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PloS One 2023Although statins are often discontinued when myalgia arises, a causal relationship may not always exist. How well-tolerated statins are when rechallenge is blinded and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Although statins are often discontinued when myalgia arises, a causal relationship may not always exist. How well-tolerated statins are when rechallenge is blinded and controlled is unclear.
METHODS AND FINDINGS
We performed a systematic review and meta-analysis (PROSPERO CRD42023437648) to evaluate the success of statin rechallenge versus matched placebo in those who were previously statin intolerant. Our primary outcome was intolerance; our secondary outcome was the myalgia or global symptom score. Medline, Embase, CINAHL Plus, Scopus, and CENTRAL were searched from inception to May 1, 2023. Eligible trials were randomized controlled trials with parallel or crossover designs examining statin rechallenge in statin-intolerant adults. Two independent reviewers selected studies, extracted data, and assessed risk of bias (Cochrane Collaboration's risk-of-bias tool 1). Relative risk (RR) and mean difference (MD) were estimated using fixed effect Mantel-Haenszel statistics. Of 1,941 studies screened, 8 met our inclusion criteria (8 to 491 participants from Asia, Europe, North America, and Oceana). Compared to placebo, intolerance was more common in statin users [325/906 (36%) vs 233/911 (26%), RR 1.40, 95% CI, 1.23 to 1.60, I2 = 0%, 7 trials, number needed to harm 10] and there was no statistically significant difference in myalgia or global symptom score on a 100-point scale [MD 1.08, 95% CI, -1.51 to 3.67, I2 = 0%, 5 trials]. Limitations include only 1 trial asking participants about intolerable symptoms (vs inferring intolerance from discontinuation or trial withdrawal); the small number of trials; the possibility of attrition bias; and the potential for carryover effects in crossover/n-of-1 trial designs.
CONCLUSIONS
Of those previously intolerant of statins who were rechallenged with a statin and compared to placebo recipients, medication intolerance was more common amongst statin recipients. However, there was no significant difference in mean myalgia or global symptom score between statin and placebo, and only one-third of those previously believed to be statin intolerant were unable to tolerate a statin on blinded rechallenge; one-quarter were intolerant of placebo.
Topics: Adult; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Myalgia; Randomized Controlled Trials as Topic; Asia; Europe
PubMed: 38128013
DOI: 10.1371/journal.pone.0295857 -
The Saudi Dental Journal Dec 2023The aim of this systematic review was to evaluate the in vitro accuracy of dental implant impressions taken using digitally coded healing abutments (CHAs) compared with... (Review)
Review
The aim of this systematic review was to evaluate the in vitro accuracy of dental implant impressions taken using digitally coded healing abutments (CHAs) compared with impressions taken with conventional techniques (CI) and/or within the CHA group at varying degrees of angulations for multiple implant units. Two independent reviewers conducted a systematic electronic search in the MedLine, PubMed, Google Scholar, Cochrane Library, Web of Science, and Scopus databases. Some of the employed key terms, combined with the help of Boolean operators, were: "digitally coded healing abutments", "encode healing abutment", "dental implants", "impression accuracy", "digital impression", and "conventional impression". Publication dates ranged from January 2010 to November 2022. A total of 7 articles fulfilled the inclusion criteria: 6 studies compared the accuracy of CHA with conventional pick-up impression techniques, and one study only used CHAs at different angulations and heights to compare accuracy within the group. The results were divided into Group A (elastomeric impression of CHA) and Group B (CHA + Intraoral scanner). According to the results of this systematic review, elastomeric impression of CHA performed poorly when compared to CI for multiple implants, although an intraoral scan of CHA appears to be more accurate. Within the CHA group, the angulation and visible height of CHA play a significant role in impression accuracy. However, more studies are needed before CHA can be recommended for all non-parallel multiple implant-supported restorations.
PubMed: 38107040
DOI: 10.1016/j.sdentj.2023.08.006 -
International Journal of Environmental... Nov 2023The COVID-19 pandemic and the accompanying social changes severely impacted mental health globally. Children and adolescents may have been vulnerable to adverse mental... (Review)
Review
The COVID-19 pandemic and the accompanying social changes severely impacted mental health globally. Children and adolescents may have been vulnerable to adverse mental health outcomes, especially obsessive-compulsive disorder (OCD), due to their underdeveloped resilience and coping skills stemming from their progressing physical and psychological development. Few studies have explored the parallels between the pandemic and OCD trends in this population. This systematic review aims to identify the impacts of COVID-19 on OCD among children and adolescents. Using the PRISMA guidelines, a systematic search of eight databases for studies that assessed OCD outcomes independently or as part of other psychiatric diagnoses during the COVID-19 pandemic was conducted. The search was limited to studies on humans and those written in English and published between January 2020 and May 2023. We identified 788 articles, out of which 71 were selected for a full-text review. Twenty-two papers were synthesized from 10 countries for the final analysis. We found that 77% of our studies suggested that the COVID-19 pandemic had a negative impact on OCD among children and adolescents. We also found a complex interplay of individual, household, and socio-structural factors associated with the aggravation of OCD. Conversely, a few studies revealed that the pandemic strengthened relationships and resilience. The findings of this study emphasize the need for mental health screening and support for this population, especially during pandemic periods.
