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Alternative Therapies in Health and... Jun 2024This meta-analysis systematically investigates the association between Patent Foramen Ovale (PFO) and the prevalence of migraine. Our goal is to quantify this...
OBJECTIVE
This meta-analysis systematically investigates the association between Patent Foramen Ovale (PFO) and the prevalence of migraine. Our goal is to quantify this relationship and evaluate its implications for clinical practice and future research.
METHODS
An extensive literature search was carried out in various databases, such as PubMed, Embase, The Cochrane Library, Web of Science, CNKI, VIP, WanFang Data, and CBM, up to November 2023. The search focused on case-control, cross-sectional, and cohort studies examining the link between PFO and migraine. The literature screening and data extraction, based on predefined inclusion and exclusion criteria, were independently conducted by two reviewers. The studies' quality was evaluated using the Newcastle-Ottawa Scale (NOS), and RevMan 5.3 software was employed for the meta-analysis.
RESULTS
A total of 27 studies involving 8,875 participants were included in the meta-analysis. The results indicate a statistically significant association between PFO and migraine prevalence. Key findings include: (1) Overall, individuals with migraine had higher rates of PFO compared to healthy controls (OR = 3.22, 95% CI = 2.21 to 4.67, P < .00001). (2) The association was stronger in the Migraine with Aura group (OR = 3.69, 95% CI = 1.93 to 7.04, P < .0001) than in the Non-Migraine with Aura group (OR = 1.48, 95% CI = 1.09 to 2.00, P = .01). (3) The prevalence of PFO was notably higher in the Migraine with Aura group compared to the Non-Migraine with Aura group (OR = 2.32, 95% CI = 1.96 to 2.76, P < .00001).
CONCLUSION
The analysis confirms a noteworthy correlation between PFO and migraine, underscoring the relationship and suggesting additional studies need to elucidate the underlying mechanisms and clinical ramifications.
PubMed: 38940792
DOI: No ID Found -
Alternative Therapies in Health and... Jun 2024Congenital anal atresia poses a significant challenge in pediatric surgery, necessitating precise and effective interventions to ensure optimal outcomes. While...
BACKGROUND
Congenital anal atresia poses a significant challenge in pediatric surgery, necessitating precise and effective interventions to ensure optimal outcomes. While traditional anterior sagittal approach anoplasty has been a standard procedure, emerging evidence suggests potential benefits of anal dimple anorectoplasty.
OBJECTIVE
This study aims to assess the clinical efficacy of anal dimple anorectoplasty in treating congenital anal atresia.
METHODS
We conducted a rigorous systematic review and meta-analysis, extensively searching various databases such as Wanfang, CNKI, VIP, PubMed, Web of Science, and the Cochrane Library. Our aim was to identify randomized controlled trials comparing the efficacy of traditional anterior sagittal approach anoplasty with anal dimple anorectoplasty in treating congenital anal atresia. Search terms included "anal dimple anorectoplasty," "congenital anal atresia," and "RCT." Data regarding operation time, postoperative hospitalization duration, and complication rates were collected.
RESULTS
Anal dimple anorectoplasty exhibited significantly greater clinical efficacy (odds ratio [OR]=4.91, 95% confidence interval [CI]: 2.02-11.94, P < .00001), along with markedly reduced postoperative hospitalization duration (95% CI: -1.27 to -0.57, P < .00001), and a substantially lower incidence of complications (OR=0.1, 95% CI: 0.04-0.25, P < .00001) compared to traditional anterior sagittal approach anoplasty. These findings underscore the clear advantage of anal dimple anorectoplasty over conventional methods, indicating its potential as a preferred surgical approach for congenital anal atresia.
CONCLUSIONS
Anal dimple anorectoplasty emerges as a highly effective intervention for pediatric patients with congenital anal atresia, demonstrating a notable decrease in postoperative complications. These findings highlight its potential as a preferred surgical approach to enhance patient outcomes and minimize adverse events.
