The prevalence of agranulocytosis and related death in clozapine-treated patients: a comprehensive meta-analysis of observational studies

2019 ◽  
Vol 50 (4) ◽  
pp. 583-594 ◽  
Author(s):  
Xiao-Hong Li ◽  
Xiao-Mei Zhong ◽  
Li Lu ◽  
Wei Zheng ◽  
Shi-bin Wang ◽  
...  
Keyword(s):  
Observational Studies ◽  
Literature Search ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Study Quality ◽  
Analysis Program ◽  
Clozapine Treatment ◽  
Knowledge Infrastructure ◽  
Prevalence Estimates ◽  
Chinese National Knowledge Infrastructure

AbstractBackgroundClozapine treatment increases the risk of agranulocytosis, but findings on the epidemiology of agranulocytosis have been inconsistent. This meta-analysis examined the prevalence of agranulocytosis and related death in clozapine-treated patients.MethodsA literature search in the international (PubMed, PsycINFO, and EMBASE) and Chinese (WanFang, Chinese National Knowledge Infrastructure, and Sinomed) databases was conducted. Prevalence estimates of agranulocytosis and related death in clozapine-treated patients were synthesized with the Comprehensive Meta-Analysis program using the random-effects model.ResultsThirty-six studies with 260 948 clozapine-treated patients published between 1984 and 2018 were included in the meta-analysis. The overall prevalence of agranulocytosis and death caused by agranulocytosis were 0.4% (95% CI 0.3–0.6%) and 0.05% (95% CI 0.03–0.09%), respectively. The prevalence of agranulocytosis was moderated by sample size, study quality, year of publication, and that of data collection.ConclusionsThe prevalence of clozapine-associated agranulocytosis is low. Agranulocytosis-related death appears rare.

scholarly journals Effect of Exposure to Famine during Early Life on Risk of Metabolic Syndrome in Adulthood: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Lu-Lu Qin ◽  
Bang-An Luo ◽  
Fan Gao ◽  
Xiang-Lin Feng ◽  
Jia-He Liu
Keyword(s):  
Metabolic Syndrome ◽  
Early Life ◽  
Web Of Science ◽  
Meta Analysis ◽  
Random Effects Model ◽  
The Metabolic Syndrome ◽  
Knowledge Infrastructure ◽  
Famine Exposure ◽  
Study Designs ◽  
Chinese National Knowledge Infrastructure

Background. Emerging studies have explored the association between the famine exposure during early life and the risk of the metabolic syndrome, and the results remain controversial. This meta-analysis was performed to summarize the famine effects on the prevalence of metabolic syndrome (MetS) in adulthood. Materials and Methods. We searched the PubMed, Web of Science, Embase, ScienceDirect, and Chinese National Knowledge Infrastructure for relevant studies up to December 2019. Pooled odd ratios (ORs) with 95% confidence intervals (CIs) were used to estimate the effect exposure to famine on MetS using a random-effects model, and the I2 was used to evaluate the heterogeneity. Results. The analyses included 39 studies from 10 articles with a total of 81504 participants. Fourteen studies from 10 articles for fetal famine exposure, 20 studies from 7 articles for childhood famine exposure, and 5 studies from 3 articles for adolescence/adult famine exposure were included in this meta-analysis. Compared with a nonexposed group, famine exposure significantly increased the risk of MetS for early life famine exposure (OR=1.27, 95% CI: 1.18-1.38), fetal famine exposure (OR=1.27, 95% CI: 1.14-1.43), and childhood famine exposure (OR=1.29, 95% CI: 1.16-1.44). Subgroup analyses showed that the result was consistent regardless of the study designs, definitions of MetS, and causes of famine, with or without adjustment for age, smoking, drinking, and physical activity. Conclusions. This meta-analysis suggests that exposure to famine during early life may increase the risk of MetS in adulthood.

scholarly journals Effects of β-Cryptoxanthin on Improvement in Osteoporosis Risk: A Systematic Review and Meta-Analysis of Observational Studies

Foods ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 296
Author(s):  
Sun Jo Kim ◽  
Nguyen Hoang Anh ◽  
Nguyen Co Diem ◽  
Seongoh Park ◽  
Young Hyun Cho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Fracture ◽  
Bone Health ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effects Model ◽  
High Intake ◽  
Quantitative Evidence ◽  
Osteoporosis Risk ◽  
Reduced Risk

