Abstract 16310: Association Between the Use of Antithrombotics and Cardiac Implantable Electronic Device Infections: A Systematic Review and Meta-analysis

Introduction: Studies have shown that the use of antiplatelet and anticoagulant increases the risk of cardiac implantable electronic device (CIED) infection following the implantation. However, results were contradicting. In this study, we performed a systematic review and meta-analysis to explore the effect of antiplatelets and anticoagulants and the risk of CIED infection following the implantation. Methods: We searched the databases of MEDLINE and EMBASE from inception to March 2020. Included studies were published studies of patients undergoing CIED implantations which reported effect size of the use of either antiplatelet or anticoagulant, or both, on the risk of CIED infections. CIED infection was defined as either device-related local or systemic infection. Data from each study were combined using the random-effects, generic inverse variance method of Der Simonian and Laird to calculate effect size and 95% confidence intervals (CI). Results: Fifteen studies from 2008-2019 involving a total of 72,028 patients were included. In random-effect model, we found that the use of antiplatelet was not associated with an increased risk of CIED infections (risk ratio (RR) =1.13, 95% CI: 0.89-1.44, p=0.314, I 2 =51.3%), while the use of anticoagulant was associated with increased risk of CIED infections (RR =1.50, 95%CI: 1.02-2.21, p=0.038, I 2 =75%). There was no publication bias observed in the funnel plot as well as no small-study effect observed in Egger’s test. Conclusions: Our meta-analysis demonstrated that the use of anticoagulant significantly increases the risk of CIED infection following the implantation by up to 1.50-fold, however, this effect was not observed with antiplatelet use. Our study suggested that patients on anticoagulation considering CIED implantations should proceed with caution.

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Association between Oral Contraceptives and cutaneous melanoma: a systematic review and metanalysis

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.1093 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

I Giacchetta ◽

M Chiavarini ◽

G Naldini ◽

R Fabiani

Keyword(s):

Systematic Review ◽

Malignant Melanoma ◽

Publication Bias ◽

Oral Contraceptives ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Cutaneous Malignant Melanoma ◽

Hormonal Factors ◽

Increased Risk

Abstract Background The probability of developing invasive cutaneous malignant melanoma (CMM) is higher in women than in men up until the age of 49. Several studies investigated the association between hormonal factors and CMM. The aim of this systematic review and meta-analysis is to summarize the evidence on the association between Oral Contraceptives (OC) and the risk of CMM. Methods This review and meta-analysis follow the PRISMA guidelines. A systematic literature search was conducted on Medline and Web of Science until December 2019. Studies were eligible if reported a risk estimate for the association between OC and CMM. Heterogeneity testing was performed using Cochran's Q and I2 statistics. Publication bias was assessed by Egger's test and Begg's test. Meta-analysis was performed using random effect model. Results The results of the pooled analysis of all 32 studies showed no significant association between OC and the risk of CMM (OR 1.02; 95% CI 0.94-1.11; I2=39.32%, p = 0.013). The stratified analyses by study design found no significant association between OC and the risk of CMM neither in the 18 case-control studies (OR 1.02; 95% CI 0.87-1.21; I2=56.91%, p = 0.002) nor in the 14 cohort studies (OR 1.04; 95% CI 0.98-1.11; I2=0.00%, p = 0.557). No significant publication bias could be detected by Egger's test or Begg's test. Conclusions This meta-analysis of available literature suggests no significant association between OC and the risk of developing CMM. Further investigations are needed to evaluate the possible relationship of OC use and other hormonal factors potentially contributing to the increased risk of CMM in women during their reproductive years. Key messages Oral contraceptives (OC) do not significantly contribute to the risk of Cutaneous Malignant Melanoma (CMM). Further studies are needed to investigate the potential role of other hormonal factors in the increased probability of developing CMM in women during their reproductive years.

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Prevalence, awareness and control of hypertension in Malaysia 1980 – 2017: A Systematic Review and Meta-Analysis

10.1101/625004 ◽

2019 ◽

Author(s):

Zhen Yee Chow ◽

Soo Man Jun ◽

Siew Mooi Ching ◽

Chun Han Tan ◽

Kai Wei Lee ◽

...

