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PloS One 2016We conducted this systematic review and meta-analysis to address the open question of a possible association between the socioeconomic level of the neighborhoods in... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
We conducted this systematic review and meta-analysis to address the open question of a possible association between the socioeconomic level of the neighborhoods in which pregnant women live and the risk of Congenital Heart Defects (CHDs), Neural Tube Defects (NTDs) and OroFacial Clefts (OFCs).
METHODS
We searched MEDLINE from its inception to December 20th, 2015 for case-control, cohort and ecological studies assessing the association between neighborhood socioeconomic level and the risk of CHDs, NTDs and the specific phenotypes Cleft Lip with or without Cleft Palate (CLP) and Cleft Palate (CP). Study-specific risk estimates were pooled according to random-effect and fixed-effect models.
RESULTS
Out of 245 references, a total of seven case-control studies, two cohort studies and two ecological studies were assessed in the systematic review; all studies were enrolled in the meta-analysis with the exception of the two cohort studies. No significant association has been revealed between CHDs or NTDs and neighborhood deprivation index. For CLP phenotype subgroups, we found a significantly higher rate in deprived neighborhoods (Odds Ratios (OR) = 1.22, 95% CI: 1.10, 1.36) whereas this was not significant for CP phenotype subgroups (OR = 1.20, 95%CI: 0.89, 1.61).
CONCLUSION
In spite of the small number of epidemiological studies included in the present literature review, our findings suggest that neighborhood socioeconomic level where mothers live is associated only with an increased risk of CLP phenotype subgroups. This finding has methodological limitations that impede the formulation of firm conclusions, and further investigations should confirm this association.
Topics: Databases, Factual; Female; Heart Defects, Congenital; Humans; Mouth Abnormalities; Neural Tube Defects; Odds Ratio; Pregnancy; Residence Characteristics; Risk Factors; Socioeconomic Factors
PubMed: 27783616
DOI: 10.1371/journal.pone.0159039 -
International Journal of Environmental... Feb 2022Ehlers-Danlos syndrome type arthrochalasia (aEDS) is a rare genetic disease characterized by severe generalized joint hypermobility, bilateral congenital hip... (Review)
Review
Ehlers-Danlos syndrome type arthrochalasia (aEDS) is a rare genetic disease characterized by severe generalized joint hypermobility, bilateral congenital hip dislocation, skin hyperextensibility, muscle hypotonia, and mild dysmorphic features. It is an autosomal dominant connective tissue disease causing defects in collagen, associated with two genes, COL1A1 or COL1A2. Only about 42 cases have been published worldwide. Treatment is currently symptomatic and focuses on increasing the quality of life of these patients, as there is no curative treatment. The main objective of the review was to update information on Ehlers-Danlos syndrome type arthrochalasia from scientific publications. The review report was carried out in accordance with the criteria of the Preferred Reporting Items for Systematic reviews and MetaAnalyses (PRISMA) review protocol, by searching Orphanet, OMIM, PubMed, and Scopus, as well as free sources. A total of 20 articles were analyzed, which, after analysis, provide an updated report that aims to establish a solid starting point for future lines of research.
Topics: Collagen; Ehlers-Danlos Syndrome; Humans; Joint Instability; Quality of Life; Skin Abnormalities
PubMed: 35162892
DOI: 10.3390/ijerph19031870 -
The Journal of Pediatrics Apr 2016To assess the role of screening and prophylactic surgery for intestinal rotational abnormalities (IRAs) in asymptomatic patients with heterotaxy. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To assess the role of screening and prophylactic surgery for intestinal rotational abnormalities (IRAs) in asymptomatic patients with heterotaxy.
STUDY DESIGN
PubMed, Embase, and Cinahl were searched electronically to determine the overall incidence of IRAs in heterotaxy; the detection rate of IRAs associated with screening; the incidence of midgut volvulus in patients without screening; and the incidence of morbidity and mortality after prophylactic and emergency Ladd procedures. Relevant data were computed with a meta-analysis of proportions. Between-study heterogeneity was assessed with the I(2) statistic.
