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Spine Deformity Nov 2022To assess surgical and safety outcomes associated with different rod materials and diameters in adolescent idiopathic scoliosis (AIS) surgery. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To assess surgical and safety outcomes associated with different rod materials and diameters in adolescent idiopathic scoliosis (AIS) surgery.
METHODS
A systematic literature review and meta-analysis evaluated the surgical management of AIS patients using pedicle screw fixation systems (i.e., posterior rods and pedicle screws) with rods of different materials and sizes. Postoperative surgical outcomes (e.g., kyphosis and coronal correction) and complications (i.e., hyper/hypo-lumbar lordosis, proximal junctional kyphosis, revisions, reoperations, and infections) were assessed. Random-effects models (REMs) pooled data for outcomes reported in ≥ 2 studies.
RESULTS
Among 75 studies evaluating AIS surgery using pedicle screw fixation systems, 46 described rod materials and/or diameters. Two studies directly comparing titanium (Ti) and cobalt-chromium (CoCr) rods found that CoCr rods provided significantly better postoperative kyphosis angle correction vs. Ti rods during a shorter follow-up (0-3 months, MD = - 2.98°, 95% CI - 5.79 to - 0.17°, p = 0.04), and longer follow-up (≥ 24 months, MD = - 3.99°, 95% CI - 6.98 to - 1.00, p = 0.009). Surgical infection varied from 2% (95% CI 1.0-3.0%) for 5.5 mm rods to 4% (95% CI 2.0-7.0%) for 6 mm rods. Reoperation rates were lower with 5.5 mm rods 1% (95% CI 0.0-3.0%) vs. 6 mm rods [6% (95% CI 2.0-9.0%); p = 0.04]. Differences in coronal angle, lumbar lordosis, proximal junctional kyphosis, revisions, and infections did not differ significantly (p > 0.05) among rods of different materials or diameters.
CONCLUSION
For AIS, CoCr rods provided better correction of thoracic kyphosis compared to Ti rods. Patients with 5.5 mm rods had fewer reoperations vs. 6.0 and 6.35 mm diameter rods.
LEVEL OF EVIDENCE
III.
Topics: Humans; Adolescent; Scoliosis; Lordosis; Titanium; Spinal Fusion; Kyphosis; Cobalt; Chromium
PubMed: 35737287
DOI: 10.1007/s43390-022-00537-1 -
Journal of Intellectual Disability... Aug 2023Down syndrome (DS) is the most common genetic disorder. To date, the scientific literature regarding micronutrient status in children and adolescents with DS has not... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Down syndrome (DS) is the most common genetic disorder. To date, the scientific literature regarding micronutrient status in children and adolescents with DS has not been systematically reviewed. Therefore, our aim was to provide a systematic review and meta-analysis on this topic.
METHODS
We identified all relevant case-control studies published by 1 January 2022, by searching the PubMed and Scopus databases for original English-language articles analysing the micronutrient status of individuals with DS. Forty studies were included in the systematic review and 31 in the meta-analysis.
RESULTS
Statistically significant differences between individuals with DS (cases) and non-DS (controls) (P ≤ 0.05) were obtained for zinc, selenium, copper, vitamin B12, sodium and calcium. Serum, plasma and whole blood analyses showed lower zinc levels in cases than controls {standardised mean difference [SMD] serum [95% confidence interval (CI)] = -2.32 [-3.22, -1.41], P < 0.00001; SMD plasma [95% CI] = -1.29 [-2.26, -0.31], P < 0.01; SMD blood [95% CI] = -1.59 [-2.29, -0.89], P < 0.00001}. Similarly, plasma and blood selenium concentrations were significantly lower in cases than controls (SMD plasma [95% CI] = -1.39 [-2.26, -0.51], P = 0.002; SMD blood [95% CI] = -1.86 [-2.59, -1.13], P < 0.00001). Intraerythrocytic copper and serum B12 were higher in cases than controls (SMD Cu [95% CI] = 3.33 [2.19, 4.46], P < 0.00001; SMD B12 [95% CI] = 0.89 [0.01, 1.77], P = 0.048). Blood calcium was lower in cases than controls (SMD Ca [95% CI] = -0.77 [-1.34, -0.21], P = 0.007).
