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Scientific Reports Jan 2024The premise for effective prevention and treatment of obesity is the availability of accurate prevalence figures. However, the prevalence of pediatric obesity and... (Meta-Analysis)
Meta-Analysis
The premise for effective prevention and treatment of obesity is the availability of accurate prevalence figures. However, the prevalence of pediatric obesity and overweight in South Asian countries has seldom been analyzed. This article provides a comprehensive review and meta-analysis of studies on overweight and obesity to provide a more precise prevalence estimate. The study protocol was registered on PROSPERO (CRD42022320625). PubMed and Embase databases were comprehensively searched from inception till September 2023. The random-effects model was utilized to derive the pooled prevalence of obesity and overweight. Subgroup meta-analysis was used to assess variations in prevalence estimates across subgroups. A meta-regression analysis was also performed to assess the trend of overweight and obesity over the years. 152 studies were included with 489,525 participants. The pooled prevalence was 12.4 (95% CI 11.1-13.6) for overweight, 6.6% (95% CI 5.6-7.8) for obesity, and 19.3% (95% CI 17.1-21.7) for obesity and overweight. In subgroup analysis, Bangladesh reported a higher prevalence for both obesity (8.9%; 95% CI 4.9-13.9) and overweight (13.6%; 95% CI 9.2-18.8). Meta-regression analysis found a significant association between obesity prevalence and the publication year (β = 0.004; p = 0.03; R = 2.74%). The results of this study indicate a relatively higher prevalence of childhood obesity in South Asia, emphasizing the necessity for large-scale awareness efforts and context-specific preventative methods.
Topics: Child; Humans; Overweight; Pediatric Obesity; Prevalence; South Asian People
PubMed: 38182700
DOI: 10.1038/s41598-023-50973-w -
Immunity, Inflammation and Disease Mar 2024Down syndrome (DS) is associated with multiple comorbid conditions and chronic immune dysfunction. Persons with DS who contract COVID-19 are at high risk for... (Review)
Review
INTRODUCTION
Down syndrome (DS) is associated with multiple comorbid conditions and chronic immune dysfunction. Persons with DS who contract COVID-19 are at high risk for complications and have a poor prognosis. We aimed to study the clinical symptoms, laboratory and biochemical profiles, radiologic findings, treatment, and outcomes of patients with DS and COVID-19.
METHOD
We systematically searched PubMed, MEDLINE, Web of Science, Scopus, and the Cochrane Library using the keywords COVID-19 or coronavirus or SARS-CoV-2 and DS or trisomy 21. Seventeen articles were identified: eight case reports and nine case series published from December 2019 through March 2022, with a total of 55 cases.
RESULTS
Patients averaged 24.8 years (26 days to 60 years); 29 of the patients were male. The most common symptoms were fever, dyspnea, and cough. Gastrointestinal and upper respiratory tract symptoms were commonly reported for pediatric patients. The most common comorbidities present in patients with DS were obesity (49.0%), hypothyroidism (21.6%) and obstructive sleep apnea (15.6%). The patients were hospitalized for a mean of 14.8 days. When the patients were compared with the general COVID-19 population, the mean number of hospitalized days was higher. Most patients had leukopenia, lymphopenia, and elevated inflammatory markers (d-dimer and C-reactive protein). Bilateral infiltrations and bilateral ground-glass opacifications were frequently seen in chest radiographs and chest computed tomographic imaging. Most of the patients were treated with methylprednisolone, macrolides, and hydroxychloroquine. Of the 55 patients, 22 died. The mean age of the patients who died was 42.8 years. Mortality rate was higher in individuals with DS over 40 years of age.
CONCLUSION
More studies are needed to better understand COVID-19 infections among persons with DS. In addition, the study was limited by a lack of statistical analyses and a specific comparison group.
