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International Urogynecology Journal Apr 2021Numerous analytic observational studies assess family history as a risk factor for POP and report a wide range of associations. This review aims to systematically... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION AND HYPOTHESIS
Numerous analytic observational studies assess family history as a risk factor for POP and report a wide range of associations. This review aims to systematically evaluate the role of family history of POP in relation to POP risk and its recurrence.
METHODS
A review was performed of the PubMed/MEDLINE database with search criteria specifying family history, risk factors, POP, and their synonyms as title/abstract keywords, as well as MESH terms, up to March 2020. We aggregated evidence across studies with fixed effects (FE) and random effects (RE) meta-analysis.
RESULTS
Forty-three articles underwent full-text review. Eighteen independent studies evaluating the relationship between family history of POP and POP risk in 3639 POP cases and 10,912 controls were eligible for meta-analysis. Four studies evaluating family history and POP recurrence in 224 recurrent cases and 400 non-recurrent cases were eligible for inclusion into another meta-analyses. A positive family history of POP is on average associated with 2.3- to 2.7-fold increased risk for POP (RE OR = 2.64; 95% CI = 2.07, 3.35) as well as a 1.4-fold increased risk for POP recurrence (FE OR = 1.44; 95% CI = 1.00, 2.08). Meta-analysis estimates of POP risk varied by study design, definition of family history, and model adjustment status. We found evidence that publication bias and recall bias are a possibility.
CONCLUSIONS
Family history of POP is a risk factor for both POP presence and recurrence. However, reported magnitudes may be overestimates due to confounding, recall bias, and publication bias.
Topics: Humans; Medical History Taking; Pelvic Organ Prolapse; Recurrence; Risk Factors
PubMed: 33084962
DOI: 10.1007/s00192-020-04559-z -
Open Access Journal of Contraception 2018Evidence on the association between contraceptive use and risk of sexually transmitted infections (STIs) and bacterial vaginosis (BV) is lacking, with few prospective... (Review)
Review
PURPOSE
Evidence on the association between contraceptive use and risk of sexually transmitted infections (STIs) and bacterial vaginosis (BV) is lacking, with few prospective studies. We systematically reviewed the last 10 years' evidence on the association between contraception and STI/BV, building on the most recent systematic reviews published in 2006 and 2009.
METHODS
We searched the MEDLINE and POPLINE databases for peer-reviewed articles p ublished between January 1, 2008 and January 31, 2018 reporting prospective studies that assessed the association between contraceptive use and incident STI and/or incident or recurrent BV.
RESULTS
We identified 33 articles that evaluated combined oral contraceptives (COC), depot medroxyprogesterone acetate (DMPA), the copper intrauterine device (Cu-IUD), the levonorgestrel intrauterine system (LNG-IUS) and other methods. The strength of the evidence for many specific contraceptive method/STI associations is limited by few prospective studies with comparably defined exposures and outcomes. Available data suggest no association of COCs and , , HSV-2 or syphilis, and mixed evidence on the association with HPV, , and BV. For DMPA, none of the studies identified found an association with or syphilis, and data on HPV and BV were mixed. Two large studies showed a highly clinically significant increased risk of HSV-2 infection with DMPA use. Data on the effect of Cu-IUD and the LNG-IUS on the acquisition of , and s are sparse, and data on HPV and BV are mixed.
CONCLUSION
Few data are available from prospective studies, including randomized trials, to draw strong conclusions about the relationships between contraceptive methods and specific STIs. The overall evidence on the association between contraceptive use and STI/BV risk is limited by the lack of any randomized trials, few published prospective studies designed to analyze these associations, wide variability in exposure definitions and comparator groups, potential for confounding due to inaccurate sexual behavior data, differential confounder adjustment and differences in study populations and sizes. Despite these limitations, new evidence is supportive of a significantly increased risk of HSV-2 infection among DMPA users which warrants additional research to better understand this association.
PubMed: 30519127
DOI: 10.2147/OAJC.S135439 -
Sleep Medicine Feb 2018A systematic review and meta-analysis of the association between alcohol consumption and risk of sleep apnoea in adults. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
A systematic review and meta-analysis of the association between alcohol consumption and risk of sleep apnoea in adults.
METHODS
We searched Medline, EMBASE and Web of Science databases from 1985 to 2015 for comparative epidemiological studies assessing the relation between alcohol consumption and sleep apnoea. Two authors independently screened and extracted data. Random effects meta-analysis was used to estimate pooled effect sizes with 95% confidence intervals (CI). Heterogeneity was quantified using I and explored using subgroup analyses based on study exposure and outcome measures, quality, design, adjustment for confounders and geographical location. Publication bias was assessed using a funnel plot and Egger's test.
