Background: Hematopoietic stem cell transplantation (HSCT) is a procedure used in different malignant and non-malignant diseases. Although post-transplant lymphoproliferative disorder (PTLD) is infrequently observed in patients with HSCT, no study on the overall global incidence rate is available to date. Methodology: In this study, we selected 39 studies from 941 studies from three databases (i.e., PubMed, ScienceDirect, and Google Scholar) to identify the global incidence rate of PTLD in HSCT. Results: The pooled incidence was determined to be 5.6% (95% CI: 5.0 to 6.3) and rose further to 12.4% (95% CI: 10.2 to 14.7) after excluding outlier studies. The quality of the studies was high as well. PTLD was prevalent the most in allogenic HSCT (i.e., 5.6% (95% CI: 4.9 to 6.3)) and within the European region (i.e., 27.1% (95% CI: 21.4 to 32.8)). Among risk factors, human leukocyte antigen (HLA) mismatch was reported in most of the studies. Conclusions: This study assessed and discussed the overall global incidence of PTLD in HSCT patients, continent-based incidence, and risk factors that can be helpful in finding the possible prevention mechanism of PTLD and implementing individualized treatment approaches based on the treatment availability during HSCT.

Background Previous studies investigating the prevalence of postpartum haemorrhage have shown inconsistent findings. One reason for the inconsistency is the method of measuring blood loss, with subjective estimation of blood loss to diagnose postpartum haemorrhage known to be inaccurate. We aimed to synthesise the prevalence of postpartum haemorrhage and severe postpartum haemorrhage according to the method of blood loss assessment and mode of birth. Methods In this systematic review and meta-analysis, we searched PubMed, Web of Science, Embase, Google Scholar, Cochrane, ClinicalTrials.gov, and ISRCTN between Jan 1, 1960, and Aug 11, 2025 for studies of postpartum haemorrhage available in English with no restrictions on participants' age, ethnicity, or geographical setting. At least two authors independently assessed heterogeneity (τ2), publication bias (Doi plots) and certainty of evidence (GRADE approach). A random-effects model was used to meta-analyse the prevalence of postpartum haemorrhage (defined as blood loss ≥500 mL) and severe postpartum haemorrhage (defined as blood loss ≥1000 mL). The outcomes were synthesised pooled prevalence of postpartum haemorrhage and severe postpartum haemorrhage according to blood loss assessment method (subjective and objective) and mode of birth (vaginal and caesarean). This study is registered with PROSPERO (CRD42023418635). Findings Of 24 969 identified records, the final quantitative synthesis comprised 81 eligible studies (n=42 709 185 women), conducted in 40 countries. The pooled prevalence of objectively diagnosed postpartum haemorrhage (≥500 mL) after vaginal birth was 12·6% (95% CI 10·1–15·2, τ2=0·02 [n=329 782]), compared with 3·9% (3·0–4·9, τ2=0·02 [n=24 330 539]) for subjective diagnosis. For severe postpartum haemorrhage after vaginal birth, the pooled prevalence was 3·3% (2·6–4·1, τ2=0·01 [n=3 061 456]) using objective methods, compared with 2·3% (1·3–3·6, τ2=0·02 [n=2 465 141]) using subjective methods. The pooled prevalence of postpartum haemorrhage after caesarean birth was 8·2% (3·7–14·3, τ2=0·04 [n=120 635]) using subjective methods; there were no data for objective methods. For severe postpartum haemorrhage after caesarean birth, the pooled prevalence was 8·5% (5·8–11·6, τ2=0·01 [n=480 306]) for objective methods compared with 3·7% (2·7–4·9, τ2=0·02 [n=11 921 326]) for subjective methods. There was evidence of publication bias for all study outcomes. All outcomes had moderate-certainty evidence, except for subjectively diagnosed postpartum haemorrhage after caesarean birth which had low-certainty evidence. Interpretation Postpartum haemorrhage and severe postpartum haemorrhage rates were substantially higher when using objective blood loss assessment methods for diagnosis, suggesting underestimation of blood loss with subjective assessment methods. Awareness of the correct prevalence of postpartum haemorrhage can help establish its health-care burden and improve outcomes. Funding Gates Foundation.

