Medication-Related Osteonecrosis of the Jaw in Patients Treated Concurrently with Antiresorptive and Antiangiogenic Agents: Systematic Review and Meta-Analysis

ABSTRACT Introduction Medication-related osteonecrosis of the jaws (MRONJ) is a known adverse event related to the use of antiresorptive (AR) drugs. More recently, an association between antiangiogenic (AA) drugs and MRONJ has been suggested. This review aimed to investigate the overall prevalence and relative risk of MRONJ in patients treated concurrently with AA and AR agents in comparison with a single AA or AR drug. Methods A review protocol was registered with PROSPERO (ID: CRD42020214244). A systematic literature search, study selection, quality assessment, and data extraction were carried out following PRISMA guidelines. Random-effects meta-analysis models were used to summarize relative estimates for the outcomes, namely prevalence and relative risk of MRONJ. Exposure variable included type of drug, specifically AA and AR agents administered either concurrently or individually. Results Eleven studies were included in the final qualitative and quantitative syntheses. The overall pooled weighted prevalence of MRONJ with concurrent AA-AR drugs was 6% (95% CI: 3–8%), compared with 0% (95% CI: 0–0%) for AA only and 5% (95% CI: 0–10%) for AR only. However, high heterogeneity was noted among included studies. Retrospective cohort studies showed a higher pooled prevalence of 13% (95% CI: 10–17%) for concurrent AA-AR therapy. The pooled risk ratio for MRONJ revealed a risk with concurrent AA-AR drugs 2.57 times as high as with AR only (95% CI: 0.84–7.87); however, this difference was not statistically significant. Concurrent AA-AR drugs had a risk for MRONJ 23.74 times as high as with AA only (95% CI: 3.71–151.92). Conclusions High-quality, representative studies are needed for accurate estimation of relative risk of MRONJ with concurrent AA and AR therapy.

Download Full-text

Prevalence of Hypothyroidism in Pregnant Women in India: A Meta-Analysis of Observational Studies

Journal of Thyroid Research ◽

10.1155/2021/5515831 ◽

2021 ◽

Vol 2021 ◽

pp. 1-19

Author(s):

Vikas Yadav ◽

Deepti Dabar ◽

Akhil D. Goel ◽

Mohan Bairwa ◽

Akanksha Sood ◽

...

Keyword(s):

Pregnant Women ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Rank Correlation ◽

Overt Hypothyroidism ◽

Study Selection ◽

Pooled Prevalence ◽

Meta Regression Analysis ◽

Women In India

Introduction. This meta-analysis was conducted to estimate the prevalence of hypothyroidism among pregnant women in India. Methods. We searched PubMed, Web of Science, Scopus, Google Scholar, and Shodhganga (Indian thesis repository) for observational studies, providing prevalence of hypothyroidism among pregnant women in India. Systematic study selection and data extraction procedures were followed. Quality assessment of each study was done using JBI critical appraisal checklist. The random effects model was used for pooling the effect sizes. Publication bias was assessed using the funnel plot and rank correlation test. I2 statistics was used to measure heterogeneity across the studies. Heterogeneity in the pooled estimates was further explored with subgroup analyses and meta-regression analysis. Results. Sixty-one studies were found eligible and included in this review. The pooled estimate of the prevalence of hypothyroidism in pregnant women was 11.07% (95% CI: 8.79–13.84, I2 = 99%). Pooled prevalence estimates of subclinical and overt hypothyroidism are 9.51% (95% CI: 7.48–12.04, I2 = 98%) and 2.74% (95% CI: 2.08–3.58, I2 = 94%). Conclusion. We documented 11.07% pooled prevalence of hypothyroidism in pregnant women in India.

Download Full-text

Estimated prevalence of dental fear in adults: a systematic review and meta-analysis

10.1101/2020.11.30.20241216 ◽

2020 ◽

Cited By ~ 1

Author(s):

