scholarly journals Association of Metformin Use with Asthma Exacerbation in Patients with Concurrent Asthma and Diabetes: A Systematic Review and Meta-Analysis of Observational Studies

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Li Wen ◽  
Wang Zhong ◽  
Yihui Chai ◽  
Qin Zhong ◽  
Jie Gao ◽  
...  
Keyword(s):  
Emergency Room ◽  
Asthma Exacerbation ◽  
Observational Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Emergency Department Visits ◽  
Emergency Room Visits ◽  
Fixed Effects Model ◽  
Adjusted Risk ◽  
Wide Range

Background. Asthma and diabetes are both diseases that affect a wide range of people worldwide. As a common treatment for diabetes, metformin has also been reported to be effective in improving asthma outcomes. We conducted a combined analysis to examine the efficacy of metformin in reducing asthma exacerbation in patients with concurrent asthma and diabetes. Methods. We searched the PubMed, Embase, and CENTRAL databases for articles published prior to April 2020 to find observational studies of individuals with concurrent asthma and diabetes that compared the risk of asthma exacerbation between metformin users and nonusers. Two researchers separately screened the studies, extracted data, and evaluated the risk of bias. The primary outcome was the adjusted risk of asthma exacerbation. The secondary outcomes were the adjusted risk of asthma-related hospitalization and emergency room visits. Review Manager was used for data analysis and plotting. I2 and χ2 tests were used to estimate heterogeneity. A random effects or fixed effects model was used depending on the heterogeneity. Odds ratios were calculated for dichotomous variables. Results. We included two studies with a total of 25252 patients. The pooled effect size showed that metformin was inversely associated with a risk of asthma exacerbation (OR = 0.65, 95% CI 0.28–1.48; χ2 = 5.42, P=0.02; I2 = 82%), asthma-related emergency department visits (OR = 0.81, 95% CI 0.74–0.89; χ2 = 0.36, P=0.55; I2 = 0%), and hospitalizations (OR = 0.43, 95% CI 0.14–1.29; χ2 = 4.01, P=0.05; I2 = 75%). Conclusion. This meta-analysis suggested that metformin decreased the risk of asthma-related emergency room visits for patients with concurrent asthma and diabetes. Metformin reduced the risk of asthma-related hospitalization and exacerbation but was not statistically significant. More randomized trials involving larger samples should be considered, and the mechanisms of these effects need to be fully elucidated.

scholarly journals Statin use and clinical outcomes in patients with COVID-19: An updated systematic review and meta-analysis

2021 ◽  
pp. postgradmedj-2020-139172
Author(s):  
Rimesh Pal ◽  
Mainak Banerjee ◽  
Urmila Yadav ◽  
Sukrita Bhattacharjee
Keyword(s):  
Clinical Outcomes ◽  
Observational Studies ◽  
Fixed Effects ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Fixed Effects Model ◽  
Adjusted Risk ◽  
Risk Estimates ◽  
Statin Use

PurposeObservations studies have shown that prior use of statins is associated with a reduced risk of adverse clinical outcomes in patients with COVID-19. However, the available data are limited, inconsistent and conflicting. Besides, no randomised controlled trial exists in this regard. Hence, the present meta-analysis was conducted to provide an updated summary and collate the effect of statin use on clinical outcomes in COVID-19 using unadjusted and adjusted risk estimates.MethodsPubMed, Scopus and Web of Science databases were systematically searched using appropriate keywords till December 18 2020, to identify observational studies reporting clinical outcomes in COVID-19 patients using statins versus those not using statins. Prior and in-hospital use of statins were considered. Study quality was assessed using the Newcastle-Ottawa Scale. Unadjusted and adjusted pooled odds ratio (OR) with 95% CIs were calculated.ResultsWe included 14 observational studies pooling data retrieved from 19 988 patients with COVID-19. All the studies were of high/moderate quality. Pooled analysis of unadjusted data showed that statin use was not associated with improved clinical outcomes (OR 1.02; 95% CI 0.69 to 1.50, p=0.94, I2=94%, random-effects model). However, on pooling adjusted risk estimates, the use of statin was found to significantly reduce the risk of adverse outcomes (OR 0.51; 95% CI 0.41 to 0.63, p<0.0005, I2=0%, fixed-effects model).ConclusionsStatin use is associated with improved clinical outcomes in patients with COVID-19. Individuals with multiple comorbidities on statin therapy should be encouraged to continue the drug amid the ongoing pandemic.

