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Diseases (Basel, Switzerland) Dec 2021Obstructive sleep apnea (OSA) is a serious, potentially life-threatening condition. Epidemiologic studies show that sleep apnea increases cardiovascular diseases risk... (Review)
Review
Obstructive sleep apnea (OSA) is a serious, potentially life-threatening condition. Epidemiologic studies show that sleep apnea increases cardiovascular diseases risk factors including hypertension, obesity, and diabetes mellitus. OSA is also responsible for serious illnesses such as congestive heart failure, stroke, arrhythmias, and bronchial asthma. The aim of this systematic review is to evaluate evidence for the association between OSA and cardiovascular disease morbidities and identify risk factors for the conditions. In a review of 34 studies conducted in 28 countries with a sample of 37,599 people, several comorbidities were identified in patients with severe OSA-these were: heart disease, stroke, kidney disease, asthma, COPD, acute heart failure, chronic heart failure, hyperlipidemia, thyroid disease, cerebral infarct or embolism, myocardial infarction, and psychological comorbidities including stress and depression. Important risk factors contributing to OSA included: age > 35 years; BMI ≥ 25 kg/m; alcoholism; higher Epworth sleepiness scale (ESS); mean apnea duration; oxygen desaturation index (ODI); and nocturnal oxygen desaturation (NOD). Severe OSA (AHI ≥ 30) was significantly associated with excessive daytime sleepiness and oxygen desaturation index. The risk of OSA and associated disease morbidities can be reduced by controlling overweight/obesity, alcoholism, smoking, hypertension, diabetes mellitus, and hyperlipidemia.
PubMed: 34940026
DOI: 10.3390/diseases9040088 -
BMC Infectious Diseases Aug 2021Mortality rates of coronavirus disease-2019 (COVID-19) continue to rise across the world. The impact of several risk factors on coronavirus mortality has been previously... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Mortality rates of coronavirus disease-2019 (COVID-19) continue to rise across the world. The impact of several risk factors on coronavirus mortality has been previously reported in several meta-analyses limited by small sample sizes. In this systematic review, we aimed to summarize available findings on the association between comorbidities, complications, smoking status, obesity, gender, age and D-dimer, and risk of mortality from COVID-19 using a large dataset from a number of studies.
METHOD
Electronic databases including Google Scholar, Cochrane Library, Web of Sciences (WOS), EMBASE, Medline/PubMed, COVID-19 Research Database, and Scopus, were systematically searched till 31 August 2020. We included all human studies regardless of language, publication date or region. Forty-two studies with a total of 423,117 patients met the inclusion criteria. To pool the estimate, a mixed-effect model was used. Moreover, publication bias and sensitivity analysis were evaluated.
RESULTS
The findings of the included studies were consistent in stating the contribution of comorbidities, gender, age, smoking status, obesity, acute kidney injury, and D-dimer as a risk factor to increase the requirement for advanced medical care. The analysis results showed that the pooled prevalence of mortality among hospitalized patients with COVID-19 was 17.62% (95% CI 14.26-21.57%, 42 studies and 423,117 patients). Older age has shown increased risk of mortality due to coronavirus and the pooled odds ratio (pOR) and hazard ratio (pHR) were 2.61 (95% CI 1.75-3.47) and 1.31 (95% CI 1.11-1.51), respectively. A significant association were found between COVID-19 mortality and male (pOR = 1.45; 95% CI 1.41-1.51; pHR = 1.24; 95% CI 1.07-1.41), and current smoker (pOR = 1.42; 95% CI 1.01-1.83). Furthermore, risk of mortality among hospitalized COVID-19 patients is highly influenced by patients with Chronic Obstructive Pulmonary Disease (COPD), Cardiovascular Disease (CVD), diabetes, hypertension, obese, cancer, acute kidney injury and increase D-dimer.
CONCLUSION
Chronic comorbidities, complications, and demographic variables including acute kidney injury, COPD, diabetes, hypertension, CVD, cancer, increased D-dimer, male gender, older age, current smoker, and obesity are clinical risk factors for a fatal outcome associated with coronavirus. The findings could be used for disease's future research, control and prevention.