Background: Critical thinking is fundamental for registered nurses (RNs) when making clinical decisions, which impact patient outcomes. This review aimed to identify studies on critical thinking and clinical decision making among nurses in clinical practice and synthesize their findings based on the regional area, observed findings, and predictive factors, and to assess the measurement tools used. Methods: A comprehensive search of the PubMed, Web of Science, CINAHL, and SCOPUS databases up to December 2024 was conducted in accordance with the PRISMA guidelines. The Newcastle–Ottawa Scale was used to assess the quality of included studies. Studies with similarly themed components were grouped for narrative synthesis. A meta-analysis of random-effects model calculations was performed. Results: This review included forty studies (twenty-four on CT, twelve on CDM, four on both) from various WHO regions, revealing diverse findings on observed skills. Ten CT and four CDM measurement tools were identified. Many studies also explored individual and group-level predictive factors for these skills. Meta-analyses of four common tools (CCTDI, NCT4P, CDMNS, and NDMI) showed significant heterogeneity, with statistically significant pooled mean scores. Conclusions: The synthesis highlights the global research on nurses’ critical thinking and clinical decision making, including the exploration of various predictive factors. However, the significant heterogeneity in the findings from meta-analyses of commonly used measurement tools underscores a need for more standardized measurement and analytical approaches, such as multilevel modeling, to better account for the hierarchical nature of potential predictive factors (individual and group levels), which would allow for more reliable comparisons and stronger conclusions in this field.

Introduction: BCR-ABL-negative myeloproliferative neoplasms (MPNs)-including polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF)-together with myelodysplastic/myeloproliferative neoplasms (MDS/MPNs), are clinically heterogeneous chronic myeloid disorders. These entities are predominantly driven by somatic mutations in Janus kinase 2 (JAK2), calreticulin (CALR) and myeloproliferative leukemia (MPL) genes. Although JAK2 exon 12 and MYD88 mutations are reported less frequently, they may still contribute to disease pathogenesis and progression. This study aimed to investigate the mutational landscape of JAK2 ( V617F and exon 12), TET2 and MYD88 in a Malaysian cohort of patients with BCR-ABL-negative MPNs or MDS/MPNs. Methods: A total of 54 patients with BCR-ABL-negative MPNs (n = 48) or MDS/MPNs (n = 6) were prospectively enrolled between 2015 and 2018. Genomic DNA isolated from peripheral blood was analyzed by polymerase chain reaction followed by Sanger sequencing. Results: The JAK2 V617F mutation was identified in 81.5 % of cases, including 90 % of PV, 84.6 % of ET and 80% of PMF patients. Among the JAK2 exon 12 variants detected, D544N and c.1194+12G>A were consistently observed on repeat sequencing. These variants, previously reported by other investigators, were likewise present in our cohort, reinforcing their potential relevance to the molecular profile of MPNs. No pathogenic variants were found in TET2 exons 1 or 7. In addition, a known MYD88 intronic single-nucleotide polymorphism (rs4988457) was detected in three MPN patients (PV = 2, ET = 1), all of whom were co-mutated for JAK2 V617F and/or an exon 12 variant. Conclusion: This study confirms the central role of JAK2 V617F in BCR-ABL-negative MPNs and documents rare but potentially significant JAK2 exon 12 co-mutations. The presence of the MYD88 rs4988457 variant supports a possible inflammatory component in MPN pathogenesis. Together, these findings underscore the value of comprehensive mutational screening and provide further insight into the molecular complexity of MPNs, with implications for diagnosis, risk stratification and the development of targeted therapies.

