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Autism Research : Official Journal of... Feb 2022Children with autism spectrum disorder (ASD) are frequently diagnosed with co-occurring medical conditions including inflammatory bowel disease (IBD). To investigate the... (Meta-Analysis)
Meta-Analysis
Children with autism spectrum disorder (ASD) are frequently diagnosed with co-occurring medical conditions including inflammatory bowel disease (IBD). To investigate the association, we conducted a systematic review registered in PROSPERO (ID:CRD42021236263) with a random-effects meta-analysis. We searched PubMed, Embase, and PsycInfo (last search on January 25, 2021), and manually searched relevant publications. We included observational studies measuring the association between ASD and IBD. The primary outcome was the association (odds ratio, OR) between ASD and later development of IBD. Sensitivity analyses were conducted by quality, confounding adjustment, and study design. We performed meta-regression analyses and assessed heterogeneity, publication bias, and quality of studies with the Newcastle-Ottawa Scale. Overall, we included six studies consisting of eight datasets, including over 11 million participants. We found that ASD was significantly associated with subsequent incident IBD (any IBD, OR = 1.66, 95% confidence interval[CI] = 1.25-2.21, p < 0.001; ulcerative colitis, OR = 1.91, 95%CI = 1.41-2.6, p < 0.001; Crohn's disease, OR = 1.47, 95%CI = 1.15-1.88, p = 0.002). ASD and IBD were also associated regardless of temporal sequence of diagnosis (any IBD, OR = 1.57, 95%CI = 1.28-1.93, p < 0.001; ulcerative colitis, OR = 1.7, 95%CI = 1.36-2.12, p < 0.001; Crohn's disease, OR = 1.37, 95%CI = 1.12-1.69, p = 0.003). Sensitivity analyses confirmed the findings of the main analysis. Meta-regression did not identify any significant moderators. Publication bias was not detected. Quality was high in four datasets and medium in four. In conclusion, our findings highlight the need to screen for IBD in individuals with ASD, and future research should identify who, among those with ASD, has the highest risk of IBD, and elucidate the shared biological mechanisms between ASD and IBD. LAY SUMMARY: This systematic review and meta-analysis of eight observational datasets found that individuals with autism spectrum disorder (ASD) are more likely to develop any inflammatory bowel disease, ulcerative colitis, or Crohn's disease. Our findings highlight the need to screen for inflammatory bowel disease in patients with ASD and elucidate the shared biological mechanisms between the two disorders.
Topics: Autism Spectrum Disorder; Child; Chronic Disease; Humans; Inflammatory Bowel Diseases; Observational Studies as Topic; Odds Ratio
PubMed: 34939353
DOI: 10.1002/aur.2656 -
American Journal of Obstetrics and... Feb 2024This study aimed to assess the risk of adverse maternal and perinatal complications between twin and singleton pregnancies affected by gestational diabetes mellitus and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study aimed to assess the risk of adverse maternal and perinatal complications between twin and singleton pregnancies affected by gestational diabetes mellitus and the respective group without gestational diabetes mellitus (controls).
DATA SOURCES
A literature search was performed using MEDLINE, Embase, and Cochrane from January 1980 to May 2023.
STUDY ELIGIBILITY CRITERIA
Observational studies reporting maternal and perinatal outcomes in singleton and/or twin pregnancies with gestational diabetes mellitus vs controls were included.
METHODS
This was a systematic review and meta-analysis. Pooled estimate risk ratios with 95% confidence intervals were generated to determine the likelihood of adverse pregnancy outcomes between twin and singleton pregnancies with and without gestational diabetes mellitus. Heterogeneity among studies was evaluated in the model and expressed using the I statistic. A P value of <.05 was considered statistically significant. The meta-analyses were performed using Review Manager (RevMan Web). Version 5.4. The Cochrane Collaboration, 2020. Meta-regression was used to compare relative risks between singleton and twin pregnancies. The addition of multiple covariates into the models was used to address the lack of adjustments.
