-
Clinical and Experimental Allergy :... Aug 2023Asthma control is generally monitored by assessing symptoms and lung function. However, optimal treatment is also dependent on the type and extent of airway... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Asthma control is generally monitored by assessing symptoms and lung function. However, optimal treatment is also dependent on the type and extent of airway inflammation. Fraction of exhaled Nitric Oxide (FeNO) is a noninvasive biomarker of type 2 airway inflammation, but its effectiveness in guiding asthma treatment remains disputed. We performed a systematic review and meta-analysis to obtain summary estimates of the effectiveness of FeNO-guided asthma treatment.
DESIGN
We updated a Cochrane systematic review from 2016. Cochrane Risk of Bias tool was used to assess risk of bias. Inverse-variance random-effects meta-analysis was performed. Certainty of evidence was assessed using GRADE. Subgroup analyses were performed based on asthma severity, asthma control, allergy/atopy, pregnancy and obesity.
DATA SOURCES
The Cochrane Airways Group Trials Register was searched on 9 May 2023.
ELIGIBILITY CRITERIA
We included randomized controlled trials (RCTs) comparing the effectiveness of a FeNO-guided treatment versus usual (symptom-guided) treatment in adult asthma patients.
RESULTS
We included 12 RCTs (2,116 patients), all showing high or unclear risk of bias in at least one domain. Five RCTs reported support from a FeNO manufacturer. FeNO-guided treatment probably reduces the number of patients having ≥1 exacerbation (OR = 0.61; 95%CI 0.44 to 0.83; six RCTs; GRADE moderate certainty) and exacerbation rate (RR = 0.67; 95%CI 0.54 to 0.82; six RCTs; moderate certainty), and may slightly improve Asthma Control Questionnaire score (MD = -0.10; 95%CI -0.18 to -0.02, six RCTs; low certainty), however, this change is unlikely to be clinically important. An effect on severe exacerbations, quality of life, FEV1, treatment dosage and FeNO values could not be demonstrated. There were no indications that effectiveness is different in subgroups of patients, although evidence for subgroup analysis was limited.
CONCLUSIONS
FeNO-guided asthma treatment probably results in fewer exacerbations but may not have clinically important effects on other asthma outcomes.
Topics: Female; Pregnancy; Adult; Humans; Asthma; Nitric Oxide; Inflammation
PubMed: 37293870
DOI: 10.1111/cea.14359 -
Cells Aug 2023There is an increasing interest in biomarkers of nitric oxide dysregulation and oxidative stress to guide management and identify new therapeutic targets in patients... (Meta-Analysis)
Meta-Analysis Review
There is an increasing interest in biomarkers of nitric oxide dysregulation and oxidative stress to guide management and identify new therapeutic targets in patients with chronic obstructive pulmonary disease (COPD). We conducted a systematic review and meta-analysis of the association between circulating metabolites within the arginine (arginine, citrulline, ornithine, asymmetric, ADMA, and symmetric, SDMA dimethylarginine), transsulfuration (methionine, homocysteine, and cysteine) and folic acid (folic acid, vitamin B, and vitamin B) metabolic pathways and COPD. We searched electronic databases from inception to 30 June 2023 and assessed the risk of bias and the certainty of evidence. In 21 eligible studies, compared to healthy controls, patients with stable COPD had significantly lower methionine (standardized mean difference, SMD = -0.50, 95% CI -0.95 to -0.05, = 0.029) and folic acid (SMD = -0.37, 95% CI -0.65 to -0.09, = 0.009), and higher homocysteine (SMD = 0.78, 95% CI 0.48 to 1.07, < 0.001) and cysteine concentrations (SMD = 0.34, 95% CI 0.02 to 0.66, = 0.038). Additionally, COPD was associated with significantly higher ADMA (SMD = 1.27, 95% CI 0.08 to 2.46, = 0.037), SDMA (SMD = 3.94, 95% CI 0.79 to 7.08, = 0.014), and ornithine concentrations (SMD = 0.67, 95% CI 0.13 to 1.22, = 0.015). In subgroup analysis, the SMD of homocysteine was significantly associated with the biological matrix assessed and the forced expiratory volume in the first second to forced vital capacity ratio, but not with age, study location, or analytical method used. Our study suggests that the presence of significant alterations in metabolites within the arginine, transsulfuration, and folic acid pathways can be useful for assessing nitric oxide dysregulation and oxidative stress and identifying novel treatment targets in COPD. (PROSPERO registration number: CRD42023448036.).
