Meta-Analysis: Pesticides and Orofacial Clefts

2007 ◽  
Vol 44 (4) ◽  
pp. 358-365 ◽  
Author(s):  
Paul A. Romitti ◽  
Anna M. Herring ◽  
Leslie K. Dennis ◽  
Donna L. Wong-Gibbons
Keyword(s):  
Occupational Exposure ◽  
Fixed Effects ◽  
Pesticide Exposure ◽  
Meta Analysis ◽  
Significant Risk ◽  
Occupational Exposures ◽  
Final Analysis ◽  
Orofacial Clefts ◽  
Random Effects Models ◽  
Increased Risk

Objective: The risk of orofacial clefts associated with pesticide exposure was examined by conducting a meta-analysis of studies published from 1966 through 2005. Design: The full text of 230 studies was reviewed in detail, and of these, 19 studies were included in the final analysis. Fixed effects and random effects models were used to calculate pooled odds ratios (ORs) and 95% confidence intervals (CIs), and homogeneity among studies was evaluated. Main outcome measures: Exposure- and phenotype-specific risks associated with pesticides. Results: Many of the studies identified as suitable for analysis used a retrospective design with varying sample sizes, levels of exposure assessment, and phenotype evaluation. For all phenotypes combined, maternal occupational exposure was associated with an increased risk of clefting (OR = 1.37; CI = 1.04 to 1.81), whereas the estimates were somewhat weaker for paternal occupational exposures (OR = 1.16; CI = 0.94 to 1.44) or for any residential exposure (OR = 0.77; CI = 0.20 to 2.96). Calculation of pooled estimates for individual cleft phenotypes was mostly limited to studies of paternal occupational exposure; estimates exceeded unity but were not statistically significant. Conclusions: The results of this meta-analysis suggest that maternal exposure to pesticides is associated with a modest but marginally significant risk of clefting. To better understand the relationship between pesticide exposure and orofacial clefts, future studies should consider evaluation of multiple routes of parental exposure, etiologically homogenous phenotypes, and individual genetic susceptibility.

scholarly journals Occupational Exposures and Neurodegenerative Diseases—A Systematic Literature Review and Meta-Analyses

2019 ◽  
Vol 16 (3) ◽  
pp. 337 ◽  
Author(s):  
Lars-Gunnar Gunnarsson ◽  
Lennart Bodin
Keyword(s):  
Alzheimer’S Disease ◽  
Parkinson’S Disease ◽  
Alzheimer's Disease ◽  
Parkinson's Disease ◽  
Occupational Exposure ◽  
Neurodegenerative Diseases ◽  
Meta Analysis ◽  
Occupational Exposures ◽  
Increased Risk ◽  
Meta Analyses

Objectives: To carry out an integrated and stratified meta-analysis on occupational exposure to electromagnetic fields (EMFs), metals and pesticides and its effects on amyotrophic lateral sclerosis (ALS) and Parkinson’s and Alzheimer’s disease, and investigate the possibility of publication bias. Methods: In the current study, we updated our recently published meta-analyses on occupational exposures in relation to ALS, Alzheimer’s and Parkinson’s disease. Based on 66 original publications of good scientific epidemiological standard, according to the Meta-analysis of Observational Studies in Epidemiology (MOOSE) and the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines, we analysed subgroups by carrying out stratified meta-analyses on publication year, statistical precision of the relative risk (RR) estimates, inspection of the funnel plots and test of bias. Results: Based on 19 studies the weighted RR for occupational exposure to EMFs was 1.26 (95% confidence interval (CI) 1.07–1.50) for ALS, 1.33 (95% CI 1.07–1.64) for Alzheimer’s disease and 1.02 (95% CI 0.83–1.26) for Parkinson’s disease. Thirty-one studies concerned occupational exposure to pesticides and the weighted RR was 1.35 (95% CI 1.02–1.79) for ALS, 1.50 (95% CI 0.98–2.29) for Alzheimer’s disease and 1.66 (95% CI 1.42–1.94) for Parkinson’s disease. Finally, 14 studies concerned occupational exposure to metals and only exposure to lead (five studies) involved an elevated risk for ALS or Parkinson’s disease and the weighted RR was 1.57 (95% CI 1.11–2.20). The weighted RR for all the non-lead exposures was 0.97 (95% CI 0.88–1.06). Conclusions: Exposure to pesticides increased the risk of getting the mentioned neurodegenerative diseases by at least 50%. Exposure to lead was only studied for ALS and Parkinson’s disease and involved 50% increased risk. Occupational exposure to EMFs seemed to involve some 10% increase in risk for ALS and Alzheimer’s disease only.