Many studies have analyzed the effects of β-cryptoxanthin (BCX) on osteoporosis and bone health. This systematic review and meta-analysis aimed at providing quantitative evidence for the effects of BCX on osteoporosis. Publications were selected and retrieved from three databases and carefully screened to evaluate their eligibility. Data from the final 15 eligible studies were extracted and uniformly summarized. Among the 15 studies, seven including 100,496 individuals provided information for the meta-analysis. A random effects model was applied to integrate the odds ratio (OR) to compare the risk of osteoporosis and osteoporosis-related complications between the groups with high and low intake of BCX. A high intake of BCX was significantly correlated with a reduced risk of osteoporosis (OR = 0.79, 95% confidence interval (CI) 0.70–0.90, p = 0.0002). The results remained significant when patients were stratified into male and female subgroups as well as Western and Asian cohorts. A high intake of BCX was also negatively associated with the incidence of hip fracture (OR = 0.71, 95% CI 0.54–0.94, p = 0.02). The results indicate that BCX intake potentially reduces the risk of osteoporosis and hip fracture. Further longitudinal studies are needed to validate the causality of current findings.

scholarly journals Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 39
Author(s):  
Prakrati Acharya ◽  
Chirag Acharya ◽  
Charat Thongprayoon ◽  
Panupong Hansrivijit ◽  
Swetha R. Kanduri ◽  
...  
Keyword(s):  
Uric Acid ◽  
Kidney Stones ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Ketogenic Diets ◽  
Cochrane Database ◽  
Uric Acid Stones ◽  
Low Carbohydrate

Very-low-carbohydrate diets or ketogenic diets are frequently used for weight loss in adults and as a therapy for epilepsy in children. The incidence and characteristics of kidney stones in patients on ketogenic diets are not well studied. Methods: A systematic literature search was performed, using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the databases’ inception through April 2020. Observational studies or clinical trials that provide data on the incidence and/or types of kidney stones in patients on ketogenic diets were included. We applied a random-effects model to estimate the incidence of kidney stones. Results: A total of 36 studies with 2795 patients on ketogenic diets were enrolled. The estimated pooled incidence of kidney stones was 5.9% (95% CI, 4.6–7.6%, I2 = 47%) in patients on ketogenic diets at a mean follow-up time of 3.7 +/− 2.9 years. Subgroup analyses demonstrated the estimated pooled incidence of kidney stones of 5.8% (95% CI, 4.4–7.5%, I2 = 49%) in children and 7.9% (95% CI, 2.8–20.1%, I2 = 29%) in adults, respectively. Within reported studies, 48.7% (95% CI, 33.2–64.6%) of kidney stones were uric stones, 36.5% (95% CI, 10.6–73.6%) were calcium-based (CaOx/CaP) stones, and 27.8% (95% CI, 12.1–51.9%) were mixed uric acid and calcium-based stones, respectively. Conclusions: The estimated incidence of kidney stones in patients on ketogenic diets is 5.9%. Its incidence is approximately 5.8% in children and 7.9% in adults. Uric acid stones are the most prevalent kidney stones in patients on ketogenic diets followed by calcium-based stones. These findings may impact the prevention and clinical management of kidney stones in patients on ketogenic diets.

scholarly journals Tobacco use among the elderly: a systematic review and meta-analysis

2010 ◽  
Vol 26 (12) ◽  
pp. 2213-2233 ◽  
Author(s):  
Valeska Marinho ◽  
Jerson Laks ◽  
Evandro Silva Freire Coutinho ◽  
Sergio Luís Blay
Keyword(s):  
Systematic Review ◽  
Tobacco Use ◽  
Literature Search ◽  
Economic Status ◽  
Meta Analysis ◽  
The Elderly ◽  
Epidemiological Studies ◽  
Elderly Subjects ◽  
Random Effects Model ◽  
Prevalence Rates

The aim of this study was to combine the results of identified surveys on the prevalence of tobacco use in old age to estimate world prevalence of tobacco use and possible factors related to such behavior among the elderly. The literature search included electronic databases such as MEDLINE, LILACS, and Biological Abstracts, hand-searching of specialist journals and cited reference searches. The combined global prevalence was estimated using the random effects model. The total number of elderly subjects included in all surveys was 140,058, with data available from all the continents. Overall prevalence of tobacco use was 13% in both genders (22% male and 8% female). The prevalence rates were heterogeneous among surveys and were associated with smoking definition, questionnaire application, and country economic status. Few epidemiological studies assessed tobacco use among the elderly. A higher prevalence rate of tobacco use in males who live in higher income countries could be found, although additional evidence regarding elderly samples is still required.

