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Nutricion Hospitalaria Aug 2022Background: in recent years, n-3 PUFAs have been confirmed to be associated with cardiovascular and cerebrovascular diseases, but the link between n-3 PUFAs and stroke... (Meta-Analysis)
Meta-Analysis
Background: in recent years, n-3 PUFAs have been confirmed to be associated with cardiovascular and cerebrovascular diseases, but the link between n-3 PUFAs and stroke remains controversial. Objective: this study aimed to evaluate the association between n-3 PUFAs and stroke. Methods: we performed a comprehensive search of the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science and CNKI. Literature screening and quality assessment were performed according to inclusion and exclusion criteria. Cochrane's tool was used to assess the methodological components of each study, and the Stata 15.1 software was used to perform the meta-analysis. Results: a total of 18 RCTs were included, and the meta-analysis showed no differences in vascular disease-related death between the n-3 PUFA and control groups (RR, 0.95, 95 % CI: 0.89 to 1.01, p = 0.114 > 0.05). However, there was a significant difference in the lower n-3 PUFA dose subgroup (RR, 0.93, 95 % CI: 0.87 to 0.99, p = 0.034 < 0.05). Oral administration of n-3 PUFAs did not significantly reduce the risk of the following cerebrovascular accidents: stroke (RR = 1.00, 95 % CI: 0.93 to 1.07, p = 0.983 > 0.05), ischemic stroke (RR = 0.99, 95 % CI: 0.896 to 1.094, p = 0.841 > 0.05), hemorrhagic stroke (RR = 1.249, 95 % CI: 0.939 to 1.662, p = 0.127 > 0.05) and TIA (RR = 1.016, 95 % CI: 0.882 to 1.170, p = 0.824 > 0.05). The levels of TC (SMD, -0.167, 95 % CI: -0.193 to -0.141, p = 0 < 0.05) and TG (SMD, -0.065, 95 % CI: -0.087 to -0.042, p = 0 < 0.05) in the n-3 PUFA group were significantly decreased, but no significant improvement in the LDL (SMD, 0.022, 95 % CI: 0.005 to 0.040, p = 0.889 > 0.05) and HDL (SMD, 0.008, 95 % CI: -0.009 to 0.025, p = 0.368 > 0.05) levels was observed. Conclusion: this systematic review and meta-analysis suggests that treatment with low-dose n-3 PUFAs can reduce cerebrovascular disease-related death. After the oral administration of n-3 PUFAs, the levels of TC and TG decreased significantly, but n-3 PUFAs did not prevent the occurrence of cerebrovascular accidents or improve LDL or HDL levels.
Topics: Fatty Acids, Omega-3; Fatty Acids, Unsaturated; Humans; Secondary Prevention; Stroke
PubMed: 35916137
DOI: 10.20960/nh.04148 -
Iranian Journal of Public Health Jan 2021Cancer is the third cause of death following cardiovascular disease and accidents, in Iran. The purpose of this study was to systematically review the economic burden of... (Review)
Review
BACKGROUND
Cancer is the third cause of death following cardiovascular disease and accidents, in Iran. The purpose of this study was to systematically review the economic burden of cancer studies in Iran.
METHODS
This systematic review examined the types of direct medical and non-medical costs and indirect costs in cancer patients and includes studies in English and Persian that were reviewed in Scopus, Web of science, SID, Iranmedex, Magiran and databases of Medline, etc., from 1995-2019.
RESULTS
Twenty-one articles were included. Most studies have examined the direct costs of all types of cancers. The articles reviewed different types of cancer, such as prostate cancer (n=2), colorectal cancer (n=2), breast cancer (n=4), gastric cancer (n=2), oral and pharyngeal cancer (n=1), lung cancer (n=3), and blood cancer (n=4). The great number of studies were related to the gastrointestinal, breast and blood cancers. The gastrointestinal (gastric and colorectal) and breast cancer had the major economic burden than others.
CONCLUSION
It is necessary that special attention to patients, supportive measures to reduce the share of costs, and more budget allocation for prevention, screening and early detection being at priorities in the health system planning.
