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Advances in Nutrition (Bethesda, Md.) Feb 2021Subcutaneous abdominal adipose tissue (SAT), is the largest fat depot and major provider of free fatty acids to the liver. Abdominal fat is indirectly (via increased... (Meta-Analysis)
Meta-Analysis
The Effect of Aerobic and Resistance Training and Combined Exercise Modalities on Subcutaneous Abdominal Fat: A Systematic Review and Meta-analysis of Randomized Clinical Trials.
Subcutaneous abdominal adipose tissue (SAT), is the largest fat depot and major provider of free fatty acids to the liver. Abdominal fat is indirectly (via increased levels of low-grade inflammation) correlated with many of the adverse health effects of obesity. Although exercise is one of the most prominent components of obesity management, its effects on SAT are still unclear. The aim of this study was to investigate the independent effects of aerobic training (AT) and resistance training (RT) modalities and combined exercise modalities on SAT in adults. PubMed, SCOPUS, and Google Scholar were searched to find relevant publications up to November 2018. The effect sizes were represented as weighted mean difference (WMD) and 95% CIs. Between-study heterogeneity was examined using the I2 test. Overall, 43 identified trials that enrolled 3552 subjects (2684 women) were included. After removal of outliers, combining effect sizes indicated a significant effect of AT (WMD: -13.05 cm2; 95% CI: -18.52, -7.57; P < 0.001), RT (WMD: -5.39 cm2; 95% CI: -9.66, -1.12; P = 0.01), and combined exercise training (CExT; WMD: -28.82 cm2; 95% CI: -30.83, -26.81; P < 0.001) on SAT relative to control groups. Pooled effect sizes demonstrated a significant effect of AT on SAT compared with a CExT group (WMD: 11.07 cm2; 95% CI: 1.81, 20.33; P = 0.01). However, when comparing the AT and RT groups, no significant difference was seen in SAT (WMD: -0.73 cm2; 95% CI: -4.50, 3.04; P = 0.70). Meta-analysis of relevant trials indicated that AT, RT, and CExT lead to SAT reduction. Aerobic exercise was shown to produce greater efficacy in decreasing SAT.
Topics: Abdominal Fat; Diabetes Mellitus, Type 2; Exercise; Humans; Randomized Controlled Trials as Topic; Resistance Training
PubMed: 32804997
DOI: 10.1093/advances/nmaa090 -
Frontiers in Psychiatry 2019Meditation, yoga, and mindfulness are popular interventions at universities and tertiary education institutes to improve mental health. However, the effects on...
Meditation, yoga, and mindfulness are popular interventions at universities and tertiary education institutes to improve mental health. However, the effects on depression, anxiety, and stress are unclear. This study assessed the effectiveness of meditation, yoga, and mindfulness on symptoms of depression, anxiety, and stress in tertiary education students. We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, PsycINFO and identified 11,936 articles. After retrieving 181 papers for full-text screening, 24 randomized controlled trials were included in the qualitative analysis. We conducted a random-effects meta-analysis amongst 23 studies with 1,373 participants. At post-test, after exclusion of outliers, effect sizes for depression, g = 0.42 (95% CI: 0.16-0.69), anxiety g = 0.46 (95% CI: 0.34-0.59), stress g = 0.42 (95% CI: 0.27-0.57) were moderate. Heterogeneity was low ( = 6%). When compared to active control, the effect decreased to g = 0.13 (95% CI: -0.18-0.43). No RCT reported on safety, only two studies reported on academic achievement, most studies had a high risk of bias. Most studies were of poor quality and results should be interpreted with caution. Overall moderate effects were found which decreased substantially when interventions were compared to active control. It is unclear whether meditation, yoga or mindfulness affect academic achievement or affect have any negative side effects.
PubMed: 31068842
DOI: 10.3389/fpsyt.2019.00193 -
Experimental Gerontology May 2022An association between osteoarthritis (OA) and atherosclerosis (AT) has been proposed, but evidence is controverted, with recent meta-analysis showing disparate results.... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
An association between osteoarthritis (OA) and atherosclerosis (AT) has been proposed, but evidence is controverted, with recent meta-analysis showing disparate results. To better refine this possible association, we performed a systematic review and meta-analysis subdividing OA by joint, i.e., hip and knee, hands, and OA in general, and stratified the results by subclinical AT, manifest cardiovascular (CV) disease, and CV death. Separation by sex, whenever this information was available, was also accounted.
