Influence of job assignment on melanoma (MEL) incidence in commercial aircrew.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21058-e21058
Author(s):  
Lee D. Cranmer
Keyword(s):  
Meta Analysis ◽  
Occupational Exposures ◽  
Study Groups ◽  
Job Assignment ◽  
Commercial Aircraft ◽  
Cabin Crew ◽  
Different Types ◽  
Keywords Cancer ◽  
The Difference

e21058 Background: Commercial cabin and cockpit aircrews are at increased cutaneous MEL risk. Occupational and social factors have been invoked to explain this. However, the two groups work in on-board environments with different types/levels of potential exposures. Meta-analysis is conducted to address the hypothesis that differences exist in aircrew MEL risk based on location of in-aircraft job assignment, reflecting differential etiologic occupational exposures. Methods: Medline was searched with the keywords “Cancer,” “Aviation,” and “Melanoma.” Included studies: (1) primarily focused on cutaneous MEL; (2) were in commercial aircrew; (3) measured risk vs a general population; (4) measured risk by Standardized Incidence Ratio (SIR) with 95% confidence intervals (CI); (5) defined the gender distribution; and (7) defined cabin vs cockpit job assignment. Summary SIRs and CIs were calculated using maximum-likelihood, random effects meta-analysis. Values obtained were compared to one another using a z-test, with p < 0.05 pre-specified for null hypothesis rejection. Results: 6 primary studies were identified in the initial search. These were screened for other pertinent references. The secondary search yielded an additional 9 primary studies. For cabin crew, 10 study groups from 6 studies were included. 411,561 person-years of follow-up among 28,093 subjects (86% female) were included (SIR 2.18, 95% CI 1.83-2.60). For cockpit crew, data from 9 studies representing 830,670 person-years of follow-up among 45,986 subjects (1% female) were included (SIR 2.44, 95% CI 1.94-3.08). z-test for the difference indicated that the two SIR values were not statistically different ( z= 0.77, p = 0.441). Conclusions: Though cockpit crew demonstrate an increased SIR vs cabin crew, this is not statistically significant. These results suggest that occupational exposures in different locations within commercial aircraft does not influence MEL risk. Other factors, such as cosmic radiation, non-aircraft occupational exposures and avocational exposures, should be the targets of further assessment.

Obstructive Sleep Apnea in Acromegaly and the Effect of Treatment: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 105 (3) ◽  
pp. e23-e31 ◽  
Author(s):  
Matteo Parolin ◽  
Francesca Dassie ◽  
Luigi Alessio ◽  
Alexandra Wennberg ◽  
Marco Rossato ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Meta Analysis ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Before And After ◽  
The Difference

Abstract Background Obstructive sleep apnea (OSA) is a common disorder characterized by upper airway collapse requiring nocturnal ventilatory assistance. Multiple studies have investigated the relationship between acromegaly and OSA, reporting discordant results. Aim To conduct a meta-analysis on the risk for OSA in acromegaly, and in particular to assess the role of disease activity and the effect of treatments. Methods and Study Selection A search through literature databases retrieved 21 articles for a total of 24 studies (n = 734). Selected outcomes were OSA prevalence and apnea-hypopnea index (AHI) in studies comparing acromegalic patients with active (ACT) vs inactive (INACT) disease and pretreatment and posttreatment measures. Factors used for moderator and meta-regression analysis included the percentage of patients with severe OSA, patient sex, age, body mass index, levels of insulin-like growth factor 1, disease duration and follow-up, and therapy. Results OSA prevalence was similar in patients with acromegaly who had ACT and INACT disease (ES = −0.16; 95% CI, −0.47 to 0.15; number of studies [k] = 10; P = 0.32). In addition, AHI was similar in ACT and INACT acromegaly patients (ES = −0.03; 95% CI, −0.49 to 0.43; k = 6; P = 0.89). When AHI was compared before and after treatment in patients with acromegaly (median follow-up of 6 months), a significant improvement was observed after treatment (ES = −0.36; 95% CI, −0.49 to −0.23; k = 10; P &lt; 0.0001). In moderator analysis, the percentage of patients with severe OSA in the populations significantly influenced the difference in OSA prevalence (P = 0.038) and AHI (P = 0.04) in ACT vs INACT patients. Conclusion Prevalence of OSA and AHI is similar in ACT and INACT patients in cross-sectional studies. However, when AHI was measured longitudinally before and after treatment, a significant improvement was observed after treatment.