Topics: Aged; COVID-19; Cardiovascular Diseases; Comorbidity; Humans; Male; Risk Factors; SARS-CoV-2
PubMed: 34418980
DOI: 10.1186/s12879-021-06536-3 -
Minerva Urology and Nephrology Jun 2021Retrograde ureteroscopy (URS), intra-renal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) represent routine interventions for the treatment of ureteral and renal... (Review)
Review
INTRODUCTION
Retrograde ureteroscopy (URS), intra-renal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) represent routine interventions for the treatment of ureteral and renal stones, although at times associated with serious adverse events. Of note, the evidence on perioperative complications after these procedures remains sparse and controversial. Moreover, there is a lack of standardized reporting of adverse events using uniform systems. The aim of the present study was to systematically review of the available evidence on URS/RIRS and PCNL for the surgical treatment of urinary stone, assessing the incidence of intra- and postoperative events, classified according to the modified Clavien-Dindo scale.
EVIDENCE ACQUISITION
A systematic review of the literature was performed according to PRISMA recommendations and was conducted on intra- and postoperative complications, as well as on their management, following URS, RIRS and PCNL procedures, particularly focusing on major events.
EVIDENCE SYNTHESIS
Overall, 26 studies (13 on URS/RIRS and 11 on PCNL) met the inclusion criteria and were evaluated. The highest intraoperative complication rate was 11.5% and 8.5% for RIRS and PCNL, respectively. Major complication rate following URS/RIRS and PCNL ranged between 0.3-31.7% and 2-17.1%, respectively. The most frequent adverse events were obstructive pyelonephritis or urinary leakage requiring the placement of a double J stent or a drainage. Among PCNLs series, life-threatening adverse events have also been reported, including bleeding requiring renal angioembolization and urothorax.
CONCLUSIONS
Despite the inclusion of series using a standardized reporting system, the complication rate after URS/RIRS/PCNL remains extensively heterogeneous in the literature; in addition, a non-negligible proportion of studies did not characterize the adverse events nor report the actual management strategy to solve them. Future research is needed to standardize the classification and reporting of surgical complications after endourological procedures (taking into consideration the surgeon's experience and skills), aiming to improve patient counseling and potentially the strategy for their prevention.
Topics: Humans; Intraoperative Complications; Kidney; Kidney Calculi; Nephrolithotomy, Percutaneous; Postoperative Complications; Treatment Outcome; Ureteroscopy; Urologic Surgical Procedures
PubMed: 33887891
DOI: 10.23736/S2724-6051.21.04294-4 -
BMC Medicine Dec 2021Obesity is a worldwide epidemic that has been associated with a plurality of diseases in observational studies. The aim of this study was to summarize the evidence from... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Obesity is a worldwide epidemic that has been associated with a plurality of diseases in observational studies. The aim of this study was to summarize the evidence from Mendelian randomization (MR) studies of the association between body mass index (BMI) and chronic diseases.
METHODS
PubMed and Embase were searched for MR studies on adult BMI in relation to major chronic diseases, including diabetes mellitus; diseases of the circulatory, respiratory, digestive, musculoskeletal, and nervous systems; and neoplasms. A meta-analysis was performed for each disease by using results from published MR studies and corresponding de novo analyses based on summary-level genetic data from the FinnGen consortium (n = 218,792 individuals).
RESULTS
In a meta-analysis of results from published MR studies and de novo analyses of the FinnGen consortium, genetically predicted higher BMI was associated with increased risk of type 2 diabetes mellitus, 14 circulatory disease outcomes, asthma, chronic obstructive pulmonary disease, five digestive system diseases, three musculoskeletal system diseases, and multiple sclerosis as well as cancers of the digestive system (six cancer sites), uterus, kidney, and bladder. In contrast, genetically predicted higher adult BMI was associated with a decreased risk of Dupuytren's disease, osteoporosis, and breast, prostate, and non-melanoma cancer, and not associated with Alzheimer's disease, amyotrophic lateral sclerosis, or Parkinson's disease.
CONCLUSIONS
The totality of the evidence from MR studies supports a causal role of excess adiposity in a plurality of chronic diseases. Hence, continued efforts to reduce the prevalence of overweight and obesity are a major public health goal.