Rash to mTOR inhibitor everolimus: Systematic review and meta-analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e19624-e19624 ◽  
Author(s):  
Marigdalia K. Ramirez-Fort ◽  
Emily Christine Case ◽  
Alyx C. Rosen ◽  
Shenhong Wu ◽  
Mario E. Lacouture
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Fixed Effects ◽  
Mtor Inhibitor ◽  
Meta Analysis ◽  
Significant Risk ◽  
Phase Iii ◽  
Subependymal Giant Cell Astrocytoma ◽  
High Grade ◽  
Increased Risk

e19624 Background: Everolimus is an mTOR inhibitor approved for treatment of renal cell carcinoma, subependymal giant cell astrocytoma, and progressive neuroendocrine tumors of pancreatic origin. Its use may be hindered due to adverse events, including rash. The reported incidence and risk of rash to everolimus varies widely and has not been closely investigated. Therefore, we conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing rash. Methods: We searched PubMed and Web of Science databases and abstracts presented at the American Society of Clinical Oncology from 1998 to July 2011 using the keyword “everolimus” to identify relevant clinical trials. Eligible studies included prospective phase II and phase III clinical trials of cancer patients on 10 mg of everolimus daily with available data on incidence of rash. The summary incidence and relative risk (RR) of rash were calculated using either the random-effects or fixed-effects model, depending on the heterogeneity of the constituent studies. Results: A total of 2,242 patients with various malignancies from 13 clinical trials were included in the analysis. The summary incidences of all-grade and high-grade rash in patients on everolimus were28.6% (95% CI: 20.8 – 38.0) and 1.0% (95% CI: 0.6 – 1.7), respectively. Everolimus was associated with a statistically significant increased risk of all-grade rash (RR=3.853, 95% CI: 2.470 – 6.013, p=0.000), but the RR for high-grade rash (RR= 2.997, 95% CI: 0.633 – 14.185) was not statistically significant, with a p value of 0.166. Conclusions: Everolimus is associated with a significant risk of developing rash. Management of rash to everolimus is critical to prevent dose modifications and decreased quality of life, both of which can negatively affect clinical outcomes.

Maternal Common Cold or Fever During Pregnancy and the Risk of Orofacial Clefts in the Offspring: A Systematic Review and Meta-analysis

2021 ◽  
pp. 105566562110676
Author(s):  
Fang-ping Shi ◽  
Ying-ying Huang ◽  
Qiao-qun Dai ◽  
Yu-lu Chen ◽  
Hai-yin Jiang ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Common Cold ◽  
Cleft Lip ◽  
Meta Analysis ◽  
Case Control Studies ◽  
Orofacial Clefts ◽  
Random Effects Models ◽  
Relative Risks ◽  
Increased Risk ◽  
The Common