METHODS
We searched PubMed, Web of Science, LILACS, and SciELO from inception until September 2021, using the MeSH search terms "osteoarthritis", "aorta", "carotid", "intima-media thickness", "coronary artery disease", "atherosclerosis", "cardiovascular disease", and "death". To appraise the quality of the studies, we applied the NewCastle-Ottawa scale. To assess for heterogeneity, I was used. A random-fixed effect model was adopted, and outliers were excluded when detected. Publication bias was ascertained by funnel plot and Egger regression test.
RESULTS
A total of 49 studies, comprising 552,857 individuals with OA and 688,820 controls, were included on the narrative synthesis, and 33 on the meta-analysis. All but five studies were deemed as of fair or good quality. Hip and knee OA increased the risk for both subclinical AT (OR 1.15, 95% CI 1.01-1.31), and CV disease (OR 1.13, 95% CI 1.05-1.22), but not for CV death (OR 1.08, 95% CI 0.99-1.19). Hands OA was associated with subclinical AT (OR 1.18, 95% CI 1.02-1.36), but not with CV disease (OR 1.49, 95% CI 0.90-2.46) or CV death (OR 1.02, 95% CI 0.73-1.44).
CONCLUSIONS
Having OA was associated with subclinical AT for all joints evaluated, but with CV disease only for weight-bearing joints. Even though there was a trend in favor of a positive association between OA and CV death, it did not reach statistical significance.
Topics: Atherosclerosis; Carotid Arteries; Hand; Humans; Knee Joint; Osteoarthritis, Hip; Osteoarthritis, Knee
PubMed: 35151784
DOI: 10.1016/j.exger.2022.111734 -
Pediatrics Jul 2023Necrotizing enterocolitis (NEC) is a devastating intestinal disease affecting preterm infants. Studies implicate viral infections in etiopathogenesis. (Meta-Analysis)
Meta-Analysis
CONTEXT
Necrotizing enterocolitis (NEC) is a devastating intestinal disease affecting preterm infants. Studies implicate viral infections in etiopathogenesis.
OBJECTIVE
To summarize the association of viral infections with NEC by systematic review and meta-analysis.
DATA SOURCES
We searched Ovid-Medline, Embase, Web of Science, and Cochrane databases in November 2022.
STUDY SELECTION
We included observational studies that examined the association between viral infections and NEC in newborn infants.
DATA EXTRACTION
We extracted data regarding the methodology, participant characteristics, and outcome measures.
RESULTS
We included 29 and 24 studies in the qualitative review and meta-analysis, respectively. The meta-analysis demonstrated a significant association between viral infections and NEC (odds ratio [OR], 3.81, 95% confidence interval: 1.99-7.30, 24 studies). The association remained significant after excluding the outliers (OR, 2.89 [1.56-5.36], 22 studies) and studies with poor methodology (OR, 3.33 [1.73-6.43], 22 studies). In subgroup analysis based on participants' birth weight, studies including very low birth weight infants only (OR, 3.62 [1.63-8.03], 8 studies) and non-very low birth weight infants only (OR, 5.28 [1.69-16.54], 6 studies) showed a significant association. In subgroup analysis based on specific viruses, infection with rotavirus (OR, 3.96 [1.12-13.95], 10 studies), cytomegalovirus (OR, 3.50 [1.60-7.65], 5 studies), norovirus (OR, 11.95 [2.05-69.84], 2 studies), and astrovirus (OR, 6.32 [2.49-16.02], 2 studies) was significantly associated with NEC.
LIMITATIONS
Heterogeneity of the included studies.
CONCLUSIONS
Viral infection is associated with an increased risk of NEC in newborn infants. We need methodologically sound prospective studies to assess the effect of preventing or treating viral infections on NEC incidence.