Use of Statins and Breast Cancer: A Meta-Analysis of Seven Randomized Clinical Trials and Nine Observational Studies

2005 ◽  
Vol 23 (34) ◽  
pp. 8606-8612 ◽  
Author(s):  
Stefanos Bonovas ◽  
Kalitsa Filioussi ◽  
Nikolaos Tsavaris ◽  
Nikolaos M. Sitaras
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Publication Bias ◽  
Observational Studies ◽  
Fixed Effects ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Fixed Effects Model

Purpose A growing body of evidence suggests that statins may have chemopreventive potential against breast cancer. Laboratory studies demonstrate that statins induce apoptosis and reduce cell invasiveness in various cell lines, including breast carcinoma cells. However, the clinical relevance of these data remains unclear. The nonconclusive nature of the epidemiologic data prompted us to conduct a detailed meta-analysis of the studies published on the subject in peer-reviewed literature. Patients and Methods A comprehensive search for articles published up until 2005 was performed; reviews of each study were conducted; and data were abstracted. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% CIs were calculated using the random and the fixed-effects models. Subgroup and sensitivity analyses were also performed. Results Seven large randomized trials and nine observational studies (five case-control and four cohort studies) contributed to the analysis. We found no evidence of publication bias or heterogeneity among the studies. Statin use did not significantly affect breast cancer risk (fixed effects model: RR = 1.03; 95% CI, 0.93 to 1.14; random effects model: RR = 1.02; 95% CI, 0.89 to 1.18). When the analyses were stratified into subgroups, there was no evidence that study design substantially influenced the estimate of effects. Furthermore, the sensitivity analysis confirmed the stability of our results. Conclusion Our meta-analysis findings do not support a protective effect of statins against breast cancer. However, this conclusion is limited by the relatively short follow-up times of the studies analyzed. Further studies are required to investigate the potential decrease in breast cancer risk among long-term statin users.

Prognosis of Adenosquamous Carcinoma Compared With Adenocarcinoma in Uterine Cervical Cancer: A Systematic Review and Meta-Analysis of Observational Studies

2014 ◽  
Vol 24 (2) ◽  
pp. 289-294 ◽  
Author(s):  
Jung-Yun Lee ◽  
Chulmin Lee ◽  
SeoKyung Hahn ◽  
Min A. Kim ◽  
Hee Seung Kim ◽  
...  
Keyword(s):  
Observational Studies ◽  
Fixed Effects ◽  
Adenosquamous Carcinoma ◽  
Meta Analysis ◽  
Uterine Cervical Cancer ◽  
Recurrence Free Survival ◽  
Fixed Effects Model ◽  
Free Survival ◽  
Clinical Stages ◽  
Histologic Subtypes

ObjectiveThe aim of this study was to compare the survival outcomes of adenosquamous carcinoma (ASC) and adenocarcinoma (AC) of the cervix.MethodsWe searched PubMed and Embase for observational studies that compared the outcomes of 2 histologic subtypes. Hazards ratios (HRs) with 95% confidence intervals (CIs) were calculated with a fixed effects model.ResultsA total of 17 studies were included in the analyses. Patients with ASC were associated significantly with poorer overall survival (death HR, 1.27; 95% CI, 1.12–1.43; I2= 0%) and recurrence-free survival (recurrence HR, 1.43; 95% CI, 1.05–1.95; I2= 19.4%) than those with AC. For clinical stages I and II in particular, ASC predicted significantly poorer outcomes compared with AC (death HR, 1.41; 95% CI, 1.17–1.70; I2= 0%).ConclusionsThis meta-analysis suggests that ASC may have poorer outcomes compared with AC of the cervix.

scholarly journals Clinical symptoms, comorbidities and complications features in severe and non-severe patients with COVID-19: a systematic review and meta-analysis without cases duplication