Topics: Adiposity; Adult; Body Mass Index; Diabetes Mellitus, Type 2; Female; Genome-Wide Association Study; Humans; Male; Mendelian Randomization Analysis; Multiple Chronic Conditions; Polymorphism, Single Nucleotide
PubMed: 34906131
DOI: 10.1186/s12916-021-02188-x -
Frontiers in Public Health 2021The EQ-5D-5L is a generic preference-based questionnaire developed by the EuroQol Group to measure health-related quality of life (HRQoL) in 2005. Since its... (Meta-Analysis)
Meta-Analysis
The EQ-5D-5L is a generic preference-based questionnaire developed by the EuroQol Group to measure health-related quality of life (HRQoL) in 2005. Since its development, it has been increasingly applied in populations with various diseases and has been found to have good reliability and sensitivity. This study aimed to summarize the health utility elicited from EQ-5D-5L for patients with different diseases in cross-sectional studies worldwide. Web of Science, MEDLINE, EMBASE, and the Cochrane Library were searched from January 1, 2012, to October 31, 2019. Cross-sectional studies reporting utility values measured with the EQ-5D-5L in patients with any specific disease were eligible. The language was limited to English. Reference lists of the retrieved studies were manually searched to identify more studies that met the inclusion criteria. Methodological quality was assessed with the Agency for Health Research and Quality (AHRQ) checklist. In addition, meta-analyses were performed for utility values of any specific disease reported in three or more studies. In total, 9,400 records were identified, and 98 studies met the inclusion criteria. In the included studies, 50 different diseases and 98,085 patients were analyzed. Thirty-five studies involving seven different diseases were included in meta-analyses. The health utility ranged from 0.31 to 0.99 for diabetes mellitus [meta-analysis random-effect model (REM): 0.83, (95% CI = 0.77-0.90); fixed-effect model (FEM): 0.93 (95% CI = 0.93-0.93)]; from 0.62 to 0.90 for neoplasms [REM: 0.75 (95% CI = 0.68-0.82); FEM: 0.80 (95% CI = 0.78-0.81)]; from 0.56 to 0.85 for cardiovascular disease [REM: 0.77 (95% CI = 0.75-0.79); FEM: 0.76 (95% CI = 0.75-0.76)]; from 0.31 to 0.78 for multiple sclerosis [REM: 0.56 (95% CI = 0.47-0.66); FEM: 0.67 (95% CI = 0.66-0.68)]; from 0.68 to 0.79 for chronic obstructive pulmonary disease [REM: 0.75 (95% CI = 0.71-0.80); FEM: 0.76 (95% CI = 0.75-0.77)] from 0.65 to 0.90 for HIV infection [REM: 0.84 (95% CI = 0.80-0.88); FEM: 0.81 (95% CI = 0.80-0.82)]; from 0.37 to 0.89 for chronic kidney disease [REM: 0.70 (95% CI = 0.48-0.92; FEM: 0.76 (95% CI = 0.74-0.78)]. EQ-5D-5L is one of the most widely used preference-based measures of HRQoL in patients with different diseases worldwide. The variation of utility values for the same disease was influenced by the characteristics of patients, the living environment, and the EQ-5D-5L value set. : https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42020158694.
Topics: Cross-Sectional Studies; HIV Infections; Humans; Quality of Life; Reproducibility of Results; Surveys and Questionnaires
PubMed: 34268287
DOI: 10.3389/fpubh.2021.675523 -
Roczniki Panstwowego Zakladu Higieny 2022Background. SARS-CoV-2 virus is one of the largest RNA viruses, included in the coronavirus group, showing tropism to airway epithelial cells. SARS-CoV-2 causes an acute...
BACKGROUND
Background. SARS-CoV-2 virus is one of the largest RNA viruses, included in the coronavirus group, showing tropism to airway epithelial cells. SARS-CoV-2 causes an acute respiratory infectious disease, Covid-19. According to WHO reports, mortality due to Covid-19 is higher in the elderly and in those burdened with comorbidities such as diabetes, obstructive pulmonary disease, coronary artery disease, cancer, hypertension, hepatitis B, obesity or chronic kidney disease.
OBJECTIVE
The aim of the study was to review the current literature on the influence and importance of vitamin D levels on the course of SARS-CoV-2 infection.
MATERIAL AND METHOD
A systematic review of studies published from January 1, 2009 to June 31, 2021 has been performed. For this purpose, bibliographic databases such as PubMed and Scopus were searched. The following keywords and combinations were used: Covid-19, vitamin D, 25-hydroxy-vitamin D, vitamin D supplementation, SARS-CoV-2.
