scholarly journals Gender and Regional Disparities in Incidence of Hepatocellular Carcinoma in Autoimmune Hepatitis: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Lun-Jie Yan ◽  
Sheng-Yu Yao ◽  
Guang-Xiao Meng ◽  
Kai-Xuan Liu ◽  
Hai-Chao Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
North America ◽  
Autoimmune Hepatitis ◽  
Incidence Rate ◽  
Regional Disparities ◽  
Cochrane Library ◽  
Population Difference ◽  
Asian Populations ◽  
Increased Risk ◽  
The Impact

Abstract BackgroundRecent studies have identified an increased risk of hepatocellular carcinoma (HCC) in autoimmune hepatitis (AIH). Gender and regional disparities in incidence of HCC in AIH continue to be reported worldwide. Nevertheless, the magnitude of this gap remains unknown.MethodWe searched several databases including PubMed, Embase, Web of Science, Cochrane Library, Wangfang Data, CNKI and Sinomed. Incidence rates of HCC in AIH were combined and analyzed following the EBayes method. Incidence rate ratios were pooled to assess the gender differences. The impact of population difference, gender, age, cirrhotic condition was further analyzed with subgroup analysis and linear regression analysis.Result39 studies meeting our eligibility criteria were chosen for the analysis. The pooled incidence rate of HCC in AIH was 3.54 per 1,000 person-years (95%CI = 2.76–4.55). Pooled IRR for the risk of HCC in male AIH patients compared to female was 2.16 (95%CI = 1.25–3.75), with mild heterogeneity among studies. The pooled HCC incidence rate in AIH by continents was as follows: Europe 2.37 per 1,000 person-years (95%CI = 1.45–3.88), Asia 6.18 per 1,000 person-years (95%CI = 5.51–6.93), North America 2.97 per 1,000 person-years (95%CI = 2.40–3.68), Oceania 2.60 (95%CI = 0.54–7.58). The pooled HCC incidence rate in AIH related cirrhosis by continent was as follows: Europe 6.35 per 1,000 person-years (95%CI = 3.94–10.22), Asia 17.02 per 1,000 person-years (95%CI = 11.18–25.91), North America 10.89 per 1,000 person-years (95%CI = 6.69–17.74).ConclusionA higher HCC incidence in AIH was observed among male and in Asian populations. Routine HCC surveillance is cost effective for patients with AIH cirrhosis, especially for those in Asian populations.

scholarly journals Prediction of sepsis-related outcomes in neonates through systematic genotyping of polymorphisms in genes for innate immunity and inflammation: a narrative review and critical perspective

2013 ◽  
Vol 131 (5) ◽  
pp. 338-350 ◽  
Author(s):  
Juliana Kilesse Carvalho ◽  
Daniella Batalha Moore ◽  
Ricardo Alves Luz ◽  
Pedro Paulo Xavier-Elsas ◽  
Maria Ignez Capella Gaspar-Elsas
Keyword(s):  
Innate Immunity ◽  
Gene Polymorphisms ◽  
Large Scale ◽  
Scientific Evidence ◽  
Cochrane Library ◽  
Increased Risk ◽  
Immunity Genes ◽  
Hemostatic Factors ◽  
Narrative Literature Review ◽  
The Impact

CONTEXT AND OBJECTIVE: Neonatal sepsis is associated with premature birth and maternal infection. Large-scale studies seek to define markers that identify neonates at risk of developing sepsis. Here, we examine whether the scientific evidence supports systematic use of polymorphism genotyping in cytokine and innate immunity genes, to identify neonates at increased risk of sepsis. DESIGN AND SETTING: Narrative literature review conducted at Fernandes Figueira Institute, Brazil. METHODS: The literature was searched in PubMed, Embase (Excerpta Medica Database), Lilacs (Literatura Latino-Americana e do Caribe em Ciências da Saúde), SciELO (Scientific Electronic Library Online) and Cochrane Library. From > 400,000 references, 548 were retrieved based on inclusion/exclusion criteria; 22 were selected for detailed analysis after quality assessment. RESULTS: The studies retrieved addressed the impact of gene polymorphisms relating to immune mechanisms (most often TNF-a, LT-a, IL-6, IL-1β, IL-1ra, L-selectin, CD14 and MBL) or inflammatory mechanisms (ACE and angiotensin II receptors; secretory PLA2; and hemostatic factors). Despite initial reports suggesting positive associations between specific polymorphisms and increased risk of sepsis, the accumulated evidence has not confirmed that any of them have predictive power to justify systematic genotyping. CONCLUSIONS: Sepsis prediction through systematic genotyping needs to be reevaluated, based on studies that demonstrate the functional impact of gene polymorphisms and epidemiological differences among ethnically distinct populations.

