scholarly journals Diabetes as a risk factor for incident peripheral arterial disease in women compared to men: a systematic review and meta-analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Alyssa Z. Chase-Vilchez ◽  
Isaac H. Y. Chan ◽  
Sanne A. E. Peters ◽  
Mark Woodward
Keyword(s):  
Cardiovascular Disease ◽  
Risk Factor ◽  
Relative Risk ◽  
Meta Analysis ◽  
Arterial Disease ◽  
Excess Risk ◽  
Newcastle Ottawa Scale ◽  
Peripheral Arterial ◽  
Meta Analyses ◽  
Ottawa Scale

Abstract Aims/hypothesis Previous meta-analyses have suggested that diabetes confers a greater excess risk of coronary heart disease, stroke, vascular dementia, and heart failure in women compared to men. While the underlying mechanism that explains such greater excess risk is unknown, in the current meta-analysis we hypothesized that we would find a similar sex difference in the relationship between diabetes and peripheral arterial disease (PAD). Methods PubMed MEDLINE, the Cochrane Database of Systematic Reviews, and Embase were systematically searched for prospective population-based cohort studies, with no restriction on publication date, language, or country. We included studies that reported the relative risk (RR), and its variability, for incident PAD associated with diabetes in both sexes. We excluded studies that did not adjust at least for age, and in which participants had pre-existing PAD. In cases where sex-specific results were not reported, study authors were contacted. Random-effects meta-analyses with inverse variance weighting were used to obtain summary sex-specific RRs and the women: men ratio of RRs for PAD. The Newcastle–Ottawa scale was used to assess study quality. Results Data from seven cohorts, totalling 2071,260 participants (49.8% women), were included. The relative risk for incident PAD associated with diabetes compared with no diabetes was 1.96 (95% CI 1.29–2.63) in women and 1.84 (95% CI 1.29–2.86) in men, after adjusting for potential confounders. The multiple-adjusted RR ratio was 1.05 (95% CI 0.90–1.22), with virtually no heterogeneity between studies (I2 = 0%). All studies scored 6–8, on the Newcastle–Ottawa scale of 0–9, indicating good quality. Eleven of the 12 studies that met review inclusion criteria did not report sex-specific relative risk, and these data were collected through direct correspondence with the study authors. Conclusion/interpretation Consistent with other studies, we found evidence that diabetes is an independent risk factor for PAD. However, in contrast to similar studies of other types of cardiovascular disease, we did not find evidence that diabetes confers a greater excess risk in women compared to men for PAD. More research is needed to explain this sex differential between PAD and other forms of CVD, in the sequelae of diabetes. In addition, we found that very few studies reported the sex-specific relative risk for the association between diabetes and PAD, adding to existing evidence for the need for improved reporting of sex-disaggregated results in cardiovascular disease research.

Prevalence of Cognitive Impairment and Dementia in Older Adults Living at High Altitude: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-11
Author(s):  
Diego Urrunaga-Pastor ◽  
Diego Chambergo-Michilot ◽  
Fernando M. Runzer-Colmenares ◽  
Josmel Pacheco-Mendoza ◽  
Vicente A. Benites-Zapata
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
High Altitude ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Language Restriction ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

<b><i>Introduction:</i></b> Dementia is a chronic disease with a variable prevalence throughout the world; however, this could be higher at high-altitude populations. We aimed to summarize the prevalence of cognitive impairment and dementia in older adults living at high altitude. <b><i>Methods:</i></b> We searched in PubMed, Medline, Scopus, Web of Science, and Embase and included the studies published from inception to July 20, 2020, with no language restriction, which reported the frequency of cognitive impairment or dementia in older adults living at high-altitude populations. Random-effects meta-analyses were performed to calculate the overall prevalence and 95% confidence intervals (95% CI) of cognitive impairment and dementia. The risk of bias was evaluated using the Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. <b><i>Results:</i></b> Six studies were included (3,724 participants), and 5 of the 6 included studies were carried out in Latin America. The altitude ranged from 1,783 to 3,847 m, the proportion of women included varied from 38.7 to 65.6%, and the proportion of participants with elementary or illiterate educational level ranged from 71.7 to 97.6%. The overall prevalence of cognitive impairment was 22.0% (95% CI: 8–40, <i>I</i><sup>2</sup>: 99%), and the overall prevalence of dementia was 11.0% (95% CI: 6–17, <i>I</i><sup>2</sup>: 92%). In a subgroup analysis according to the instrument used to evaluate cognitive impairment, the prevalence of cognitive impairment was 21.0% (95% CI: 5–42, <i>I</i><sup>2</sup>: 99%) in the MMSE group while the prevalence was 29.0% (95% CI: 0–78) in the non-MMSE group. <b><i>Conclusions:</i></b> The prevalence of cognitive impairment and dementia in older adults living at high altitude is almost twice the number reported in some world regions.

