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Epilepsy Research Dec 2017The aim of this study is to systematically review the scientific literature to investigate if use of antiepileptic drugs (AEDs) is associated with falls and/or recurrent... (Review)
Review
OBJECTIVE
The aim of this study is to systematically review the scientific literature to investigate if use of antiepileptic drugs (AEDs) is associated with falls and/or recurrent falls in old age.
METHOD
We searched the literature for relevant articles in PubMed and Embase published up until 3rd December 2015. Studies on people aged 60 years and over with an observational design assessing the risk of fall in people exposed to AEDs compared to people not exposed to AED were included.
RESULTS
We found 744 studies by searching Medline and Embase and an additional 9 studies by reviewing relevant reference lists. Of these studies, 13 fulfilled our predefined criteria. The articles were of various study design, sizes and follow-up times, and presented the results in different ways. Also, confounder adjustment varied considerably between the studies. Ten studies presented results for the association between use of any AED and any fall/injurious fall. Of these studies, 6 presented adjusted estimates, of which all but one showed statistically significant associations between use of any AED and any fall/injurious fall. Six studies investigated the association between use of any AED and recurrent falls. Of these, only 3 studies presented adjusted effect estimates of which 2 reached statistical significance for the association between use of AEDs and recurrent falls in elderly people.
CONCLUSION
Our results indicate an association between use of AEDs and risk of falls and recurrent falls in older people. This finding may be clinically important given that a substantial amount of older people use these drugs. However, further research is needed to increase the knowledge about the actual risk of falls when using these drugs in old age.
Topics: Accidental Falls; Aged; Aged, 80 and over; Anticonvulsants; Epilepsy; Humans; Recurrence; Risk
PubMed: 29096135
DOI: 10.1016/j.eplepsyres.2017.10.022 -
European Journal of Cancer (Oxford,... Sep 2005The association between occupations that involve night shift work (a surrogate for exposure to light at night with subsequent melatonin suppression) and breast cancer... (Meta-Analysis)
Meta-Analysis Review
The association between occupations that involve night shift work (a surrogate for exposure to light at night with subsequent melatonin suppression) and breast cancer risk is uncertain. We therefore conducted a systematic review and meta-analysis of observational studies to assess the effects of night work on breast cancer risk. Data sources were MEDLINE from January 1960 to January 2005, experts in the field, bibliographies, and abstracts. Search terms included night work terms, flight personnel terms, cancer terms, and risk terms. Independent data extraction by two authors using standardised forms was performed. The method of DerSimonian and Laird was used to derive combined estimates and Egger's; and Begg and Mazumdar's tests for publication bias were conducted. Based on 13 studies, including seven studies of airline cabin crew and six studies of other night shift workers, the aggregate estimate for all studies combined was 1.48 (95% CI, 1.36-1.61), with a similar significant elevation of breast cancer risk among female airline cabin crew (standardised incidence ratio (SIR), 1.44; 95% CI, 1.26-1.65), and female night workers (relative risk (RR), 1.51; 95% CI, 1.36-1.68) separately. We found some evidence suggesting confounding due to incomplete adjustment for breast cancer risk factors, with smaller effects in the studies that more completely adjusted for reproductive history and other confounding factors. Egger's and Begg and Mazumdar's tests for publication bias showed no significant asymmetry (P>0.05). Studies on night shift work and breast cancer risk collectively show an increased breast cancer risk among women. Publication bias is unlikely to have influenced the results.
Topics: Aircraft; Breast Neoplasms; Cohort Studies; Female; Humans; Occupational Diseases; Retrospective Studies; Risk Factors; Work Schedule Tolerance
PubMed: 16084719
DOI: 10.1016/j.ejca.2005.05.010 -
Clinics (Sao Paulo, Brazil) 2018Increased stroke risk among chronic obstructive pulmonary disease patients has not yet been established. In this study, we conducted a systematic review and... (Meta-Analysis)
Meta-Analysis Review
Increased stroke risk among chronic obstructive pulmonary disease patients has not yet been established. In this study, we conducted a systematic review and meta-analysis to assess stroke risk among chronic obstructive pulmonary disease patients. PubMed, EMBASE, and the Cochrane Library were systematically searched from database inception until December 31, 2016 to identify longitudinal observational studies that investigated the association between chronic obstructive pulmonary disease and stroke. Stroke risk was quantified by overall and subgroup analyses, and a pooled hazard ratio was calculated. Study quality was evaluated using the Newcastle-Ottawa Scale. Publication bias was assessed using Begg's rank correlation test. Eight studies met the inclusion criteria. In a random-effects model, significantly increased stroke risk was observed among chronic obstructive pulmonary disease patients (hazard ratio, 1.30; 95% confidence interval, 1.18-1.43). In subgroup analyses stratified by stroke subtype, study quality, and adjustment by socioeconomic status, the association between increased stroke risk and chronic obstructive pulmonary disease patients was robust. Statistically significant publication bias was not detected. In summary, chronic obstructive pulmonary disease was found to be associated with increased stroke risk. Additional prospective studies are required to elucidate the mechanisms underlying the increase in stroke risk and identify effective preventive interventions.
