scholarly journals Meta-Analysis of the Association between Asbestos Exposure and Esophageal Cancer

2021 ◽  
Vol 18 (21) ◽  
pp. 11088
Author(s):  
Chih-Wei Wu ◽  
Hung-Yi Chuang ◽  
Dong-Lin Tsai ◽  
Tzu-Yu Kuo ◽  
Chen-Cheng Yang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Subgroup Analysis ◽  
Textile Industry ◽  
Meta Analysis ◽  
Asbestos Exposure ◽  
Latency Period ◽  
High Dose ◽  
Long Latency ◽  
Standardized Mortality Rate

Background: We conducted a meta-analysis to quantitatively assess the association between asbestos exposure and esophageal cancer. Methods: We systematically collected articles from three electronic databases and calculated the pooled standardized mortality rate (SMR) from the meta-analysis. Subgroup analysis according to the type of asbestos exposure, follow-up years, sample size, industry classification, sex, and high-dose exposure was conducted. Results: From 242 studies, 34 cohort studies were included in our meta-analysis. Pooled SMR was positively associated with asbestos exposure and esophageal cancer (pooled SMR = 1.28; 95% confidence interval (CI) 1.19–1.38, p < 0.00001). In the subgroup analysis, (1) chrysolite, (2) four groups with follow-up over ten years, (3) the textile industry and shipyard, (4) both male and female, and (5) eight studies on highest asbestos exposure, all the subgroups showed significantly increased pooled SMRs. Conclusion: Asbestos exposure was significantly and positively associated with esophageal cancer, especially chrysolite. Considering the long latency period, we suggest that patients should be followed up for cancer, including esophageal cancer, for over ten years.

scholarly journals Recombinant Human Thyrotropin-Stimulated Radioiodine Therapy in Patients with Multinodular Goiters: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 52 (12) ◽  
pp. 841-849
Author(s):  
Chunmei Xu ◽  
Ping Wang ◽  
Huikai Miao ◽  
Tianyue Xie ◽  
Xiaojun Zhou ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Dose Group ◽  
Low Dose ◽  
Radioiodine Therapy ◽  
Meta Analysis ◽  
High Dose Group ◽  
High Dose ◽  
Fixed Effects Model ◽  
Recombinant Human Thyrotropin

AbstractA potential reduction of goiter volume (GV) of recombinant human thyrotropin (rhTSH) on multinodular goiters (MNG) was previously reported but controversial. Hence we conducted a meta-analysis to estimate the effect of rhTSH-stimulated radioiodine therapy in patients with MNG. PubMed, Cochrane, CNKI, VIP, and Wanfang databases were searched. Mean difference (MD) and odds ratios with 95% confidence intervals (95% CI) were derived by using an inverse variance random-effects model and fixed-effects model, respectively. Six studies (n=237) were involved in the analysis. For 12 months follow up, high dose (>0.1 mg) of rhTSH significantly reduced GV (MD=17.61; 95% CI=12.17 to 23.04; p<0.00001) compared with placebo. No effective pooled results of low dose of rhTSH (<0.1 mg) were applicable for only one study included. For 6 months follow up, the source of heterogeneity was determined by subgroup and sensitivity analysis. High dose group showed vast improvement in GV reduction (MD=16.62; 95% CI=1.34 to 31.90; p=0.03). The reduction of low dose group compared with placebo was inferior to high dose group. No available data were obtained to assess the influence of rhTSH after 36 months follow up for the only included study. Hypothyroidism incidence was higher for rhTSH group. No publication bias was seen. High dose of rhTSH treatment-stimulated radioactive 131I therapy after 6 months and 12 months follow up had a better effect in reducing GV, but with higher incidence of hypothyroidism. Owing to the limited methodological quality, more clinical researches are warranted in the future.