BACKGROUND:An understanding of the causes of postpartum haemorrhage is needed to provide appropriate treatment and services. Knowledge of the risk factors for postpartum haemorrhage can help address modifiable risk factors. We did a systematic review and meta-analysis to identify and quantify the various causes and risk factors for postpartum haemorrhage. METHODS:In this systematic review and meta-analysis, we did a systematic literature search in MEDLINE, Embase, Web of Science, Cochrane Library, and Google Scholar for cohort studies of postpartum haemorrhage from Jan 1, 1960, to Nov 30, 2024 without language restrictions. At least two authors independently undertook study selection, data extraction, and quality assessment. Population-based cohort studies available in English were eligible. Rates of postpartum haemorrhage causes as well as crude and adjusted odds ratios (ORs) for risk factors were pooled using a random-effects model. Risk factors were classified as having weak, moderate, or strong association based on the pooled ORs: weak (OR >1 to 1·5), moderate (OR >1·5 to 2), and strong (OR >2). This study is registered with PROSPERO, CRD42023479686. FINDINGS:We synthesised data from 327 studies, including 847 413 451 women with no restriction on age, race, or ethnicity. Most studies were of high methodological quality. The pooled rates of the five commonly reported causes of postpartum haemorrhage were uterine atony (70·6% [95% CI 63·9-77·3]; n=834 707 women, 14 studies), genital tract trauma (16·9% [9·3-24·6]; n=18 449 women, six studies), retained placenta (16·4% [12·3-20·5]; n=235 021 women, nine studies), abnormal placentation (3·9% [0·1-7·6]; n=29 638 women, two studies), and coagulopathy (2·7% [0·8-4·5]; n=236 261, nine studies). The pooled rate of women with multiple postpartum haemorrhage causes was 7·8% (95% CI 4·7-10·8; n=666, two studies). Risk factors with a strong association with postpartum haemorrhage included anaemia, previous postpartum haemorrhage, caesarean birth, female genital mutilation, sepsis, no antenatal care, multiple pregnancy, placenta praevia, assisted reproductive technology use, macrosomia with a birthweight of more than 4500 g, and shoulder dystocia. Risk factors with moderate association with postpartum haemorrhage included BMI ≥30 kg/m2, COVID-19 infection, gestational diabetes, polyhydramnios, pre-eclampsia, and antepartum haemorrhage. Risk factors with weak association with postpartum haemorrhage included Black and Asian ethnicity, BMI 25-29·9 kg/m2, asthma, thrombocytopenia, uterine fibroids, antidepressant use, induction of labour, instrumental birth, and premature rupture of membranes. INTERPRETATION:The finding that uterine atony is the commonest cause of postpartum haemorrhage supports the WHO recommendation for all women giving birth to be given prophylactic uterotonics. Knowledge of risk factors with a strong association with postpartum haemorrhage can help to identify women at high risk of postpartum haemorrhage who could benefit from enhanced prophylaxis and treatment. The importance of multiple concurrent causes of postpartum haemorrhage supports the use of treatment bundles. FUNDING:Gates Foundation.

Background: Nucleotide-binding oligomerization domain-containing protein 2, encoded by NOD2, can trigger chronic gut inflammation that leads to colorectal cancer (CRC). However, studies that have investigated the association of NOD2 polymorphisms and CRC susceptibility have produced inconsistent findings. To clarify this relationship, a meta-analysis was conducted to integrate data from previous studies to achieve a more precise evaluation of the risk association. Methods: PubMed, Scopus, and Web of Science databases were systematically searched to identify relevant studies on the association of NOD2 polymorphisms with CRC risk. Genetic risk association was quantitatively assessed under five genetic models: homozygous, heterozygous, dominant, recessive, and allele. Thirteen studies, comprising 5,013 cases and 4,463 controls, were included in this study. Four NOD2 polymorphisms were investigated in these studies, namely rs2066842, rs2066844, rs2066845, and rs2066847. Results: Of these, only rs2066845 and rs2066847 were found to be significantly associated with increased CRC risk (rs2066845, heterozygous OR = 1.544, 95% CI = 1.014–2.349, P = 0.043; dominant OR = 1.561, 95% CI = 1.035–2.354, P = 0.034; allele OR = 1.572, 95% CI = 1.040–2.375, P = 0.032; rs2066847, heterozygous OR = 1.321, 95% CI = 1.060–1.647, P = 0.013; dominant OR = 1.402, 95% CI = 1.147–1.713, P = 0.001; allele OR = 1.345, 95% CI = 1.088–1.663, P = 0.006). Conclusions: In conclusion, the NOD2 rs2066845 and rs2066847 polymorphisms are associated with an increased risk of CRC and may potentially serve as predisposition biomarkers for the cancer.