The common cold and/or an associated fever during pregnancy have/has been suspected to harm the developing fetus. We sought possible correlations between a maternal common cold or fever during pregnancy and the risk of orofacial clefts in the offspring. We systematically searched PubMed and Embase using appropriate keywords, and we checked the reference lists of retrieved articles. We used random-effects models to estimate overall relative risks. Incidence of orofacial clefts. We included 13 case-control studies. Modest but statistically significant associations were found between a maternal common cold and cleft lip with or without a cleft palate (CL/CP) (odds ratio [OR] 2.17; 95% confidence interval [CI] 1.66–2.83) and a cleft palate only (CPO) (OR 3.08; 95% CI 1.5–6.34). Furthermore, maternal fever was also associated with an increased risk of CL/CP (OR 1.91, 95% CI 1.3–2.8) and CPO (OR 1.48, 95% CI 0.83–2.63) in the offspring. Further analyses of maternal influenza (alone) yielded similar results. Although evidence of heterogeneity should be carefully evaluated, our findings suggest that maternal common cold or fever during pregnancy may be associated with a greater risk of CL/CP or CPO in the offspring. Future cohort studies using valid assessments of maternal common cold exposure during pregnancy that consider the severity of fever are needed to clarify the contribution of maternal common cold or fever status to the risk of orofacial clefts in children.

scholarly journals Methylation of Ecadherin gene is correlated with increased risk of nasopharyngeal carcinoma: A meta-analysis

2020 ◽  
Vol 9 (1) ◽  
pp. 28-40
Author(s):  
Truong Kim Phuong ◽  
Lao Duc Thuan ◽  
Nguyen Thi Hoang Trinh ◽  
Nguyen Thi Phuong Dieu ◽  
Nguyen Thi Le
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Promoter Methylation ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Nasopharyngeal Cancer ◽  
Clinical Samples ◽  
Fixed Effects Model ◽  
Random Effects Models ◽  
Increased Risk ◽  
Data Heterogeneity

Background: The objective of this study was to estimate the correlation between the Ecadherin (CDH1) promoter methylation and the risk of nasopharyngeal cancer. Methods: Based on previous online articles for the evaluation the hypermethylated status of CDH1 gene at the promoter region with nasopharyngeal carcinoma, two independent reviewers selected studies through databases on PubMed, Google Scholar from 2001 to 2014. The software MedCalc® version 18.11 was applied for calculating pooled odd ratios (OR) with levels of data heterogeneity by the fixed and random effects models. Results: Of a total of 99 articles, 12 studies with 508 clinical samples of nasopharyngeal carcinoma patients and 282 normal samples were selected in the systematic review for meta-analysis. Overall, the results demonstrated the highly significant association between CDH1 promoter methylation with nasopharyngeal carcinoma under the fixed effects model (OR = 16.155, 95% CI: 8.533 - 30.585, p

Risk of skin rash with the proteasome inhibitor bortezomib: Updated systematic review and meta-analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9092-9092
Author(s):  
Emily Christine Case ◽  
Shenhong Wu ◽  
John F. Gerecitano ◽  
Mario E. Lacouture
Keyword(s):  
Skin Rash ◽  
Proteasome Inhibitor ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Significant Risk ◽  
Phase Iii ◽  
High Grade ◽  
Fixed Effects Model ◽  
Increased Risk ◽  
American Society