RESULTS
It has been shown that vitamin D plays an important role in the mechanisms of the innate immunity in the course of the acute respiratory infections. The overlapping factors of the severity of COVID-19 disease, vitamin D deficiency, and the prevalence of obesity, age scare, ethnicity, has led some researchers to hypothesize that vitamin D supplementation may be promising as a preventive or therapeutic measure for COVID-19.
CONCLUSIONS
A very important factor that has an immunomodulatory character is vitamin D, the adequate supplementation of which can be a preventive or therapeutic measure in case of SARS-CoV-2 infection, especially in elderly people, with obesity and other chronic diseases.
Topics: Aged; COVID-19; Humans; SARS-CoV-2; Vitamin D; Vitamin D Deficiency; Vitamins
PubMed: 35322953
DOI: 10.32394/rpzh.2022.0191 -
Infection Oct 2023Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the... (Review)
Review
BACKGROUND
Currently, there are no standardized guidelines for the diagnosis or management of the complications of urogenital schistosomiasis (UGS). This systematic review of the literature aims to investigate the state of the art in reference to diagnostic approaches and the clinical management of this condition.
METHODS
A systematic review of literature published between January 1990 and January 2021 was conducted in the MEDLINE database, scoping for articles regarding diagnostic means or therapeutic options for the complications of UGS, namely obstructive uropathy, bladder cancer, abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures. Relevant data were then extracted from the articles deemed eligible according to the inclusion criteria.
MAIN RESULTS
In total, 3052 articles were identified by the research query, of which 167 articles fulfilling inclusion criteria after title/abstract screening and full-text evaluation were included, 35% on both diagnostic and therapeutic aspects, and 51% on diagnosis and 14% on therapy. Ultrasound was the most frequently tool employed for the diagnosis of UGS complications showing a good performance. Concerning the management of hydronephrosis, the majority of available evidences came from community-based studies where universal treatment with praziquantel was used leading to decrease of prevalence of obstructive uropathy. Concerning studies on surgical procedures, laser endoureterotomy followed by stenting was mostly employed in adult patients leading to a crude cure rate of 60% (43 of 71 patients). In the case of severe hydronephrosis, surgery consisting of ureteral re-implantation showed excellent results with a crude cure rate of 98% (157 cured patients of 160 treated). Concerning bladder cancer, data on 93 patients with a clear diagnosis of UGS-related bladder were available reporting a variable and sometime combined approach based on disease stage. Available data on diagnosis and management of abortion, ectopic pregnancy, infertility, kidney failure, urolithiasis and the need for invasive procedures due to UGS are also presented.
CONCLUSIONS
The review produced a complete picture of the diagnostic and therapeutic options currently available for complicated UGS. These results can be useful both for guiding clinicians towards correct management and for tracing the direction of future research.
Topics: Female; Pregnancy; Adult; Humans; Schistosomiasis haematobia; Hydronephrosis; Infertility; Pregnancy, Ectopic; Renal Insufficiency; Urinary Bladder Neoplasms; Urolithiasis
PubMed: 37466786
DOI: 10.1007/s15010-023-02060-5 -
Antioxidants (Basel, Switzerland) Apr 2022Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation.... (Review)
Review
Recent studies indicate that cerebrovascular diseases and processes of atherosclerosis originate in the childhood era and are largely influenced by chronic inflammation. Some features of vascular dysfunction in adulthood may even be programmed prenatally via genetic influences and an unfavorable intrauterine milieu. Oxidative stress, defined by an imbalance between the production and generation of reactive oxygen species (ROS) in cells and tissues and the capability of an organism to scavenge these molecules via antioxidant mechanisms, has been linked to adverse cardiovascular health in adults, yet has not been systematically reviewed in the pediatric population. We performed a systematic search as per the PRISMA guidelines in PubMed/Medline and Cochrane Reviews and detected, in total, 1228 potentially eligible pediatric articles on systemic inflammation, oxidative stress, antioxidant use, cardiovascular disease and endothelial dysfunction. The abstracts and full-text manuscripts of these were screened for inclusion and exclusion criteria, and a total of 160 articles were included. The results indicate that systemic inflammation and oxidative stress influence cardiovascular health in many chronic pediatric conditions, including hypertension, obesity, diabetes mellitus types 1 and 2, chronic kidney disease, hyperlipidemia and obstructive sleep apnea. Exercise and diet may diminish ROS formation and enhance the total serum antioxidant capacity. Antioxidant supplementation may, in selected conditions, contribute to the diminution of the oxidative state and improve endothelial function; yet, in many areas, studies provide unsatisfactory results.