CONCLUSIONS
This study provides the first systematic overview of micronutrient status in children and adolescents with DS and has shown that relatively little consistent research has been executed in this field. There is a clear need for more well-designed, clinical trials to study the micronutrient status and effects of dietary supplements in children and adolescents with DS.
Topics: Child; Humans; Adolescent; Micronutrients; Down Syndrome; Selenium; Copper; Calcium; Zinc
PubMed: 37218392
DOI: 10.1111/jir.13042 -
The Science of the Total Environment Dec 2022Previous studies have indicated that heavy metal levels in milk vary partly depending on environmental metal concentrations. Given the increasing consumption of milk in... (Review)
Review
Previous studies have indicated that heavy metal levels in milk vary partly depending on environmental metal concentrations. Given the increasing consumption of milk in China, it is essential to pay attention to milk safety. We performed a systematic review of relevant published studies to evaluate the heavy metal levels in milk and dairy products and the associated health risks, discuss environmental sources of heavy metals, and propose future research directions. A literature search was implemented in the Web of Science Core Collection and PubMed using multiple keywords such as "metal," "milk," "dairy products," and "China". A total of 16 published studies that analyzed metal levels in milk and dairy products in 20 provincial administrative regions were included. Most studies detected toxic heavy metals in milk and dairy products samples, including mercury, lead, cadmium, chromium, and arsenic. The lead concentration in milk from these studies did not exceed the Chinese standard for milk. However, three studies detected relatively high lead levels in both commercial and raw milk, exceeding the European Commission standard. The polluted environment surrounding the farm, feed, and packaging materials are likely sources of metals in milk and dairy products. The hazard index for the 11 analyzed metal elements in milk and dairy products was lower than 1, indicating negligible non-carcinogenic health risks from exposure to these metals. Children are at a higher risk than adults. This review illustrates that research in this field is limited to China. More research should be conducted in the future, such as evaluating the contribution of each environmental source of metal in milk and dairy products.
Topics: Adult; Animals; Arsenic; Cadmium; Child; Chromium; Environmental Monitoring; Humans; Lead; Mercury; Metals, Heavy; Milk; Risk Assessment
PubMed: 35988597
DOI: 10.1016/j.scitotenv.2022.158161 -
Biological Trace Element Research Mar 2023There have been numerous reports of welder's worker exposure to metal fumes. Carcinogenic and non-carcinogenic (neurological, dermal, and etc.) effects are the adverse... (Review)
Review
There have been numerous reports of welder's worker exposure to metal fumes. Carcinogenic and non-carcinogenic (neurological, dermal, and etc.) effects are the adverse outcomes of exposure to welding fumes. In this review study, data were collected from previous studies conducted in Iran from 1900 to 2020. The risk of carcinogenicity and non-carcinogenicity due to exposure to welding metal fumes was assessed using the United States Environmental Protection Agency (USEPA) method based on the Monte Carlo simulation (MCS). Results showed mean of metal fume concentration in gas welding was in the range of 1.8248 to 1060.6 (µg/m) and in arc welding was 54.935 to 4882.72 (µg/m). The mean concentration of fumes in gas welding is below the recommended American Conference of Governmental Industrial Hygienists (ACGIH) standard exposure limit except for manganese, and in the arc welding, all metal fume concentrations are below the standard exposure limit except for manganese and aluminum. The results showed that the risk of carcinogenicity due to exposure to nickel, manganese in both gas and arc welding, and cadmium in gas welding was higher than standard level (hazard quotient (HQ) more than 1). Cancer risk due to exposure to nickel in both gas and arc welding was probable (1 × 10 < cancer risk (CR) < 1 × 10). Health risk assessment showed that welders are exposed to health risks. Preventive measures should be applied in welding workplaces to reduce the concentrations of metal fumes.
Topics: Humans; Iran; Air Pollutants, Occupational; Metal Workers; Nickel; Manganese; Occupational Exposure; Risk Assessment; Welding; Neoplasms
PubMed: 35508890
DOI: 10.1007/s12011-022-03246-y -
The American Journal of Clinical... Jun 2023Dietary interventions are a widely available mediation for depression and anxiety among pregnant and/or postpartum (i.e., perinatal) persons, but their effectiveness is... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Dietary interventions are a widely available mediation for depression and anxiety among pregnant and/or postpartum (i.e., perinatal) persons, but their effectiveness is not well known.