9092 Background: Rash is a common, adverse event to the novel proteasome inhibitor bortezomib (Velcade). Indicated for the treatment of multiple myeloma and mantle cell lymphoma, bortezomib is the first proteasome inhibitor approved by regulatory agencies. Because the incidence of bortezomib-induced skin rash varies widely in published manuscripts, we performed a systematic literature review and meta-analysis to determine the incidence and overall risk. Methods: We searched PubMed and Web of Science databases and abstracts presented at the American Society of Clinical Oncology and The American Society of Hematology annual meetings (1998 to July 2011) to identify relevant clinical studies. Eligible studies included prospective clinical phase II and phase III trials, with data on the incidence of rash in patients taking 1.3mg/m2, 1.5mg/m2, or 1.6 mg/m2 of bortezomib intravenously either weekly or twice weekly. The incidence of rash and relative risk (RR) were calculated using random-effects or fixed-effects model, depending on the heterogeneity of included studies. Results: A total of 2,616 patients with various hematologic and solid malignancies from 35 clinical trials were included for analysis. Among patients receiving twice weekly bortezomib, the summary incidence of all-grade and high-grade rash were 18.8 % (95% CI: 14.9% to 23.5%) and 3.6 % (95% CI: 2.3% to 5.7%), respectively. We found no significant increase in all grade rash incidence with higher doses of bortezomib: 19.3 % (95% CI: 15% to 24.5%) and 20.8% (95% CI: 11.6% to 34.4%) for doses of 1.3 mg/m2 and 1.5 mg/m2, respectively. In addition, bortezomib was associated with an increased risk in both all grade (RR: 19.70, 95% CI: 8.73 to 44.44, p<0.001) and high-grade rash (RR: 5.35, 95% CI: 2.16 to 13.29, p<0.001), compared to controls. Weekly bortezomib is associated with lower risk of rash compared to twice weekly dosing (incidence 3.9% versus 18.8%, p=0.001). Conclusions: Bortezomib is associated with a significant risk of developing rash with a higher risk among patients receiving twice weekly dosage. Management of rash to bortezomib is critical to prevent a negative effect on quality of life and dose modifications, both of which affect clinical outcome.

Risk of rash with nilotinib: A systematic review of the literature and meta-analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9088-9088
Author(s):  
Aaron Mark Drucker ◽  
Shenhong Wu ◽  
Ellin Berman ◽  
Mario E. Lacouture
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Fixed Effects ◽  
Systemic Mastocytosis ◽  
Meta Analysis ◽  
Significant Risk ◽  
Myelogenous Leukemia ◽  
High Grade ◽  
Pubmed Database ◽  
Increased Risk

9088 Background: Nilotinib is indicated for the treatment of chronic myelogenous leukemia (CML). The reported incidence and risk of rash from this medication vary widely and have been inconsistently reported in published trials. Therefore we conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing rash. Methods: Relevant studies were identified from the PubMed database (1998-2012), abstracts presented at ASCO and ASH Conferences (2004-2011) and Web of Science database (1998-2012). Eligible studies were limited to prospective Phase II-III clinical trials in which patients received nilotinib at doses of either 300 mg or 400 mg twice daily. Incidence, relative risk (RR), and 95% confidence intervals (CI) were calculated using random-effects or fixed-effects models based on heterogeneity of included studies. Results: Data from a total of 3,186 patients receiving nilotinib in 16 clinical trials were available for analysis. The overall incidence of all-grade and high-grade (grade ≥3) rash were 33.1% (95% CI: 27.7-39.1) and 2.6% (95% CI: 2.1-3.4), respectively. Incidence of all-grade rash for patients with CML, gastrointestinal stromal tumor (GIST) and systemic mastocytosis were 33.2% (95% CI: 27.2-39.9), 25.7% (95% CI: 14.0-42.5) and 25.0% (95% CI: 15.7-37.4), respectively. Nilotinib was associated with increased risk of all-grade rash (RR=2.891, 95% CI: 2.079-4.020; P<0.001) when compared to patients treated with imatinib. Risk of high-grade rash was increased compared to imatinib (RR=1.823, 95% CI: 0.670-4.957), but this was not statistically significant (P=0.24). Conclusions: Patients with hematologic malignancies and GIST who are treated with nilotinib are at significant risk for developing a rash. Further studies for characterization, prevention and treatment of this untoward toxicity are needed in order to maintain patients’ quality of life and minimize the need for dose modification, which may impact clinical outcome.