Serially increasing change in lipoprotein(a) concentration has predictive value in acute vascular events

2005 ◽  
Vol 42 (4) ◽  
pp. 285-291 ◽  
Author(s):  
Soon Jun Hong ◽  
Hong Seog Seo ◽  
Chang Gyu Park ◽  
Seung Woon Rha ◽  
Dong Joo Oh ◽  
...  
Keyword(s):  
Risk Factor ◽  
Relative Risk ◽  
Vascular Disease ◽  
Predictive Value ◽  
Arterial Disease ◽  
Atherosclerotic Vascular Disease ◽  
Vascular Events ◽  
Lipoprotein A ◽  
Peripheral Arterial

Background: Lipoprotein(a) (Lp(a)) has been regarded in some studies as an independent risk factor of atherosclerotic vascular disease. However, the use of a baseline plasma Lp(a) concentration as a screening tool for future acute vascular events (AVE) is controversial. We therefore investigated whether progressively increasing change in plasma Lp(a) concentration is associated with the development of AVE. Methods: We investigated prospective analyses of 985 participants (464 women and 521 men) who had either clinically evident vascular disease (VD group, n=443) or its risk factor(s) (RF group, n=542). Blood samples were taken from all participants every six months to measure inflammatory markers such as Lp(a) and C-reactive protein during a 10-year follow-up period. Results: During the follow-up, 223 new cases of myocardial infarction, stroke, and peripheral arterial disease were identified. In the RF group, the relative risk of positive ∆ Lp(a) for predicting AVE was 4.36 (95% confidence interval [CI] 1.76-10.85; P=0.002). In the VD group, the relative risk of positive ∆ Lp(a) for predicting AVE was 6.35 (95% CI 3.68-10.97; P<0.001). Conclusions: These results suggest that a progressively increasing change in Lp(a) concentration has a highly significant predictive value in AVE in both the VD and the RF groups.

scholarly journals Anosmia and dysgeusia in SARS-CoV-2 infection: incidence and effects on COVID-19 severity and mortality, and the possible pathobiology mechanisms - a systematic review and meta-analysis

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 40
Author(s):  
Endang Mutiawati ◽  
Marhami Fahriani ◽  
Sukamto S. Mamada ◽  
Jonny Karunia Fajar ◽  
Andri Frediansyah ◽  
...  
Keyword(s):  
Web Of Science ◽  
Respiratory Infections ◽  
Meta Analysis ◽  
Research Quality ◽  
Future Studies ◽  
Pooled Prevalence ◽  
Protocol Registration ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

Background: The present study aimed to determine the global prevalence of anosmia and dysgeusia in coronavirus disease 2019 (COVID-19) patients and to assess their association with severity and mortality of COVID-19. Moreover, this study aimed to discuss the possible pathobiological mechanisms of anosmia and dysgeusia in COVID-19. Methods: Available articles from PubMed, Scopus, Web of Science, and preprint databases (MedRxiv, BioRxiv, and Researchsquare) were searched on November 10th, 2020. Data on the characteristics of the study (anosmia, dysgeusia, and COVID-19) were extracted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Newcastle–Ottawa scale was used to assess research quality. Moreover, the pooled prevalence of anosmia and dysgeusia were calculated, and the association between anosmia and dysgeusia in presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was assessed using the Z test. Results: Out of 32,142 COVID-19 patients from 107 studies, anosmia was reported in 12,038 patients with a prevalence of 38.2% (95% CI: 36.5%, 47.2%); whereas, dysgeusia was reported in 11,337 patients out of 30,901 COVID-19 patients from 101 studies, with prevalence of 36.6% (95% CI: 35.2%, 45.2%), worldwide. Furthermore, the prevalence of anosmia was 10.2-fold higher (OR: 10.21; 95% CI: 6.53, 15.96, p < 0.001) and that of dysgeusia was 8.6-fold higher (OR: 8.61; 95% CI: 5.26, 14.11, p < 0.001) in COVID-19 patients compared to those with other respiratory infections or COVID-19 like illness. To date, no study has assessed the association of anosmia and dysgeusia with severity and mortality of COVID-19. Conclusion: Anosmia and dysgeusia are prevalent in COVID-19 patients compared to those with the other non-COVID-19 respiratory infections. Several possible mechanisms have been hypothesized; however, future studies are warranted to elucidate the definitive mechanisms of anosmia and dysgeusia in COVID-19. Protocol registration: PROSPERO CRD42020223204.