RESULTS
From 276 papers identified, 24 studies with a total of 1433 patients with heterotaxy were included for systematic review. No randomized study was identified. True incidence of IRA in heterotaxy could not be ascertained through meta-analysis. In patients who underwent screening, the incidence of IRA was 58%. Acute midgut volvulus occurred in 5.8% of those who did not undergo screening. Postoperative mortality after Ladd procedure mainly was associated with cardiac insufficiency, and overall it was significantly greater in the emergency group compared with the prophylactic group (18% vs 5.6%). The complication rate also was greater in case of emergency vs prophylactic abdominal surgery (27% vs 16%); adhesional small bowel obstruction was the most common complication overall (6%).
CONCLUSION
The screen-detected incidences of IRA and acute midgut volvulus were significantly greater in heterotaxy than the normal population. Prophylactic Ladd procedure was associated with less morbidity and mortality compared with emergency surgery. A long-term prospective randomized trial is needed to define the indication for screening and prophylactic treatment of IRA in heterotaxy.
Topics: Digestive System Abnormalities; Digestive System Surgical Procedures; Heterotaxy Syndrome; Humans; Incidence; Intestinal Volvulus; Intestines; Mass Screening; Postoperative Complications; Postoperative Period; Rotation
PubMed: 26868865
DOI: 10.1016/j.jpeds.2015.12.074 -
The Journal of Maternal-fetal &... May 2018Congenital portosystemic shunts (CPSS) are rare, congenital malformations that are increasingly often discovered during the fetal period, and for which, the... (Review)
Review
AIM
Congenital portosystemic shunts (CPSS) are rare, congenital malformations that are increasingly often discovered during the fetal period, and for which, the manifestations and evolution are poorly understood. The objective of this review is to describe the phenotype and evolution of forms diagnosed in the antenatal period.
MATERIALS AND METHODS
We performed a systematic review of the literature cited in Pubmed between 1982 and 2016 for CPSS cases diagnosed during the fetal period.
RESULTS
We identified 123 cases. The median age at diagnosis was 25 GA (14-38 weeks GA). Eighty patients had 128 associated congenital anomalies. The congenital abnormalities most frequently associated with antenatal diagnosis of CPSS were congenital cardiac disease (30 cases), intrauterine growth restriction (21 cases), vascular anomalies (14 cases), and trisomy 21 (7 cases). Seventy-five complications were reported in the literature. The most frequent were antenatal hemodynamic abnormalities (27 cases), neonatal cholestasis (11 cases), and hyperammonemia (10 cases). Twenty-nine patients had no complications. The choice of treatment was conservative in 29/56 cases, interventional radiology in 15 cases and surgery in 15 cases (three of the latter after failure of embolization).
CONCLUSION
From this review, we propose an algorithm for the perinatal management of this congenital abnormality.
Topics: Algorithms; Congenital Abnormalities; Female; Fetal Growth Retardation; Gestational Age; Humans; Infant; Infant, Newborn; Portal Vein; Pregnancy; Ultrasonography, Prenatal; Vascular Malformations
PubMed: 28372492
DOI: 10.1080/14767058.2017.1315093 -
Journal of Women's Health (2002) Oct 2010The nursing profession has been associated with several adverse pregnancy outcomes. However, the associations between occupational exposures and adverse pregnancy... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The nursing profession has been associated with several adverse pregnancy outcomes. However, the associations between occupational exposures and adverse pregnancy outcomes among this group have not been systematically examined. This review collates all epidemiological evidence to examine the strength of associations and consistency among eligible studies.