scholarly journals Interleukin-13 +1923C/T Polymorphism Is Associated with Asthma Risk: A Meta-Analysis

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Yongan Liu ◽  
Tao Liu ◽  
Wei Nie ◽  
Guoxiang Lai ◽  
Qingyu Xiu
Keyword(s):  
Sensitivity Analysis ◽  
Risk Factor ◽  
Meta Analysis ◽  
Study Quality ◽  
China National Knowledge Infrastructure ◽  
High Quality ◽  
Interleukin 13 ◽  
Knowledge Infrastructure ◽  
Asthma Risk ◽  
Codominant Model

There are controversies on the association betweeninterleukin-13(IL-13) +1923C/T polymorphism (rs1295686) and the risk of asthma. We performed this study to assess the association by the method of meta-analysis. A systematic search current to October 16, 2012, was conducted using PubMed, EMBASE, and China National Knowledge Infrastructure (CNKI) and identified ten studies comprising 13698 cases and 38209 controls. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. There was a significant association betweenIL-13+1923C/T polymorphism and asthma risk in codominant model. When stratified by ethnicity,IL-13+1923C/T polymorphism remained significantly associated with higher asthma risk in Asians and Caucasians. In the subgroup analysis by study quality, a significantly increased asthma risk was observed in high quality studies. Sensitivity analysis and cumulative analysis further strengthened the validity of the results. No publication bias was found in this meta-analysis. In conclusion, results from this meta-analysis suggested thatIL-13+1923C/T polymorphism was a risk factor of asthma.

scholarly journals Risk factors associated with echinococcosis in Chinese general population: a meta-analysis and systematic review

2021 ◽  
Author(s):  
tiantian zhang ◽  
Bin Li ◽  
Yuying Liu ◽  
Shou Liu
Keyword(s):  
Risk Factors ◽  
Subgroup Analysis ◽  
Human Life ◽  
Meta Analysis ◽  
Test Results ◽  
Knowledge Infrastructure ◽  
Pooled Prevalence ◽  
Specific Subgroup ◽  
And Control ◽  
Chinese National Knowledge Infrastructure

Abstract Background Echinococcosis is a severe zoonotic disease that imposes a substantial burden on human life. Numerous studies on echinococcosis have involved a variety of risk factors, and it is difficult to evaluate the key risk factors. The objectives of this meta-analysis are to summarize available data on the prevalence of human echinococcosis and identify the key risk factors for echinococcosis. Methods Relevant studies were comprehensively searched in the PubMed, EMBASE, Web of Science, Cochrane, Chinese National Knowledge Infrastructure (CNKI), Chongqing VIP Information (VIP), Wanfang and SinoMed databases from database inception until August 22, 2020. A random-effects model was used to estimate the pooled odds ratio (OR) and 95% confidence interval (CI) by integrating the OR values of each risk factor. The I2 and Q statistics were calculated to evaluate the heterogeneity, and potential sources of heterogeneity were identified using sensitivity analysis and subgroup analysis. Publication bias was estimated by funnel plots and Egger’s test. Results A total of 1026 studies were identified through the database search, of which 26 were eligible for this meta-analysis. In total, 23 and 9 of the 26 studies were cystic echinococcosis (CE) and alveolar echinococcosis (AE) studies, respectively (6 papers included both AE and CE). The pooled prevalence of echinococcosis was 5.52% (95% CI: 5.47%-5.58%). Ethnicity (OR = 2.93, 95% CI: 1.81–4.75; I2 = 0), being a herder (OR = 2.66, 95%CI95% CI: 2.25–3.14; I2 = 8%), not washing hands before meals (OR = 2.40, 95% CI: 1.34–4.28; I2 = 82.8%) and being female (OR = 1.45, 95% CI: 1.26–1.66; I2 = 33.9%) were risk factors for AE. The top five risk factors for CE were ethnicity (OR = 3.18, 95% CI: 1.55–6.52; I2 = 79.2%), nomadism (OR = 2.71, 95% CI: 1.65–4.47; I2 = 55.8%), drinking nonboiled water (OR = 2.47, 95% CI: 1.36–4.47; I2 = 85.7), feeding viscera to dogs (OR = 2.35, 95% CI: 1.89–2.91; I2 = 21.5%), and being a herder (OR = 2.19, 95% CI: 1.67–2.86; I2 = 85.1%). The study design-specific subgroup analysis showed that the heterogeneity of CE risk factors decreased to varying degrees. Conclusions Specific characteristics (i.e., ethnicity and herder status) and behaviors (i.e., not washing hands before meals and feeding viscera to dogs ) are possible risk factors for echinococcosis. This study provided remarkable insight for future prevention and control of echinococcosis.

