scholarly journals Mortality rate and predictors of Stroke: A Meta-Analysis and Systematic Review

2019 ◽  
Author(s):  
Amanual Getnet Mersha ◽  
Tadesse Melaku Abegaz ◽  
Mohammed Assen Seid ◽  
Eyob Alemayehu Gebreyohannes ◽  
Akshaya Srikanth Bhagavath ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Stroke Mortality ◽  
Stroke Event ◽  
Meta Analyses ◽  
Random Effect Models ◽  
Overall Mortality

Abstract Background Global data on stroke mortality remained to be sparse. In light of this, we aimed to conduct a Meta-analysis and systematic review of observational studies to estimate the mortality of stroke and to identify risk factors that predispose patients for stroke-related death.Methods This study was conducted based on the Meta-Analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Overall mortality, in-hospital and 30- day mortality due to stroke were the primary outcome measures of the study. The meta-analysis was performed using Stata (Version 14, Stata Corp, College Station, Texas). Random-effect models were used for estimating pooled effects.Findings Overall, thirty two studies assessed overall mortality due to stroke. A total number of 2,885, 126 patients were recruited for the study. Pooled estimate indicated that the overall mortality of stroke was reported to be 20% (19%-22%). Whereas, the 30-day and In-hospital mortality were found to be 18% (16%-20%) and 16% (16%-19%), respectively. A subgroup analysis revealed that Africa registered the highest stroke-related death 29% (23%-36%). Hypertension was found to be an important risk factor for mortality secondary to stroke 61.9% (52.8%-71.1%).Conclusion Overall mortality of stroke was estimated to be twenty percent. The burden of stroke mortality was prominent in Africa region. Hypertension remained to be an independent risk factor for stroke mortality. Mortality of stroke can be minimized by establishing stroke centers that promptly deliver emergency management of stroke event.

scholarly journals Impact of metformin on the risk and treatment outcomes of tuberculosis in diabetics: a systematic review

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Xinyu Yu ◽  
Ling Li ◽  
Liangtao Xia ◽  
Xin Feng ◽  
Fan Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Outcomes ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effect ◽  
Patients With Diabetes ◽  
Latent Tb Infection ◽  
Meta Analyses ◽  
Diabetes Mellitus Treatment ◽  
The Impact

Abstract Background Tuberculosis (TB) remains one of the infectious diseases with a leading cause of death among adults worldwide. Metformin, a first-line medication for the treatment of type 2 diabetes, may have potential for treating TB. The aims of the present systematic review were to evaluate the impact of metformin prescription on the risk of tuberculosis diseases, the risk of latent TB infection (LTBI) and treatment outcomes of tuberculosis among patients with diabetic mellitus. Methods Databases were searched through March 2019. Observational studies reporting the effect of metformin prescription on the risk and treatment outcomes of TB were included in the systematic review. We qualitatively analyzed results of included studies, and then pooled estimate effects with 95% confidence intervals (CIs) of different outcome using random-effect meta-analyses. Results This systematic review included 6980 cases from 12 observational studies. The meta-analysis suggested that metformin prescription could decrease the risk of TB among diabetics (pooled odds ratio [OR], 0.38; 95%CI, 0.21 to 0.66). Metformin prescription was not related to a lower risk of LTBI (OR, 0.73; 95%CI, 0.30 to 1.79) in patients with diabetes. Metformin medication during the anti-tuberculosis treatment is significantly associated with a smaller TB mortality (OR, 0.47; 95%CI, 0.27 to 0.83), and a higher probability of sputum culture conversion at 2 months of TB disease (OR, 2.72; 95%CI, 1.11 to 6.69) among patients with diabetes. The relapse of TB was not statistically reduced by metformin prescription (OR, 0.55; 95%CI, 0.04 to 8.25) in diabetics. Conclusions According to current observational evidence, metformin prescription significantly reduced the risk of TB in patients with diabetes mellitus. Treatment outcomes of TB disease could also be improved by the metformin medication among diabetics.