RESULTS
Overall, 85 studies in singleton pregnancies and 27 in twin pregnancies were included. In singleton pregnancies with gestational diabetes mellitus, compared with controls, there were increased risks of hypertensive disorders of pregnancy (relative risk, 1.85; 95% confidence interval, 1.69-2.01), induction of labor (relative risk, 1.36; 95% confidence interval, 1.05-1.77), cesarean delivery (relative risk, 1.31; 95% confidence interval, 1.24-1.38), large-for-gestational-age neonate (relative risk, 1.61; 95% confidence interval, 1.46-1.77), preterm birth (relative risk, 1.36; 95% confidence interval, 1.27-1.46), and admission to the neonatal intensive care unit (relative risk, 1.43; 95% confidence interval, 1.38-1.49). In twin pregnancies with gestational diabetes mellitus, compared with controls, there were increased risks of hypertensive disorders of pregnancy (relative risk, 1.69; 95% confidence interval, 1.51-1.90), cesarean delivery (relative risk, 1.10; 95% confidence interval, 1.06-1.13), large-for-gestational-age neonate (relative risk, 1.29; 95% confidence interval, 1.03-1.60), preterm birth (relative risk, 1.19; 95% confidence interval, 1.07-1.32), and admission to the neonatal intensive care unit (relative risk, 1.20; 95% confidence interval, 1.09-1.32) and reduced risks of small-for-gestational-age neonate (relative risk, 0.89; 95% confidence interval, 0.81-0.97) and neonatal death (relative risk, 0.50; 95% confidence interval, 0.39-0.65). When comparing relative risks in singleton vs twin pregnancies, there was sufficient evidence to suggest that twin pregnancies have a lower relative risk of cesarean delivery (P=.003), have sufficient adjustment for confounders, and have lower relative risks of admission to the neonatal intensive care unit (P=.005), stillbirths (P=.002), and neonatal death (P=.001) than singleton pregnancies.
CONCLUSION
In both singleton and twin pregnancies, gestational diabetes mellitus was associated with an increased risk of adverse maternal and perinatal outcomes. In twin pregnancies, gestational diabetes mellitus may have a milder effect on some adverse perinatal outcomes and may be associated with a lower risk of neonatal death.
Topics: Female; Humans; Infant, Newborn; Pregnancy; Diabetes, Gestational; Hypertension, Pregnancy-Induced; Perinatal Death; Pregnancy Outcome; Pregnancy, Twin; Premature Birth; Retrospective Studies; Observational Studies as Topic
PubMed: 37595821
DOI: 10.1016/j.ajog.2023.08.011 -
BMC Sports Science, Medicine &... Oct 2023To compare the effect of low-load blood flow restricted resistance training (BFR-RT) versus high-load resistance training (HL-RT) on muscle strength, muscle mass,...
OBJECTIVE
To compare the effect of low-load blood flow restricted resistance training (BFR-RT) versus high-load resistance training (HL-RT) on muscle strength, muscle mass, physical function, patient-reported outcomes, and adherence to training in clinical musculoskeletal populations.
DATA SOURCES
Web of Science, Cochrane Central, Medline, Embase, SportDiscus was searched on the 30 May 2022.
REVIEW METHODS
This study was conducted as a systematic review and meta-analysis. Randomized Controlled Trials (RCTs) were included if they (i) included patients, (ii) comprised of a BFR-RT intervention protocol and a group who performed HL-RT (≥ 70%1RM) for at least eight exercise sessions, and (iii) involved at least 1 exercise that targeted the lower limbs. The Cochrane Risk of Bias tool was used to evaluate the risk of bias. The meta-analyses were performed using a random effects model with an adjustment to the confidence interval.
RESULTS
Seven RCTs comprising 303 participants (BFR-RT: n = 151; HL-RT: n = 152) were identified. HL-RT and BFR-RT showed similar gains in dynamic (1-10RM) knee extensor strength and leg press strength, quadriceps cross sectional area, sit-to-stand performance, and patient reported pain and function. There was a moderate effect favoring BFR-RT for increasing maximal isometric knee extensor strength. The grading of certainty in evidence was low-to-very low for all outcome variables.
CONCLUSION
This systematic review and meta-analysis extends our current knowledge about BFR-RT and HL-RT as equally effective exercise methods for inducing gains in maximal muscle strength in healthy populations, by now also comprising patients suffering from various clinical musculoskeletal conditions. The certainty in the estimates was low-to-very low, prompting the inclusion of future higher-quality trials.
TRIAL REGISTRATION
PROSPERO ID (CRD42022337173). Registered June 18th 2022.
