Association between statin use and plasma D-dimer levels

SummaryD-dimers, specific breakdown fragments of cross-linked fibrin, are generally used as circulating markers of activated coagulation. Statins influence haemostatic factors, but their effect on plasma D-dimer levels is controversial. Therefore, the aim of this meta-analysis was to evaluate the association between statin therapy and plasma D-dimer levels. We searched PubMed, Web of Science, Cochrane Library, Scopus and EMBASE (up to September 25, 2014) to identify randomised controlled trials (RCTs) investigating the impact of statin therapy on plasma D-dimer levels. Two independent reviewers extracted data on study characteristics, methods and outcomes. Meta-analysis of data from nine RCTs with 1,165 participants showed a significant effect of statin therapy in reducing plasma D-dimer levels (standardised mean difference [SMD]: –0.988 µg/ml, 95 % confidence interval [CI]: –1.590 – –0.385, p=0.001). The effect size was robust in sensitivity analysis and omission of no single study significantly changed the overall estimated effect size. In the subgroup analysis, the effect of statins on plasma D-dimer levels was significant only in the subsets of studies with treatment duration ≥ 12 weeks (SMD: –0.761 µg/ml, 95 %CI: –1.163– –0.360; p< 0.001), and for lipophilic statins (atorvastatin and simvastatin) (SMD: –1.364 µg/ml, 95 % CI: –2.202– –0.526; p=0.001). Hydrophilic statins (pravastatin and rosuvastatin) did not significantly reduce plasma D-dimer levels (SMD: –0.237 µg/ml, 95 %CI: –1.140–0.665, p=0.606). This meta-analysis of RCTs suggests a decrease of plasma D-dimer levels after three months of statin therapy, and especially after treatment with lipophilic statins. Well-designed trials are required to validate these results.Note: The review process for this paper was fully handled by Christian Weber, Editor in Chief.

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The Effectiveness of Dynamic Geometry Software Applications in Learning Mathematics: A Meta-Analysis Study

International Journal of Interactive Mobile Technologies (iJIM) ◽

10.3991/ijim.v15i02.18853 ◽

2021 ◽

Vol 15 (02) ◽

pp. 18

Author(s):

Dadang Juandi ◽

Yaya Sukjaya Kusumah ◽

Maximus Tamur ◽

Krisna Satrio Perbowo ◽

Muhammad Daut Siagian ◽

...

Keyword(s):

High Schools ◽

Effect Size ◽

Meta Analysis ◽

Random Effect Model ◽

Dynamic Geometry ◽

Dynamic Geometry Software ◽

Analysis Study ◽

Mathematical Abilities ◽

Study Characteristics ◽

The Impact

The purpose of this study was to (1) assess the impact of using Dynamic Geometry Software (DGS) on students’ mathematical abilities, (2) determine the differences in effectiveness based on study characteristics in order to help educators decide under what conditions the use of DGS would be suitable in improving students' mathematical abilities. This meta-analysis study investigates 57 effect sizes from 50 articles that have been published in journals, international and domestic proceedings from 2010 to 2020 using the Comprehensive Meta-Analysis (CMA) tool as a calculation tool. Meanwhile, the Hedges coefficient is applied to the calculation of the effect size at the 95% confidence level. Based on a random effect model with a standard error of 0.09, the analysis results have found an overall effect size of 1.07. This means that learning using DGS has a high positive effect on students' mathematical abilities. The effect size of 1.07 explains the average student who uses DGS exceeds 84% math ability of those in conventional classes that are initially equivalent. Analysis of the study characteristics found significant differences in terms of sample size, student to computer ratio, and education level. This research showed the DGS used was more effective under certain conditions. First, it is very effective in sample conditions less than or equal to 30. Second, it provides classrooms with a sufficient number of computers, allowing students to use them individually, which is required to achieve higher effectiveness levels. Third, DGS is effective in high schools and colleges than in junior high schools. These facts can help educators in deciding on the appropriate sample sizes, student to computer ratios, and future levels of education in using DGS.