Topics: Child; Humans; Adolescent; COVID-19; Pandemics; Obsessive-Compulsive Disorder; Mental Health
PubMed: 38063525
DOI: 10.3390/ijerph20237095 -
Frontiers in Public Health 2023We decided to conduct the first systematic review with meta-analysis to provide the highest level of up-to-date evidence on the occupational risk factors for Multiple... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
We decided to conduct the first systematic review with meta-analysis to provide the highest level of up-to-date evidence on the occupational risk factors for Multiple Sclerosis.
METHODS
A systematic, comprehensive literature search was performed in four electronic academic databases. We included any case-control study that enrolled working-age subjects and compared the proportion of MS cases with controls who were not exposed to an occupational risk factor. The primary outcome was the occurrence of MS. The quality assessment was performed with the Critical Appraisal Checklist for Case Control Studies, developed, and validated by the Joanna Briggs Institute. All the selection process was also carried out by two independent and previously trained researchers.
RESULTS
Overall, the total sample included 19,004 people with MS and 4,164,162 controls. Agricultural workers (OR = 1.44, 95% CI 1.13-1.83), offshore workers (OR = 3.56, 95% CI 2.74-4.61), and hairdressers (OR = 8.25, 95% CI 1.02-66.52) were associated with a higher probability of being diagnosed with MS. In parallel, workers exposed to toxic fumes from oil wells (OR = 16.80, 95% CI 8.33-33.90), low-frequency magnetic fields (OR = 1.71, 95% CI 1.03-2.72), and pesticides (OR = 3.17, 95% CI = 2.53-3.99) also had an increased likelihood of having MS.
CONCLUSION
Our study has the potential to influence more assertive public policies. Nevertheless, future studies on how the occupational setting may contribute to the incidence of MS are highly recommended.
SYSTEMATIC REVIEW REGISTRATION
The protocol was registered in the international prospective register of systematic reviews (PROSPERO- CRD42023443257).
Topics: Humans; Occupational Diseases; Multiple Sclerosis; Case-Control Studies; Occupational Exposure; World Health Organization; Cost of Illness; Risk Factors
PubMed: 38054069
DOI: 10.3389/fpubh.2023.1285103 -
Atencion Primaria Apr 2024To analyse predictor variables of contraceptive method use in young people.
OBJECTIVE
To analyse predictor variables of contraceptive method use in young people.
DESIGN
Systematic review.
DATA SOURCES
PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted.
STUDY SELECTION
An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected.
DATA EXTRACTION
Information was extracted on the selected study population, contraceptive method studied and predictor variables identified.
RESULTS
Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with women having higher knowledge of hormonal contraceptive options and more positive attitudes.
CONCLUSION
Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.
Topics: Humans; Male; Female; Adolescent; Contraception; Contraceptive Agents; Condoms; Health Knowledge, Attitudes, Practice
PubMed: 38043175
DOI: 10.1016/j.aprim.2023.102773 -
Inquiry : a Journal of Medical Care... 2023As e-cigarette use has steadily increased over the recent years, the public health interest in the potential implications of e-cigarette use on cigarette smoking has... (Review)
Review
As e-cigarette use has steadily increased over the recent years, the public health interest in the potential implications of e-cigarette use on cigarette smoking has grown in parallel. With strict adherence to PRISMA guidelines, this systematic review examined the potential associations between e-cigarette use and relapse to cigarette smoking among former cigarette smokers. The protocol was registered on November 06, 2018 (PROSPERO 2018 CRD42018115674). Literature searches were executed from January 01, 2007 to August 20, 2022 and search results were screened according to the PICOS review method. One RCT and 10 adjusted studies examined relapse to cigarette smoking (evidence grade "moderate") among regular e-cigarette users, reporting mixed and inconsistent findings according to varying definitions of e-cigarette use and relapse. Findings were similarly inconsistent among the 8 adjusted studies examining relapse to cigarette smoking among non-regular e-cigarette users. The inconsistency in findings among studies evaluating regular measures of e-cigarette use, combined with the numerous methodological flaws in the overall body of literature, limit the generalizability of results associated with a causal association between e-cigarette use and relapse to cigarette smoking. Based on findings from this review, more robust studies are required to determine whether a causal association exists between e-cigarette use and relapse to cigarette smoking. Future studies should apply consistent measures of e-cigarette use to examine causality with future use patterns, and sufficiently account for known or suspected confounding variables to support inform determinations related to e-cigarette use and cigarette smoking behaviors.
