Influence of physical activity on recurrence and survival of colorectal cancer patients: A meta-analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1583-1583 ◽  
Author(s):  
Gaetan Des Guetz ◽  
Thierry Bouillet ◽  
Bernard Uzzan ◽  
Kader Chouahnia ◽  
Patrick Nicolas ◽  
...  

1583 Background: Colorectal cancer (CRC) predominates in developed countries among sedentary populations. A meta-analysis (MA) showed that physical activity (PA) decreased the incidence of new cases of CRC. The impact of PA on recurrence and mortality of non-metastatic CRC patients is still controversial. Methods: We performed a literature-based meta-analysis of all published observational studies, using the following keywords (colorectal cancer, physical activity, survival) in PubMed and EMBASE. We searched for a dedicated MA in the Cochrane Library (none found). We cross-checked all references. Pre- and post-diagnostic PA levels were assessed with MET (Metabolic Equivalent Task). Usually, high PA levels corresponded to > 17 MET hours/week. Overall survival (OS) and cancer-specific survival (CSS) were assessed by means of Hazard Ratios (HRs) with their 95 % Confidence Interval (CI). We pooled adjusted HRs since the variables of adjustment were almost identical between studies (age, sex, BMI, tobacco use, alcohol and red meat consumptions ). By convention, when higher PA levels were associated to an improved survival compared with lower PA levels, HRs for detrimental events were < 1. We used EasyMA software. We used fixed effect model whenever possible and random effect model only in case of between-study heterogeneity. Results: Eight studies (11298 participants) published from 2006 to 2013 met the inclusion criteria, representing 3110 males and 3710 females, 3072 colon and 1318 rectum cancers. Mean age was 67 years (range 21-82 years). HR CSS for post-diagnostic PA (higher PA level vs. lower) was 0.61 (CI: 0.44-0.86; random effect model). The corresponding HR for OS was 0.62 (CI: 0.54-0.71). HR CSS for pre-diagnostic PA was 0.80 (CI: 0.69-0.92). The corresponding HR for OS was 0.74 (CI: 0.63-0.86). Conclusions: This MA is the first to show that higher PA levels are associated with a better CSS, suggesting that sustained PA should be advised for non-metastatic CRC patients. OS also significantly improved, not surprisingly since PA should reduce risk of cardio-vascular events. These findings should be tempered by the rather small number of studies included.

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Gaetan Des Guetz ◽  
Bernard Uzzan ◽  
Thierry Bouillet ◽  
Patrick Nicolas ◽  
Kader Chouahnia ◽  
...  

Background. Physical activity (PA) reduces incidence of colorectal cancer (CRC). Its influence on cancer-specific (CSS) and overall survival (OS) is controversial.Methods. We performed a literature-based meta-analysis (MA) of observational studies, using keywords “colorectal cancer, physical activity, and survival” in PubMed and EMBASE. No dedicated MA was found in the Cochrane Library. References were cross-checked. Pre- and postdiagnosis PA levels were assessed by MET. Usually, “high” PA was higher than 17 MET hour/week. Hazard ratios (HRs) for OS and CSS were calculated, with their 95% confidence interval. We used more conservative adjusted HRs, since variables of adjustment were similar between studies. When higher PA was associated with improved survival, HRs for detrimental events were set to <1. We used EasyMA software and fixed effect model whenever possible.Results. Seven studies (8056 participants) were included, representing 3762 men and 4256 women, 5210 colon and 1745 rectum cancers. Mean age was 67 years. HR CSS for postdiagnosis PA (higher PA versus lower) was 0.61 (0.44–0.86). The corresponding HR OS was 0.62 (0.54–0.71). HR CSS for prediagnosis PA was 0.75 (0.62–0.91). The corresponding HR OS was 0.74 (0.62–0.89).Conclusion. Higher PA predicted a better CSS. Sustained PA should be advised for CRC. OS also improved (reduced cardiovascular risk).


Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001687
Author(s):  
Aliya Amirova ◽  
Theodora Fteropoulli ◽  
Paul Williams ◽  
Mark Haddad

