scholarly journals Pesticide use and risk of non-Hodgkin lymphoid malignancies in agricultural cohorts from France, Norway and the USA: a pooled analysis from the AGRICOH consortium

2019 ◽  
Vol 48 (5) ◽  
pp. 1519-1535 ◽  
Author(s):  
Maria E Leon ◽  
Leah H Schinasi ◽  
Pierre Lebailly ◽  
Laura E Beane Freeman ◽  
Karl-Christian Nordby ◽  
...  
Keyword(s):  
Cox Regression ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
Pooled Analysis ◽  
Pesticide Use ◽  
Exposure Misclassification ◽  
Active Ingredients ◽  
Lymphoid Malignancies ◽  
The Usa ◽  
Phenoxy Herbicides

Abstract Background Pesticides are commonly used in agriculture, and previous studies endorsed the need to further investigate the possible association between their use and risk of lymphoid malignancies in agricultural workers. Methods We investigated the relationship of ever use of 14 selected pesticide chemical groups and 33 individual active chemical ingredients with non-Hodgkin lymphoid malignancies (NHL) overall or major subtypes, in a pooled analysis of three large agricultural worker cohorts. Pesticide use was derived from self-reported history of crops cultivated combined with crop-exposure matrices (France and Norway) or self-reported lifetime use of active ingredients (USA). Cox regression models were used to estimate cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs), which were combined using random effects meta-analysis to calculate meta-HRs. Results During follow-up, 2430 NHL cases were diagnosed in 316 270 farmers accruing 3 574 815 person-years under risk. Most meta-HRs suggested no association. Moderately elevated meta-HRs were seen for: NHL and ever use of terbufos (meta-HR = 1.18, 95% CI: 1.00–1.39); chronic lymphocytic leukaemia/small lymphocytic lymphoma and deltamethrin (1.48, 1.06–2.07); and diffuse large B-cell lymphoma and glyphosate (1.36, 1.00–1.85); as well as inverse associations of NHL with the broader groups of organochlorine insecticides (0.86, 0.74–0.99) and phenoxy herbicides (0.81, 0.67–0.98), but not with active ingredients within these groups, after adjusting for exposure to other pesticides. Conclusions Associations of pesticides with NHL appear to be subtype- and chemical-specific. Non-differential exposure misclassification was an important limitation, showing the need for refinement of exposure estimates and exposure–response analyses.

Abstract P255: Association of Mild Chronic Kidney Disease with Venous Thromboembolism: Pooled Analysis of Prospective General Population Cohorts

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Bakhtawar K Mahmoodi ◽  
Ron T Gansevoort ◽  
Inger Anne Naess ◽  
Pamela L Lutsey ◽  
Sigrid K Braekkan ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Venous Thromboembolism ◽  
Kidney Disease ◽  
General Population ◽  
Cox Regression ◽  
Meta Analysis ◽  
Random Effect ◽  
Pooled Analysis ◽  
Individual Level ◽  
Increased Risk

Background: Recent findings suggest that mild chronic kidney disease (CKD) might be associated with increased risk of venous thromboembolism (VTE). However, results were partially inconsistent, which may be due to lack of power. We therefore performed a meta-analysis to investigate the association between mild CKD and VTE incidence. Methods: A literature search was performed to retrieve community-based cohorts with information on the association of estimated glomerular filtration rate (eGFR) and albuminuria with VTE. Five cohorts were identified that were pooled on individual level. To obtain pooled hazard ratios (HRs) for VTE, linear spline models were fitted using Cox regression with shared-frailty. Models were adjusted for age, sex, hypertension, total cholesterol, smoking, diabetes, history of cardiovascular disease and body-mass index. Random-effect meta-analysis was used to obtain adjusted pooled HRs of VTE with CKD versus no CKD. Results: The analysis included 95,154 participants with 1,178 VTE cases and 599,453 person-years of follow-up. Risk of VTE increased continuously with lower eGFR and higher ACR (Figure). Compared with eGFR 100 mL/min/1.73m², pooled adjusted HRs for VTE were 1.3 (1.0–1.7) for eGFR 60, 1.8 (1.3–2.6) for 45 and 1.9 (1.2–2.9) for 30 mL/min/1.73m². Compared with albumin-creatinine ratio (ACR) 5 mg/g, pooled adjusted HRs for VTE were 1.3 (1.04–1.7) for ACR 30, 1.6 (1.1–2.4) for 300 and 1.9 (1.2–3.1) for 1000 mg/g. There was no evidence for interaction between eGFR and ACR (P=0.22). The pooled adjusted HR for CKD (eGFR <60 ml/min/1.73m² or albuminuria ≥30 mg/g) vs. no CKD was 1.5 (95%CI, 1.2–2.1). Results were similar for idiopathic and provoked VTE. Conclusion: Both reduced eGFR and elevated albuminuria are novel independent predictors of VTE in the general population.