Topics: Humans; Cysteine; Nitric Oxide; Metabolomics; Arginine; Methionine; Racemethionine; Folic Acid; Homocysteine; Vitamins
PubMed: 37681911
DOI: 10.3390/cells12172180 -
Neurology Nov 2023Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
Approximately 5 million fatalities occur annually due to stroke, along with its substantial effects on patient well-being and functional impairment. Research has established a connection between extended exposure to air pollutants and ischemic stroke. However, the link between short-term exposure to air pollutants and stroke remains less definitive.
METHODS
A comprehensive search was conducted on MEDLINE, Scopus, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Sciences databases up until February 2023, without any language restrictions. The inclusion criteria encompassed observational or interventional studies that examined the correlation between short-term exposure to air pollutants (carbon monoxide [CO], sulfur dioxide [SO], nitrogen dioxide [NO], ozone [O]) and particulate matter with diameters of less than 1 µm, less than 2.5 µm, or less than 10 µm (PM, PM, and PM), with the incidence and mortality of ischemic stroke. Short-term exposure was defined as exposure occurring within 5 days of the onset of stroke.
RESULTS
A total of 18,035,408 cases of ischemic stroke were included in the analysis, derived from 110 observational studies. Asia accounted for most included studies, representing 58.8% of the total. By contrast, Europe and the Americas contributed 24.6% and 16.7% of the studies, respectively. Notably, none of the included studies were conducted in Africa. Stroke incidence was significantly associated with an increase in the concentration of NO (RR = 1.28; 95% CI 1.21-1.36), O (RR = 1.05; 95% CI 1.03-1.07), CO (RR = 1.26; 95% CI 1.21-1.32), SO (RR = 1.15; 95% CI 1.11-1.19), PM (RR = 1.09; 95% CI 1.06-1.12), PM (RR = 1.15; 95% CI 1.13-1.17), and PM (RR = 1.14; 95% CI 1.12-1.16). Moreover, an increase in the concentration of NO (RR = 1.33; 95% CI 1.07-1.65), SO (RR = 1.60; 95% CI 1.05-2.44), PM (RR = 1.09; 95% CI 1.04-1.15), and PM (RR = 1.02; 95% CI 1.00-1.04) was associated with an increase in stroke mortality.
DISCUSSION
There is a strong and significant correlation between gaseous and particulate air pollutants and the occurrence and mortality rates of stroke. This close temporal association underscores the importance of implementing global initiatives to develop policies aimed at reducing air pollution. By doing so, alleviate the burden of ischemic stroke and its consequences.
Topics: Humans; Ischemic Stroke; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Air Pollutants; Particulate Matter; Stroke
PubMed: 37758483
DOI: 10.1212/WNL.0000000000207856 -
The Science of the Total Environment Jan 2024The COVID-19 pandemic presents unprecedented challenge for global public health systems and exacerbates existing health disparities. Epidemiological evidence suggested a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The COVID-19 pandemic presents unprecedented challenge for global public health systems and exacerbates existing health disparities. Epidemiological evidence suggested a potential linkage between particulate and gaseous pollutants and COVID-19 mortality. We aimed to summarize the overall risk of COVID-19 mortality associated with ambient air pollutants over the short- and long-term.
METHODS
For the systematic review and meta-analysis, we searched five databases for studies evaluating the risk of COVID-19 mortality from exposure to air pollution. Inclusion of articles was assessed independently on the basis of research topic and availability of effect estimates. The risk estimates (relative risk) for each pollutant were pooled with a random-effect model. Potential heterogeneity was explored by subgroup analysis. Funnel plots and trim-and-fill methods were employed to assess and adjust for publication bias.
FINDINGS
The systematic review retrieved 2059 records, and finally included 43 original studies. PM (RR: 1.71, 95 % CI: 1.40-2.08, per 10 μg/m increase), NO (RR: 1.33, 1.07-1.65, per 10 ppb increase) and O (RR: 1.61, 1.00-2.57, per 10 ppb increase) were positively associated with COVID-19 mortality for long-term exposures. Accordingly, a higher risk of COVID-19 mortality was associated with PM (1.05, 1.02-1.08), PM (1.05, 1.01-1.08), and NO (1.40, 1.04-1.90) for short-term exposures. There was some heterogeneity across subgroups of income level and geographical areas.
