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Anticancer Research May 2020Skeletal muscle mass loss is an emerging concern in oncology. Our systematic review and meta-analysis identified the mean difference in skeletal muscle index pre- to... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND/AIM
Skeletal muscle mass loss is an emerging concern in oncology. Our systematic review and meta-analysis identified the mean difference in skeletal muscle index pre- to post-chemotherapy and synthesized potential key factors.
MATERIALS AND METHODS
We searched primary original research published through October 2019 in four databases: MEDLINE via PubMed, Scopus, CINAHL, and Embase.
RESULTS
Fifteen studies were included, 60% published in the past 2 years (2018-2019). Advanced non-small cell lung cancer was the most frequently reported cancer, and overall survival the most often identified key related factor. Mean difference in skeletal muscle index during chemotherapy was 2.72 (95%CI=1.77-3.67, p=0.00), with muscle loss in males (4.52, 95%CI=3.34-5.71, p=0.00) about 1.6 times higher than that in females (2.86, 95%CI=0.81-4.92, p=0.01).
CONCLUSION
Oncologists should recognize sex-specific differences in skeletal muscle mass loss during chemotherapy and consider adjusting treatment accordingly.
Topics: Antineoplastic Combined Chemotherapy Protocols; Humans; Muscle, Skeletal; Neoplasms; Organ Size; Sarcopenia
PubMed: 32366384
DOI: 10.21873/anticanres.14210 -
Surgery For Obesity and Related... Dec 2023Obstructive sleep apnea (OSA) is highly prevalent in patients with morbid obesity. There is a growing interest in the role of bariatric surgery in OSA management. This... (Meta-Analysis)
Meta-Analysis Review
The efficacy of bariatric surgery on pulmonary function and sleep architecture of patients with obstructive sleep apnea and co-morbid obesity: a systematic review and meta-analysis.
Obstructive sleep apnea (OSA) is highly prevalent in patients with morbid obesity. There is a growing interest in the role of bariatric surgery in OSA management. This study aims to evaluate the therapeutic efficacy of bariatric surgery on changes in pulmonary function and sleep architecture. Studies of patients with OSA that underwent bariatric surgery were searched in 4 different databases (PubMed, Cochrane, Web of Science, and Embase) until October 31, 2022. We identified studies evaluating the efficacy of surgical intervention on primary outcomes (body mass index [BMI] and apnea-hypopnea index [AHI]) and secondary outcomes such as forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), FEV1/FVC, oxygen desaturation index (ODI), T90, mean oxygen saturation (SpO), nadirSpO, sleep efficiency (SE), N1%, N2%, N3%, rapid eye movement (REM%), arousal index, Epworth sleepiness scale (ESS), neck circumference, waist circumference, and weight. A total of 24 eligible studies were finally chosen. Risk of bias assessed through funnel plots was collected and analyzed via random effects meta-analyses. There were significant reductions in BMI and AHI after bariatric surgery induced weight loss. Accordingly, improvement in FVC, meanSpO, nadirSpO, SE, N3%, REM%, and ESS were observed compared with baseline. Patients with OSA also exhibit lower ODI, T90, arousal index, neck circumference, waist circumference, and weight after treatment. Bariatric surgery has beneficial effects on patients with OSA and obesity, particularly with morbid obesity. Surgical weight loss significantly eliminates apnea-hypopnea events, reduces weight, increases oxygen saturation, N3 and REM sleep stage, reduces sleep fragmentation, and improves pulmonary functions with augmented FVC.
Topics: Humans; Obesity, Morbid; Polysomnography; Sleep; Sleep Apnea, Obstructive; Bariatric Surgery; Weight Loss
PubMed: 37673709
DOI: 10.1016/j.soard.2023.07.007 -
Thrombosis Research Sep 2018Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is the mainstay for the treatment of patients with acute cerebral vein... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Anticoagulation with unfractionated heparin (UFH) or low molecular weight heparin (LMWH) is the mainstay for the treatment of patients with acute cerebral vein thrombosis (CVT) with or without intracranial hemorrhage (ICH).