OBJECTIVES
We performed a systematic review and meta-analysis to assess the effectiveness of dietary interventions for the treatment of perinatal depression and/or anxiety.
METHODS
We searched MEDLINE, EMBASE, PsycINFO, CINAHL, and Web of Science from their inception to 2 November, 2022. Studies were included if they were available in English and examined the effectiveness of a dietary intervention for perinatal depression and/or anxiety in a randomized controlled trial.
RESULTS
Our search identified 4246 articles, of which 36 were included and 28 were eligible for meta-analysis. Random-effects meta-analyses were performed. Polyunsaturated fatty acids (PUFAs) were not found to improve symptoms of perinatal depression compared to control conditions [standardized mean differences (SMD): -0.11; 95% CI: -0.26 to 0.04]. These results neither changed when examined during pregnancy or the postpartum period separately nor varied according to the fatty acid (FA) ratio. Elemental metals (iron, zinc, and magnesium) were also not found to be superior to placebo (SMD: -0.42; 95% CI: -1.05 to 0.21), although vitamin D yielded a small to medium effect size improvement (SMD: -0.52; 95% CI: -0.84 to -0.20) in postpartum depression. Iron may help in those with confirmed iron deficiency. Narrative synthesis was performed for studies ineligible for meta-analyses.
CONCLUSIONS
Despite their widespread popularity, PUFAs and elemental metals do not appear to effectively reduce perinatal depression. Vitamin D taken in doses of 1800-3500 International Units per day may be, to some extent, promising. Additional high-quality, large-scale randomized controlled trials are needed to determine the true effectiveness of dietary interventions on perinatal depression and/or anxiety. This study was registered at PROSPERO (registration date: 5 July, 2020; CRD42020208830).
Topics: Pregnancy; Female; Humans; Depression; Randomized Controlled Trials as Topic; Anxiety; Fatty Acids, Unsaturated; Iron; Vitamin D
PubMed: 37019362
DOI: 10.1016/j.ajcnut.2023.03.025 -
Food and Chemical Toxicology : An... Mar 2018The ingestion of heavy metals through contaminated seafood can causes significant outcomes on human health. In recent years, consume fishes and shrimps has increased in... (Meta-Analysis)
Meta-Analysis Review
The ingestion of heavy metals through contaminated seafood can causes significant outcomes on human health. In recent years, consume fishes and shrimps has increased in Iran, and several study about heavy metals content in fishes and shrimps from Persian Gulf were carried out to check their food safety. The aims of these systematic reviews and meta-analysis was to summarize the evidence on the relation of the intakes of Arsenic (As) and lead (Pb) levels, based on the origin and sub-groups of shrimp species consumed, Hence that we can estimate the risk of oral cancer induced by Pb and As in these groups of shrimp from the persian gulf. We carried out a search of all suitable studies published between 1995 and 2017 in Scopus, Science Direct, PubMed and Web of Science databases. Since the heterogeneity among studied was significant, we used the random effect model (REM) to perform meta-analysis of data. Data were obtained from 9 articles (14 studies), with 511 samples, and it was reported that pooled levels of As and Pb in the muscle shrimps were 1.37 (95% CI: 0.66-2.08 mg/kg d.w.) and 0.58 (95% CI: 0.33-0.82 mg/kg d.w.), respectively. This pooled levels in muscle shrimps were higher than safe dose reported on Food and Agriculture Organization/World Health Organization guidelines (FAO/WHO). The rank order of shrimps species based on As was Panulirus homarus > Penaeus semisulcatus and for the Pb levels was Litopenaeus vannamei > Panulirus homarus > Fenneropenaeus indicus > Metapenaeus affinis. The lowest and highest risk levels of oral cancer, divided by consumers age groups, were respectively 45-54 (6.94E-04) and 15-24 (8.42E-04) for the Pb, and 45-54 (2.87E-01) and 15-24 (3.51E-01) for arsenic. Incremental Lifetime Cancer Risk (ILCR) of Pb and As was higher than 10-4 and 10-3, respectively. All groups (age) of consumers are subject to the cancer risk of due to the consumption of shrimps contaminated by Pb and As, therefore, should be started a control plan for the reduction of the heavy metal bioaccumulation levels in shrimps of the Persian Gulf coupled to a capillary food safety communication.