Mindfulness- and Acceptance-Based Interventions for Stroke Survivors: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 003435522110432
Author(s):  
Areum Han
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Mental Fatigue ◽  
Stroke Survivors ◽  
Positive Effects ◽  
Meta Analyses

Objective: Mindfulness- and acceptance-based intervention (MABI) is an emerging evidenced-based practice, but no systematic review incorporating meta-analyses for MABIs in stroke survivors has been conducted. The objective of this systematic review was to measure the effectiveness of MABIs on outcomes in people with stroke. Method: Three electronic databases, including PubMed, CINAHL, and PsycINFO, were searched to identify relevant studies published in peer-reviewed journals. The methodological quality of the included studies was assessed. Data were extracted and combined in a meta-analysis with a random-effect model to compute the size of the intervention effect. Results: A total of 11 studies met the eligibility criteria. Meta-analyses found a small-to-moderate effect of MABIs on depressive symptoms (standardized mean difference [SMD] = 0.39, 95% confidence interval [CI] = [0.12, 0.66]) and a large effect on mental fatigue (SMD = 1.22, 95% CI = [0.57, 1.87]). No statistically significant effect of MABIs on anxiety, quality of life, and mindfulness was found, but there was a trend in favor of MABIs overall. Conclusions: This meta-analysis found positive effects of MABIs on depressive symptoms and mental fatigue in stroke survivors, but future high-quality studies are needed to guarantee treatment effects of MABIs on varied outcomes in stroke survivors.

Arthrodesis of First Metatarsophalangeal Joint by Plate and Screws for Treatment of Hallux Rigidus (Systematic Review and Meta-Analysis)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Ossama Abdelraoof El Shazly ◽  
Mohamed Mokhtar Abdellah ◽  
Mostafa Abdelnabee Abouzaid
Keyword(s):  
Systematic Review ◽  
Observational Studies ◽  
Plate Fixation ◽  
Meta Analysis ◽  
Metatarsophalangeal Joint ◽  
Hallux Rigidus ◽  
Superficial Infection ◽  
First Metatarsophalangeal Joint ◽  
Non Union ◽  
Meta Analyses

Abstract Background With continued loss of dorsiflexion of the 1st MTP, degenerative changes occur within the joint with severe restriction of movement and increase in pain, which leads to the condition known as hallux rigidus. The amount of dorsiflexion may be reduced to 0-10 degrees with pain on both active and passive motion. Objectives Systematically reviewing available evidence from published articles to assess the effectiveness of arthrodesis of first metatarsophalangeal joint by plate and screws in hallux rigidus. The assessment also would encompass safety, side effects, and complications of this mode of treatment. Materials and Methods We performed this systematic review and meta-analysis in accordance to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) statement. PRISMA and MOOSE are reporting checklists for Authors, Editors, and Reviewers of Meta-analyses of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results Previous results for arthrodesis have been favourable with a union rate of almost 96%. In the present systematic review and meta-analysis, the overall effect estimates showed that the union rates after plate and screw arthrodesis for 1st MTPJ was 96.2% (95% CI 94 – 98.4%). In addition, the overall effect estimates showed that the non-union rates after plate and screw arthrodesis for 1st MTPJ was 4.2% (95% CI 2.4 – 6.1%). Moreover, the overall effect estimates showed that the satisfaction rates after plate and screw arthrodesis for 1st MTPJ was 94.5% (95% CI 90 – 99%). In the present study, the overall effect estimates showed that the overall complications rate after plate and screw arthrodesis for 1st MTPJ was 7.2% (95% CI 2.5 – 12%). The overall effect estimates showed that the malunion rates after plate and screw arthrodesis for 1st MTPJ was 2.7% (95% CI 0 – 6.4%). Additionally, the overall effect estimates showed that the hardware removal and superficial infection rates after plate and screw arthrodesis for 1st MTPJ were 2% and 2.9%, respectively. Conclusion Our analysis showed that plate and screws fixation is effective techniques that can be used for first MTPJ arthrodesis in patients with hallux rigidus. We found that the screw and plate fixation has a significantly lower rate of nonunion compared with the screw alone, as reported by the literature. However, owing to the small group sizes and methodologic shortcomings, we were unable to identify the clinically superior fixation technique for first MTPJ arthrodesis arthrodesis.

scholarly journals Association of Toxoplasmosis with suicide: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Eissa Soleymani ◽  
Fariba Faizi ◽  
Rashid Heidarimoghadam ◽  
Lotfollah Davoodi ◽  
Younes Mohammadi
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Publication Bias ◽  
Potential Risk ◽  
Meta Analysis ◽  
Random Effect ◽  
Potential Risk Factor ◽  
Analysis Phase ◽  
Analysis Methods ◽  
And Control

