The treatment of pediatric myocarditis is controversial, and the benefits of intravenous immunoglobulin (IVIG) are inconclusive due to limited data. We searched studies from PubMed, MEDLINE, Embase, and Cochrane Library databases since establishment until October 1st, 2018. Thirteen studies met the inclusion criteria. We included a total of 812 patients with IVIG treatment and 592 patients without IVIG treatment. The meta-analysis showed that the survival rate in the IVIG group was higher than that in the non-IVIG group (odds ratio = 2.133, 95% confidence interval (CI): 1.32–3.43, p = 0.002). There was moderate statistical heterogeneity among the included studies (I
2
= 35%, p = 0.102). However, after adjustment using Duval and Tweedie’s trim and fill method, the point estimate of the overall effect size was 1.40 (95% CI 0.83, 2.35), which became insignificant. Moreover, the meta-regression revealed that age (coefficient = −0.191, 95% CI (−0.398, 0.015), p = 0.069) and gender (coefficient = 0.347, 95% CI (−7.586, 8.279), p = 0.93) were not significantly related to the survival rate. This meta-analysis showed that IVIG treatment was not associated with better survival. The use of IVIG therapy in acute myocarditis in children cannot be routinely recommended based on current evidence. Further prospective and randomized controlled studies are needed to elucidate the effects of IVIG treatment.
A significantly higher prevalence of cardiovascular disease (CVD) is reported in patients with systemic lupus erythematosus (SLE) as compared with the general population and accounts for approximately 30% of deaths in SLE patients. However, the mechanism of and treatments for CVD in patients with SLE are still unclear. To explore the effects of taurine on cardiac abnormality in SLE, NZB/W F1 mice were used as the experimental model by receiving control, cholesterol, or cholesterol/taurine diets, respectively. Improved cardiac histopathological changes were observed in left ventricle tissues from the cholesterol/taurine group as compared to the control or cholesterol group. Significant reductions of TUNEL-positive cells, Fas death receptor-related components, mitochondrial-dependent apoptosis, cardiac fibrosis, and fibrotic signaling components were detected in the left ventricle tissues from the cholesterol/taurine group as compared to the control or cholesterol group. Additionally, cardiac IGR1R survival signaling components were significantly increased in the left ventricle tissues from the cholesterol/taurine group as compared to the control or cholesterol group. These findings revealed the protective effects of taurine against the cardiac abnormalities in NZB/W F1 mice and may suggest the potential for clinical application of taurine in treatment of CVD in SLE.
Microscopic haematuria is proposed as a prognostic factor for renal outcomes in patients with glomerulonephritis. However, the role of haematuria in patients with advanced chronic kidney disease (CKD) or heavy proteinuria has not been investigated. We divided 1799 patients with stage 3–5 nondiabetic CKD into 3 groups according to the results from 3 urinalyses: no haematuria (0–2 red blood cells [RBCs]/hpf ≥2 times), mild haematuria (2–5 RBCs/hpf ≥2 times) and moderate haematuria (≥5–10 RBCs/hpf ≥2 times). The estimated glomerular filtration rate was 25.4 mL/min/1.73 m2, with a urine protein-to-creatinine ratio (UPCR) of 881 mg/g. The hazard ratios (HRs) of mild and moderate haematuria for end-stage renal disease (ESRD) were 1.28 (95% confidence interval [CI]: 1.05–1.56, P = 0.024) and 1.34 (95% CI: 1.03–1.74, P = 0.030), respectively. The HR of moderate haematuria for mortality was 1.56 (95% CI: 1.11–2.20, P = 0.011). According to subgroup analysis, the HR of moderate haematuria for ESRD in patients with a UPCR of <500 mg/g was more prominent than that in patients with a UPCR of ≥500 mg/g. Microscopic haematuria in patients with stage 3–5 nondiabetic CKD is associated with increased risks of ESRD and mortality.
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