scholarly journals Effect of leisure-time physical activity in controlling hypertension: a systematic review and meta-analysis protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e056270
Author(s):  
Md Shariful Islam ◽  
Md Golam Rabbani ◽  
Ammatul Fardousi ◽  
Monaemul Islam Sizear ◽  
KM Saif-Ur-Rahman
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Ethical Approval ◽  
Registration Number ◽  
Meta Analyses

IntroductionHypertension is a major risk factor for cardiovascular diseases. In 2015, over 1.13 billion individuals worldwide had hypertension. Globally, it results in 10.8 million deaths every year. Around half of the individuals do not continue treatment with medicine to control blood pressure. Physical activity, a non-pharmacological option of treatment, reduces blood pressure. We aim in this research to examine the effect of leisure-time physical activity in controlling blood pressure.Methods and analysisWe will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to conduct this study. We will perform a systematic search in Medline/PubMed, Embase, Scopus, Web of Science, Physical Education Index (ProQuest) and CENTRAL (the Cochrane Library). Both experimental and observational studies will be included. The study population would be people with hypertension. Two reviewers will perform screening of the articles, bias assessment and data extraction independently. We will use the Joanna Briggs Institute Critical Appraisal Tools to assess the risk of bias. We will conduct a meta-analysis if it is applicable.Ethics and disseminationThe results will be published in peer-reviewed journals and presented at relevant scientific seminars and conferences. Ethical approval is not applicable.PROSPERO registration numberCRD42021260751.

scholarly journals Accuracy of potential diagnostic indicators for coeliac disease: a systematic review protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038994
Author(s):  
Martha Maria Christine Elwenspoek ◽  
Joni Jackson ◽  
Sarah Dawson ◽  
Hazel Everitt ◽  
Peter Gillett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Coeliac Disease ◽  
Prediction Models ◽  
Data Extraction ◽  
Meta Analysis ◽  
Case Finding ◽  
Endoscopic Biopsy ◽  
Cochrane Library ◽  
Ethical Approval ◽  
Registration Number

IntroductionCoeliac disease (CD) is a systemic immune-mediated disorder triggered by gluten in genetically predisposed individuals. CD is diagnosed using a combination of serology tests and endoscopic biopsy of the small intestine. However, because of non-specific symptoms and heterogeneous clinical presentation, diagnosing CD is challenging. Early detection of CD through improved case-finding strategies can improve the response to a gluten-free diet, patients’ quality of life and potentially reduce the risk of complications. However, there is a lack of consensus in which groups may benefit from active case-finding.Methods and analysisWe will perform a systematic review to determine the accuracy of diagnostic indicators (such as symptoms and risk factors) for CD in adults and children, and thus can help identify patients who should be offered CD testing. MEDLINE, Embase, Cochrane Library and Web of Science will be searched from 1997 until 2020. Screening will be performed in duplicate. Data extraction will be performed by one and checked by a second reviewer. Disagreements will be resolved through discussion or referral to a third reviewer. We will produce a narrative summary of identified prediction models. Studies, where 2×2 data can be extracted or reconstructed, will be treated as diagnostic accuracy studies, that is, the diagnostic indicators are the index tests and CD serology and/or biopsy is the reference standard. For each diagnostic indicator, we will perform a bivariate random-effects meta-analysis of the sensitivity and specificity.Ethics and disseminationResults will be reported in peer-reviewed journals, academic and public presentations and social media. We will convene an implementation panel to advise on the optimum strategy for enhanced dissemination. We will discuss findings with Coeliac UK to help with dissemination to patients. Ethical approval is not applicable, as this is a systematic review and no research participants will be involved.PROSPERO registration numberCRD42020170766.

scholarly journals Outcomes of hyperglycaemia in pregnancy in Africa: systematic review study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e040921
Author(s):  
Ezekiel Musa ◽  
Tawanda Chivese ◽  
Mahmoud Werfalli ◽  
Mushi Matjila ◽  
Shane A Norris ◽  
...  
Keyword(s):  
Systematic Review ◽  
Narrative Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Published Data ◽  
Metabolic Complication ◽  
Ethical Approval ◽  
Registration Number ◽  
Meta Analyses ◽  
In Pregnancy