“Re-Emergence” of Silicosis and Coal Workers Pneumoconiosis in Australia

2020 ◽  
Vol 119 (1) ◽  
pp. 65-92
Author(s):  
Beris Penrose
Keyword(s):  
Data Collection ◽  
Coal Mining ◽  
Disease Onset ◽  
Latency Period ◽  
Dust Exposure ◽  
Long Latency ◽  
History Of ◽  
Coal Workers Pneumoconiosis ◽  
Coal Workers

Some reporters, politicians, and doctors have described current cases as a “re-emergence” of these diseases, based on the notion that they had been eliminated. However, silicosis persisted in centuries-old industries like sandblasting and stonemasonry and coal workers pneumoconiosis (CWP) continued in coal mining. Until recently, their presence was obscured by a combination of factors such as misdiagnosis, especially if there was a history of smoking; the failure to follow up workers thought to have silicosis or CWP; the long latency period between dust exposure and disease onset that can conceal the link between the two; and the lack of data collection that may have revealed their presence. As the recent Queensland government inquiry into CWP noted, current cases are more accurately a reidentification.

scholarly journals Standard-dose versus high-dose radiotherapy with concurrent chemotherapy in esophageal cancer: A prospective randomized study

2018 ◽  
Vol 07 (01) ◽  
pp. 27-30 ◽  
Author(s):  
Navin Nayan ◽  
M. Bhattacharyya ◽  
Vikas K. Jagtap ◽  
A. K. Kalita ◽  
R. Sunku ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Total Dose ◽  
Standard Dose ◽  
Randomized Study ◽  
Complete Response ◽  
Concurrent Chemotherapy ◽  
Prospective Randomized Study ◽  
High Dose ◽  
Large Sample Size

Abstract Objective: The objective of this study is comparision of local and distant control rates with high-dose versus standard-dose radiotherapy along with concurrent chemotherapy in esophageal cancer – a prospective randomized study. Materials and Methods: Histologically proven Stage I–III patients with carcinoma esophagus were randomized into two groups. One group has been treated with standard-dose radiotherapy, i.e., a total dose of 50.4 Gy (1.8 Gy/day, 28#, 5 days/week). The other group (study arm) has received high-dose radiotherapy, i.e. a total dose of 64.8 Gy (1.8 Gy/day, 36#, 5 days/week). Both groups have received 2 cycles of 3 weekly concurrent chemotherapy (cisplatin 75 mg/m[2] on day 1 and 5-fluorouracil 750 mg/m[2] continuous intravenous infusion over 24 h on day 1–4). Follow-up response evaluation was done by both endoscopy and computed tomography scan after 6–8 weeks and after 2 months thereafter. Results: Out of a total of 28 patients, 68% showed a complete response, 14% showed partial response, and 18% patients developed progressive disease at first and subsequent follow up (median follow-up of 21 months). Among the complete response patients, rates were higher in high-dose group compared to standard-dose radiotherapy group (71% vs. 64%, P = 0.38). Treatment-related toxicities were acceptable in both groups. Conclusion: High-dose radiotherapy with concurrent chemotherapy seems to be more effective with acceptable toxicity in our study. However, further follow-up and large sample size may be required to validate the current study conclusion.

scholarly journals Outcome of tantalum rod insertion in the treatment of osteonecrosis of the femoral head with minimum follow-up of 1 year: a meta-analysis and systematic review

2020 ◽  
Vol 7 (2) ◽  
pp. 329-339
Author(s):  
James Randolph Onggo ◽  
Mithun Nambiar ◽  
Jason Derry Onggo ◽  
Guan Tay ◽  
Parminder J Singh ◽  
...  
Keyword(s):  
Femoral Head ◽  
Subgroup Analysis ◽  
Bone Grafting ◽  
Meta Analysis ◽  
Degenerative Joint Disease ◽  
Joint Disease ◽  
Safe Alternative ◽  
Meta Analyses ◽  
Marginal Risk