Topics: Adolescent; Adult; Animals; Arsenic; Carcinogens; Crustacea; Female; Humans; Indian Ocean; Lead; Male; Middle Aged; Mouth Neoplasms; Muscles; Population Health; Risk Assessment; Seafood; Species Specificity; Young Adult
PubMed: 29407475
DOI: 10.1016/j.fct.2018.01.046 -
International Journal of Implant... Jul 2023The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The purpose of this study was to perform a systematic review with meta-analysis on the long-term survival rates of zygomatic implants (ZI). ZI success, prostheses survival and success, sinus pathology and patient reported outcomes were also investigated.
METHODS
Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed. Embase and OvidMedline databases were searched alongside the grey literature. The systematic review was recorded in PROSPERO (CRD42022358024). Studies reporting titanium/titanium alloy ZI survival data, ZI-supported prosthesis data, ZIs directly compared to any other implant therapy including grafted sites, a minimum follow-up time of 3 years and a minimum number of 10 patients were included. All study designs were considered if they met the inclusion criteria. Studies not involving ZIs, ZIs not made from titanium/titanium alloy, a follow-up time of < 3 years or < 10 patients, animal studies and in vitro studies were excluded. Long-term follow-up has not been defined in the literature. A minimum of 3 years follow-up was considered acceptable to capture survival after initial healing, alongside in-function prosthesis data via delayed or immediate load protocols. ZI success, was predominantly defined as ZI survival without biological or neurological complications. Meta-analyses were performed for ZI survival, ZI failure incidence, ZI success, loading protocol, prosthesis survival, and prevalence of sinusitis using random effects models. Descriptive analysis was used for ZI success, prosthesis success and patient reported outcome measures.
RESULTS
Five hundred and seventy-four titles were identified, of which 18 met the inclusion criteria. Eligible studies included 1349 ZIs in 623 patients. Mean follow-up period was 75.4 months (range 36-141.6). The mean survival of ZIs was 96.2% [95% CI: 93.8; 97.7] at 6 years. Mean survival for delayed loading was 95% [95% CI: 91.7; 97.1] and 98.1% [95% CI: 96.2; 99.0] for immediate loading (p = 0.03). Annual incidence rate of ZI failure was 0.7% [95% CI 0.4; 1.0]. Mean ZI success was 95.7% [95% CI 87.8; 98.6]. Mean prosthesis survival was 94% [95% CI 88.6; 96.9]. Sinusitis prevalence was 14.2% [95% CI 8.8; 22.0] at 5 years. Patients' reported increased satisfaction with ZIs.
CONCLUSIONS
ZIs have long-term survival comparable to conventional implants. Immediate loading showed a statistically significant increase in survival over delayed loading. Prosthesis survival was similar to that of prostheses supported by conventional implants, with similar complications. Sinusitis was the most frequently encountered biological complication. Patients reported improved outcome measures with ZI use.
Topics: Humans; Dental Implantation, Endosseous; Dental Implants; Prosthesis Failure; Titanium; Treatment Outcome; Alloys
PubMed: 37405545
DOI: 10.1186/s40729-023-00479-x -
Nutrients Sep 2023Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality... (Meta-Analysis)
Meta-Analysis Review
Hypertension is the leading preventable risk factor for cardiovascular disease and all-cause mortality worldwide. However, studies have shown increased risk of mortality from heart disease and stroke even within the normal blood pressure (BP) range, starting at BPs above 110-115/70-75 mm Hg. Nutraceuticals, such as vitamins and minerals, have been studied extensively for their efficacy in lowering BP and may be of benefit to the general, normotensive population in achieving optimal BP. Our study investigated the effects of six nutraceuticals (Vitamins: C, D, E; Minerals: Calcium, Magnesium, Potassium) on both systolic blood pressure (SBP) and diastolic blood pressure (DBP) in this population. We performed a systematic review and pairwise meta-analysis for all six supplements versus placebo. Calcium and magnesium achieved significant reductions in both SBP and DBP of -1.37/-1.63 mm Hg and -2.79/-1.56 mm Hg, respectively. Vitamin E and potassium only yielded significant reductions in SBP with values of -1.76 mm Hg and -2.10 mm Hg, respectively. Vitamins C and D were not found to significantly lower either SBP or DBP. Future studies should determine optimal dosage and treatment length for these supplements in the general, normotensive population.