scholarly journals Neurocognitive Deficits Associated With ADHD in Athletes: A Systematic Review

2018 ◽  
Vol 10 (4) ◽  
pp. 317-326 ◽  
Author(s):  
Poyrung Poysophon ◽  
Ashwin L. Rao
Keyword(s):  
Systematic Review ◽  
Stimulant Medication ◽  
Adolescent And Young Adult ◽  
Symptom Reporting ◽  
Cognitive Test ◽  
Cochrane Library ◽  
Neurocognitive Deficits ◽  
Inclusion Criteria ◽  
Increased Risk ◽  
The Impact

Context: Attention deficit hyperactivity disorder (ADHD) is a common childhood disorder and is frequently diagnosed in young adults. Emerging studies suggest a relationship between ADHD and concussion. Objective: To determine whether athletes with ADHD are at increased risk for neurocognitive deficits related to concussion risk, symptom reporting, and recovery. Data Sources: A comprehensive search of PubMed, CINAHL, PsychInfo, and Cochrane Library databases was performed. Studies conducted between 2006 and 2017 were reviewed, although only those between 2013 and 2017 met inclusion criteria. Study Selection: Studies that examined neurocognitive deficits in adolescent and young adult athletes aged 15 to 19 years who had ADHD and reported using notable neuropsychological evaluation tools were included. Study Design: Systematic review. Level of Evidence: Level 2. Results: A total of 17 studies met the inclusion criteria. The prevalence of ADHD in athletes varied between 4.2% and 8.1%. Overall, athletes with ADHD demonstrated lower scores on neurocognitive testing such as the ImPACT (Immediate Post-Concussion Assessment and Cognitive Test), increased risk for concussion, and increased symptom reporting. There was no evidence that treatment with stimulant medication changed these risks. Conclusion: ADHD is associated with increased neurocognitive deficits in athletes, although pathophysiology remains unclear. Evidence for stimulant treatment in athletes with ADHD continues to be sparse.

scholarly journals Looking beyond the obvious: a critical systematic review and meta-analyses of risk factors for fertility problems in a globalized world

2021 ◽  
Author(s):  
Rasha R Bayoumi ◽  
Jacky Boivin ◽  
Human M Fatemi ◽  
Lisa Hurt ◽  
Gamal I Serour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Global Health ◽  
Neonatal Death ◽  
Cochrane Library ◽  
Reproductive Process ◽  
Increased Risk ◽  
Fertility Problems ◽  
Meta Analyses ◽  
The Impact