Abstract Osteonecrosis of the femoral head (ONFH) is a debilitating disease that can cause deformity and collapse of the femoral head, thus leading to the development of degenerative joint disease that can incapacitate the patient with pain and reduction in hip mobility. This study aims to determine the safety and efficacy of tantalum rod insertion in the treatment of ONFH with a minimum follow-up period of 1 year. A multi-database search was performed according to Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Data from studies assessing the clinical and radiological outcomes as well as complications of tantalum rod insertion in the treatment of ONFH with a minimum follow-up period of 1 year were extracted and analyzed. Ten studies were included in this meta-analysis, consisting of 550 hips. There was a statistically significant increase in HHS (MD = 30.35, 95% CI: 20.60–40.10, P &lt; 0.001) at final follow-up versus pre-operative scores. The weighted pooled proportion (PP) of radiographic progression of ONFH was 0.221 (95% CI: 0.148–0.316), while that of progression into femoral head collapse was 0.102 (95% CI: 0.062–0.162). Conversion to total hip arthroplasty (THA) had a PP of 0.158 (95% CI: 0.107–0.227) with a mean weighted period of 32.4 months (95% CI: 24.9–39.9 months). Subgroup analysis of conversion to THA when tantalum rods were used in conjunction with bone grafting (PP = 0.150, 95% CI: 0.092–0.235) showed a marginal risk reduction than when compared with subgroup analysis of tantalum rods being used alone (PP = 0.154, 95% CI: 0.078–0.282). Tantalum rod is a safe alternative option to the current joint-preserving procedures available in the treatment of ONFH. However, more studies are needed to investigate and identify the most appropriate patients who would benefit most and the synergistic effect brought on by the use of complementary biological augmentation of bone grafting or stem cells with tantalum rods.

scholarly journals Incisional hernia formation in hepatobiliary surgery using transverse and hybrid incisions: a systematic review and meta-analysis

2020 ◽  
Vol 102 (9) ◽  
pp. 663-671
Author(s):  
S Davey ◽  
N Rajaretnem ◽  
D Harji ◽  
J Rees ◽  
D Messenger ◽  
...  
Keyword(s):  
Subgroup Analysis ◽  
Meta Analysis ◽  
A Priori ◽  
Primary Outcome Measure ◽  
Future Research ◽  
Hepatobiliary Surgery ◽  
Weighted Mean ◽  
Hernia Formation ◽  
Hepatopancreatobiliary Surgery

Introduction Evidence suggests that midline incisions should be closed with the small-bite technique to reduce IH formation. No recommendations exist for the closure of transverse incisions used in hepatobiliary surgery. This work systematically summarises rates of IH formation and associated technical factors for these transverse incisions. Methods A systematic search was undertaken. Studies describing the incidence of IH were included. Incisions were classified as transverse (two incision types) or hybrid (transverse with midline extension, comprising five incision types). The primary outcome measure was the pooled proportion of IH. Subgroup analysis based on minimum follow-up of two years and a priori definition of IH with clinical and radiological diagnosis was undertaken. Findings Thirteen studies were identified and included 5,427 patients; 1,427 patients (26.3%) underwent surgery for benign conditions, 3,465 (63.8%) for malignancy and 535 (9.9%) for conditions that were not stated or classified as ‘other’. The pooled incidence of IH was 6.0% (2.0–10.0%) at a weighted mean follow-up of 17.5 months in the transverse group, compared with 15.0% (11.0–19.0%) at a weighted mean follow-up of 42.0 months in the hybrid group (p = 0.045). Subgroup analysis did not demonstrate a statistical difference in IH formation between the hybrid versus transverse groups. Conclusion Owing to the limitations in study design and heterogeneity, there is limited evidence to guide incision choice and methods of closure in hepatopancreatobiliary surgery. There is an urgent need for a high-quality prospective cohort study to understand the techniques used and their outcomes, to inform future research.

Radiation-Induced Primary Brain Lymphoma: A Case Report

1995 ◽  
Vol 81 (3) ◽  
pp. 204-207 ◽  
Author(s):  
Moshe E. Stein ◽  
Nissim Haim ◽  
Menachem Ben-Shachar ◽  
Dorith Goldsher ◽  
Zvi Bernstein ◽  
...  
Keyword(s):  
Latency Period ◽  
High Dose ◽  
Low Grade ◽  
Whole Brain Irradiation ◽  
Brain Lymphoma ◽  
Brain Irradiation ◽  
Long Latency ◽  
Primary Brain Lymphoma ◽  
Radiation Induced ◽  
Acquired Immunodeficiency