2020 ◽  
Author(s):  
Zhufeng Wang ◽  
Hongsheng Deng ◽  
Changxing Ou ◽  
Jingyi Liang ◽  
Yingzhi Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Observational Studies ◽  
Fixed Effects ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Mortality Rates ◽  
Fixed Effects Model ◽  
Review Of The Literature ◽  
Q Statistic

Abstract Background: The pandemic of COVID-19 posed a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 31.8%, and it is particularly important to identify risk factors that aggravate the disease.Methods: We performed a systematic review of the literature with meta-analysis, using 7 databases to assess clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% CI. Measure of heterogeneity was estimated by Cochran’s Q statistic, I2 index and P value.Results: 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension (severe: 33.4%, 95% CI: 25.4% - 41.4%; non-severe 21.6%, 95% CI: 9.9% - 33.3%), followed by diabetes (severe: 14.4%, 95% CI: 11.5% - 17.3%; non-severe: 8.5%, 95% CI: 6.1% - 11.0%). The prevalence of ARDS, AKI and shock were all higher in severe cases, with 41.1% (95% CI: 14.1% - 68.2%), 16.4% (95% CI: 3.4% - 29.5%) and 19.9% (95% CI: 5.5% - 34.4%), rather than 3.0% (95% CI: 0.6% - 5.5%), 2.2% (95% CI: 0.1% - 4.2%) and 4.1% (95% CI -4.8% - 13.1%) in non-severe patients, respectively. The death rate was higher in severe cases (30.3%, 95% CI: 13.8% - 46.8%) than non-severe cases (1.5%, 95% CI: 0.1% - 2.8%).Conclusions: Hypertension, diabetes and cardiovascular diseases may be risk factors for COVID-19 patients to develop into severe cases.

scholarly journals Cinacalcet Treatment Significantly Improves All-Cause and Cardiovascular Survival in Dialysis Patients: Results from a Meta-Analysis

2019 ◽  
Vol 44 (6) ◽  
pp. 1327-1338 ◽  
Author(s):  
Yuan Zu ◽  
Xiangxue Lu ◽  
Jinghong Song ◽  
Ling Yu ◽  
Han Li ◽  
...  
Keyword(s):  
Cardiovascular Mortality ◽  
Observational Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Fixed Effects Model ◽  
Long Term Effects ◽  
Dialysis Patients ◽  
All Cause Mortality

Objective: To assess the long-term effects including all-cause mortality, cardiovascular mortality, and fracture incidence, of cinacalcet on secondary hyperparathyroidism (SHPT) in patients on dialysis. Methods: PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from their inception to October 2018. Randomized controlled trials (RCTs) and cohort design prospective observational studies assessing cinacalcet for the treatment of SHPT in dialysis patients were included. Data extraction was independently completed by 2 authors who determined the methodological quality of the studies and extracted data in duplicate. Study-specific risk estimates were tested by using a fixed effects model. Results: A total of 14 articles with 38,219 participants were included, of which 10 RCTs with 7,471 participants and 4 prospective observational studies with 30,748 participants fulfilled the eligibility criteria. Compared with no cinacalcet, cinacalcet administration reduced all-cause mortality (relative risk [RR] 0.91, 95% CI 0.89–0.94, p < 0.001) and cardiovascular mortality (RR 0.92, 95% CI 0.89–0.95, p < 0.001), but it did not significantly reduce the incidence of fractures (RR 0.93, 95% CI 0.87–1.00, p = 0.05). Conclusions: The results of this meta-analysis indicated that the treatment of SHPT with cinacalcet may in fact reduce all-cause mortality and cardiovascular mortality among patients receiving maintenance dialysis.

The Safety of Ovarian Preservation in Early-Stage Adenocarcinoma Compared With Squamous Cell Carcinoma of Uterine Cervix: A Systematic Review and Meta-Analysis of Observational Studies

2016 ◽  
Vol 26 (8) ◽  
pp. 1510-1514 ◽  
Author(s):  
Xiao-Bing Jiao ◽  
Jun Hu ◽  
Li-Rong Zhu
Keyword(s):  
Systematic Review ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Observational Studies ◽  
Fixed Effects ◽  
Early Stage ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Ovarian Preservation