Topics: Adult; Child; Female; Humans; Male; Middle Aged; Cough; COVID-19; Down Syndrome; Lymphopenia; SARS-CoV-2; Infant, Newborn; Infant; Child, Preschool; Adolescent; Young Adult
PubMed: 38501534
DOI: 10.1002/iid3.1219 -
Frontiers in Nutrition 2023The prevalence of metabolic syndrome (MetS) and its components have markedly increased worldwide. Among lifestyle factors introduced to lower the risk of MetS, healthy...
AIM/INTRODUCTION
The prevalence of metabolic syndrome (MetS) and its components have markedly increased worldwide. Among lifestyle factors introduced to lower the risk of MetS, healthy dietary patterns have gained considerable attention. This study aimed to assess the association between adherence to plant-based diet indices including O-PDI (overall plant-based diet index), H-PDI (healthy plant-based diet index), U-PDI (unhealthy plant-based diet index), and risk of MetS development.
METHODS
To find related observational studies which assessed the association between Plant-based Diet indices and risk of MetS development, PubMed/Medline, Scopus, and Web of Science databases were searched from January 2016 to November 2023. A random effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (95% CI). To assess the heterogeneity of included studies, the index was used.
RESULTS
Nine studies including 34,953 participants from the initial 288 studies were recognized to include in this meta-analysis study. According to pooled analysis, there was a significant relationship between the adherence to H-PDI and the lower risk of MetS (ES: 0.81; 95% CI: 0.67, 0.97; = 77.2%, < 0.001), while greater adherence to U-PDI was associated with 27% increases in the risk of MetS (ES: 1.27; 95% CI: 1.05, 1.54; = 76.8%, < 0.001). According to our analysis of the association between adherence to PDIs and the risk of MetS components, greater adherence to O-PDI and H-PDI was significantly associated with a higher risk of elevated FBS and obesity, respectively. As well, greater adherence to U-PDI was significantly associated with a higher risk of obesity, hypertriglyceridemia, low HDL-C, and elevated FBS.
CONCLUSION
Our results highlighted the importance of food choices in the context of a plant-based dietary pattern, indicating that adherence to unhealthy plant-based dietary patterns rich in less healthful carbohydrates may induce the risk of MetS development.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42023428981.
PubMed: 38260063
DOI: 10.3389/fnut.2023.1305755 -
Public Health Nutrition Oct 2023This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes. (Review)
Review
OBJECTIVE
This review aimed to identify and synthesise the enablers and barriers that influence the long-term (≥ 2 years) sustainment of school-based nutrition programmes.
DESIGN
Four databases (PubMed, Cochrane Library, Embase and Scopus) were searched to identify studies reporting on the international literature relating to food and nutrition programmes aimed at school-age (5-14 years) children that had been running for ≥ 2 years (combined intervention and follow-up period). Eligible studies were analysed using the Integrated Sustainability Framework (ISF), which involved deductive coding of programme enablers and barriers. A quality assessment was completed, using the Mixed-Methods Appraisal Tool and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.
SETTING
International school-based nutrition programmes.
SUBJECTS
Individuals involved with the implementation of school-based nutrition programmes.
RESULTS
From the 7366 articles identified, thirteen studies (seven qualitative, five mixed methods and one quantitative descriptive) were included, from which the enablers and barriers of eleven different nutrition-related programmes were analysed. Thirty-four factors across the five domains of the ISF were identified that influenced the sustained implementation of programmes. The most common barrier was a lack of organisational readiness and resources, whereas the most common enabler was having adequate external partnerships and a supportive environment.
CONCLUSIONS
These findings have application during the initiation and implementation phases of school-based nutrition programmes. Paying attention to the 'outer contextual factors' of the ISF including the establishment and maintenance of robust relationships across whole of government systems, local institutions and funding bodies are crucial for programme sustainment.