IntroductionThe prevalence of diabetes mellitus globally has increased considerably over the past decades with a resultant increase in the incidence of diabetes-complicated pregnancies. Hyperglycaemia in pregnancy is the most common metabolic complication encountered during pregnancy and is associated with adverse maternal and fetal outcomes. This systematic review aims to examine maternal, fetal, neonatal, childhood and long-term maternal outcomes of hyperglycaemia in pregnancy in Africa.Methods and analysisA systematic review of all studies that investigated hyperglycaemia in pregnancy outcomes, carried out in Africa from 1998 to 2019. A comprehensive search of all published articles indexed in PubMed-MEDLINE, Cochrane Library, Scopus, CINAHL (EBSCOhost), Embase and Web of Science databases will be performed. Studies will be screened for eligibility by title, abstract and full text in duplicate by two independent reviewers. For data where meta-analysis is not possible, narrative analysis will be carried out using themes from data. For data where meta-analysis is possible, random effects meta-analysis will be conducted. This systematic review will be reported according to the Meta-analyses of Observational Studies in Epidemiology.Ethics and disseminationEthical approval is not required for this study considering this is a systematic review protocol that uses only published data. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42020184573.

scholarly journals Efficacy and safety of aliskiren combination therapy: a protocol for an umbrella review

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043807
Author(s):  
Jiantong Shen ◽  
Wenming Feng ◽  
Yike Wang ◽  
Qiyuan Zhao ◽  
Billong Laura Flavorta ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Systematic Reviews ◽  
Cochrane Library ◽  
Umbrella Review ◽  
Quality Of Reporting ◽  
Ethical Approval ◽  
Registration Number ◽  
Third Person ◽  
Meta Analyses ◽  
The Impact

IntroductionEfficacy of aliskiren combination therapy with other antihypertensive has been evaluated in the treatment of patients with hypertension in recent systematic reviews. However, most previous reviews only focused on one single health outcome or one setting, none of them made a full summary that assessed the impact of aliskiren combination treatment comprehensively. As such, this umbrella review based on systematic reviews and meta-analyses is aimed to synthesise the evidences on efficacy, safety and tolerability of aliskiren-based therapy for hypertension and related comorbid patients.Methods and analysisA comprehensive search of PubMed, EMBASE, Cochrane Library, CNKI published from inception to August 2020 will be conducted. The selected articles are systematic reviews which evaluated efficacy, safety and tolerability of aliskiren combination therapy. Two reviewers will screen eligible articles, extract data and evaluate quality independently. Any disputes will be resolved by discussion or the arbitration of a third person. The quality of reporting evidence will be assessed using the Assessment of Multiple Systematic Reviews V.2 tool tool. We will take a mixed-methods approach to synthesising the review literatures, reporting summary of findings tables and iteratively mapping the results.Ethics and disseminationEthical approval is not required for the study, as we would only collect data from available published materials. This umbrella review will be also submitted to a peer-reviewed journal for publication after completion.PROSPERO registration numberCRD42020192131.

scholarly journals Physical activity, sedentary time and their associations with clustered metabolic risk among people with type 2 diabetes in Jiangsu province: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e027906
Author(s):  
Yijia Chen ◽  
Jie Yang ◽  
Jian Su ◽  
Yu Qin ◽  
Chong Shen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Systolic Blood Pressure ◽  
Leisure Time ◽  
Sedentary Time ◽  
Leisure Time Physical Activity ◽  
Jiangsu Province ◽  
Metabolic Risk