PubMed: 37880727
DOI: 10.1186/s13102-023-00750-z -
Journal of Affective Disorders Jan 2022Each year, nearly 790.000 new cases of myocardial infarction (MI) are recorded in the United States. Better knowledge of the modifiable risk factors for this... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Each year, nearly 790.000 new cases of myocardial infarction (MI) are recorded in the United States. Better knowledge of the modifiable risk factors for this cardiovascular disease remains a major public health issue. In this perspective, the aim of this systematic review and meta-analysis was to estimate the relationship between post-traumatic stress disorder (PTSD) and risk of subsequent myocardial infarction (MI).
METHODS
A systematic review using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines was performed by searching four bibliographic databases (PubMed/Medline, PsycINFO, Science Direct and Proquest Dissertations and Theses).
RESULTS
A total of 14 articles were included. Nine of these included depression as a covariate. Among 13 studies (N = 848.903), the pooled HR for the magnitude of the relationship between PTSD and MI was 1.49 (95% CI 1.31-1.69) before adjustment for depression. The pooled HR estimate for the 9 depression-adjusted estimates (N = 814.441) was 1.32 (95% CI 1.12-1.56).
LIMITATIONS
These results should be considered with caution because there is high heterogeneity between studies and possible publication bias; thus, further research is required to support these results.
CONCLUSIONS
Further research is still needed to identify in more precise terms the mediating factors involved in the direct association between PTSD and the subsequent occurrence of ischemic heart disease.
Topics: Humans; Myocardial Infarction; Risk Factors; Stress Disorders, Post-Traumatic
PubMed: 34715167
DOI: 10.1016/j.jad.2021.10.056 -
American Journal of Preventive Medicine Oct 2019Anxiety symptoms and disorders are highly prevalent and costly. Prospective studies suggest that physical activity may prevent anxiety development; however, this body of... (Meta-Analysis)
Meta-Analysis
CONTEXT
Anxiety symptoms and disorders are highly prevalent and costly. Prospective studies suggest that physical activity may prevent anxiety development; however, this body of literature has not been reviewed comprehensively.
EVIDENCE ACQUISITION
Studies measuring physical activity at baseline and anxiety at a designated follow-up at least 1 year later were located using MEDLINE, PsycINFO, and CINAHL Complete through June 2018.
EVIDENCE SYNTHESIS
Data were analyzed July-December 2018. Study quality was assessed using Q-Coh. Among studies of adults, a random-effects meta-analysis was conducted for crude and the most fully adjusted models for three outcomes: self-reported anxiety symptoms, a diagnosis of any anxiety disorder, and a diagnosis of generalized anxiety disorder. As there were few studies with diverse samples and outcome measures, findings were elaborated with a critical narrative review of all studies. Twenty-four studies (median follow-up, 4.75 years) of >80,000 unique individuals were included in the systematic review; thirteen were included in the meta-analyses. Six studies were assessed as low quality, nine as acceptable, and nine as good. From adjusted models, odds of elevated anxiety symptoms (OR=0.8742, 95% CI=0.7731, 0.9886, n=9), any anxiety disorder (OR=0.6626, 95% CI=0.5337, 0.8227, n=3), and generalized anxiety disorder specifically (OR=0.5438, 95% CI=0.3231, 0.9153, n=3) were significantly lower after physical activity exposure.
CONCLUSIONS
Available evidence suggests that engaging in physical activity protects against anxiety symptoms and disorders. However, notable challenges in the current evidence base include issues regarding exposure and outcome measures, consistent adjustment for putative confounders, representativeness of samples, and attrition bias, which warrant further research.