Quantifying the association of low-intensity and late initiation of tobacco smoking with total and cause-specific mortality in Asia

2020 ◽  
pp. tobaccocontrol-2019-055412
Author(s):  
Jae Jeong Yang ◽  
Danxia Yu ◽  
Xiao-Ou Shu ◽  
Neal D Freedman ◽  
Wanqing Wen ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Cox Regression ◽  
Meta Analysis ◽  
Lung Cancer Mortality ◽  
Pooled Analysis ◽  
Low Intensity ◽  
Increased Risk ◽  
Late Initiation ◽  
Specific Mortality ◽  
Never Smokers

BackgroundLittle is known about the health harms associated with low-intensity smoking in Asians who, on average, smoke fewer cigarettes and start smoking at a later age than their Western counterparts.MethodsIn this pooled analysis of 738 013 Asians from 16 prospective cohorts, we quantified the associations of low-intensity (<5 cigarettes/day) and late initiation (≥35 years) of smoking with mortality outcomes. HRs and 95% CIs were estimated for each cohort by Cox regression. Cohort-specific HRs were pooled using random-effects meta-analysis.FindingsDuring a mean follow-up of 11.3 years, 92 068 deaths were ascertained. Compared with never smokers, current smokers who consumed <5 cigarettes/day or started smoking after age 35 years had a 16%–41% increased risk of all-cause, cardiovascular disease (CVD), respiratory disease mortality and a >twofold risk of lung cancer mortality. Furthermore, current smokers who started smoking after age 35 and smoked <5 cigarettes/day had significantly elevated risks of all-cause (HRs (95% CIs)=1.14 (1.05 to 1.23)), CVD (1.27 (1.08 to 1.49)) and respiratory disease (1.54 (1.17 to 2.01)) mortality. Even smokers who smoked <5 cigarettes/day but quit smoking before the age of 45 years had a 16% elevated risk of all-cause mortality; however, the risk declined further with increasing duration of abstinence.ConclusionsOur study showed that smokers who smoked a small number of cigarettes or started smoking later in life also experienced significantly elevated all-cause and major cause-specific mortality but benefited from cessation. There is no safe way to smoke—not smoking is always the best choice.

scholarly journals Safety of Anti-CD-19 Chimeric Antigen Receptor T-Cell Therapy in the Older Population with Diffuse Large B Cell Lymphoma: A Meta-Analysis

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 4814-4814
Author(s):  
Anosha Tariq ◽  
Vatsala Katiyar ◽  
Talha Aijaz
Keyword(s):  
Elderly Population ◽  
Meta Analysis ◽  
B Cell Lymphoma ◽  
The Elderly ◽  
Pooled Analysis ◽  
Younger Patients ◽  
Large B Cell Lymphoma ◽  
Car T ◽  
The Mean ◽  
Grade 3

