Anxiety disorders and risk of stroke: A systematic review and meta-analysis

AbstractBackgroundAnxiety disorders are the most common mental health problem worldwide. However, the evidence on the association between anxiety disorders and risk of stroke is limited. This systematic review and meta-analysis presents a critical appraisal and summary of the available evidence on the association between anxiety disorders and risk of stroke.MethodsCohort studies reporting risk of stroke among patients with anxiety disorders were searched in PubMed, Embase, PsycINFO, Scopus, and the Web of Science, from database inception to June 2016. The quality of the studies was assessed using standard criteria. A meta-analysis was undertaken to obtain pooled estimates of the risk of stroke among patients with anxiety disorders.ResultsEight studies, including 950,759 patients, from the 11,764 references initially identified, were included in this review. A significantly increased risk of stroke for patients with anxiety disorders was observed, with an overall hazard ratio: 1.24 (1.09–1.41), P = 0.001. No significant heterogeneity between studies was detected and the funnel plot suggested that publication bias was unlikely. Limited evidence suggests that the risk of stroke is increased shortly after the diagnosis of anxiety and that risk of stroke may be higher for patients with severe anxiety.ConclusionsAnxiety disorders are a very prevalent modifiable condition associated with risk of stroke increased by 24%. This evidence could inform the development of interventions for the management of anxiety and the prevention of stroke. Further studies on the risk of stroke in patients with anxiety, and the explanatory factors for this association, are required.

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Systematic review and meta-analysis of female lifestyle factors and risk of recurrent pregnancy loss

Scientific Reports ◽

10.1038/s41598-021-86445-2 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Ka Ying Bonnie Ng ◽

George Cherian ◽

Alexandra J. Kermack ◽

Sarah Bailey ◽

Nick Macklon ◽

...

Keyword(s):

Systematic Review ◽

General Population ◽

Pregnancy Loss ◽

Recurrent Pregnancy Loss ◽

Meta Analysis ◽

Lifestyle Factors ◽

Caffeine Intake ◽

Increased Risk ◽

Secondary Outcomes

AbstractIt is known that lifestyle factors affect sporadic miscarriage, but the extent of this on RPL (recurrent pregnancy loss) is less well known. A systematic review and meta-analysis was performed to assess the associations between lifestyle factors and RPL. Studies that analysed RPL in the context of BMI, smoking, alcohol and caffeine intake were included. The primary and secondary outcomes were odds of having RPL in the general population and odds of further miscarriage, respectively. Underweight and women with BMI > 25 are at higher odds of RPL in the general population (OR 1.2, 95% CI 1.12–1.28 and OR 1.21, 95% CI 1.06–1.38, respectively). In women with RPL, having BMI > 30 and BMI > 25 has increased odds of further miscarriages (OR 1.77, 95% CI 1.25–2.50 and OR 1.35, 95% CI 1.07–1.72, respectively). The quality of the evidence for our findings was low or very low. Being underweight and BMI > 25 contributes significantly to increased risk of RPL (general population). BMI > 25 or BMI > 30 increases the risk of further miscarriages (RPL population). Larger studies addressing the effects of alcohol, cigarette smoking and caffeine on the risk of RPL with optimisation of BMI in this cohort of women are now needed.

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Two-Way Relationship Between Helicobacter Pylori Infection and Periodontitis: Results from A Systematic Review and Meta-Analysis

10.31487/j.cei.2020.01.03 ◽

2020 ◽

pp. 1-7

Author(s):

Felipe Rodolfo ◽

Silvania Conceição Furtado ◽

Alessandro Luiz Araújo Bentes Leal ◽

Any Carolina Cardoso Guimarães Vasconcelos ◽

Daniel Fernando Pereira Vasconcelos ◽

...