ObjectivesThis meta-analysis aims to (1) evaluate the efficacy of physical activity interventions in heart failure and (2) to identify intervention characteristics significantly associated with the interventions’ efficacy.MethodsRandomised controlled trials reporting intervention effects on physical activity in heart failure were combined in a meta-analysis using a random-effect model. Exploratory meta-analysis was performed by specifying the general approach (eg, cardiac rehabilitation), strategies used (eg, action planning), setting (eg, centre based), mode of delivery (eg, face to face or online), facilitator (eg, nurse), contact time and behavioural change theory use as predictors in the random-effect model.ResultsInterventions (n=21) had a significant overall effect (SMD=0.54, 95% CI (0.13 to 0.95), p<0.0005). Combining an exercise programme with behavioural change intervention was found efficacious (SMD=1.26, 95% CI (0.26 to 2.26), p<0.05). Centre-based (SMD=0.98, 95% CI (0.35 to 1.62), and group-based (SMD=0.89, 95% CI (0.29 to 1.50),) delivery by a physiotherapist (SMD=0.84, 95% CI (0.03 to 1.65),) were significantly associated with efficacy. The following strategies were identified efficacious: prompts/cues (SMD=3.29, 95% CI (1.97 to 4.62)), credible source (standardised mean difference, SMD=2.08, 95% CI (0.95;3.22)), adding objects to the environment (SMD=1.47, 95% CI (0.41 to 2.53)), generalisation of the target behaviour SMD=1.32, 95% CI (0.22 to 2.41)), monitoring of behaviour by others without feedback (SMD=1.02, 95% CI (0.05 to 1.98)), self-monitoring of outcome(s) of behaviour (SMD=0.79, 95% CI (0.06 to 1.52), graded tasks (SMD=0.73, 95% CI (0.22 to 1.24)), behavioural practice/rehearsal (SMD=0.72, 95% CI (0.26 to 1.18)), action planning (SMD=0.62, 95% CI (0.03 to 1.21)) and goal setting (behaviour) (SMD=0.56, 95% CI (0.03 to 1.08)).ConclusionThe meta-analysis suggests intervention characteristics that may be suitable for promoting physical activity in heart failure. There is moderate evidence in support of an exercise programme combined with a behavioural change intervention delivered by a physiotherapist in a group-based and centre-based settings.PROSPERO registerationCRD42015015280.


2019 ◽  
Vol 7 (4) ◽  
pp. 106-112
Author(s):  
Masoud Dadashi ◽  
Shaian Tavakolian ◽  
Ebrahim Faghihloo

Background: Human papillomavirus (HPV) is considered as one of the most common carcinogenic viruses in humans throughout the world and is mostly associated with gynecologic malignancies. However, it is also one of the environmental factors that is involved in colorectal cancer (CRC). Objective: A meta-analysis was performed to investigate the prevalence of HPV infection in patients suffering from the CRC. Methods: The frequency of the HPV in patients with CRC was studied from 2001 to 2016. To this end, several databases were reviewed, including PubMed, Web of Science, Embase, Cochrane Library, Google Scholar, Iranmedex, and the Scientific Information Database. Then, the analysis was done by Comprehensive Meta-Analysis (V2.0, Biostat) software. Considering heterogeneity between different studies, the random effect model was used and then the results were checked with Cochran’s Q-statistic. Results: The meta-analysis revealed that the frequency of HPV infection in patients with CRC was 33.7% (a 95% CI of 28.4-39.5). The additional stratified analysis also showed that HPV infection in CRC patients was more widespread in European countries compared to Asian and American countries. Conclusion: The high rate of HPV infection is a major concern in sexually transmitted diseases around the world, therefore, controlling high-risk behaviors, vaccination, screening, and HPV subtyping can be useful in managing HPV infections.


2020 ◽  
Vol 78 (4) ◽  
pp. 1775-1782
Author(s):  
Nanyang Liu ◽  
Jiahui Sun ◽  
Xiyuan Wang ◽  
Ming Zhao ◽  
Qianqian Huang ◽  
...  

Background: The emergence of the coronavirus disease 2019 (COVID-19) has brought large challenges to dementia patients. We reviewed the existing literature on COVID-19 to assess the incidence and mortality of dementia comorbidities in COVID-19 patients. Objective: To investigate the impact of pre-existing dementia comorbidities on COVID-19. Methods: We searched the PubMed, Embase, and Web of Science databases for patients with preexisting dementia who were diagnosed with COVID-19. The statistical data on the prevalence and mortality of dementia comorbidities were examined. A fixed-or random-effect model was used to calculate the overall pooled risk estimates. Forest plots were generated to show the summarized results. Results: A total of 265 articles were retrieved from the three databases. After removing duplicates and performing two screenings, 10 articles were selected for meta-analysis, including 119,218 participants. Overall, the meta-analysis of the 10 studies showed that the incidence of dementia in COVID-19 patients was (R: 9%, [95% CI: 6% to 13%]). Moreover, the meta-analysis of 9 studies showed that the mortality rate of individuals with dementia after being infected with COVID-19 was higher than that of individuals with no dementia (OR: 5.17 [95% CI: 2.31 to 11.59]). Substantial heterogeneity was observed in this meta-analysis. Significant publication bias was also found. Conclusion: Emerging literature shows that dementia comorbidities are a high risk factor for the prevalence and mortality of COVID-19. Our results should have an impact on preventive interventions and encourage more targeted approaches to prioritize older people with specific risk factors, such as dementia.


BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e035287
Author(s):  
Min Chen ◽  
Tai-Chun Tang ◽  
Tao-Hong He ◽  
Yong-Jun Du ◽  
Di Qin ◽  
...  

IntroductionThe prevalence of haemorrhoidal diseases was high in general population, and many treatments are proposed for the management of haemorrhoids. The treatments include conservative and surgical interventions; the credibility and strength of current evidence of their effectiveness are not comprehensively evaluated. We aim to evaluate the credibility of systematic reviews and meta-analyses that assess the effectiveness of the treatments for haemorrhoidal diseases through an umbrella review.Methods and analysisWe will search Ovid Medline, Embase, Cochrane library and Web of Science from inception to March 2020 without any language restriction. We will include meta-analyses that examine the effectiveness of treatments in the management of haemorrhoids. Two reviewers will independently screen the titles and abstracts of retrieved articles, and they will extract data from the included meta-analyses. For each meta-analysis, we will estimate the effect size of a treatment through the random-effect model and the fixed-effect model, and we will evaluate between-study heterogeneity (Cochrane’s Q and I2statistics) and small-study effect (Egger’s test); we will also estimate the evidence of excess significance bias. Evidence of each treatment will be graded according to prespecified criteria. Methodological quality of each meta-analysis will be evaluated by using Assessment of Multiple Systematic Reviews 2. The corrected cover area method will be used to assess the impact of overlap in reviews on the findings of the umbrella review.Ethics and disseminationWe will present the results of the umbrella review at conferences and publish the final report in a peer-reviewed journal. The umbrella review does not require ethical approval.PROSPERO registration numberCRD42019140702.


2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Liyuan Han ◽  
Lina Zhang ◽  
Wenhua Xing ◽  
Renjie Zhuo ◽  
XiaLu Lin ◽  
...  

Aims. Published data on the associations of VEGF polymorphisms with diabetic retinopathy (DR) susceptibility are inconclusive. A systematic meta-analysis was undertaken to clarify this topic.Methods. Data were collected from the following electronic databases: PubMed, Embase, OVID, Web of Science, Elsevier Science Direct, Excerpta Medica Database (EMBASE), and Cochrane Library with the last report up to January 10, 2014. ORs and 95% CIs were calculated for VEGF–2578C/A (rs699947), –1154G/A (rs1570360), –460T/C (rs833061), −634G>C (rs2010963), and +936C/T (rs3025039) in at least two published studies. Meta-analysis was performed in a fixed/random effect model by using the software STATA 12.0.Results. A total of 11 studies fulfilling the inclusion criteria were included in this meta-analysis. A significant relationship between VEGF+936C/T (rs3025039) polymorphism and DR was found in a recessive model (OR = 3.19, 95% CI = 1.20–8.41, andP(z)=0.01) in Asian and overall populations, while a significant association was also found between –460T/C (rs833061) polymorphism and DR risk under a recessive model (OR = 2.12, 95% CI = 1.12–4.01, andP(z)=0.02).Conclusions. Our meta-analysis demonstrates that +936C/T (rs3025039) is likely to be associated with susceptibility to DR in Asian populations, and the recessive model of –460T/C (rs833061) is associated with elevated DR susceptibility.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Guo Tian ◽  
Jia-Ning Liang ◽  
Zhuo-Yun Wang ◽  
Dian Zhou

Background. The incidence of breast cancer in RA patients remains controversial. Thus we performed a meta-analysis to investigate the impact of RA on breast cancer.Methods. Published literature was available from PubMed, Embase, and Cochrane Library. Pooled standardized incidence rate (SIR) was computed by random-effect model analysis.Results. We identified 16 separate studies in the present study, in which the number of patients ranged from 458 to 84,475. We did not find the increased cancer risk in RA patients (SIR=0.86, 95%CI=0.72–1.02). However, subgroup analysis showed that breast cancer risk in RA patients was positively different in Caucasians (SIR=0.82, 95%CI=0.73–0.93) and non-Caucasians (SIR=1.21, 95%CI=1.19–1.23), respectively. In subgroup analysis by style, a reduced incidence was found in hospital-based case subjects (SIR=0.82, 95%CI=0.69–0.97). Similarly, subgroup analysis for adjusted factors indicated that in A3 (age and sex) and A4 (age, sex, and race/ethnicity) the risk was decreased (SIR=0.87, 95%CI=0.76–0.99;SIR=0.63, 95%CI=0.59–0.67).Conclusions. The meta-analysis revealed no increased breast cancer risk in RA patients. However, in the subgroup analysis, the risk of breast cancer is increased in non-Caucasians patients with RA while it decreased in Caucasian population, hospital-based case subjects, and A3 group. Such relationship may provide preference for risk of breast cancer in different population.