Abstract Introduction Patients with refractory or relapsed diffuse large B cell lymphoma (DLBCL) have very limited treatment options. Axicabtagene ciloleucel, tisagenlecleucel, and lisocabtagene maraleucel are the Anti-CD-19 chimeric antigen receptor T-cell (CAR-T) therapy have been recently approved for refractory or relapsed DLBCL patients who have failed at least two lines of treatment. CAR-T therapy has significant adverse effects, most notably cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), limiting its use, particularly in the elderly population. In this meta-analysis, we analyzed the safety of CAR-T therapy in the elderly population compared to the younger patients with DLBCL. Methods Randomized controlled trials and observational studies in adult patients with DLBCL treated with anti-CD-19 CAR-T therapy were included in the meta-analysis. Case reports, case series, and review articles were excluded. We searched PubMed for studies published before 1st July 2021 using keywords "tisagenlecleucel," "axicabtagene ciloleucel," and "lisocabtagene maraleucel." The study selection process is shown in figure 1. Statistical analysis was performed with Comprehensive meta-analysis version 3. The fixed-effect model was used for pooled analysis. Heterogeneity across studies was analyzed using I2 statistics. Results Three studies, comprising of 616 patients, were included in the analysis. Characteristics of the study population and the number of events in each study are shown in figure 2. Two studies used a cut-off of 65 years, while one study used a cut-off of 70 years for the older population. The mean age in the younger population was 55, while the mean age in the elderly population ranged from 69 to 76. Mean follow-up ranged widely in the three studies ranging from 7 months to 27.1 months. Incidence of CRS ranged from 36% to 84% in the elderly population compared to 34% to 83% in younger patients. Grade 3 or 4 CRS ranged from 1 to 14% in the elder compared to 2 to 14% in younger patients. The pooled analysis shown in figure 3 revealed an odd ratio of 1.11 with a confidence interval ranging from 0.76 to 1.63 (p=0.58), implying there is no statistical difference between the two groups. The incidence of ICANS ranged from 27% to 65% in elderly patients compared to 8.5% to 47% in younger patients. Grade 3 or 4 ICANS ranging from 2 to 47% in elderly patients compared to 2% to 18% in younger patients. The pooled analysis shown in figure 4 showed an odd ratio of 1.59 with a confidence interval ranging from 1.09 to 2.34 (p=0.02), suggesting the risk of ICANS is higher in older patients. Conclusion CRS and ICANS are the most common adverse effects limiting the use of CAR-T therapy in the elderly. Our analysis showed that age does not impact the risk of CRS in DLBCL patients treated with anti-CD19 CAR-T treatment. However, older patients are at a higher risk of ICANS as compared to younger, suggesting CAR-T therapy should be used with caution in patients older than 65 years of age, especially if they have baseline neurological impairment. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Efficacy and Safety of Ramucirumab in Asian and Non-Asian Patients with Advanced Hepatocellular Carcinoma and Elevated Alpha-Fetoprotein: Pooled Individual Data Analysis of Two Randomized Studies

Liver Cancer ◽  
2020 ◽  
Vol 9 (4) ◽  
pp. 440-454 ◽  
Author(s):  
Chia-Jui Yen ◽  
Masatoshi Kudo ◽  
Ho-Yeong Lim ◽  
Chih-Hung Hsu ◽  
Arndt Vogel ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Cox Regression ◽  
Meta Analysis ◽  
Progression Free Survival ◽  
Pooled Analysis ◽  
Alpha Fetoprotein ◽  
Advanced Hepatocellular Carcinoma ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Asian Patients

Objective: REACH-2 and REACH were randomized, placebo-controlled, double-blind, multicenter phase 3 trials which showed survival benefits of ramucirumab treatment in patients with advanced hepatocellular carcinoma (HCC) and elevated alpha-fetoprotein (AFP). We evaluated the efficacy and safety of ramucirumab in Asian and non-Asian patients with AFP ≥400 ng/mL from REACH-2 and REACH. Methods: We pooled Asian and non-Asian patients from the REACH-2 and REACH trials and performed an individual patient data meta-analysis. Overall survival (OS) and progression-free survival were evaluated using the Kaplan-Meier method. Hazard ratios (HRs) were estimated with a stratified Cox regression model. Results: In the pooled REACH-2 and REACH patient population, 291 Asian patients were randomly assigned to receive ramucirumab (n = 168) or placebo (n = 123), and 251 non-Asian patients received ramucirumab (n = 148) or placebo (n = 103). The median OS was significantly longer in the ramucirumab arm in comparison to the placebo arm for Asian patients (8.08 vs. 4.76 months, stratified HR 0.73 [95% CI 0.56–0.95], p = 0.0189) and non-Asian patients (7.98 vs. 5.22 months, stratified HR 0.65 [95% CI 0.49–0.86], p = 0.0028). The overall response rate (ORR) and disease control rate (DCR) were significantly higher in the ramucirumab arm compared to the placebo arm for Asian patients (ORR: 4.2 vs. 0.8%; DCR: 53.6 vs. 33.3%) and non-Asian patients (ORR: 6.8 vs. 1.0%; DCR: 59.5 vs. 41.7%). The most common grade ≥3 treatment-emergent adverse events reported in the ramucirumab arm were hypertension (7.7%), decreased appetite (1.2%), and ascites (1.2%) for Asian patients and hypertension (16.9%), ascites (8.8%), asthenia (4.7%), and fatigue (5.4%) for non-Asian patients. Discussion and Conclusion: This pooled analysis of the REACH-2/REACH trials demonstrates significant benefits, with a manageable safety profile, of ramucirumab treatment in Asian and non-Asian patients with advanced HCC and baseline AFP ≥400 ng/mL.