PubMed: 34178762
DOI: 10.18502/ijph.v50i1.5070 -
PloS One 2018Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related... (Review)
Review
OBJECTIVE
Drowning claims 7% of the global burden of injury-related deaths. Lifejackets are routinely recommended as a drowning prevention strategy; however, a review of related factors regarding lifejacket wear has not previously been investigated.
METHODS
This systematic review examined literature published from inception to December 2016 in English and German languages. The personal, social, and environmental factors associated with lifejacket wear among adults and children were investigated, a quantitative evaluation of the results undertaken, and gaps in the literature identified.
RESULTS
Twenty studies, with sample sizes of studies ranging between 20 and 482,331, were identified. Fifty-five percent were cross-sectional studies. All studies were scored IV or V on the Australian National Health and Medical Research Council (NHMRC) grading system indicating mostly descriptive and cross-sectional levels of evidence. Factors associated with increased wear included age (mostly children), gender (mostly female), boat type (non-motorised), boat size (small boats), role modelling (children influenced by adult lifejacket wear), and activity (water-skiing, fishing). Factors not associated or inconsistent with lifejacket wear included education, household income, ethnicity, boating ability, confidence in lifejackets, waterway type, and weather and water conditions. Factors associated with reduced lifejacket wear included adults, males, discomfort, cost and accessibility, consumption of alcohol, and swimming ability. Three studies evaluated the impact of interventions.
CONCLUSION
This review identified factors associated with both increased and decreased lifejacket wear. Future research should address the motivational factors associated with individuals' decisions to wear or not wear lifejackets. This, combined with further research on the evaluation of interventions designed to increase lifejacket wear, will enhance the evidence base to support future drowning prevention interventions.
Topics: Adolescent; Adult; Child; Drowning; Emergencies; Female; Humans; Male; Ships; Swimming; Young Adult
PubMed: 29718971
DOI: 10.1371/journal.pone.0196421 -
BMJ Open Mar 2014Motor vehicle accidents associated with commercial driving are an important cause of occupational death and impact public safety. (Review)
Review
BACKGROUND
Motor vehicle accidents associated with commercial driving are an important cause of occupational death and impact public safety.
OBJECTIVES
We summarise the evidence regarding the type, prevalence and impact of medical conditions discovered during health assessment of commercial drivers.
EVIDENCE REVIEW
We conducted a systematic review of multiple electronic databases and made a manual search for relevant studies that enrolled commercial drivers in any country and reported the outcomes of health assessment carried out in the context of commercial driving through November 2012. Data were extracted by a pair of independent reviewers and synthesised using a metanarrative approach.
RESULTS
We identified 32 studies of moderate methodological quality enrolling 151 644 commercial drivers (98% men). The prevalence of multiple health conditions was high (sleep disorders 19%, diabetes 33%, hypertension 23% and obesity 45%). Some conditions, such as sleep disorders and obesity, were linked to increased risk of crashes. Evidence on several other highly relevant medical conditions was lacking. Cost-effectiveness data were sparse.
CONCLUSIONS
Several medical conditions are highly prevalent in commercial drivers and can be associated with increased risk of crashes, thus providing a rationale for health assessment of commercial drivers.
Topics: Accidents, Traffic; Automobile Driving; Chronic Disease; Commerce; Diabetes Mellitus; Female; Health Status; Humans; Hypertension; Male; Obesity; Physical Fitness; Safety; Sleep Wake Disorders
PubMed: 24604478
DOI: 10.1136/bmjopen-2013-003434 -
Revista Do Colegio Brasileiro de... 2024burns represent a pivotal component of trauma in Brazil, accounting for 2 million incidents and 2,500 deaths annually. Self-intentional burns are associated with a worse... (Meta-Analysis)
Meta-Analysis
INTRODUCTION
burns represent a pivotal component of trauma in Brazil, accounting for 2 million incidents and 2,500 deaths annually. Self-intentional burns are associated with a worse prognosis, larger burned surface area, higher infection rates, and death. The lack of studies on the issue of self-immolation raises epidemiological questions regarding Brazilian victims. This study aimed to investigate the profile of burn events associated with self-injurious behavior among Brazilian victims.
