Opioids and the Risk of Motor Vehicle Collision: A Systematic Review

2021 ◽  
pp. 875512252110599
Author(s):  
Silvia J. Leon ◽  
Aaron Trachtenberg ◽  
Derek Briscoe ◽  
Maira Ahmed ◽  
Ingrid Hougen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dose Response ◽  
Motor Vehicle ◽  
Motor Vehicle Collision ◽  
Prescription Opioid ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Opioid Prescription ◽  
Vehicle Collision ◽  
Increased Risk

Background: Opioid analgesics are among the most commonly prescribed medications, but questions remain regarding their impact on the day-to-day functioning of patients including driving. We set out to perform a systematic review on the risk of motor vehicle collision (MVC) associated with prescription opioid exposure. Method: We searched Medline, PubMed, EMBASE, Scopus, and TRID from January 1990 to August 31, 2021 for primary studies assessing prescribed opioid use and MVCs. Results: We identified 14 observational studies that met inclusion criteria. Among those, 8 studies found an increased risk of MVC among those participants who had a concomitant opioid prescription at the time of the MVC and 3 found no significant increase of culpability of fatal MVC. The 3 studies that evaluated the presence of a dose-response relationship between the dose of opioids taken and the effects on MVC risk reported the existence of a dose-response relationship. Due to the heterogeneity of the different studies, a quantitative meta-analysis to sum evidence was deemed unfeasible. Our review supports increasing evidence on the association between motor vehicle collisions and prescribed opioids. This research would guide policies regarding driving legislation worldwide. Conclusion: Our review indicates that opioid prescriptions are likely associated with an increased risk of MVCs. Further studies are warranted to strengthen this finding, and investigate additional factors such as individual opioid medications, opioid doses and dose adjustments, and opioid tolerance for their effect on MVC risk.

Alcohol consumption as a risk factor for pneumonia: a systematic review and meta-analysis

2010 ◽  
Vol 138 (12) ◽  
pp. 1789-1795 ◽  
Author(s):  
A. V. SAMOKHVALOV ◽  
H. M. IRVING ◽  
J. REHM
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Dose Response ◽  
Meta Analysis ◽  
Alcohol Use Disorders ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Increased Risk

SUMMARYThe aim of this study was to quantify the association between alcohol consumption and incidence of pneumonia and to examine possible pathways. This was done by a systematic review and meta-analyses on the dose–response relationship between alcohol consumption or alcohol-use disorders and the incidence of community-acquired pneumonia (CAP). The relative risk (RR) of CAP increased monotonically with increasing alcohol consumption. Individuals consuming 24, 60, and 120 g of pure alcohol daily demonstrated RRs for incident CAP of 1·12 (95% CI 1·02–1·23), 1·33 (95% CI 1·06–1·67) and 1·76 (95% CI 1·13–2·77), respectively, relative to non-drinkers. Clinically defined alcohol-use disorders were associated with an eightfold increased risk of CAP (RR 8·22, 95% CI 4·85–13·95). In conclusion, alcohol was found to be a risk factor for pneumonia with a clear statistical association, and a monotonic dose–response relationship.

Abstract P190: Antihypertensive Monotherapy And Risk Of Depression Incidence

Hypertension ◽  
2020 ◽  
Vol 76 (Suppl_1) ◽  
Author(s):  
Anwar Alnakhli ◽  
Richard Shaw ◽  
Daniel Smith ◽  
Sandosh Padmanabhan
Keyword(s):  
Dose Response ◽  
Enzyme Inhibitor ◽  
Previous History ◽  
Cox Proportional Hazards ◽  
Recent Theory ◽  
Defined Daily Dose ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Antihypertensive Medications ◽  
Increased Risk

Background: Recent theory suggests that antihypertensive medications may be useful as repurposed treatments for mood disorders, however, empirical evidence is inconsistent Objective: We aimed to assess the risk of depression incidence as indicated by first-ever prescription of antidepressant in patients newly exposed to antihypertensive monotherapy and whether there is a dose-response relationship. Method: This study enrolled 2406 new users of antihypertensive monotherapy aged between 18 and 80 years with no previous history of antidepressant prescriptions. The exposure period (EP) to antihypertensive medication was fixed at one year starting from the first date of antihypertensive prescription between Jan 2005 and Mar 2012 and extended up to 12 months. Follow-up commence after the EP until March 2013. To test for dose-response relationship the cumulative defined daily dose (cDDD) of antihypertensive during the EP were stratified into tertiles. Cox proportional hazards models were used to estimate hazard ratios (HR) for depression incidence. Results: Among the five major classes of antihypertensive medications, calcium channel blocker (CCB) had the highest risk of developing depression after adjusting for covariates (HR = 1.40 95%CI 1.11,1.78) compared to angiotensin-converting enzyme inhibitor (ACEI). Angiotensin-receptor blocker (ARB) treatment showed higher risk of depression incidence with tertile 2(HR= 1.46, 95%CI 0.88,2.44) and tertile 3 (HR= 1.75, 95%CI 1.03,2.97) compared to tertile 1 of cDDD. Conclusion: Our findings confirmed previous evidence suggesting that CCB is associated with increased risk of depression incidence compared to ACEI. Risk of developing depression is also linked to ARB, though it might be dose dependent.

scholarly journals Dose–response relationship between protein intake and muscle mass increase: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 79 (1) ◽  
pp. 66-75
Author(s):  
Ryoichi Tagawa ◽  
Daiki Watanabe ◽  
Kyoko Ito ◽  
Keisuke Ueda ◽  
Kyosuke Nakayama ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Lean Body Mass ◽  
Body Mass ◽  
Dose Response ◽  
Protein Intake ◽  
Controlled Trials ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Randomized Controlled

Abstract Context Lean body mass is essential for health, yet consensus regarding the effectiveness of protein interventions in increasing lean body mass is lacking. Objective The aim of this systematic review was to evaluate the dose–response relationship of the effects of protein intake on lean body mass. Data Sources The PubMed and Ichushi-Web databases were searched electronically, and reference lists of the literature included here and in other meta-analyses were searched manually. Study Selection Randomized controlled trials evaluating the effects of protein intake on lean body mass were included. Data Extraction Two authors independently screened the abstracts; 5 reviewed the full texts. Results A total of 5402 study participants from 105 articles were included. In the multivariate spline model, the mean increase in lean body mass associated with an increase in protein intake of 0.1 g/kg of body weight per day was 0.39 kg (95%CI, 0.36–0.41) and 0.12 kg (95%CI, 0.11–0.14) below and above the total protein intake of 1.3 g/kg/d, respectively. Conclusions These findings suggest that slightly increasing current protein intake for several months by 0.1 g/kg/d in a dose-dependent manner over a range of doses from 0.5 to 3.5 g/kg/d may increase or maintain lean body mass. Systematic Review Registration UMIN registration number UMIN000039285.

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