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International Journal of Paediatric... Jul 2024For caries risk assessment (CRA) tools for young children to be evidence-based, it is important to systematically review the literature to identify factors associated... (Review)
Review
BACKGROUND
For caries risk assessment (CRA) tools for young children to be evidence-based, it is important to systematically review the literature to identify factors associated with the onset of early childhood caries (ECC).
AIM
This updated systematic review aimed to identify current evidence on caries risk in young children.
DESIGN
A comprehensive and systematic literature search of relevant databases was conducted to update a previous systematic review and identify risk factors associated with ECC. Potential risk factors were identified based on strength of association using odds ratios, hazard ratios, relative risk, etc. GRADE was used for rating quality evidence through consensus.
RESULTS
Twenty-two studies met inclusion criteria for the search from mid-2017 to 2021. Twenty-five publications from the prior systematic review, from 1997 to mid-2017, were also included. Several socioeconomic, behavioral, and clinical variables were identified as ECC risk factors. Factors included the following: age, socioeconomic status, frequency of and supervised toothbrushing, fluoride exposure, breast- and bottle-feeding, feeding habits, absence of a dental home, past caries experience, active non-cavitated lesions, visible plaque, enamel defects, and microbiome.
CONCLUSION
This study provides updated evidence of risk factors for ECC that could be included in CRA tools.
Topics: Humans; Dental Caries; Risk Factors; Child, Preschool; Risk Assessment; Infant; Toothbrushing
PubMed: 38071403
DOI: 10.1111/ipd.13140 -
Resuscitation Dec 2023Extracorporeal cardiopulmonary resuscitation (ECPR), has demonstrated promise in the management of refractory out-of-hospital cardiac arrest (OHCA). However, evidence... (Meta-Analysis)
Meta-Analysis Review
Prognostic factors associated with favourable functional outcome among adult patients requiring extracorporeal cardiopulmonary resuscitation for out-of-hospital cardiac arrest: A systematic review and meta-analysis.
BACKGROUND
Extracorporeal cardiopulmonary resuscitation (ECPR), has demonstrated promise in the management of refractory out-of-hospital cardiac arrest (OHCA). However, evidence from observational studies and clinical trials are conflicting and the factors influencing outcome have not been well established.
METHODS
We conducted a systematic review and meta-analysis summarizing the association between pre-ECPR prognostic factors and likelihood of good functional outcome among adult patients requiring ECPR for OHCA. We searched Medline and Embase databases from inception to February 28, 2023 and screened studies with two independent reviewers. We performed meta-analyses of unadjusted and adjusted odds ratios, adjusted hazard ratios and mean differences separately. We assessed risk of bias using the QUIPS tool and certainty of evidence using the GRADE approach.
FINDINGS
We included 29 observational and randomized studies involving 7,397 patients. Factors with moderate or high certainty of association with increased survival with favourable functional outcome include pre-arrest patient factors, such as younger age (odds ratio (OR) 2.13, 95% CI 1.52 to 2.99) and female sex (OR 1.37, 95% CI 1.11 to 1.70), as well as intra-arrest factors, such as shockable rhythm (OR 2.79, 95% CI 2.04 to 3.80), witnessed arrest (OR 1.68 (95% CI 1.16 to 2.42), bystander CPR (OR 1.55, 95% CI 1.19 to 2.01), return of spontaneous circulation (OR 2.81, 95% CI 2.19 to 3.61) and shorter time to cannulation (OR 1.14, 95% CI 1.17 to 1.69 per 10 minutes).
INTERPRETATION
The findings of this review confirm several clinical concepts wellestablished in the cardiac arrest literature and their applicability to the patient for whom ECPR is considered - that is, the impact of pre-existing patient factors, the benefit of timely and effective CPR, as well as the prognostic importance of minimizing low-flow time. We advocate for the thoughtful consideration of these prognostic factors as part of a risk stratification framework when evaluating a patient's potential candidacy for ECPR.