Topics: Confidence Intervals; Humans; Life Style; Observational Studies as Topic; Pulmonary Disease, Chronic Obstructive; Risk; Risk Assessment; Socioeconomic Factors; Stroke
PubMed: 29723340
DOI: 10.6061/clinics/2018/e177 -
The International Journal of... Nov 2018To perform a systematic review and meta-analysis of the association between alcohol consumption and risk of tuberculosis (TB). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To perform a systematic review and meta-analysis of the association between alcohol consumption and risk of tuberculosis (TB).
METHODS
Medline, EMBASE and Web of Science were searched for observational studies from 2005 to April 2018. Reference lists of included studies were screened.
RESULTS
Forty-nine studies were included. Compared with people with low or no alcohol intake, the risk of TB in people with high or any alcohol consumption was increased by relative odds of 1.90 (95%CI 1.63-2.23). Substantial levels of heterogeneity were seen (² = 82%); however, there was no evidence of publication bias ( = 0.54). Sensitivity analysis restricted to studies using no alcohol drinking as a reference group found a slightly lower but still increased risk (OR 1.60, 95%CI 1.39-1.84). Subgroup analyses revealed no significant differences in relation to study design and quality, geographic location, publication year or adjustment for confounders. A pooled analysis of a further four studies reporting hazard ratios (HRs) found a nearly three-fold increase in risk of TB in relation to alcohol consumption during follow-up (HR 2.81, 95%CI 2.12-3.74). An exposure-response analysis showed that for every 10-20 g daily alcohol intake, there was a 12% increase in TB risk.
CONCLUSION
Alcohol consumption is an important risk factor for the development of TB.
Topics: Alcohol Drinking; Humans; Risk Factors; Tuberculosis
PubMed: 30355406
DOI: 10.5588/ijtld.18.0092 -
PloS One 2017Although high leptin concentration has been shown to be correlated with established vascular risk factors, epidemiologic studies have reported inconclusive results on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND PURPOSE
Although high leptin concentration has been shown to be correlated with established vascular risk factors, epidemiologic studies have reported inconclusive results on the association between leptin and cardiovascular diseases (CVD). Therefore, a meta-analysis was performed to evaluate this issue.
METHODS
We searched Pubmed, Embase, and the Cochrane Library from their inception to Jan 2016 for both case-control and cohort studies that assessed leptin concentration and CVD risk. Reports with odds ratio (OR), risk ratio (RR) and corresponding 95% confidence intervals (CI) were considered. The data were extracted by two investigators independently.
RESULTS
A total of 13 epidemiologic studies totaling 4257 CVD patients and 26710 controls were included. A significant inverse association was shown between leptin and coronary heart disease (CHD), with an overall OR of 1.16 (95% CI: 1.02-1.32), but not for stroke (OR = 1.21, 95% CI 0.98-1.48) under sociodemographic adjustment. Further adjustment for additional cardiovascular risk factors resulted in ORs of 1.16 (95% CI 0.97-1.40) for CHD and 1.10 (95% CI 0.89-1.35) for stroke. The findings remained when analyses were restricted to high-quality studies and indicated OR estimates of 1.07 (95% CI 0.96-1.19) for CHD and 0.98 (95% CI 0.76-1.25) for stroke. In a subgroup meta-analysis, a high leptin level was not independently associated with CHD in both females (OR = 1.03, 95% CI 0.86-1.23) and males (OR = 1.09, 95% CI 0.95-1.26) or with stroke in both females (OR = 1.13, 95% CI 0.87-1.47) and males (OR = 0.80, 95% CI 0.59-1.09). There was no significant publication bias as suggested by Egger test outcomes.
CONCLUSIONS
Our findings indicate that high leptin levels may not be associated with risks of CHD and stroke. Further large, well-designed prospective cohort studies are needed to fully evaluate the role of leptin on the risk of CVD.
Topics: Coronary Disease; Humans; Leptin; Risk Factors; Stroke
PubMed: 28278178
DOI: 10.1371/journal.pone.0166360 -
Academic Emergency Medicine : Official... Sep 2011The objectives were to conduct a comprehensive, systematic review of the literature for risk adjustment measures (RAMs) and outcome measures (OMs) for prehospital trauma... (Review)
Review
OBJECTIVES
The objectives were to conduct a comprehensive, systematic review of the literature for risk adjustment measures (RAMs) and outcome measures (OMs) for prehospital trauma research and to use a structured expert panel process to recommend measures for use in future emergency medical services (EMS) trauma outcomes research.
