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BMC Oral Health Jul 2022Several studies have demonstrated association between coffee consumption and periodontal diseases. However, no systematic review and meta-analysis was performed.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Several studies have demonstrated association between coffee consumption and periodontal diseases. However, no systematic review and meta-analysis was performed. Therefore, we performed a systematic review and meta-analysis to evaluate the association between coffee intake and periodontitis.
METHODS
We defined PICO statement as "Do coffee drinkers have a higher association of periodontitis or tooth loss than non-coffee drinkers?". We searched for articles using the Embase and Medline databases. The odds ratio was used as an effect measure to evaluate the association between coffee and periodontitis We divided coffee intake doses into three groups: no intake (≤ 0.03 cups/day), low intake (0.03 < x < 1 cups/day), and high intake (≥ 1 cup/day). Cohort and cross-sectional studies were eligible for inclusion in this study. The Newcastle-Ottawa scale was used to qualitatively assess the risk of bias. The degree of heterogeneity between studies was quantified using I statistics.
RESULTS
Six articles were analysed, including two cohort studies and four cross-sectional studies. The pooled unadjusted odds ratios of periodontitis were 1.14 (0.93-1.39), 1.05 (0.73-1.52), 1.03 (0.91-1.16) and 1.10 (0.84-1.45) in the 4 meta-analyses (coffee drinker vs. non-coffee drinker, high intake vs. low intake, low intake vs. no intake, high intake vs. no intake), respectively.
CONCLUSION
This is the first meta-analysis to investigate the relationship between coffee consumption and periodontitis. There was no relationship between coffee consumption and periodontitis. Further studies are required to assess whether a relationship between coffee consumption and periodontitis exists or not. PROSPERO registration number: CRD42022301341.
Topics: Cohort Studies; Cross-Sectional Studies; Humans; Odds Ratio; Periodontitis; Risk Factors
PubMed: 35790921
DOI: 10.1186/s12903-022-02310-2 -
Clinical Microbiology and Infection :... Nov 2023The clinical features and predictors of Clostridioides difficile infection overlap with many conditions. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The clinical features and predictors of Clostridioides difficile infection overlap with many conditions.
OBJECTIVES
We performed a systematic review to evaluate the diagnostic utility of clinical features (clinical examination, risk factors, laboratory tests, and radiographic findings) associated with C. difficile.
METHODS
Systematic review and meta-analysis of diagnostic features for C. difficile.
DATA SOURCES
MEDLINE, EMBASE, CINAHL, and Cochrane databases were searched up to September 2021.
STUDY ELIGIBILITY CRITERIA
Studies that reported clinical features of C. difficile, a valid reference standard test for confirming diagnosis of C. difficile, and a comparison among patients with a positive and negative test result.
PARTICIPANTS
Adult and paediatric patients across diverse clinical settings.
OUTCOMES
Sensitivity, specificity, likelihood ratios.
REFERENCE STANDARD
Stool nucleic acid amplification tests, enzyme immunoassays, cell cytotoxicity assay, and stool toxigenic culture.
ASSESSMENT OF RISK OF BIAS
Rational Clinical Examination Series and Quality Assessment of Diagnostic Accuracy Studies-2.
METHODS OF DATA SYNTHESIS
Univariate and bivariate analyses.
RESULTS
We screened 11 231 articles of which 40 were included, enabling the evaluation of 66 features for their diagnostic utility for C. difficile (10 clinical examination findings, 4 laboratory tests, 10 radiographic findings, prior exposure to 13 antibiotic types, and 29 clinical risk factors). Of the ten features identified on clinical examination, none were significantly clinically associated with increased likelihood of C. difficile infection. Some features that increased likelihood of C. difficile infection were stool leukocytes (LR+ 5.31, 95% CI 3.29-8.56) and hospital admission in the prior 3 months (LR+ 2.14, 95% CI 1.48-3.11). Several radiographic findings also strongly increased the likelihood of C. difficile infection like ascites (LR+ 2.91, 95% CI 1.89-4.49).
DISCUSSION
There is limited utility of bedside clinical examination alone in detecting C. difficile infection. Accurate diagnosis of C. difficile infection requires thoughtful clinical assessment for interpretation of microbiologic testing in all suspected cases.