METHODS
A computer search of EMBASE and PubMed from 1966 through August 2009 was performed, followed by a search of reference lists of relevant studies and narrative reviews
RESULTS
Fourteen studies explored the relation between anesthetic gases and spontaneous abortion, 8 the relation between anesthetic gases and congenital malformations, 7 the relation between chemotherapy agents and congenital malformations, and 4 the relation between shift work and spontaneous abortion. In the random-effects models the summary odds ratio (OR) was moderately elevated for all the relations: OR = 1.27, 95% confidence interval (CI) 0.99-1.63 for anesthetic gases and spontaneous abortion. The summary OR was between 1.05 and 1.09 in high-quality studies, registry-based studies, and cohort studies: OR = 1.33, 95% CI 1.09-1.68 for anesthetic gases and congenital malformation. The summary OR was between 0.97 and 1.22 for high-quality studies, registry-based studies, and cohort studies: OR = 1.35; 95% CI 0.91-2.01 for chemotherapy agent and spontaneous abortion. The summary OR was between 1.34 and 1.69 for high-quality studies, registry-based studies, and cohort studies: OR = 1.44, 95% CI 1.06-1.95 for shift work and spontaneous abortion.
CONCLUSIONS
Nurses were found to be at increased risk of adverse pregnancy outcomes, but the strength of association was weaker in the well-designed studies. The significance of the findings is limited by the number and heterogeneity of the studies.
Topics: Abortion, Spontaneous; Anesthetics, Inhalation; Antineoplastic Agents; Congenital Abnormalities; Epidemiologic Studies; Evidence-Based Medicine; Female; Humans; Nursing Staff; Occupational Exposure; Pregnancy; Pregnancy Outcome; Women, Working; Work Schedule Tolerance
PubMed: 20809857
DOI: 10.1089/jwh.2009.1876 -
Clinical Endocrinology Jun 2022The risk of congenital anomalies following in utero exposure to thionamide antithyroid drugs (ATDs) is unresolved. Observational studies are contradictory and existing... (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The risk of congenital anomalies following in utero exposure to thionamide antithyroid drugs (ATDs) is unresolved. Observational studies are contradictory and existing meta-analyses predate and preclude more recent studies. We undertook an updated meta-analysis of congenital anomaly risk in women exposed to carbimazole or methimazole (CMZ/MMI), propylthiouracil (PTU), or untreated hyperthyroidism in pregnancy.
METHODS
We searched Medline, Embase, and the Cochrane database for articles published up till August 2021. We pooled separate crude and adjusted risk estimates using random effects models and subgroup analyses to address heterogeneity.
RESULTS
We identified 16 cohort studies comprising 5957, 15,785, and 15,666 exposures to CMZ/MMI, PTU, and untreated hyperthyroidism, respectively. Compared to nondisease controls, adjusted risk ratio (RR) and 95% confidence intervals (95% CIs) for congenital anomalies was increased for CMZ/MMI (RR, 1.28; 95% CI, 1.06-1.54) and PTU (RR, 1.16; 95% CI, 1.08-1.25). Crude risk for CMZ/MMI was increased relative to PTU (RR, 1.20; 95% CI, 1.01-1.43). Increased risk was also seen with exposure to both CMZ/MMI and PTU, that is, women who switched ATDs in pregnancy (RR, 1.51; 95% CI, 1.14-1.99). However, the timing of ATD switch was highly variable and included prepregnancy switches in some studies. The excess number of anomalies per 1000 live births was 17.2 for patients exposed to CMZ/MMI, 9.8, for PTU exposure, and 31.4 for exposure to both CMZ/MMI and PTU. Risk in the untreated group did not differ from control or ATD groups. The untreated group was however highly heterogeneous in terms of thyroid status. Subgroup analysis showed more positive associations in studies with >500 exposures and up to 1-year follow-up.
CONCLUSIONS
ATD therapy carries a small risk of congenital anomalies which is higher for CMZ/MMI than for PTU and does not appear to be reduced by switching ATDs in pregnancy. Due to key limitations in the available data, further studies will be required to clarify the risks associated with untreated hyperthyroidism and with switching ATDs in pregnancy.