AIM
We conducted a systematic review and meta-analysis to determine the efficacy and safety of LMWH compared to UFH for the treatment of acute CVT.
METHODS
An electronic search of MEDLINE, Pubmed, CENTRAL and Google Scholar was performed. Randomized controlled trials (RCT) reporting on the efficacy and safety of anticoagulation for acute treatment of CVT were included. Outcomes of interest included mortality, disability, new ICH and pulmonary embolism (PE).
RESULTS
Overall, 4 RCTs were included in the meta-analysis. Two trials compared anticoagulation (UFH (N = 1) and LMWH (N = 1)) to placebo. The use of anticoagulation therapy was associated with an odd ratio (OR) for mortality and disability of 0.31 (95% confidence interval (CI) 0.07 to 1.45; p = 0.14) and 0.3 (95% CI 0.09 to 1.01; p = 0.05), respectively. Three new ICHs were observed among patients receiving placebo and no patient had a PE complication. The other two trials compared LMWH to UFH. LMWH was associated with an OR for mortality and disability of 0.21 (95% CI 0.02 to 2.44, p = 0.21) and 0.5 (95% CI 0.11 to 2.23; p = 0.36), respectively. There were no new events of ICH or PE.
CONCLUSION
LMWH seems to be safe and effective for the management of acute CVT.
Topics: Acute Disease; Anticoagulants; Heparin; Heparin, Low-Molecular-Weight; Humans; Intracranial Hemorrhages; Intracranial Thrombosis; Pulmonary Embolism; Treatment Outcome; Venous Thrombosis
PubMed: 30056293
DOI: 10.1016/j.thromres.2018.07.023 -
Surgery For Obesity and Related... Feb 2018Morbid obesity may affect several body systems and cause ill effects to the cardiovascular, hepatobiliary, endocrine, and mental health systems. However, the impact on... (Meta-Analysis)
Meta-Analysis Review
Morbid obesity may affect several body systems and cause ill effects to the cardiovascular, hepatobiliary, endocrine, and mental health systems. However, the impact on the pulmonary system and pulmonary function has been debated in the literature. A systematic review and meta-analysis for studies that have evaluated the impact of bariatric surgery on pulmonary function were pooled for this analysis. PubMed, Cochrane, and Embase databases were evaluated through September 31, 2016. They were used as the primary search engine for studies evaluating the impact pre- and post-bariatric surgery on pulmonary function. Pooled effect estimates were calculated using random-effects model. Twenty-three studies with 1013 participants were included in the final meta-analysis. Only 8 studies had intervention and control groups with different time points, but 15 studies had matched groups with different time points. Overall, pulmonary function score was significantly improved after bariatric surgery, with a pooled standardized mean difference of .59 (95% confidence interval: .46-.73). Heterogeneity test was performed by using Cochran's Q test (I = 46%; P heterogeneity = .10). Subgroup analysis and univariate meta-regression based on study quality, age, presurgery body mass index, postsurgery body mass index, study design, female patients only, study continent, asthmatic patients in the study, and the type of bariatric surgery confirmed no statistically significant difference among these groups (P value>.05 for all). A multivariate meta-regression model, which adjusted simultaneously for these same covariates, did not change the results (P value > .05 overall). Assessment of publication bias was done visually and by Begg's rank correlation test and indicated the absence of publication bias (asymmetric shape was observed and P = .34). This meta-analysis shows that bariatric surgery significantly improved overall pulmonary functions score for morbid obesity.