OBJECTIVE:The incidence of persistent tracheocutaneous fistula (TCF) in children has dramatically increased with the increasing number of tracheostomies performed earlier in the paediatric population. Despite the various emerging techniques, two fundamental surgical approaches are primary closure and healing by secondary intention. We aim to compare the surgical outcomes between the two procedures. DATA SOURCE:PubMed, EMBASE and Scopus databases were searched from inception to 31 December 2023 with no restrictions on the setting or design of studies. REVIEW METHODS:Data were pooled using a random effects model to assess the success and complication rates between the two surgical techniques. RESULTS:A total of 26 studies were identified with a total of 1263 children. Persistent TCF was surgically treated with primary closure in 24 studies (n = 898), whereas healing by secondary intention was reported in 12 studies (n = 366). The success rate following primary closure and healing by secondary intention is 97.3% (95% CI: 95.7%-99.0%) and 94.0% (95% CI: 91.2%-96.7%), respectively. The pooled rate of complications following primary closure was 14.1% (95% CI: 8.9%-19.4%) and 8.4% (95% CI: 3.4%-13.3%) following healing by secondary intention. CONCLUSION:Based on the pooled results, healing by secondary intention is a safer surgical option in children with persistent TCF.

INTRODUCTION:Postpartum haemorrhage (PPH) remains the leading cause of maternal death. Yet there is a lack of clarity around what research is needed to determine what works and how best to deliver proven PPH interventions. This article describes a WHO-led effort to develop a global PPH research agenda for 2023-2030, to reinvigorate research and innovation while avoiding duplication and waste. METHODS:Potential questions were culled from evidence gaps in a forthcoming Lancet PPH series, a pipeline analysis on PPH medicines and devices, international PPH guidelines, previous research prioritisation efforts and submissions from a reference group of PPH experts and stakeholders. Questions were deduplicated and consolidated, categorised into three tracks (innovation, implementation and cross-cutting) and subjected to an online prioritisation survey. Survey participants (n=120) assessed these questions using five criteria (answerability, effectiveness, deliverability, maximum potential for disease burden reduction and equity) following the Child Health and Nutrition Research Initiative methodology. The outcome of this exercise was complemented by an in-person consensus meeting (Global PPH Summit from 7 March 2023 to 10 March 2023 in Dubai, United Arab Emirates) to finalise the research agenda. RESULTS:Fifteen research questions (five per track) were identified as top priority. The top question per track called for research on the comparative effectiveness and safety of alternative routes of administration (other than the intravenous route) of tranexamic acid in the treatment of PPH (innovation); identifying barriers and facilitators affecting the adoption and use of evidence-based recommendations for PPH management (implementation) and the effectiveness of a strategy of early detection and first response treatment using a bundle of recommended interventions for improving PPH-related outcomes (cross-cutting). CONCLUSION:This shared research agenda should guide future investments into PPH studies with high potential to transform policy and clinical practice in the near term to medium term. Funding for the new research priorities is urgently needed.

