Abstract P269: Cardio-Ankle Vascular Index and the Risk of Cardiovascular Outcomes and All-cause Mortality: A Systematic Review

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Ning Ding ◽  
Esther Kim

Introduction: Arterial stiffness is widely used as an index of arteriosclerosis and is associated with cardiovascular disease (CVD). Recently, cardio-ankle vascular index (CAVI) was developed as a measurement of arterial stiffness that is independent of blood pressure at the time of arterial stiffness evaluation. The associations of CAVI with CVD events and all-cause mortality have not been extensively assessed. We therefore systematically reviewed the studies reporting CAVI and relevant outcomes. Methods: We searched for both prospective and cross-sectional studies using MEDLINE, Embase, and Cochrane from inception to April 11, 2017. Two independent reviewers screened the retrieved papers, extracted relevant data and assessed the risk of bias. Any discrepancy was solved by discussion or a third reviewer. Heterogeneity among studies was assessed using the I 2 statistic. We pooled the results of studies that were sufficiently homogeneous. Results: Among 1,519 records, we identified 9 cohort studies (n=5,292) and 17 cross-sectional eligible studies (n=7,309). All 9 cohort studies reported the outcome of composited CVD (498 cases), but the categorization/modeling of CAVI was not consistent across those studies. The pooled hazard ratio (HR) of CVD for the highest vs. lowest CAVI category in 3 studies was borderline significant (pooled HR=1.34 [0.95, 1.87], p=0.092) (I 2 = 25.2%, p=0.263). For 3 studies examining the continuous association between CAVI and CVD, 1standard deviation (SD) increment of CAVI was significantly associated with CVD risk (pooled HR=1.22 [1.03, 1.45], p=0.023) (I 2 = 27.1%, p=0.253). Only 3 cohort studies investigated CAVI and all-cause mortality, and none of them reported a significant association. All 17 cross-sectional studies reported higher CAVI values in patients with CVD compared to those without CVD, with statistical significance in most studies. Conclusions: CAVI was generally higher in patients with CVD compared to their counterparts. In terms of the prospective prognostic value of CAVI, we found a limited number of studies, but they indicated a modest association between CAVI and CVD risk. Our systematic review highlighted the need for large prospective studies to assess the usefulness of CAVI as a predictor of CVD and mortality.

2021 ◽  
Author(s):  
Lisbeth Lund ◽  
Ida Nielsen Sølvhøj ◽  
Dina Danielsen ◽  
Susan Andersen

Abstract Background In recent years, there has been an increasing interest in whether the use of electronic media affects children and young adolescents' sleep. We performed a systematic review of the association between electronic media use and sleep outcomes among 0-15-year-olds.Methods Searches were carried out in four databases (CINAHL, Web of Science, EMBASE, and Medline). Additional studies were identified by hand-searching reference lists of retrieved systematic reviews and meta-analyses. Inclusion criteria were age range from 0 to 15.9 years, in English, and intervention studies, cohort studies, and cross-sectional studies from western countries. Qualitative studies were excluded due to a low number of identified studies. Exclusion criteria were study populations with psychiatric diagnoses, obesity, or any sleep disorder. Results The search identified 10,719 unique studies, of which 108 fulfilled the inclusion and exclusion criteria and were assessed for methodological quality. In total, 49 studies were included in the review. The study designs were randomized controlled trials (n=3), quasi-experimental studies (n=two), prospective cohort studies (n=15), and cross-sectional studies (n=29). Evidence for an association between electronic media use and sleep duration was identified; particularly excessive electronic media use and bedtime use. The evidence was stronger for 6-15-years-olds than 0-5-year-olds. The relationship between electronic media use and other sleep outcomes was more inconclusive. Conclusions Overall, electronic media use was generally associated with shorter sleep duration in children and adolescents aged 0-15. Studies with stronger research design and of higher quality are needed to draw solid conclusions about electronic media’s impact on sleep outcomes and gain better understands of the mechanisms behind the associations. Public awareness and interventions could be promoted about the potential negative impact on children's sleep duration of electronic media devices that are used excessively and close to bedtime.


