Impact of the menstrual cycle on peripheral vascular function in premenopausal women: systematic review and meta-analysis

2020 ◽  
Vol 319 (6) ◽  
pp. H1327-H1337
Author(s):  
Jennifer S. Williams ◽  
Emily C. Dunford ◽  
Maureen J. MacDonald
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Endothelial Function ◽  
Vascular Function ◽  
Meta Analysis ◽  
Premenopausal Women ◽  
Cycle Phase ◽  
Peripheral Vascular ◽  
The Impact

Fluctuations in endogenous hormones estrogen and progesterone during the menstrual cycle may offer vasoprotection for endothelial and smooth muscle (VSM) function. While numerous studies have been published, the results are conflicting, leaving our understanding of the impact of the menstrual cycle on vascular function unclear. The purpose of this systematic review and meta-analysis was to consolidate available research exploring the role of the menstrual cycle on peripheral vascular function. A systematic search of MEDLINE, Web of Science, and EMBASE was performed for articles evaluating peripheral endothelial and VSM function across the natural menstrual cycle: early follicular (EF) phase versus late follicular (LF), early luteal, mid luteal, or late luteal. A meta-analysis examined the effect of the menstrual cycle on the standardized mean difference (SMD) of the outcome measures. Analysis from 30 studies ( n = 1,363 women) observed a “very low” certainty of evidence that endothelial function increased in the LF phase (SMD: 0.45, P = 0.0001), with differences observed in the macrovasculature but not in the microvasculature (SMD: 0.57, P = 0.0003, I2 = 84%; SMD: 0.21, P = 0.17, I2 = 34%, respectively). However, these results are partially explained by differences in flow-mediated dilation [e.g., discrete (SMD: 0.86, P = 0.001) vs. continuous peak diameter assessment (SMD: 0.25, P = 0.30)] and/or menstrual cycle phase methodologies. There was a “very low” certainty that endothelial function was largely unchanged in the luteal phases, and VSM was unchanged across the cycle. The menstrual cycle appears to have a small effect on macrovascular endothelial function but not on microvascular or VSM function; however, these results can be partially attributed to methodological differences.

scholarly journals The Effect of Anakinra in Hospitalized Patients with COVID-19: An Updated Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4462
Author(s):  
Konstantinos G. Kyriakoulis ◽  
Anastasios Kollias ◽  
Garyphallia Poulakou ◽  
Ioannis G. Kyriakoulis ◽  
Ioannis P. Trontzas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Interleukin 1 ◽  
Severe Pneumonia ◽  
Hospitalized Patients ◽  
Current Evidence ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
The Impact

The role of immunomodulatory agents in the treatment of hospitalized patients with COVID-19 has been of increasing interest. Anakinra, an interleukin-1 inhibitor, has been shown to offer significant clinical benefits in patients with COVID-19 and hyperinflammation. An updated systematic review and meta-analysis regarding the impact of anakinra on the outcomes of hospitalized patients with COVID-19 was conducted. Studies, randomized or non-randomized with adjustment for confounders, reporting on the adjusted risk of death in patients treated with anakinra versus those not treated with anakinra were deemed eligible. A search was performed in PubMed/EMBASE databases, as well as in relevant websites, until 1 August 2021. The meta-analysis of six studies that fulfilled the inclusion criteria (n = 1553 patients with moderate to severe pneumonia, weighted age 64 years, men 66%, treated with anakinra 50%, intubated 3%) showed a pooled hazard ratio for death in patients treated with anakinra at 0.47 (95% confidence intervals 0.34, 0.65). A meta-regression analysis did not reveal any significant associations between the mean age, percentage of males, mean baseline C-reactive protein levels, mean time of administration since symptoms onset among the included studies and the hazard ratios for death. All studies were considered as low risk of bias. The current evidence, although derived mainly from observational studies, supports a beneficial role of anakinra in the treatment of selected patients with COVID-19.