(Abstracted from Fertil Steril 2023;120:940–944 Early pregnancy loss, or miscarriage, is a relatively common occurrence. Of these losses, 80% occur in the first 12 weeks of gestation and 50% of them are diagnosed with chromosomal abnormalities.

Zika virus (ZIKV) and chikungunya virus (CHIKV) are arthropod-borne viruses with significant pathogenicity, posing a substantial health and economic burden on a global scale. Moreover, ZIKV-CHIKV coinfection imposes additional therapeutic challenges as there is no specific treatment for ZIKV or CHIKV infection. While a growing number of studies have documented the ZIKV-CHIKV coinfection, there is currently a lack of conclusive reports on this coinfection. Therefore, we performed a systematic review and meta-analysis to determine the true statistics of ZIKV-CHIKV coinfection in the global human population. Relevant studies were searched for in PubMed, Scopus, and Google Scholar without limitation in terms of language or publication date. A total of 33 studies containing 41,460 participants were included in this meta-analysis. The study protocol was registered with PROSPERO under the registration number CRD42020176409. The pooled prevalence and confidence intervals of ZIKV-CHIKV coinfection were computed using a random-effects model. The study estimated a combined global prevalence rate of 1.0% [95% CI: 0.7–1.2] for the occurrence of ZIKV-CHIKV coinfection. The region of North America (Mexico, Haiti, and Nicaragua) and the country of Haiti demonstrated maximum prevalence rates of 2.8% [95% CI: 1.5–4.1] and 3.5% [95% CI: 0.2–6.8], respectively. Moreover, the prevalence of coinfection was found to be higher in the paediatric group (2.1% [95% CI: 0.0–4.2]) in comparison with the adult group (0.7% [95% CI: 0.2–1.1]). These findings suggest that the occurrence of ZIKV-CHIKV coinfection varies geographically and by age group. The results of this meta-analysis will guide future investigations seeking to understand the underlying reasons for these variations and the causes of coinfection and to develop targeted prevention and control strategies.

The goal of this meta-analysis was to study nasal nitric oxide (nNO) measurements in allergic rhinitis (AR) and non-allergic rhinitis (non-AR). The protocol was registered with PROSPERO (no: CRD4202124828). Electronic databases from PubMed, Google Scholar, Scopus, Web of Science, and Cochrane were all thoroughly searched and studies were chosen based on the qualifying requirements. The quality of the studies was evaluated by Joanna Briggs Institute evaluation tools, and publication bias using funnel plots. The meta-analysis included 18 studies, whereas the systematic review included 20 studies, totaling 3097 participants (1581 AR, 458 non-AR, and 1058 healthy/control). Patients with AR had significantly greater nNO levels than the control group, although this did not change significantly before or after treatment. AR patients had significantly greater nNO levels than non-AR patients, but there was no significant difference between non-AR patients and healthy controls. Nineteen of the studies were of high quality and the remaining one was of moderate quality. nNO measurement has a promising role in the management of AR and non-AR patients, but more investigations are needed to document clinical benefits.

Kikuchi–Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare, benign condition affecting young Oriental-Asian females. It is characterized by fever and tender cervical lymphadenopathy with an unclear aetiology, and in most longitudinal reviews, KFD occurs before systemic lupus erythematosus (SLE). Herein, the case of a 28-year-old Kuwaiti female without any relevant past medical history, who was simultaneously diagnosed with KFD and SLE following an Ebstein–Barr virus infection, is reported. The patient was treated with oral prednisolone, hydroxychloroquine, cyclosporin, and belimumab and her response was clinically and biochemically favourable. Although KFD is prevalent in Asian populations, it may affect all races. Early diagnosis of KFD is difficult, particularly when simultaneously diagnosed with SLE, but crucial to preventing inappropriate therapy. Clinicians need to know about this rare disease, especially when patients present with fever and swollen lymph nodes, due to a risk of misdiagnosis with tuberculosis or lymphoma, as these are more often thought to be the cause of such symptoms.