Topics: Humans; Infant; Infant, Newborn; Enterocolitis, Necrotizing; Infant, Newborn, Diseases; Infant, Premature; Infant, Very Low Birth Weight; Prospective Studies; Virus Diseases
PubMed: 37293714
DOI: 10.1542/peds.2022-060876 -
Phytotherapy Research : PTR Mar 2022This systematic review and meta-analysis were conducted to determine the effects of anthraquinone (AQ) laxatives on colorectal cancer (CRC). We searched PubMed, Embase,... (Meta-Analysis)
Meta-Analysis Review
This systematic review and meta-analysis were conducted to determine the effects of anthraquinone (AQ) laxatives on colorectal cancer (CRC). We searched PubMed, Embase, Google Scholar, and CENTRAL from inception until March 2021, for randomized controlled trials (RCTs) and observational studies. Through the systematic review, we identified 8 observational studies evaluating AQ laxatives use as a risk factor for CRC development, and 5 studies on CRC risk were included in the meta-analysis using a random-effects model. Through the meta-analysis, we found that a history of AQ laxatives use compared with "other" and "no laxatives" use was associated with CRC development (OR: 1.41; 95% CI: 0.94-2.11), although not at a statistically significant level. The possible association persists even after removal of the outlier studies (OR: 1.51; 95% CI: 0.97-2.34). Selection of cases and controls was judged at low or unclear risk of bias across almost all studies, and the quality of evidence was from moderate to low. In conclusion, it is not possible to associate the use of AQ laxatives with the development of CRC. However, the trend toward an increased risk of CRC provides a strong indication for investigating this issue by performing further high-quality studies.
Topics: Anthraquinones; Colorectal Neoplasms; Constipation; Humans; Laxatives
PubMed: 35040201
DOI: 10.1002/ptr.7373 -
Journal of Integrative and... Jan 2022The research aim was to perform a systematic review and meta-analysis evaluating the ability of acupressure to reduce anxiety. Randomized controlled trials were... (Meta-Analysis)
Meta-Analysis Review
The research aim was to perform a systematic review and meta-analysis evaluating the ability of acupressure to reduce anxiety. Randomized controlled trials were obtained through a search of electronic medical databases (four in English and one in Chinese) from inception to October 5, 2020. Two authors searched the databases, evaluated studies' methodological quality, and performed data extraction independently. The final studies for analysis were identified after discussion with the third author. We obtained 27 studies for our systematic review and meta-analysis. Eight studies had a low overall risk of bias, and 13 had some bias concerns with methodological quality. According to the results, acupressure significantly reduced patient anxiety (standardized mean difference = 1.152; 95% confidence interval: 0.847-1.459, < 0.001), and the study heterogeneity was high ( = 299.74, < 0.001, = 91.333%). Two studies reported acupressure-associated adverse events. We also performed a sensitivity analysis by omitting one outlier study, which had the largest effect size; however, high heterogeneity remained ( = 87.816%). A subgroup analysis revealed significant differences between participant types ( = 46.573, < 0.001), levels of methodological quality ( = 6.228, = 0.044), and massage equipment ( = 4.642, = 0.031). Our meta-analysis suggests that acupressure can alleviate anxiety. Acupressure was more effective for inpatients and preoperative patients when finger massage was applied. In individuals with anxiety and a stable hemodynamic status, acupressure could be a promising treatment option. However, the substantial heterogeneity across studies means that any inference from the results should be performed cautiously.
Topics: Acupressure; Anxiety; Anxiety Disorders; Humans; Massage
PubMed: 35085025
DOI: 10.1089/jicm.2020.0256 -
Arthroscopy : the Journal of... Jun 2024To assess the efficacy of intra-articular viscosupplementation as a therapeutic intervention for hip osteoarthritis (OA), as well as to assess the duration of efficacy,... (Review)
Review
PURPOSE
To assess the efficacy of intra-articular viscosupplementation as a therapeutic intervention for hip osteoarthritis (OA), as well as to assess the duration of efficacy, effect of dose, composition and number of injections of the viscosupplement, and the incidence of adverse effects.
