Background Integrated information on the global prevalence and incidence of bullous pemphigoid (BP) is lacking. Objective To estimate the incidence and prevalence of BP in a systematic review and meta‐analysis. Methods Observational studies were included by using databases of Medline, EMBASE, and Cochrane Library. Subgroup analysis was by continent, age, sex, and country income level. Random‐effects model was used. Between‐study heterogeneity was assessed using the I2 statistic. Results The global incidence was 0.0419 per 1000 person‐years (95% CI: 0.0414–0.0424). The incidence was 0.047 per 1000 person‐years (95% CI: 0.0462–0.0477), 0.0419 per 1000 person‐years (95% CI: 0.0411–0.0426), 0.0072 per 1000 person‐years (95% CI: 0.0067–0.0078), 0.003 per 1000 person‐years (95% CI: 0.0023–0.0039) in North America, Europe, Asia, and Africa, respectively; 0.0202 per 1000 person‐years (95% CI: 0.0196–0.0208) and 0.0181 per 1000 person‐years (95% CI: 0.0175–0.0188) females and males; 0.001 per 1000 person‐years (95% CI: 0.001–0.001), 0.002 per 1000 person‐years (95% CI: 0.001–0.002), 0.004 per 1000 person‐years (95% CI: 0.004–0.004); 0.007 per 1000 person‐years (95% CI: 0.007–0.008), 0.011 per 1000 person‐years (95% CI: 0.011–0.012), 0.017 per 1000 person‐years (95% CI: 0.015–0.018) for age <50, 50–59, 60–69, 70–79, 80–89, and ≥90 years; 0.0038 per 1000 person‐years (95% CI: 0.0036–0.004112) (I2 = 99%, p < .05) and 0.0456 per 1000 person‐years (95% CI: 0.0450–0.0462) (I2 = 100%, p < .05). The pooled clinic‐based prevalence was 0.79% (95% CI: 0.75%–0.84%), 1.13% (95% CI: 1.06%–1.21%), 0.21% (95% CI: 0.17%–0.26%), and 0.13% (95% CI: 0.1%–0.15%) for Asia, Africa, and Europe. Conclusions This study identified the global incidence and prevalence of BP in terms of spatial and population distributions and among various income level. A relatively higher incidence was in Europe, females, older people, and high‐income level country. The prevalence was higher in Asia. These findings should be interpreted with caution due to high heterogeneity of included studies.
Background Intense pulse light (IPL) has been adopted by numerous patients. However, no existing study has analyzed the efficiency and safety of IPL in the treatment of acne vulgaris. Objective To assess the efficiency and safety of IPL in the treatment of acne vulgaris. Methods Electronic databases, including Embase, Cochrane Library, and MEDLINE, were retrieved to identify related studies. In this study, the primary and secondary outcomes were the mean percentage reduction of inflammatory acne lesion improvement (MPRI) and the mean percentage reduction of noninflammatory acne lesion improvement (NMPRI), respectively. Between‐study heterogeneities were assessed using the I 2 statistic. Results Eight randomized controlled trials (RCTs) including 450 patients were enrolled into the present analysis. With regard to MPRI, the result of IPL group was poorer than that of control group [mean deviation (MD) = −4.37 (95% confidence interval CI: −7.83, −0.91), P = .01]. In addition, the efficiency of IPL was poor among African and Asian populations [MD = −3.87 (95% CI: −7.36, −0.37), P = .03; MD = −28.37 (95% CI: −52.26, −4.18), P = .02]. Meanwhile, difference in the efficiency between IPL and 1064 nm Nd:YAG was not statistically significant [MD = −3.25 (95% CI: −7.01, −0.51). P = .09]. Besides, the efficiency of IPL was lower than that of PDL [MD = −28.37 (95% CI: −52.26, −4.18), P = .02]. There was no statistically significant difference in the efficiency between IPL and other treatments for NMPRI. With regard to adverse effects, erythema (46.73%) and pain (39.13%) were the most common. Conclusions IPL is not so efficient as other supplementary therapies. For inflammatory acne lesions, the efficiency of IPL is poorer than that of PDT. Difference in geographic regions may affect the IPL efficiency. However, the results obtained in this study should be cautiously interpreted due to the heterogeneities and the lack of studies with a large sample size.
Febrile seizure is the most common neurologic disorder in infants and children. This study aimed to elaborate safe and effective therapy for preventing FS recurrence by levetiracetam (LEV). A prospective study was performed in two groups of children, the no treatment group (n=51, 24.1±9.0 months) and the LEV treatment group (n=45, 23.3±8.9 months). The findings demonstrated that a significant difference (P<0.01) was observed between the no treatment group 51.0% (26/51) and LEV treatment group 15.5% (7/45) in terms of FS recurrence after 50 weeks. FS recurrence/fever episode was 12.4% (12/97) in the LEV treatment group and 51.8% (57/110) in the no treatment group. Furthermore, LEV administration significantly improved (P<0.001) epileptiform + nonspecific EEG abnormalities (17.8%; 8/45), as compared with the no treatment group (68.6%; 35/51). In conclusion, LEV could function as an effective therapeutic agent for the prevention of FS recurrence and reducing the frequency of fever episodes. Furthermore, LEV administration significantly improved nonspecific EEG abnormalities, which may be used as a clinical monitoring index for LEV treatment in patients with FS.
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