Primary antiphospholipid syndrome (PAPS) is a systemic autoimmune disorder, characterised by consistently high levels of antiphospholipid antibodies, thrombosis, and/or pregnancy morbidity. Due to various suspected causes, deficient or insufficient levels of vitamin D in the serum have been reported in patients with PAPS; however, the reports have been sporadic and inconclusive. This systematic review and meta-analysis aimed to comprehensively evaluate the serum vitamin D levels in patients with PAPS compared to controls. A protocol was registered in PROSPERO (Registration No. CRD42019132128) and a systematic literature search was conducted through Google Scholar, PubMed, Web of Science, Scopus, and ScienceDirect databases without restricting language and year. Pooled prevalence, mean difference (MD), and odds ratio (OR) along with 95% confidence intervals (CI) were determined by using a random effects model. Study quality was assessed by the Joana Brigg's Institute (JBI) protocol and publication bias was evaluated by a trim and fill funnel plot, Begg's, and Egger's tests. The pooled prevalence of vitamin D deficiency and insufficiency was found to be 32.2% [95% CI: 16.3-48.2] and 61.5% [95% CI: 40.2-82.8], respectively. Serum levels of vitamin D were considerably lower in the PAPS patients compared to controls (MD: -5.75, 95% CI: -9.73 to -1.77; p = 0.005). Multiple sensitivity analyses showed that the results remained statistically significant, demonstrating the robustness of this meta-analysis. No significant publication bias was detected in determining the MD of serum vitamin D levels in PAPS and controls. In conclusion, PAPS patients had greater rates of vitamin D deficiency or insufficiency, higher frequency of thrombosis, and lower serum vitamin D levels than healthy individuals.

Background: Publications on the associations of genetic variants with the response to platinum-based chemotherapy (PBC) in NSCLC patients have surged over the years, but the results have been inconsistent. Here, a comprehensive meta-analysis was conducted to combine eligible studies for a more accurate assessment of the pharmacogenetics of PBC in NSCLC patients.Methods: Relevant publications were searched in PubMed, Scopus, and Web of Science databases through 15 May 2021. Inclusion criteria for eligible publications include studies that reported genotype and allele frequencies of NSCLC patients treated with PBC, delineated by their treatment response (sensitive vs. resistant). Publications on cell lines or animal models, duplicate reports, and non-primary research were excluded. Epidemiological credibility of cumulative evidence was assessed using the Newcastle-Ottawa Scale (NOS) and Venice criteria. Begg’s and Egger’s tests were used to assess publication bias. Cochran’s Q-test and I2 test were used to calculate the odds ratio and heterogeneity value to proceed with the random effects or fixed-effects method. Venice criteria were used to assess the strength of evidence, replication methods and protection against bias in the studies.Results: A total of 121 publications comprising 29,478 subjects were included in this study, and meta-analyses were performed on 184 genetic variants. Twelve genetic variants from 10 candidate genes showed significant associations with PBC response in NSCLC patients with strong or moderate cumulative epidemiological evidence (increased risk: ERCC1 rs3212986, ERCC2 rs1799793, ERCC2 rs1052555, and CYP1A1 rs1048943; decreased risk: GSTM1 rs36631, XRCC1 rs1799782 and rs25487, XRCC3 rs861539, XPC rs77907221, ABCC2 rs717620, ABCG2 rs2231142, and CDA rs1048977). Bioinformatics analysis predicted possible damaging or deleterious effects for XRCC1 rs1799782 and possible low or medium functional impact for CYP1A1 rs1048943.Conclusion: Our results provide an up-to-date summary of the association between genetic variants and response to PBC in NSCLC patients.