Prognostic significance of CD30 expression in diffuse large B cell lymphoma: A systematic review with meta‐analysis

2021 ◽  
Author(s):  
Carla Isabelly Rodrigues‐Fernandes ◽  
Lucas Guimarães Abreu ◽  
Raghu Radhakrishnan ◽  
Danyel Elias da Cruz Perez ◽  
Gleyson Kleber Amaral‐Silva ◽  
...  
Keyword(s):  
Systematic Review ◽  
B Cell ◽  
Cell Lymphoma ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Performance of the ESC 0/3-hour algorithm for rapid triage of myocardial infarction: systematic review and meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Chiang ◽  
C.H Chiang ◽  
G.H Lee ◽  
C.C Lee
Keyword(s):  
Myocardial Infarction ◽  
Predictive Value ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Public Institution ◽  
Systematic Evaluation ◽  
Funding Source ◽  
Cochrane Central Register ◽  
Comparative Performance ◽  
Rule Out

Abstract Objective The European Society of Cardiology (ESC) 0/3-hour algorithm is one of the most widely strategies used for rule-out or rule-in of acute myocardial infarction (AMI). However, a systematic evaluation of its performance has not been conducted. Furthermore, recent studies showed that the 0/3-hour algorithm is non-superior to the 0/1-hour algorithm. Purpose This study aims to summarize the safety and efficacy of the 0/3-hour algorithm and its comparative performance with the 0/1-hour algorithm. Methods We conducted literature search on PubMed, Embase, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials for studies published between 1 January 2008 and 31 May 2019. A bivariate random-effects meta-analysis was used to estimate the primary and secondary outcomes, defined as index myocardial infarction and triage efficacy, major adverse cardiac event (MACE) or mortality at 30 days, respectively. Results A total of 10,832 patients from 9 studies with a pooled AMI prevalence of 16% were analyzed. The 0/3-hour algorithm ruled out 69% of the patients with a pooled sensitivity of 94.2% [95% CI: 87.6%–97.4%] and negative predictive value of 98.6% [95% CI: 97.0%–99.4%]; 17% of the patients were ruled in with a pooled specificity of 94.9% [95% CI: 88.6%–97.8%] and positive predictive value of 72.9% [95% CI: 54.6%–85.7%]. The 30-day mortality and 30-day MACE for patients that were ruled out were 0.0% [95% CI: 0.0%–0.0%] and 1.4% [95% CI: 0.9%–2.0%], respectively. In a pooled analysis of 3 cohorts, the 0/3-hour algorithm had a non-superior sensitivity compared with the 0/1-hour algorithm (94.4% [95% CI: 87.0%–97.7%] vs. 98.4% [95% CI: 95.4%–99.7%]). The 0/3-hour algorithm also had a similar rule-out efficacy compared with the 0/1-hour algorithm (52% [95% CI: 39%–65%] vs. 53% [95% CI: 42%–64%]). Conclusion The widely used 0/3-hour algorithm has sensitivity substantially below the consensus goal of 99% and may not be sufficiently safe for triage of myocardial infarction. Furthermore, the 0/3-hour algorithm is not superior to the 0/1-hour algorithm despite the additional triage time. Performance of ESC 0/3-hour algorithm Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Taiwan National Ministry of Science and Technology Grants

scholarly journals Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis

2021 ◽  
Vol 18 ◽  
pp. 147997312110022
Author(s):  
Kevin Cares-Marambio ◽  
Yessenia Montenegro-Jiménez ◽  
Rodrigo Torres-Castro ◽  
Roberto Vera-Uribe ◽  
Yolanda Torralba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chest Pain ◽  
Hospital Admission ◽  
Respiratory Symptoms ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Data Synthesis ◽  
Recent Onset ◽  
Persistent Symptoms

Knowledge on the sequelae of Coronavirus Disease 2019 (COVID-19) remains limited due to the relatively recent onset of this pathology. However, the literature on other types of coronavirus infections prior to COVID-19 reports that patients may experience persistent symptoms after discharge. To determine the prevalence of respiratory symptoms in survivors of hospital admission after COVID-19 infection. A living systematic review of five databases was performed in order to identify studies which reported the persistence of respiratory symptoms in COVID-19 patients after discharge. Two independent researchers reviewed and analysed the available literature, and then extracted and assessed the quality of those articles. Of the 1,154 reports returned by the initial search nine articles were found, in which 1,816 patients were included in the data synthesis. In the pooled analysis, we found a prevalence of 0.52 (CI 0.38–0.66, p < 0.01, I 2 = 97%), 0.37 (CI 0.28–0.48, p < 0.01, I 2 = 93%), 0.16 (CI 0.10–0.23, p < 0.01, I 2 = 90%) and 0.14 (CI 0.06–0.24, p < 0.01, I 2 = 96%) for fatigue, dyspnoea, chest pain, and cough, respectively. Fatigue, dyspnoea, chest pain, and cough were the most prevalent respiratory symptoms found in 52%, 37%, 16% and 14% of patients between 3 weeks and 3 months, after discharge in survivors of hospital admission by COVID-19, respectively.