Ethieli R. Silveira ◽

Mariana G. Cademartori ◽

Helena S. Schuch ◽

Jason M. Armfield ◽

Flavio F. Demarco

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

Population Based ◽

Dental Fear ◽

Study Selection ◽

Pooled Prevalence ◽

Subgroup Analyses ◽

Fear And Anxiety

ABSTRACTObjectivesTo systematically review the literature on the prevalence of dental fear in adults to estimate a worldwide pooled prevalence and to investigate factors related to the heterogeneity of estimates.MethodsInclusion criteria were population-based studies reporting the prevalence or data that allowed the calculation of prevalence of dental fear in adults and/or elders. Five electronic databases (Embase, PubMed, Scopus, Virtual Health Library (BVS) and Web of Science) were searched. Two researchers independently performed the study selection, data extraction and quality assessment of the included studies. The prevalence pooled estimates of dental fear were calculated using fixed- and random-effect models. Subgroup analyses were performed to investigate variability between studies.ResultsThe search strategy identified 4,486 studies. After removal of duplicates (1,722), title and abstract screening (2,764) and full-text reading (108), 31 publications were deemed eligible for this systematic review. A total of 72,577 individuals 18 years of age or older composed the sample of this systematic review. The global estimated prevalence of dental fear and anxiety (DFA), high DFA and severe DFA in adults were 13.8%, 11.2% and 2.6%, respectively. Subgroup analyses showed a higher prevalence of DFA, high DFA and severe DFA among women and younger adults. The instrument used to measure dental fear also affected the prevalence of the outcome.ConclusionsDental fear and high dental fear are prevalent in adults worldwide, being more prevalent among women.

Download Full-text

Epidemiology of hepatitis E virus infection in animals in Africa: a systematic review and meta-analysis

BMC Veterinary Research ◽

10.1186/s12917-021-02749-5 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Abdou Fatawou Modiyinji ◽

Jean Joel Bigna ◽

Sebastien Kenmoe ◽

Fredy Brice N. Simo ◽

Marie A. Amougou ◽

...

Keyword(s):

Systematic Review ◽

Hepatitis E Virus ◽

Data Extraction ◽

Meta Analysis ◽

Hepatitis E ◽

Epidemiological Studies ◽

Cross Sectional ◽

Resource Limited ◽

Study Selection ◽

Language Restriction

Abstract Background Hepatitis E virus (HEV) is a major cause of acute hepatitis in humans worldwide and have high burden in the resource-limited countries. Better knowledge of the epidemiology of hepatitis in animals in Africa can help to understand the epidemiology among humans. The objective of this study was to summarize the prevalence of HEV infection and distribution of HEV genotypes among animals in Africa. Methods In this systematic review and meta-analysis, we comprehensively searched PubMed, EMBASE, African Journals Online, and Africa Index Medicus from January 1st, 2000 to March 22th, 2020 without any language restriction. We considered cross-sectional studies of HEV infection in animals in Africa. Study selection, data extraction, and methodological quality of included studies were done independently by two investigators. Prevalence data were pooled using the random-effects meta-analysis. This review was registered in PROSPERO, CRD42018087684. Results Twenty-five studies (13 species and 6983 animals) were included. The prevalence (antibodies or ribonucleic acid [RNA]) of HEV infection in animals varied widely depending on biological markers of HEV infection measured: 23.4% (95% confidence interval; 12.0–37.2) for anti-HEV immunoglobulins G, 13.1% (3.1–28.3) for anti-HEV immunoglobulins M, and 1.8% (0.2–4.3) for RNA; with substantial heterogeneity. In subgroup analysis, the immunoglobulins G seroprevalence was higher among pigs 37.8% (13.9–65.4). The following HEV genotypes were reported in animals: Rat-HEV genotype 1 (rats and horses), HEV-3 (pigs), HEV-7 (dromedaries), and Bat hepeviruses (bats). Conclusions We found a high prevalence of HEV infection in animals in Africa and HEV genotypes close to that of humans. Some animals in Africa could be the reservoir of HEV, highlighting the need of molecular epidemiological studies for investigating zoonotic transmission.

Download Full-text

Overweight and Obesity Among Adult HIV Infected Peoples Receiving ART in Ethiopia: A Systematic Review and Meta-Analysis

Journal of Primary Care & Community Health ◽

10.1177/2150132721993647 ◽

2021 ◽

Vol 12 ◽

pp. 215013272199364

Author(s):

Robel Hussen Kabthymer ◽

Solomon Nega Techane ◽

Temesgen Muche ◽

Helen Ali Ewune ◽

Semagn Mekonnen Abate ◽

...

Keyword(s):