Background: Well-established risk factors for fertility problems such as smoking have been included in fertility awareness efforts globally. However, these efforts neglect risks that women in low and middle-income countries (LMIC) face. Objective: To address this gap, we identified eight risk factors affecting women in LMIC and the aim of the current review was to estimate the impact of these risks on fertility. Methods: We conducted systematic reviews and where data was available meta-analyses. We searched Medline, Embase, Cochrane library, regional databases and key organizational websites (1946-June 2016, updated January 2018, latest update taking place in 2021). Two researchers screened and extracted data independently. We included all study designs that assessed exposure to risk in clinical or community-based samples and excluded studies without control groups. The outcome of interest was fertility problems (inability to achieve pregnancy or live birth and neonatal death). We calculated pooled effect estimates from reported effect sizes or raw data. We assessed study quality using the Newcastle-Ottawa Scale. We registered the review with PROSPERO, registration number CRD42016048497. Results: We identified 2,418 studies and included 61 (57 in meta-analyses). Results revealed a nine-fold increased risk of inability to become pregnant in genital tuberculosis (OR 8.91, CI 1.89-42.12) and almost threefold in HIV (OR 2.93, CI 1.95-4.42) and bacterial vaginosis (OR 2.81, CI 1.85-4.27). A twofold increased risk of tubal-factor infertility in Female Genital Mutilation/Cutting [Type II/III] (OR 2.06, CI 1.03-4.15) and increased post-natal mortality in consanguinity (stillbirth, OR 1.28, CI 1.04-1.57; neonatal death, OR 1.57, CI 1.22-2.02). Strength and limitations: Reliability of results was bolstered by a rigorous systematic review methodology that is replicable but limited by methodological shortcomings of the available primary studies and the small number of studies in each meta-analysis. Conclusions: The risk factors investigated appeared to impact the reproductive process through multiple biological, behavioural, and clinical pathways. Additionally, infection and pelvic inflammatory disease seemed to be common pathways for several risk factors. The complex multifactorial risk profile can be addressed by LMIC using a global health framework to determine which risk factors are significant to their populations and how to tackle them. The subsequent health promotion encompassing these relevant health indicators could translate into more prevention and effective early detection of fertility problems in LMIC. Finally, the findings of multifactorial risk reinforced the need to put fertility as an agenda in global health initiatives.

scholarly journals Hospital Frailty Risk Score Is Independently Associated with Mortality and Encephalopathy in Hospitalized Patients with Hepatocellular Carcinoma

Biomedicines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1693
Author(s):  
Daryl Ramai ◽  
Khoi P. Dang-Ho ◽  
Anjali Kewalramani ◽  
Praneeth Bandaru ◽  
Rodolfo Sacco ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Encephalopathy ◽  
Length Of Stay ◽  
Risk Score ◽  
Cox Regression ◽  
Surrogate Marker ◽  
Hospital Length Of Stay ◽  
Frail Patients ◽  
Increased Risk ◽  
The Impact

Frailty represents a state of vulnerability to multiple internal physiologic factors, as well as external pressures, and has been associated with clinical outcomes. We aim to understand the impact of frailty on patients admitted with hepatocellular carcinoma (HCC) by using the validated Hospital Frailty Risk Score, which is implemented in several hospitals worldwide. We conducted a nation-wide retrospective cohort study to determine the effect of frailty on the risk of in-patient mortality, hepatic encephalopathy, length of stay and cost. Frailty was associated with a 4.5-fold increased risk of mortality and a 2.3-fold increased risk of hepatic encephalopathy. Adjusted Cox regression showed that frailty was correlated with increased risk of in-patient mortality (hazard ratio: 2.3, 95% CI 1.9–2.8, p < 0.001). Frail HCC patients had longer hospital stay (median 5 days) vs. non-frail HCC patients (median 3 days). Additionally, frail patients had higher total costs of hospitalization ($40,875) compared with non-frail patients ($31,667). Frailty is an independent predictor of hepatic encephalopathy and in-patient mortality. Frailty is a surrogate marker of hospital length of stay and cost.

scholarly journals Geographical Distribution of Fast Food and CRC Incidence in Young Adults

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 193s-193s
Author(s):  
M.-S.K. Ku
Keyword(s):  
Colorectal Cancer ◽  
Young Adults ◽  
Incidence Rate ◽  
Geographic Distribution ◽  
Fast Food ◽  
Random Effect ◽  
Food Stores ◽  
Increased Risk ◽  
Increasing Trend ◽  
The Impact