Topics: Adult; Humans; Female; Out-of-Hospital Cardiac Arrest; Cardiopulmonary Resuscitation; Prognosis; Odds Ratio; Extracorporeal Membrane Oxygenation; Retrospective Studies
PubMed: 37863420
DOI: 10.1016/j.resuscitation.2023.110004 -
The European Journal of Neuroscience Aug 2023Mendelian randomization (MR) is a powerful approach for assessing the causal effect of putative risk factors on an outcome, using genetic variants as instrumental...
Mendelian randomization (MR) is a powerful approach for assessing the causal effect of putative risk factors on an outcome, using genetic variants as instrumental variables. The methodology and application developed in the framework of MR have been dramatically improved, taking advantage of the many public genome-wide association study (GWAS) data. The availability of summary-level data allowed to perform numerous MR studies especially for complex diseases, pinpointing modifiable exposures causally related to increased or decreased disease risk. Multiple sclerosis (MS) is a complex multifactorial disease whose aetiology involves both genetic and non-genetic risk factors and their interplay. Previous observational studies have revealed associations between candidate modifiable exposures and MS risk; although being prone to confounding, and reverse causation, these studies were unable to draw causal conclusions. MR analysis addresses the limitations of observational studies and allows to establish reliable and accurate causal conclusions. Here, we systematically reviewed the studies evaluating the causal effect, through MR, of genetic and non-genetic exposures on MS risk. Among 107 papers found, only 42 were eligible for final evaluation and qualitative synthesis. We found that, above all, low vitamin D levels and high adult body mass index (BMI) appear to be uncontested risk factors for increased MS risk.
Topics: Mendelian Randomization Analysis; Multiple Sclerosis; Humans; Causality; Risk Factors
PubMed: 37463755
DOI: 10.1111/ejn.16088 -
Scientific Reports Nov 2023Cardiovascular events remain a substantial global health concern, necessitating innovative strategies for prevention. This study aims to assess the potential impact of... (Meta-Analysis)
Meta-Analysis
Cardiovascular events remain a substantial global health concern, necessitating innovative strategies for prevention. This study aims to assess the potential impact of influenza vaccination on major cardiovascular events. A search of the medical English literature was conducted using PubMed/MEDLINE, EMBASE, and the Cochrane CENTRAL up to 1 August 2023. Meta-analysis and stratified analyses were performed to investigate specific outcomes, including myocardial infarction (MI), cardiovascular death, and stroke. Pooled relative risks (RR) along with their 95% confidence intervals (CI) were calculated to evaluate the associations. A comprehensive analysis was conducted on a total of 9059 patients, with 4529 patients receiving the influenza vaccine and 4530 patients receiving a placebo. Among patients who received the influenza vaccine, a notable reduction in the occurrence of major cardiovascular events was observed, with 517 cases compared to 621 cases in the placebo group (RR 0.70; 95% CI 0.55-0.91). The stratified analysis revealed a decreased risk of MI in vaccinated patients (RR 0.74; 95% CI 0.56-0.97) and a significant reduction in cardiovascular death events (RR 0.67; 95% CI 0.45-0.98). This study provides compelling evidence that influenza vaccination is associated with a decreased risk of major cardiovascular events, particularly myocardial infarction, and cardiovascular death. These findings highlight the potential of influenza vaccination as an adjunctive strategy in cardiovascular disease prevention. Further research and exploration of underlying mechanisms are warranted to elucidate the observed beneficial effects.
Topics: Humans; Cardiovascular Diseases; Influenza Vaccines; Influenza, Human; Risk Factors; Vaccination; Myocardial Infarction; Heart Disease Risk Factors
PubMed: 37981651
DOI: 10.1038/s41598-023-47690-9 -
Effective and Scalable Interventions to Reduce Sodium Intake: a Systematic Review and Meta-Analysis.Current Nutrition Reports Sep 2023High-sodium intake is a main risk factor for increased blood pressure and cardiovascular disease, the leading cause of death worldwide. Reducing sodium intake at the... (Meta-Analysis)
Meta-Analysis Review
PURPOSE OF REVIEW
High-sodium intake is a main risk factor for increased blood pressure and cardiovascular disease, the leading cause of death worldwide. Reducing sodium intake at the population level is one of the most cost-effective strategies to address this. The aim of the present systematic review and meta-analysis are to examine data from recent studies that measure the effectiveness and scalability of interventions aimed at reducing sodium intake at both the population and individual level.