Objective To determine the prevalence and associated risk factors of undiagnosed metabolic syndrome (MetS) using three different definitions among apparently healthy adults of Karachi, Pakistan. Methods This community-based cross-sectional survey was conducted in Karachi, Pakistan, from January 2022 to August 2022. A total of 1065 healthy individuals aged 25–80 years of any gender were consecutively included. MetS was assessed using the National Cholesterol Education Program for Adult Treatment Panel (NCEP-ATP) III guidelines, International Diabetes Federation (IDF), and modified NCEP-ATP III. Results The prevalence of MetS was highest with the modified NCEP-ATP III definition at 33.9% (95% CI: 31–36), followed by the IDF definition at 32.2% (95% CI: 29–35). In contrast, the prevalence was lower at 22.4% (95% CI: 19–25) when using the NCEP ATP III definition. The risk of MetS significantly increases with higher BMI, as defined by the IDF criteria (adjusted OR [ORadj] 1.13, 95% CI 1.09–2.43), NCEP-ATP III criteria (ORadj 1.15, 95% CI 1.11–1.19), and modified NCEP-ATP III criteria (ORadj 1.16, 95% CI 1.12–1.20). Current smokers had significantly higher odds of MetS according to the IDF (ORadj 2.72, 95% CI 1.84–4.03), NCEP-ATP III (ORadj 3.93, 95% CI 2.55–6.06), and modified NCEP-ATP III (ORadj 0.62, 95% CI 0.43–0.88). Areca nut use was associated with higher odds of MetS according to both IDF (ORadj 1.71, 95% CI 1.19–2.47) and modified NCEP-ATP III criteria (ORadj 1.58, 95% CI 1.10–2.72). Furthermore, low physical activity had significantly higher odds of MetS according to the NCEP-ATP III (ORadj 1.36, 95% CI 1.01–1.84) and modified NCEP-ATP III criteria (ORadj 1.56, 95% CI 1.08–2.26). Conclusion One-third of the healthy individuals were diagnosed with MetS based on IDF, NCEP-ATP III, and modified NCEP-ATP III criteria. A higher BMI, current smoking, areca nut use, and low physical activity were significant factors.

BACKGROUND:Multiple myeloma (MM) is a hematological malignancy characterized by the exponential growth of malignant plasma cells. Individuals diagnosed with MM exhibit a deficiency in vitamin D and may suffer fatigue, a loss of muscular strength, persistent musculoskeletal aches, and pain. The objective of this systematic review and meta-analysis is to determine the prevalence of vitamin D insufficiency and deficiency in individuals diagnosed with MM. METHODS:We searched five electronic databases using relevant keywords. The quality of the included studies was evaluated using the critical appraisal tool developed by the Joanna Briggs Institute. We employed a random-effects model and presented the findings in the form of percentages accompanied by 95% confidence intervals (CI). This protocol has been officially registered in PROSPERO under the registration number CRD42021248710. RESULTS:The meta-analysis comprised a total of eighteen studies and found that, among patients with MM, the occurrence of serum vitamin D deficiency and insufficiency was 39.4% (95% CI: 25.8 to 52.9, n = 3746) and 34.1% (95% CI: 20.9 to 47.2, n = 3559), respectively. The findings indicate that a greater proportion of newly diagnosed patients exhibited vitamin D deficiency and insufficiency, with rates of 43.0% and 41.6%, respectively, compared to those receiving treatment (rates of 41.6% and 32.3%, respectively). The findings of the sensitivity analyses were consistent, and most of the studies (72.2%) were deemed to be of high quality. The results of Egger's test indicated the absence of publication bias. CONCLUSIONS:Patients diagnosed with MM have been found to exhibit significantly elevated levels of both vitamin D deficiency and insufficiency. Therefore, it is recommended to consider vitamin D testing as an additional parameter in the current criteria for the clinical evaluation of MM.