PubMed: 38940776
DOI: No ID Found -
Medeniyet Medical Journal Jun 2024sp. is considered an indispensable probiotic, and this probiotic has an effective role in maintaining the immune system. We evaluated the effect of the probiotic sp....
sp. is considered an indispensable probiotic, and this probiotic has an effective role in maintaining the immune system. We evaluated the effect of the probiotic sp. on modulating inflammation in several cases. In collecting the literature, we used databases from the Web of Science, the Cochrane Central Register of Controlled Trials, PubMed, and Embase. Studies that met the inclusion criteria were analyzed using Review Manager (version 5.4). A p-value of <0.05 of the total effect is considered statistically significant. Finally, 1895 references were retrieved and 20 were included in the meta-analysis. This meta-analysis suggested that most cases in this study were healthy elderly who received treatment with sp. sp. has a positive effect on B cells, eosinophils, IgE, NK cells, TNF-α, and IL-10. could regulate the immune system by modulating inflammation in the healthy elderly.
PubMed: 38940492
DOI: 10.4274/MMJ.galenos.2024.53822 -
The Oncologist Jun 2024There is little evidence on the safety, efficacy, and survival benefit of restarting immune checkpoint inhibitors (ICI) in patients with cancer after discontinuation due...
BACKGROUNDS
There is little evidence on the safety, efficacy, and survival benefit of restarting immune checkpoint inhibitors (ICI) in patients with cancer after discontinuation due to immune-related adverse events (irAEs) or progressive disease (PD). Here, we performed a meta-analysis to elucidate the possible benefits of ICI rechallenge in patients with cancer.
METHODS
Systematic searches were conducted using PubMed, Embase, and Cochrane Library databases. The objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and incidence of irAEs were the outcomes of interest.
RESULTS
Thirty-six studies involving 2026 patients were analyzed. ICI rechallenge was associated with a lower incidence of all-grade (OR, 0.05; 95%CI, 0.02-0.13, P < .05) and high-grade irAEs (OR, 0.37; 95%CI, 0.21-0.64, P < .05) when compared with initial ICI treatment. Though no significant difference was observed between rechallenge and initial treatment regarding ORR (OR, 0.69; 95%CI, 0.39-1.20, P = .29) and DCR (OR, 0.85; 95%CI, 0.51-1.40, P = 0.52), patients receiving rechallenge had improved PFS (HR, 0.56; 95%CI, 0.43-0.73, P < .05) and OS (HR, 0.55; 95%CI, 0.43-0.72, P < .05) than those who discontinued ICI therapy permanently. Subgroup analysis revealed that for patients who stopped initial ICI treatment because of irAEs, rechallenge showed similar safety and efficacy with initial treatment, while for patients who discontinued ICI treatment due to PD, rechallenge caused a significant increase in the incidence of high-grade irAEs (OR, 4.97; 95%CI, 1.98-12.5, P < .05) and a decrease in ORR (OR, 0.48; 95%CI, 0.24-0.95, P < .05).
CONCLUSION
ICI rechallenge is generally an active and feasible strategy that is associated with relative safety, similar efficacy, and improved survival outcomes. Rechallenge should be considered individually with circumspection, and randomized controlled trials are required to confirm these findings.
PubMed: 38940446
DOI: 10.1093/oncolo/oyae134 -
Anatolian Journal of Cardiology Jul 2024Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Women are often neglected in cardiovascular health prevention. Age at menarche (AAM) has been linked to cardiovascular (CVD) disease in women and is potentially identified as one of the significant CVD risk factor. However, there is still limited comprehensive evidence addressing this issue. This systematic review and meta-analysis aimed to investigate how early menarche affects the outcome of all-cause mortality, CVD mortality, total cardiovascular disease event, stroke (ischemic, hemorrhagic, and total stroke), and coronary heart disease (CHD).
METHOD
The Cochrane Library, MEDLINE, Embase, ScienceDirect, and Google Scholar databases were searched from March 2013 to March 2023 for cohorts investigating the effect of early onset of menarche on CVD events with a minimum follow-up period of 5 years. Studies that observed specific population and/or included women with a history of CVD at baseline were excluded. The Newcastle-Ottawa scale was used for risk of bias assessment for each cohort included. The data were presented as dichotomous measure using risk ratios. I2 statistics were utilized to evaluate the heterogeneity of presented data.