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Burden of tinea capitis among children in Africa: protocol for a systematic review and meta-analysis of observational studies, 1990–2020

BMJ Open ◽

10.1136/bmjopen-2020-041230 ◽

2020 ◽

Vol 10 (9) ◽

pp. e041230

Author(s):

Felix Bongomin ◽

Ronald Olum ◽

Lauryn Nsenga ◽

Joseph Baruch Baluku

Keyword(s):

Systematic Review ◽

Tinea Capitis ◽

Meta Analysis ◽

Cochrane Library ◽

Trend Test ◽

Qualitative Synthesis ◽

Institutional Review ◽

Ethical Approval ◽

Study Characteristics ◽

The Impact

IntroductionTinea capitis is the most common form of dermatophytosis among children, contributing significantly to the global burden of skin and hair infections. However, an accurate account of its burden in Africa, where most cases are thought to occur, is lacking. We aim to systematically evaluate the burden, aetiology and epidemiological trend of tinea capitis among children over a 30-year period in Africa.Methods and analysisA systematic review will be conducted using Embase, PubMed, African Journals Online, Web of Science and the Cochrane Library of Systematic Review. These resources will be used to identify studies published between 1990 and December 2020, which report the prevalence, aetiology and trend of tinea capitis among children younger than 18 years in Africa. Articles in English and French will be considered. Two independent reviewers will screen the articles for eligibility, and any discrepancies will be resolved by discussion and consensus between the authors. Methodological quality of all studies will be assessed and critically appraised. We will perform a metaregression to assess the impact of study characteristics on heterogeneity and also to correct the meta-analytical estimates for biases. A qualitative synthesis will be performed, and STATA V.16.0 software will be used to estimate the pooled prevalence and aetiology of tinea capitis. The Mann-Kendall trend test will be use to evaluate the trend in the prevalence of tinea capitis over the study period.Ethics and disseminationEthical approval from an institutional review board or research ethics committee is not required for this systematic review and meta-analysis. The results will be published in a peer-reviewed journal and presented in conferences.

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The effectiveness of the loci method as a mnemonic device: Meta-analysis

Quarterly Journal of Experimental Psychology ◽

10.1177/1747021821993457 ◽

2021 ◽

pp. 174702182199345

Author(s):

Conal Twomey ◽

Meike Kroneisen

Keyword(s):

Academic Success ◽

Effect Size ◽

Random Sequence ◽

Meta Analysis ◽

Allocation Concealment ◽

Medium Effect ◽

Mnemonic Device ◽

Random Sequence Generation ◽

Randomised Controlled ◽

The Impact

The “loci method” is a popular mnemonic device that involves visualising and recalling items at specific points along a familiar route. The loci method has been used for thousands of years, and by many successful memory athletes; yet there have been relatively few educational and clinical applications, possibly owing to empirical uncertainty. The current meta-analysis of 13 randomised controlled trials (RCTs) mostly based in university settings demonstrated the effectiveness of the loci method as a mnemonic device, with a medium effect size ( g = 0.65, 95% confidence interval [CI] = [0.45, 0.85]; I2 = 45.5%). The effect size remained at similar levels in further analyses adjusting for publication bias, the impact of removing each study, setting, control conditions, outliers, and number of loci method sessions. High risk of experimental bias was indicated, however, as the vast majority of studies did not report procedures to minimise biases relating to random sequence generation and allocation concealment. Overall, this meta-analysis of predominantly university-based RCTs has provided good initial support for the loci method as a mnemonic device and this may encourage future investigations and applications, particularly in educational settings, where it has the potential to improve recall of information relevant to academic success.

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Effect of Stains on LDL Reduction and Liver Safety: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2018/7092414 ◽

2018 ◽

Vol 2018 ◽

pp. 1-10 ◽

Cited By ~ 5

Author(s):

Xiao Liang ◽

Qin He ◽

Qinghua Zhao

Keyword(s):

Systematic Review ◽

Liver Injury ◽

Statin Therapy ◽

Meta Analysis ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Cochrane Library ◽