METHODS
this systematic review was performed according to PRISMA 2020 guidelines and evaluated the correlation between self-injurious behavior as a cause of burns in Brazilian victims and its epidemiological implications in the last 20 years (2003-2023). The MeSH terms "Burns", "Self-Injurious Behavior", "Epidemiology" and "Brazil" were queried in the PubMed/MEDLINE, SciELO, and Cochrane Library databases, and, after selection by inclusion/exclusion criteria, the most relevant studies were critically analyzed.
RESULTS
From 1,077 pre-selected studies, 92 were potentially eligible, resulting in 7 manuscripts incorporated in this review. From 3,510 burned victims assembled in the pool of selected studies, 311 cases displayed self-injurious behavior. Burned patients who attempted to burn their lives have a higher risk of death (p<0.05; RR=5.1 [3.2-8.1]) and larger burned surface area (p<0.05; MD=19.2 [10-28.2]), compared to accidental cases. Moreover, the female gender was at a higher risk of attempting self-immolation (p<0.05; RR=4.01 [2.9-5.5]).
CONCLUSION
our results show that self-inflicted burn cases were associated with a larger burned surface area and a higher risk of death, and the female gender was identified as a relevant risk factor in Brazil.
Topics: Humans; Brazil; Burns; Self-Injurious Behavior; Female; Male
PubMed: 38716915
DOI: 10.1590/0100-6991e-20243665-en -
Scandinavian Journal of Trauma,... Oct 2016Motorcyclists are a vulnerable road-user population who are overrepresented in traffic injuries. Utilisation of back protectors may be an effective preventive measure... (Review)
Review
BACKGROUND
Motorcyclists are a vulnerable road-user population who are overrepresented in traffic injuries. Utilisation of back protectors may be an effective preventive measure for spine injuries in motorcyclists. Since use of back protectors is increasing it is important that clinical evidence supports their use. The study aimed to investigate the current evidence on the ability of back protectors to reduce the rate of back injuries and patient mortality in motorcycle crashes.
METHODS
A systematic literature search was conducted using various electronic databases. Systematic reviews, randomised controlled trials, controlled clinical trials, cohort studies, case series and case reports were included Opinion pieces and laboratory or biomechanical studies were excluded. Back protectors and spine protectors were included as the intervention; neck braces and speed humps were excluded. The target outcomes were any injuries to the back or death. Only English language studies were included.
RESULTS
The search strategy yielded 185 studies. After excluding 183 papers by title and abstract and full-text evaluation, only two small cross-sectional studies were included. Foam inserts in motorcycle jackets and non-standard clothing may possibly be associated with higher risk of injuries, while hard shell and standard back protectors may possibly be associated with a reduced rate of back and spinal injury.
CONCLUSION
This systematic review highlighted lack of appropriate evidence on efficacy of back protectors. Based on limited information, we are uncertain about the effects of back protectors on spinal injuries. Further research is required to substantiate the effects of back protectors on mortality and other injuries to the back.