RESULTS
Thirteen cohorts included 18 626 799 female patients with ages ranging from 43 to 62.6 years. These reported 6 estimates each for CHD (5 483 298 patients) and all-cause mortality (1 595 878 patients), 5 estimates each for total stroke (2 941 321 patients) and CVD mortality (1 706 742 patients), 4 estimates each for total CVD events (3 988 311 patients) and ischemic stroke (2 434 580 patients), and 1 estimate for hemorrhagic stroke (66 104 patients). Our study found that events of CHD were significantly lower in early menarche (RR 0.57; 95% CI 0.41-0.78; P <.00001), as well as total stroke (RR 0.51; 95% CI 0.35-0.73; P =.0003), CVD mortality (RR 0.47; 95% CI 0.22-0.98; P =.04), total CVD events (RR 0.44; 95% CI 0.25-0.76; P =.003), ischemic stroke (RR 0.31; 95% CI 0.15-0.61; P <.0008), and hemorrhagic stroke (RR 0.12; 95% CI 0.07-0.20; P <.00001); and insignificantly higher in all-cause mortality (RR 0.90, 95% CI 0.76-1.06, P =.20).
CONCLUSION
In our study, cardiovascular events are lower in women with early menarche; hence, the later age of menarche is a potential risk factor to be considered when assessing CVD risk in a patient. However, our sample characteristics were heterogenous, and we did not consider other female hormonal factors that might potentially contribute to the CVD outcomes observed; thus, further studies are needed to clarify.
Topics: Humans; Female; Menarche; Cardiovascular Diseases; Risk Factors; Protective Factors; Age Factors; Middle Aged
PubMed: 38940409
DOI: 10.14744/AnatolJCardiol.2024.3996 -
Clinical Cardiology Jul 2024Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic heart failure (CHF) has always posed a significant threat to human survival and health. The efficacy of thiamine supplementation in CHF patients remains uncertain.
HYPOTHESIS
Receiving supplementary thiamine may not confer benefits to patients with CHF.
METHODS
A comprehensive search was conducted across the Cochrane Library, PubMed, EMBASE, ClinicalTrials.gov, and Web of Science databases up until May 2023 to identify articles investigating the effects of thiamine supplementation in CHF patients. Predefined criteria were utilized for selecting data on study characteristics and results.
RESULTS
Seven randomized, double-blind, controlled trials (five parallel trials and two crossover trials) involving a total of 274 patients were enrolled. The results of the meta-analysis pooling these studies did not reveal any significant effect of thiamine treatment compared with placebo on left ventricular ejection fraction (WMD = 1.653%, 95% CI: -1.098 to 4.405, p = 0.239, I = 61.8%), left ventricular end-diastolic volume (WMD = -6.831 mL, 95% CI: -26.367 to 12.704, p = 0.493, I = 0.0%), 6-min walking test (WMD = 16.526 m, 95% CI: -36.582 to 69.634, p = 0.542, I = 66.3%), N-terminal pro-B type natriuretic peptide (WMD = 258.150 pg/mL, 95% CI: -236.406 to 752.707, p = 0.306, I = 21.6%), or New York Heart Association class (WMD = -0.223, 95% CI: -0.781 to 0.335, p = 0.434, I = 87.1%). However, it effectively improved the status of thiamine deficiency (TD).
CONCLUSIONS
Our meta-analysis indicates that thiamine supplementation does not have a direct therapeutic effect on CHF, except for correcting TD.
Topics: Humans; Heart Failure; Thiamine; Randomized Controlled Trials as Topic; Dietary Supplements; Chronic Disease; Ventricular Function, Left; Stroke Volume; Vitamin B Complex; Treatment Outcome
PubMed: 38940395
DOI: 10.1002/clc.24309 -
Journal of Global Health Jun 2024There is minimal data on the number of adolescents in sub-Saharan Africa (SSA) with elevated blood pressure (BP) at increased risk of future cardiovascular events.... (Meta-Analysis)
Meta-Analysis
BACKGROUND
There is minimal data on the number of adolescents in sub-Saharan Africa (SSA) with elevated blood pressure (BP) at increased risk of future cardiovascular events. Combining country-specific population data with data derived from two previously conducted meta-analyses (one African-specific, one based on international cohorts), we sought to address this knowledge deficit.
METHODS
We used meta-analysis data from 37 926 adolescents participating in 36 contemporary SSA studies to generate sex-specific proportions of adolescents aged 10-14 and 15-19 years with elevated BP. The estimates were applied to the 2021 World Bank population data for each country in SSA. We then applied the rate of cardiovascular events attributable to elevated BP levels, derived from a meta-analysis of 17 observational, longitudinal cohort studies comprising 4.5 million young adults (non-African), to determine the excess number of cardiovascular events linked to hypertension among those aged 15-19 years transitioning to adulthood.