scholarly journals Age at Menopause and Risk of Developing Endometrial Cancer: A Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-13
Author(s):  
Yanjun Wu ◽  
Wenjun Sun ◽  
Hui Liu ◽  
Dongfeng Zhang
Keyword(s):  
Endometrial Cancer ◽  
Dose Response ◽  
Meta Analysis ◽  
Positive Association ◽  
Response Analysis ◽  
Age At Menopause ◽  
Relative Risks ◽  
Knowledge Infrastructure ◽  
Study Heterogeneity ◽  
Chinese National Knowledge Infrastructure

Object. The association of age at menopause with endometrial cancer remains controversial. Therefore, we quantitatively summarized the evidence from observational studies with a meta-analysis. Methods. We searched PubMed, Web of Science, Embase, Medline, Chinese National Knowledge Infrastructure (CNKI), and Wan Fang Med online up to March 2019, and all eligible case-control and cohort studies were included in the study. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were calculated using the random-effects model. The dose-response relationship was assessed by restricted cubic spline model. The heterogeneity among studies was evaluated by I2. Metaregression was used to explore the potential sources of between-study heterogeneity. Egger’s test was used to estimate publication bias. Results. Eighteen articles including 957242 subjects with 4781 cases were included in the meta-analysis. The pooled RR (95%CI) of endometrial cancer for the highest versus the lowest age at menopause was 1.89 (95%CI: 1.58-2.26). For dose-response analysis, a nonlinear relationship was found between age at menopause and endometrial cancer, and the positive association became statistically significant when age at menopause was greater than 46.5 years old. Conclusions. This meta-analysis suggested that age at menopause was positively associated with endometrial cancer. For women whose menopausal age over 46.5 years old, the risk of endometrial cancer increased with the age at menopause.

scholarly journals Clinical Effects and Safety of Electroacupuncture for the Treatment of Poststroke Dysphagia: A Comprehensive Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Jinke Huang ◽  
Yao Shi ◽  
Xiaohui Qin ◽  
Min Shen ◽  
Manli Wu ◽  
...  
Keyword(s):  
Rating Scale ◽  
Meta Analysis ◽  
Effective Rate ◽  
Control Treatment ◽  
Sufficient Evidence ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Knowledge Infrastructure ◽  
Swallowing Rehabilitation ◽  
Chinese National Knowledge Infrastructure

Objectives. Electroacupuncture (EA), an extension of acupuncture, which is based on traditional acupuncture combined with modern electrotherapy, is commonly used for poststroke dysphagia (PSD) in clinical treatment and research. However, there is still a lack of sufficient evidence to recommend the routine use of EA for PSD. The aim of this study was to assess the efficacy and safety of EA in the treatment of PSD. Methods. Randomized controlled trials (RCTs) evaluating the effects of EA on PSD were identified through a comprehensive literature search of the PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, Chinese Biomedical Database, and VIP databases from their inception to July 2020. The quality assessment of the included trials was performed based on the guidance of the Cochrane Reviewers’ Handbook, and meta-analysis (MA) was performed by using the RevMan 5.3 software. Results. Sixteen trials were identified, and these included 1,216 patients with PSD. The results demonstrated that EA in combination with swallowing rehabilitation training (SRT) was significantly superior to SRT alone with regard to effective rate (OR 5.40, 95% CI [3.78, 7.72], P < 0.00001 , water swallow test (WST) (MD −0.78, 95% CI [−1.07, −0.50], P < 0.00001 ), the video fluoroscopic swallowing study (VFSS) (MD 1.47, 95% CI [1.11, 1.84], P < 0.00001 ), the Ichiro Fujishima Rating Scale (IFRS) (MD 1.94, 95% CI [1.67, 2.22], P < 0.00001 ), and the incidence of aspiration pneumonia (IAP) (OR 0.20, 95% CI [0.06, 0.61], P = 0.005 ). Conclusions. The results showed that EA was better than the control treatment in terms of the effective rate, WST, VFSS, IFRS, and IAP of dysphagia after stroke. Strict evaluation standards and high-quality RCT designs are necessary for further exploration.