Abstract Background findings on association of Toxoplasmosis and suicide is contradictory. This paper aimed to resolve this uncertainty with help of Meta-analysis. Methods using keywords include “Toxoplasmosis” and “suicide” and the relayed synonyms in international databases such as ISI, Medline and Scopus, we found the relevant studies. The eligible studies included into Meta-analysis phase. Random effect approach was used to combine the results. Results out of 150 initial studies, 16 were included into meta-analysis. Odds of suicide in person with toxoplasmosis was 47% (OR: 1.47, 95%CI; 1.20 to 1.79) higher than of that without toxoplasmosis. Test for publication bias was not statistically significant, which indicate absence of likely publication bias. Conclusion This study confirm which toxoplasmosis is a potential risk factor for suicide. To reduce cases of suicide attributable to Toxoplasmosis, it deserving the measures to prevent and control of transmission of toxoplasmosis should be taken.

scholarly journals Is Sensory Loss an Understudied Risk Factor for Frailty? A Systematic Review and Meta-analysis

2020 ◽  
Vol 75 (12) ◽  
pp. 2461-2470
Author(s):  
Benjamin Kye Jyn Tan ◽  
Ryan Eyn Kidd Man ◽  
Alfred Tau Liang Gan ◽  
Eva K Fenwick ◽  
Varshini Varadaraj ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Longitudinal Studies ◽  
Meta Analysis ◽  
Sensory Loss ◽  
Cross Sectional ◽  
Sensory Impairments ◽  
Subgroup Analyses ◽  
Meta Regression ◽  
Meta Analyses

Abstract Background Age-related sensory loss and frailty are common conditions among older adults, but epidemiologic research on their possible links has been inconclusive. Clarifying this relationship is important because sensory loss may be a clinically relevant risk factor for frailty. Methods In this systematic review and meta-analysis, we searched 3 databases for observational studies investigating 4 sensory impairments—vision (VI), hearing (HI), smell (SI), and taste (TI)—and their relationships with frailty. We meta-analyzed the cross-sectional associations of VI/HI each with pre-frailty and frailty, investigated sources of heterogeneity using meta-regression and subgroup analyses, and assessed publication bias using Egger’s test. Results We included 17 cross-sectional and 7 longitudinal studies in our review (N = 34,085) from 766 records. Our cross-sectional meta-analyses found that HI and VI were, respectively, associated with 1.5- to 2-fold greater odds of pre-frailty and 2.5- to 3-fold greater odds of frailty. Our results remained largely unchanged after subgroup analyses and meta-regression, though the association between HI and pre-frailty was no longer significant in 2 subgroups which lacked sufficient studies. We did not detect publication bias. Longitudinal studies largely found positive associations between VI/HI and frailty progression from baseline robustness, though they were inconclusive about frailty progression from baseline pre-frailty. Sparse literature and heterogenous methods precluded meta-analyses and conclusions on the SI/TI–frailty relationships. Conclusions Our meta-analyses demonstrate significant cross-sectional associations between VI/HI with pre-frailty and frailty. Our review also highlights knowledge gaps on the directionality and modifiability of these relationships and the impact of SI/TI and multiple sensory impairments on frailty.

scholarly journals A continuum of executive function deficits in early subcortical vascular cognitive impairment: A systematic review and meta-analysis

2017 ◽  
Vol 11 (4) ◽  
pp. 371-380 ◽  
Author(s):  
Felipe Kenji Sudo ◽  
Patricia Amado ◽  
Gilberto Sousa Alves ◽  
Jerson Laks ◽  
Eliasz Engelhardt
Keyword(s):  
Systematic Review ◽  
Cognitive Impairment ◽  
Executive Function ◽  
Mild Cognitive Impairment ◽  
Meta Analysis ◽  
Random Effect ◽  
Vascular Cognitive Impairment ◽  
Color Test ◽  
Meta Analyses ◽  
Subcortical Vascular Cognitive Impairment

ABSTRACT. Background. Subcortical Vascular Cognitive Impairment (SVCI) is a clinical continuum of vascular-related cognitive impairment, including Vascular Mild Cognitive Impairment (VaMCI) and Vascular Dementia. Deficits in Executive Function (EF) are hallmarks of the disorder, but the best methods to assess this function have yet to be determined. The insidious and almost predictable course of SVCI and the multidimensional concept of EF suggest that a temporal dissociation of impairments in EF domains exists early in the disorder. Objective: This study aims to review and analyze data from the literature about performance of VaMCI patients on the most used EF tests through a meta-analytic approach. Methods: Medline, Web of Knowledge and PsycINFO were searched, using the terms: “vascular mild cognitive impairment” OR “vascular cognitive impairment no dementia” OR “vascular mild neurocognitive disorder” AND “dysexecutive” OR “executive function”. Meta-analyses were conducted for each of the selected tests, using random-effect models. Results: Systematic review showed major discrepancies among the results of the studies included. Meta-analyses evidenced poorer performance on the Trail-Making Test part B and the Stroop color test by VaMCI patients compared to controls. Conclusion: A continuum of EF impairments has been proposed in SVCI. Early deficits appear to occur in cognitive flexibility and inhibitory control.