RECENT FINDINGS
Worldwide, sodium intake is higher than the World Health Organization recommendations. Structural interventions such as mandatory reformulation of foods, food labeling, taxes or subsidies, and communication campaigns have shown to be the most effective in reducing the population's sodium consumption. Interventions in education, particularly those that use a social marketing framework with short duration, food reformulation, and combined strategies, have the potential to decrease sodium intake.
Topics: Sodium; Risk Factors; Nutritional Status; Humans
PubMed: 37226030
DOI: 10.1007/s13668-023-00477-w -
Sleep Medicine Sep 2023Previous research has identified a relationship between sleep problems and multimorbidity, defined as the co-occurrence of two or more chronic health conditions in the... (Review)
Review
Previous research has identified a relationship between sleep problems and multimorbidity, defined as the co-occurrence of two or more chronic health conditions in the same individual. This systematic review sought to summarize the literature on the association between sleep duration and quality and multimorbidity in adult community-dwelling populations. A comprehensive search of the PubMed, Embase and CINAHL databases identified studies published between January 1990 and January 2023. Studies were included if they focused on community-dwelling populations, used an observational design, measured sleep quality or duration, used multimorbidity as the main study outcome, and explored the relationship between sleep and multimorbidity. Two reviewers independently conducted study screening, data extraction, and bias assessments. Twenty-four cross-sectional and five prospective cohort studies met the inclusion criteria, with studies from 16 countries and two with cross-country comparisons, and a total participant number of 481,862. Overall, poorer sleep quality and sleep duration outside current recommendations were consistently associated with multimorbidity, though with varying strength. This association was present regardless of specific multimorbidity definitions from different studies. Definitions of sleep duration and quality were inconsistent across studies, possibly contributing to mixed evidence on the observed association. Most studies were cross-sectional, limiting the assessment of the temporal direction of association. Our results corroborate relationships between poor sleep and risk of multimorbidity in adult community-dwelling populations around the world. Examining this relationship may help increase public health awareness of sleep as a modifiable risk factor for the prevention of chronic disease and healthy aging.
Topics: Adult; Humans; Multimorbidity; Independent Living; Prospective Studies; Sleep; Risk Factors; Sleep Initiation and Maintenance Disorders
PubMed: 37490803
DOI: 10.1016/j.sleep.2023.07.002 -
Trauma, Violence & Abuse Dec 2023Attacks perpetrated using acid are a particular form of interpersonal violence, possibly one of the most heinous manifestations of Intimate Partner Violence (IPV). Acid... (Review)
Review
Attacks perpetrated using acid are a particular form of interpersonal violence, possibly one of the most heinous manifestations of Intimate Partner Violence (IPV). Acid attacks are mainly motivated by extramarital cheating, marital conflicts, women's rejection of marriage proposals, and sexual advances. As these attacks are not well understood from a psychological perspective, we conducted a systematic review, following Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines, of 284 articles identified, 13 were eligible for inclusion. Three main focuses were identified: "Risk and vulnerability factors," "Consequences and implications," and "Interventions and treatments." Acid attacks seem to be more frequent in countries where social and economic development leads to greater tensions over traditional gender roles like Bangladesh, Pakistan, and India. Identified risk factors were young age, low socioeconomic status, low educational attainment, ethnicity, unemployment status of the victim, alcohol, and drug use of the perpetrator. Among the main psychosocial consequences of acid attacks, isolation and social exclusion emerged. Additionally, the paper will discuss the role of mental health consequences and specific treatments from psychological, clinical, and medical-legal points of view.
