Looking for crumbs in the obesity forest: anti-obesity interventions in the Mexican population. History, and systematic review with Meta-Analysis

Mexicans and Mexican Americans share culture, genetic background, and predisposition for chronic complications associated with obesity and diabetes making imperative efficacious treatments and prevention. Obesity has been treated for centuries focused-on weight loss while other treatments on associated conditions like gout, diabetes (T2D), and hypertriglyceridemia. To date, there is no systematic review that synthetize the origin of obesity clinics in Mexico and the efforts to investigate treatments for obesity tested by randomized clinical trials (RCT). We conducted systematic searches in Pubmed, Scopus, and Web of Science to retrieve anti-obesity RCT through 2019 and without inferior temporal limit. The systematic review included RCT of anti-obesity treatments in the Mexican adult population, including alternative medicine, pharmacological, nutritional, behavioral, and surgical interventions reporting biometric outcomes such as BMI, weight, waist circumference, triglycerides, glucose, among others. Studies with at least three months of treatment were included in the meta-analysis. We found 634 entries, after removal of duplicates and screening the studies based on eligibility criteria, we analyzed 43, and 2 multinational-collaborative studies. Most of the national studies have small sample sizes, and the studied strategies do not have replications in the population. The nutrition/behavioral interventions were difficult to blind, and most studies have medium to high risk of bias. Nutritional/behavioral interventions and medications showed effects on BMI, waist circumference, and blood pressure. Simple measures like plain water instead of sweet beverages decrease triglycerides and systolic blood pressure. Participants with obesity and hypertension can have benefic effects with antioxidants, and treatment with insulin increase weight in those with T2D. The study of obesity in Mexico has been on-going for more than four decades, but the interest on RCT just increased until this millennium, but with small sample sizes and lack of replication. The interventions affect different metabolic syndrome components, which should be analyzed in detail with the population living on the U.S.-Mexico border; therefore, bi-national collaboration is desirable to disentangle the cultural effects on this population's treatment response.

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Human Papillomavirus in Sinonasal Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis

Cancers ◽

10.3390/cancers13010045 ◽

2020 ◽

Vol 13 (1) ◽

pp. 45

Author(s):

Kim J. W. Chang Sing Pang ◽

Taha Mur ◽

Louise Collins ◽

Sowmya R. Rao ◽

Daniel L. Faden

Keyword(s):

Systematic Review ◽

Human Papillomavirus ◽

Squamous Cell ◽

Meta Analysis ◽

Small Sample ◽

Squamous Cell Carcinomas ◽

Causative Role ◽

Sample Sizes ◽

Geographic Regions ◽

Small Sample Sizes

Human papillomavirus (HPV) drives tumorigenesis in a subset of oropharyngeal squamous cell carcinomas (OPSCC) and is increasing in prevalence across the world. Mounting evidence suggests HPV is also involved in a subset of sinonasal squamous cell carcinomas (SNSCC), yet small sample sizes and variability of HPV detection techniques in existing literature hinder definitive conclusions. A systematic review was performed by searching literature through March 29th 2020 using PubMed, Embase, and Web of Science Core Collection databases. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed by two authors independently. A meta-analysis was performed using the random-effects model. Sixty studies (n = 1449) were eligible for statistical analysis estimating an overall HPV prevalence of 25.5% (95% CI 20.7–31.0). When stratified by HPV detection method, prevalence with multiple substrate testing (20.5%, 95% CI 14.5–28.2) was lower than with single substrate testing (31.7%, 95% CI 23.6–41.1), highest in high-exposure anatomic subsites (nasal cavity and ethmoids) (37.6%, 95% CI 26.5–50.2) vs. low-exposure (15.1%, 95% CI 7.3–28.6) and highest in high HPV+ OPSCC prevalence geographic regions (North America) (30.9%, 95% CI 21.9–41.5) vs. low (Africa) (13.1, 95% CI 6.5–24.5)). While small sample sizes and variability in data cloud firm conclusions, here, we provide a new reference point prevalence for HPV in SNSCC along with orthogonal data supporting a causative role for virally driven tumorigenesis, including that HPV is more commonly found in sinonasal subsites with increased exposure to refluxed oropharyngeal secretions and in geographic regions where HPV+ OPSCC is more prevalent.