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Meta Analysis ◽

Current Systematic Review ◽

Increased Risk ◽

Statistical Program ◽

H Pylori ◽

Ci Calculations ◽

Review Manager

Aim: Helicobacter pylori (H. pylori) infection and periodontitis have considerable worldwide prevalence once they both present systemic alterations with a possible association between them. Therefore, we have performed this meta-analysis to assess the possible association between H. pylori infection and periodontitis. Material and Methods: A systematic search in the literature was performed for studies published before December 2, 2019 in diverse scientific and educational databases. The data was extracted by two investigators and the statistical analysis was performed by Review Manager statistical program with heterogeneity and Odds Ratio (OR) with 95% of Confidence Intervals (CI) calculations as well as a sensitive analysis to assess the accuracy of the results. The value of P<0.05 was considered as significant. In addition, we performed the analysis of the quality of included studies as well as the evaluation for risk of bias. Results: In overall analysis, H. pylori infection was associated with the risk of periodontitis development (OR = 1.72, CI: 1.47, 2.02, P<0.00001) and the periodontitis was considered as a risk factor for H. pylori infection (OR = 3.21, CI: 2.31, 4.47, P<0.00001). Moreover, the evaluation of dental plaque from patients with periodontitis reveled increased risk of H. pylori infection (OR = 3.46, CI: 2.39, 5.01, P<0.00001). Conclusions: This current systematic review and meta-analysis composed by 12 studies in 7,059 participants showed that H. pylori infection increased significantly the risk of the development of periodontitis and the periodontitis may be a risk for this bacterial infection.

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Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽

10.1093/europace/euab116.145 ◽

2021 ◽

Vol 23 (Supplement_3) ◽

Author(s):

T Al Bahhawi ◽

A Aqeeli ◽

S L Harrison ◽

D A Lane ◽

I Buchan ◽

...

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Cohort Studies ◽

Observational Studies ◽

Large Scale ◽

Data Extraction ◽

Meta Analysis ◽

Significant Heterogeneity ◽

Random Effects Models ◽

Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis. Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

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Systematic Review with Meta-Analysis: Endoscopic and Surgical Resection for Ampullary Lesions

Journal of Clinical Medicine ◽

10.3390/jcm9113622 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3622

Author(s):

Christian Heise ◽

Einas Abou Ali ◽

Dirk Hasenclever ◽

Francesco Auriemma ◽

Aiste Gulla ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Significant Risk ◽

Significant Heterogeneity ◽

Incomplete Resection ◽

Quality Of Data ◽

Surgical Interventions ◽

Random Effects Models ◽

Fixed And Random Effects

Ampullary lesions (ALs) can be treated by endoscopic (EA) or surgical ampullectomy (SA) or pancreaticoduodenectomy (PD). However, EA carries significant risk of incomplete resection while surgical interventions can lead to substantial morbidity. We performed a systematic review and meta-analysis for R0, adverse-events (AEs) and recurrence between EA, SA and PD. Electronic databases were searched from 1990 to 2018. Outcomes were calculated as pooled means using fixed and random-effects models and the Freeman-Tukey-Double-Arcsine-Proportion-model. We identified 59 independent studies. The pooled R0 rate was 76.6% (71.8–81.4%, I2 = 91.38%) for EA, 96.4% (93.6–99.2%, I2 = 37.8%) for SA and 98.9% (98.0–99.7%, I2 = 0%) for PD. AEs were 24.7% (19.8–29.6%, I2 = 86.4%), 28.3% (19.0–37.7%, I2 = 76.8%) and 44.7% (37.9–51.4%, I2 = 0%), respectively. Recurrences were registered in 13.0% (10.2–15.6%, I2 = 91.3%), 9.4% (4.8–14%, I2 = 57.3%) and 14.2% (9.5–18.9%, I2 = 0%). Differences between proportions were significant in R0 for EA compared to SA (p = 0.007) and PD (p = 0.022). AEs were statistically different only between EA and PD (p = 0.049) and recurrence showed no significance for EA/SA or EA/PD. Our data indicate an increased rate of complete resection in surgical interventions accompanied with a higher risk of complications. However, studies showed various sources of bias, limited quality of data and a significant heterogeneity, particularly in EA studies.