Random Effects Models ◽

Liver Safety ◽

Study Characteristics

Background and Aim. Statin is a class of medications used to decrease low-density lipoprotein cholesterol level to prevent cardiovascular disease. However, the risk of hepatic damage caused by statin therapy is still controversial. We conducted a systematic review and meta-analysis summarizing the existing evidence of the effect of statin therapy on incidence of liver injury to clarify whether statin therapy could lead to liver function test abnormalities.Methods. We searched the Cochrane Library, PubMed, and Embase database for the relevant studies update till Jan. 2017 regarding statin therapy and liver injury. Two researchers screened the literature independently by the selection and exclusion criteria. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled using random effects models, and subgroup analyses were performed by study characteristics. This meta-analysis was performed by STATA 13.1 software.Results. Analyses were based on 74,078 individuals from 16 studies. The summary OR of statin therapy was 1.18 (95% CI: 1.01–1.39,p=0.04;I2=0.0%) for liver injury. Subgroup analysis indicated that fluvastatin increased the risk of liver injury significantly (OR, 3.50; 95% CI: 1.07–11.53,p=0.039;I2=0.0%) and dose over 40 mg/daily had an unfavorable effect on the liver damage (OR, 3.62; 95% CI: 1.52–8.65,p=0.004;I2=0.0%). The sensitivity analysis indicated that the results were robust.Conclusion. Our findings confirm that statin therapy substantially increases the risk of liver injury, especially using fluvastatin over 40 mg/d.

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The impact of laparoscopic ovarian drilling on AMH and ovarian reserve: a meta-analysis

Reproduction ◽

10.1530/rep-17-0063 ◽

2017 ◽

Vol 154 (1) ◽

pp. R13-R21 ◽

Cited By ~ 19

Author(s):

Saad A Amer ◽

Tarek T El Shamy ◽

Cathryn James ◽

Ali H Yosef ◽

Ahmed A Mohamed

Keyword(s):

Ovarian Reserve ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Pooled Analysis ◽

Cochrane Library ◽

Laparoscopic Ovarian Drilling ◽

Ovarian Drilling ◽

Randomised Controlled ◽

Ovarian Reserve Markers ◽

The Impact

Laparoscopic ovarian drilling (LOD) has been widely used as an effective treatment of anovulatory women with polycystic ovarian syndrome (PCOS). However, there has been a growing concern over a possible damaging effect of this procedure on ovarian reserve. The objective of this study was to investigate the hypothesis that LOD compromises ovarian reserve as measured by post-operative changes in circulating anti-Müllerian hormone (AMH). This meta-analysis included all cohort studies as well as randomised controlled trials (RCTs) investigating serum AMH concentrations and other ovarian reserve markers in women with PCOS undergoing LOD. Various databases were searched including MEDLINE, EMBASE, Dynamed Plus, ScienceDirect, TRIP database, ClinicalTrials.gov and Cochrane Library from January 2000 to December 2016. Sixty studies were identified, of which seven were deemed eligible for this review. AMH data were extracted from each study and entered into the RevMan software to calculate the weighted mean difference (WMD) between pre- and post-operative values. Pooled analysis of all studies (n = 442) revealed a statistically significant decline in serum AMH concentration after LOD (WMD −2.13 ng/mL; 95% confidence interval (CI) −2.97 to −1.30). Subgroup analysis based on duration of follow-up, AMH kit, laterality of surgery and amount of energy applied during LOD consistently showed a statistically significant fall in serum AMH concentration. In conclusion, although LOD seems to markedly reduce circulating AMH, it remains uncertain whether this reflects a real damage to ovarian reserve or normalisation of the high pre-operative serum AMH levels. Further long-term studies on ovarian reserve after LOD are required to address this uncertainty.

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Abstract 18967: Analysis of Vitamin D Levels in Patients With and Without Statin-induced Myalgia - A Systematic Review and Meta-analysis of 7 Studies with 2416 Patients

Circulation ◽

10.1161/circ.130.suppl_2.18967 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Marta Michalska-Kasiczak ◽

Amirhossein Sahebkar ◽

Dimitri P Mikhailidis ◽

Jacek Rysz ◽

Paul Muntner ◽

...