Topics: Accidents, Traffic; Humans; Motorcycles; Protective Clothing; Spinal Injuries
PubMed: 27716409
DOI: 10.1186/s13049-016-0307-3 -
Environmental Pollution (Barking, Essex... Jan 2021We aimed to update the evidence-base of long-term noise exposures from road, rail, and aircraft traffic on both non-accidental and cardiovascular mortality. A systematic... (Meta-Analysis)
Meta-Analysis
We aimed to update the evidence-base of long-term noise exposures from road, rail, and aircraft traffic on both non-accidental and cardiovascular mortality. A systematic review and meta-analysis were conducted following PRISMA guidelines. The literature was searched using PubMed, Scopus, Web of Science, and EMBASE for the period between January 01, 2000 and October 05, 2020. 13 studies were selected for final review. The risk of bias and overall quality of evidence was evaluated using a pre-defined list of criteria. Risk estimates from each study were converted into per 10 dB higher of L for each traffic source. Inverse-Variance heterogeneity (I-Vhet) meta-analysis was used to pool these individual risk estimates, along with assessment of heterogeneity and publication bias. Sensitivity analyses include using random-effect model and leave-one-out meta-analysis. Subgroup analyses by study design and noise exposure assessment were conducted to explore potential sources of heterogeneity. For road traffic, the pooled relative risk (RR) per 10 dB higher L for mortality from non-accidental causes was 1.01 (95% CI: 0.98, 1.05) (5 studies, I = 78%), CVD was 1.01 (95% CI: 0.98, 1.05) (5 studies, I = 41%), ischemic heart disease (IHD) was 1.03 (95% CI: 0.99, 1.08) (7 studies, I = 46%), and stroke was 1.05 (95% CI: 0.97, 1.14) (5 studies, I = 62%). The overall quality of evidence for most meta-analyses was rated as very low to low, except for CVD or IHD mortality, for which the quality of evidence was rated as moderate. A possible threshold of 53 dB was visually suggested for CVD-related mortality from road traffic noise in the trend analysis. For aircraft noise, pooled estimates were based on fewer studies and varied by mortality outcomes. Evidence of long-term exposure to traffic noise on mortality remains weak except the association between road traffic noise and IHD mortality. High-quality longitudinal studies are required to better characterise mortality effects of traffic noise.
Topics: Aircraft; Environmental Exposure; Humans; Longitudinal Studies; Myocardial Ischemia; Noise, Transportation
PubMed: 33307398
DOI: 10.1016/j.envpol.2020.116222 -
Traffic Injury Prevention 2021Motor vehicle crashes are a leading cause of death for adolescents and young adults. The aim of this study is to examine and discuss the state-of-the-art literature...
OBJECTIVE
Motor vehicle crashes are a leading cause of death for adolescents and young adults. The aim of this study is to examine and discuss the state-of-the-art literature which uses neuroscience methods in the context of driving simulation to study adolescent and young adult drivers.
METHODS
We conducted a systematic English-language literature search of Ovid MEDLINE (1946-2020), PsycINFO (1967-2020), PubMed, Web of Science, SCOPUS, and CINAHL using keywords and MeSH terms. Studies were excluded if participants were not within the ages of 15-25, if the driving simulator did not include a visual monitor/computer monitor/projection screen and steering wheel and foot pedals, or brain data (specifically EEG [electroencephalogram], fNIRS [functional near-infrared spectroscopy], or fMRI [functional magnetic resonance imaging]) was not collected at the same time as driving simulation data.
RESULTS
Seventy-six full text articles of the 736 studies that met inclusion criteria were included in the final review. The 76 articles used one of the following neuroscience methods: electrophysiology, functional near-infrared spectroscopy, or functional magnetic resonance imaging. In the identified studies, there were primarily two areas of investigation pursued; driving impairment and distraction in driving. Impairment studies primarily explored the areas of drowsy/fatigued driving or alcohol-impaired driving. Studies of distracted driving primarily focused on cognitive load and auditory and visual distractors.
CONCLUSIONS
Our state of the science systematic review highlights the feasibility for coupling neuroscience with driving simulation to study the neurocorrelates of driving behaviors in the context of young drivers and neuromaturation. Findings show that, to date, most research has focused on examining brain correlates and driving behaviors related to contributing factors for fatal motor vehicle crashes. However, there remains a considerable paucity of research designed to understand underlying brain mechanisms that might otherwise facilitate greater understanding of individual variability of normative and risky driving behavior within the young driving population.
Topics: Accidents, Traffic; Adolescent; Automobile Driving; Computer Simulation; Humans; Neurosciences; Risk-Taking; Young Adult
PubMed: 33320014
DOI: 10.1080/15389588.2020.1847283 -
The Cochrane Database of Systematic... Oct 2006Pedestrians and cyclists account for nearly one in three of all road users killed and seriously injured in road traffic crashes. Late detection of other road users is... (Review)
Review
BACKGROUND
Pedestrians and cyclists account for nearly one in three of all road users killed and seriously injured in road traffic crashes. Late detection of other road users is one of the basic driver failures responsible for collisions. Aids to improve pedestrians and cyclist visibility have been used to avert potential collisions. However, the impact of these strategies on drivers' responses, and on pedestrian and cyclist safety is not known.