METHODS
We performed a systematic review using the literature search from the following databases: Embase, Medline, PubMed, Web of Science, and Scopus. Quality assessment of the included studies was performed using the Modified Newcastle-Ottawa Quality Assessment Scale. Random-effects meta-analysis and mixed-effects subgroup analysis were carried out, but due to the high heterogeneity, low level of evidence, and high risk of bias of the included studies after analyzing the data, weighted means and pooled estimates have not been provided. Instead, we have provided a subjective synthesis of the results.
RESULTS
Forty studies were included in the analysis from an initial search of 3,265 studies, with data from a total of 3,350 patients. The level of available evidence was low with an overall high risk of bias. Nearly all studies showed a reduction in mean pain at 1 month, 3 months, and 6 months of follow-up, as well as at the end point, and an improvement in mean patient-reported function was also seen at these time points. However, heterogeneity was extremely high at all time points and remained despite attempts at removing outliers. Subgroup analyses looking at the effects of dose, volume, composition of viscosupplement, and number of injections were carried out, but substantial heterogeneity still remained. There were no lasting adverse effects.
CONCLUSIONS
Weak evidence suggests that viscosupplementation improves patient-reported pain and function at end point compared to baseline, regardless of dose, volume, composition, and number of injections. However, due to the high heterogeneity, low level of evidence, and high risk of bias in the current available literature, the strength of our conclusions is limited.
LEVEL OF EVIDENCE
Level IV, systematic review of level I to IV studies.
Topics: Humans; Viscosupplementation; Osteoarthritis, Hip; Injections, Intra-Articular; Viscosupplements; Hyaluronic Acid; Treatment Outcome
PubMed: 38000487
DOI: 10.1016/j.arthro.2023.11.010 -
Journal of Autoimmunity Apr 2024Among the over 80 different autoimmune diseases, psoriasis (PsO), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) are common representatives. Previous studies... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
Among the over 80 different autoimmune diseases, psoriasis (PsO), rheumatoid arthritis (RA), and ankylosing spondylitis (AS) are common representatives. Previous studies indicated a potential link with cancer risk, but suffered often from low statistical power. Thus, we aimed to synthesize the evidence and quantify the association to different female-specific cancer sites.
METHODS
The systematic review was performed according to PRISMA guidelines. A search string was developed for the databases PubMed, Web of Science, Cochrane Library and Embase. Results were screened independently by two investigators and the risk of bias was assessed using the ROBINS-E tool. Meta-analyses were performed using inverse variance weighted random-effects models. Statistical between-study heterogeneity was quantified by calculating Cochran's Q, τ, and Higgins' I statistics. Sources of heterogeneity were analyzed and adjusted for within an intensive bias assessment in the form of meta-regression, outlier, influential, and subgroup analyses. A range of methods were used to test and adjust for publication bias.
RESULTS
Of 10,096 records that were originally identified by the search strategy, 45 were included in the meta-analyses. RA was inversely associated with both breast and uterine cancer occurrence, while PsO was associated with a higher breast cancer risk. Outlier-adjusted estimates confirmed these findings. Bias assessment revealed differences in geographic regions, particularly in RA patients, with higher estimates among Asian studies. An additional analysis revealed no association between psoriatic arthritis and breast cancer.
CONCLUSIONS
RA seems to reduce the risk of breast and uterine cancers, while PsO appears to increase breast cancer risk. Further large studies are required to investigate potential therapy-effects and detailed biological mechanisms.
Topics: Humans; Female; Autoimmune Diseases; Arthritis, Rheumatoid; Arthritis, Psoriatic; Psoriasis; Breast Neoplasms
PubMed: 38428110
DOI: 10.1016/j.jaut.2024.103187 -
Journal of Comparative Effectiveness... May 2023Stent-retriever (SR) thrombectomy has demonstrated superior outcomes in patients with acute ischemic stroke compared with medical management alone, but differences... (Meta-Analysis)
Meta-Analysis Review
MASTRO I: Meta-Analysis and Systematic Review of thrombectomy stent retriever outcomes: comparing functional, safety and recanalization outcomes between EmboTrap, Solitaire and Trevo in acute ischemic stroke.
