scholarly journals Checking whether there is an increased risk of post-transplant lymphoproliferative disorder and other cancers with specific modern immunosuppression regimens in renal transplantation: Protocol for a network meta-analysis of randomized and observational studies

2014 ◽  
Vol 3 (1) ◽  
Author(s):  
Brian Hutton ◽  
Lawrence Joseph ◽  
Fatemeh Yazdi ◽  
Jennifer Tetzlaff ◽  
Mona Hersi ◽  
...  
Keyword(s):  
Renal Transplantation ◽  
Observational Studies ◽  
Lymphoproliferative Disorder ◽  
Meta Analysis ◽  
Post Transplant ◽  
Increased Risk

scholarly journals Thyroid cancer and renal transplantation: a meta-analysis

2010 ◽  
Vol 17 (1) ◽  
pp. 159-167 ◽  
Author(s):  
Dheeraj Karamchandani ◽  
Ramiro Arias-Amaya ◽  
Nora Donaldson ◽  
Jackie Gilbert ◽  
Klaus-Martin Schulte
Keyword(s):  
Thyroid Cancer ◽  
Renal Transplantation ◽  
Meta Analysis ◽  
Solid Organ Transplantation ◽  
Solid Organ ◽  
Post Transplantation ◽  
Post Transplant ◽  
Increased Risk

Kidney transplantation and the associated immune suppression are associated with a significantly increased risk of developing cancer during long-term follow-up. Thyroid cancer has been recognised as a potential post-transplant risk but has not yet been subject of a focused review. We therefore performed a meta-analysis on data of 50 861 patients with a total follow-up of 198 595 patient-years and identified a 6.9-fold higher standardised incidence ratio (95% confidence interval 5.6–8.7, P<0.001) of thyroid cancer post renal transplantation as compared with a non-transplant group. All such cancers were of papillary type as far as histopathology was known. The mean time to discovery was 6.0 years post transplantation. This puts thyroid cancer into the group of high cancer risk following solid organ transplantation which already includes cervical cancer, non-melanoma skin cancer, oral and lip cancer and haematological malignancies. It is unclear what causes the increased cancer incidence. Inclusion of thyroid ultrasound in long-term post-transplant evaluation may help to ensure timely recognition of this condition.

scholarly journals Breakfast skipping and the risk of type 2 diabetes: a meta-analysis of observational studies

2015 ◽  
Vol 18 (16) ◽  
pp. 3013-3019 ◽  
Author(s):  
Huashan Bi ◽  
Yong Gan ◽  
Chen Yang ◽  
Yawen Chen ◽  
Xinyue Tong ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Adjusted Relative Risk ◽  
China National Knowledge Infrastructure ◽  
Cross Sectional ◽  
Breakfast Skipping ◽  
Risk Estimates ◽  
Increased Risk

AbstractObjectiveBreakfast skipping has been reported to be associated with type 2 diabetes (T2D), but the results are inconsistent. No meta-analyses have applied quantitative techniques to compute summary risk estimates. The present study aimed to conduct a meta-analysis of observational studies summarizing the evidence on the association between breakfast skipping and the risk of T2D.DesignSystematic review and meta-analysis.SettingRelevant studies were identified by a search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI) and SINOMED up to 9 August 2014. We also reviewed reference lists from retrieved articles. We included studies that reported risk estimates (including relative risks, odds ratios and hazard ratios) with 95 % confidence intervals for the association between breakfast skipping and the risk of T2D.SubjectsEight studies involving 106 935 participants and 7419 patients with T2D were included in the meta-analysis.ResultsA pooled adjusted relative risk for the association between exposure to breakfast skipping and T2D risk was 1·21 (95 % CI 1·12, 1·31; P=0·984; I2=0·0 %) in cohort studies and the pooled OR was 1·15 (95 % CI, 1·05, 1·24; P=0·770; I2=0·0 %) in cross-sectional studies. Visual inspection of a funnel plot and Begg’s test indicated no evidence of publication bias.ConclusionsBreakfast skipping is associated with a significantly increased risk of T2D. Regular breakfast consumption is potentially important for the prevention of T2D.