CONCLUSION
Both long-term and short-term exposures to ambient air pollution may increase the risk of COVID-19 mortality. Future studies utilizing individual-level information on demographics, exposures, outcome ascertainment and confounders are warranted to improve the accuracy of estimates.
Topics: Humans; Nitrogen Dioxide; Pandemics; Environmental Exposure; COVID-19; Air Pollution; Air Pollutants; Dust; Particulate Matter
PubMed: 37797765
DOI: 10.1016/j.scitotenv.2023.167542 -
BMC Pregnancy and Childbirth Dec 2023The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The occurrence of orofacial Clefts (OFCs) is a congenital disease caused by many factors. According to recent studies, air pollution has a strong correlation with the occurrence of OFCs. However, there are still some controversies about the current research results, and there is no relevant research to review the latest results in recent years.
OBJECTIVE
In this paper, the authors conducted a systematic review and meta-analysis to explore the correlation between ambient air pollution and the occurrence of neonatal OFCs deformity.
METHODS
We searched Pubmed, Web of science, and Embase databases from the establishment of the database to May 2023. We included observational studies on the relationship between prenatal exposure to fine particulate matter 2.5 (PM2.5), fine particulate matter 10 (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ozone (O3), carbon monoxide (CO) and the risk of cleft lip (CL), cleft palate (CP), cleft lip with or without palate (CL/P). the Newcastle-Ottawa quality assessment scale (NOS) was used to evaluate the quality of the literature. Funnel plot and Egger's regression were used to verify the publication bias. Random effect model or fixed effect model was used to estimate the combined relative risk (RR) and 95% confidence interval (95%CI).
RESULTS
A total of eleven studies were included in this study, including four cohort studies and seven case-control studies, including 22,453 cases of OFCs. Ten studies had low risk of bias and only one study had high risk of bias. Three studies reported that PM was positively correlated with CL and CP, with a combined RR and 95%CI of 1.287(1.174,1.411) and 1.267 (1.105,1.454). Two studies reported a positive correlation between O and CL, with a combined RR and 95%CI of 1.132(1.047,1.225). Two studies reported a positive correlation between PM and CL, with a combined RR and 95%CI of 1.108 (1.017,1.206). No association was found between SO, CO, NO exposure during pregnancy and the risk of OFCs.
CONCLUSION
The results of this study showed that there was a significant statistical correlation between exposure to PM, PM, O and the risk of OFCs in the second month of pregnancy. Exposure assessment, research methods and mechanisms need to be further explored.
Topics: Infant, Newborn; Female; Pregnancy; Humans; Air Pollutants; Cleft Lip; Cleft Palate; Air Pollution; Particulate Matter; Ozone; Sulfur Dioxide; Nitrogen Dioxide; Environmental Exposure
PubMed: 38041018
DOI: 10.1186/s12884-023-06104-4 -
Clinical Oral Investigations Sep 2023The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess the comparative clinical success and survival of intracoronal indirect restorations using gold, lithium disilicate, leucite, and indirect composite materials.
MATERIAL AND METHODS
This systematic review and meta-analysis were conducted following the Cochrane Handbook for Systematic Reviews of Interventions and PRISMA guidelines. The protocol for this study was registered in PROSPERO (registration number: CRD42021233185). A comprehensive literature search was conducted across various databases and sources, including PubMed/Medline, Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, and gray literature. A total of 7826 articles were screened on title and abstract. Articles were not excluded based on the vitality of teeth, the language of the study, or the observation period. The risk difference was utilized for the analyses, and a random-effects model was applied. All analyses were conducted with a 95% confidence interval (95% CI). The calculated risk differences were derived from the combined data on restoration survival and failures obtained from each individual article. The presence of heterogeneity was assessed using the I statistic, and if present, the heterogeneity of the data in the articles was evaluated using the non-parametric chi-squared statistic (p < 0.05).
RESULTS
A total of 12 eligible studies were selected, which included 946 restorations evaluated over a minimum observation period of 1 year and a maximum observation period of 7 years. Results of the meta-analysis indicated that intracoronal indirect resin composite restorations have an 18% higher rate of failure when compared to intracoronal gold restorations over 5-7 years of clinical service (risk difference = - 0.18 [95% CI: - 0.27, - 0.09]; p = .0002; I = 0%). The meta-analysis examining the disparity in survival rates between intracoronal gold and leucite restorations could not be carried out due to methodological differences in the studies.