Topics: Female; Humans; Family Conflict; Gender-Based Violence; Intimate Partner Violence; Risk Factors; Sexual Behavior
PubMed: 36062902
DOI: 10.1177/15248380221121288 -
Environmental Science and Pollution... Aug 2023Cancer is a chronic disease that seriously endangers human health, and studies on its association with greenspace have been published. We aimed to systematically review... (Meta-Analysis)
Meta-Analysis
Cancer is a chronic disease that seriously endangers human health, and studies on its association with greenspace have been published. We aimed to systematically review the epidemiological evidence and obtain the best available evidence. PubMed, Web of Science, Embase, and Cochrane Library were used as search databases, the time limit was September 12, 2022, and the cited articles were manually supplemented. Two researchers independently performed literature screening and data extraction. We performed a meta-analysis of data using a normalized difference vegetation index (NDVI) as the greenspace measure, providing hazard ratio (HR) and corresponding 95% CI. After standardization of the data, we used a random effects model for pooling. We also assessed the risk of bias for each study and the quality of each evidence body. We identified 10,108 items and included 14 studies from 11 institutions in eight countries. All studies had a low risk of bias. Quantitative analysis of 13 studies found a beneficial association of greenspace with the mortality of lung cancer (pooled HR [95% CI]=0.965 [0.947, 0.983]) and prostate cancer (HR [95% CI]=0.939 [0.898, 0.980]) based on 0.1-unit NDVI increment and a potential beneficial association with the incidence of prostate, lung, and breast cancer. Greenspace had opposite associations with cancer mortality for urban and rural populations. Indirect comparisons did not find statistically significant differences in the effects of greenspace on different cancer outcomes. The evidence body assessment was considered to be "very low." This review indicated potential beneficial associations between greenspace for lung, prostate, and breast cancer outcomes. However, there was a lack of mediation analysis to explore the underlying mechanism of a causal association. Meanwhile, the interstudy heterogeneity was large. Therefore, future studies should consider more accurate exposure assessment and more comprehensive covariate coverage, while focusing on mediating analysis. PROSPERO: CRD42022361068.
Topics: Male; Humans; Parks, Recreational; Cohort Studies; Causality; Proportional Hazards Models; Breast Neoplasms
PubMed: 37474858
DOI: 10.1007/s11356-023-28461-5 -
Cancer Sep 2023The World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations are lifestyle-based guidelines that aim to reduce cancer risk. A... (Meta-Analysis)
Meta-Analysis
Adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations and cancer risk: A systematic review and meta-analysis.
BACKGROUND
The World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations are lifestyle-based guidelines that aim to reduce cancer risk. A systematic review and meta-analysis of studies investigating associations between a score for adherence to the 2018 Cancer Prevention Recommendations and cancer risk was conducted.
METHODS
MEDLINE, Embase, Web of Science, and Scopus were searched for studies published to November 28, 2022. In meta-analysis, the estimated risk ratios and 95% CIs for adherence score as a continuous (per 1-point increment) and categorical (highest vs. lowest score category) variable using random-effects models were estimated.
RESULTS
Eighteen studies (11 cohort; seven case-control) were included investigating incidence of breast (n = 7), colorectal (n = 5), prostate (n = 2), lung (n = 2), pancreatic (n = 1), endometrial (n = 1), unknown primary cancer (n = 1), chronic lymphocytic leukemia (n = 1), and overall (any) cancer (n = 1). The summary risk ratio per 1-point increment in adherence score was 0.89 (95% CI, 0.85-0.93; I = 76.5%; n = 7) for breast cancer, 0.88 (95% CI, 0.84-0.91; I = 26.2%; n = 4) for colorectal cancer, and 0.92 (95% CI, 0.86-0.98, I = 66.0%; n = 2) for lung cancer. There were no significant associations with prostate or other cancers. Meta-analysis results using categorical adherence score variables were consistent with these findings.