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P113: A systematic review and meta-analysis of tourniquet devices for speed of application, successful hemostasis and patient tolerance

CJEM ◽

10.1017/cem.2018.311 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S97-S97

Author(s):

C. Picard ◽

M. J. Douma

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Meta Analysis ◽

Case Series ◽

Small Sample ◽

Blood Pressure Cuff ◽

Special Operations ◽

Pressure Cuff ◽

Small Sample Sizes ◽

Guide Device

Introduction: Tourniquets are a mainstay of hemorrhage management. However, there is insufficient evidence to guide device sselection. This review analyses the literature on tourniquets, for the following outcomes: lower-extremity arterial hemostasis, application speed, and pain. Methods: Studies were limited to English. Non-human studies, case series, and intra-operative applications were excluded. A systematic review of MEDLINE, PubMed, Google Scholar, and the Cochrane Database from 1992 to Dec 2017 was performed. Article citations were also assessed. Results: Twenty-one studies met criteria, testing 28 tourniquet devices. The most popular devices for arterial hemostasis were the Combat Application Tourniquet (C-A-T) (662 applications), Special Operations Forces Tactical Tourniquet (SOFTT) (307 applications), blood pressure cuff (80 applications), rubber tubing (58 applications) and the Emergency Medical Tourniquet (EMT) (52 applications). The blood pressure cuff achieved the highest (weighted averages) rate of 99% (95% CI 93 to 100) based on four studies of 80 applications. Followed by the EMT which achieved 83% (95% CI 72 to 93), based on three studies of 52 applications (p<0.01). The fastest device to apply, taking 17 seconds (95% CI 11 to 23), was surgical tubing, based on two studies totalling 30 applications. The next fastest was the blood pressure cuff, requiring 20 seconds (95% CI 18 to 22), based on two studies totaling 58 applications (though there was no statistical difference in application time, p=0.08). Tolerance could not be analyzed, due to heterogeneity of outcome measures. Conclusion: This is the first meta-analysis of tourniquet outcomes. The literature lacks a standard approach to device application. The quality of evidence is of very low due to the small sample sizes, lack of blinding, selective outcome reporting and result inconsistency. Common medical equipment appear to outperform commercial tourniquets for arterial hemostasis and speed of application; however, they are some of the least studied devices.

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What Types of Exercise Are More Effective in Reducing Obesity and Blood Pressure for Middle-Aged Women? A Systematic Review With Meta-Analysis

Biological Research For Nursing ◽

10.1177/10998004211015424 ◽

2021 ◽

pp. 109980042110154

Author(s):

Seong-Hi Park ◽

Chul-Gyu Kim

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Metabolic Syndrome ◽

Body Weight ◽

Waist Circumference ◽

Meta Analysis ◽

Physical Activities ◽

Risk Of Bias ◽

Cochrane Library ◽

Middle Aged

Background: A systematic review was performed to identify the types of physical activities effective as interventions in preventing metabolic syndrome in middle-aged women. Methods: Electronic databases (MEDLINE, EMBASE, the Cochrane Library, and CINAHL) served as the data sources. Cochrane’s Risk of Bias 2 was applied to assess the risk of bias of the randomized controlled trials. Meta-analyses were performed on selected studies using Review Manager 5.3. Thirty-one trials enrolling 2,202 participants were included. Results: Compared to controls, the effects of physical activity were indicated by pooled mean differences, which were −0.57 kg for body weight, −0.43 kg/m2 for body mass index, −1.63 cm for waist circumference, −4.89 mmHg for systolic blood pressure (BP), and −2.71 mmHg for diastolic BP. The effects were greater on the measurements of waist circumference and BP than on body weight and BMI. The types of physical activities were further analyzed according to sub-groups. Only aerobic exercise did not affect body weight and resistance exercise did not significantly change any results. Contrarily, combined exercises significantly reduced measurements of waist circumference and BP. Conclusion: This review can provide valuable information for research and implementation of measures to prevent metabolic syndrome in middle-aged women.