ObjectiveThe aim of this study was to compare the incidence of ovarian metastasis (OM) in adenocarcinoma (ADC) and squamous cell carcinoma (SCC) in early-stage cervical cancer and evaluate the safety of ovarian preservation in early-stage ADC.MethodsTo perform a meta-analysis to compare the incidence of OM between early-stage ADC and SCC, we searched PubMed, EMBASE, and Cochrane for observational studies that compared it with pathological evidence after radical hysterectomy and oophorectomy. Odds ratios with 95% confidence intervals were calculated with a fixed effects model. We also found a few articles evaluating the oncological prognosis of patients with ovarian preservation to perform a systematic review.ResultsA total of 5 studies were included in the meta-analyses. The incidence of OM of patients with early-stage ADC and SCC were 2% and 0.4%, respectively (odds ratio, 5.27; 95% confidence interval, 2.14–13.45). In 1427 patients with ADC or SCC of the cervix FIGO stage (CIS-IIA) who underwent hysterectomy, no ovarian recurrences were observed after unilateral or bilateral ovarian preservation in ADC patients in the follow-up (30–68 months); however, 15 patients with SCC developed pelvic recurrence.ConclusionsAlthough the incidence of OM was higher in early-stage ADC than SCC according to ovarian pathology, it might be relatively safe to perform ovarian preservation with early-stage ADC because of low ovarian recurrence rate in short-term follow-ups.

CONSTIPATION PRECEDING PARKINSON'S DISEASE–META-ANALYSIS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.193-e4 ◽  
Author(s):  
Kerala Adams-Carr ◽  
Anette Schrag ◽  
Samuel Shribman ◽  
Jonathan Bestwick ◽  
Andrew Lees ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Studies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Original Data ◽  
Fixed Effects Model ◽  
Clinical Criteria ◽  
History Of ◽  
Reported Data

Constipation is a well-recognised non-motor feature of Parkinson's disease (PD) and has been reported to predate PD in a number of observational studies, in some cases by over two decades. A systematic review and meta-analysis was carried out following MOOSE criteria. The literature search was undertaken on 7 December 2014 using PubMed and the relevant search terms ‘Parkinson's disease’ and ‘Constipation’. Articles were screened for suitability and included if they met the specific criteria: observational studies with a cohort or case–control design; cases were patients with PD according to standard clinical criteria; controls were healthy or had no history of neurological disease; cohorts were representative of the general population; constipation in controls was assessed over the same time period as for patients; original data were reported. Data were extracted and combined using a fixed-effects model. Nine studies were included in the meta-analysis. Constipation was associated with an OR of 2.28 (95% confidence interval 2.10-2.46; p<0.001) for subsequent PD, offering further evidence that people with constipation are at a higher risk of developing PD and constipation may predate PD diagnosis by many years. This could have implications for our understanding of the pathogenesis of disease and planning of neuroprotective interventional trials.

scholarly journals Aspirin and Reducing Risk of Gastric Cancer: Systematic Review and Meta-Analysis of the Observational Studies

2020 ◽  
Vol 29 (2) ◽  
pp. 191-198 ◽  
Author(s):  
Thin Thin Win ◽  
Saint Nway Aye ◽  
Joyce Lau Chui Fern ◽  
Cheng Ong Fei
Keyword(s):  
Gastric Cancer ◽  
Systematic Review ◽  
Observational Studies ◽  
Fixed Effects ◽  
Low Dose ◽  
Meta Analysis ◽  
High Dose ◽  
Fixed Effects Model ◽  
Dose Aspirin

Background and Aims: The latest meta-analysis on the role of aspirin on various cancers was published in early 2018. By including the latest and updated primary observational studies, we aimed to conduct this systematic review and meta-analysis to synthesize stronger evidence on the role of aspirin in reducing gastric cancer (GC) risk. Methods: The PubMed, Scopus, and MEDLINE databases were systematically searched up to December 2019 to identify relevant studies. Random-effects model was used to calculate summary ORs and 95%CI for I 2 >50%. If the heterogeneity is not significant, the fixed-effects model was used. Overall analysis of the studies, inverse variance weighting after transforming the estimates of each study into log OR and its standard error were used. Results: 21 studies were included in this meta-analysis. Results showed that aspirin significantly reduced the GC risk (OR=0.64, 95%CI=0.54-0.76) with substantial heterogeneity (I 2 =96%). Effect of GC risk reduction in low dose (OR=0.80, 95%CI=0.59-1.09) is slightly greater than high dose aspirin (OR=1.08, 95%CI=0.77-1.52). Protective effect of aspirin uses >5 years (OR=0.67, 95%CI=0.34-1.31) was greater than <5 years (OR=1.01, 95%CI=0.72-1.43) Conclusion: In conclusion, this meta-analysis showed that low dose aspirin with longer duration of more than 5 years were associated with a statistically significant reduction in GC risk. However, due to possible confounding variables and bias, these results should be cautiously treated.