scholarly journals Systematic review on risk factors of rotator cuff tears

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668431 ◽  
Author(s):  
Andrew Arjun Sayampanathan ◽  
Tan Hwee Chye Andrew
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Rotator Cuff ◽  
Meta Analysis ◽  
Random Effect ◽  
Female Gender ◽  
Analysis Data ◽  
Rotator Cuff Tears ◽  
Dominant Hand ◽  
Random Effect Models

Purpose: Rotator cuff tears (RCTs) occur commonly, especially among certain groups of individuals. In this meta-analysis, we aim to identify risk factors for RCTs. Methods: We searched MEDLINE for 210 articles. Seventeen articles were selected for systematic review, of which 10 were eligible for meta-analysis. Data was analysed with Review Manager 5.3, using Mantel–Haenszel statistics and random effect models. Results: A total of 6653 individuals were analysed. The odds of sustaining a RCT on the dominant hand was 2.30 times more than the non-dominant hand (95% confidence interval (CI): 1.01–5.25, Z = 1.99, p = 0.05; Heterogenity: τ2 = 0.38, χ2 = 8.84, df = 2 ( p = 0.01), I2 = 77%). The odds of an individual aged 60 years and above sustaining a RCT was 5.07 times higher than an individual less than 60 years old (95% CI: 2.45–10.51, Z = 4.37, p < 0.001; Heterogenity: τ2 = 0.47, χ2 = 25.24, df = 3 ( p < 0.001), I2 = 88%). Female gender was not a significant association, with an odds ratio of 0.98 when compared to the male gender (95% CI: 0.66–1.45, Z = 0.09, p = 0.93; Heterogenity: τ2 = 0.20, χ2 = 44.24, df = 5 ( p < 0.001), I2 = 89%). Conclusions: Hand dominance and older age are associated with RCTs. More studies are required for further assessment of associations and risk factors of RCTs.

scholarly journals Assessing the Association between the Methylenetetrahydrofolate Reductase (MTHFR) 677C->T Polymorphism on Blood Folate Concentrations: A Systematic Review and Meta-analysis of Trials and Observational Studies

2015 ◽  
pp. 650-651
Author(s):  
Becky Tsang ◽  
Amy Cordero ◽  
Claire Marchetta ◽  
Joseph Mulinare ◽  
Patricia Mersereau ◽  
...  
Keyword(s):  
Systematic Review ◽  
Protein Binding ◽  
Observational Studies ◽  
Methylenetetrahydrofolate Reductase ◽  
Meta Analysis ◽  
Mthfr C677t ◽  
Review Of Literature ◽  
Binding Assays ◽  
Lower Blood ◽  
Meta Analyses

Objectives: The methylenetetrahydrofolate reductase (MTHFR) 677C->T polymorphism is a risk factor for neural tube birth defects (NTDs). The T allele produces an enzyme with reduced folate processing capacity, which has been shown to produce lower blood folate concentrations in some studies. Our objective was to assess the association between MTHFR C677T genotypes (CC, CT, TT) and blood folate concentrations among women aged 12-49 years. Methods: We conducted a systematic review of literature published between 1/1992-7/2013 to identify controlled trials and observational studies that reported serum, plasma, or red blood cell (RBC) folate concentrations and MTHFR C677T genotype. We applied a Bayesian random-effects model to predict differences in blood folate concentrations between MTHFR C677T genotypes, stratified by folate assay. Results: Thirty-eight studies met criteria for inclusion. Serum/plasma folate concentrations showed a consistent genotype trend with the highest concentrations for CC (CC > CT > TT) regardless of assay type. RBC folate concentrations measured by microbiologic assay also demonstrated this trend; however, this trend was reversed (CC < CT < TT) in studies using protein-binding assays. Conclusions: Meta-analyses results showed blood folate concentrations differed by assay type and genotype. Previous evidence has shown that RBC folate concentrations measured with a radioimmunoassay requires adjustment for genotype-dependent folate recovery; our results suggest that other protein-binding assays could have similar limitations. Compared to CC individuals, TT individuals have lower blood folate concentrations, which may increase a woman's risk for an NTD-affected pregnancy.

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