2020 ◽  
Author(s):  
Haoran Jiang ◽  
Lihao Zhao ◽  
Han Yang ◽  
Mengjing Zhao ◽  
Yuxia Duan ◽  
...  

Abstract Background: MAGEA3 is a member of melanoma antigen family and has been recognized to express in many types of human cancers recently. In spite of the development of cancer vaccine, the prognostic value of MAGEA3 has not been well evaluated, due to the variability of clinical data and lack of clinical trials on the prognostic values.Method: Studies that evaluated MAGEA3 expression with a follow-up for at least 36 months were selected by searching in PubMed, WOS, Cochrane library, Embase. Published data was recorded and calculated into odds ratios (OR) for mortality in three or five years with Mantel-Haenszel random-effect model. Results: 11 studies were selected. The median positive rate was 45%. MAGEA3 always combines with worse survival on three or five years survival. The correlation between MAGEA3 and squamous carcinoma seemed stronger than adenocarcinoma on three-year OS while things got a reverse when it came to five-year OS. Most importantly, we found that all solid tumors originated from endoderm seemed to enjoy a strongest correlation among all the three germ layers.Conclusion: In this meta-analysis, we found that the expression of MAGEA3 can connect with worse outcome, and it probably can be a predictor for patients’ prognosis in clinical practice.


2020 ◽  
Vol 8 (3) ◽  
pp. 259-264
Author(s):  
Sanaz Musavi ◽  
Leila Nikniaz ◽  
Hosein Hoseinifard ◽  
Arezou Hamzehzadeh ◽  
Shabnam Vazifekhah

This systematic review and meta-analysis aimed to evaluate the effect of betamethasone and dexamethasone on biophysical profile (BPP) parameters. In addition, it was performed in 2017, using several databases such as PubMed/MEDLINE, Scopus, EMBASE, Cochrane library, ISI Web of science, Proquest, and Google scholar, along with Magiran SID and IranMedex. Eligible studies were selected by two reviewers and the outcomes of interest were extracted as well. Meta-analysis was done using the random effect model. Further, I-square statistic test was used for heterogeneity analysis and the presence of publication bias was also checked. At last, 12 studies were included and a random and fixed effect model was used for analysis. The pooled event rates were 4.5% (95% CI = 0.01-64.3, P=0.1), 76.8% (% 95 CI=33.5-95.6, P=0.21), 71.8% (% 95 CI=38.8-91.1, P=0.18), 70.9% (%95 CI=38.4-90.5, P=0.20), and 92.3% (%95 CI=76.0-97.8, P<0.001) for the reduced amniotic fluid volume, baseline fetal heart rate reactivity, fetal breathing, fetal movement, and heart rate variability, respectively. In summary, a significant decrease was observed in heart rate variability following betamethasone and dexamethasone administration. However, further systematic reviews are necessary to differentiate steroid induced changes in the fetal BPP from those due to fetal compromise


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Hongying Zhang ◽  
Zhiping Yang ◽  
Zhen Ni ◽  
Yongquan Shi

Background. To investigate whether PPIs BID is superior to QD for treatment of GERD in a short time. Methods. We searched PubMed, Cochrane Library, Scopus, EMBASE, Ovid, EBSCO, and Web of Science databases (from 1998 to May 2016) to select RCTs, which compared the efficacy of PPIs BID versus QD for GERD. The primary outcomes were symptom relief or esophageal mucosal healing at weeks 4 and 8. The M-H method with fixed-effect or random-effect model was used to calculate RR and 95% CIs. Results. Seven RCTs were enrolled. The esophageal healing rates were higher in PPIs BID group (P=0.01), and rabeprazole 20 mg BID can achieve better mucosal healing than 20 mg QD after 8 weeks (P<0.05). However, no significant differences were observed in heartburn relief (P=0.27), sustained symptom relief rates at week 4 (P=0.05), 24 h pH monitoring after treatment (P=0.11), endoscopic response at week 4 (P=0.22), and adverse events (P=0.18). Conclusion. PPIs BID more effectively improve endoscopic healing rate at week 8 than PPIs QD. But there are no significant differences in symptom relief, 24 h pH monitoring, sustained symptom relief, and endoscopic response at week 4.


Sign in / Sign up

Export Citation Format

Share Document