scholarly journals Long-Term Nightshift Work and Breast Cancer Risk: An Updated Systematic Review and Meta-Analysis with Special Attention to Menopausal Status and to Recent Nightshift Work

Cancers ◽  
2021 ◽  
Vol 13 (23) ◽  
pp. 5952
Author(s):  
Christine Schwarz ◽  
Ana María Pedraza-Flechas ◽  
Roberto Pastor-Barriuso ◽  
Virginia Lope ◽  
Nerea Fernández de Larrea ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Menopausal Status ◽  
Case Control ◽  
Risk Exposure ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Nested Case Control ◽  
Ottawa Scale

This systematic review discusses long-term NSW and female BC risk, with special attention to differences between pre- and postmenopausal BC, to test the association with recent NSW. The review follows PRISMA guidelines (Prospero registry: CRD42018102515). We searched PubMed, Embase, and WOS for case–control, nested case–control, and cohort studies addressing long-term NSW (≥15 years) as risk exposure and female BC as outcome until 31 December 2020. Risk of bias was evaluated with the Newcastle–Ottawa scale. Eighteen studies were finally included (eight cohorts; five nested case–control; five case–control). We performed meta-analyses on long-term NSW and BC risk; overall and by menopausal status; a subanalysis on recent long-term NSW, based on studies involving predominantly women below retirement age; and a dose–response meta-analysis on NSW duration. The pooled estimate for long-term NSW and BC was 1.13 (95%CI = 1.01–1.27; 18 studies, I2 = 56.8%, p = 0.002). BC risk increased 4.7% per 10 years of NSW (95%CI = 0.94–1.09; 16 studies, I2 = 33.4%, p = 0.008). The pooled estimate for premenopausal BC was 1.27 (95%CI = 0.96–1.68; six studies, I2 = 32.0%, p = 0.196) and for postmenopausal BC 1.05 (95%CI = 0.90–1.24,I2 = 52.4%; seven studies, p = 0.050). For recent long-term exposure, the pooled estimate was 1.23 (95%CI = 1.06–1.42; 15 studies; I2 = 48.4%, p = 0.018). Our results indicate that long-term NSW increases the risk for BC and that menopausal status and time since exposure might be relevant.

scholarly journals Detection of Cytomegalovirus Infection in Infants with Biliary Atresia: A Meta-analysis

2021 ◽  
Author(s):  
Sagad Omer Obeid Mohamed ◽  
Almutasim B. E. Elhassan ◽  
Ibrahim H. E. Elkhidir ◽  
Almigdad H.M. Ali ◽  
Mohamed Elata Hassan Elbathani ◽  
...  
Keyword(s):  
Biliary Atresia ◽  
Regional Differences ◽  
Meta Analysis ◽  
Autoimmune Response ◽  
Cmv Infection ◽  
Eligibility Criteria ◽  
Pooled Prevalence ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