ObjectiveInvestigating the association between total physical activity, physical activity in different domains and sedentary time with clustered metabolic risk in patients with type 2 diabetes from Jiangsu province, China.DesignInterview-based cross-sectional study conducted between December 2013 and January 2014.Setting44 selected townships across two cities, Changshu and Huai’an, in Jiangsu province.Participants20 340 participants selected using stratified cluster-randomised sampling and an interviewer-managed questionnaire.MethodsWe constructed clustered metabolic risk by summing sex-specific standardised values of waist circumference, fasting triacylglycerol, fasting plasma glucose, systolic blood pressure and the inverse of blood high-density lipoprotein cholesterol (HDL-cholesterol). Self-reported total physical activity included occupation, commuting and leisure-time physical activity. The un-standardised regression coefficient [B] and its 95% CI were calculated using multivariate linear regression analyses.ResultsThis study included 17 750 type 2 diabetes patients (aged 21–94 years, 60.3% female). The total (B=−0.080; 95% CI: −0.114 to −0.046), occupational (B=−0.066; 95% CI: −0.101 to− 0.031) and leisure-time physical activity (B=−0.041; 95% CI: −0.075 to −0.007), and sedentary time (B=0.117; 95% CI: 0.083 to 0.151) were associated with clustered metabolic risk. Total physical activity, occupational physical activity and sedentary time were associated with waist circumference, triacylglycerol and HDL-cholesterol, but not with systolic blood pressure. Commuting physical activity and sedentary time were significantly associated with triacylglycerol (B=−0.012; 95% CI: −0.019 to −0.005) and fasting plasma glucose (B=0.008; 95% CI: 0.003 to 0.01), respectively. Leisure-time physical activity was only significantly associated with systolic blood pressure (B=−0.239; 95% CI: −0.542 to− 0.045).ConclusionsTotal, occupational and leisure-time physical activity were inversely associated with clustered metabolic risk, whereas sedentary time increased metabolic risk. Commuting physical activity was inversely associated with triacylglycerol. These findings suggest that increased physical activity in different domains and decreased sedentary time may have protective effects against metabolic risk in type 2 diabetes patients.

scholarly journals The Optimal Time of Applying Enteral Immunonutrition in Esophageal Cancer Patients Receiving Esophagectomy: A Network Meta-Analysis of Randomized Clinical Trials

2021 ◽  
Author(s):  
Xu Tian ◽  
Yan-Fei Jin ◽  
Zhao-Li Zhang ◽  
Hui Chen ◽  
Wei-Qing Chen ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cancer Patients ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Infectious Complications ◽  
Cochrane Library ◽  
Optimal Time ◽  
Registration Number ◽  
Meta Analyses ◽  
The Impact

Abstract Background: Enteral immunonutrition (EIN) has been extensively applied in cancer patients, however its role in esophageal cancer (EC) patients receiving esophagectomy remains unclear. We performed this network meta-analysis to investigate the impact of EIN on patients undergoing surgery for EC and further determine the optimal time of applying EIN.Methods: We searched PubMed, EMBASE, Cochrane library, and China National Knowledgement Infrastructure (CNKI) to identify eligible studies. Categorical data was expressed as the odds ratio with 95% confidence interval (CI), and continuous data was expressed as mean difference (MD) with 95% CI. Pair-wise and network meta-analysis was performed to evaluate the impact of EIN on clinical outcomes using RevMan 5.3 and ADDIS V.1.16.8 softwares. The surface under the cumulative ranking curve (SUCRA) was calculated to rank all nutritional regimes.Results: Total 14 studies involving 1071 patients were included. Pair-wise meta-analysis indicated no difference between EIN regardless of the application time and standard EN (SEN), however subgroup analyses found that postoperative EIN was associated with decreased incidence of total infectious complications (OR=0.47; 95%CI=0.26 to 0.84; p=0.01) and pneumonia (OR=0.47; 95%CI=0.25 to 0.90; p=0.02) and shortened LOH (MD=-1.01; 95%CI=-1.44 to -0.57; p<0.001) compared to SEN, which were all supported by network meta-analyses. Ranking probability analysis further indicated that postoperative EIN has the highest probability of being the optimal option in terms of these three outcomes.Conclusions: Postoperative EIN should be preferentially utilized in EC patients undergoing esophagectomy because it has optimal potential of decreasing the risk of total infectious complications and pneumonia and shortening LOH.OSF registration number: 10.17605/OSF.IO/KJ9UY.

scholarly journals Exercise therapy improves eGFR, and reduces blood pressure and BMI in non-dialysis CKD patients: evidence from a meta-analysis