scholarly journals CD44 overexpression related to lymph node metastasis and poor prognosis of pancreatic cancer

2018 ◽  
Vol 33 (3) ◽  
pp. 308-313 ◽  
Author(s):  
Yijuan Liu ◽  
Ting Wu ◽  
Dong Lu ◽  
Jiantao Zhen ◽  
Lin Zhang
Keyword(s):  
Pancreatic Cancer ◽  
Lymph Node ◽  
Meta Analysis ◽  
Clinicopathological Features ◽  
Current Evidence ◽  
Overall Survival Rate ◽  
Node Metastasis ◽  
Knowledge Infrastructure ◽  
Chinese National Knowledge Infrastructure ◽  
Comprehensive Literature Search

Background: CD44 has recently been reported as a biomarker for pancreatic cancer. However, the predictive value of CD44 in pancreatic cancer remains controversial. Therefore, we performed this meta-analysis to evaluate the association between the expression of CD44 and clinicopathological features, and the outcome of pancreatic cancer patients. Materials and method: A comprehensive literature search was performed using PubMed, Embase, and Chinese National Knowledge Infrastructure. The statistical analysis was conducted using Stata software. Results: A total of nine studies including 583 cases were included in this meta-analysis. The meta-analysis indicated that CD44 overexpression was associated with poor five-year overall survival rate (OR 0.52; 95% CI 0.30, 0.91; P = 0.02), more lymph node invasion (OR 3.14 (positive vs. negative); 95% CI 1.47, 6.73; P = 0.003), more advanced T stage (OR 2.4 (T3,4 vs. T1,2); 95% CI 1.28, 4.52; P = 0.007), and more advanced TNM stage (OR 4.53 (III~IV vs. I~II); 95% CI 1.46, 14.08; P = 0.01). However, CD44 overexpression was not associated with other clinicopathological features, such as tumor size, differentiation, and distance metastasis. Conclusions: The current evidence suggests that CD44 is an efficient prognostic factor in pancreatic cancer.

scholarly journals Circulating Levels of Osteopontin in Patients With Psoriasis: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 4 (1) ◽  
pp. 15-21
Author(s):  
Aikaterini Kyriakou ◽  
Aikaterini Patsatsi ◽  
Nikiforos Galanis ◽  
Dimitrios G. Goulis
Keyword(s):  
Immune Responses ◽  
Meta Analysis ◽  
Cell Lineage ◽  
Severity Index ◽  
Random Effects Model ◽  
Study Quality ◽  
Psoriasis Area Severity Index ◽  
Pubmed Central ◽  
Meta Regression Analysis ◽  
Circulating Levels

Background: Both Th1 and Th17 have been proposed to be pathogenically essential in psoriasis. Osteopontin (OPN) is known to enhance Th1 responses, inhibit Th2 ones, and take part in the modulation of Th17 cell lineage. Due to its impact on Th1/Th17 immune responses, several reports have suggested that OPN may be of pathogenic importance in psoriasis. Our objective was to review the literature for studies that have assessed the circulating levels of OPN in psoriatic cases and controls and to meta-analyze the evidence obtainable. Methods: Search was performed in PubMed, Central, and Embase. Eligible were studies that have assessed OPN concentrations in patients with psoriasis and a group of reference. Results: Patients with psoriasis had increased OPN concentrations compared with controls (random-effects model, standardized mean difference: 1.58 ng/mL, 95% confidence interval: 0.90-2.26; P < .0001]). Heterogeneity among studies was high ( I2: 92.2%; P < .0001). The meta-regression analysis showed that the study quality (RTI score) reduced heterogeneity ( I2: 85.2%; P < .005), but not age, body mass index (BMI), Psoriasis Area Severity Index, or matching for BMI. Conclusions: This meta-analysis provided evidence that OPN is involved in the pathogenesis of psoriasis, enlarging the list of cytokines able to stimulate the inflammatory response in this disease.

Sign in / Sign up

Export Citation Format

Share Document