Topics: Humans; Smokers; Electronic Nicotine Delivery Systems; Smoking Cessation; Vaping; Tobacco Products; Chronic Disease; Recurrence
PubMed: 38031340
DOI: 10.1177/00469580231214457 -
Frontiers in Cardiovascular Medicine 2023The purpose of this systematic review and meta-analysis was to incorporate data from the latest clinical studies and compare the safety and efficacy of surgical left... (Review)
Review
OBJECTIVE
The purpose of this systematic review and meta-analysis was to incorporate data from the latest clinical studies and compare the safety and efficacy of surgical left subclavian artery (LSA) revascularization and endovascular LSA revascularization during thoracic endovascular aortic repair (TEVAR).
METHODS
This study was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered with the PROSPERO database on 16 April 2023 (CRD42023414579). The Embase, MEDLINE (PubMed), and the Cochrane Library databases were searched from January 2000 to May 2023.
RESULTS
A total of 14 retrospective cohort studies with a total of 1,695 patients, were included for review. The peri-operative stroke rates of the surgical and endovascular LSA revascularization groups were 3.8% and 2.6%, respectively ( = 0.97). The peri-operative technical success rates for the surgical and endovascular LSA revascularization groups were 95.6% and 93.0%, respectively ( = 0.24). The peri-operative spinal cord ischemia rates were 1.6% ( = 18) and 1.9% ( = 7) in the surgical and endovascular LSA revascularization groups, respectively ( = 0.90). The peri-operative type Ⅰ endoleak rates for the surgical and endovascular LSA revascularization groups were 6.6% and 23.2%, respectively ( = 0.25). The subgroup analysis showed that the incidence of peri-operative type I endoleak in the parallel stent group was significantly higher than that in the surgical LSA revascularization group ( < 0.0001). The peri-operative left upper limb ischemia rates for the surgical and endovascular LSA revascularization groups were 1.2% and 0.6%, respectively ( = 0.96). The peri-operative mortality rates of the surgical and endovascular LSA revascularization groups were 2.0% and 2.0%, respectively ( = 0.88).
CONCLUSION
There was no significant difference in the terms of short-term outcomes when comparing the two revascularization techniques. The quality of evidence assessed by GRADE scale was low to very-low. Surgical and endovascular LSA revascularization during TEVAR were both safe and effective. Compared with surgical LSA revascularization techniques, parallel stent revascularization of LSA significantly increased the rate of type I endoleak.
PubMed: 38028461
DOI: 10.3389/fcvm.2023.1274629 -
Frontiers in Global Women's Health 2023Episiotomy at the time of vaginal birth is a common lifesaving surgical procedure. In Ethiopia, several studies have been conducted concerning the proportion of... (Review)
Review
BACKGROUND
Episiotomy at the time of vaginal birth is a common lifesaving surgical procedure. In Ethiopia, several studies have been conducted concerning the proportion of episiotomy. However, its prevalence varies across these series of studies. Thus, this systematic review and meta-analysis aimed to estimate the level of episiotomy practice and its disparity among primiparous and multiparous women in Ethiopia.
METHODS
This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We systematically searched the PubMed/MEDLINE, EMBASE, Google Scholar, and Science Direct databases for studies conducted in Ethiopia focusing on episiotomy. We included all cross-sectional studies published until October 5,2022. Data were analyzed using R version 4.2.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. A random-effects meta-analysis was conducted on extracted crude rates to calculate the national and regional pooled estimates for the country. The -squared test and Egger's regression test were used to assess heterogeneity and publication bias, respectively.
RESULTS
Our search yielded 390 articles. A total of 13 studies covering five administrative regions and 6,404 women who delivered vaginally were involved. The mean age of the study participants ranged from 22 to 27.7 years. The estimated overall pooled prevalence rate of episiotomy in Ethiopian women was 42.75% (95% CI: 34.97%-50.54%). In the subgroup analysis, the pooled prevalence rate of episiotomy was 61.45% (95% CI: 51.11%-71.80%) among primiparous women. Meanwhile, the pooled estimate appears to be approximately 30.47% (95% CI: 22.08%-38.85%) among multiparous women.