2021 ◽  
Vol 12 ◽  
Author(s):  
Yingying Cai ◽  
Fei Feng ◽  
Qianqian Wei ◽  
Zheng Jiang ◽  
Ruwei Ou ◽  
...  

Background: Parkinson's disease (PD) and sarcopenia are two common diseases in aging people. To date, the prevalence of sarcopenia in PD patients and the relationship between clinical features and sarcopenia in PD patients are not clear. The aim of the study was to (1) assess the prevalence of sarcopenia in PD patients and (2) reveal the clinical features between PD patients with and without sarcopenia.Method: A systematic review was carried out through screening PubMed, EMBASE, and Cochrane database in May 2020. All study designs (case–control, cohort, and cross-sectional studies) were eligible for meta-analysis. Data of patients' characteristics, sarcopenia criteria, sarcopenia prevalence, and sarcopenia measures were retrieved. The primary outcome was estimated prevalence of sarcopenia by a pooled prevalence (%) and its 95% confidence interval (CI), using a random-effects model. The secondary outcome was the differences in clinical features between PD patients with and without sarcopenia by meta-analysis. Included articles were assessed for risk of bias. Potential sources of variation were investigated by using subgroup analyses and meta-regression.Result: Ten studies were included in the review. Among them, nine were cross-sectional studies, and one was a prospective cohort study. Age of participants with PD in the studies ranged from 51.1 to 80.7 years. The estimated prevalence of sarcopenia ranged from 6 to 55.5%. The random-effects pooled prevalence was 29% (95% CIs: 0.18–0.40). When only studies at low risk of bias were considered, pooled prevalence decreased to 17% (95% CIs: 0.02–0.33), with still high heterogeneity. The incidence of falls in PD patients with sarcopenia was higher than that in PD patients without sarcopenia. There was no difference in sex ratio between PD patients with and without sarcopenia.Conclusion: Sarcopenia seems to be common in patients with PD. Early assessment of sarcopenia should be implemented in PD to avoid fall and disability.


Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Sikarin Upala ◽  
Anawin Sanguankeo

Background: Studies have shown that patients with psoriasis have higher risk of CVD, independent of traditional CVD risk factors. However, pathophysiology of the development of CVD in psoriasis is not well known. Arterial stiffness has been recognized as an independent predictor of cardiovascular risk. It is controversial whether psoriasis and arterial stiffness is associated. In this systematic review and meta-analysis, we sought to assess the hypothesis that patients with psoriasis have increased arterial stiffness compared with controls. Methods: Systematic literature search was performed using MEDLINE and EMBASE databases from inception to May 2016. We included original research publications that contained data on arterial stiffness and psoriasis. Aortic pulse wave velocity (aPWV) is the non-invasive marker for assessment of arterial stiffness. We compared aPWV between patients with psoriasis and controls and estimated the pooled mean difference (MD) and 95% confidence interval (CI) of aPWV using a random-effects model meta-analysis. Results: Data from five observational studies involving 438 participants (233 with psoriasis) were extracted and included in the meta-analysis. Pooled MD of aPWV was 1.17 m/sec higher in patients with psoriasis compared with controls (95% CI: 0.78-1.55, P-value<0.01, I 2 = 69%). There is no change in the direction or statistical significance of MD of aPWV after removing each study at a time in the sensitivity analysis. Conclusion: Psoriasis is associated with increased arterial stiffness. Assessment of arterial stiffness parameters may be important for early detection of cardiovascular deterioration in psoriasis patients.


2020 ◽  
pp. 1-11 ◽  
Author(s):  
G. Pagliai ◽  
M. Dinu ◽  
M. P. Madarena ◽  
M. Bonaccio ◽  
L. Iacoviello ◽  
...  