scholarly journals Differential mortality rates in major and subthreshold depression: meta-analysis of studies that measured both

2013 ◽  
Vol 202 (1) ◽  
pp. 22-27 ◽  
Author(s):  
Pirn Cuijpers ◽  
Nicole Vogelzangs ◽  
Jos Twisk ◽  
Annet Kleiboer ◽  
Juan Li ◽  
...  
Keyword(s):  
Major Depression ◽  
Excess Mortality ◽  
Meta Analysis ◽  
Population Attributable Fraction ◽  
Attributable Fraction ◽  
Differential Mortality ◽  
Bibliographic Databases ◽  
Subthreshold Depression ◽  
The Difference

BackgroundAlthough the association between depression and excess mortality has been well established, it is not clear whether this is greater in major depression than in subthreshold depression.AimsTo compare excess mortality in major depression with that in subthreshold depression.MethodWe searched bibliographic databases and included prospective studies in which both major and subthreshold depression were examined at baseline and mortality was measured at follow-up.ResultsA total of 22 studies were included. People with major depression had a somewhat increased chance of dying earlier than people with subthreshold depression but this difference was not significant, although there was a trend (relative risk 1.13, 95% CI 0.98-1.30, P=0.1). The population attributable fraction was 7% for major depression and an additional 7% for subthreshold depression.ConclusionsAlthough excess mortality may be somewhat higher in major than in subthreshold depression, the difference is small and the overall impact on excess mortality is comparable.

scholarly journals Conjoined versus separate technique: a meta-analysis of anastomosis techniques for urinary diversion after bladder cancer

2019 ◽  
Author(s):  
Liu Daqian ◽  
Wang Yonghua ◽  
Zhao Yang ◽  
Yang Xuecheng ◽  
wang xinsheng ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Diversion ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Anastomosis Group ◽  
Separate Group ◽  
Cochrane Central Register ◽  
Central Register ◽  
The Difference

Abstract Introduction: This was a meta-analysis of studies on conjoined and separate anastomosis for urinary diversion after radical cystectomy due to bladder cancer. Methods: We searched databases (PubMed, Embase and the Cochrane Central Register of Controlled Trials) for studies regarding anastomosis for urinary diversion due to bladder cancer. The meta-analysis was designed to determine the difference between conjoined and separate anastomosis. Six studies including 1601 patients were considered in the meta-analysis (654 in the separate group and 947 in the conjoined group). Results: There were no significant differences with respect to age, gender or duration of follow-up. There were seven studies that compared the rate of stricture and the rate of hydronephrosis. For overall stricture, there were 186 of 1163 ureters in the separate group and 64 of 1718 ureters in the conjoined group (odds ratio, 4.53; 95% CI, 2.01-10.22; P = 0.0003). For overall hydronephrosis patients, there were 55 of 205 ureters in the separate group and 51 of 254 ureters in the conjoined group (odds ratio, 1.48; 95% CI, 0.95-2.29; P = 0.08). Conclusion: The separate anastomosis had a higher ratio of strictures than did the conjoined group. The separate anastomosis group experienced hydronephrosis more often than did the conjoined anastomosis group. The separate anastomosis is the better choice for surgery during the operation.