Antiphospholipid antibodies are highly prevalent in autoimmune diseases and mainly associated with thromboembolic events, which is one of the major reasons for cancer-related mortality. Confirmed adult cancer patients were included (n = 40) with an equal number of age- and sex-matched healthy controls. The presence and concentration of anticardiolipin antibodies were investigated by the enzyme-linked immunosorbent assay using the venous blood samples. aCL antibodies were detected in 60.0% (n = 24) of the cancer patients compared to none in the healthy controls (p < 0.001). The serum concentration of aCL antibodies was significantly higher in cancer patients than controls (p < 0.001) and ranged from 89.0 U/mL to 133.0 U/mL among the aCL-positive patients. All the lung cancer patients (n = 6) were diagnosed with positive aCL, and a borderline significant association of aCL antibody positivity was observed in colon cancer patients (p = 0.051). About 72.7% of the advanced-stage cancer individuals and 81.8% of the cancer patients who underwent surgery were diagnosed with positive aCL antibodies. A significant association of aCL antibody positivity was observed with cancer patients comorbid with heart diseases (p = 0.005). The prevalence and serum levels of aCL antibodies were significantly higher in cancer patients compared to healthy controls. Cancer patients (i.e., lung, liver, and colon), at advanced-stage, comorbid with heart diseases, who underwent surgery, were more likely to be diagnosed with aCL antibodies.

The assurance of safety and effectiveness is a significant focal point in all therapeutic approaches. Although mesenchymal stem cells (MSCs) have been identified as a potential novel therapeutic strategy for multiple sclerosis (MS), existing evidence regarding the effectiveness and safety of this strategy remains inconclusive. Thus, the primary aim of this systematic review and meta-analysis (SRMA) was to comprehensively assess the effectiveness and safety of MSC therapy in individuals diagnosed with MS. A comprehensive search was conducted using appropriate keywords in the PubMed, Scopus, Cochrane, ScienceDirect, and Google Scholar databases to determine the eligible studies. The change in the expanded disability status scale (EDSS) score from baseline to follow-up was used to assess MSC efficacy. The effectiveness of the therapy was assessed using a random-effects model, which calculated the combined prevalence and 95% confidence intervals (CIs) for MS patients who experienced improvement, stability, or worsening of their condition. The protocol was registered in PROSPERO (CRD42020209671). The findings indicate that 40.4% (95% CI: 30.6–50.2) of MS patients exhibited improvements following MSC therapy, 32.8% (95% CI: 25.5–40.1) remained stable, and 18.1% (95% CI: 12.0–24.2) experienced a worsening of their condition. Although no major complications were observed, headaches 57.6 [37.9–77.3] and fever 53.1 [20.7–85.4] were commonly reported as minor adverse events. All of the results reported in this meta-analysis are consistent and credible according to the sensitivity analyses. Regardless of different individual studies, our meta-analysis provides a comprehensive overview showing the potential of MSC therapy as a possible effective treatment strategy for patients with MS.

Burkitt lymphoma (BL) is a form of B-cell malignancy that progresses aggressively and is most often seen in children. While Epstein-Barr virus (EBV) is a double-stranded DNA virus that has been linked to a variety of cancers, it can transform B lymphocytes into immortalized cells, as shown in BL. Therefore, the estimated prevalence of EBV in a population may assist in the prediction of whether this population has a high risk of increased BL cases. This systematic review and meta-analysis aimed to estimate the prevalence of Epstein-Barr virus in patients with Burkitt lymphoma. Using the appropriate keywords, four electronic databases were searched. The quality of the included studies was assessed using the Joanna Briggs Institute's critical appraisal tool. The results were reported as percentages with a 95% confidence interval using a random-effects model (CI). PROSPERO was used to register the protocol (CRD42022372293), and 135 studies were included. The prevalence of Epstein-Barr virus in patients with Burkitt lymphoma was 57.5% (95% CI: 51.5 to 63.4, n = 4837). The sensitivity analyses demonstrated consistent results, and 65.2% of studies were of high quality. Egger's test revealed that there was a significant publication bias. EBV was found in a significantly high proportion of BL patients (more than 50% of BL patients). This study recommends EBV testing as an alternative for predictions and the assessment of the clinical disease status of BL.