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Public Health Problem ◽

High Morbidity ◽

Hypertension Status ◽

Increased Risk ◽

And Control

AbstractBackgroundHypertension is a common public health problem worldwide and is a well-known risk factor for increased risk of cardiovascular diseases, contributing to high morbidity and mortality. However, there is no systematic review and meta-analysis that has been done in a multi-ethnic population like Malaysia. This systematic review aims to determine the trend in prevalence, awareness and control of hypertension in Malaysia.MethodsSystematic searches were conducted in PubMed, Scopus, Ovid, Cumulative Index to Nursing and Allied Health Literature, Malaysian Medical Repository and Malaysia Citation Index published between 1980 and 2017. All original articles in English were included. Studies included were those on adults aged 18 years and above. Studies of prevalence in children and adolescents and pregnancy related hypertension were excluded. Two authors independently reviewed the studies, carried out data extraction and performed quality assessment. Heterogeneity between studies and publication bias was assessed and effect size was pooled by the random effect model.ResultsFifty-six studies with a total of 241,796 subjects were included. The prevalence of hypertension throughout Malaysia varied (I2= 99.3%). The overall pooled prevalence of hypertension over the past 4 decades was 28.2% in adults aged 18 years and older (95% CI: 26.1 – 33.3) and the prevalence in those 30 years and older was 40.0% (95% CI: 35.3-44.8).For subgroup analysis, the prevalence of hypertension in male aged 18 and above was 31.4% (95% CI: 26.5 - 36.2) and 27.8% in female (95% CI: 20.7 – 34.9). The prevalence of hypertension among the ethnic groups aged 18 years and above were 37.3% in Malays (95% CI: 32.9 – 41.7); 36.4% in Chinese (95% CI 31.6 - 41.2) and 34.8% in Indians (95% CI: 31.2-38.4). The prevalence of hypertension was the lowest in the 1980s (16.2%, 95% CI: 13.4-19.0%), increases up to 36.8% in the 1990s (95% CI: 6.1-67.5), then came down to 28.7% (95% CI: 21.7-35.8) in the 2000s and 29.2% (95% CI: 24.0-34.4) in the 2010s. The prevalence of awareness was 38.7% (95% CI: 31.7 – 45.8) whereas the control of hypertension of those on treatment was 33.3% (95% CI: 28.4 – 38.2).ConclusionThree in 10 adults aged 18 years old and above have hypertension, whereas four in 10 adults aged 30 years old and above have hypertension. Four out of 10 are aware of their hypertension status and only one-third of them who were under treatment achieved control of their hypertension. Concerted efforts by policymakers and healthcare professionals to improve the awareness and control of hypertension should be of high priority.

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Association between Anemia and Risk of Parkinson Disease

Behavioural Neurology ◽

10.1155/2021/8360627 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Yao-Chin Wang ◽

Abel Po-Hao Huang ◽

Sheng-Po Yuan ◽

Chu-Ya Huang ◽

Chieh-Chen Wu ◽

...

Keyword(s):

Systematic Review ◽

Parkinson Disease ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Epidemiological Studies ◽

Effect Model ◽

Increased Risk ◽

Male Patients ◽

Risk Ratios

Background and Objective. People with anemia have higher rates of developing Parkinson disease (PD) than the general population. Previous epidemiological studies have invested the risk of PD in patients with anemia. However, the findings are still inconclusive. Therefore, we did a systematic review with meta-analysis to clarify the association between anemia and risk of PD. Methods. We systematically searched articles on electronic databases such as PubMed, Embase, Scopus, and Google Scholar between January 1, 2000 and July 30, 2020. Articles were independently evaluated by two authors. We included observational studies (case-control and cohort) and calculated the risk ratios (RRs) for associated with anemia and PD. Heterogeneity among the studies was assessed using the Q and I 2 statistic. We utilized the random-effect model to calculate the overall RR with 95% CI. Results. A total of 342 articles were identified in the initial searches, and 7 full-text articles were evaluated for eligibility. Three articles were further excluded for prespecified reasons including insufficient data and duplications, and 4 articles were included in our systematic review and meta-analysis. A random effect model meta-analysis of all 4 studies showed no increased risk of PD in patients with anemia ( N = 4 , R R adjusted = 1.17 (95% CI: 0.94-1.45, p = 0.15 ). However, heterogeneity among the studies was significant ( I 2 = 92.60 , p = < 0.0001 ). The pooled relative risk of PD in female patients with anemia was higher ( N = 3 , R R adjusted = 1.14 (95% CI: 0.83-1.57, p = 0.40 ) as compared to male patients with anemia ( N = 3 , R R adjusted = 1.09 (95% CI: 0.83-1.42, p = 0.51 ). Conclusion. This is the first meta-analysis that shows that anemia is associated with higher risk of PD when compared with patients without anemia. However, more studies are warranted to evaluate the risk of PD among patients with anemia.