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Efficacy of Internet-Delivered Psychodynamic Therapy: Systematic Review and Meta-Analysis

Psychodynamic Psychiatry ◽

10.1521/pdps.2020.48.4.437 ◽

2020 ◽

Vol 48 (4) ◽

pp. 437-454

Author(s):

Tomas Lindegaard ◽

Matilda Berg ◽

Gerhard Andersson

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Psychodynamic Therapy ◽

Significant Heterogeneity ◽

Psychodynamic Treatment ◽

Literature Searches ◽

Treatment Models ◽

Promising Treatment

Recent years have seen an increase of internet-delivered interventions based on psychodynamic treatment models. To test the efficacy of internet-delivered psychodynamic therapy (IPDT), we conducted a systematic review and meta-analysis of randomized controlled trials. Following literature searches, we identified seven studies meeting inclusion criteria. The total number of participants was 528 in the treatment group and 552 in the control conditions. We found small effects favoring IPDT compared to inactive control conditions for main outcomes (g = 0.44), depression (g = 0.46), anxiety (g = 0.20), and quality of life (g = 0.40). There was significant heterogeneity between studies for main outcomes and depression. Within-group effects ranged from Hedges's g = 0.32–0.99. The effects of IPDT were maintained or increased at follow-up. Study quality varied but was generally high. No indications of publication bias were found. In conclusion, IPDT is a promising treatment alternative, especially for depression, although the small number of studies limits the generalizability of the findings.

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Prevalence of idiopathic REM behavior disorder: a systematic review and meta-analysis

SLEEP ◽

10.1093/sleep/zsaa294 ◽

2021 ◽

Author(s):

Calogero Edoardo Cicero ◽

Loretta Giuliano ◽

Jaime Luna ◽

Mario Zappia ◽

Pierre-Marie Preux ◽

...

Keyword(s):

Systematic Review ◽

Subgroup Analysis ◽

Meta Analysis ◽

Random Effect Model ◽

Behavior Disorder ◽

Significant Heterogeneity ◽

Pooled Prevalence ◽

Screening Questionnaires ◽

Meta Regression

Abstract Study Objectives To provide an overall estimate of the prevalence of idiopathic REM Sleep Behavior Disorder (iRBD). Methods Two investigators have independently searched the PubMed and Scopus databases for population-based studies assessing the prevalence of iRBD. Data about type of diagnosis (polysomnographic diagnosis, defined iRBD [dRBD]; clinical diagnosis, probable RBD [pRBD]), continent, age range of the screened population, quality of the studies, sample size, screening questionnaires and strategies have been gathered. A random effect model was used to estimate the pooled prevalence. Heterogeneity was investigated with subgroup analysis and meta-regression. Results From 857 articles found in the databases, 19 articles were selected for the systematic review and meta-analysis. According to the type of diagnosis, five studies identified dRBD cases given a pooled prevalence of 0.68% (95%CI 0.38-1.05) without significant heterogeneity (Cochran’s Q p=0.11; I 2 = 46.43%). Fourteen studies assessed the prevalence of pRBD with a pooled estimate of 5.65% (95%CI 4.29-7.18) and a significant heterogeneity among the studies (Cochran’s Q p<0.001; I 2 = 98.21%). At the subgroup analysis, significant differences in terms of prevalence were present according to the quality of the studies and, after removing two outlaying studies, according to the continents and the screening questionnaire used. Meta-regression did not identify any significant effect of the covariates on the pooled estimates. Conclusion Prevalence estimates of iRBD are significantly impacted by diagnostic level of certainty. Variations in pRBD prevalence are due to methodological differences in study design and screening questionnaires employed.

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The risk of offspring mood and anxiety disorders in the context of prenatal maternal somatic diseases: a systematic review and meta-analysis

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796021000706 ◽

2022 ◽

Vol 31 ◽

Author(s):

Xiayu Gong ◽

Zhixin Fan ◽

Hanfang Xu ◽

Hanzhang Wang ◽

Ningxi Zeng ◽

...

