10.8) for patients with a reaction size ≥ 10 mm, 29.9% (22.3–37.4) for a reaction size of 5–9 mm, and 60% (48.9–71.1) for a reaction size < 5 mm.

Conclusion

Our study showed that large numbers of Iranian children and teens have no positive BCG vaccine reaction and a considerable number of children have been exposed to Mycobacterium tuberculosis.

Epidemiological and Clinical Features of People with Malta Fever in Iran: A Systematic Review and Meta-Analysis
Mahmood Moosazadeh, Roja Nikaeen, Ghasem Abedi, Motahareh Kheradmand, Saeid Safiri
Osong Public Health Res Perspect. 2016;7(3):157-167.   Published online June 30, 2016
DOI: https://doi.org/10.1016/j.phrp.2016.04.009
  • 2,004 View
  • 20 Download
  • 11 Citations
AbstractAbstract PDF
Objectives
Numerous studies have reported the epidemiological and clinical features of Malta fever incidence in Iran. Review and synthesis of the related literature through meta-analysis can provide an appropriate measurement for aforementioned indices. Therefore, the present study aimed to determine the epidemiological and clinical features of people with Malta fever in Iran.
Methods
The required documents were obtained through searching national and international databases. In each study, standard deviation of the indices was calculated using binomial distribution formulas. Finally, the heterogeneity index was determined between studies using Cochran (Q) and I2 tests.
Results
Combining the results of 47 articles in the meta-analysis indicated that 57.6% (55.02–60.1%) and 42.3% (49.8–44.9%) of the patients were male and female, respectively. Most of the patients lived in rural areas; 68.4% (63.6–73.2%) compared to 31.4% (26.7–36.3%). In addition, 20.8% (17.4–24.2%) of the patients were ranchers and farmers, 16.9% (14.5–19.4%) were students, and 31.6% (27–36.2%) were housewives. Of the patients studies, 50.5% (35.6–65.2%) experienced contact with animals and 57.1% (46.4–67.9%) used unpasteurized dairy products. Fever, joint pain, and sweating were detected among 65.7% (53.7–77.8%) and 55.3% (44.4–66.2%), respectively.
Conclusion
The present study revealed that the frequency of male patients with brucellosis was considerably more than that of female patients. The number of patients with Malta fever in rural areas was significantly more than in urban areas. High-risk behavior, unprotected contact with animals, and using unpasteurized dairy products were among the most significant factors affecting Malta fever incidence in Iran. Fever, joint pain, and sweating were detected among most of the patients with Malta fever.
Exposure to Dichlorodiphenyltrichloroethane and the Risk of Breast Cancer: A Systematic Review and Meta-analysis
Jae-Hong Park, Eun Shil Cha, Yousun Ko, Myung-Sil Hwang, Jin-Hwan Hong, Won Jin Lee
Osong Public Health Res Perspect. 2014;5(2):77-84.   Published online April 30, 2014
DOI: https://doi.org/10.1016/j.phrp.2014.02.001
  • 1,742 View
  • 24 Download
  • 19 Citations
AbstractAbstract PDF
Objectives
This study extended and updated a meta-analysis of the association between exposure to dichlorodiphenyltrichloroethane (DDT) and the risk of breast cancer.
Methods
We reviewed the published literature on exposure to DDE and breast cancer risk to update a meta-analysis from 2004. The total of 35 studies included 16 hospital-based case–control studies, 11 population-based case–control studies, and 10 nested case–control studies identified through keyword searches in the PubMed and EMBASE databases.
Results
The summary odds ratio (OR) for the identified studies was 1.03 (95% confidence interval 0.95–1.12) and the overall heterogeneity in the OR was observed (I2 = 40.9; p = 0.006). Subgroup meta-analyses indicated no significant association between exposure to DDE and breast cancer risk by the type of design, study years, biological specimen, and geographical region of the study, except from population-based case–control studies with estimated DDE levels in serum published in 1990s.
Conclusion
Existing studies do not support the view that DDE increases the risk of breast cancer in humans. However, further studies incorporating more detailed information on DDT exposure and other potential risk factors for breast cancer are needed.

PHRP : Osong Public Health and Research Perspectives