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Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis

International Journal of Behavioral Nutrition and Physical Activity ◽

10.1186/s12966-019-0896-0 ◽

2019 ◽

Vol 16 (1) ◽

Cited By ~ 4

Author(s):

Rubina Mulchandani ◽

Ambalam M. Chandrasekaran ◽

Roopa Shivashankar ◽

Dimple Kondal ◽

Anurag Agrawal ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Blood Pressure ◽

Body Weight ◽

Waist Circumference ◽

Meta Analysis ◽

Workplace Interventions ◽

Working Adults ◽

Reduced Body ◽

Physical Activity Interventions

Abstract Background Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults. Methods All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome. Results A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: − 2.61 kg, 95% CI: − 3.89 to − 1.33) BMI (19 studies, mean diff: − 0.42 kg/m2, 95% CI: − 0.69 to − 0.15) and waist circumference (13 studies; mean diff: − 1.92 cm, 95% CI: − 3.25 to − 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant. Conclusions Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research. Prospero registration number: CRD42018094436.

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Prevalence of tuberculosis, brucellosis and trypanosomiasis in cattle in Tanzania: a systematic review and meta-analysis

Animal Health Research Reviews ◽

10.1017/s146625231600013x ◽

2016 ◽

Vol 17 (1) ◽

pp. 16-27 ◽

Cited By ~ 8

Author(s):

Silvia Alonso ◽

Ian Dohoo ◽

Johanna Lindahl ◽

Cristobal Verdugo ◽

Isaiah Akuku ◽

...

Keyword(s):

Systematic Review ◽

Production Systems ◽

Strong Predictor ◽

Meta Analysis ◽

Small Sample ◽

Skin Tests ◽

Prevalence Studies ◽

Prevalence Estimates ◽

Using Data ◽

Small Sample Sizes

AbstractA meta-analysis was performed to derive prevalence estimates for Brucella spp., Mycobacterium spp. and Trypanosoma spp. in cattle in Tanzania using data derived from a systematic review of zoonotic hazards in cattle production systems. Articles published before 2012 reporting prevalence and considered at least moderate in quality were included in the analysis. Results showed high heterogeneity between studies, with wide ranges in the reported prevalence: Brucella (0.3–60.8%), Mycobacterium (0.1–13.2%) and Trypanosoma (0.82–33.3%). Overall meta-analytic mean prevalence estimates were 8.2% (95% CI 6.5–10.2), 1.28% (95% CI 0.35–4.58) and 10.3% (95% CI 6.20–16.70) respectively, for Brucella spp., Mycobacterium spp. and Trypanosoma spp. Time and region were predictors of variability of Brucella spp. prevalence, while diagnostic test was a strong predictor of Mycobacterium spp. prevalence, with higher prevalence estimates given by skin tests compared with post-mortem inspection. None of the studied factors were associated with prevalence of Trypanosoma spp. The small sample sizes, range of study locations, study designs and diagnostics used, contributed to high variability among prevalence estimates. Larger and more robust prevalence studies are needed to adequately support risk assessment and management of animal and public health threats.

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Effectiveness of Outdoor Exercise Parks on Health Outcomes in Older Adults—A Mixed-Methods Systematic Review and Meta-Analysis

Journal of Aging and Physical Activity ◽

10.1123/japa.2020-0031 ◽

2020 ◽

pp. 1-13

Author(s):