RESULTS
We identified 21 studies from which estimates of relative risk could be obtained. Meta-analysis of these estimates demonstrated that higher levels of alcohol consumption increased the risk of sleep apnoea by 25% (RR 1.25, 95%CI 1.13-1.38, I = 82%, p < 0.0001). This estimate's differences were robust in alcohol consumption and sleep apnoea definitions, study design, and quality but was greater in Low and Middle Income Country locations. We detected evidence of publication bias (p = 0.001). A further eight included studies reported average alcohol consumption in people with and without sleep apnoea. Meta-analysis revealed that mean alcohol intake was two units/week higher in those with sleep apnoea, but this difference was not statistically significant (p = 0.41).
CONCLUSION
These findings suggest that alcohol consumption is associated with a higher risk of sleep apnoea, further supporting evidence that reducing alcohol intake is of potential therapeutic and preventive value in this condition.
Topics: Alcohol Drinking; Humans; Risk; Sleep Apnea Syndromes
PubMed: 29458744
DOI: 10.1016/j.sleep.2017.12.005 -
PLoS Medicine Oct 2008Markers of kidney dysfunction such as proteinuria or albuminuria have been reported to be associated with coronary heart disease, but the consistency and strength of any... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Markers of kidney dysfunction such as proteinuria or albuminuria have been reported to be associated with coronary heart disease, but the consistency and strength of any such relationship has not been clearly defined. This lack of clarity has led to great uncertainty as to how proteinuria should be treated in the assessment and management of cardiovascular risk. We therefore undertook a systematic review of published cohort studies aiming to provide a reliable estimate of the strength of association between proteinuria and coronary heart disease.
METHODS AND FINDINGS
A meta-analysis of cohort studies was conducted to obtain a summary estimate of the association between measures of proteinuria and coronary risk. MEDLINE and EMBASE were searched for studies reporting an age- or multivariate-adjusted estimate and standard error of the association between proteinuria and coronary heart disease. Studies were excluded if the majority of the study population had known glomerular disease or were the recipients of renal transplants. Two independent researchers extracted the estimates of association between proteinuria (total urinary protein >300 mg/d), microalbuminuria (urinary albumin 30-300 mg/d), macroalbuminuria (urinary albumin >300 mg/d), and risk of coronary disease from individual studies. These estimates were combined using a random-effects model. Sensitivity analyses were conducted to examine possible sources of heterogeneity in effect size. A total of 26 cohort studies were identified involving 169,949 individuals and 7,117 coronary events (27% fatal). The presence of proteinuria was associated with an approximate 50% increase in coronary risk (risk ratio 1.47, 95% confidence interval [CI] 1.23-1.74) after adjustment for known risk factors. For albuminuria, there was evidence of a dose-response relationship: individuals with microalbuminuria were at 50% greater risk of coronary heart disease (risk ratio 1.47, 95% CI 1.30-1.66) than those without; in those with macroalbuminuria the risk was more than doubled (risk ratio 2.17, 1.87-2.52). Sensitivity analysis indicated no important differences in prespecified subgroups.
CONCLUSION
These data confirm a strong and continuous association between proteinuria and subsequent risk of coronary heart disease, and suggest that proteinuria should be incorporated into the assessment of an individual's cardiovascular risk.
Topics: Cardiovascular Diseases; Humans; Proteinuria; Risk Factors
PubMed: 18942886
DOI: 10.1371/journal.pmed.0050207 -
International Journal of Cardiology Sep 2013Heart failure risk factors are diverse and likely to vary among world regions. Systematic review and pooled analysis were used to describe contributions of major... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Heart failure risk factors are diverse and likely to vary among world regions. Systematic review and pooled analysis were used to describe contributions of major underlying risk factors for heart failure in six world regions.
METHODS
Electronic databases were systematically searched, and 37 clinic-based studies representing 40 countries published in 1980-2008 and reporting underlying risk factors for heart failure were included. Risk factors were classified as ischemic heart disease (IHD), hypertension, rheumatic/other valvular heart disease, cardiopulmonary disease, cardiomyopathy, and "other". Crude and age- and sex-adjusted risk factor prevalences were estimated for each region using a regression analysis, under specifications of overlapping as well as additive contributions.
RESULTS
Many heart failure cases were assigned multiple underlying risk factors, leading to a considerable overlap. Crude IHD prevalence among heart failure patients was >50% in Europe and North America, approximately 30-40% in East Asia and Latin America and the Caribbean, and <10% in Sub-Saharan Africa. Age and sex adjustment attenuated regional differences in IHD-as-risk factor but IHD remained rare in Sub-Saharan Africa. Hypertension prevalence was high in heart failure patients of all regions but the highest in Eastern and Central Europe and Sub-Saharan Africa (age- and sex-adjusted, 35.0% and 32.6%, respectively). Cardiomyopathy was most common in Latin America, the Caribbean and Sub-Saharan Africa (age- and sex-adjusted, 19.8% and 25.7%).