Topics: Child; Humans; Child, Preschool; Adolescent; Health Education; Schools
PubMed: 37548226
DOI: 10.1017/S1368980023001647 -
Journal of Clinical Medicine Jun 2024: The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical... (Review)
Review
: The number of corneal transplants is rising, with the aim to treat a spectrum of diseases ranging from dystrophies to corneal opacities caused by trauma or chemical burns. Refractive outcomes after this procedure are often impossible to predict and associated with high levels of astigmatism. However, there are many techniques that affect the reduction of astigmatism and improve the quality of life of patients. : The aim was to compare the improvement in postoperative visual acuity (logMAR) and amount of corneal astigmatism (Diopters) after corneal keratoplasty in patients who additionally underwent a surgical procedure, which affects the reduction in postoperative astigmatism, and to determine the most effective method. A thorough search was carried out across online electronic databases including PubMed, Embrase, Ovid MEDLINE, Scopus, and Web of Science, using combinations containing the following phrases: postoperative astigmatism, post-keratoplasty astigmatism, anterior lamellar keratoplasty (ALK), deep anterior lamellar keratoplasty (DALK), posterior lamellar keratoplasty, endothelial keratoplasty (EK), penetrating keratoplasty (PK), corneal transplant, keratoplasty, refractive surgery, kerato-refractive surgery, laser in situ keratomileusis (LASIK), and femtosecond LASIK. This was to determine all English-language publications that discuss refractive operations for postoperative or post-keratoplasty astigmatism. These bibliographies were searched for English-language publications published between 2010 and 2023. We proceeded to review each detected record's reference list. Study characteristics such as study design, sample size, participant information, operations performed, and clinical outcomes were all extracted. The Comprehensive Meta-Analysis software (version 3.3.070, 2014) was used to perform the analysis. The threshold of 0.05 for -values was considered statistically significant. All effect sizes are reported as standardized differences (Std diff) in means with a 95% confidence interval (CI) and visualized graphically as forest plots. Publication bias is presented as a funnel plot of standard error by Std diff in means. Four methods were used to evaluate the heterogeneity among the studies: Q-value, I, chi-square (χ), and tau-squared. We included 21 studies that randomized 1539 eyes that underwent corneal transplantation surgery either by PKP, DALK, or DSEAK techniques. The results showed the most significant improvement in the visual acuity and significant decrease in the corneal astigmatism after laser surgery procedures, like femtosecond-assisted keratotomy after DALK and PKP and LASIK after DSEAK.
PubMed: 38893017
DOI: 10.3390/jcm13113306 -
PloS One 2024The incidence of childhood malnutrition i.e., both obesity and undernutrition, is on a rise. While there is extensive evidence of the influence of body mass index (BMI)... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The incidence of childhood malnutrition i.e., both obesity and undernutrition, is on a rise. While there is extensive evidence of the influence of body mass index (BMI) on the survival and other important outcomes of adult cancers, the impact of childhood BMI on one of the common pediatric cancers i.e., leukemia is not well studied.
METHODS
Systematic search of PubMed, Scopus, and Google Scholar databases was done to identify studies that were conducted among pediatric patients with leukemia and had examined outcomes of interest based on BMI at the time of diagnosis.
RESULTS
Effect sizes were reported as pooled hazards ratio (HR) along with 95% confidence intervals (CI). A total of 17 studies were included. Compared to pediatric leukemia patients with normal BMI, underweight (HR 1.07, 95% CI: 1.04, 1.11) and obese (HR 1.42, 95% CI: 1.18, 1.71) children with leukemia had higher risks of overall mortality. Underweight (HR 1.10, 95% CI: 1.02, 1.19) and obese (HR 1.34, 95% CI: 1.15, 1.55) pediatric leukemia patients had a tendency to lower event-free survival compared to children with normal BMI. The risk of relapse was not significant for underweight, overweight, and obese children.
CONCLUSIONS
Both underweight and obese status at the time of diagnosis were associated with poor survival outcomes in pediatric patients with leukemia.