scholarly journals Non-SARS, non-MERS human coronavirus infections and risk of Kawasaki disease: a meta-analysis

2021 ◽  
Author(s):  
Pratap Kumar Patra ◽  
Rashmi Ranjan Das ◽  
Aaqib Zaffar Banday ◽  
Mini Singh ◽  
Kapil Goyal ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Prospective Studies ◽  
Observational Studies ◽  
Meta Analysis ◽  
Database Search ◽  
Human Coronavirus ◽  
Increased Risk ◽  
Protocol Registration ◽  
Coronavirus Infections

Aim: To study the association between non-SARS, non-MERS human coronavirus (HCoV) infections and Kawasaki disease (KD). Methods: Meta-analysis of observational studies published until 1 May 2021. Results: Out of 571 papers retrieved through database search, 10 provided data of 17,732 children. Age ranged from 2 months–14.9 years with 66% being male and 71% being complete KD. Compared with controls, there was an increased risk of developing KD in those detected to have HCoV infection (OR: 2.3 [95% CI: 1.06–4.99]; p = 0.03). The GRADE evidence for all outcomes was of ‘low-certainty’. Conclusion: A ‘low certainty’ of evidence suggests an increased risk of KD in children infected with HCoV. We need multi-center, prospective studies to support or refute this finding. PROSPERO protocol registration: CRD42021251582.

scholarly journals Sirolimus-Based Immunosuppression Is Associated with Decreased Incidence of Post-Transplant Lymphoproliferative Disorder after Heart Transplantation: A Double-Center Study

2022 ◽  
Vol 11 (2) ◽  
pp. 322
Author(s):  
Rabea Asleh ◽  
Darko Vucicevic ◽  
Tanya M. Petterson ◽  
Walter K. Kremers ◽  
Naveen L. Pereira ◽  
...  
Keyword(s):  
Heart Transplantation ◽  
Lymphoproliferative Disorder ◽  
Univariate Analysis ◽  
Mammalian Target Of Rapamycin ◽  
Mtor Inhibitors ◽  
Lymphoid Cells ◽  
Post Transplant ◽  
Barr Virus ◽  
Increased Risk ◽  
Epstein Barr

Mammalian target of rapamycin (mTOR) inhibitors have been shown to reduce proliferation of lymphoid cells; thus, their use for immunosuppression after heart transplantation (HT) may reduce post-transplant lymphoproliferative disorder (PTLD) risk. This study sought to investigate whether the sirolimus (SRL)-based immunosuppression regimen is associated with a decreased risk of PTLD compared with the calcineurin inhibitor (CNI)-based regimen in HT recipients. We retrospectively analyzed 590 patients who received HTs at two large institutions between 1 June 1988 and 31 December 2014. Cox proportional-hazard modeling was used to examine the association between type of primary immunosuppression and PTLD after adjustment for potential confounders, including Epstein–Barr virus (EBV) status, type of induction therapy, and rejection. Conversion from CNI to SRL as primary immunosuppression occurred in 249 patients (42.2%). During a median follow-up of 6.3 years, 30 patients developed PTLD (5.1%). In a univariate analysis, EBV mismatch was strongly associated with increased risk of PTLD (HR 10.0, 95% CI: 3.8–26.6; p < 0.001), and conversion to SRL was found to be protective against development of PTLD (HR 0.19, 95% CI: 0.04–0.80; p = 0.02). In a multivariable model and after adjusting for EBV mismatch, conversion to SRL remained protective against risk of PTLD compared with continued CNI use (HR 0.12, 95% CI: 0.03–0.55; p = 0.006). In conclusion, SRL-based immunosuppression is associated with lower incidence of PTLD after HT. These findings provide evidence of a benefit from conversion to SRL as maintenance therapy for mitigating the risk of PTLD, particularly among patients at high PTLD risk.

scholarly journals Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Al Bahhawi ◽  
A Aqeeli ◽  
S L Harrison ◽  
D A Lane ◽  
I Buchan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cohort Studies ◽  
Observational Studies ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Random Effects Models ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis.  Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

scholarly journals Maternal Vitamin D Status and Risk of Gestational Diabetes: a Meta-Analysis