Abstract Objectives Biliary atresia (BA) is the most common indication of liver transplantation in children. Several reports attributed BA to both prenatal and perinatal etiologies, including a viral infection-induced autoimmune response that targets the bile ducts. Cytomegalovirus (CMV) remains the most common virus being linked to BA. This meta-analysis aimed to estimate to what extent CMV infection is detected in patients with BA. Methods This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases of MEDLINE, Embase, Scopus, WHO-Virtual Health Library (VHL), ScienceDirect, and Google Scholar were used for the systematic search. The risk of bias was assessed using the Newcastle–Ottawa scale. Random effects model was used to estimate the pooled prevalence estimate with the corresponding 95% confidence interval (CI) using Comprehensive Meta-Analysis Software version 3.3. Results A total of 19 studies that fulfilled the eligibility criteria were included in the meta-analysis. The total number of infants with BA was 630 patients, and the pooled overall prevalence of CMV infection among them was 25.4% (95% CI: 15.9%–38.0%). There was high heterogeneity among studies (I2 = 85.1%, p < .001), and subgroup analyses showed significant regional differences (X2 = 48.9, p <.001). Data on the prognosis of CMV-associated BA were scarce and obtainable from few studies that suggested an association between detection of CMV infection and poor prognosis of BA. Conclusions The limited available data demonstrates that the rate of detection of CMV infection is high in infants with BA. There is still a need for large studies with appropriate controls for obtaining more reliable results about the various aspects of the association between CMV infection and BA.

scholarly journals Systematic review of pharmacological therapies for the management of ischaemic pain in patients with non-reconstructable critical limb ischaemia

2017 ◽  
Vol 8 (4) ◽  
pp. 400-410 ◽  
Author(s):  
Áine Ní Laoire ◽  
Fliss E M Murtagh
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Arterial Disease ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Pharmacological Management ◽  
Pharmacological Agents ◽  
Peripheral Arterial ◽  
Meta Analyses

BackgroundCritical limb ischaemia (CLI) is a severe manifestation of peripheral arterial disease, characterised by chronic ischaemic rest pain, ulcers or gangrene. Management of ischaemic pain is challenging in patients with no options for revascularisation and optimal pharmacological therapies have not been established.ObjectivesTo identify and evaluate the effectiveness of pharmacological therapies to treat ischaemic pain secondary to non-reconstructable CLI.MethodsThis systematic review was reported in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline. Comprehensive searches of three electronic databases, a PubMed-related articles link search, grey literature search and hand-searches of the bibliographies of relevant papers and textbooks were performed. Studies recruiting adult patients with CLI of any aetiology were eligible for inclusion. Surgical and revascularisation procedures, and all invasive interventions were excluded.ResultsOf 792 studies, six met full inclusion criteria. These studies researched the use of intravenous lidocaine, intravenous ketamine, oral gabapentin and the combination of transdermal buprenorphine and epidural morphine/ropivacaine infusion. All studies showed an improvement in severity of ischaemic pain in CLI but with varying side effect profiles and quality. The extracted studies showed substantial heterogeneity and therefore a meta-analysis was not performed.ConclusionThe pharmacological management of pain secondary to non-reconstructable CLI is a challenging review topic. No recommendations of pharmacological agents can be made following this review but a number of novel approaches to manage pain in this cohort have shown positive results and require further investigation.

Association of systemic lupus erythematosus with peripheral arterial disease: a meta-analysis of literature studies

Rheumatology ◽  
2020 ◽  
Vol 59 (11) ◽  
pp. 3181-3192 ◽  
Author(s):  
Francesco Forte ◽  
Alessio Buonaiuto ◽  
Ilenia Calcaterra ◽  
Gabriella Iannuzzo ◽  
Pasquale Ambrosino ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Lupus Erythematosus ◽  
Functional Disability ◽  
Meta Analysis ◽  
Ankle Brachial Index ◽  
Arterial Disease ◽  
Chronic Patients ◽  
Cardiovascular Morbidity And Mortality ◽  
Peripheral Arterial ◽  
Meta Analyses

Abstract Objective SLE patients have an increased cardiovascular morbidity and mortality. Contrasting data are available about the association between peripheral arterial disease (PAD) and SLE. We aimed to perform a meta-analysis of studies evaluating the association between SLE and PAD. Methods Studies were systematically searched in the PubMed, Web of Science, Scopus and EMBASE databases according to preferred reporting items for systematic reviews and meta-analyses guidelines. Results Eight studies reporting on 263 258 SLE patients and 768 487 controls showed that the prevalence of PAD was 15.8% (95% CI: 10.5%, 23.2%) in SLE patients and 3.9% (95% CI: 1.8%, 7.9%) in controls with a corresponding odds ratio of 4.1 (95% CI: 1.5, 11.6; P &lt;0.001). In addition, five studies reporting on ankle-brachial index showed significantly lower values in 280 SLE patients as compared with 201 controls (mean difference: −0.018; 95% CI: −0.034, −0.001; P =0.033). Meta-regression models showed that age, hypertension and diabetes were inversely associated with the difference in the prevalence of PAD between SLE patients and non-SLE controls, whereas no effect for all the other clinical and demographic variables on the evaluated outcome was found. Conclusion SLE patients exhibit an increased prevalence of PAD and lower ankle-brachial index values as compared with non-SLE controls. This should be considered when planning prevention, interventional and rehabilitation strategies for these chronic patients with functional disability and poor long-term outcomes.

scholarly journals Oxytocin levels in individuals with schizophrenia are high in cerebrospinal fluid but low in serum: A systematic review and meta-analysis.