Clinical and radiological characteristics of tumefactive demyelinating lesions: follow-up study

2012 ◽  
Vol 18 (10) ◽  
pp. 1448-1453 ◽  
Author(s):  
A Altintas ◽  
B Petek ◽  
N Isik ◽  
M Terzi ◽  
F Bolukbasi ◽  
...  
Keyword(s):  
Clinical Course ◽  
Demographic Data ◽  
Laboratory Data ◽  
Study Groups ◽  
Oligoclonal Band ◽  
Medical Centers ◽  
Closed Ring ◽  
Demyelinating Lesions ◽  
The Difference

Background: Demyelinating lesions over 20 mm in size, referred to as tumefactive demyelinating lesions, can be misdiagnosed as being either a tumor or an abscess. Although some radiological characteristics can help make a differential diagnosis easier, a cerebral biopsy may still be necessary. Objective: Our objective was to assess the clinical characteristics of tumefactive lesions, with or without a diagnosis of multiple sclerosis (MS), and present follow-up data for 54 patients with tumefactive lesions. Methods: Demographic, clinical, radiological and laboratory data were gathered and treatment responses were evaluated in a total of 54 patients from five medical centers. Result: Twenty-nine patients were diagnosed with tumefactive lesions at the onset, whereas 25 patients were diagnosed with tumefactive lesions after a diagnosis of MS. Median follow-up was 38.12 months. At final examination, 19 of the patients with a tumefactive lesion diagnosis at the onset eventually developed relapsing–remitting MS, while 10 remained with the condition as a clinically isolated syndrome. The tumefactive lesions studied were mostly focal, with closed-ring enhancement. We found that oligoclonal band positivity was less frequent in the patients with tumefactive onset. Conclusion: Although our demographic data were similar to formerly collected Turkish MS data, we found that the distribution of the patients’ clinical course differed if there was an absence of primary progressive MS and that there was a lower frequency of secondary progressive MS cases in our group of patients. We believe that less frequent oligoclonal band positivity and the difference we witnessed in the clinical course of disease in our study groups suggest that there is a need for further studies to compare all the biological and immunological differences between MS and tumefactive lesion cases, in order to reveal whether there are different pathogenetic mechanisms involved.

scholarly journals The Effect of Silver Diamine Fluoride in Preventing Caries in the Primary Dentition: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 53 (1) ◽  
pp. 24-32 ◽  
Author(s):  
Branca Heloisa Oliveira ◽  
Anjana Rajendra ◽  
Analia Veitz-Keenan ◽  
Richard Niederman
Keyword(s):  
Systematic Review ◽  
Primary Teeth ◽  
Data Extraction ◽  
Meta Analysis ◽  
Glass Ionomer Cement ◽  
Silver Diamine Fluoride ◽  
Caries Increment ◽  
The Difference ◽  
Caries Lesions

Objectives: To investigate whether silver diamine fluoride (SDF) is effective in preventing new caries lesions in primary teeth when compared to placebo or active treatments. Methods: Systematic review (CRD42016036963) of controlled clinical trials. Searches were performed in 9 electronic databases, 5 registers of ongoing trials, and reference lists of identified review articles. Two researchers carried out data extraction and quality appraisal independently. The primary outcome was the difference in caries increment (decayed, missing, and filled surfaces or teeth – dmfs or dmft) between SDF and control groups. These differences were pooled as weighted mean differences (WMD) and prevented fractions (PF). Results: Searches yielded 2,366 unique records; 6 reports of 4 trials that randomized 1,118 and analyzed 915 participants were included. Two trials compared SDF to no treatment, 1 compared SDF to placebo and sodium fluoride varnish (FV), and 1 compared SDF to high-viscosity glass ionomer cement (GIC). All studies had at least 1 domain with unclear or high risk of bias. After 24 months of follow-up, in comparison to placebo, no treatment, and FV, SDF applications significantly reduced the development of new dentin caries lesions (placebo or no treatment: WMD = –1.15, PF = 77.5%; FV: WMD = –0.43, PF = 54.0%). GIC was more effective than SDF after 12 months of follow-up but the difference between them was not statistically significant (WMD, dmft: 0.34, PF: –6.09%). Conclusion: When applied to caries lesions in primary teeth, SDF compared to no treatment, placebo or FV appears to effectively prevent dental caries in the entire dentition. However, trials specifically designed to assess this outcome are needed.