Prognostic Factors for Recurrence After Fertility-Preserving Surgery in Patients With Borderline Ovarian Tumors: A Systematic Review and Meta-analysis of Observational Studies

2017 ◽  
Vol 27 (9) ◽  
pp. 1833-1841 ◽  
Author(s):  
Xiaobing Jiao ◽  
Jun Hu ◽  
Lirong Zhu
Keyword(s):  
Prognostic Factors ◽  
Observational Studies ◽  
Fixed Effects ◽  
Negative Impact ◽  
Meta Analysis ◽  
Ovarian Tumors ◽  
Fixed Effects Model ◽  
Recurrence Rates ◽  
Borderline Ovarian Tumors

ObjectiveThe aim of this study was to find the unfavorable prognostic factors for recurrence after fertility-preserving surgery (FPS) in patients with borderline ovarian tumors (BOTs).MethodsTo perform a meta-analysis to compare the recurrence rates of BOT patients after FPS according to different prognostic factors, we searched PubMed, EMBASE, and Cochrane for observational studies. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated with a fixed-effects model.ResultsWe analyzed 32 studies that included 2691 BOT patients who underwent FPS, 383 patients of whom had a relapse in the follow-up. In meta-analysis, risks associated with recurrence in patients with unilateral cystectomy (OR, 2.49; 95% CI, 1.86–3.33) or serous borderline ovarian tumors (OR, 3.15; 95% CI, 1.97–5.02) were significantly increased, and there was no significantly increased OR for patients with laparoscopy compared with those with laparotomy (OR, 0.96; 95% CI, 0.57–1.60).ConclusionsUnilateral cystectomy (19.4%) and serous BOTs (19.2%) are significantly associated with higher recurrence rates, and no negative impact of laparoscopy on recurrence can be demonstrated when compared with laparotomy in the meta-analysis.

scholarly journals Preoperative Serum Prealbumin Level and Adverse Prognosis in Patients With Hepatocellular Carcinoma After Hepatectomy: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Yu Fan ◽  
Yimeng Sun ◽  
Changfeng Man ◽  
Yakun Lang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Fixed Effects Model ◽  
Poor Overall Survival ◽  
Free Survival ◽  
Adjusted Risk ◽  
Preoperative Serum ◽  
Low Serum

BackgroundPrealbumin is a sensitive indicator of liver function and nutritional status.ObjectivesThis meta-analysis aimed to examine the association of the serum prealbumin level with the prognosis of patients with hepatocellular carcinoma (HCC) undergoing hepatectomy.MethodsWe comprehensively searched the PubMed, Embase, Wanfang, China Academic Journals (CNKI), and SinoMed databases up to September 1, 2021. Eligible studies should report the association of the serum prealbumin level with prognosis and provide the multivariable-adjusted risk estimates of the outcomes of interest in HCC patients undergoing hepatectomy.ResultsA total of 11 studies with 7,442 HCC patients were identified and analyzed. Meta-analysis of a fixed effects model showed that a low serum prealbumin level was associated with poor overall survival [hazard ratio (HR) = 1.54, 95% confidence interval (CI) = 1.42–1.68], recurrence-free survival (HR = 1.34, 95% CI = 1.17–1.52), and a higher risk of postoperative hepatic insufficiency (HR = 2.21; 95% CI = 1.36–3.60) in HCC patients. Sensitivity and subgroup analyses confirmed the robustness of low serum prealbumin in predicting poor overall survival.ConclusionsThis meta-analysis indicated that a low preoperative serum prealbumin level was significantly associated with adverse prognosis in HCC patients undergoing hepatectomy.

Sign in / Sign up

Export Citation Format

Share Document