Topics: Adult; Anxiety; Anxiety Disorders; Exercise; Humans; Prospective Studies
PubMed: 31542132
DOI: 10.1016/j.amepre.2019.05.012 -
Environmental Health : a Global Access... May 2015Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the... (Meta-Analysis)
Meta-Analysis Review
Bisphenol A (BPA) is suspected to be associated with several chronic metabolic diseases. The aim of the present study was to review the epidemiological literature on the relation between BPA exposure and the risk of cardiometabolic disorders. PubMed and Embase databases were searched up to August 2014 by two independent investigators using standardized subject terms. We included observational studies (cohort, case-control and cross-sectional studies) carried out in children or adults, measuring urinary BPA (uBPA), including at least 100 participants and published in English. The health outcomes of interest were diabetes, hyperglycemia, measures of anthropometry, cardiovascular disease (CVD) and hypertension. Data were extracted and meta-analyzed when feasible, using a random-effects model. Thirty-three studies with sample size ranging from 239 to 4811 met the inclusion criteria, including five with a prospective design. Twelve studies reported on diabetes or hyperglycemia, 16 on anthropometry, 6 on CVD and 3 on hypertension. Evidence for a positive association between uBPA concentrations and diabetes, overweight, obesity, elevated waist circumference (WC), CVD and hypertension was found in 7/8, 2/7, 6/7, 5/5, 4/5 and 2/3 of the cross-sectional studies, respectively. We were able to conduct outcome-specific meta-analyses including 12 studies. When comparing the highest vs. the lowest uBPA concentrations, the pooled ORs were 1.47 (95% CI: 1.21-1.80) for diabetes, 1.21 (95% CI: 0.98-1.50) for overweight, 1.67 (95% CI: 1.41-1.98) for obesity, 1.48 (95% CI: 1.25-1.76) for elevated WC, and 1.41 (95% CI: 1.12-1.79) for hypertension. Moreover, among the five prospective studies, 3 reported significant findings, relating BPA exposure to incident diabetes, incident coronary artery disease, and weight gain. To conclude, there is evidence from the large body of cross-sectional studies that individuals with higher uBPA concentrations are more likely to suffer from diabetes, general/abdominal obesity and hypertension than those with lower uBPA concentrations. Given the potential importance for public health, prospective cohort studies with proper adjustment for dietary characteristics and identification of critical windows of exposure are urgently needed to further improve knowledge about potential causal links between BPA exposure and the development of chronic disease.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Benzhydryl Compounds; Biomarkers; Cardiovascular Diseases; Child; Cohort Studies; Cross-Sectional Studies; Female; Glucose Metabolism Disorders; Humans; Male; Middle Aged; Phenols; Prospective Studies; Risk Factors; White People; Young Adult
PubMed: 26026606
DOI: 10.1186/s12940-015-0036-5 -
Journal of Epidemiology and Community... Jun 2020Several observational studies have been conducted to investigate the link between anaemia and adult depression but have shown inconsistent results. This systematic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several observational studies have been conducted to investigate the link between anaemia and adult depression but have shown inconsistent results. This systematic review and meta-analysis was performed to investigate this association.
METHODS
A comprehensive search of four electronic databases (PubMed, EMBASE, PsycINFO and the Cochrane Library) was conducted to identify relevant papers published up to November 2019 for the systematic review and meta-analysis. The Newcastle-Ottawa Scale was used to assess the methodological quality of selected studies. A random-effects model was used to draw metaestimates of the relationship between anaemia and adult depression.
RESULTS
A total of 9706 papers were retrieved, and 14 observational epidemiological studies (9 case-control studies and 5 prospective cohort studies) comprising 10 764 cases of depression were finally included in this meta-analysis. The mean age of the participants ranged from 38.4 to 75.0 years. A significant association was identified between low haemoglobin levels and adult depression (OR or relative risk 1.43; 95% CI 1.23 to 1.65). Subgroup analyses according to study design, mean age, diagnostic criteria of anaemia, geographical region, number of participants, methodological quality and adjustment for various confounding factors such as education, smoking, comorbid disorders, physical activity, alcohol intake and medication use showed similar results.
CONCLUSIONS
The current study showed that anaemia was related to an increased risk of adult depression. One of the important limitations of our study was a moderate degree of heterogeneity due to the variety of assessment tools used to identify depression and the existence of publication bias. Another limitation of this meta-analysis was the lack of prospective cohort studies.
Topics: Adult; Aged; Anemia; Depression; Female; Humans; Male; Middle Aged; Observational Studies as Topic
PubMed: 32291287
DOI: 10.1136/jech-2020-213842 -
Psychological Trauma : Theory,... Sep 2023A core challenge in working with first responders worldwide (e.g., firefighters, emergency service personnel, police officers) is identifying theoretically and...
OBJECTIVE
A core challenge in working with first responders worldwide (e.g., firefighters, emergency service personnel, police officers) is identifying theoretically and empirically based individual-level factors that are associated with adjustment and that can be translated to interventions. The transactional model of stress and coping provides an excellent framework to guide interventions with first responders, yet no review to date has explicitly and comprehensively focused on coping responses in this population.
METHOD
The current study systematically evaluated global evidence linking primary appraisals and coping efforts to mental health and behavioral risk-taking in first responders, with an eye toward their application to interventions.