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Relationship between fluoroquinolones and the risk of aortic diseases: a meta-analysis of observational studies

10.21203/rs.2.16520/v2 ◽

2020 ◽

Author(s):

Xiao-ce Dai ◽

Xin-xin Yang ◽

Lan Ma ◽

Guan-min Tang ◽

Yan-yun Pan ◽

...

Keyword(s):

Observational Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Aortic Diseases ◽

Inverse Variance ◽

Increased Risk ◽

Statistical Heterogeneity ◽

First Occurrence ◽

The Relationship

Abstract Background. Our aim was to determine the relationship between the use of fluoroquinolones and the risk of aortic diseases. Methods. PubMed, EMBASE and the Web of Science were searched from inception to July 6, 2019, to identify observational studies that evaluated the risk of aortic diseases associated in users of fluoroquinolones compared with nonusers or users of other antibiotics. The primary outcome was the first occurrence of aortic diseases. We used the GRADE approach to rate the strength of evidence. We used the inverse variance method random-effect model to estimate the odds ratios (ORs) with 95% CIs, and statistical heterogeneity was assessed by the I 2 statistic. Results. This meta-analysis enrolled 2,829,385 patients reported the relationship between fluoroquinolones and the risk of aortic diseases. Compared with nonusers or users of other antibiotics, users of fluoroquinolone had a significantly increased risk of aortic diseases (adjusted OR, 2.10; 95% CI, 1.65-2.68; P =.000, I 2 =16.4%). The quality of evidence was moderate, and the number needed to harm (NNH) for aortic diseases among patients was estimated to be 1301. Conclusions. The fluoroquinolone use in patients significantly increases the risk of new-onset aortic diseases. Clinicians need to pay attention to these severe adverse events when considering fluoroquinolone use. Key Words: Fluoroquinolones; aortic aneurysm; aortic dissection; meta-analysis

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Association between Smoking and Risk of Primary Biliary Cholangitis: A Systematic Review and Meta-Analysis

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld-181 ◽

2019 ◽

Vol 28 ◽

pp. 197-203

Author(s):

Karn Wijarnpreecha ◽

Monia Werlang ◽

Panadeekarn Panjawatanan ◽

Paul T Kroner ◽

Omar Y Mousa ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Statistical Significance ◽

Random Effect ◽

Primary Biliary Cholangitis ◽

Case Control Studies ◽

Eligibility Criteria ◽

Inverse Variance ◽

Increased Risk ◽

Former Smokers

Background & Aims: Studies have suggested that smokers may have a higher risk of primary biliary cholangitis (PBC) although the results have been inconsistent. This systematic review and meta-analysis aim to better characterize the risk of PBC among smokers by identifying all relevant studies and summarizing their results together. Methods: A comprehensive literature review was conducted using Embase and Pubmed/MEDLINE databases from inception to September 2018 to identify all studies which compared the risk of PBC among current, ever and former smokers to non-smokers. Effect estimates from each study were extracted and combined together using the random-effect, generic inverse variance method of DerSimonian and Laird. Results: Nine case-control studies with 21,577 participants met the eligibility criteria and were included in the meta-analysis. The risk of PBC among ever smokers was significantly higher than non-smokers with the pooled odds ratio (OR) of 1.31 (95% CI, 1.03-1.67; I 2 89%). Subgroup analysis found that the risk was higher in both former smokers (pooled OR 1.36; 95% CI, 1.01-1.84; I 2 75%) and current smokers (pooled OR 1.18; 95% CI, 0.94-1.50; I 2 79%), although the latter did not reach statistical significance. Immunomodulatory and cytotoxic effect of cigarettes were the possible mechanisms behind this increased risk. Conclusions: A significantly increased risk of PBC among individuals who ever smoked was observed in this study, adding to the already long list of harmful health consequences of smoking.