CONCLUSIONS
Heart failure risk factors vary substantially among world regions. More detailed regional heart failure epidemiology studies are needed in order to quantify the global burden of heart failure and identify regional prevention and treatment strategies.
Topics: Databases, Factual; Global Health; Heart Failure; Humans; Risk Factors
PubMed: 23201083
DOI: 10.1016/j.ijcard.2012.11.065 -
Nutrients Sep 2015To provide a quantitative assessment of the association between excess body weight, interpreted as increased body mass index (BMI), and the risk of gallbladder cancer... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To provide a quantitative assessment of the association between excess body weight, interpreted as increased body mass index (BMI), and the risk of gallbladder cancer (GBC).
METHODS
We identified eligible studies in Medline and EMBASE up to 1 February 2015, and reference lists of retrieved articles. Summary relative risks with their 95% confidence intervals were calculated in a random-effects model. Subgroup analyses were performed according to study design, gender, geographic location, ascertainment of exposure and adjustment for confounders.
RESUITS
A total of 12 cohort studies and 8 case-control studies were included in the meta-analysis. Overall, compared with "normal" weight, the summary relative risks of GBC were 1.14 (95% CI, 1.04-1.25) for overweight individuals (BMI 25-30 kg/m²) and 1.56 (95% CI, 1.41-1.73) for obese individuals (BMI > 30 kg/m²). Obese women had a higher risk of GBC than men did (women: SRRs 1.67, 95% CI 1.38-2.02; men: SRRs 1.42, 95% CI 1.21-1.66), and there was significant association between overweight and GBC risk in women (SRRs 1.26, 95% CI 1.13-1.40), but not in men (SRRs 1.06, 95% CI 0.94-1.20).
CONCLUSIONS
Findings from this meta-analysis indicate that obesity is associated with an increased risk of GBC, especially in women. Overweight is associated with GBC risk only in women.
Topics: Body Mass Index; Case-Control Studies; Cohort Studies; Female; Gallbladder Neoplasms; Gallstones; Genetic Predisposition to Disease; Humans; MEDLINE; Male; Obesity; Overweight; Risk; Risk Factors; Sex Factors
PubMed: 26426043
DOI: 10.3390/nu7105387 -
The International Journal of... Jul 2015Qat (also known as Khat, Kat and Miraa) is a green-leaved plant (Catha edulis). It is a shrub indigenous to Yemen and certain parts of eastern Africa. Chewing the... (Review)
Review
BACKGROUND
Qat (also known as Khat, Kat and Miraa) is a green-leaved plant (Catha edulis). It is a shrub indigenous to Yemen and certain parts of eastern Africa. Chewing the leaves, which have sympathomimetic and euphoric effects, has been documented in many countries and increased with worldwide migration. The effect of long-term chewing Qat on the oral cavity is unknown.
OBJECTIVE
A systematic review was performed to identify any associations between Qat chewing and the occurrence of potentially malignant and malignant oral disorders.
METHODS
Medline and the Web of Science were searched for articles published before May 2014 without limits with regard to publication date and language.
RESULTS
From a total of 890 papers identified, 17 English papers reported potentially malignant or malignant oral disorders and Qat chewing. One additional paper in Arabic language was identified from reviewing the list of references of eligible papers. It was found that exposure to Qat may be associated with potentially malignant and malignant oral disorders, but methodological issues, such as inadequate study design, sample size, selection of study subjects, clinical evaluations of outcome and limited adjustment for confounders, limit the strength of the evidence base in this area.
CONCLUSION
The association between Qat chewing and potentially malignant and malignant oral disorders remains debatable and requires further investigations.
Topics: Blood Pressure; Cardiovascular System; Catha; Female; Gastrointestinal Tract; Heart Rate; Humans; Male; Mastication; Mouth Neoplasms; Plant Leaves; Research Design; Yemen
PubMed: 26174990
DOI: 10.15171/ijoem.2015.537 -
International Journal of Environmental... Jan 2022Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their... (Review)
Review
Hereditary cancer syndromes are inherited pathogenic genetic variants that significantly increase the risk of developing cancer. When individuals become aware of their increased probability of having cancer, the whole family is affected by this new reality and needs to adjust. However, adjustment to hereditary cancer syndromes has been mainly studied at an individual level, and research about familial adjustment remains dispersed and disorganized. To overcome this gap, this review aims to understand how families adjust to genetic testing and risk management, and to what extent the family's adjustment influences the psychological response and risk management behaviors of mutation carriers. We conducted searches on the PubMed/Med Line, PsycInfo, SCOPUS, and Google Scholar databases and used the Mixed Methods Appraisal Tool (MMAT-v2018) to assess the methodological quality of each selected study. Thirty studies met the inclusion criteria. Most results highlighted the interdependent nature of adjustment of pathogenic variant carriers and their families. The way carriers adjust to the syndrome is highly dependent on family functioning and related to how family members react to the new genetic information, particularly partners and siblings. Couples who share their worries and communicate openly about cancer risk present a better long-term adjustment than couples who use protective buffering (not talking about it to avoid disturbing the partner) or emotional distancing. Parents need help dealing with disclosing genetic information to their children. These findings reinforce the importance of adopting a family-centered approach in the context of genetic counseling and the necessity of involving family members in research.