RESULTS
The estimated prevalence of elevated BP among male and female adolescents aged 10-14 years living in SSA was 7.2% (95% confidence interval (CI) = 4.9-9.9) and 6.9% (95% CI = 4.7-9.5), respectively, which increased to 13.0% (95% CI = 10.6-15.6) and 12.5% (95% CI = 10.4-15.3) among male and female adolescents aged 15-19 years, respectively. Consequently, we estimate that 13.6/138.0 million (95% CI = 10.4-17.3) male and 12.9/135.7 million (95% CI = 9.83-16.3) female adolescents living in SSA have elevated BP. Among the estimated 16.1 million adolescents aged 15-19 years with elevated BP approaching adulthood, the projected excess in cardiovascular events attributable to hypertension (vs normotension) is 201 000 (95% CI = 115 000-322 000) to 503 000 (95% CI = 286 000-805 000) over the next 10-25 years.
CONCLUSIONS
Based on the best available data, we estimate that 26.5 million adolescents living in SSA have elevated BP. If left undetected and untreated among those approaching adulthood (those aged 15-19 years), they will experience >0.5 million excess cardiovascular events associated with persistently elevated BP within the next 25 years.
REGISTRATION
PROSPERO: CRD42022297948.
Topics: Humans; Adolescent; Africa South of the Sahara; Hypertension; Male; Female; Child; Young Adult; Prevalence; Cardiovascular Diseases; Cost of Illness
PubMed: 38940275
DOI: 10.7189/jogh.14.04136 -
Polski Przeglad Chirurgiczny Jan 2024<b><br>Introduction:</b> Obesity's associated comorbidities and treatment costs have risen significantly, highlighting the importance of early... (Meta-Analysis)
Meta-Analysis
<b><br>Introduction:</b> Obesity's associated comorbidities and treatment costs have risen significantly, highlighting the importance of early weight loss strategies. Bariatric surgeries like Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG) have been effective in promoting weight loss and improving type 2 diabetes mellitus (T2DM) management.</br> <b><br>Aim:</b> The aim was to determine whether Roux-en-Y gastric bypass is more effective than vertical sleeve gastrectomy in the remission of type 2 diabetes mellitus (T2DM).</br> <b><br>Methods:</b> A systematic review and meta-analysis was performed. A literature search was performed in the databases Web of Science, Medline/PubMed, Embase, Scopus, and Medline/Ovid. A total of 1323 results were identified; after screening, 14 articles were selected and included in the systematic review. Primary and secondary outcomes were measured by RR with a 95% CI.</br> <b><br>Results:</b> The primary outcome of T2DM remission was 15% in favor of VSG (RR: 1.15, [95% CI: 1.04-1.28]). For secondary outcomes, hypertension remission was 7% in favor of VSG (RR: 1.07, [95% CI: 1.00-1.16]). Remission of dyslipidemia was 16% in favor of VSG (RR: 1.16, [95% CI: 1.06-1.26]). BMI after surgery was in favor of RYGB (MD: -1.31, [95% CI: -1.98 to -0.64]). For weight loss, the results favored VSG (MD: 6.50, [95% CI: 4.99-8.01]). In relation to total cholesterol, they were 65% favorable for RYGB (MD: -0.35, [95% CI: -0.46 to -0.24]), with a value of p <0.05. For LDL values, our results were 69% favorable for RYGB (MD: -0.31, [95% CI: -0.45 to -0.16]), p <0.01 value.</br> <b><br>Conclusions:</b> Laparoscopic sleeve gastrectomy is more effective in T2DM remission, hypertension remission, dyslipidemia remission, and weight loss compared to Roux-en-Y gastric bypass. Roux-en-Y gastric bypass is more effective at lowering BMI, total cholesterol, LDL, and TG compared to laparoscopic sleeve gastrectomy.</br>.