Topics: Bariatric Surgery; Body Mass Index; Case-Control Studies; Female; Humans; Lung Diseases; Male; Obesity, Morbid; Prognosis; Quality Improvement; Respiratory Function Tests; Risk Assessment; Treatment Outcome; United States; Weight Loss
PubMed: 29126864
DOI: 10.1016/j.soard.2017.09.533 -
The Journal of Heart and Lung... Dec 2014Lung transplant candidates and recipients have significant impairments in skeletal muscle mass, strength and function--individual measures of sarcopenia. Skeletal muscle... (Review)
Review
Lung transplant candidates and recipients have significant impairments in skeletal muscle mass, strength and function--individual measures of sarcopenia. Skeletal muscle dysfunction has been observed in the pre-transplant and post-transplant period and could have an important effect on transplant outcomes. A systematic review was performed to characterize the techniques used to study sarcopenia and assess the level of impairment throughout the transplant process. Electronic databases were searched (inception to July 2013) for prospective studies measuring at least 1 element of sarcopenia (muscle mass, strength, or function) in lung transplant patients. Eighteen studies were included, and study quality was assessed using the Downs and Black scale. A variety of measurements were used to evaluate sarcopenia in 694 lung transplant patients. Muscle mass in 7 studies was assessed using bioelectrical impedance (n = 4), computed tomography or magnetic resonance imaging (n = 2), or skin folds (n = 1), and was significantly reduced. Quadriceps strength was examined in 14 studies with computerized dynamometer (n = 10) and hand-held dynamometer (n = 4). Quadriceps strength was reduced in the pre-transplant period (mean range, 49%-86% predicted; n = 455 patients), further reduced immediately after transplant (51%-72%, n = 126), and improved beyond 3 months after transplant (58%-101%, n = 164). Only 2 studies measured lower extremity function (sit-to-stand test). A multitude of measurement techniques have been used to assess individual measures of sarcopenia, with reduced muscle mass and quadriceps strength observed in the pre-transplant and post-transplant period. Further standardization of measurement techniques is needed to assess the clinical effect of sarcopenia in lung transplantation.
Topics: Adult; Humans; Lung Transplantation; Magnetic Resonance Imaging; Middle Aged; Muscle Strength; Muscle, Skeletal; Prevalence; Sarcopenia; Tomography, X-Ray Computed
PubMed: 25044057
DOI: 10.1016/j.healun.2014.06.003 -
Journal of Voice : Official Journal of... Jan 2023Bariatric surgery has been documented to improve comorbidities associated with obesity. Obesity can cause deposition of excess adipose tissue, narrowing of the vocal... (Review)
Review
OBJECTIVE
Bariatric surgery has been documented to improve comorbidities associated with obesity. Obesity can cause deposition of excess adipose tissue, narrowing of the vocal tract, and decreased lung capacity contributing to reduced vocal quality and increased vocal effort. Limited information is available regarding the impact of bariatric surgery on voice outcomes. This review seeks to examine the role of bariatric surgery on voice outcomes.
STUDY DESIGN
Systematic review.
METHODS
A systematic review was completed using PubMed and Embase for measures of vocal change before and after bariatric surgery. Studies were reviewed by three authors, and data related to acoustic, aerodynamic, auditory-perceptual, and patient-reported outcome measures were extracted.
RESULTS
Forty-nine abstracts were identified with seven meeting criteria for analysis. Voice outcomes pre and postbariatric surgery were measured across 122 individuals. Results revealed increased fundamental frequency (F) and increased maximum phonation time (MPT) during sustained vowel productions. Correlation coefficients for MPT for /a/ were -0.683 and -0.725 for F, respectively, indicating a strong negative correlation between body mass index and MPT and F. Trends toward improved auditory-perceptual ratings and improved patient-reported outcome measures were also noted. However, studies were limited by restricted patient demographics and limited use of standardized and/or comprehensive evaluation techniques.
CONCLUSION
Weight loss associated with bariatric surgery can result in improved voice outcomes; however, the mechanism by which it helps is unclear. To better understand this, otolaryngologists and speech-language pathologists may consider advocating for pre- and postsurgery voice evaluation in patients undergoing bariatric surgery.
PubMed: 36641252
DOI: 10.1016/j.jvoice.2022.12.019 -
Journal of Global Health Mar 2024This study was designed to evaluate the effects of body mass index (BMI) and weight change on the risk of developing cancer overall and cancer at different sites. (Meta-Analysis)
Meta-Analysis
BACKGROUND
This study was designed to evaluate the effects of body mass index (BMI) and weight change on the risk of developing cancer overall and cancer at different sites.