Effects of menstrual cycle and menopause on internal carotid artery shear-mediated dilation in women

2020 ◽  
Author(s):  
Erika Iwamoto ◽  
Rintaro Sakamoto ◽  
Wakako Tsuchida ◽  
Kotomi Yamazaki ◽  
Tatsuki Kamoda ◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Endothelial Function ◽  
Internal Carotid ◽  
Premenopausal Women ◽  
Cycle Phase ◽  
Serum Estradiol ◽  
Cross Sectional ◽  
Potential Index

This study aimed to elucidate the effects of change in estrogen during the menstrual cycle and menopause on shear-mediated dilation of the internal carotid artery (ICA), a potential index of cerebrovascular endothelial function. Shear-mediated dilation of the ICA and serum estradiol were measured in 11 premenopausal (Pre-M, 21±1yrs), 13 perimenopausal (Peri-M, 49±2yrs), and 10 postmenopausal (Post-M, 65±7yrs) women. Measurements were made twice within the Pre-M group at their early follicular (EF, lower estradiol) and late follicular (LF, higher estradiol) phases. Shear-mediated dilation was induced by 3min of hypercapnia (target PETCO2 +10mmHg from individual baseline) and was calculated as the percent rise in peak diameter relative to baseline diameter. ICA diameter and blood velocity were simultaneously measured by Doppler ultrasound. In Pre-M, shear-mediated dilation was higher during the LF phase than during the EF phase (P<0.01). Comparing all groups, shear-mediated dilation was reduced across the menopausal transition (P<0.01), and Pre-M during the LF phase showed the highest value (8.9±1.4%) compared with other groups (Pre-M in EF, 6.4±1.1%; Peri-M, 5.5±1.3%; Post-M, 5.2±1.9%, P<0.05 for all). Shear-mediated dilation was positively correlated with serum estradiol even after adjustment of age (P<0.01, r=0.55, age-adjusted; P=0.02, r=0.35). Collectively, these data indicate that controlling the menstrual cycle phase is necessary for the cross-sectional assessments of shear-mediated dilation of the ICA in premenopausal women. Moreover, current findings suggest that a decline in cerebrovascular endothelial function may be partly related to the reduced circulating estrogen levels in peri- and postmenopausal women.

The role of LHRH agonists in ovarian function preservation in premenopausal women undergoing chemotherapy for early stage breast cancer: A systematic review and meta-analysis.

2015 ◽  
Vol 33 (15_suppl) ◽  
pp. 1050-1050
Author(s):  
Rodrigo Ramella Munhoz ◽  
Allan Andresson Lima Pereira ◽  
Andre Deeke Sasse ◽  
Paulo Marcelo Hoff ◽  
Tiffany A. Traina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Ovarian Function ◽  
Early Stage ◽  
Meta Analysis ◽  
Premenopausal Women ◽  
Early Stage Breast Cancer ◽  
Lhrh Agonists ◽  
Function Preservation

scholarly journals Effect of menstrual cycle phase, menstrual irregularities and hormonal contraceptive use on anterior knee laxity and non-contact anterior cruciate ligament injury occurrence in women: a protocol for a systematic review and meta-analysis

2021 ◽  
Vol 7 (4) ◽  
pp. e001170
Author(s):  
Elisa Nédélec ◽  
Elvis Foli ◽  
Sandra J Shultz ◽  
Paul A Swinton ◽  
Eimear Dolan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Ligament Injury ◽  
Secondary Outcome ◽  
Hormonal Contraceptives ◽  
Cycle Phase ◽  
Acl Injuries ◽  
Anterior Knee