Background: There is an increasing trend of colorectal cancer (CRC) in young adults who also used to take fast food. However, little is known about the association between fast food and the occurrence of CRC in young adults. Aim: To investigate the impact of fast food diet on the incidence rate of CRC in terms of geographic distribution. Methods: Geographic distribution of fast food diet was measured by the density of fast food stores (numbers of fast food stores/population per 105) according to each county. We summed up total numbers of the fast food stores ranking the top 3 in Taiwan from the corresponding official Web sites. The incidence of CRC from 2004 to 2013 for young adults aged 15 to 49 years old was computed from Interactive Information System of the National Cancer Registry, provided by Health Promotion Administration, Ministry of Health and Welfare. Multilevel random-effect regression model was applied to estimating the effects of geographical location of fast food stores at city/county level on incidence of CRC with adjustment for age and gender at individual level. Results: The incidence rate of CRC in young adults aged 50 years or below was in parallel with the distribution of fast food stores in geographical pattern. After adjusting for age and sex, the results show that an increase in the growth of 1 unit of density in fast food store led to an increase in incidence of CRC by 2%. Approximately 87% accuracy was noted in predicting the highest one-third percentage of incident CRC cases in young adults. Conclusion: The density of fast food stores was highly associated with the increased risk of colorectal cancer incidence in young adults. This may account for the increasing trend of CRC in young adults in Taiwan.

scholarly journals Association of Leptin and Adiponectin with Risk and Prognosis of Hepatocellular Carcinoma: A Combination of Traditional, Survival and Dose-response Meta-analysis

2020 ◽  
Author(s):  
Lilong Zhang ◽  
Qihang Yuan ◽  
Man Li ◽  
Dongqi Chai ◽  
Wenhong Deng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Meta Analysis ◽  
Healthy Control Group ◽  
Cochrane Library ◽  
Control Group ◽  
Linear Relationships ◽  
Increased Risk ◽  
Healthy Control ◽  
Carcinoma Risk

Abstract Background: The association between leptin, adiponectin levels and the risk as well as prognosis of hepatocellular carcinoma has been investigated by an increasing number of studies, but the results were controversial.Methods: A meta-analysis was performed to assess the correlation between leptin, adiponectin levels and risk and prognosis of hepatocellular carcinoma (CRD42020195882). Through June 14, 2020, PubMed, Cochrane Library, Embase databases, Clinicaltrials, and Opengrey were searched, including references of qualifying articles. Titles, abstracts, and main texts were reviewed by at least 2 independent readers. Stata 16.0 was used to calculate statistical data.Results: Thirty studies were included in this meta-analysis and results showed that hepatocellular carcinoma group had significantly higher leptin levels than the cancer-free control group (SMD = 1.83, 95% CI (1.09, 2.58), P = 0.000) , the healthy control group (SMD = 4.32, 95% CI (2.41, 6.24), P = 0.000) and the cirrhosis group (SMD = 1.85, 95% CI (0.70, 3.01), P = 0.002). Hepatocellular carcinoma group had significantly higher adiponectin levels than the healthy control group (SMD = 1.57, 95% CI (0.37, 2.76), P = 0.010), but no statistical difference compared with the cancer-free control group (SMD = 0.24, 95% CI (-0.35, 0.82), P = 0.430) and the cirrhosis group (SMD = -0.51, 95% CI (-1.30, 0.29), P= 0.213). The leptin rs7799039 polymorphism was associated with increased risk of hepatocellular carcinoma (G vs A: OR = 1.28, 95% CI (1.10, 1.48), P = 0.002). There were linear relationships between adiponectin levels and the risk of hepatocellular carcinoma (OR = 1.066, 95% CI (1.03, 1.11), P = 0.001). In addition, the results showed that high/positive expression of adiponectin was significantly related to lower overall survival in hepatocellular carcinoma patients (HR = 1.70, 95% CI (1.22, 2.37), P = 0.002); however, there was no significantly association between the leptin levels and overall survival (HR = 0.92, 95% CI (0.53, 1.59), P = 0.766).Conclusion: The study shows that high leptin levels are associated with a higher risk of hepatocellular carcinoma. Adiponectin levels are proportional to hepatocellular carcinoma risk, and are related to the poor prognosis.