Topics: Humans; Clostridium Infections; Clostridioides difficile; Risk Factors; Sensitivity and Specificity; Feces; Adult; Child
PubMed: 37327874
DOI: 10.1016/j.cmi.2023.06.010 -
Sleep Medicine Reviews Oct 2021We examined the association between self-reported sleep duration and metabolic syndrome (MetS). Data were collected from 36 cross-sectional and 9 longitudinal studies... (Meta-Analysis)
Meta-Analysis Review
We examined the association between self-reported sleep duration and metabolic syndrome (MetS). Data were collected from 36 cross-sectional and 9 longitudinal studies with a total of 164,799 MetS subjects and 430,895 controls. Odds ratios (ORs) for prevalent MetS and risk ratios (RRs) for incident MetS were calculated through meta-analyses of adjusted data from individual studies. Short sleep duration was significantly associated with increased prevalent MetS (OR = 1.11, 95% CI = 1.05-1.18) and incident MetS (RR = 1.28, 95% CI = 1.07-1.53) in cross-sectional and longitudinal studies, respectively. Furthermore, long sleep duration was significantly associated with increased prevalent MetS in cross-sectional studies (OR = 1.14, 95% CI = 1.05-1.23), but not incident MetS (RR = 1.16, 95% CI = 0.95-1.41) in longitudinal studies. Interestingly, the association between long sleep and prevalent MetS was found in sleep duration defined by 24-h sleep (including naps) rather than nighttime sleep. Our findings suggest 1) a "U-shape" relationship between sleep duration and MetS in cross-sectional studies and 2) association between short sleep duration, but not long sleep duration with incident MetS. Future studies should shed light on the underlying mechanisms related to the association between sleep duration and MetS and examine if normalizing sleep duration reduces MetS risk in the general population.
Topics: Cross-Sectional Studies; Humans; Metabolic Syndrome; Odds Ratio; Risk Factors; Sleep; Time Factors
PubMed: 33618187
DOI: 10.1016/j.smrv.2021.101451 -
Asian Journal of Psychiatry Jul 2022Since the 1950 s, several studies have reported that patients using first generation and/or second-generation antipsychotics had increased risk of venous... (Meta-Analysis)
Meta-Analysis Review
Since the 1950 s, several studies have reported that patients using first generation and/or second-generation antipsychotics had increased risk of venous thromboembolism events. These events include deep vein thrombosis and/or pulmonary embolism (PE). However, data about fatal PE in patients on antipsychotics (APs) remain scarce. Thus, the current study aimed to investigate sociodemographic, clinical and pharmacological characteristics related to psychiatric patients on APs and who died from a fatal PE. We reported a case-series, then conducted a literature review of relevant studies and performed a meta-analysis of studies with usable data. The main outcome of the study suggested a significantly high risk of fatal PE in patients using APs compared to nonusers (Odds Ratio=6.68, with 95% confidence interval 1.43-31.11). Clozapine was the most incriminated drug. Low potency first generation APs were the second most exhibited medication. Studies about the topic remain scarce with a high heterogeneity and a high probability of bias. Further studies are needed to ascertain this risk and to establish target preventive measures in this particularly vulnerable population.
Topics: Antipsychotic Agents; Clozapine; Humans; Odds Ratio; Pulmonary Embolism; Risk Factors; Venous Thromboembolism
PubMed: 35452966
DOI: 10.1016/j.ajp.2022.103105 -
European Journal of Preventive... Jun 2024The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular... (Meta-Analysis)
Meta-Analysis
AIMS
The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs).
METHODS AND RESULTS
EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias. Data were analysed with a random-effects meta-analysis. This meta-analysis included 59 studies (1 881 382 participants). Participants with ideal CVH had a considerably lower risk of a variety of CVDs and CMDs as compared with those with poor CVH, varying from 40% lower risk for atrial fibrillation (AF) {hazard ratio [HR] = 0.60 [95% confidence interval (CI) 0.44-0.83]} to 82% lower risk for myocardial infarction [HR = 0.18 (95% CI 0.12-0.28)]. Intermediate CVH was associated with 27-57% lower risk in CVDs and CMDs compared with poor CVH, with the highest hazard for AF [HR = 0.73 (95% CI 0.59-0.91)] and the lowest hazard for peripheral arterial disease [HR = 0.43 (95% CI 0.30-0.60)].
CONCLUSION
Ideal and moderate CVH were associated with a lower incidence of CVDs and CMDs than poor CVH. Life Simple's 7 holds significant potential for promoting overall CVH and thereby contributing to the prevention of CVDs.