2021 ◽  
Author(s):  
Yazmin Hernández-Díaz ◽  
Thelma Beatriz González-Castro ◽  
Carlos Tovilla-Zarate ◽  
María Lilia López-Narváez ◽  
Alma Delia Genis-Mendoza ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Comparison Group ◽  
Meta Analysis ◽  
Analysis Software ◽  
Exclusion Criteria ◽  
Prisma Statement ◽  
Newcastle Ottawa Scale ◽  
Meta Analyses ◽  
Ottawa Scale

Abstract Schizophrenia is a mental and disabling disease. Levels of oxytocin have been proposed as a biomarker of schizophrenia; however, the observed levels of oxytocin in individuals with schizophrenia have been inconsistent across studies. We performed a meta-analysis to evaluate oxytocin levels in plasma, serum and cerebrospinal fluid to see if there are statistically different concentrations between individuals with schizophrenia and the comparison group.The meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to guarantee a high quality and reproducibility.Following the inclusion and exclusion criteria, 14 studies were included in the meta-analysis. The quality of the study was evaluated by the Newcastle-Ottawa Scale (NOS). A random-effects model was performed using the Comprehensive Meta-analysis software with the standardized mean difference (SMD) and 95% confidence intervals (CIs).Serum oxytocin levels in individuals with schizophrenia were significantly lower than that in comparison group (SMD = − 1.74, 95% CI = − 3.22 to − 0.26, p = 0.02) but cerebrospinal fluid oxytocin levels in individuals with schizophrenia were significantly higher than those in the comparison group (SMD = 0.55, 95% CI = 0.05 to 1.04, p = 0.03).Our results suggest that oxytocin levels in cerebrospinal fluid are increased in individuals with schizophrenia but decreased in serum. Therefore, the oxytocin system dysregulation may play a role in the pathophysiology of schizophrenia and it should be measured in more populations for a possible implementation as a biomarker of schizophrenia.

scholarly journals The Impact of Different Types of Shift Work on Blood Pressure and Hypertension: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (13) ◽  
pp. 6738
Author(s):  
Sara Gamboa Madeira ◽  
Carina Fernandes ◽  
Teresa Paiva ◽  
Carlos Santos Moreira ◽  
Daniel Caldeira
Keyword(s):  
Blood Pressure ◽  
Shift Work ◽  
Meta Analysis ◽  
Epidemiological Studies ◽  
Shift Workers ◽  
Newcastle Ottawa Scale ◽  
Mean Differences ◽  
Meta Analyses ◽  
The Impact ◽  
Ottawa Scale

Shift work (SW) encompasses 20% of the European workforce. Moreover, high blood pressure (BP) remains a leading cause of death globally. This review aimed to synthesize the magnitude of the potential impact of SW on systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN). MEDLINE, EMBASE and CENTRAL databases were searched for epidemiological studies evaluating BP and/or HTN diagnosis among shift workers, compared with day workers. Random-effects meta-analyses were performed and the results were expressed as pooled mean differences or odds ratios and 95% confidence intervals (95% CI). The Newcastle–Ottawa Scale was used to assess the risk of bias. Forty-five studies were included, involving 117,252 workers. We found a significant increase in both SBD and DBP among permanent night workers (2.52 mmHg, 95% CI 0.75–4.29 and 1.76 mmHg, 95% CI 0.41–3.12, respectively). For rotational shift workers, both with and without night work, we found a significant increase but only for SBP (0.65 mmHg, 95% CI 0.07–1.22 and 1.28 mmHg, 95% CI 0.18–2.39, respectively). No differences were found for HTN. Our findings suggest that SW is associated with an increase of BP, mainly for permanent night workers and for SBP. This is of special interest given the large number of susceptible workers exposed over time.

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