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Anxiety Disorders ◽

Mood Disorders ◽

Maternal Obesity ◽

Polycystic Ovary ◽

Meta Analysis ◽

Mood And Anxiety Disorders ◽

Increased Risk ◽

Somatic Diseases

Abstract Aims The importance of prenatal maternal somatic diseases for offspring mood and anxiety disorders may be overlooked or undervalued. We conducted the first systematic review and meta-analysis assessing the risk of offspring mood and anxiety disorders in the context of prenatal maternal somatic diseases. Methods We screened articles indexed in Embase (including Embase, MEDLINE, PubMed-not-MEDLINE), PsycARTICLES and PsycINFO databases up to August 2021. 21 studies were included. We examined the overall associations between prenatal maternal somatic diseases and offspring mood/anxiety disorders. Analyses were stratified according to maternal somatic diseases and follow-up duration. Results We observed an increased risk of mood and anxiety disorders in the context of prenatal maternal somatic diseases [relative risk (RR) = 1.26; 95% confidence interval (CI) 1.15–1.37, RR = 1.31; 95% CI 1.24–1.38]; maternal obesity(RR = 1.92; 95% CI 1.72–2.11), hypertensive disorders (RR = 1.49; 95% CI 1.11–1.86) and infertility (RR = 1.26, 95% CI 1.14–1.39) were risk factors for mood disorders; maternal polycystic ovary syndrome (RR = 1.61; 95% CI 1.42–1.80), severe obesity (RR = 1.56; 95% CI 1.44–1.68) and moderate obesity (RR = 1.36; 95% CI 1.28–1.44) were risk factors for anxiety disorders. Prenatal maternal somatic diseases increased the risk of mood disorders in childhood and adulthood (RR = 1.71; 95% CI 1.34–2.09/RR = 1.19; 95% CI 1.09–1.30), as well as the risk of anxiety disorders in adulthood (RR = 1.33; 95% CI 1.26–1.41). Conclusion The results indicate that prenatal maternal somatic diseases are associated with offspring mood and anxiety disorders, and that the associations may be long-lasting.

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Glycaemic control at risk? - Impact of temperature, humidity and other physical factors on the analytical quality of point of care testing of blood glucose, a systematic review protocol

10.21203/rs.3.rs-678622/v1 ◽

2021 ◽

Author(s):

Cilia Maria Katharina Sindt ◽

Lene Noehr-Jensen

Keyword(s):

Systematic Review ◽

Blood Glucose ◽

Environmental Factors ◽

Search Strategy ◽

Critical Appraisal ◽

Current Knowledge ◽

Meta Analysis ◽

Review Protocol ◽

Comprehensive Search

Abstract Background Diabetes is a chronic metabolic disease characterized by increased blood glucose concentration. Self-monitoring of blood glucose (SMBG) is a corner stone in lowering the risk of vascular complications of diabetes and requires reliable measurements by the blood glucose meter and test strips (BG System). Environmental factors as temperature, humidity, altitude, and electromagnetic radiation may affect the measurement of blood glucose to a level that might compromise the glycaemic control. Manufactures often restrict the validation and approved use a limited span of environmental conditions and there is a considerable risk of exposing the equipment to temperature outside the range recommended by manufacturers. This systematic review aims to explore, aggregate, and present the current knowledge of the effect of environmental factors on the quality of results measured by BG systems. Methods Relevant studies will be found by using a comprehensive search strategy in the following databases: EMBASE, PubMed, CINAHL, Academic Search Premier, SweMed+, DANS Easy and Cochrane Library. The search strategy will assess if there is an impact on precision and accuracy of BG systems under varying environmental conditions compared to precision recommended by manufacturers. Both authors will screen titles and in case of disagreement, the study will be included for screening by abstract. After screening of all titles, the procedure will be repeated for screening and reading of abstracts. Full text of papers selected by abstract will be assessed according to in- and exclusions criteria. Homogenous results will be pooled and summarized statistically for meta-analysis. Narrative synthesis will be performed for heterogeneous data that cannot be pooled for meta-analysis. Reporting will follow the Preferred Items for Systematic Reviews and Meta-Analysis 2020 (PRISMA 2020). The risk of bias will be evaluated by choosing an appropriate tool from acknowledged institutions I.e., Joanna Briggs Critical Appraisal for Systematic Reviews Checklist tools or the Critical Appraisal Skills Program (CASP). Discussion This systematic review protocol utilizes rigorous methodology to provide a comprehensive search for outcomes of the impact of environmental factors on BG systems. The outcomes will be examined, and a summary of the current knowledge will be provided.