scholarly journals Outcomes of microdebrider-assisted versus radiofrequency-assisted inferior turbinate reduction surgery: a systematic review and meta-analysis of interventional randomised studies

2020 ◽  
Vol 58 (6) ◽  
pp. 530-537
Author(s):  
A.A. Mirza ◽  
T.A. Alandejani ◽  
H.Y. Shawli ◽  
M.S. Alsamel ◽  
M.O. Albakrei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Nasal Obstruction ◽  
Meta Analysis ◽  
Inferior Turbinate ◽  
Acoustic Rhinometry ◽  
Randomised Trials ◽  
Long Term Follow Up ◽  
The Difference

Background: The microdebrider technique was introduced in clinical practice to provide a better outcome in nasal obstruction caused by inferior turbinate hypertrophy. We conducted this systematic review to evaluate the effectiveness of this technique, by comparison with the radiofrequency-assisted modality. Methodology: PubMed, Embase and the Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched to retrieve relevant randomised studies published prior to November 2019. Randomised Trials in English that studied the difference between the two techniques among adult patients were eligible for the current review. Data extraction and study inclusion were guided by PRISMA guidelines. The outcome measures were visual analogue scale (VAS, 0-10) for nasal obstruction, anterior active rhinomanometry, and acoustic rhinometry. A meta-analysis was carried out to quantify the difference between the two techni- ques, for each measured outcome. Results: Seven randomised trials were included and quantitatively analysed in this meta-analysis. Our analysis revealed that the microdebrider-assisted technique demonstrated significantly better VAS (0-10) for nasal obstruction scores in early and late posto- perative follow-up. Whilst no difference was noted using the objective measurements (rhinomanometry and acoustic rhinometry) at early follow-up, microdebrider-assisted technique showed superior results in long-term follow-up, as evidenced using anterior active rhinomanometry. Conclusions: The microdebrider-assisted technique results in a better outcome, particularly in long-term follow-up, when compa- red with radiofrequency.

Abstract P141: Dairy Consumption and Risk of Type 2 Diabetes: 3 Cohorts of US Adults and An Updated Meta-Analysis

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Mu Chen ◽  
Qi Sun ◽  
Edward Giovannucci ◽  
Walter Willett ◽  
Dariush Mozaffarian ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Meta Analysis ◽  
Random Effect ◽  
Health Study ◽  
Dairy Foods ◽  
Dairy Consumption ◽  
Different Types ◽  
Reduced Risk

Introduction: The relation between consumption of different types of dairy foods and risk of type 2 diabetes (T2D) remains uncertain. Hypothesis: We hypothesized that total dairy intake is not associated with incident T2D but some specific types of dairy foods may be associated with reduced risk of T2D in US adults. Methods: We followed 41,705 men in Health Professionals Follow-Up Study (1986-2010), 67,812 women in Nurses’ Health Study (1980-2010), and 86,158 women in the Nurses’ Health Study II (1991-2009). Diet was assessed by validated food-frequency questionnaires, and data were updated every 4 yrs. Incident T2D was confirmed by a validated supplementary questionnaire. Analyses were performed by using Cox regression models and fixed-effect meta-analyses were conducted to summarize the estimates of association if no significant heterogeneities were shown otherwise random-effect models were used. Results: During 4,054,783 person-years of follow-up, we documented 14,372 incident T2D cases. After adjustment for age, BMI, and other lifestyle and dietary risk factors, total dairy consumption was not associated with T2D risk and the pooled HR (95% CI) for each 1 serving/d increase in total dairy was 0.99 (0.98, 1.01). Among different types of dairy products, yogurt was consistently associated with lower T2D risk in all three cohorts, with a pooled HR of 0.83 (0.76, 0.91) for each 1 serving/d increment. Other types of dairy foods such as milk and cheese were not significantly associated with T2D. The results were confirmed by a meta-analysis of 13 prospective cohorts (543,438 participants and 39,555 diabetes cases): the RRs (95% CIs) were 0.98 (0.96, 1.01) and 0.83 (0.73, 0.95) for 400g total dairy/d and for 200g yogurt/d, respectively. Conclusion: These results suggest that intake of yogurt is associated with a reduced risk of T2D, whereas other dairy foods are not associated with incidence of T2D.