METHODS
A systematic literature search and review was performed identifying the published studies evaluating RAMs and OMs for prehospital injury research. An explicit structured review of all articles pertaining to each measure was conducted using the previously established methodology developed by the Canadian Physiotherapy Association ("Physical Rehabilitation Outcome Measures").
RESULTS
Among the 4,885 articles reviewed, 96 RAMs and/or OMs were identified from the existing literature (January 1958 to February 2010). Only one measure, the Glasgow Coma Scale (GCS), currently meets Level 1 quality of evidence status and a Category 1 (strong) recommendation for use in EMS trauma research. Twelve RAMs or OMs received Category 2 status (promising, but not sufficient current evidence to strongly recommend), including the motor component of GCS, simplified motor score (SMS), the simplified verbal score (SVS), the revised trauma score (RTS), the prehospital index (PHI), EMS provider judgment, the revised trauma index (RTI), the rapid acute physiology score (RAPS), the rapid emergency medicine score (REMS), the field trauma triage (FTT), the pediatric triage rule, and the out-of-hospital decision rule for pediatrics.
CONCLUSIONS
Using a previously published process, a structured literature review, and consensus expert panel opinion, only the GCS can currently be firmly recommended as a specific RAM or OM for prehospital trauma research (along with core measures that have already been established and published). This effort highlights the paucity of reliable, validated RAMs and OMs currently available for outcomes research in the prehospital setting and hopefully will encourage additional, methodologically sound evaluations of the promising, Category 2 RAMs and OMs, as well as the development of new measures.
Topics: Emergency Medical Services; Humans; Outcome Assessment, Health Care; Pilot Projects; Reproducibility of Results; Risk Adjustment; Trauma Severity Indices
PubMed: 21906205
DOI: 10.1111/j.1553-2712.2011.01148.x -
Obesity Reviews : An Official Journal... Aug 2003The specific effect of central rather than general obesity on breast cancer risk is not clear. This review examines the relationship between waist and waist-hip ratio... (Meta-Analysis)
Meta-Analysis Review
The specific effect of central rather than general obesity on breast cancer risk is not clear. This review examines the relationship between waist and waist-hip ratio (WHR) and risk of breast cancer in pre- and post-menopausal women using all available cohort and case-control data. The databases of the Cochrane Library, Medline, Cancer Lit and Embase were searched until October 2002. Relevant cohort and case-control studies with separate analyses in pre- and/or post-menopausal women were included. Random effects meta-analyses were carried out, subgrouped by pre- or post-menopausal status and cohort or case-control design. Sensitivity analyses were also performed. Five cohort studies with 72,1705 person years of observation (453 pre-menopausal and 2684 post-menopausal cases), and three case-control studies comprising 276 pre-menopausal cases with 758 pre-menopausal controls and 390 post-menopausal cases with 1071 post-menopausal controls were included. Pooled results from cohort studies using the most adjusted data [but without adjustment for weight or body mass index (BMI)] suggest a 39% lower risk of breast cancer in post-menopausal women with the smallest waist (compared with the largest) and a 24% lower risk in women with the smallest WHR. In pre-menopausal women, however, pooled results suggest that measurement of waist or WHR have little effect on risk of breast cancer. Adjustment for BMI abolished the relationship between waist or WHR and risk of post-menopausal breast cancer, but introduced such a relationship amongst pre-menopausal women. The relationship between a smaller measurement of waist or WHR and lower risk of post-menopausal breast cancer appears to result from the associated correlation with BMI. Amongst pre-menopausal women, central (not general) obesity may be specifically associated with an increased risk of breast cancer.
Topics: Anthropometry; Body Composition; Body Constitution; Body Mass Index; Breast Neoplasms; Case-Control Studies; Cohort Studies; Female; Humans; Menopause; Obesity; Risk Factors
PubMed: 12916817
DOI: 10.1046/j.1467-789x.2003.00108.x -
Journal of Hypertension Sep 2016Increased urine albumin excretion (UAE) is a well known predictor of cardiovascular events in patients with primary hypertension. Whether a reduction in UAE is... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Increased urine albumin excretion (UAE) is a well known predictor of cardiovascular events in patients with primary hypertension. Whether a reduction in UAE is associated to an improvement in cardiovascular risk is at present unclear. We performed a systematic review and meta-regression analysis of available trials to investigate whether treatment-induced changes in UAE are related to cardiovascular outcome.
METHODS
We searched MEDLINE, ISIWeb of Science, Cochrane Database and Scopus for studies including hypertensive patients, which reported cardiovascular events and UAE at baseline and at end of follow-up.