Topics: Humans; Cardiovascular Diseases; Risk Assessment; Health Status; Risk Reduction Behavior; Protective Factors; Risk Factors; Healthy Lifestyle; Female; Male; Middle Aged; Prognosis; Aged; Cardiometabolic Risk Factors
PubMed: 38149986
DOI: 10.1093/eurjpc/zwad405 -
Journal of Cardiothoracic Surgery Jun 2021The burden of frailty on cardiac surgical outcomes is incompletely understood. Here we perform a systematic review and meta-analysis of studies comparing frail versus... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The burden of frailty on cardiac surgical outcomes is incompletely understood. Here we perform a systematic review and meta-analysis of studies comparing frail versus pre-frail versus non-frail patients following cardiac surgery.
METHODS
We searched MEDLINE and EMBASE databases until July 2018 for studies comparing cardiac surgery outcomes in "frail", "pre-frail" and "non-frail" patients. Data was extracted in duplicate. Primary outcome was operative mortality.
RESULTS
There were 19 observational studies with 66,448 patients. Frail patients were more likely female (risk ratio [RR]1.7; 95%CI:1.5-1.9), older (mean difference: 2.4; 95%CI:1.3-3.5 years older) with greater comorbidities and higher STS-PROM. Frailty (RR2.35; 95%CI:1.57-3.51; p < 0.0001) and pre-frailty (RR2.03; 95%CI:1.52-2.70; p < 0.00001) were associated with increased operative mortality compared with non-frail patients. Frailty was also associated with greater risk of prolonged hospital stay (RR1.83; 95%CI:1.61-2.08; p < 0.0001) and intermediate care facility discharge (RR2.71; 95%CI:1.45-5.05; p = 0.002). Frail (Hazard Ratio [HR]3.27; 95%CI:1.93-5.55; p < 0.0001) and pre-frail patients (HR2.30; 95%CI:1.29-4.09; p = 0.005) had worse mid-term mortality (median follow-up 1 years [range 0.5-4 years]). After adjustment for baseline imbalances, frailty was still associated with greater operative mortality (odds ratio [OR]1.97; 95%CI:1.51-2.57; p < 0.00001), intermediate care facility discharge (OR4.61; 95%CI:2.78-7.66; p < 0.00001) and midterm mortality (HR1.37; 95%CI:1.03-1.83; p = 0.03).
CONCLUSION
In patients undergoing cardiac surgery, frailty and pre-frailty were associated with 2-fold and 1.5-fold greater adjusted operative mortality, respectively, greater adjusted perioperative complications and frailty was associated with almost 5-fold risk of non-home discharge. Burden of frailty and pre-frailty on cardiac surgical outcomes.
Topics: Age Factors; Cardiac Surgical Procedures; Comorbidity; Female; Frailty; Humans; Intraoperative Complications; Length of Stay; Male; Odds Ratio; Postoperative Complications; Proportional Hazards Models; Risk Factors; Sex Factors
PubMed: 34172059
DOI: 10.1186/s13019-021-01541-8 -
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 -
Nutrition Reviews Aug 2021Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However,... (Meta-Analysis)
Meta-Analysis
CONTEXT
Diet may be one of the modifiable environmental factors that could reduce depressive symptoms or abate the development of depression without side effects. However, previous reviews mainly focused on general adult populations.
OBJECTIVE
The aim of this systematic review and meta-analysis was to explore the association between healthy dietary patterns and depression risk in older adults.
DATA SOURCES
Eight databases were searched up to September 2019. The inclusion criteria were older adults aged ≥ 65 years, healthy dietary patterns, depression assessed by a physician or by validated screening tools, and quantitative study design.
DATA EXTRACTION
Data were extracted independently by 2 researchers, and the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline was followed.
DATA ANALYSIS
Meta-analysis was conducted by calculating the pooled odds ratio (OR) and 95% CIs. A total of 18 eligible studies were meta-analyzed. Results showed that a healthy dietary pattern is associated with a reduced risk of depression in older adults (OR, 0.85; 95%CI, 0.78-0.92; P < 0.001). There was high heterogeneity (I2 = 64.9%; P < 0.001) among the studies. Subgroup analyses indicated that sample size and depression screening tools were the main sources of study heterogeneity.
CONCLUSIONS
An inverse association between healthy dietary patterns and depression risk in older adults was found. However, the high heterogeneity among the studies should be considered.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO registration no. CRD 42020169195.