Abstract Increasing evidence suggests that high consumption of ultra-processed foods (UPF) is associated with an increase in non-communicable diseases, overweight and obesity. The present study systematically reviewed all observational studies that investigated the association between UPF consumption and health status. A comprehensive search of MEDLINE, Embase, Scopus, Web of Science and Google Scholar was conducted, and reference lists of included articles were checked. Only cross-sectional and prospective cohort studies were included. At the end of the selection process, twenty-three studies (ten cross-sectional and thirteen prospective cohort studies) were included in the systematic review. As regards the cross-sectional studies, the highest UPF consumption was associated with a significant increase in the risk of overweight/obesity (+39 %), high waist circumference (+39 %), low HDL-cholesterol levels (+102 %) and the metabolic syndrome (+79 %), while no significant associations with hypertension, hyperglycaemia or hypertriacylglycerolaemia were observed. For prospective cohort studies evaluating a total population of 183 491 participants followed for a period ranging from 3·5 to 19 years, highest UPF consumption was found to be associated with increased risk of all-cause mortality in five studies (risk ratio (RR) 1·25, 95 % CI 1·14, 1·37; P < 0·00001), increased risk of CVD in three studies (RR 1·29, 95 % CI 1·12, 1·48; P = 0·0003), cerebrovascular disease in two studies (RR 1·34, 95 % CI 1·07, 1·68; P = 0·01) and depression in two studies (RR 1·20, 95 % CI 1·03, 1·40; P = 0·02). In conclusion, increased UPF consumption was associated, although in a limited number of studies, with a worse cardiometabolic risk profile and a higher risk of CVD, cerebrovascular disease, depression and all-cause mortality.


2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mohammad Almohideb

Background. Large epidemiological studies on patterns of skin diseases in Saudi Arabia are scarce. Therefore, this systematic review and meta-analysis was conducted to gather available epidemiologic data describing the pattern of skin diseases in different geographical areas in Saudi Arabia. Methods. A comprehensive literature search of articles was conducted in PubMed, SCOPUS, and Web of Science through October 2019. We included all published cross-sectional studies that provided data on relevant incidence or prevalence of skin disease in Saudi Arabia. The risk of bias within the included cross-sectional studies was assessed using the Hoy tool for the prevalence studies. All statistical analysis was performed using the Comprehensive Meta-analysis software. Results. The present meta-analysis included 14 studies that reported the frequency of the skin disease patterns in different regions in Saudi Arabia with a total sample size of 30436 patients with an overall low risk of bias. The diseases of skin appendages and dermatitis were the most commonly reported skin diseases in Saudi Arabia (24.8% (95% CI, 24.3–25.3) and 24% (95% CI, 23.6%–24.6%), respectively). Skin infection represented about 18.5% (95% CI, 18.1%–19%), while the papulosquamous disorders represented 5.3% (95% CI, 5%–5.6%) of the skin diseases in Saudi Arabia. Skin cancers were pooled from only two studies. Basal cell carcinoma and squamous cell carcinoma were the most common malignant neoplasm in Saudi Arabia (51.4% and 22.5% of the malignant neoplasm, respectively), while malignant melanoma represents only 3.8% of the malignant skin cancer. Conclusion. Adnexal disorders and dermatitis are the most common skin disease in Saudi Arabia, followed by skin infection and pigmentary disorders. While skin cancer is more frequent than other countries, awareness campaigns should be initiated to increase knowledge about the harmful effect of long-term sun exposure.


2021 ◽  
pp. jnnp-2021-326405
Author(s):  
Jonathan P Rogers ◽  
Cameron J Watson ◽  
James Badenoch ◽  
Benjamin Cross ◽  
Matthew Butler ◽  
...  