RESULTS
In trials reporting pairwise comparisons between antihypertensive treatment for cardiovascular outcome (16 randomized controlled trials and 48 580 patients, mean follow-up 45 months, 5867 cardiovascular events) after adjustment for differences in achieved blood pressure, a relationship between changes in albuminuria and risk was evident in the presence of a relevant between-arms difference in albuminuria [relative risks (RR) pooled 0.45, confidence interval (CI) 0.23-0.85] but not when no improvement in UAE was found between randomized arms (RR pooled 1.04, 95% CI 0.86-1.26, P for difference between subgroups <0.001). Meta-regression analysis showed a relationship between changes in albuminuria and risk after adjustment for blood pressure variation under treatment (adj. coeff. 0.005, 95% CI 0.0005-0.0096, P = 0.033, R 34.8%). In studies reporting changes in cardiovascular events on the basis of UAE variations (six trials and 36 325 patients, mean follow-up 60 months, 3741 cardiovascular events), the overall adjusted RR of total cardiovascular events was 0.51 (95% CI 0.38-0.59, P = 0.000) for albuminuria regression/stable vs increase.
CONCLUSION
Reduction in UAE under antihypertensive treatment is associated with reduced risk of clinical cardiovascular events. Our findings suggest that UAE changes may represent a valuable intermediate end point for cardiovascular events in primary hypertension.
Topics: Albuminuria; Antihypertensive Agents; Cardiovascular Diseases; Humans; Hypertension; Risk Factors
PubMed: 27254313
DOI: 10.1097/HJH.0000000000000991 -
Eye (London, England) Oct 2023Obstructive sleep apnoea (OSA) has been thought to be associated with glaucoma, however there are many conflicting studies on this topic. With many new studies having... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Obstructive sleep apnoea (OSA) has been thought to be associated with glaucoma, however there are many conflicting studies on this topic. With many new studies having been published since the previous meta-analysis, we believe it is important to clarify this association. Hence, in this study we meta-analyse the recent literature regarding the association between OSA and glaucoma.
METHODS
Pubmed, Embase, Scopus and Cochrane Library were searched from inception till the 28th February 2022 for observational as well as cross-sectional studies examining the association between OSA and glaucoma. Two reviewers selected studies, extracted data, graded the quality of included non-randomized studies using the Newcastle-Ottawa scale. The overall quality of evidence was assessed using GRADE. Random-effects models were used to meta-analyse the maximally covariate- adjusted associations.
RESULTS
48 studies were included in our systematic review, with 46 suitable for meta-analysis. Total study population was 4,566,984 patients. OSA was associated with a higher risk of glaucoma (OR 3.66, 95% CI 1.70 to 7.90, I = 98%, p < 0.01). After adjustment for various important confounders including age, gender and patient comorbidities such as hyperlipidaemia, hypertension, cardiovascular diseases and diabetes, patients with OSA had up to 40% higher odds of glaucoma. Substantial heterogeneity was eliminated through subgroup and sensitivity analyses after consideration of glaucoma subtype, OSA severity and adjustment for confounders.
CONCLUSIONS
In this meta-analysis, OSA was associated with higher risk of glaucoma, as well as more severe ocular findings characteristic of the glaucomatous disease process. We suggest more clinical studies looking into the effects of OSA treatment on the progression of glaucoma to help clinical decision making for patients.
Topics: Humans; Cross-Sectional Studies; Sleep Apnea, Obstructive; Glaucoma; Cardiovascular Diseases; Data Collection
PubMed: 36977937
DOI: 10.1038/s41433-023-02471-6 -
Journal of Traumatic Stress Dec 2020Child refugees are at high risk for problems with academic achievement and psychosocial well-being. We aimed to review the literature concerning these outcomes in...
Child refugees are at high risk for problems with academic achievement and psychosocial well-being. We aimed to review the literature concerning these outcomes in primary school-aged child refugees. This study was a systematic review and included studies that reported on outcomes of interest in child refugees between 5 and 12 years of age. Our search generated 3,172 articles; we selected 313 for review and included 45. Child refugees are diverse in their educational performance, and early deficits often resolve with time spent in the host country. These children are at an increased risk of emotional and behavioral difficulties, and multiple factors are associated with these outcomes. Although educational difficulties of primary school-aged child refugees in high-income countries tend to resolve, the risks for psychosocial problems persist. This review provides a deepened understanding of the diverse educational and psychosocial experiences of these children and highlights the need for developing health and educational programs to support this population.
Topics: Academic Success; Anxiety; Child; Child, Preschool; Depression; Emotional Adjustment; Female; Humans; Male; Refugees; Stress Disorders, Post-Traumatic
PubMed: 32803884
DOI: 10.1002/jts.22582