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Lijun Zhang ◽  
Yangyang Wang ◽  
Lianlian Xiong ◽  
Yanfang Luo ◽  
Zhijun Huang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Exercise Therapy ◽  
Cardiovascular Health ◽  
Data Extraction ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Cochrane Library ◽  
Healthy Population ◽  
Short Term

Abstract Background Patients with chronic kidney disease (CKD) have a high prevalence of cardiovascular diseases, which often lead to physical inactivity that correlates with CKD exacerbation. The benefits of regular exercise to cardiovascular health have been well established in healthy population and highly suggestive in patients with CKD. To further strengthen the evidence base for the management of CKD, this meta-analysis was performed to systematically evaluate the effects of exercise therapy on renal function, blood pressure, blood lipid and body mass index (BMI) in non-dialysis CKD patients. Methods This meta-analysis was conducted following a previous protocol. Randomized controlled trials (RCTs) examining the effects of exercise therapy in non-dialysis CKD patients were searched in Pubmed, Embase, Cochrane Library, and three major Chinese biomedical databases (CNKI, WANGFANG and VIP) from their start date to October 30th, 2018. The Cochrane systematic review methods were applied for quality assessment and data extraction, and Revman version 5.3 was used for systematic review and meta-analysis. Results 13 RCTs, representing 421 patients with non-dialysis CKD, were included in this meta-analysis. Compared to the controls, exercise therapy brought an increase in eGFR (MD = 2.62, 95% CI:0.42 to 4.82, P = 0.02, I2 = 22%), and decreases in systolic blood pressure (SBP) (MD = -5.61, 95% CI:-8.99 to − 2.23, P = 0.001, I2 = 44%), diastolic blood pressure (DBP) (MD = -2.87, 95% CI:-3.65 to − 2.08, P < 0.00001, I2 = 16%) and BMI (MD = -1.32, 95% CI:-2.39 to − 0.25, P = 0.02, I2 = 0%) in non-dialysis CKD patients. Exercise therapy of short-term (< 3 months) decreased triglyceride (TG) level (P = 0.0006). However, exercise therapy did not significantly affect serum creatinine (SCr), total cholesterol (TC), high density lipoprotein (HDL) or low density lipoprotein (LDL) in non-dialysis CKD patients. Conclusion Exercise therapy could benefit non-dialysis CKD patients by increasing eGFR while reducing SBP, DBP and BMI. Additionally, short-term intervention of exercise could decrease TG.

Greater daily leisure time physical activity is associated with lower chronic disease risk in adults with spinal cord injury

2009 ◽  
Vol 34 (4) ◽  
pp. 640-647 ◽  
Author(s):  
Andrea C. Buchholz ◽  
Kathleen A. Martin Ginis ◽  
Steven R. Bray ◽  
B. Catharine Craven ◽  
Audrey L. Hicks ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Cord Injury

The objective of this study was to examine the relationship between leisure time physical activity (LTPA) and common risk factors for cardiovascular disease (CVD) and type 2 diabetes in community-dwelling adults with chronic spinal cord injury (SCI). LTPA was measured using the Physical Activity Recall Assessment for People with SCI in 76 men and women with chronic (≥1 year) paraplegia or tetraplegia, living in or near Hamilton, Ontario. Body mass index (BMI), waist circumference, body composition (fat mass (FM) and fat-free mass (FFM)), blood pressure, and biochemical data were collected. Thirty-seven percent (n = 28 participants) were inactive, reporting no LTPA whatsoever, and were compared with an equal-sized group consisting of the most active study participants (≥25 min of LTPA per day). After adjusting for significant covariates, BMI (18.7%), %FM (19.4%), and C-reactive protein (143%) were all lower, and %FFM was higher (7.2%), in active participants (all p ≤ 0.05). Ten percent of active participants vs. 33% of inactive participants were insulin resistant (p = 0.03). Waist circumference (17.6%) and systolic blood pressure (15.3%) were lower in active vs. inactive participants with paraplegia (both p ≤ 0.05), but not tetraplegia. In conclusion, greater daily LTPA is associated with lower levels of selected CVD and type 2 diabetes risk factors in individuals living with SCI. Whether this relationship translates into a lower incidence of these chronic diseases has yet to be determined.

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