Keyword(s):

Vitamin D ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Final Analysis ◽

Vitamin D Supplementation ◽

Cochrane Library ◽

Increased Risk ◽

Vitamin D Levels ◽

Study Characteristics ◽

The Impact

Introduction: Vitamin D (vit D) deficiency may be associated with an increased risk of statin-related muscle complaints, and symptomatic myalgia in statin-treated patients. Hypothesis: The aim of this meta-analysis was to investigate whether subjects with statin-induced myalgia have lower serum vit D levels compared with those who are asymptomatic. Methods: We searched PubMed, Web of Science, Cochrane Library, Scopus and EMBASE (up to March 2014) to identify studies that investigated the impact of vit D levels in statin-treated subjects with and without myalgia. Two independent reviewers extracted data on study characteristics, methods and outcomes. Results: The electronic search yielded 437 articles, of those 20 were scrutinized in the full text, of which 13 studies were considered unsuitable. The final analysis included 7 studies with 2416 statin-treated patients divided to subgroups of patients with (n = 666 [27.6%]) or without (n = 1750) myalgia. The combination of data from individual observational studies revealed a significantly lower vit D plasma concentration in the statin-induced myalgia compared with the asymptomatic subgroup with weighted mean difference -9.41 ng/mL(95% confidence interval (Cl): -10.17 to -8.64; p < 0.00001) (figure) . Conclusions: This meta-analysis provides evidence that low vit D levels are associated with myalgia in patients on statin therapy. Well-designed, randomized controlled trials are necessary to establish whether vitamin D supplementation reduces risk for statin myalgia in patients with vitamin D deficiency.

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Indicated preventive interventions for anxiety in children and adolescents: a review and meta-analysis of school based programs

10.31234/osf.io/jadxq ◽

2019 ◽

Author(s):

Siobhan Hugh-Jones ◽

Sophie Beckett ◽

Pavan Mallikarjun

Keyword(s):

Meta Analysis ◽

Child And Adolescent ◽

Sensitivity Analyses ◽

Cochrane Library ◽

Control Groups ◽

Adolescent Anxiety ◽

School Based ◽

Intervention Intensity ◽

Randomised Controlled ◽

And Control

Schools are promising sites for the delivery of prevention and early intervention programs to reduce child and adolescent anxiety. It is unclear whether universal or targeted approaches are most effective. This review and meta-analysis examines the effectiveness of school-based indicated interventions and was registered with PROSPERO [CRD42018087628].MEDLINE, EMBASE, PsycINFO and the Cochrane Library were searched for randomised controlled trials comparing indicated school programs for child and adolescent anxiety to active or inactive control groups. Twenty original studies, with 2076 participants, met the inclusion criteria and 18 were suitable for meta-analysis. Sub-group and sensitivity analyses explored intervention intensity, delivery agent and control type. A small beneficial effect was found for indicated programs compared to controls on self-reported anxiety symptoms at post-test (g = -0.28, CI = -0.50, -0.05, k= 18). The small effect was maintained at 6 (g = -0.35, CI= -0.58, -0.13, k = 9) and 12 months (g = -0.24, CI = -0.48, 0.00, k = 4). Based on two studies, >12 month effects were very small (g = -0.01, CI= -0.38, 0.36). No differences were found based on intervention intensity, delivery agent and control type. There was evidence of publication bias and a relatively high risk of contamination in studies. Findings support the value of school based indicated programs for child and adolescent anxiety. Effects at 12 months outperform many universal programs. High quality, randomised controlled and pragmatic trials are needed, with attention control groups and beyond 12 month diagnostic assessments are needed.

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Psychological interventions as an alternative and add-on to antidepressant medication to prevent depressive relapse: systematic review and meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.2020.198 ◽

2020 ◽

pp. 1-8

Author(s):

Josefien Johanna Froukje Breedvelt ◽

Maria Elisabeth Brouwer ◽

Mathias Harrer ◽

Maria Semkovska ◽

David Daniel Ebert ◽

...