PubMed: 35624760
DOI: 10.3390/antiox11050894 -
ESC Heart Failure Oct 2021Takotsubo cardiomyopathy (TCM), characterized by reversible ventricular dysfunction, has similar mortality to acute coronary syndrome. With the growing interest in the... (Review)
Review
Takotsubo cardiomyopathy (TCM), characterized by reversible ventricular dysfunction, has similar mortality to acute coronary syndrome. With the growing interest in the diagnosis of and interventions for TCM, many risk factors had been found to affect the prognosis of TCM patients, such as age, sex, and pre-existing diseases. Because of the incomplete understanding of the pathophysiologic mechanism in TCM, evidence-based medical therapy for this condition is lacking. Early intervention on risk factors may improve the outcomes of TCM. In this review, we sought to provide up-to-date evidence on risk factors and medical therapies that affect TCM outcome. We found that male sex, physical triggers, and certain comorbidities such as chronic kidney disease, malignant disease, higher body mass index, sepsis, chronic obstructive pulmonary disease, and anaemia were associated with poor TCM prognosis. In contrast, race, hyperlipidaemia, diabetes mellitus, and mood disorders were not clearly associated with TCM prognosis. We also reviewed the effect of medical therapies on TCM outcome, including angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, β-blockers, calcium channel blockers, and statins. The evidence that these medications confer a survival benefit on TCM patients is limited. Understanding these prognostic factors could help develop risk-stratification tools for TCM and establish effective prevention and interventions for this not-so-benign condition. Further multicentre clinical studies with large samples and meta-analyses of findings from previous studies are needed to address the inconsistent findings among the many potential risk factors for TCM.
Topics: Body Mass Index; Comorbidity; Humans; Male; Prognosis; Risk Factors; Takotsubo Cardiomyopathy
PubMed: 34374223
DOI: 10.1002/ehf2.13531 -
Therapeutic Advances in Respiratory... 2023The readmission rate following hospitalization for chronic obstructive pulmonary disease (COPD) is surprisingly high, and frequent readmissions represent a higher risk... (Meta-Analysis)
Meta-Analysis
All-cause readmission rate and risk factors of 30- and 90-day after discharge in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis.
BACKGROUND
The readmission rate following hospitalization for chronic obstructive pulmonary disease (COPD) is surprisingly high, and frequent readmissions represent a higher risk of mortality and a heavy economic burden. However, information on all-cause readmissions in patients with COPD is limited.
OBJECTIVE
This study aimed to systematically summarize all-cause COPD readmission rates within 30 and 90 days after discharge and their underlying risk factors.
METHODS
Eight electronic databases were searched to identify relevant observational studies about COPD readmission from inception to 1 August 2022. Newcastle-Ottawa Scale was used for methodological quality assessment. We adopt a random effects model or a fixed effects model to estimate pooled all-cause COPD readmission rates and potential risk factors.
RESULTS
A total of 28 studies were included, of which 27 and 8 studies summarized 30- and 90-day all-cause readmissions, respectively. The pooled all-cause COPD readmission rates within 30 and 90 days were 18% and 31%, respectively. The World Health Organization region was initially considered to be the source of heterogeneity. We identified alcohol use, discharge destination, two or more hospitalizations in the previous year, and comorbidities such as heart failure, diabetes, chronic kidney disease, anemia, cancer, or tumor as potential risk factors for all-cause readmission, whereas female and obesity were protective factors.
CONCLUSIONS
Patients with COPD had a high all-cause readmission rate, and we also identified some potential risk factors. Therefore, it is urgent to strengthen early follow-up and targeted interventions, and adjust or avoid risk factors after discharge, so as to reduce the major health economic burden caused by frequent readmissions.
TRIAL REGISTRATION
This systematic review and meta-analysis protocol was prospectively registered with PROSPERO (no. CRD42022369894).
Topics: Female; Humans; Patient Discharge; Patient Readmission; Pulmonary Disease, Chronic Obstructive; Retrospective Studies; Risk Factors; Male
PubMed: 37822218
DOI: 10.1177/17534666231202742