Yoke Leng Ng ◽

Keith D. Hill ◽

Pazit Levinger ◽

Elissa Burton

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Older Adults ◽

Meta Analysis ◽

Small Sample ◽

Activity Levels ◽

Single Leg Stance ◽

Small Sample Sizes ◽

Meta Analyses

The objective of this systematic review was to examine the effectiveness of outdoor exercise park equipment on physical activity levels, physical function, psychosocial outcomes, and quality of life of older adults living in the community and to evaluate the evidence of older adults’ use of outdoor exercise park equipment. A search strategy was conducted from seven databases. Nine articles met the inclusion criteria. The study quality results were varied. Meta-analyses were undertaken for two physical performance tests: 30-s chair stand test and single-leg stance. The meta-analysis results were not statistically significant. It was not possible to conclude whether exercise parks were effective at improving levels of physical activity. The review shows that older adults value the benefits of health and social interaction from the use of exercise parks. Findings should be interpreted with caution due to the small sample sizes and the limited number of studies.

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Systematic Review and Meta-Analysis of Prevalence of Coeliac Disease in Women with Infertility

Nutrients ◽

10.3390/nu11081950 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1950 ◽

Cited By ~ 1

Author(s):

Mercedes Castaño ◽

Rubén Gómez-Gordo ◽

David Cuevas ◽

Concepción Núñez

Keyword(s):

Systematic Review ◽

Coeliac Disease ◽

Data Extraction ◽

Meta Analysis ◽

Numerical Data ◽

Current Data ◽

Small Sample ◽

Unexplained Infertility ◽

Intestinal Biopsy ◽

Sample Sizes

We aimed to estimate the seroprevalence and the prevalence of coeliac disease (CD) in women with reproductive problems. A systematic review of English published articles until June 2019 was performed in PubMed and Scopus using the terms: (infertility and (coeliac disease OR gluten) OR (miscarriage and (coeliac disease OR gluten) OR (abortion and (coeliac disease OR gluten). All articles showing numerical data of anti-transglutaminase type 2 or anti-endomisium antibodies, or intestinal biopsy information were included. The study group comprised women with overall infertility, unexplained infertility, or recurrent spontaneous abortions. Two authors independently performed data extraction using a predefined data sheet. The initial search yielded 310 articles, and 23 were selected for data extraction. After meta-analysis, the pooled seroprevalence was very similar for overall and unexplained infertility, with a pooled proportion of around 1.3%–1.6%. This implies three times higher odds of having CD in infertility when compared to controls. The pooled prevalence could not be accurately calculated due to the small sample sizes. Further studies with increased sample sizes are necessary before giving specific recommendations for CD screening in women with reproductive problems, but current data seem to support a higher risk of CD in these women.

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Unsuccessful Treatments of “Writer's Block”: A Meta-Analysis

Psychological Reports ◽

10.2466/28.pr0.115c12z0 ◽

2014 ◽

Vol 115 (1) ◽

pp. 276-278 ◽

Cited By ~ 2

Author(s):

Derrick C. McLean ◽

Benjamin R. Thomas

Keyword(s):

Meta Analysis ◽

Small Sample ◽

The Body ◽

Effect Sizes ◽

Sample Sizes ◽

Writer's Block ◽

Unsuccessful Treatment ◽

Group Treatments ◽

Writer’S Block ◽

Small Sample Sizes

A wide literature of the unsuccessful treatment of writer's block has emerged since the early 1970's. Findings within this literature seem to confer generalizability of this procedure; however, small sample sizes may limit this interpretation. This meta-analysis independently analyzed effect sizes for “self-treatments” and “group-treatments” using number of words in the body of the publication as indication of a failure to treat writer's block. Results of the reported findings suggest that group-treatments tend to be slightly more unsuccessful than self-treatments.

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Whole grain food diet slightly reduces cardiovascular risks in obese/overweight adults: a systematic review and meta-analysis

10.21203/rs.2.15716/v3 ◽

2019 ◽

Author(s):

Weihao Wang ◽

Jianan Li ◽

Xiaoxi Chen ◽

Miao Yu ◽

Qi Pan ◽

...