Topics: Humans; Body Mass Index; Child; Leukemia; Thinness; Obesity; Child, Preschool
PubMed: 38709714
DOI: 10.1371/journal.pone.0302879 -
Nutrients Apr 2024Over the past four decades, obesity in children of all ages has increased worldwide, which has intensified the search for innovative intervention strategies. Serious... (Meta-Analysis)
Meta-Analysis Review
Impact of Serious Games on Body Composition, Physical Activity, and Dietary Change in Children and Adolescents: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Over the past four decades, obesity in children of all ages has increased worldwide, which has intensified the search for innovative intervention strategies. Serious games, a youth-friendly form of intervention designed with educational or behavioral goals, are emerging as a potential solution to this health challenge. To analyze the effectiveness of serious games in improving body composition, physical activity, and dietary change, we performed a systematic review and meta-analysis of randomized controlled trials (RCTs) from PubMed, Web of Science, EMBASE, and Scopus databases. Pooled standardized mean differences (SMD) were calculated for 20 studies ( = 2238 the intervention group; n = 1983 in the control group) using random-effect models. The intervention group demonstrated a slightly better, although non-significant, body composition score, with a pooled SMD of -0.26 (95% CI: -0.61 to 0.09). The pooled effect tends to be stronger with longer duration of intervention (-0.40 [95% CI: -0.96, 0.16] for >3 months vs. -0.02 [95% CI: -0.33, 0.30] for ≤3 months), although the difference was not statistically significant (-difference = 0.24). As for the specific pathways leading to better weight control, improvements in dietary habits due to serious game interventions were not significant, while a direct positive effect of serious games on increasing physical activity was observed (pooled SMD = 0.61 [95% CI: 0.04 to 1.19]). While the impact of serious game interventions on body composition and dietary changes is limited, their effectiveness in increasing physical activity is notable. Serious games show potential as tools for overweight/obesity control among children and adolescents but may require longer intervention to sustain its effect.
Topics: Humans; Child; Adolescent; Body Composition; Randomized Controlled Trials as Topic; Exercise; Video Games; Pediatric Obesity; Female; Male; Diet
PubMed: 38732536
DOI: 10.3390/nu16091290 -
Children (Basel, Switzerland) Jun 2024Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood,...
BACKGROUND
Obesity in children is a critical public health issue in developed countries and developing countries. The establishment of health-related behaviors in childhood, significantly influenced by parental involvement, underscores the need for effective intervention measures.
AIM
This original research is a systematic review and meta-analysis that aimed to investigate the impact of parental involvement on the prevention and management of childhood obesity, focusing on outcomes such as BMI z-score, exercise levels, screen time, dietary self-efficacy, and percentage body fat.
METHODS
Adhering to the PRISMA guidelines, we conducted a systematic review and meta-analysis of 12 randomized controlled trials (RCTs) identified through comprehensive searches of PubMed, Scopus, Web of Science, and the Cochrane Library, including RCTs involving children aged 2-18 years with parental or caregiver participation, reporting on the specified outcomes. Data analysis was performed using RevMan 5.3, employing a random effects model.
RESULTS
A total of 5573 participants were included. The meta-analysis revealed a significant reduction in BMI z-score (MD = -0.06, 95% CI: -0.09 to -0.02, = 0.005, I = 58%), a non-significant increase in exercise levels (SMD = 0.26, 95% CI: -0.01 to 0.52, = 0.05, I = 52%), and a significant reduction in screen time (MD = -0.36 h per day, 95% CI: -0.61 to -0.11, = 0.005, I = 0%). Dietary self-efficacy also improved significantly (MD = 0.59, 95% CI: 0.12 to 1.05, = 0.01, I = 0%). However, changes in percentage body fat did not reach statistical significance (MD = -1.19%, 95% CI: -2.8% to 0.41%, = 0.15, I = 0%).
CONCLUSION
Parental involvement in childhood obesity interventions significantly impacts BMI z-score, exercise levels, screen time, and dietary self-efficacy but not percentage body fat. These findings highlight the importance of engaging parents in obesity prevention and management strategies.