Topics: Humans; Vitamins; Blood Pressure; Magnesium; Calcium; Dietary Supplements; Hypertension; Minerals; Hypotension; Calcium, Dietary; Potassium; Antihypertensive Agents
PubMed: 37836507
DOI: 10.3390/nu15194223 -
Biological Trace Element Research Nov 2022It has been reported that heavy metals have adverse effects on the immune system. However, the relationship between heavy metal exposure and allergic outcomes remains... (Meta-Analysis)
Meta-Analysis Review
It has been reported that heavy metals have adverse effects on the immune system. However, the relationship between heavy metal exposure and allergic outcomes remains unclear. This systematic review was conducted to examine whether heavy metal exposure is associated with allergic outcomes during childhood. We performed a systematic search of all relevant articles in Web of Science, EMBASE, and PubMed, from inception through to November 2020. We used odds ratio (OR) and the standard mean differences (SMDs) with 95% confidence intervals (CIs) to present estimates from individual studies. In addition, random-effects meta-analysis was used to pool the data. We also conducted the meta-regression and subgroup analysis to explore potential sources of heterogeneity. After duplicate removal, we finally included 35 articles in the systematic review and meta-analysis from an initial 11,181 articles. The overall results showed that copper (Cu) was associated with asthma (pooled SMD = 1.50, 95% CI = 0.13-2.86); in the subgroup analysis, the results indicated that lead (Pb) was associated with asthma (pooled OR = 6.27, 95% CI = 2.24-17.56), and Cu and Pb were connected with atopic dermatitis (SMD = - 1.05, 95% CI = - 1.45 to - 0.65; SMD = 5.68, 95% CI = 5.05-6.32), respectively. Mercury (Hg) was associated with atopic dermatitis (pooled OR = 1.13, 95% CI = 1.04-1.22) and wheeze (OR = 1.20, 95% CI = 1.05-1.37). The meta-analysis results indicate that Cu might be connected with childhood asthma, but not with other allergic diseases; Hg and Pb may have no association with allergic diseases during childhood. Given some limits observed in the current studies, more prospective cohort studies are still needed to verify our findings. Review registration: PROSPERO CRD42020222167.
Topics: Asthma; Child; Copper; Dermatitis, Atopic; Humans; Lead; Mercury; Metals, Heavy; Prospective Studies
PubMed: 35006554
DOI: 10.1007/s12011-021-03070-w -
Environmental Research Nov 2017Neurodegenerative processes encompass a large variety of diseases with different pathological patterns and clinical presentation such as Amyotrophic Lateral Sclerosis... (Review)
Review
Neurodegenerative processes encompass a large variety of diseases with different pathological patterns and clinical presentation such as Amyotrophic Lateral Sclerosis (ALS), Alzheimer Disease (AD) and Parkinson's disease (PD). Genetic mutations have a known causative role, but the majority of cases are likely to be probably caused by a complex gene-environment interaction. Exposure to metals has been hypothesized to increase oxidative stress in brain cells leading to cell death and neurodegeneration. Neurotoxicity of metals has been demonstrated by several in vitro and in vivo experimental studies and it is likely that each metal could be toxic through specific pathways. The possible pathogenic role of different metals has been supported by some epidemiological evidences coming from occupational and ecological studies. In order to assess the possible association between metals and neurodegenerative disorders, several case-control studies have also been carried out evaluating the metals concentration in different biological specimens such as blood/serum/plasma, cerebrospinal fluid (CSF), nail and hair, often reporting conflicting results. This review provides an overview of our current knowledge on the possible association between metals and ALS, AD and PD as main neurodegenerative disorders.
Topics: Alzheimer Disease; Amyotrophic Lateral Sclerosis; Environmental Pollutants; Humans; Metals; Parkinson Disease, Secondary
PubMed: 28777965
DOI: 10.1016/j.envres.2017.07.048