Publication Bias ◽

Addis Ababa ◽

Data Extraction ◽

Meta Analysis ◽

Overweight And Obesity ◽

Obesity And Overweight ◽

Pooled Prevalence ◽

Nutrition And Diet ◽

Prevalence Of Obesity ◽

Trim And Fill

Background: Over-nutrition and diet-linked non-communicable morbidities are showing increasing trend overtime. Even if there are different factors that affect the change in BMI other than ART, several authors have reported increases in BMI among PLHIV on treatment that are equal to or surpass the general population. This study is aimed to estimate the prevalence of obesity and overweight among adult HIV infected peoples taking ART in Ethiopia. Method: PubMed, CINAHL, Web of science, global health and Google scholar electronic databases were used to perform a systematic literature search. Two authors independently extracted all the necessary data using a structured data extraction format. Data analysis was done using STATA Version 14. The heterogeneity of the studies was assessed by using I2 test. A random-effects model was used to estimate the pooled prevalence. Publication bias was checked using Funnel plot and Egger’s test. Result: Two thousand seven hundred and fifty-one studies were reviewed and 13 studies fulfilling the inclusion criteria were included in the meta-analysis. The meta-analysis of 13 studies, comprising 4994 participants resulted in pooled prevalence of overweight to be 17.85% (95% CI: 12.22-23.47). Whereas, the pooled prevalence of overweight was found to be 3.90 (95% CI: 2.31-5.49) but after adjusting for publication bias using trim and fill analysis it has become 3.58 (95% CI: 2.04-5.13). Magnitude of both overweight and obesity was higher in studies conducted in Addis Ababa, studies done after 2016 and studies having sample size of less than 400, in subgroup analysis. Conclusion: The magnitude of overweight and obesity among HIV infected peoples taking ART in Ethiopia is high. There is a need to have a routine screening to PLWHA on the risk of over-nutrition in order to facilitate early detection.

Download Full-text

Impact of maternal supplementation with probiotics during pregnancy on atopic eczema in childhood – a meta-analysis

British Journal Of Nutrition ◽

10.1017/s0007114511003400 ◽

2011 ◽

Vol 107 (1) ◽

pp. 1-6 ◽

Cited By ~ 77

Author(s):

Katja Doege ◽

Donata Grajecki ◽

Birgit-Christiane Zyriax ◽

Elena Detinkina ◽

Christine zu Eulenburg ◽

...

Keyword(s):

Atopic Eczema ◽

Data Extraction ◽

Meta Analysis ◽

Significant Risk ◽

Controlled Trials ◽

Bacterial Strains ◽

Double Blind ◽

Double Blind Placebo ◽

Study Selection ◽

The Impact

In the present study, we sought to conduct a literature review of randomised, double-blind, placebo-controlled trials, which assessed the impact of probiotics intake during pregnancy on the development of eczema in children. A meta-analysis was conducted for comparison of the development of atopic eczema in children whose mothers took probiotics during pregnancyv.placebo. Study selection, quality appraisal and data extraction were performed independently and in duplicate. The studies were rated according to their size in order to calculate the influence of individual studies on the meta-analysis. A total of seven randomised, double-blind, placebo-controlled trials, published between 2001 and 2009, were selected from the PubMed and Ovid databases for the meta-analysis. The meta-analysis was performed with statistical software Stata/SE11.0. The completed meta-analysis of the seven studies shows a significant risk reduction for atopic eczema in children aged 2–7 years by the administration of probiotics during pregnancy (reduction 5·7 %;P = 0·022). However, this effect was only significant for lactobacilli (reduction 10·6 %;P = 0·045), but not for a mixture of various bacterial strains as probiotics (difference 3·06 %,P = 0·204). In conclusion, the meta-analysis shows that the administration of lactobacilli during pregnancy prevents atopic eczema in children aged from 2 to 7 years. However, a mixture of various bacterial strains does not affect the development of atopic eczema, independent of whether they contain lactobacilli or not.

Download Full-text

Thromboembolic events, recurrent bleeding and mortality after resuming anticoagulant following gastrointestinal bleeding

Thrombosis and Haemostasis ◽

10.1160/th15-01-0063 ◽

2015 ◽

Vol 114 (10) ◽

pp. 819-825 ◽

Cited By ~ 44

Author(s):

Chatree Chai-Adisaksopha ◽

Christopher Hillis ◽

Manuel Monreal ◽

Daniel Witt ◽

Mark Crowther

Keyword(s):