Topics: Child; Family; Genetic Counseling; Genetic Testing; Humans; Neoplastic Syndromes, Hereditary; Risk
PubMed: 35162625
DOI: 10.3390/ijerph19031603 -
Oncotarget Mar 2016In vivo and in vitro studies have indicated the link of cholesterol consumption and endometrial cancer risk, however, previous observational studies have yielded... (Meta-Analysis)
Meta-Analysis Review
In vivo and in vitro studies have indicated the link of cholesterol consumption and endometrial cancer risk, however, previous observational studies have yielded inconsistent results. Additionally, a previous meta-analysis published in 2007 found limited evidence of aforementioned association. Therefore, we performed the dose-response meta-analysis to address this concern. Studies were identified using the PubMed, EMBASE and Web of Science databases from the database inception to the end of June 2015 as well as by examining the references of retrieved articles. Two authors independently performed the eligibility evaluation and data extraction. The summary risk estimates and 95% confidence intervals (CIs) were summarized by the random-effects models. One cohort and nine case-control studies were included in the dose-response analyses. Risk of endometrial cancer increased by 6% for 100 mg/day increment in the dietary consumption of cholesterol (Odds ratio (OR) = 1.06; 95% CI = 1.00-1.12), with significant heterogeneity (I2 = 64.2, P = 0.003). When stratified by study design, the result was significant in case-control studies (OR = 1.07; 95% CI = 1.01-1.13). Additionally, although the direction of the associations were consistent in the subgroup analyses stratified by study characteristics and adjustment for potential confounders, not all of them showed statistical significance. In summary, findings of the present dose-response meta-analysis partly support the positive association between dietary cholesterol consumption and risk of endometrial cancer. Since only one cohort study was included, more prospective studies and pooled analysis of observational studies are warranted to confirm our findings in the future.
Topics: Cholesterol, Dietary; Endometrial Neoplasms; Female; Humans; Observational Studies as Topic
PubMed: 26959738
DOI: 10.18632/oncotarget.7913 -
Schizophrenia Bulletin Oct 2017Ample evidence supports a neurodevelopmental origin in some cases of schizophrenia (SZ). More inconsistent information is available for bipolar disorder (BD). We herein... (Comparative Study)
Comparative Study Review
Ample evidence supports a neurodevelopmental origin in some cases of schizophrenia (SZ). More inconsistent information is available for bipolar disorder (BD). We herein review studies with a focus on premorbid (adjustment and functionality) and early developmental milestones that include both SZ and BD patients. A search was performed in the PubMed electronic database, retrieving 619 abstracts; 30 were ultimately included in this systematic review. Eight prospective cohorts, 15 retrospective studies, and 7 studies based on national registries. Psychomotor developmental deviations and general adjustment problems characterize the childhood of subjects later diagnosed with SZ or BD; they are more marked in those later diagnosed with SZ vs BD, earlier onset vs later onset, and psychotic vs nonpsychotic disorders. Cognitive impairment follows a linear risk trend for SZ and a U-shaped trend for BD. Social isolation and visuoperceptual/reading anomalies more frequently antecede SZ. Pervasive developmental disorders increase the risk for both SZ and BD, more so in cases with normal intelligence. The predictive risk of each isolated developmental marker is low, but a significant percentage of subjects with SZ and a minority of adults with BD showed signs of premorbid abnormalities in childhood. The great limitation is still the lack of studies comparing SZ and BD that include psychotic and nonpsychotic bipolar cases separately. There are many cases, even in childhood/adolescent SZ, where no premorbid anomalies are found, and immunological disorders or other etiologies should be searched for. At least in cases with clear neurodevelopmental markers, rare genetic variants should be investigated.
Topics: Bipolar Disorder; Cognitive Dysfunction; Human Development; Humans; Psychotic Disorders; Schizophrenia
PubMed: 29045744
DOI: 10.1093/schbul/sbx126