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Vital Bleaching Influences the Bond Strength of Adhesive Systems to Enamel and Dentin: A Systematic Review and Meta-Analysis of In Vitro Studies

Operative Dentistry ◽

10.2341/20-035-lit ◽

2021 ◽

Author(s):

TG Savian ◽

J Oling ◽

FZM Soares ◽

RO Rocha

Keyword(s):

Systematic Review ◽

Bond Strength ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

In Vitro Studies ◽

Adhesive Systems ◽

Inverse Variance ◽

Meta Analyses

Clinical Relevance Vital bleaching impairs the bonding of adhesive systems to enamel and dentin. Thus, restoration placement should be delayed for at least two weeks after completion of bleaching procedures. SUMMARY Objective: This systematic review evaluates the influence of vital bleaching on the bond strength of adhesive systems to enamel and dentin. Methods: This review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). In vitro studies comparing the bond strength of bleached and unbleached enamel and dentin were searched at the electronic databases—PubMed/MEDLINE, Scopus, and Web of Science—with no limit on year or language. The studies were screened and had data extracted by two reviewers independently. Bond strength data were meta-analyzed using the inverse variance method and the random effect model (p≤0.05). Results: The electronic search provided 4941 eligible studies, and 52 were included in the systematic review and the meta-analysis. The global meta-analysis showed that bleaching impairs the bond strength of adhesive systems to enamel and dentin (p<0.001; mean difference [MD]: –0.96; confidence interval [CI]: −1.18 to −0.73), regardless of the bleaching agent (p<0.001; MD: −9.98; CI: −1.37 to −0.58) or substrate (p<0.001; MD: −0.89; CI: −1.12 to −0.66). The detrimental effect of bleaching on bond strength was not observed after two and three weeks after bleaching (p=0.1; MD: −0.39; CI: −0.84 to 0.65; and p=0.18; MD: −0.99; CI: −2.45 to 0.47, respectively). Conclusion: This systematic review and meta-analysis demonstrated that vital bleaching impairs the bonding of adhesive systems to enamel and dentin, and this adverse effect persists for two weeks.

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Relationship between fluoroquinolones and the risk of aortic diseases: a meta-analysis of observational studies

10.21203/rs.2.16520/v3 ◽

2020 ◽

Author(s):

Xiao-ce Dai ◽

Xin-xin Yang ◽

Lan Ma ◽

Guan-min Tang ◽

Yan-yun Pan ◽

...

Keyword(s):

Observational Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Aortic Diseases ◽

Inverse Variance ◽

Increased Risk ◽

Statistical Heterogeneity ◽

First Occurrence ◽

The Relationship

Abstract Background. Our aim was to determine the relationship between the use of fluoroquinolones and the risk of aortic diseases.Methods. PubMed, EMBASE and the Web of Science were searched from inception to July 6, 2019, to identify observational studies that evaluated the risk of aortic diseases associated in users of fluoroquinolones compared with nonusers or users of other antibiotics. The primary outcome was the first occurrence of aortic diseases. We used the GRADE approach to rate the strength of evidence. We used the inverse variance method random-effect model to estimate the odds ratios (ORs) with 95% CIs, and statistical heterogeneity was assessed by the I2 statistic.Results. This meta-analysis enrolled 2,829,385 patients reported the relationship between fluoroquinolones and the risk of aortic diseases. Compared with nonusers or users of other antibiotics, users of fluoroquinolone had a significantly increased risk of aortic diseases (adjusted OR, 2.10; 95% CI, 1.65-2.68; P=.000, I2=16.4%). The quality of evidence was moderate, and the number needed to harm (NNH) for aortic diseases among patients was estimated to be 1301.Conclusions. The fluoroquinolone use in patients significantly increases the risk of new-onset aortic diseases. Clinicians need to pay attention to these severe adverse events when considering fluoroquinolone use.

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Effects of Grief Focused Intervention on the Mental Health of Dementia Caregivers: Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v49i12.4808 ◽

2020 ◽

Author(s):

Haewon BYEON

Keyword(s):

Mental Health ◽

Systematic Review ◽

Quality Assessment ◽

Effect Size ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Dementia Caregivers ◽

Standard Quality ◽

Grief Intervention

Background: The objectives of this study were to systematically review the effects of grief-focused interventions, applied to dementia caregivers, on emotional burden including sadness and to provide baseline information for dementia caregivers to maintain mental health by identifying the effect size of intervention using a meta-analysis. Methods: We evaluated literature published from Jan 1, 2000, to Jun 28, 2019. Consequently, we selected five studies to conduct a systematic review. The Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields was used for conducting a quality assessment on the selected literature. Results: The results of the quality assessment showed that the score ranged from 11 to 24 points: one strong, one good, two adequate, and one limited. When the meta-mean was compared before and after grief intervention, the effect size of the random-effect model was 0.31 (95% CI: -0.07, 0.69) showed ‘intermediate effect’, but the confidence interval was not significant. Conclusion: The grief intervention for dementia caregivers revealed a moderate effect but it was not significant. In order to prove the effectiveness of grief intervention for dementia caregivers, a meta-analysis targeting RCT studies is needed.