Keyword(s):

Systematic Review ◽

Blood Pressure ◽

Body Weight ◽

Waist Circumference ◽

Food Consumption ◽

Meta Analysis ◽

Control Group ◽

Whole Grain ◽

Cardiovascular Risks ◽

Overweight Adults

Abstract Background: The effects of whole grain diet on cardiovascular risks in obese and overweight adults is not well established. Our goal was to conduct a systematic review and meta-analysis on the effect of whole grain diet on cardiovascular risks in obese/overweight adults. Methods: PubMed, Embase and Cochrane were systematically scanned for randomized controlled trials (RCTs), and studies were selected based on certain inclusion and exclusion criteria. The primary outcome was the effectiveness of whole grain food consumption in reducing body weight. The secondary outcomes were the effect of whole grain food consumption on cardiovascular disease (CVD) risk factors including plasma low-density lipoprotein cholesterol (LDL-C), insulin resistance index, blood pressure, body mass index (BMI), C-reactive protein (CRP), and waist circumference in obese/overweight adults. Results: Our results showed that whole grain consumption was associated with lower body weight (mean difference (MD) =-0.5, 95% confidence intervals (CI) [-0.74, 0.25], I2 = 35%, P < 0.0001) and lower CRP (MD =-0.36, 95% CI [-0.54, -0.18], I2=69%, P<0.0001), compared with the control group. However, there were no significant differences in LDL-C (MD =-0.08, 95% CI [-0.16, 0.00], I2 = 27%, P = 0.05), waist circumference (MD=-0.12, 95% CI [-0.92, 0.68], I2=44%, P=0.76), systolic blood pressure (MD=-0.11, 95% CI [-1.55, 1.33], I2=3%, P=0.88), diastolic blood pressure (MD=-0.44, 95% CI [-1.44, 0.57], I2=15%, P=0.39), and fasting glucose (MD=-0.05, 95% CI [-0.12, 0.01], I2=31%, P=0.11) between the two groups. Conclusion: This study suggests that whole grain food consumption can slightly reduce body weight and CRP in obese/overweight population.

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Systematic review and meta-analysis: does colonic mural thickening on CT correlate with endoscopic findings at colonoscopy?

Frontline Gastroenterology ◽

10.1136/flgastro-2018-100966 ◽

2018 ◽

Vol 9 (4) ◽

pp. 278-284 ◽

Cited By ~ 2

Author(s):

Subashini Chandrapalan ◽

Faraz Tahir ◽

Peter Kimani ◽

Rakesh Sinha ◽

Ramesh Arasaradnam

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Positive Predictive Value ◽

Search Strategy ◽

Meta Analysis ◽

Small Sample ◽

Limiting Factors ◽

Endoscopic Findings ◽

Registration Number ◽

Small Sample Sizes

BackgroundColonic mural thickening (MT) is often reported on standard CT examinations of the abdomen and pelvis. It often presents a dilemma for the clinician on whether any further evaluation is needed, especially in the absence of any set guidelines.ObjectiveTo evaluate the significance of colonic MT and to assess its correlation with colonoscopy.MethodsThe search strategy was initially developed in Medline and adapted for use in Embase, Medline, NHS Evidence and TRIP. Studies were included if they had reported colonic MT and subsequent colonoscopy in adults.ResultsA total of 9 cohort studies examining 1252 patients were selected having undergone both CT and colonoscopy. Of the 1252 patients with MT, 950 had an abnormal colonoscopy. In the presence of MT, the pooled positive predictive value (PPV) of having any abnormal findings at colonoscopy was 0.73 (95% CI 0.60 to 0.84). The pooled PPV for colorectal cancer, in the presence of MT reporting suspicion of cancer, was 0.63 (95% CI 0.49 to 0.75), and MT suggestive of inflammation confirmed at colonoscopy was 0.97.ConclusionThe probability of having an abnormal colonoscopy in the presence of MT identified on CT is high, especially for inflammation. Asymptomatic cancers may also be detected; hence, further endoscopic confirmation is reasonable when a finding of MT is demonstrated on CT examinations. Small sample sizes of the available studies and lack of data on the description of MT detected are the main limiting factors in this review.Trial registration numberCRD42016039378.

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