METHODS
We searched PubMed and other databases up to July 2023 using the keywords related to 'risk', 'cancer', 'weight', 'overweight', and 'obesity'. We identified eligible studies, and the inclusion criteria encompassed cohort studies in English that focused on cancer diagnosis and included BMI or weight change as an exposure factor. Multiple authors performed data extraction and quality assessment, and statistical analyses were carried out using RevMan and R software. We used random- or fixed-effects models to calculate the pooled relative risk (RR) or hazard ratio along with 95% confidence intervals (CIs). We used the Newcastle-Ottawa Scale to assess study quality.
RESULTS
Analysis included 66 cohort studies. Compared to underweight or normal weight, overweight or obesity was associated with an increased risk of endometrial cancer, kidney cancer, and liver cancer but a decreased risk of prostate cancer and lung cancer. Being underweight was associated with an increased risk of gastric cancer and lung cancer but not that of postmenopausal breast cancer or female reproductive cancer. In addition, weight loss of more than five kg was protective against overall cancer risk.
CONCLUSIONS
Overweight and obesity increase the risk of most cancers, and weight loss of >5 kg reduces overall cancer risk. These findings provide insights for cancer prevention and help to elucidate the mechanisms underlying cancer development.
REGISTRATION
Reviewregistry1786.
Topics: Male; Female; Humans; Body Mass Index; Overweight; Thinness; Obesity; Cohort Studies; Breast Neoplasms; Lung Neoplasms; Weight Loss
PubMed: 38547495
DOI: 10.7189/jogh.14.04067 -
Chronic Respiratory Disease 2022Computed tomography (CT) is commonly utilized in chronic obstructive pulmonary disease (COPD) for lung cancer screening and emphysema characterization. Computed... (Review)
Review
BACKGROUND
Computed tomography (CT) is commonly utilized in chronic obstructive pulmonary disease (COPD) for lung cancer screening and emphysema characterization. Computed tomography-morphometric analysis of body composition (muscle mass and adiposity) has gained increased recognition as a marker of disease severity and prognosis. This systematic review aimed to describe the CT-methodology used to assess body composition and identify the association of body composition measures and disease severity, health-related quality of life (HRQL), cardiometabolic risk factors, respiratory exacerbations, and survival in patients with COPD.
METHODS
Six databases were searched (inception-September 2021) for studies evaluating adult COPD patients using thoracic or abdominal CT-muscle or adiposity body composition measures. The systematic review was conducted in accordance with the PRISMA guidelines.
RESULTS
Twenty eight articles were included with 15,431 COPD patients, across all GOLD stages with 77% males, age range (mean/median 59-78 years), and BMI range 19.8-29.3 kg/m. There was heterogeneity in assessment of muscle mass and adiposity using thoracic ( = 22) and abdominal ( = 8) CT-scans, capturing different muscle groups, anatomic locations, and adiposity compartments (visceral, subcutaneous, and epicardial). Low muscle mass and increased adiposity were associated with increased COPD severity measures (lung function, exercise capacity, dyspnea) and lower HRQL, but were not consistent across studies. Increased visceral adiposity ( = 6) was associated with cardiovascular disease or risk factors (hypertension, hyperlipidemia, and diabetes). Low muscle CSA was prognostic of respiratory exacerbations or mortality in three of six studies, whereas the relationship with increased intermuscular adiposity and greater mortality was only observed in one of three studies.
CONCLUSION
There was significant variability in CT-body composition measures. In several studies, low muscle mass was associated with increased disease severity and lower HRQL, whereas adiposity with cardiovascular disease/risk factors. Given the heterogeneity in body composition measures and clinical outcomes, the prognostic utility of CT-body composition in COPD requires further study.
Topics: Adult; Aged; Body Composition; Body Mass Index; Cardiovascular Diseases; Early Detection of Cancer; Female; Humans; Lung Neoplasms; Male; Middle Aged; Obesity; Pulmonary Disease, Chronic Obstructive; Quality of Life; Tomography, X-Ray Computed
PubMed: 36223552
DOI: 10.1177/14799731221133387 -
Lung Cancer (Amsterdam, Netherlands) Dec 2016We aimed to assess the association between premorbid obesity, measured using body mass index (BMI) and lung cancer-related mortality, through a systematic review and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
We aimed to assess the association between premorbid obesity, measured using body mass index (BMI) and lung cancer-related mortality, through a systematic review and meta-analysis.