Topics: Abnormalities, Drug-Induced; Antithyroid Agents; Carbimazole; Female; Humans; Hyperthyroidism; Methimazole; Pregnancy; Pregnancy Complications; Propylthiouracil
PubMed: 34845757
DOI: 10.1111/cen.14646 -
Clinical Anatomy (New York, N.Y.) Nov 2014The literature contains various estimates of the prevalence and distribution of the sesamoid bones in the hands. The aims of this systematic review are to provide a... (Meta-Analysis)
Meta-Analysis Review
The literature contains various estimates of the prevalence and distribution of the sesamoid bones in the hands. The aims of this systematic review are to provide a better estimate of the frequency of hand sesamoids and its association with variables such as ancestry, gender, and side. Nineteen studies met the inclusion criteria. The pooled rates of the sensitive meta-analyses from large-sample studies in adults showed: (a) true overall rates of 99.9% for the metacarpophalangeal (MCP) joint of the thumb (MCP-I), 53% for the interphalangeal joint (IP-I), 43.4% for the MCP of the index (MCP-II), 1.47% for the MCP of the medius finger (MCP-III), 0.6% for the MCP of the ring finger (MCP-IV), and 67.7% for the MCP of the auricular finger (MCP-V); (b) true radiological rates of 99.9% for the radial thumb sesamoid, 99.6% for the ulnar thumb sesamoid, 47.8% for IP-I, 40% for MCP-II, 1.3% for MCP-III, 0.8% for MCP-VI, and 62.8% for MCP-V. Black, Middle Eastern, and European ancestries conferred significantly higher sesamoid frequencies at IP-I, MCP-II, and MCP-V, respectively. There was a significant association with female gender at MCP-II, MCP-IV, and MCP-V, with ORs of 1.53, 4, and 1.3, respectively, and a nonsignificant "female" trend for the other locations. There was no significant association with hand side. The pooled rates of hand sesamoids in children aged 10-17 years were 92.7, 42.2, 33.8, 0.5, 0.3, and 36.5% for MCP-I, IP-I, MCP-II, MCP-III, MCP-IV, and MCP-V, respectively. The findings of this evidence-based anatomical review provide quantitative evidence that the incidence of sesamoid bones in human hands depends on genetic rather than functional factors.
Topics: Adolescent; Adult; Age Factors; Asian People; Black People; Child; Female; Hand Bones; Hand Deformities, Congenital; Humans; Male; Metacarpophalangeal Joint; Prevalence; Sesamoid Bones; Sex Factors; White People
PubMed: 24615762
DOI: 10.1002/ca.22378 -
Pediatric Surgery International Nov 2022Tubular esophageal duplication is a rare congenital malformation The surgical treatment of this lesion can be challenging. We aimed to present our experience in two... (Review)
Review
Tubular esophageal duplication is a rare congenital malformation The surgical treatment of this lesion can be challenging. We aimed to present our experience in two cases with tubular esophageal duplication. Both cases were endoscopically treated by a dual knife. The first patient underwent a single, while the second patient required three sessions of endoscopic septum division using an electrosurgical knife. Both showed satisfactory clinical, radiological and endoscopic response to treatment. Moreover, a systematic literature review has been performed. To identify all available studies, a detailed search on tubular esophageal duplication was performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Tubular esophageal duplication was reported in 16 pediatric cases in 14 studies in the literature. Surgery was applied to 10 of these cases and endoscopic treatment was applied to two of them. In the follow-up, nine patients who underwent surgical treatment and two patients who underwent endoscopic treatment were uneventful. Tubular esophageal duplications can be successfully treated endoscopically. Endoscopic septum division is a minimally invasive procedure that allows full anatomical recovery and satisfactory therapeutic response.