CONCLUSIONS
According to the currently available evidence, medium-quality data indicates that lithium disilicate and indirect composite materials demonstrate comparable survival rates in short-term follow-up. Furthermore, intracoronal gold restorations showed significantly higher survival rates, making them a preferred option over intracoronal indirect resin-composite restorations. Besides that, the analysis revealed no statistically significant difference in survival rates between leucite and indirect composite restorations. The short observation period, limited number of eligible articles, and low sample size of the included studies were significant limitations.
CLINICAL SIGNIFICANCE
Bearing in mind the limitations of the reviewed literature, this systematic review and meta-analysis help clinicians make evidence-based decisions on how to restore biomechanically compromised posterior teeth.
Topics: Dental Porcelain; Aluminum Silicates; Composite Resins; Gold
PubMed: 37597003
DOI: 10.1007/s00784-023-05050-x -
Environmental Pollution (Barking, Essex... Jun 2021Stillbirth has a great impact on contemporary and future generations. Increasing evidence show that ambient air pollution exposure is associated with stillbirth.... (Meta-Analysis)
Meta-Analysis Review
Stillbirth has a great impact on contemporary and future generations. Increasing evidence show that ambient air pollution exposure is associated with stillbirth. However, previous studies showed inconsistent findings. To clarify the effect of maternal air pollution exposure on stillbirth, we searched for studies examining the associations between air pollutants, including particulate matter (diameter ≤ 2.5 μm [PM] and ≤10 μm [PM]) and gaseous pollutants (sulfur dioxide [SO], nitrogen dioxide [NO], carbon monoxide [CO] and ozone [O]), and stillbirth published in PubMed, Web of Science, Embase and Cochrane Library until December 11, 2020. The pooled effect estimates and 95% confidence intervals (CI) were calculated, and the heterogeneity was evaluated using Cochran's Q test and I statistic. Publication bias was assessed using funnel plots and Egger's tests. Of 7546 records, 15 eligible studies were included in this review. Results of long-term exposure showed that maternal third trimester PM and CO exposure (per 10 μg/m increment) increased the odds of stillbirth, with estimated odds ratios (ORs) of 1.094 (95% CI: 1.008-1.180) and 1.0009 (95% CI: 1.0001-1.0017), respectively. Entire pregnancy exposure to PM was also associated with stillbirth (OR: 1.103, 95% CI: 1.074-1.131). A 10 μg/m increment in O in the first trimester was associated with stillbirth, and the estimated OR was 1.028 (95% CI: 1.001-1.055). Short-term exposure (on lag day 4) to O was also associated with stillbirth (OR: 1.002, 95% CI: 1.001-1.004). PM, SO and NO exposure had no significant effects on the incidence of stillbirth. Additional well-designed cohort studies and investigations regarding potential biological mechanisms are warranted to elaborate the suggestive association that may help improve intergenerational inequality.
Topics: Air Pollutants; Air Pollution; Environmental Exposure; Epidemiologic Studies; Female; Humans; Nitrogen Dioxide; Ozone; Particulate Matter; Pregnancy; Stillbirth; Sulfur Dioxide
PubMed: 33689950
DOI: 10.1016/j.envpol.2021.116752 -
The Science of the Total Environment Apr 2023Accumulating evidence has linked exposure to ambient air pollution to a reduction in semen quality; however, the exposure-response associations are yet to be synthesized. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Accumulating evidence has linked exposure to ambient air pollution to a reduction in semen quality; however, the exposure-response associations are yet to be synthesized.
OBJECTIVE
To summarize the exposure-response associations between air pollution and semen quality.
METHODS
We systematically searched PubMed, Embase, and Web of Science for relevant studies published before April 20, 2022. Studies investigating the exposure-response association of PM, PM, SO, NO, CO, and O with semen quality written in English were included. Semen quality parameters included semen volume, sperm concentration, total sperm number, total motility, progressive motility, and normal forms. Random-effects and fixed-effects models were performed to synthesize associations in the meta-analysis.