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Psoriatic Arthritis and Risk of Vertebral Fracture: A Systematic Review and Meta-analysis

Current Rheumatology Reviews ◽

10.2174/1573397117666210908094349 ◽

2021 ◽

Vol 17 ◽

Author(s):

Nipith Charoenngam ◽

Ben Ponvilawan ◽

Jerapas Thongpiya ◽

Pitchaporn Yingchoncharoen ◽

Patompong Ungprasert

Keyword(s):

Systematic Review ◽

Psoriatic Arthritis ◽

Vertebral Fracture ◽

Cohort Studies ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Eligibility Criteria ◽

Inverse Variance ◽

Independent Review

Objective: This study was conducted in order to determine the association between psoriatic arthritis and risk of vertebral fracture by pooling the evidence from previous studies. Methods: Potentially eligible studies were identified from MEDLINE and EMBASE database from inception to March 2020 using search strategy that comprised of terms for “Psoriatic Arthritis” and “Vertebral Fracture”. Studies were eligible for the meta-analysis if they were cohort studies that included psoriatic arthritis and individuals without psoriasis and followed them for incident vertebral fracture. Studies were also required to report standardized incidence ration, hazard risk ratio or relative risk with related 95% confidence intervals (CI) comparing the incidence of vertebral fracture between the two cohorts. The retrieved point estimates with standard errors from each study were pooled into the final result by the random-effect model, generic inverse variance method. Results: A total of 26,090 articles were identified. After two rounds of independent review by three investigators, we included five cohort studies that met the eligibility criteria in the meta-analysis. PsA is significantly associated with VF the pooled odds ratio of 2.09 (95% CI, 1.11 – 3.96; I2 70%). The funnel plot was fairly asymmetric, thus, the publication bias in favor of studies may present. Conclusions: This systematic review and meta-analysis indicates that psoriatic arthritis patients have a significantly elevated risk of developing vertebral fracture.

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Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis

PLoS ONE ◽

10.1371/journal.pone.0252461 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0252461

Author(s):

Athira Balakrishnan ◽

Sandra Puthean ◽

Gautam Satheesh ◽

Unnikrishnan M. K. ◽

Muhammed Rashid ◽

...

Keyword(s):

Systematic Review ◽

Blended Learning ◽

Effect Size ◽

Meta Analysis ◽

Random Effect ◽

Random Effect Model ◽

Pharmacy Education ◽

Cochrane Library ◽

Control Group ◽

Effect Model

Background & objective Though blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education. Methods PubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify published literature. The retrieved studies from databases were screened for its title and abstracts followed by the full-text in accordance with the pre-defined inclusion and exclusion criteria. Methodological quality was appraised by modified Ottawa scale. Random effect model used for statistical modelling. Key findings A total of 26 studies were included for systematic review. Out of which 20 studies with 4525 participants for meta-analysis which employed traditional teaching in control group. Results showed a statistically significant positive effect size on knowledge (standardized mean difference [SMD]: 1.35, 95% confidence interval [CI]: 0.91 to 1.78, p<0.00001) and skill (SMD: 0.68; 95% CI: 0.19 to 1.16; p = 0.006) using a random effect model. Subgroup analysis of cohort studies showed, studies from developed countries had a larger effect size (SMD: 1.54, 95% CI: 1.01 to 2.06), than studies from developing countries(SMD: 0.44, 95% CI: 0.23 to 0.65, studies with MCQ pattern as outcome assessment had larger effect size (SMD: 2.81, 95% CI: 1.76 to 3.85) than non-MCQs (SMD 0.53, 95% CI 0.33 to 0.74), and BL with case studies (SMD 2.72, 95% CI 1.86–3.59) showed better effect size than non-case-based studies (SMD: 0.22, CI: 0.02 to 0.41). Conclusion BL is associated with better academic performance and achievement than didactic teaching in pharmacy education.

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