Exercising women report three to six times more ACL tears than men, which happen, in the majority of cases, with a non-contact mechanism. This sex disparity has, in part, been attributed to the differences in reproductive hormone profiles between men and women. Many studies have shown that anterior knee (AK) laxity and the rate of non-contact ACL injuries vary across the menstrual cycle, but these data are inconsistent. Similarly, several studies have investigated the potential protective effect of hormonal contraceptives on non-contact ACL injuries, but their conclusions are also variable. The purpose of this systematic review and meta-analysis is to, identify, evaluate and summarise the effects of endogenous and exogenous ovarian hormones on AK laxity (primary outcome) and the occurrence of non-contact ACL injuries (secondary outcome) in women. We will perform a systematic search for all observational studies conducted on this topic. Studies will be retrieved by searching electronic databases, clinical trial registers, author’s personal files and cross-referencing selected studies. Risk of bias will be assessed using the Newcastle Ottawa Quality Assessment Scale for Cohort and Case–Control Studies. Certainty in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. The meta-analyses will use a Bayesian approach to address specific research questions in a more intuitive and probabilistic manner. This review is registered on the international database of prospectively registered systematic reviews (PROSPERO; CRD42021252365).

scholarly journals The Role of Machine Learning Techniques to Tackle COVID-19 Crisis: A Systematic Review.

2020 ◽  
Author(s):  
Hafsa Bareen Syeda ◽  
Mahanazuddin Syed ◽  
Kevin Wayne Sexton ◽  
Shorabuddin Syed ◽  
Salma Begum ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Disease Progression ◽  
Meta Analysis ◽  
Machine Learning Techniques ◽  
Data Types ◽  
Detection And Diagnosis ◽  
Novel Coronavirus ◽  
The Impact

Background: The novel coronavirus responsible for COVID-19 has caused havoc with patients presenting a spectrum of complications forcing the healthcare experts around the globe to explore new technological solutions, and treatment plans. Machine learning (ML) based technologies have played a substantial role in solving complex problems, and several organizations have been swift to adopt and customize them in response to the challenges posed by the COVID-19 pandemic. Objective: The objective of this study is to conduct a systematic literature review on the role of ML as a comprehensive and decisive technology to fight the COVID-19 crisis in the arena of epidemiology, diagnosis, and disease progression. Methods: A systematic search in PubMed, Web of Science, and CINAHL databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify all potentially relevant studies published and made available between December 1, 2019, and June 27, 2020. The search syntax was built using keywords specific to COVID-19 and ML. A total of 128 qualified articles were reviewed and analyzed based on the study objectives. Results: The 128 publications selected were classified into three themes based on ML applications employed to combat the COVID-19 crisis: Computational Epidemiology (CE), Early Detection and Diagnosis (EDD), and Disease Progression (DP). Of the 128 studies, 70 focused on predicting the outbreak, the impact of containment policies, and potential drug discoveries, which were grouped into the CE theme. For the EDD, we grouped forty studies that applied ML techniques to detect the presence of COVID-19 using the patient's radiological images or lab results. Eighteen publications that focused on predicting the disease progression, outcomes (recovery and mortality), Length of Stay (LOS), and number of Intensive Care Unit (ICU) days for COVID-19 positive patients were classified under the DP theme. Conclusions: In this systematic review, we assembled the current COVID-19 literature that utilized ML methods to provide insights into the COVID-19 themes, highlighting the important variables, data types, and available COVID-19 resources that can assist in facilitating clinical and translational research.

scholarly journals Exacerbation of Psychosis During the Perimenstrual Phase of the Menstrual Cycle: Systematic Review and Meta-analysis

2019 ◽  
Vol 46 (1) ◽  
pp. 78-90 ◽  
Author(s):  
Thomas J Reilly ◽  
Vanessa C Sagnay de la Bastida ◽  
Dan W Joyce ◽  
Alexis E Cullen ◽  
Philip McGuire
Keyword(s):  
Systematic Review ◽  
Menstrual Cycle ◽  
Random Effects ◽  
Psychotic Disorders ◽  
Meta Analysis ◽  
Psychotic Symptoms ◽  
Cycle Phase ◽  
Menstrual Cycle Phase ◽  
Psychiatric Admission ◽  
Admission Rates

