A systematic review of the safety of topical therapies for atopic dermatitis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75613/1/j.1365-2133.2006.07538.x.pd

The effects of acute respiratory illness on exercise and sports performance outcomes in athletes - a systematic review by a subgroup of the IOC consensus group on "Acute respiratory illness in the athlete"

SUPPLEMENTARY FILE 1: PRISMA checklist.SUPPLEMENTARY FILE 2: Search terms and results of literature search.SUPPLEMENTARY FILE 3: Downs and Black Quality Assessment Checklist adapted for non-randomised control trial articles.SUPPLEMENTARY TABLE S1: Pathological classification (main and subgroups) of acute respiratory illness (ARill) by diagnostic method* .SUPPLEMENTARY TABLE S2: Number of studies included by pathological and anatomical classification,SUPPLEMENTARY TABLE S3: Detailed results of the acute (short term) effects of acute respiratory infection on exercise and sports performance outcomes.SUPPLEMENTARY TABLE S4: Detailed results of the longer term effects of acute respiratory infection on exercise and sports performance outcomes.Acute respiratory infections (ARinf) are common in athletes, but their effects on exercise and sports performance remain unclear. This systematic review aimed to determine the acute (short-term) and longer-term effects of ARinf, including SARS-CoV-2 infection, on exercise and sports performance outcomes in athletes. Data sources searched included PubMed, Web of Science and EBSCOhost, from January 1990 to 31 December 2021. Eligibility criteria included original research studies published in English, measuring exercise and/or sports performance outcomes in athletes/physically active/military aged 15–65 years with ARinf. Information regarding the study cohort, diagnostic criteria, illness classification and quantitative data on the effect on exercise/sports performance were extracted. Database searches identified 1707 studies. After full-text screening, 17 studies were included (n = 7793). Outcomes were acute or longer-term effects on exercise (cardiovascular or pulmonary responses), or sports performance (training modifications, change in standardised point scoring systems, running biomechanics, match performance or ability to start/finish an event). There was substantial methodological heterogeneity between studies. ARinf was associated with acute decrements in sports performance outcomes (four studies) and pulmonary function (three studies), but minimal effects on cardiorespiratory endurance (seven studies in mild ARinf). Longer-term detrimental effects of ARinf on sports performance (six studies) were divided. Training mileage, overall training load, standardised sports performance-dependent points and match play can be affected over time. Despite few studies, there is a trend towards impairment in acute and longer-term exercise and sports outcomes after ARinf in athletes. Future research should consider a uniform approach to explore relationships between ARinf and exercise/sports performance.OC Research Center of South Africa.https://www.tandfonline.com/loi/tejs202023-07-08hj2023PhysiologySports Medicin

Acute respiratory illness and return to sport:a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'

OBJECTIVE : To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in >1 day lost from training/competition, and symptom duration (days) of ARill in athletes. DESIGN : Systematic review and meta-analysis. DATA SOURCES : PubMed, EBSCOhost, Web of Science, January 1990–July 2020. ELIGIBILITY CRITERIA : Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss >1 day after ARill or symptom duration (days) of ARill. RESULTS : 767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss >1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens). CONCLUSIONS : In 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.Partially supported by funding from the IOC Research Centre of South Africa.http://bjsm.bmj.comhj2023PhysiologySports Medicin

Acute respiratory illness and return to sport : a systematic review and meta-analysis by a subgroup of the IOC consensus on 'acute respiratory illness in the athlete'

OBJECTIVE : To determine the days until return to sport (RTS) after acute respiratory illness (ARill), frequency of time loss after ARill resulting in >1 day lost from training/competition, and symptom duration (days) of ARill in athletes. DESIGN : Systematic review and meta-analysis. DATA SOURCES : PubMed, EBSCOhost, Web of Science, January 1990–July 2020. ELIGIBILITY CRITERIA : Original research articles published in English on athletes/military recruits (15–65 years) with symptoms/diagnosis of an ARill and reporting any of the following: days until RTS after ARill, frequency (%) of time loss >1 day after ARill or symptom duration (days) of ARill. RESULTS : 767 articles were identified; 54 were included (n=31 065 athletes). 4 studies reported days until RTS (range: 0–8.5 days). Frequency (%) of time loss >1 day after ARill was 20.4% (95% CI 15.3% to 25.4%). The mean symptom duration for all ARill was 7.1 days (95% CI 6.2 to 8.0). Results were similar between subgroups: pathological classification (acute respiratory infection (ARinf) vs undiagnosed ARill), anatomical classification (upper vs general ARill) or diagnostic method of ARinf (symptoms, physical examination, special investigations identifying pathogens). CONCLUSIONS : In 80% of ARill in athletes, no days were lost from training/competition. The mean duration of ARill symptoms in athletes was 7 days. Outcomes were not influenced by pathological or anatomical classification of ARill, or in ARinf diagnosed by various methods. Current data are limited, and future studies with standardised approaches to definitions, diagnostic methods and classifications of ARill are needed to obtain detailed clinical, laboratory and specific pathogen data to inform RTS.Partially supported by funding from the IOC Research Centre of South Africa.http://bjsm.bmj.comhj2023PhysiologySports Medicin

Change in MRI-PDFF and Histologic Response in Patients With Nonalcoholic Steatohepatitis: A Systematic Review and Meta-Analysis.