RESULTS
The search returned 850 studies, 11 of which were eligible for meta-analysis. Each 10 μg/m increase of exposure to PM and SO was respectively associated with a 2.18 % (95 % confidence interval [CI]: 0.10 %-4.21 %) and 8.61 % (1.00 %-15.63 %) reduction in sperm concentration, and a 2.76 % (0.10 %-5.35 %) and 9.52 % (5.82 %-13.93 %) reduction in total sperm number. Each 10 μg/m increase of exposure to PM and PM was respectively associated with a 1.06 % (95 % CI: 0.31 %-1.82 %) and 0.75 % (0.43 %-1.08 %) reduction in total motility, and a 0.55 % (0.09 %-1.01 %) and 0.31 % (0.06 %-0.56 %) reduction in progressive motility. No association was observed for PM or PM with semen volume; PM, NO, CO, or O with sperm concentration or total sperm number; and gaseous air pollutants with total or progressive motility. The association between air pollution and normal forms was not summarized due to insufficient number of studies. No significant publication bias was detected.
CONCLUSIONS
Exposure to ambient PM, PM, and SO was inversely associated with sperm concentration, total sperm number, total motility, and/or progressive motility. Our findings add to the evidence that air pollution may lead to adverse effects on male reproductive system and suggest that reducing exposure to air pollution may help maintain better semen quality.
Topics: Male; Humans; Semen Analysis; Nitrogen Dioxide; Particulate Matter; Semen; Air Pollution; Air Pollutants; Environmental Exposure
PubMed: 36731563
DOI: 10.1016/j.scitotenv.2023.161892 -
Revista Brasileira de Enfermagem 2022to map the strategies for managing thirst in postoperative adult patients. (Review)
Review
OBJECTIVES
to map the strategies for managing thirst in postoperative adult patients.
METHODS
scoping review was conducted in October 2021 in 19 data sources: 14 databases and 5 platforms to search in the grey literature. It was prepared according to the recommendations of the Joanna Briggs Institute and the checklist of the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Nine selected articles were part of the final sample.
RESULTS
there is evidence of strategies to manage postoperative thirst using interventions such as water, ice, mentholated measures, carbohydrate and protein enriched fluid, oral hydrator, flavored gargling, cold gargling, wet gauze, 0.75% citric acid spray, and cold water.
FINAL CONSIDERATIONS
the strategies observed may be reduced to cold and menthol use, salivary stimulants, and early introduction of fluids. The outcomes were positive in all the studies reviewed.
Topics: Adult; Carbohydrates; Citric Acid; Humans; Ice; Menthol; Research Design; Thirst; Water
PubMed: 36228294
DOI: 10.1590/0034-7167-2022-0154 -
Public Health Feb 2023This study aimed to provide evidence of the associations between pre- and post-birth and adulthood air pollution exposure with telomere length. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This study aimed to provide evidence of the associations between pre- and post-birth and adulthood air pollution exposure with telomere length.
STUDY DESIGN
The databases of PubMed, Embase, and Web of Science were searched up to June 1st, 2022 in order to include relevant observational studies and perform a systematic review and meta-analysis.
METHODS
The random-effects meta-analysis was grouped by air pollutant and exposure window (pre- and post-birth and adulthood) to evaluate the summary effect estimate. Cochran's Q and I statistics were used to evaluate the heterogeneity among the included studies. The quality of individual studies was evaluated using the national toxicology program/office of health assessment and translation risk of bias rating tool.
RESULTS
We identified 18 studies, covering 8506 children and 2263 adults from multiple countries. We found moderate evidence that particulate matter less than 2.5 μm (PM) exposure during the entire pregnancy (-0.043, 95% CI: -0.067, -0.018), nitrogen dioxide (NO) exposure during the first trimester (-0.016, 95% confidence interval [CI]: -0.027, -0.005), long-term adulthood PM exposure were associated with shortening telomere length. Mild to high between-study heterogeneity was observed for the most tested air pollutant-telomere length combinations in different exposure windows.
CONCLUSIONS
This systematic review and meta-analysis provides the evidence which strongly supports that prenatal PM and NO exposures were related to reduced telomere length, while prenatal sulfur dioxide (SO) and carbon monoxide (CO) exposures, childhood PM, particulate matter less than 10 μm (PM), NO exposures and short-term adulthood PM and PM exposures were not associated with telomere length. Further high-quality studies are needed to elaborate our suggestive associations.
Topics: Child; Adult; Female; Pregnancy; Humans; Nitrogen Dioxide; Environmental Exposure; Air Pollution; Air Pollutants; Particulate Matter; Telomere
PubMed: 36642039
DOI: 10.1016/j.puhe.2022.11.022