Abstract Psychotic disorders can be exacerbated by the hormonal changes associated with childbirth, but the extent to which exacerbations occur with the menstrual cycle is unclear. We addressed this issue by conducting a systematic review. Embase, Medline, and PsychINFO databases were searched for studies that measured exacerbations of psychotic disorders in relation to the menstrual cycle. We extracted exacerbation measure, definition of menstrual cycle phase, and measurement of menstrual cycle phase. Standard incidence ratios were calculated for the perimenstrual phase based on the observed admissions during this phase divided by the expected number of admissions if the menstrual cycle had no effect. Random effects models were used to examine pooled rates of psychiatric admission in the perimenstrual phase. Nineteen studies, comprising 1193 participants were eligible for inclusion. Eleven studies examined psychiatric admission rates, 5 examined symptoms scores, 2 examined self-reported exacerbation, and 1 examined both admission rates and symptom scores. A random effects model demonstrated the rate of admissions during the perimenstrual phase was 1.48 times higher than expected (95% CI: 1.31–1.67), with no significant heterogeneity detected. Four of six symptom score studies reported perimenstrual worsening, but lack of consistency in timepoints precluded meta-analysis. Two studies examining self-reported menstrual exacerbations reported prevalences ranging from 20% to 32.4%. Psychiatric admission rates are significantly higher than expected during the perimenstrual phase. There is some evidence that a worsening of psychotic symptoms also occurs during this phase, but further research with more precise measurement of the menstrual cycle and symptomatology is required.

The Impact of Maternal Preeclampsia and Hyperglycemia on the Cardiovascular Health of the Offspring: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Zahra Hoodbhoy ◽  
Nuruddin Mohammed ◽  
Karim Rizwan Nathani ◽  
Saima Sattar ◽  
Devyani Chowdhury ◽  
...  
Keyword(s):  
Systematic Review ◽  
Body Composition ◽  
Birth Weight ◽  
Vascular Function ◽  
Cardiovascular Health ◽  
Meta Analysis ◽  
The Body ◽  
Cochrane Library ◽  
And Function ◽  
The Impact

Objectives The objective of this review was to assess the impact of maternal preeclampsia or hyperglycemia on the body composition and cardiovascular health in the offspring. Study Design We conducted a systematic review utilizing PubMed, EBSCO, CINAHLPlus, Cochrane Library, and Web of Science to include all studies assessing the impact of preeclampsia/eclampsia and/or gestational/pregestational diabetes mellitus on the health of the offspring (children <10 years of age). The health measures included anthropometry, cardiac dimensions and function, and vascular function. We performed a meta-analysis using Review Manager software and computed net risk ratio (RR) with 95% confidence interval (CI) for dichotomous data and mean difference (MD) with 95% CI for continuous data. Results There were 6,376 studies in total, of which 45 were included in the review and 40 in the meta-analysis. The results demonstrated higher birth weight (MD: 0.12 kg; 95% CI: 0.06–0.18) and systolic and diastolic blood pressure (BP; MD: 5.98 mmHg; 95% CI: 5.64–6.32 and MD: 3.27 mmHg; 95% CI: 0.65–5.89, respectively) in the offspring of mothers with gestational diabetes compared to controls. In contrast, the offspring of mothers with preeclampsia had lower birth weight (MD: −0.41 kg; 95% CI: −0.7 to −0.11); however, they had increased systolic (MD: 2.2 mmHg; 95% CI: 1.28–3.12) and diastolic BP (MD: 1.41 mmHg; 95% CI: 0.3–2.52) compared to controls. There is lack of data to conduct a meta-analysis of cardiac morphology, functional, and vascular imaging parameters. Conclusion These findings suggest that the in-utero milieu can have a permanent impact on the body composition and vascular health of the offspring. Future work warrants multicenter prospective studies to understand the mechanism and the actual effect of exposure to maternal hyperglycemia and high BP on the cardiovascular health of the offspring and long-term outcomes. Key Points

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