PubMed: 38929318
DOI: 10.3390/children11060739 -
Acta Medica Philippina 2024For several decades now, the use of uncuffed endotracheal tube (ETT) is the gold standard in providing airway and ventilatory support to children under anesthesia....
BACKGROUND
For several decades now, the use of uncuffed endotracheal tube (ETT) is the gold standard in providing airway and ventilatory support to children under anesthesia. However, there has been a change in focus from the application of uncuffed ETT to cuffed ETT among children, and this matter has been debated for years. In fact, several studies have shown that even across and within countries, the attitudes and practices of anesthesiologists on the use of types of endotracheal tubes differed.
OBJECTIVE
To describe the current attitudes and practices of anesthesiologists regarding the use of uncuffed or cuffed ETT for children.
METHODS
A systematic review of observational studies on the current attitudes and practices of pediatric anesthesiologists regarding the use of cuffed and uncuffed ETT was conducted from May to November 2020. Cochrane reviews, Medline, Pubmed, and EMBASE were searched and yielded five relevant studies.
RESULTS
The use of cuffed ETT ranged between 11%-61% in the included studies and all reported that there were no consensus or standard on whether cuffed or uncuffed ETT was better. Reported factors for cuffed ETT use included: 1) Personal choice, 2) Department protocol, 3) Availability of resources, and 4) Specific conditions such as obesity, planned or emergency procedure, and reduced lung compliance. In terms of ETT size, reported criteria were: 1) Use of a formula, 2) Use of abacus/calculator, and 3) In relation to the fifth finger's width.
CONCLUSIONS
The current systematic review demonstrated that there is wide variation in current attitudes and practices of anesthesiologists regarding the use of uncuffed or cuffed endotracheal tubes in children. Likewise, factors affecting choice of ETT and criteria for selection varied in the published literature. The results of this systematic review highlight the need for a standard guideline to help clinicians choose if cuffed or uncuffed ETT is better in certain scenarios and to help them decide in selecting the most appropriate ETT size.
PubMed: 38836076
DOI: 10.47895/amp.v58i9.8743 -
Journal of Public Health (Oxford,... Nov 2023The prevalence of childhood obesity has been increasing for several decades. Active video games (AVG) may be an effective intervention to help manage this rising health... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The prevalence of childhood obesity has been increasing for several decades. Active video games (AVG) may be an effective intervention to help manage this rising health crisis. The aim of this review is to evaluate whether AVG are effective at reducing weight or improving body composition in overweight youths.
METHOD
Medline, Embase, SportDiscus, ASSIA, CINAHL Plus, CENTRAL, CDSR and PsychINFO databases were searched for studies assessing quantitative or qualitative impact of AVG in overweight adolescents published in English. Three authors screened the results using inclusion/exclusion criteria.
RESULTS
A total of 12 studies met the inclusion criteria; 11 reported a significant decrease in at least one weight outcome. Results from seven randomized controlled trials were pooled by meta-analysis, which compared with controls subjects in AVG groups demonstrated greater body mass index (BMI) Z-score reduction (mean difference: -0.09 (-0.12, -0.05) I2 = 34%, P < 0.0001). The mean weight reduction (-2.66 Kg (-5.67, +0.35) I2 = 0%, P = 0.08) and BMI (-2.29 (-4.81, +0.22) I2 = 49%, P = 0.07) were greater in AVG groups but results did not reach statistical significance.
CONCLUSIONS
BMI Z-score was significantly reduced in the AVG group and the majority of included studies reported significant results in at least one weight outcome, suggesting AVG can be used to reduce weight or improve body composition in overweight youths. Further studies investigating the long-term sustainability of this change in body composition are needed.
Topics: Child; Humans; Adolescent; Pediatric Obesity; Overweight; Body Mass Index; Video Games
PubMed: 37496202
DOI: 10.1093/pubmed/fdad115