scholarly journals The association between Helicobacter pylori and obesity: a systematic review and meta-analysis of case–control studies

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Ali Baradaran ◽  
Hojat Dehghanbanadaki ◽  
Sara Naderpour ◽  
Leila Mohammadi Pirkashani ◽  
Abdolhalim Rajabi ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Case Control ◽  
Case Control Studies ◽  
Newcastle Ottawa Scale ◽  
Prevalence Of Obesity ◽  
Quantitative Analyses ◽  
H Pylori

Abstract Introduction The relationship between H. pylori infection and obesity development has remained controversial among various studies. The aim of this study was to clarify the pooled effect of H. pylori infection on the development of obesity and vice versa. Methods We searched international databases including Medline (PubMed), Web of sciences, Scopus, EMBASE, Cochrane, Ovid, and CINHAL to retrieve all case–control studies reporting the effect of H. pylori on obesity and vice versa, which had been published in English between January 1990 and June 2019. The quality of included studies was assessed by the Modified Newcastle–Ottawa Scale for Case–Control studies. The logarithm of the odds ratio (OR) and its standard error was used for the meta-analysis. Results Eight case–control studies with 25,519 participants were included for qualitative and quantitative analyses. The pooled analysis showed that obese participants had a higher risk of H. pylori infection than lean participants with an odds ratio of 1.46 (95%CI: 1.26, 1.68). Also, the pooled analysis revealed that participants infected by H. pylori had a higher risk of obesity than non-infected participants with an odds ratio of 1.01 (95%CI: 1.01, 1.02). Conclusion The results of this meta-analysis showed that there was a positive correlation between the risk of H. pylori infection and the prevalence of obesity development. Thus, H. pylori positive patients were more likely to be obese, and obese individuals had higher risks of H. pylori infection.

scholarly journals A Bibliometric Meta-Analysis of Colistin Resistance in Klebsiella pneumoniae

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 44
Author(s):  
Ozioma Forstinus Nwabor ◽  
Pawarisa Terbtothakun ◽  
Supayang P. Voravuthikunchai ◽  
Sarunyou Chusri
Keyword(s):  
Klebsiella Pneumoniae ◽  
Research Collaboration ◽  
Research Output ◽  
Meta Analysis ◽  
Research Articles ◽  
Colistin Resistance ◽  
Carbapenem Resistant ◽  
The Usa ◽  
Carbapenem Resistant Enterobacteriaceae ◽  
Linkage Strength

Colistin is a last resort antibiotic medication for the treatment of infections caused by carbapenem-resistant Klebsiella pneumoniae. In recent years, various mechanisms have been reported to mediate colistin resistance in K. pneumoniae. This study reports a bibliometric analysis of published articles retrieved from the Scopus database relating to colistin resistance in K. pneumoniae. The research trends in colistin resistance and mechanisms of resistance were considered. A total of 1819 research articles published between 1995 and 2019 were retrieved, and the results indicated that 50.19% of the documents were published within 2017–2019. The USA had the highest participation with 340 (14.31%) articles and 14087 (17.61%) citations. Classification based on the WHO global epidemiological regions showed that the European Region contributed 42% of the articles while the American Region contributed 21%. The result further indicated that 45 countries had published at least 10 documents with strong international collaborations amounting to 272 links and a total linkage strength of 735. A total of 2282 keywords were retrieved; however, 57 keywords had ≥15 occurrences with 764 links and a total linkage strength of 2388. Furthermore, mcr-1, colistin resistance, NDM, mgrB, ceftazidime-avibactam, MDR, combination therapy, and carbapenem-resistant Enterobacteriaceae were the trending keywords. Concerning funders, the USA National Institute of Health funded 9.1% of the total research articles, topping the list. The analysis indicated poor research output, collaboration, and funding from Africa and South-East Asia and demands for improvement in international research collaboration.

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