There is accumulating evidence of the neurological and neuropsychiatric features of infection with SARS-CoV-2. In this systematic review and meta-analysis, we aimed to describe the characteristics of the early literature and estimate point prevalences for neurological and neuropsychiatric manifestations. We searched MEDLINE, Embase, PsycINFO and CINAHL up to 18 July 2020 for randomised controlled trials, cohort studies, case-control studies, cross-sectional studies and case series. Studies reporting prevalences of neurological or neuropsychiatric symptoms were synthesised into meta-analyses to estimate pooled prevalence. 13 292 records were screened by at least two authors to identify 215 included studies, of which there were 37 cohort studies, 15 case-control studies, 80 cross-sectional studies and 83 case series from 30 countries. 147 studies were included in the meta-analysis. The symptoms with the highest prevalence were anosmia (43.1% (95% CI 35.2% to 51.3%), n=15 975, 63 studies), weakness (40.0% (95% CI 27.9% to 53.5%), n=221, 3 studies), fatigue (37.8% (95% CI 31.6% to 44.4%), n=21 101, 67 studies), dysgeusia (37.2% (95% CI 29.8% to 45.3%), n=13 686, 52 studies), myalgia (25.1% (95% CI 19.8% to 31.3%), n=66 268, 76 studies), depression (23.0% (95% CI 11.8% to 40.2%), n=43 128, 10 studies), headache (20.7% (95% CI 16.1% to 26.1%), n=64 613, 84 studies), anxiety (15.9% (5.6% to 37.7%), n=42 566, 9 studies) and altered mental status (8.2% (95% CI 4.4% to 14.8%), n=49 326, 19 studies). Heterogeneity for most clinical manifestations was high. Neurological and neuropsychiatric symptoms of COVID-19 in the pandemic’s early phase are varied and common. The neurological and psychiatric academic communities should develop systems to facilitate high-quality methodologies, including more rapid examination of the longitudinal course of neuropsychiatric complications of newly emerging diseases and their relationship to neuroimaging and inflammatory biomarkers.


Author(s):  
Katrina R Kissock ◽  
Elizabeth P Neale ◽  
Eleanor J Beck

ABSTRACT Within epidemiological and intervention studies, whole grain consumption has generally shown positive associations with reductions in markers of overweight and obesity. However, studies use varied methods of determining whole grain intake, including different definitions of a whole grain food, which may explain varied results. This systematic review aimed to identify how different methods of reporting and calculating whole grain intake, including whole grain food definitions, affect reported associations between whole grain intake and body weight measures in adults. Systematic searching of PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Central Register for Controlled Trials (CENTRAL), and MEDLINE (all years to 11 June, 2020) identified eligible studies. Cohort and cross-sectional studies assessing whole grain intake and body weight measures in adults were included. Studies that did not specify methods used to calculate whole grain intake were excluded. Twenty-one cross-sectional studies (from 24 articles) and 9 prospective cohort studies (from 7 articles) were included in the review. Many cross-sectional studies showed whole grain intake was, to some degree, significantly associated with body weight measures, whereas associations varied greatly among cohort studies. Studies calculating whole grain intake using total grams of intake, USDA databases, or ≥25% whole grain in combination with listing specific foods, showed consistent beneficial effects of increasing whole grain intake on body weight. Studies with general lists of foods included as “whole grain foods” or lower cut-offs for whole grain content were inconsistent. The majority of studies reported whole grain intake as servings/day or grams whole grain/day. This review suggests that an association between whole grain and body weight measures remains likely, although precise associations are difficult to determine due to heterogeneity in methodologies and an inability to formally compare studies. Moving forward, application of a standardized methodology to calculate whole grain intake is essential.


2021 ◽  
Author(s):  
Akio Tada ◽  
Rumi Tano ◽  
Hiroko Miura

Abstract Understanding association between tooth loss and hypertension is important for improving cardiovascular health. We searched for publications that were published between July 2011 and June 2021 using three electronic databases (PubMed, EMBASE, and Scopus) and conducted a systematic review and meta-analysis on the association between tooth loss and hypertension. Quality assessments were performed using the Critical Appraisal Skills Program guideline, Newcastle–Ottawa Scale and the GRADE approach. Twenty studies (17 cross-sectional studies, and 3 cohort studies) met the inclusion criteria for this review. Most cross-sectional studies showed that subjects with more tooth loss exhibited a greater proportion of hypertension and higher systolic blood pressure than those with less tooth loss. Meta-analyses revealed a statistically significant association between tooth loss and hypertension. The pooled ORFs of hypertension for having tooth loss with no tooth loss and for edentulous with dentate were 2.22 (95% CI 2.00-2.45) and 4.94 (95% CI: 4.04–6.05), respectively. In cohort studies, subjects with more tooth loss had a greater incidence of hypertension than those with less tooth loss during the follow-up period. The present systematic review and meta-analysis suggested that tooth loss is associated with an increased risk of hypertension and higher systolic blood pressure.