A patient who developed primary brain lymphoma 6 years following whole brain irradiation due to a low-grade glioma is described. The patient had no evidence of congenital or acquired immunodeficiency state and achieved a good and prompt response to aggressive chemotherapy, including high-dose methotrexate. The previous radiation therapy is implicated in the etiology of the lymphoma because of the geometric coincidence, the relatively long latency period and the different histology. A brief review of current literature is reported.

scholarly journals Double bundle ACL reconstruction leads to better restoration of knee laxity and subjective outcomes than single bundle ACL reconstruction

2021 ◽  
Author(s):  
Arttu Seppänen ◽  
Piia Suomalainen ◽  
Heini Huhtala ◽  
Heikki Mäenpää ◽  
Tommi Kiekara ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Knee Laxity ◽  
Double Bundle ◽  
Cochrane Library ◽  
Single Bundle ◽  
Subgroup Analyses ◽  
Subjective Outcomes

Abstract Purpose The purpose of this meta-analysis is to compare arthroscopic single bundle (SB) and double bundle (DB) anterior cruciate ligament (ACL) reconstructions in the light of all available randomised controlled trials (RCTs). A meta-analysis of this well-researched topic was performed and subgroup analyses of the medial portal (MP) technique and the transtibial technique (TT) were added as a new idea. The hypothesis was that the DB technique is superior to the SB technique also in subgroup analyses of the MP and TT techniques. Methods Instructions of the PRISMA checklist were followed. Systematic literature search from electronic databases, including PubMed, Cochrane library and Scopus was performed to find RCTs that compared the SB and DB techniques. Nine outcomes were used to compare these two techniques. Each study was assessed according to the Cochrane Collaboration’s risk of bias tool and three subgroup analyses (minimum 2-years’ follow-up, TT technique and MP technique) were performed. Results A total of 40 studies were included in this meta-analysis. When analysing all the included studies, the DB technique was superior to the SB technique in KT-1000/2000 evaluation (p < 0.01), IKDC subjective evaluation (p < 0.05), Lysholm scores (p = 0.02), pivot shift (p < 0.01) and IKDC objective evaluation (p = 0.02). Similar results were also found in the subgroup analyses of minimum 2-years’ follow-up and the TT technique. However, there were no differences between the two techniques in a subgroup analysis of the MP technique. Conclusion Generally, DB ACL reconstruction leads to better restoration of knee laxity and subjective outcomes than SB ACL reconstruction. The subgroup analysis of the MP technique revealed that surgeons can achieve equally as good results with both techniques when femoral tunnels are drilled through the medial portal. Level of evidence II.

Tamoxifen-related uterine carcinosarcomas occur under/after prolonged treatment: Report of five cases and review of the literature

2002 ◽  
Vol 12 (5) ◽  
pp. 496-500 ◽  
Author(s):  
I. Kloos ◽  
S. Delaloge ◽  
P. Pautier ◽  
M. Di Palma ◽  
A. Goupil ◽  
...  
Keyword(s):  
Prolonged Exposure ◽  
Endometrial Adenocarcinoma ◽  
Latency Period ◽  
Subsequent Development ◽  
Prolonged Treatment ◽  
Uterine Carcinosarcoma ◽  
Long Latency ◽  
Daily Dose

The risk of tamoxifen-related endometrial adenocarcinoma is well established with daily dose and treatment duration of adjuvant tamoxifen as risk factors. There have also been in the past years, a few descriptions of uterine nonepithelial malignancies occuring after tamoxifen. We describe five recent cases of uterine carcinosarcomas occurring under/after tamoxifen administered in an adjuvant setting. None of these patients had received prior pelvic radiation therapy. Their median age at the diagnosis of breast cancer was 58 years (41–68), and 69 years (50–84) at the diagnosis of uterine carcinosarcoma. The median length of exposure to tamoxifen was 9 years (5–20), and the median time from the initiation of tamoxifen to the diagnosis of the uterine malignancy (latency period) 9 years (7–20). All patients presented with an advanced stage (IIA-IVA). Our data, together with those of the literature, plead for a causal role of a prolonged exposure to tamoxifen on the subsequent development of uterine carcinosarcoma. The long latency period observed even in patients receiving only 5 years of treatment leads us also to consider a prolonged gynecologic follow-up of the patients.

