Use of Grading of Recommendations, Assessment, Development, and Evaluation to Combat Fake News: A Case Study of Influenza Vaccination in Pregnancy

Evidence of Chinese herbal fumigation for knee osteoarthritis: A protocol for systematic review and meta-analysis

BACKGROUND

Knee osteoarthritis (KOA) is the most common cause of musculoskeletal pain and disability worldwide. Chinese herbal fumigation, an external therapy, is commonly used for the treatment of KOA, while there is no systematic review or meta-analysis designed to evaluate the effects of Chinese herbal fumigation on KOA.

METHODS

Seven databases including Cochrane Central Register of Controlled Trials, EMBASE, PubMed, China National Knowledge Infrastructure, Wanfang data, VIP, and Chinese Biomedical Literature Database will be searched up to October 31, 2020. Data that meet the inclusion criteria will be extracted and analyzed by using RevMan V.5.3 software. Two reviewers will assess quality of the included studies based on the Cochrane Collaboration risk of bias tool. The funnel plot and Begg test will be used to evaluate publication bias. And Grading of Recommendations Assessment, Development and Evaluation will be employed to assess the quality of evidence.

RESULTS

This study will provide high-quality evidence for Chinese herbal fumigation for the treatment of KOA in terms of effectiveness and safety.

CONCLUSION

This systematic review will provide evidence to help us confirm the clinical efficacy of Chinese herbal fumigation in the treatment of KOA.

Anti-NMDA Receptor Encephalitis, Vaccination and Virus

Anti-N-methyl-d-aspartate (Anti-NMDA) receptor encephalitis is an acute autoimmune disorder. The symptoms range from psychiatric symptoms, movement disorders, cognitive impairment, and autonomic dysfunction. Previous studies revealed that vaccination might induce this disease. A few cases were reported to be related to H1N1 vaccine, tetanus/diphtheria/pertussis and polio vaccine, and Japanese encephalitis vaccine. Although vaccination is a useful strategy to prevent infectious diseases, in a low risk, it may trigger serious neurological symptoms. In addition to anti-NMDA receptor encephalitis, other neurological diseases were reported to be associated with a number of vaccines. In this paper, the anti-NMDA receptor encephalitis cases related to a number of vaccines and other neurological symptoms that might be induced by these vaccines were reviewed. In addition, anti-NMDA receptor encephalitis cases that were induced by virus infection were also reviewed.

Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza immunization: an overview

BACKGROUND

Maternal tetanus, diphtheria, and acellular pertussis (Tdap) and influenza immunization for women during pregnancy (the so-called "maternal immunization") has been introduced in several countries, and recently also in Italy, to protect mother and fetus during pregnancy, infant in his first months of life and mother during postpartum period. However, very low vaccination coverage rates have been reached due to several variables.

METHODS

A literature search was conducted on PubMed and Embase, including any experimental or observational studies, to assesses existing evidence on the effectiveness, efficacy, safety and optimal timing of administration of Tdap and influenza immunization in pregnancy for mothers and their infants. The search was finalized in August 2019.

RESULTS

Reviewing the literature, we identified only a few studies that, among several maternal and infant outcomes, found sporadic significant associations with maternal influenza immunization and even less with Tdap immunization. Moreover, most of the authors of these studies explained these findings as a result of residual confounding effect. The effectiveness of maternal influenza immunization is more complicated to prove than the effectiveness of Tdap immunization because of several reasons. Not all nations recommend and offer vaccines in the same weeks of pregnancy and this one manifests the complexity in defining the best timing for Tdap or influenza immunization.

CONCLUSIONS

The safety of maternal Tdap or influenza immunization is supported by the evidence so far, however, regular surveillance should be maintained, especially with regard to the influenza vaccine that changes in formulation each year. There is a need to optimize the timing of vaccination in pregnancy and to have a national system of detection of maternal immunization in each country.