Effect of omega-3 fatty acids supplementation during childhood in preventing allergic disease: a systematic review and Meta-Analysis.

BACKGROUND: Early omega-3 fatty acids exposure can influence early immune development and potentially prevent allergic disease. OBJECTIVES: To review the effects of omega-3 fatty acids during childhood on allergic disease outcomes. METHODS: We conducted searches of the PubMed, EMBASE and Cochrane Central Register of Controlled Trials and international trial registers (ClinicalTrials.gov and ISRCTN Registry) to September 30, 2018. We included randomized controlled trials (RCTs) and prospective cohort studies regarding the effect of omega-3 fatty acids during childhood on allergic disease outcomes. A total of 8 publications from 2 prospective cohort studies and 6 reports representing 5 unique RCTs were included. RESULTS: The results of meta-analysis showed that omega-3 fatty acids during childhood did not appear to significantly alter the risk of any atopy (≤3 years old: RR 0.70, 95% CI 0.47 to 1.04, p = 0.08; > 3 years old: RR 0.98, 95% CI 0.82 to 1.16, p = 0.77), wheeze (≤3 years old: RR 0.82, 95% CI 0.54 to 1.26, p = 0.375; > 3 years old: RR 1.03, 95% CI 0.53 to 2.00, p = 0.929) and eczema (≤3 years old: RR 0.86, 95% CI 0.68 to 1.08, p = 0.20; > 3 years old: RR 0.90, 95% CI 0.60 to 1.35, p = 0.60). CONCLUSIONS: There is limited evidence to support omega-3 fatty acids during childhood could reduce the risk of allergic disease.

[Value of lactate dehydrogenase in predicting refractory Mycoplasma pneumoniae pneumonia in children: an evaluation based on decision curve analysis and dose-response analysis].

OBJECTIVE: To study the value of lactate dehydrogenase (LDH) in predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. METHODS: Propensity score matching was used to select 73 children with RMPP (refractory group) and 146 children with non-refractory Mycoplasma pneumoniae pneumonia (common group). The logistic regression analysis, restricted cubic spline model, and decision curve analysis were used to analyze the clinical value of LDH in predicting RMPP. RESULTS: There were significant differences in the incidence of high fever, white blood cell count, platelet count, percentage of neutrophils, and serum levels of C-reactive protein, procalcitonin, hemoglobin, albumin, glutamic-pyruvic transaminase, aspartate aminotransferase and LDH (P<0.05). There were also significant differences between the two groups in the Mycoplasma pneumoniae-DNA load in nasopharyngeal aspirates and the incidences of pleural effusion, pulmonary consolidation, atelectasis, shortness of breath and skin lesions (P<0.05). The multivariate logistic regression analysis showed that high fever, hemoglobin level, LDH level, and pulmonary consolidation were independent predictive factors for RMPP (OR=10.097, 0.956, 1.006, and 3.756; P<0.05). The results of the restricted cubic spline analysis showed a non-linear dose-response relationship between the continuous changes of LDH and the development of RMPP (P<0.01). The decision curve analysis showed that LDH had an important clinical value in predicting RMPP. CONCLUSIONS: LDH is an independent predictive factor for the development of RMPP and its intensity of association with the development of RMPP exhibits a non-linear dose-response relationship.

Development and validation of a simple-to-use nomogram for predicting refractory Mycoplasma pneumoniae pneumonia in children.

OBJECTIVE: This study aimed to develop and validate a simple-to-use nomogram for predicting refractory Mycoplasma pneumoniae pneumonia (RMPP) in children. METHODS: A total of 73 children with RMPP and 146 children with general Mycoplasma pneumoniae pneumonia were included. Clinical, laboratory, and radiological data were obtained. A least absolute shrinkage and selection operator (LASSO) regression model was used to determine optimal predictors. The nomogram was plotted by multivariable logistic regression. The performance of the nomogram was assessed by calibration, discrimination, and clinical utility. RESULTS: The LASSO regression analysis identified lactate dehydrogenase, albumin, neutrophil ratio, and high fever as significant predictors of RMPP. This nomogram-illustrated model showed good discrimination, calibration, and clinical value. The area under the receiver operating characteristic curve of the nomogram was 0.884 (95% CI, 0.823-0.945) in the training set and 0.881 (95% CI, 0.807-0.955) in the validating set. Calibration curve and Hosmer-Lemeshow test showed good consistency between the predictions of the nomogram and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. CONCLUSION: A simple-to-use nomogram for predicting RMPP in early stage was developed and validated. This may help physicians recognize RMPP earlier.