MATERIALS AND METHODS
Observational studies reporting statistical measures of association between premorbid BMI categories and lung cancer-related mortality were included in our study. We estimated hazard ratios (aHR) with 95% confidence intervals (CI), comparing lung cancer-related mortality across BMI categories. The main outcome measure was lung cancer-related mortality in obese (BMI≥30kg/m) and overweight participants (BMI 25.0-29.9kg/m), compared with normal BMI participants.
RESULTS
We included 14 studies (including 2 pooled cohort studies) comprising 3,008,137 cancer-free participants at inception, reporting 28,592 lung cancer-related deaths. On meta-analysis, we observed a significantly lower lung cancer-related mortality in overweight (aHR, 0.76; 95% CI, 0.68-0.85) and obese (aHR, 0.68, 95% CI; 0.57-0.81) participants as compared to participants with normal BMI, with considerable heterogeneity; after excluding one study with large effect size, a more conservative and consistent association was observed between BMI and lung cancer-related mortality (overweight vs. normal BMI: aHR, 0.84; 95% CI, 0.79-0.90; obese vs. normal BMI: aHR, 0.81; 95% CI, 0.75-0.87), with moderate heterogeneity. Were similar in men vs. women, non-smokers vs. smokers, and Western vs Asia-Pacific populations.
CONCLUSIONS
Based on meta-analysis, we observed an independent protective association between premorbid obesity and lung cancer-related mortality. This association was observed across sex, smoking status and geographic region. Further studies are needed to prospectively study this association.
Topics: Adult; Aged; Asia; Body Mass Index; Female; Humans; Lung Neoplasms; Male; Middle Aged; Obesity; Observational Studies as Topic; Overweight; Prognosis
PubMed: 27987589
DOI: 10.1016/j.lungcan.2016.10.017 -
The Clinical Respiratory Journal Mar 2018Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive fibrotic disease limited to the lungs. The course of disease varies widely, with some patients... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Idiopathic pulmonary fibrosis (IPF) is a chronic and progressive fibrotic disease limited to the lungs. The course of disease varies widely, with some patients experiencing acute respiratory deterioration, a condition called acute exacerbations of IPF (AE-IPF). The risk factors contributing to AE-IPF are unclear. This systematic review and meta-analysis investigated the risk factors for AE-IPF.
METHODS
Studies of risk factors for AE-IPF were identified in Medline, EMBASE and Cochrane databases. Fixed effects models were used to calculate pooled relative risks and weighted mean differences (WMD).The meta-analysis included seven articles involving 14 risk factors for AE-IPF.
RESULTS
Risk factors for AE included reductions in vital capacity (VC; WMD - 10.58, 95% confidence interval (CI) -17.17 to - 3.99), forced vital capacity (FVC; WMD -6.02, 95%CI - 8.58 to - 3.47), total lung capacity (TLC; WMD -4.88, 95%CI -7.59 to - 2.17), and PaO (WMD -4.19, 95%CI -7.66 to -0.71) and a higher alveolar-arterial oxygen difference (AaDO ; WMD 4.4, 95%CI 0.24 to 8.57). Mechanical procedures, higher serum KL-6 concentration and secondary pulmonary hypertension, might be risk factors for AE-IPF. In contrast, age, sex, body mass index (BMI), differences in diffusing lung capacity for carbon monoxide (DLCO), exposure to seasonal variations and air pollution, and virus infection might be unrelated to AE-IPF.
CONCLUSIONS
Poor pulmonary function, mechanical procedures, higher serum KL-6 and secondary pulmonary hypertension were associated with increased risks of AE-IPF.
Topics: Acute Disease; Blood Gas Analysis; Disease Progression; Humans; Idiopathic Pulmonary Fibrosis; Lung; Prognosis; Pulmonary Diffusing Capacity; Risk Factors; Vital Capacity
PubMed: 28332341
DOI: 10.1111/crj.12631