OBJECTIVES
1. To quantify the effect of visibility aids versus no visibility aids, and of different visibility aids on the occurrence of pedestrian and cyclist-motor vehicle collisions and injuries. 2. To quantify the effect of visibility aids versus no visibility aids, and of different visibility aids on drivers' detection and recognition responses.
SEARCH STRATEGY
We searched the CENTRAL, the Cochrane Injuries Group specialised register, MEDLINE, TRANSPORT, National Research Register, PsycInfo and PsycLit. We searched the reference lists of included trials, contacted authors and searched the websites of relevant transport research organisations. The searches were last updated in April 2005.
SELECTION CRITERIA
1. Randomised controlled trials and controlled before-and-after studies of the effect of visibility aids on the occurrence of pedestrian and cyclist-motor collisions and injuries. 2. Randomised controlled trials of the effect of visibility aids on drivers' detection and recognition responses. This included trials where the order of presentation of visibility aids was randomised or balanced using a Latin square design.
DATA COLLECTION AND ANALYSIS
Two authors independently screened records, extracted data and assessed trial quality.
MAIN RESULTS
We found no trials assessing the effect of visibility aids on pedestrian and cyclist-motor vehicle collisions and injuries. We identified 39 trials assessing the effect of visibility aids on drivers' responses. Fluorescent materials in yellow, red and orange colours improve detection and recognition in the daytime. For night-time visibility, lamps, flashing lights and retroreflective materials in red and yellow colours increase detection and recognition. Retroreflective materials arranged in a 'biomotion' configuration also enhance recognition. Substantial heterogeneity between and within the trials limited the possibility for meta-analysis. Summary statistics and descriptive summaries of the outcomes were presented for individual trials when appropriate.
AUTHORS' CONCLUSIONS
Visibility aids have the potential to increase visibility and enable drivers to detect pedestrians and cyclists earlier. Public acceptability of these strategies would merit further development. However, the effect of visibility aids on pedestrian and cyclist safety remains unknown. Studies which collect data on simple, meaningful outcomes are required.
Topics: Accidents, Traffic; Bicycling; Clothing; Color; Fluorescence; Humans; Lighting; Protective Devices; Safety; Time Factors
PubMed: 17054171
DOI: 10.1002/14651858.CD003438.pub2 -
Oncotarget Feb 2016Poly (ADP-ribose) polymerase (PARP) inhibitors are a class of small-molecule drugs suppressing PARP enzymes activity, inducing the death of cells deficient in homologous... (Review)
Review
Poly (ADP-ribose) polymerase (PARP) inhibitors are a class of small-molecule drugs suppressing PARP enzymes activity, inducing the death of cells deficient in homologous recombination repair (HRR). HRR deficiency is common in tumor cells with BRCA gene mutation. Since their first clinical trial in 2003, PARP inhibitors have shown benefit in the treatment of HRR-deficient tumors. Recently, several randomized clinical trials (RCTs) have been conducted to investigate the potential benefit of administration of PARP inhibitors in cancer patients. However, the results remain controversial. To evaluate the efficiency and safety of PARP inhibitors in patients with cancer, we performed a comprehensive meta-analysis of RCTs. According to our study, PARP inhibitors could clearly improve progression-free survival (PFS), especially in patients with BRCA mutation. However, our study showed no significant difference in overall survival (OS) between the PARP inhibitors and controls, even in the BRCA mutation group. Little toxicity was reported in the rate of treatment correlated adverse events (AEs) in PARP inhibitor group compared with controls. In conclusion, PARP inhibitors do well in improving PFS with little toxicity, especially in patients with BRCA deficiency.
Topics: Antineoplastic Agents; Humans; Neoplasms; Poly(ADP-ribose) Polymerase Inhibitors; Poly(ADP-ribose) Polymerases; Safety
PubMed: 26399274
DOI: 10.18632/oncotarget.5367