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Environmental, Social and Economic Sustainability Indicators Applied to Food Services: A Systematic Review

Sustainability ◽

10.3390/su12051804 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1804 ◽

Cited By ~ 9

Author(s):

Dayanne Maynard ◽

Mayara Vidigal ◽

Priscila Farage ◽

Renata Zandonadi ◽

Eduardo Nakano ◽

...

Keyword(s):

Systematic Review ◽

Web Of Science ◽

Meta Analysis ◽

Social Indicators ◽

Sustainability Indicators ◽

Economic Sustainability ◽

Food Services ◽

Cross Sectional ◽

Specific Search

Sustainability is the integration of actions focused on three pillars: environmental, social, and economical. Implementing sustainable development ranges from the pursuit of quality of life, and from environmental balance to break with the current pattern of development. Therefore, the objective of this work was to understand and analyze the sustainability indicators implemented in the production of meals in food services. The authors developed specific search strategies for Scopus, Web of Science, Pubmed, Lilacs, Google Scholar, and ProQuest Dissertations & Theses Global to perform the systematic review. The authors evaluated the methodological quality of the included studies using the Meta-analysis Statistical Assessment and Review Instrument (MASTARI). A total of 31 cross-sectional studies were analyzed. Twenty four (77.41%) of the studies had activities that covered the three indicators (environmental, social, and economic); 22.59% (n = 7) used two indicators in which 12.90% (n = 4) presented environmental and economic indicators and 9.67% (n = 3) with environmental and social indicators. This research indicates that the studies in food services are seeking to insert indicators that cover the three pillars of sustainable meal production. It is worth mentioning that in the literature, many works encompasses the importance of sustainability, but few explore which indicators are most applied or detail their implementation in food services. More studies are needed to estimate better the indicators being applied in food services.

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Acupuncture for the Treatment of Gastro-Oesophageal Reflux Disease: A Systematic Review and Meta-Analysis

Acupuncture in Medicine ◽

10.1136/acupmed-2016-011205 ◽

2017 ◽

Vol 35 (5) ◽

pp. 316-323 ◽

Cited By ~ 11

Author(s):

Jiajie Zhu ◽

Yu Guo ◽

Shan Liu ◽

Xiaolan Su ◽

Yijie Li ◽

...

Keyword(s):

Systematic Review ◽

Reflux Disease ◽

Small Sample Size ◽

Meta Analysis ◽

Small Sample ◽

Oesophageal Reflux ◽

Symptom Improvement ◽

Significant Heterogeneity ◽

Oesophageal Reflux Disease

Background Gastro-oesophageal reflux disease (GORD) is one of the most common diseases presenting to gastroenterology clinics. Acupuncture is widely used as a complementary and alternative treatment for patients with GORD. Objective To explore the effectiveness of acupuncture for the treatment of GORD. Methods Four English and four Chinese databases were searched through June 2016. Randomised controlled trials investigating the effectiveness of manual acupuncture or electroacupuncture (MA/EA) for GORD versus or as an adjunct to Western medicine (WM) were selected. Data extraction and quality evaluation were performed by two authors independently and RevMan 5.2.0 was used to analyse data. Results A total of 12 trials involving 1235 patients were included. Meta-analyses demonstrated that patients receiving MA/EA combined with WM had a superior global symptom improvement compared with those receiving WM alone (relative risk (RR) 1.17, 95% CI 1.09 to 1.26; p=0.03; six studies) with no significant heterogeneity (I2=0%, p=0.41). Recurrence rates of those receiving MA/EA alone were lower than those receiving WM (RR 0.42,95% CI 0.29 to 0.61; p<0.001; three studies) with low heterogeneity (I2=7%, p=0.34), while global symptom improvement (six studies) and symptom scores (three studies) were similar (both p>0.05). Descriptive analyses suggested that acupuncture also improves quality of life in patients with GORD. Conclusion This meta-analysis suggests that acupuncture is an effective and safe treatment for GORD. However, due to the small sample size and poor methodological quality of the included trials, further studies are required to validate our conclusions. Trial registration number PROSPERO Systematic review registration no. CRD42016041916.

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