RESULTS
Seventeen studies from eight countries met review criteria and were summarized. Studies of coping efforts predominated; only two studies assessed primary appraisals. Overall, disengaged coping efforts, relative to engaged coping, were more often associated with adjustment. Further, for engaged coping, associations with adjustment largely were present for cognitive, versus behavioral, strategies; for disengaged coping, cognitive and behavioral strategies were associated equally with poorer adjustment. Two thirds of the studies assessed posttraumatic stress (PTS) symptoms. Given the nature of PTS, use of disengaged strategies may particularly exacerbate these symptoms relative to other adjustment outcomes.
CONCLUSIONS
Additional research focused on both primary appraisals and coping efforts and that employs longitudinal designs would expand our understanding of the role of coping processes in first responders' adjustment to duty-related stress. Further, these data suggest that interventions targeting individuals (vs. systems or environments) should focus on replacing cognitive and behavioral disengaged coping strategies with engaged strategies that are cognitive in nature. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Adaptation, Psychological; Emergency Responders; Occupational Stress; Stress Disorders, Post-Traumatic
PubMed: 35653742
DOI: 10.1037/tra0001258 -
Sleep Medicine Reviews Jun 2021This study was conducted to investigate the association between shift work and metabolic syndrome (MetS) and quantify the roles of sleep, gender, and type of shift work.... (Meta-Analysis)
Meta-Analysis Review
This study was conducted to investigate the association between shift work and metabolic syndrome (MetS) and quantify the roles of sleep, gender, and type of shift work. We searched online databases, including PubMed, Scopus, and Web of Science on November 17, 2019. Of the 821 articles identified, 38 observational studies (27 cross-sectional, 10 cohorts, and one nested case-control), conducted on 128,416 participants, met our eligibility criteria. The pooled Odds ratio (OR) and 95% Confidence interval (CI) of MetS in shift-versus day-workers were estimated as 1.14 (1.07, 1.21) and 1.11 (1.06, 1.17) for the unadjusted and adjusted models. This association remained significant only for the studies with a cross-sectional design. There was a significantly higher odds of MetS in the studies conducted only on females (1.13 [1.06, 1.20]) or males (1.12 [1.02, 1.21]). The pooled adjusted OR (95% CI) for the studies without and with sleep adjustment was calculated as 1.14 (1.08, 1.21) and 1.29 (1.06, 1.52). We observed that rotating shift workers had stronger odds of MetS than the other shift workers. In conclusion, our findings revealed the significant odds of an association between shift work and MetS and different effects for sleep, gender, and type of shift work.
Topics: Cross-Sectional Studies; Female; Humans; Male; Metabolic Syndrome; Shift Work Schedule; Sleep; Work Schedule Tolerance
PubMed: 33556868
DOI: 10.1016/j.smrv.2021.101427 -
Progress in Neuro-psychopharmacology &... Jul 2022Neuroimaging findings in people at either genetic risk or at clinical high-risk for psychosis (CHR-P) or bipolar disorder (CHR-B) remain unclear. A meta-analytic review... (Meta-Analysis)
Meta-Analysis Review
A systematic review and meta-analysis of structural and functional brain alterations in individuals with genetic and clinical high-risk for psychosis and bipolar disorder.
Neuroimaging findings in people at either genetic risk or at clinical high-risk for psychosis (CHR-P) or bipolar disorder (CHR-B) remain unclear. A meta-analytic review of whole-brain voxel-based morphometry (VBM) and functional magnetic resonance imaging (fMRI) studies in individuals with genetic risk or CHR-P or CHR-B and controls identified 94 datasets (N = 7942). Notwithstanding no significant findings were observed following adjustment for multiple comparisons, several findings were noted at a more liberal threshold. Subjects at genetic risk for schizophrenia or bipolar disorder or at CHR-P exhibited lower gray matter (GM) volumes in the gyrus rectus (Hedges' g = -0.19). Genetic risk for psychosis was associated with GM reductions in the right cerebellum and left amygdala. CHR-P was associated with decreased GM volumes in the frontal superior gyrus and hypoactivation in the right precuneus, the superior frontal gyrus and the right inferior frontal gyrus. Genetic and CHR-P were associated with small structural and functional alterations involving regions implicated in psychosis. Further neuroimaging studies in individuals with genetic or CHR-B are warranted.
Topics: Bipolar Disorder; Brain; Gray Matter; Humans; Magnetic Resonance Imaging; Neuroimaging; Psychotic Disorders
PubMed: 35240226
DOI: 10.1016/j.pnpbp.2022.110540