Topics: Aged; Depression; Diet; Humans; Odds Ratio; Risk Factors
PubMed: 33236111
DOI: 10.1093/nutrit/nuaa118 -
Journal of Obstetrics and Gynaecology :... Dec 2023Previous studies evaluating the relationship between blood manganese (Mn) level and gestational diabetes mellitus (GDM) in pregnant women showed inconsistent results. A... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Previous studies evaluating the relationship between blood manganese (Mn) level and gestational diabetes mellitus (GDM) in pregnant women showed inconsistent results. A systematic review and meta-analysis was therefore performed to investigate the above association.
METHODS
Relevant observational studies were obtained by search of electronic databases including Medline, Embase, Cochrane Library and Web of Science from database inception to 10 March 2023. Two authors independently performed database search, literature identification and data extraction. A randomised-effects model was selected to pool the data by incorporating the influence of potential heterogeneity. Subgroup analysis was performed to evaluate the influence of study characteristics on the results of the meta-analysis.
RESULTS
Six datasets from five observational studies, involving 91,249 pregnant women were included in the meta-analysis. Among the participants, 3597 (3.9%) were diagnosed as GDM. Overall, pooled results showed that a high blood level of Mn was associated with a higher risk of GDM (compared between women with highest versus lowest category blood Mn, odds ratio: 1.31, 95% confidence interval: 1.19-1.44, < .001) with no significant heterogeneity ( for Cochrane -test = 0.93, = 0%). Subgroup analyses according to study design, mean maternal age, matrix or methods for measuring blood Mn, and the incidence of GDM also showed consistent results ( for subgroup difference all >.05).
CONCLUSIONS
Results of the meta-analysis suggest that a high blood Mn level may be a risk factor of GDM in pregnant women. Studies are needed to determine the underlying mechanisms, and to investigate if the relationship between blood Mn level and GDM is dose-dependent.
Topics: Pregnancy; Female; Humans; Diabetes, Gestational; Manganese; Risk Factors; Maternal Age; Odds Ratio
PubMed: 37921106
DOI: 10.1080/01443615.2023.2266646 -
Clinical Journal of the American... Oct 2021AKI is a common complication after pediatric cardiac surgery and has been associated with higher morbidity and mortality. We aimed to compare the efficacy of available... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVES
AKI is a common complication after pediatric cardiac surgery and has been associated with higher morbidity and mortality. We aimed to compare the efficacy of available pharmacologic and nonpharmacologic strategies to prevent AKI after pediatric cardiac surgery.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
PubMed/MEDLINE, Embase, Cochrane Controlled Trials Register, and reference lists of relevant articles were searched for randomized controlled trials from inception until August 2020. Random effects traditional pairwise, Bayesian network meta-analyses, and trial sequential analyses were performed.
RESULTS
Twenty randomized controlled trials including 2339 patients and 11 preventive strategies met the eligibility criteria. No overall significant differences were observed compared with control for corticosteroids, fenoldopam, hydroxyethyl starch, or remote ischemic preconditioning in traditional pairwise meta-analysis. In contrast, trial sequential analysis suggested a 80% relative risk reduction with dexmedetomidine and evidence of <57% relative risk reduction with remote ischemic preconditioning. Nonetheless, the network meta-analysis was unable to demonstrate any significant differences among the examined treatments, including also acetaminophen, aminophylline, levosimendan, milrinone, and normothermic cardiopulmonary bypass. Surface under the cumulative ranking curve probabilities showed that milrinone (76%) was most likely to result in the lowest risk of AKI, followed by dexmedetomidine (70%), levosimendan (70%), aminophylline (59%), normothermic cardiopulmonary bypass (57%), and remote ischemic preconditioning (55%), although all showing important overlap.
CONCLUSIONS
Current evidence from randomized controlled trials does not support the efficacy of most strategies to prevent AKI in the pediatric population, apart from limited evidence for dexmedetomidine and remote ischemic preconditioning.
Topics: Acute Kidney Injury; Adrenergic alpha-2 Receptor Agonists; Age Factors; Bayes Theorem; Cardiac Surgical Procedures; Cardiopulmonary Bypass; Child, Preschool; Dexmedetomidine; Female; Humans; Infant; Infant, Newborn; Ischemic Preconditioning; Male; Network Meta-Analysis; Randomized Controlled Trials as Topic; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
PubMed: 34620647
DOI: 10.2215/CJN.05800421