2021 ◽  
Author(s):  
Jonathan P Rogers ◽  
Cameron Watson ◽  
James Badenoch ◽  
Benjamin Cross ◽  
Matthew Butler ◽  
...  

Objectives There is accumulating evidence of the neurological and neuropsychiatric features of infection with SARS-CoV-2. In this systematic review and meta-analysis, we aimed to describe the characteristics of the early literature and estimate point prevalences for neurological and neuropsychiatric manifestations. Methods We searched MEDLINE, Embase, PsycInfo and CINAHL up to 18 July 2020 for randomised controlled trials, cohort studies, case-control studies, cross-sectional studies and case series. Studies reporting prevalences of neurological or neuropsychiatric symptoms were synthesised into meta-analyses to estimate pooled prevalence. Results 13,292 records were screened by at least two authors to identify 215 included studies, of which there were 37 cohort studies, 15 case-control studies, 80 cross-sectional studies and 83 case series from 30 countries. 147 studies were included in the meta-analysis. The symptoms with the highest prevalence were anosmia (43.1% [35.2-51.3], n=15,975, 63 studies), weakness (40.0% [27.9-53.5], n=221, 3 studies), fatigue (37.8% [31.6-44.4], n=21,101, 67 studies), dysgeusia (37.2% [30.0-45.3], n=13,686, 52 studies), myalgia (25.1% [19.8-31.3], n=66.268, 76 studies), depression (23.0 % [11.8-40.2], n=43,128, 10 studies), headache (20.7% [95% CI 16.1-26.1], n=64,613, 84 studies), anxiety (15.9% [5.6-37.7], n=42,566, 9 studies) and altered mental status (8.2% [4.4-14.8], n=49,326, 19 studies). Heterogeneity for most clinical manifestations was high. Conclusions Neurological and neuropsychiatric symptoms of COVID-19 in the pandemic's early phase are varied and common. The neurological and psychiatric academic communities should develop systems to facilitate high-quality methodologies, including more rapid examination of the longitudinal course of neuropsychiatric complications of newly emerging diseases and their relationship to neuroimaging and inflammatory biomarkers.


PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259317
Author(s):  
Alvaro Quincho-Lopez ◽  
Christeam A. Benites-Ibarra ◽  
Maryori M. Hilario-Gomez ◽  
Renatta Quijano-Escate ◽  
Alvaro Taype-Rondan

Background Previous studies have assessed the prevalence and characteristics of self-medication in COVID-19. However, no systematic review has summarized their findings. Objective We conducted a systematic review to assess the prevalence of self-medication to prevent or manage COVID-19. Methods We used different keywords and searched studies published in PubMed, Scopus, Web of Science, Embase, two preprint repositories, Google, and Google Scholar. We included studies that reported original data and assessed self-medication to prevent or manage COVID-19. The risk of bias was assessed using the Newcastle–Ottawa Scale (NOS) modified for cross-sectional studies. Results We identified eight studies, all studies were cross-sectional, and only one detailed the question used to assess self-medication. The recall period was heterogeneous across studies. Of the eight studies, seven assessed self-medication without focusing on a specific symptom: four performed in the general population (self-medication prevalence ranged between <4% to 88.3%) and three in specific populations (range: 33.9% to 51.3%). In these seven studies, the most used medications varied widely, including antibiotics, chloroquine or hydroxychloroquine, acetaminophen, vitamins or supplements, ivermectin, and ibuprofen. The last study only assessed self-medication for fever due to COVID-19. Most studies had a risk of bias in the “representativeness of the sample” and “assessment of outcome” items of the NOS. Conclusions Studies that assessed self-medication for COVID-19 found heterogeneous results regarding self-medication prevalence and medications used. More well-designed and adequately reported studies are warranted to assess this topic.


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