Stent-retriever (SR) thrombectomy has demonstrated superior outcomes in patients with acute ischemic stroke compared with medical management alone, but differences among SRs remain unexplored. We conducted a Systematic Review/Meta-Analysis to compare outcomes between three SRs: EmboTrap, Solitaire™, and Trevo. We conducted a PRISMA-compliant Systematic Review among English-language studies published after 2014 in PubMed/MEDLINE that reported SRs in ≥25 patients. Functional and safety outcomes included 90-day modified Rankin scale (mRS 0-2), mortality, symptomatic intracranial hemorrhage (sICH), and embolization to new territory (ENT). Recanalization outcomes included modified thrombolysis in cerebral infarction (mTICI) and first-pass recanalization (FPR). We used a random effects Meta-Analysis to compare outcomes; subgroup and outlier-influencer analysis were performed to explore heterogeneity. Fifty-one articles comprising 9,804 patients were included. EmboTrap had statistically significantly higher rates of mRS 0-2 (57.4%) compared with Trevo (50.0%, p = 0.013) and Solitaire (45.3%, p < 0.001). Compared with Solitaire (20.4%), EmboTrap (11.2%, p < 0.001) and Trevo (14.5%, p = 0.018) had statistically significantly lower mortality. Compared with Solitaire (7.7%), EmboTrap (3.9%, p = 0.028) and Trevo (4.6%, p = 0.049) had statistically significantly lower rates of sICH. There were no significant differences in ENT rates across all three devices (6.0% for EmboTrap, 5.3% for Trevo, and 7.7% for Solitaire, p = 0.518). EmboTrap had numerically higher rates of recanalization; however, no statistically significant differences were found. The results of our Systematic Review/Meta-Analysis suggest that EmboTrap may be associated with significantly improved functional outcomes compared with Solitaire and Trevo. EmboTrap and Trevo may be associated with significantly lower rates of sICH and mortality compared with Solitaire. No significant differences in recanalization and ENT rates were found. These conclusions are tempered by limitations of the analysis including variations in thrombectomy techniques in the field, highlighting the need for multi-arm RCT studies comparing different SR devices to confirm our findings.
Topics: Humans; Stroke; Ischemic Stroke; Treatment Outcome; Thrombectomy; Stents
PubMed: 37039285
DOI: 10.57264/cer-2023-0001 -
Global Health Action Dec 2023Undernutrition remains a major public health issue in low- and middle-income countries. Objective Our aim for this study was to identify the factors contributing to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Undernutrition remains a major public health issue in low- and middle-income countries. Objective Our aim for this study was to identify the factors contributing to undernutrition in children under five years old in North Africa.
METHODS
We searched five electronic bibliographic databases (Ovid MEDLINE, Web of Science, Embase (Ovid), ProQuest, and CINAHL) for eligible observational studies published after 2006. STATA version 17 software was used to calculate the odds ratios between associated factors and indicators of undernutrition, with 95% confidence intervals. For each factor, the overall odds were pooled using a forest plot. Due to the significant heterogeneity among the studies (I2 > 50%), a random-effects model was used, and sensitivity analysis was conducted to examine the effect of outliers.
RESULTS
Out of 1093 initially identified studies, 14 met the selection criteria. Our meta-analysis revealed that uneducated mothers were the most common factor associated with undernutrition in North African children. Children aged 0-23 months were significantly associated with stunting (odds ratios (OR) = 1.27; 95% CI: 1.18; 1.37) and wasting (OR = 1.68; 95% CI: 1.42; 1.99). Children living in rural areas were also at higher odds of being stunted (OR = 1.74; 95% CI: 1.64; 1.84) and underweight (OR = 1.59; 95% CI: 1.35; 1.88). These analyses also indicated that a lower wealth index, mothers' nutritional health, uneducated fathers, and low birth weight were other factors significantly associated with stunting.
CONCLUSION
Addressing undernutrition in Northern Africa requires a multidisciplinary approach prioritising mothers and young children, especially families in underprivileged areas.
Topics: Female; Humans; Child; Infant; Child, Preschool; Wasting Syndrome; Malnutrition; Mothers; Thinness; Growth Disorders; Prevalence; Africa, Northern
PubMed: 37497693
DOI: 10.1080/16549716.2023.2240158