Data Extraction ◽

Meta Analysis ◽

Anticoagulation Therapy ◽

Phase Iii ◽

Recurrent Bleeding ◽

Thromboembolic Events ◽

Gi Bleeding ◽

Study Selection ◽

Language Restriction ◽

Randomised Controlled

SummaryGastrointestinal (GI) bleeding commonly complicates anticoagulant therapy. We aimed to systematically review the published literature to determine the risk of thromboembolism, recurrent GI bleeding and mortality for patients on long-term anticoagulation who experience GI bleeding based on whether anticoagulation therapy was resumed. We performed a systematic review of phase III randomised controlled trials and cohort studies in patients with atrial fibrillation or venous thromboembolism who received oral anticoagulant. We searched MEDLINE, EMBASE and CENTRAL (from 1996-July 2014), conferences abstracts (from January 2006-July 2014) and www.clinicaltrials.gov (up to the last week of July 2014) with no language restriction. Two reviewers independently performed study selection, data extraction and study quality assessment. A total of three studies were included in the meta-analysis. The resumption of warfarin was associated with a significant reduction in thromboembolic events (hazard ratio [HR] 0.68, 95 % confidence interval [CI] 0.52 to 0.88, p < 0.004, I2=82 %). There was an increase in recurrent GI bleeding but not statistically significant for patients who restarted warfarin compared to those who did not (HR 1.20, 95 % CI 0.97 to 1.48, p = 0.10, I2 = 0 %). Resumption of warfarin was associated with significant reduction in mortality (HR 0.76, 95 % CI 0.66 to 0.88, p < 0.001, I2 = 87 %). This meta-analysis demonstrates that resumption of warfarin following interruption due to GI bleeding is associated with a reduction in thromboembolic events and mortality without a statistically significant increase in recurrent GI bleeding.Institution where the work was performed: McMaster University, Hamilton, Ontario, Canada.

Download Full-text

Aromatherapy for Symptom Relief in Patients with Burn: A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina58010001 ◽

2021 ◽

Vol 58 (1) ◽

pp. 1

Author(s):

Hye Won Lee ◽

Lin Ang ◽

Jung Tae Kim ◽

Myeong Soo Lee

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Symptom Relief ◽

Routine Care ◽

Risk Of Bias ◽

Review Author ◽

Beneficial Effects ◽

Study Selection ◽

Meta Analyses

Background and Objectives: This review aimed to provide an updated review of evidence regarding the effects of aromatherapy in relieving symptoms of burn injuries, focusing on pain and physiological distress. Materials and Methods: Fifteen databases (including five English databases, four Korean medical databases, and four Iranian databases) and trial registries were searched for studies published between their dates of inception and July 2021. Two review authors individually performed study selection, data extraction, and risk of bias assessment, and any discrepancies were solved by a third review author. Results: Eight RCTs met our inclusion criteria and were analyzed in this updated systematic review. Our meta-analyses revealed that inhaled aromatherapy plus routine care showed beneficial effects in relieving pain after dressing, as compared to placebo plus routine care (p < 0.00001) and routine care alone (p = 0.02). Additionally, inhaled aromatherapy plus routine care (p < 0.00001) and aromatherapy massage plus routine care (p < 0.0001) also showed superior effects in calming anxiety, as compared to routine care alone. None of the included studies reported on AEs. Overall, the risk of bias across the studies was concerning. Conclusions: This updated review and synthesis of the studies had brought a more detailed understanding of the potential application of aromatherapy for easing the pain and anxiety of burn patients.

Download Full-text

Risk of Gastrointestinal Bleeding on Treatment With Statin Alone or With Concomitant Administration of Warfarin: A Systematic Review and Meta-analysis of 5.3 Million Participants

Annals of Pharmacotherapy ◽

10.1177/10600280211049727 ◽

2021 ◽

pp. 106002802110497

Author(s):

Akshaya Srikanth Bhagavathula ◽

Kota Vidyasaga ◽

Eyob Alemayehu Gebreyohannes ◽

Wubshet Tesfaye

Keyword(s):

Gastrointestinal Bleeding ◽

Observational Studies ◽

Data Extraction ◽

Meta Analysis ◽

Concomitant Administration ◽

Pooled Analysis ◽

Data Synthesis ◽

Study Selection ◽

Statin Monotherapy ◽

Statin Use

Objective: This study aimed to comprehensively evaluate the risk of gastrointestinal bleeding (GIB) with statin monotherapy or with concomitant warfarin use. Data Sources: PubMed, Web of Science, and EMBASE (via Scopus) were searched for observational studies that reported the risk of GIB in adults on statin therapy or with concomitant warfarin use until August 28, 2021. Study Selection and Data Extraction: Observational studies evaluating the risk of GIB in adults (age >18 years) on statin medication or concomitant use with warfarin were included. Data Synthesis: In all, 14 studies with a total of 5 235 123 participants, reporting 48 677 GIB events (43 734 from statin users and 4943 from users of statin combined with warfarin), were included in the analyses. The pooled analysis revealed no difference in the risk of GIB with statin monotherapy (relative risk [RR]: 0.65; 95% CI: 0.42-1.02) or concomitant statin + warfarin use (RR: 0.97; 95% CI: 0.91-1.02). Prior use of statin was not associated with GIB risk (RR: 0.88; 95% CI: 0.63-1.22), whereas a shorter duration of statin use (<5 years) was associated with a lower risk of GIB (RR: 0.42; 95% CI: 0.18-0.97). Relevance to Patient Care and Clinical Practice: This analysis provides strong evidence on the association between statin use (with/without warfarin) and risk of GIB. Conclusion: Statin alone or combined with warfarin was not significantly associated with either an increased or decreased risk of GIB. The GIB risk was significantly lower when statins were used for a short duration (<5 years). The putative relationship between statins and GIB in warfarin users warrant further investigation.