2018 ◽  
Vol 45 (1) ◽  
pp. 291-300 ◽  
Author(s):  
Lingmin Hu ◽  
Yue Zhang ◽  
Xing Wang ◽  
Lianghui You ◽  
Pengfei Xu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Gestational Diabetes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Vitamin D Insufficiency ◽  
Significant Heterogeneity ◽  
Vitamin D Status ◽  
Maternal Vitamin ◽  
Increased Risk ◽  
Maternal Vitamin D Status

Background/Aims: Whether maternal vitamin D deficiency is associated with gestational diabetes remains controversial. This meta-analysis aimed to systematically evaluate published evidence on the association between maternal vitamin D status and the risk of gestational diabetes. Methods: We retrieved relevant articles from the PubMed, Medline and Embase databases up to May 2017 for observational studies investigating the association between vitamin D status and the risk of gestational diabetes. Odds ratios (OR) or risk ratios (RR) from individual studies were pooled using the fixed and random effect models. Results: The meta-analysis of 29 observational studies included 28,982 participants, of which 4,634 were diagnosed with gestational diabetes, and showed that maternal vitamin D insufficiency was associated with a significantly increased risk of gestational diabetes by 39% (pooled OR = 1.39, 95%CI = 1.20-1.60) with moderate heterogeneity (I2 = 50.2%; P = 0.001). Moreover, the 25(OH)D level was significantly lower in gestational diabetes cases than in controls with a pooled effect of -4.79 nmol/L (95% CI = -6.43, -3.15). Significant heterogeneity was also detected (I2 = 65.0%, P < 0.001). Further subgroup analysis indicated that this association was also evident in most subpopulations. Conclusion: This meta-analysis indicated a significant association between vitamin D insufficiency and increased risk of gestational diabetes. Further well-designed large-scale clinical trials are essential to verify this association.

Impact of pretransplant mitral annular calcification on the incidence of cardiac events after renal transplantation

2019 ◽  
Vol 35 (3) ◽  
pp. 526-533 ◽  
Author(s):  
Nadia El Hangouche ◽  
Javier Gomez ◽  
Addis Asfaw ◽  
Jayakumar Sreenivasan ◽  
Tauseef Akhtar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Renal Transplantation ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Cardiac Events ◽  
Mitral Annular Calcification ◽  
Post Transplant ◽  
Increased Risk ◽  
Annular Calcification

Abstract Background Mitral annular calcification (MAC) is associated with increased risk of major adverse cardiac events. We hypothesized that MAC, identified on a pretransplant transthoracic echocardiography (TTE), is predictive of cardiac events following renal transplantation (RT). Methods In a retrospective cohort of consecutive RT recipients, pretransplant MAC presence and severity were determined on TTE performed within 1 year prior to transplant. MAC severity was quantified based on the circumferential MAC extension relative to the mitral valve annulus. Post-transplant cardiac risk was assessed using the sum of risk factors (range: 0–8) set forth by the American Heart Association/American College of Cardiology Foundation consensus statement on the assessment of RT candidates. Subjects underwent pretransplant stress single-photon emission computed tomography myocardial perfusion imaging and followed for post-transplant composite outcome of cardiac death or myocardial infarction (CD/MI). Results Among 336 subjects (60.5% men; mean age 52 ± 12 years), MAC was present in 78 (23%) patients. During a mean follow-up of 3.1 ± 1.9 years, a total of 70 events were observed. Patients with MAC had a higher event rate compared with those without MAC (34.6% versus 17.8%, log-rank P = 0.001). There was a stepwise increase in CD/MI risk with increasing MAC severity (P for trend = 0.002). MAC-associated risk remained significant after adjusting for sex, duration of dialysis, sum of risk factors, ejection fraction and perfusion abnormality burden, providing an incremental prognostic value to these parameters (Δχ2 =4.63; P = 0.031). Conclusion Among RT recipients, the burden of pretransplant MAC is an independent predictor of post-transplant risk of CD/MI. MAC should be considered in the preoperative assessment of RT candidates.

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