scholarly journals Two cases of asbestosis and one case of rounded atelectasis due to non-occupational asbestos exposure

2016 ◽  
Vol 69 (1) ◽  
Author(s):  
S.M. Candura ◽  
A. Binarelli ◽  
G. Ragno ◽  
F. Scafa
Keyword(s):  
Occupational Diseases ◽  
Asbestos Exposure ◽  
Occupational Exposures ◽  
Respiratory Illnesses ◽  
Pleural Plaques ◽  
Long Latency ◽  
Asbestos Cement ◽  
Progression Of Disease ◽  
Contaminated Area

Asbestos is a well-known cause of several neoplastic (malignant mesothelioma, lung cancer) and non-neoplastic (asbestosis, pleuropathies) occupational diseases. Lower-level exposure in the general environment may induce pleural plaques and thickenings, and is associated with an increased mesothelioma risk. We present two patients (a 68-year-old man and a 72-year-old woman) who developed asbestosis (in association with pleural plaques and calcifications), and a 78-year-old man who developed rounded atelectasis (with pleural plaques and benign effusion), after living for several decades in the proximity of large Italian asbestos-cement plant. None of them had been exposed to asbestos occupationally. Besides living in a contaminated area, the woman used to clean the work clothes of her brother, who was employed in the local asbestos factory. The three cases indicate that non-neoplastic, long-latency asbestos-related diseases which are usually observed as a consequence of occupational exposures, may rarely develop in subjects living in contaminated geographical sites and buildings. These unusual environmental diseases raise the diagnostic problem of differentiating them from other, more common respiratory illnesses, and impose the duties of patient notification, assessment and follow-up, to assess the possibility of progression of disease and increased neoplastic risk.

Obesity and mortality in patients with esophageal cancer: A systematic review and meta-analysis.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 20-20
Author(s):  
Arjun Gupta ◽  
Kaustav Majumder ◽  
Nivedita Arora ◽  
Preet Paul Singh ◽  
Siddharth Singh
Keyword(s):  
Systematic Review ◽  
Esophageal Cancer ◽  
Subgroup Analysis ◽  
Observational Studies ◽  
Meta Analysis ◽  
Asia Pacific ◽  
Limited Data ◽  
Inconsistency Index ◽  
All Cause Mortality ◽  
Never Smokers

20 Background: Obesity influences incidence of esophageal cancer (EC) with contrasting impact on esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESC). However, it is unclear whether it influences mortality in patients with EC. We performed a systematic review and meta-analysis to assess the association between obesity and EC mortality. Methods: Through a systematic search of major databases and conference proceedings, up to June 2015, we identified observational studies reporting the association between obesity (premorbid body mass index [BMI] ≥ 30 kg/m2) and all-cause mortality in patients with EC. We estimated summary adjusted hazard ratio (aHR) with 95% confidence intervals (CI), comparing highest BMI category with reference category in each study using random effects model; heterogeneity was measured using the inconsistency index (I2). Results: We identified 8 studies (including 1 pooled cohort study) with 2,784,027 people, of whom 18% were obese. On meta-analysis, compared with EC patients with reference BMI, obese EC patients had aHR for mortality of 0.97 (95% CI, 0.66-1.43), with high heterogeneity (I2 = 88%) after pooling maximally adjusted HRs. On analyzing patients with EAC alone (3 studies), mortality aHR was 1.10 (95% CI, 0.43-2.82), with high heterogeneity (I2 = 95%). Data to separately analyze ESC or to perform subgroup analysis in males vs females, smokers vs never smokers and Asia Pacific vs Western populations was limited. Conclusions: Based on meta-analysis, obesity does not appear to be associated with mortality in patients with EC. However, high heterogeneity and limited data for subgroup analysis limits the interpretation of this analysis. Further prospective studies evaluating mortality in patients with established EC are needed to answer this question. [Table: see text]

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