CONCLUSIONS
Greater adherence to the 2018 World Cancer Research Fund/American Institute for Cancer Research Cancer Prevention Recommendations was associated with lower risk of breast, colorectal, and lung cancers. Future studies investigating associations with risk of other forms of cancer are warranted.
PROSPERO REGISTRATION NUMBER
CRD42022313327.
Topics: Male; Humans; United States; Risk; Life Style; Breast Neoplasms; Incidence; Colorectal Neoplasms; Risk Factors; Diet
PubMed: 37309215
DOI: 10.1002/cncr.34842 -
PloS One 2023Prehabilitation interventions are being delivered across surgical specialities to improve health risk behaviours leading to better surgical outcomes and potentially... (Meta-Analysis)
Meta-Analysis
The effect of preoperative behaviour change interventions on pre- and post-surgery health behaviours, health outcomes, and health inequalities in adults: A systematic review and meta-analyses.
BACKGROUND
Prehabilitation interventions are being delivered across surgical specialities to improve health risk behaviours leading to better surgical outcomes and potentially reduce length of hospital stay. Most previous research has focused on specific surgery specialities and has not considered the impact of interventions on health inequalities, nor whether prehabilitation improves health behaviour risk profiles beyond surgery. The aim of this review was to examine behavioural Prehabilitation interventions across surgeries to inform policy makers and commissioners of the best available evidence.
METHODS AND FINDINGS
A systematic review and meta-analysis of randomised controlled trials (RCTs) was conducted to determine the effect of behavioural prehabilitation interventions targeting at least one of: smoking behaviour, alcohol use, physical activity, dietary intake (including weight loss interventions) on pre- and post-surgery health behaviours, health outcomes, and health inequalities. The comparator was usual care or no treatment. MEDLINE, PubMed, PsychINFO, CINAHL, Web of Science, Google Scholar, Clinical trials and Embase databases were searched from inception to May 2021, and the MEDLINE search was updated twice, most recently in March 2023. Two reviewers independently identified eligible studies, extracted data, and assessed risk of bias using the Cochrane risk of bias tool. Outcomes were length of stay, six-minute walk test, behaviours (smoking, diet, physical activity, weight change, and alcohol), and quality of life. Sixty-seven trials were included; 49 interventions targeted a single behaviour and 18 targeted multiple behaviours. No trials examined effects by equality measures. Length of stay in the intervention group was 1.5 days shorter than the comparator (n = 9 trials, 95% CI -2.6 to -0.4, p = 0.01, I2 83%), although in sensitivity analysis prehabilitation had the most impact in lung cancer patients (-3.5 days). Pre-surgery, there was a mean difference of 31.8 m in the six-minute walk test favouring the prehabilitation group (n = 19 trials, 95% CI 21.2 to 42.4m, I2 55%, P <0.001) and this was sustained to 4-weeks post-surgery (n = 9 trials, mean difference = 34.4m (95%CI 12.8 to 56.0, I2 72%, P = 0.002)). Smoking cessation was greater in the prehabilitation group before surgery (RR 2.9, 95% CI 1.7 to 4.8, I2 84%), and this was sustained at 12 months post-surgery (RR 1.74 (95% CI 1.20 to 2.55, I2 43%, Tau2 0.09, p = 0.004)There was no difference in pre-surgery quality of life (n = 12 trials) or BMI (n = 4 trials).
CONCLUSIONS
Behavioural prehabilitation interventions reduced length of stay by 1.5 days, although in sensitivity analysis the difference was only found for Prehabilitation interventions for lung cancer. Prehabilitation can improve functional capacity and smoking outcomes just before surgery. That improvements in smoking outcomes were sustained at 12-months post-surgery suggests that the surgical encounter holds promise as a teachable moment for longer-term behavioural change. Given the paucity of data on the effects on other behavioural risk factors, more research grounded in behavioural science and with longer-term follow-up is needed to further investigate this potential.
Topics: Adult; Humans; Exercise; Diet; Risk Factors; Smoking Cessation; Lung Neoplasms
PubMed: 37406002
DOI: 10.1371/journal.pone.0286757