Topics: Child; Digestive System Abnormalities; Endoscopy; Humans
PubMed: 36048241
DOI: 10.1007/s00383-022-05205-z -
Surgical and Radiologic Anatomy : SRA Apr 2015The tendon of the extensor indicis (EI) is frequently used to restore the loss of function in other digits. However, it shows many variations which include splitting of... (Meta-Analysis)
Meta-Analysis Review
The tendon of the extensor indicis (EI) is frequently used to restore the loss of function in other digits. However, it shows many variations which include splitting of the extensor indicis proprius (EIP) into two or three distal slips, attachment to fingers other than the index such as the extensor medii proprius (EMP), attachment onto the index and the third finger such as the extensor indicis et medii communis, or attachment to both the index and the thumb such as the extensor pollicis et indicis (EPI). This systematic review gathers the available data on the prevalence of EI tendon and its variation in the hand. Twenty-nine cadaveric studies met the inclusion criteria with a total of 3858 hands. Meta-analysis results yielded an overall pooled prevalence estimate (PPE) of EI of 96.5% and PPEs of 92.6, 7.2 and 0.3% for the single-, double- and triple-slip EIP, respectively. The single-slip EIP is frequently inserted on the ulnar side of the extensor digitorum communis of the index (EDC-index) in 98.3%. The double-slip EIP is located on the ulnar side of the EDC-index in 53.5%, on its radial side in 17% and on both sides in 28.7%. Indian populations showed the highest rate of single-slip EIP and the lowest rate of double-slip EIP when compared to Japanese, Europeans and North Americans. The pooled prevalence of EMP, EMIC and EPI were 3.7, 1.6 and 0.75%, respectively. Knowledge of the variants of the EI tendon and their prevalence should help surgeons in correctly choosing the tendon to transfer in hand surgery.
Topics: Cadaver; Dissection; Female; Finger Joint; Hand; Hand Deformities, Congenital; Humans; Male; Musculoskeletal Abnormalities; Prevalence; Tendons
PubMed: 25096501
DOI: 10.1007/s00276-014-1352-0 -
The Science of the Total Environment Apr 2021Congenital malformations are considered as one of the significant causes of preterm as well as neonatal morbidity and mortality. Literature suggests the association of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Congenital malformations are considered as one of the significant causes of preterm as well as neonatal morbidity and mortality. Literature suggests the association of diverse congenital deformities with maternal exposure to air pollutants. However, the evidence is still inconclusive on the manifestation of these during pregnancy. Thus, systematic review was done on the available epidemiological studies studying the effect of air pollutants on congenital malformations. Furthermore, the meta-analysis was conducted for several combinations of air pollutants and congenital defects.
METHODS
Twenty six epidemiological studies were extracted from the databases and examined for association of risk of congenital defects with air pollutant concentrations. Metaanalysis was done if the risk estimates of the same anomaly and pollutant group were reported in at least three studies.
RESULTS
Each study reported a statistically significant increased risk of congenital malformation with some air pollutant, amid the several tested combinations. Our meta-analysis reported that nitrogen dioxide and PM were associated with the risk of pulmonary valve stenosis with OR = 1.74 and OR = 1.42 respectively. The risk of developing tetralogy of Fallot (TOF) was observed to be associated with PM with OR = 1.52 SO exposure was related to a high risk of the ventricular septal defect (VSD) with OR = 1.15 and orofacial defects (OR = 1.27).
CONCLUSION
It is evidenced that ambient air pollutants have some effect on congenital malformations. Standard case definitions, improved methods of exposure, and better control of confounders will improve future research in this area.
Topics: Air Pollutants; Air Pollution; Congenital Abnormalities; Databases, Factual; Environmental Pollutants; Female; Humans; Infant, Newborn; Maternal Exposure; Nitrogen Dioxide; Particulate Matter; Pregnancy
PubMed: 33183823
DOI: 10.1016/j.scitotenv.2020.142772