Keyword(s):

Psychological Intervention ◽

Meta Analysis ◽

Antidepressant Medication ◽

Cochrane Library ◽

Psychological Interventions ◽

Relapse Risk ◽

Increased Risk ◽

Antidepressant Use ◽

Randomised Controlled ◽

Risk Of Relapse

Background After remission, antidepressants are often taken long term to prevent depressive relapse or recurrence. Whether psychological interventions can be a viable alternative or addition to antidepressants remains unclear. Aims To compare the effectiveness of psychological interventions as an alternative (including delivered when tapering antidepressants) or addition to antidepressants alone for preventing depressive relapse. Method Embase, PubMed, the Cochrane Library and PsycINFO were searched from inception until 13 October 2019. Randomised controlled trials (RCTs) with previously depressed patients in (partial) remission where preventive psychological interventions with or without antidepressants (including tapering) were compared with antidepressant control were included. Data were extracted independently from published trials. A random-effects meta-analysis on time to relapse (hazard ratio, HR) and risk of relapse (risk ratio, RR) at the last point of follow-up was conducted. PROSPERO ID: CRD42017055301. Results Among 11 included trials (n = 1559), we did not observe an increased risk of relapse for participants receiving a psychological intervention while tapering antidepressants versus antidepressants alone (RR = 1.02, 95% CI 0.84–1.25; P = 0.85). Psychological interventions added to antidepressants significantly reduced the risk of relapse (RR = 0.85, 95% CI 0.74–0.97; P = 0.01) compared with antidepressants alone. Conclusions This study found no evidence to suggest that adding a psychological intervention to tapering increases the risk of relapse when compared with antidepressants alone. Adding a psychological intervention to antidepressant use reduces relapse risk significantly versus antidepressants alone. As neither strategy is routinely implemented these findings are relevant for patients, clinicians and guideline developers.

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Repetitive transcranial magnetic stimulation treatment for peripartum depression: systematic review & meta-analysis

BMC Pregnancy and Childbirth ◽

10.1186/s12884-021-03600-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hyune June Lee ◽

Sung Min Kim ◽

Ji Yean Kwon

Keyword(s):

Systematic Review ◽

Transcranial Magnetic Stimulation ◽

Side Effects ◽

Electroconvulsive Therapy ◽

Effect Size ◽

Magnetic Stimulation ◽

Repetitive Transcranial Magnetic Stimulation ◽

Meta Analysis ◽

Cochrane Library ◽

Peripartum Depression

Abstract Background Peripartum depression is a common disorder with very high potential hazards for both the patients and their babies. The typical treatment options include antidepressants and electroconvulsive therapy. However, these treatments do not ensure the safety of the fetus. Recently, repetitive transcranial magnetic stimulation has emerged as a promising treatment for neuropathies as well as depression. Nevertheless, many studies excluded pregnant women. This systematic review was conducted to confirm whether repetitive transcranial magnetic stimulation was a suitable treatment option for peripartum depression. Methods We performed a systematic review that followed the PRISMA guidelines. We searched for studies in the MEDLINE, PsycINFO, EMBASE, and Cochrane library databases published until the end of September 2020. Eleven studies were selected for the systematic review, and five studies were selected for quantitative synthesis. Data analysis was conducted using Comprehensive Meta-Analysis 3 software. The effect size was analyzed using the standardized mean difference, and the 95% confidence interval (CI) was determined by the generic inverse variance estimation method. Results The therapeutic effect size of repetitive transcranial magnetic stimulation for peripartum depression was 1.394 (95% CI: 0.944–1.843), and the sensitivity analysis effect size was 1.074 (95% CI: 0.689–1.459), indicating a significant effect. The side effect size of repetitive transcranial magnetic stimulation for peripartum depression was 0.346 (95% CI: 0.214–0.506), a meaningful result. There were no severe side effects to the mothers or fetuses. Conclusions From various perspectives, repetitive transcranial magnetic stimulation can be considered an alternative treatment to treat peripartum depression to avoid exposure of fetuses to drugs and the severe side effects of electroconvulsive therapy. Further research is required to increase confidence in the results.

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Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

The American Surgeon ◽

10.1177/0003134821989034 ◽

2021 ◽

pp. 000313482198903

Author(s):

Mitsuru Ishizuka ◽

Norisuke Shibuya ◽

Kazutoshi Takagi ◽

Hiroyuki Hachiya ◽

Kazuma Tago ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Significant Difference ◽

The Cochrane Library ◽

The Impact ◽

The Relationship ◽

Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

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