Download Full-text

Association between abnormal maternal serum levels of vitamin B12 and preeclampsia: a systematic review and meta-analysis

Nutrition Reviews ◽

10.1093/nutrit/nuaa096 ◽

2020 ◽

Author(s):

Farzaneh Mardali ◽

Somaye Fatahi ◽

Maryam Alinaghizadeh ◽

Hamed Kord Varkaneh ◽

Mohammad Hassan Sohouli ◽

...

Keyword(s):

Systematic Review ◽

Vitamin B12 ◽

Pregnant Women ◽

Data Extraction ◽

Meta Analysis ◽

Serum Vitamin ◽

Serum Levels ◽

Folic Acid Supplementation ◽

Maternal Serum ◽

Study Selection

Abstract Context Some evidence has shown an association between maternal vitamin B12 levels and the development of preeclampsia in pregnant women, but the relationship between preeclampsia and vitamin B12 is not clear. Objective The aim of this systematic review was to compare serum vitamin B12 levels in women with preeclampsia with those in normotensive pregnant women. Data Sources The PubMed/MEDLINE, Scopus, and Web of Science databases were searched up to August 2019, along with the reference lists of included articles. Study Selection The literature was searched for observational studies that investigated vitamin B12 levels in women with preeclampsia. Data Extraction Data were extracted independently by 2 authors. Data were pooled using a random-effects model. Results Vitamin B12 levels in women with preeclampsia were significantly lower than those in healthy women (mean, −15.24 pg/mL; 95%CI, −27.52 to −2.954; P < 0.015), but heterogeneity between studies was high (I2 = 97.8%; P = 0.0103). Subgroup analyses based on folic acid supplementation, homocysteine concentrations, and gestational age at the time of sampling for vitamin B12 assessment did not identify the sources of heterogeneity. Conclusions Women with preeclampsia had significantly lower vitamin B12 concentrations than normotensive pregnant women.

Download Full-text

Blinding Strategies in Dry Needling Trials: Systematic Review and Meta-Analysis

Physical Therapy ◽

10.1093/ptj/pzz111 ◽

2019 ◽

Vol 99 (11) ◽

pp. 1461-1480 ◽

Cited By ~ 10

Author(s):

Felicity A Braithwaite ◽

Julie L Walters ◽

Lok Sze Katrina Li ◽

G Lorimer Moseley ◽

Marie T Williams ◽

...

Keyword(s):

Data Extraction ◽

Meta Analysis ◽

Cognitive Strategies ◽

Evidence Based ◽

Dry Needling ◽

Data Synthesis ◽

Study Selection ◽

Methodological Bias ◽

Tactile Sensations ◽

Effectiveness Data

Abstract Background Blinding of participants and therapists in trials of physical interventions is a significant and ongoing challenge. There is no widely accepted sham protocol for dry needling. Purpose The purpose of this review was to summarize the effectiveness and limitations of blinding strategies and types of shams that have been used in dry needling trials. Data Sources Twelve databases were searched from inception to February 2016. Study Selection Trials that compared active dry needling with a sham that simulated dry needling were included. Data Extraction The main domains of data extraction were participant/therapist details, intervention details, blinding strategies, blinding assessment outcomes, and key conclusions of authors. Reported blinding strategies and sham types were synthesized descriptively, with available blinding effectiveness data synthesized using a chance-corrected measurement of blinding (blinding index). Data Synthesis The search identified 4894 individual publications with 27 trials eligible for inclusion. In 22 trials, risk of methodological bias was high or unclear. Across trials, blinding strategies and sham types were heterogeneous. Notably, no trials attempted therapist blinding. Sham protocols have focused on participant blinding using strategies related to group standardization and simulation of tactile sensations. There has been little attention given to the other senses or cognitive strategies to enhance intervention credibility. Nonpenetrating sham types may provide effective participant blinding. Limitations Trials were clinically and methodologically diverse, which limited the comparability of blinding effectiveness across trials. Reported blinding evaluations had a high risk of chance findings with power clearly achieved in only 1 trial. Conclusions Evidence-based consensus on a sham protocol for dry needling is required. Recommendations provided in this review may be used to develop sham protocols so that future protocols are more consistent and potentially more effective.

Download Full-text