Background & aimsMagnetic resonance imaging proton density fat fraction (MRI-PDFF) offers promise as a non-invasive biomarker of treatment response in early-phase nonalcoholic steatohepatitis (NASH) trials. We performed a systematic review to quantify the association between a ≥ 30% reduction in MRI-PDFF and histologic response in NASH.MethodsWe searched the Cochrane Library, Embase, Medline and trial registries through May 2020 for early-phase clinical trials that incorporated MRI-PDFF and examined histologic response following intervention in adults with NASH. Subjects were classified as MRI-PDFF responders (relative decline in liver fat ≥30%) or non-responders (relative decline in liver fat <30%). MRI-PDFF responders versus non-responders were compared. Primary outcome was histologic response defined as a 2-point improvement in NAFLD Activity Score with at least 1-point improvement in lobular inflammation or ballooning. Secondary outcome was NASH resolution. Proportions and random effects odds ratios (OR) with corresponding 95% confidence intervals (CI) were calculated.ResultsSeven studies met inclusion criteria, comprising 346 subjects (median age 51 years; 59% female; 46% with diabetes). MRI-PDFF responders were significantly more likely to have a histologic response (51% vs 14%, P < .001; OR 6.98, 95% CI 2.38-20.43, P < .001) and NASH resolution (41% vs 7%, P < .001; OR 5.45, 95% CI 1.53-19.46, P = .009) compared to non-responders.ConclusionsThis meta-analysis demonstrates that a ≥30% relative decline in MRI-PDFF is associated with higher odds of histologic response and NASH resolution. These results support the use of MRI-PDFF in non-invasive monitoring of treatment response in early-phase NASH clinical trials and provide helpful data for sample-size estimation for histology-based assessment

Magnetic Resonance vs Transient Elastography Analysis of Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Pooled Analysis of Individual Participants

BACKGROUND & AIMS: Magnetic resonance elastography (MRE) and transient elastography (TE) are noninvasive techniques for detection of liver fibrosis. Single-center studies have compared the diagnostic performance of MRE vs TE in patients with nonalcoholic fatty liver disease (NAFLD). We conducted a pooled analysis of individual participant data from published studies to compare the diagnostic performance of MRE vs TE for staging of liver fibrosis in patients with NAFLD, using liver biopsy as reference. METHODS: We performed a systematic search of publication databases, from 2005 through 2017. We identified 3 studies of adults with NAFLD who were assessed by MRE, TE, and liver biopsy. In a pooled analysis, we calculated the cluster-adjusted area under the curve (AUROC) of MRE and TE for the detection of each stage of fibrosis. AUROC comparisons between MRE and TE were performed using the Delong test. RESULTS: Our pooled analysis included 230 participants with biopsy-proven NAFLD with mean age of 52.2+/-13.9 years and a body mass index of 31.9+/-7.5 kg/m2. The proportions of patients with fibrosis of stages 0, 1, 2, 3, and 4 were: 31.7%, 27.8%, 15.7%, 13.9%, and 10.9%, respectively. The AUROC of TE vs MRE for detection of fibrosis stages \textgreater/=1 was 0.82 (95% CI, 0.76-0.88) vs 0.87 (95% CI, 0.82-0.91) (P=.04); for stage\textgreater/= 2 was 0.87 (95% CI, 0.82-0.91) vs 0.92 (95% CI, 0.88-0.96) (P=.03); for stage \textgreater/=3 was 0.84 (95% CI, 0.78-0.90) vs 0.93 (95% CI, 0.89-0.96) (P=.001); for stage \textgreater/= 4 was 0.84 (95% CI, 0.73-0.94) vs 0.94 (95% CI, 0.89-0.99) (P=.005). CONCLUSION: In a pooled analysis of data from individual participants with biopsy-proven NAFLD, we found MRE to have a statistically significantly higher diagnostic accuracy than TE in detection of each stage of fibrosis. MRE and TE each have roles in detection of fibrosis in patients with NAFLD, depending upon the level of accuracy desired