Topics: Humans; Diabetes Mellitus, Type 2; Gastric Bypass; Gastrectomy; Female; Male; Treatment Outcome; Weight Loss; Adult; Middle Aged; Obesity, Morbid; Remission Induction
PubMed: 38940248
DOI: 10.5604/01.3001.0054.2674 -
Journal of Integrative Neuroscience Jun 2024The understanding of neuropathic pain remains incomplete, highlighting the need for research on biomarkers for improved diagnosis and treatment. This review focuses on... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The understanding of neuropathic pain remains incomplete, highlighting the need for research on biomarkers for improved diagnosis and treatment. This review focuses on identifying potential biomarkers in blood and cerebrospinal fluid for neuropathic pain in different neuropathies.
METHODS
Searches were performed in six databases: PubMed, Web of Science, Scopus, Cochrane Library, EMBASE, and CINAHL. Included were observational studies, namely cross-sectional, cohort, and case-control, that evaluated quantitative biomarkers in blood or cerebrospinal fluid. Data were qualitatively synthesized, and meta-analyses were conducted using R. The study is registered with PROSPERO under the ID CRD42022323769.
RESULTS
The literature search resulted in 16 studies for qualitative and 12 for quantitative analysis, covering patients over 18 years of age with painful neuropathies. A total of 1403 subjects were analyzed, identifying no significant differences in levels of C-Reactive Protein (CRP), Interleukin-6 (IL-6), and Tumor Necrosis Factor-alpha (TNF-alpha) between patients with and without pain. Despite the high inter-rater reliability and adequate bias assessment, the results suggest negligible differences in inflammatory biomarkers, with noted publication bias and heterogeneity among studies, indicating the need for further research.
CONCLUSIONS
Our review underscores the complex nature of neuropathic pain and the challenges in identifying biomarkers, with no significant differences found in CRP, IL-6, and TNF-alpha levels between patients with and without pain. Despite methodological robustness, the results are limited by publication bias and heterogeneity. This emphasizes the need for further research to discover definitive biomarkers for improved diagnosis and personalized treatment of neuropathic pain.
Topics: Humans; Neuralgia; Biomarkers; Inflammation Mediators
PubMed: 38940091
DOI: 10.31083/j.jin2306120 -
Journal of Global Health Jun 2024Emotion-oriented approaches have demonstrated effectiveness in the care of the elderly. However, related studies have reported conflicting results. We aimed to explore... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Emotion-oriented approaches have demonstrated effectiveness in the care of the elderly. However, related studies have reported conflicting results. We aimed to explore the pooled effect of emotion-oriented approaches on the psychological outcomes and cognitive function of older adults through a meta-analysis of randomised controlled trials (RCTs).
METHODS
We searched eight databases - CINAHL, Cochrane, Embase, Ovid MEDLINE, PsycINFO, PubMed, Scopus, and Web of Science - for RCTs from inception to 11 January 2024. Participants aged 60 years or older who received emotion-oriented approaches as the intervention, and reported outcomes of interest in the studies were included. The primary outcome was psychological outcomes (depression, self-esteem, life satisfaction and loneliness), and the secondary outcome was global cognitive function. The pooled effect size was computed in comprehensive meta-analysis 3.0 software using Hedges' g (g) with random-effects model. Furthermore, heterogeneity was assessed through Cochrane's Q and I tests. The quality of the included studies was evaluated using the Cochrane Risk of Bias tool. To explore potential sources of heterogeneity, moderator analyses were conducted.
RESULTS
We included 37 RCTs and found that emotion-oriented approaches improve depression (g = -0.82, 95% CI = -1.08, -0.56), self-esteem (g = 0.98, 95% CI = 0.31, 1.64), life satisfaction (g = 0.63, 95% CI = 0.37, 0.88), loneliness (g = -2.22, 95% CI = -3.80, -0.64) and global cognitive function (g = 0.34, 95% CI = 0.19, 0.49) in older adults. We also observed significant follow-up effects on depression (g = -1.40, 95% CI = -2.45, -0.34) and loneliness (g = -3.48, 95% CI = 6.02, -0.94).
CONCLUSIONS
Emotion-oriented approaches are promising interventions in improving psychological outcomes and global cognitive function in older adults. Health care workers should receive training to promote and integrate emotion-oriented approaches into routine care of older adults emphasising the importance of collaborative efforts among health care professionals and caregivers to ensure holistic care delivery.
Topics: Humans; Randomized Controlled Trials as Topic; Aged; Cognition; Emotions; Depression; Middle Aged; Loneliness; Self Concept; Aged, 80 and over; Personal Satisfaction
PubMed: 38939961
DOI: 10.7189/jogh.14.04123