CONCLUSION
Our findings concluded that the pooled prevalence rate of episiotomy was higher than the evidence-based WHO recommendations for optimal patient care. Parallel to this, nulliparous women had a higher episiotomy rate than multiparous women. These findings highlight the importance of continued training for labor ward staff, particularly healthcare providers who often perform the majority of deliveries.
PubMed: 38025985
DOI: 10.3389/fgwh.2023.1153640 -
Biological Psychiatry Global Open... Jan 2024Inner retinal atrophy has been demonstrated in schizophrenia spectrum disorder (SSD) using optical coherence tomography (OCT). This systematic review and meta-analysis...
BACKGROUND
Inner retinal atrophy has been demonstrated in schizophrenia spectrum disorder (SSD) using optical coherence tomography (OCT). This systematic review and meta-analysis investigated the role of contemporary Fourier domain OCT devices in SSD.
METHODS
MEDLINE, PubMed, Scopus, Embase, PsycInfo, PYSNDEX, World Health Organization, and Cochrane databases were searched from inception until May 2022. All peer-reviewed adult SSD case-control studies using Fourier domain OCT were included. Ocular pathologies known to affect retinal OCT scans were excluded. Search, data appraisal, and summary data extraction were independently performed by 2 authors.
RESULTS
The review criteria was met by k = 36 studies, with k = 24 studies (1074 cases, 854 controls) suitable for meta-analysis. The SSD group exhibited a thinner global peripapillary retinal nerve fiber layer (-3.26 μm, 95% CI, -5.07 to -1.45, = 64%, k = 21), thinner average macular layer (-7.88 μm, 95% CI, -12.73 to -3.04, = 65%, k = 11), and thinner macular ganglion cell-inner plexiform sublayer (-2.44 μm, 95% CI, -4.13 to -0.76, = 30%, k = 8) compared with the control group. Retinal nerve fiber layer findings remained significant after exclusion of metabolic disease, low quality, outlier, and influential studies. Studies involving eye examinations to exclude eye disease were associated with greater atrophy in SSD. Except for cardiometabolic disease, most studies did not report clinically significant covariate data known to influence retinal thickness.
CONCLUSIONS
Individuals with SSD generally exhibited retinal atrophy, possibly paralleling reduced brain volumes documented in clinical imaging. Prospective longitudinal studies that collect clinical data, including various illness phases, and control for confounders will be necessary to evaluate retinal atrophy as a biomarker in SSD.
PubMed: 38021252
DOI: 10.1016/j.bpsgos.2023.08.013 -
The International Journal of Behavioral... Nov 2023Eating frequency may affect body weight and cardiometabolic health. Intervention trials and observational studies have both indicated that high- and low-frequency eating... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Eating frequency may affect body weight and cardiometabolic health. Intervention trials and observational studies have both indicated that high- and low-frequency eating can be associated with better health outcomes. There are currently no guidelines to inform how to advise healthy adults about how frequently to consume food or beverages.
AIM
To establish whether restricted- (≤ three meals per day) frequency had a superior effect on markers of cardiometabolic health (primary outcome: weight change) compared to unrestricted-eating (≥ four meals per day) frequency in adults.
METHODS
We searched Medline (Ovid), Embase, CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), CAB Direct and Web of Science Core Collection electronic databases from inception to 7 June 2022 for clinical trials (randomised parallel or cross-over trials) reporting on the effect of high or low-frequency eating on cardiometabolic health (primary outcome: weight change). Trial interventions had to last for at least two weeks, and had to have been conducted in human adults. Bias was assessed using the Cochrane Risk of Bias tool 2.0. Standardized mean differences (SMD) and 95% confidence intervals were calculated for all outcomes. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS
Seventeen reports covering 16 trials were included in the systematic review. Data from five trials were excluded from meta-analysis due to insufficient reporting. 15 of 16 trials were at high risk of bias. There was very low certainty evidence of no difference between high- and low-frequency eating for weight-change (MD: -0.62 kg, CI: -2.76 to 1.52 kg, p = 0.57).
CONCLUSIONS
There was no discernible advantage to eating in a high- or low-frequency dietary pattern for cardiometabolic health. We cannot advocate for either restricted- or unrestricted eating frequency to change markers of cardiometabolic health in healthy young to middle-aged adults.
PROTOCOL REGISTRATION
CRD42019137938.
Topics: Middle Aged; Adult; Humans; Randomized Controlled Trials as Topic; Diet; Body Weight; Cardiovascular Diseases; Body Composition
PubMed: 37964316
DOI: 10.1186/s12966-023-01532-z