scholarly journals Smoking and Dental Implants: A Systematic Review and Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 58 (1) ◽  
pp. 39
Author(s):  
Abir Dunia Mustapha ◽  
Zainab Salame ◽  
Bruno Ramos Chrcanovic
Keyword(s):  
Dental Implants ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Implant Failure ◽  
Negative Consequences ◽  
Marginal Bone Loss ◽  
Manual Search ◽  
The Difference ◽  
Meta Analyses

Background and Objectives: Tobacco is today the single most preventable cause of death, being associated with countless diseases, including cancer and neurological, cardiovascular, and respiratory diseases. Smoking also brings negative consequences to oral health, potentially impairing treatment with dental implants. The present review aimed to evaluate the influence of smoking on dental implant failure rates and marginal bone loss (MBL). Materials and Methods: Electronic search was undertaken in three databases, plus a manual search of journals. Meta-analyses were performed, in addition to meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. Results: The review included 292 publications. Altogether, there were 35,511 and 114,597 implants placed in smokers and in non-smokers, respectively. Pairwise meta-analysis showed that implants in smokers had a higher failure risk in comparison with non-smokers (OR 2.402, p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 2.910, p < 0.001), as well as in the mandible (OR 2.866, p < 0.001). The MBL mean difference (MD) between the groups was 0.580 mm (p < 0.001). There was an estimated decrease of 0.001 in OR (p = 0.566) and increase of 0.004 mm (p = 0.279) in the MBL MD between groups for every additional month of follow-up, although without statistical significance. Therefore, there was no clear influence of the follow-up on the effect size (OR) and on MBL MD between groups. Conclusions: Implants placed in smokers present a 140.2% higher risk of failure than implants placed in non-smokers.

scholarly journals Dental Implants Inserted in Fresh Extraction Sockets versus Healed Sites: A Systematic Review and Meta-Analysis

Materials ◽  
2021 ◽  
Vol 14 (24) ◽  
pp. 7903
Author(s):  
Adam Ibrahim ◽  
Bruno Ramos Chrcanovic
Keyword(s):  
Odds Ratio ◽  
Meta Analysis ◽  
Implant Failure ◽  
Marginal Bone Loss ◽  
Manual Search ◽  
Failure Risk ◽  
Electronic Search ◽  
The Difference ◽  
Meta Analyses

The present review aimed to evaluate the difference of dental implant failure rates and marginal bone loss (MBL) between implants inserted in fresh extraction sockets or healed sites. Electronic search was undertaken in three databases, plus manual search of journals, including studies randomized or not. Meta-analyses were performed besides meta-regressions, in order to verify how the odds ratio (OR) and MBL were associated with follow-up time. The review included 163 publications. Altogether, there were 17,278 and 38,738 implants placed in fresh extraction sockets and healed sites, respectively. Pairwise meta-analyses showed that implants in sockets had a higher failure risk in comparison to healed sites: OR 1.349, all studies included; OR 2.070, only prospective non-RCTs; OR 2.487, only RCTs (all p < 0.001). The difference in implant failure between the groups was statistically significant in the maxilla (OR 1.616, p = 0.029), but not in the mandible (OR 2.192, p = 0.075). The MBL mean difference (MD) between the groups was −0.053 mm (p = 0.089). There was an estimated decrease of 0.003 in OR (p = 0.284) and an increase of 0.006 mm (p = 0.036) in the MBL MD between groups for every additional month of follow-up. In conclusion, implants placed in fresh extraction sockets present higher risk of failure than implants placed in healed sites.

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