The influence of disease activity on pregnancy outcomes in women with inflammatory bowel disease: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Min-A Kim ◽  
Young-Han Kim ◽  
Jaeyoung Chun ◽  
Hye Sun Lee ◽  
Soo Jung Park ◽  
...  
Keyword(s):  
Systematic Review ◽  
Preterm Birth ◽  
Disease Activity ◽  
Spontaneous Abortion ◽  
Pregnancy Outcomes ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
The Impact

Abstract Background & Aims Robust evidence regarding the impact of disease activity on pregnancy outcomes in women with IBD is crucial for both clinicians and patients in preparing a birth plan. We sought to perform a systematic review and meta-analysis to assess the pooled influences of disease activity on pregnancy outcomes in women with IBD. Methods We searched MEDLINE, EMBASE, and COCHRANE library to identify articles comparing pregnancy outcomes between active and inactive IBD at the time of conception or during pregnancy. A meta-analysis was performed using a random-effects model to pool estimates and report odds ratios (ORs). Results A total of 28 studies were identified as eligible for the meta-analysis. In women with active IBD, the pooled ORs for low birth weight (LBW), preterm birth, small for gestational age (SGA), spontaneous abortion, and stillbirths were 3.81 (95% confidence interval [CI] 1.81-8.02), 2.42 (95% CI 1.74-3.35), 1.48 (95% CI 1.19-1.85), 1.87 (95% CI 1.17-3.0), and 2.27 (95% CI 1.03-5.04) compared to women with inactive IBD, respectively. In the subgroup analysis based on disease type, women with active ulcerative colitis had an increased risk of LBW, preterm birth, and spontaneous abortion. Women with active Crohn’s disease had a higher risk of preterm birth, SGA, and spontaneous abortion. Conclusions Active IBD during the periconception period and pregnancy is associated with increased risk of adverse pregnancy outcomes. Our data suggest that pregnancy should be planned when the disease is quiescent, and continuous disease control is important even during pregnancy.

Impact of spontaneous hepatocellular carcinoma rupture on surgical outcome after liver resection: a systemic review and meta-analysis

2020 ◽  
Author(s):  
Wei Zhang ◽  
Zhi-Yong Huang ◽  
Chang Shu
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Recurrence Rate ◽  
Surgical Outcome ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Tumor Rupture ◽  
Significant Difference ◽  
The Impact

Abstract Background Spontaneous tumor rupture is a rare but life-threatening complication of hepatocellular carcinoma (HCC). The impact of spontaneous ruptured HCC on long-term survival after liver resection (LR) remains unclear. Our aim was to compare the surgical outcome in patients who underwent LR with ruptured and non-ruptured HCC . Methods A comprehensive search using PubMed, Embase, Cochrane Library and Science Citation Index Expanded databases was performed. The primary outcomes were the hazard ratio (HR) for overall survival ( OS) and disease free survival (DFS). The secondary outcomes included morbidity, hospital mortality and recurrence rate . Results Ten retrospective studies including 3222 patients met the inclusion criteria. Pooled analysis revealed a significantly poorer OS and DFS for patients with ruptured HCC compared to patients with non-ruptured HCC (HR, 2.02; 95% CI, 1.61-2.54; P< 0.00001 and HR, 1.92; 95% CI, 1.56-2.35; P<0.00001, respectively). In the subgroup analysis, both the propensity score matching (PSM) and non-PSM studies demonstrated a significantly poorer OS in the ruptured HCC group (P=0.02 and P<0.00001, respectively). However, meta-analysis of two PSM studies showed that there was not significant difference in the DFS between the two groups (P=0.50). Patients in the ruptured HCC group had a higher mortality and recurrence rate than the non-ruptured HCC group, but the difference was not significant (P = 0.05 and P = 0.06, respectively) Conclusions Surgical outcomes of the patients with the ruptured or non-ruptured HCC undergoing LR were not only affected by tumor rupture itself, but also by the tumor characteristics and liver functional status. Therefore, classifying all ruptured but resectable HCC as T4 stage is unable to accurately represent their true prognosis.

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