Incidence and risk of neutropenia with palbociclib in patients with cancer: A systematic review and meta-analysis.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e12530-e12530
Author(s):  
Yan Mao ◽  
Janice Lu ◽  
Haibo Wang ◽  
Gang Nie
Keyword(s):  
Systematic Review ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Significant Risk ◽  
Metastatic Breast ◽  
Progression Free Survival ◽  
High Grade ◽  
Fixed Effects Model ◽  
Patients With Cancer ◽  
Increased Risk

e12530 Background: Palbociclib is an oral small-molecule inhibitor of cyclin-dependent kinases 4 and 6 and has improved the progression-free survival of estrogen receptor positive, metastatic breast cancer (MBC). Its application in other cancers is also undergoing clinical evaluation. Neutropenia, especially high grade (grade 3 or 4), is one of the major side-effects of palbociclib, and the incidence was reported too vary in different studies. In order to better understand the overall risk of palbociclib associated neutropenia, we conducted a systematic review and meta-analysis. Methods: We conducted a systematic literature search (including Medline, Web of Science to November, 2016 and abstracts presented at the ASCO annual meetings from 2009 to 2016). Eligible studies include prospective clinical trials of patients with cancer treated with palbociclib on a 125mg daily 3/4 week schedule and have available data on neutropenia. The incidence and relative risk (RR) of neutropenia were calculated using a random-effects or fixed-effects model, depending on the heterogeneity of the included studies. Results: Eight studies published between 2012 and 2016 included a total of 1515 patients with cancer were eligible for analysis. For patients treated with palbociclib, the overall incidence of all-grade and high grade neutropenia were 77.4% (95% CI 70.9-82.8%) and 60.9% (57.8–63.8%), respectively. Surprisingly, the incidence of neutropenia was significantly different between MBC patients and non-MBC patients (all grade: RR 1.26 [95% CI 1.01–1.56], p = 0.041; high-grade: RR 1.57 [1.23–2.00], p = 0.000) who received palbociclib. Palbociclib was associated with a significantly increased risk of all-grade neutropenia in patients with cancer with an RR of 15.03 (10.17–22.21, p < 0.001) compared with controls. Conclusions: Patients with cancer who received palbociclib have a significant risk of developing neutropenia, especially MBC patients. It is strongly recommended to monitor these patients who are treated with palbociclib to adjust dose, treatment intervals, and avoid infections.

scholarly journals Comorbidities increase the risk of severity and mortality in COVID-19 patients: a systematic review and meta-analysis

2021 ◽  
Vol 10 (2) ◽  
pp. e50010212533
Author(s):  
Edilson Leite de Moura ◽  
Jean Moises Ferreira ◽  
Ana Caroline Melo dos Santos ◽  
Denise Macedo da Silva ◽  
Maria Lidiane Ferreira da Silva ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cerebrovascular Diseases ◽  
Poor Clinical Outcome ◽  
Random Effects Models ◽  
Risk Of Death ◽  
Increased Risk ◽  
Retrospective Cohort Studies ◽  
The Relationship

Introduction: Several studies have shown that patients with comorbidities present a poor clinical outcome of COVID-19, but the conclusions are not yet consolidated. We conducted a meta-analysis to evaluate the relationship between the preexistent conditions (comorbidities) in patients infected with SARS-CoV-2 and the outcome of COVID-19. Methods: PubMed, Science Direct, ISI Web of Science and Scopus databases were examined up to November 2020. We calculated the pooled odds ratio (OR) with 95% confidence interval, using fixed-effects or random-effects models. Results: A total of 48 retrospective cohort studies with 344,290 COVID-19 patients were included in the meta-analysis. The pooled results showed that hypertension, diabetes, cardiovascular, chronic pulmonary, chronic kidney and cerebrovascular diseases increase the risk of severity and mortality in COVID-19 patients. Moreover, malignancy was associated with an increased risk of death from COVID-19. Conclusions: The comorbidities previously mentioned may be important predictors of poor outcome of COVID-19, contributing to the prognosis of severe cases of the disease.

Risk of rash associated with lenalidomide in multiple myeloma and myelodisplastic syndrome: A systematic review of the literature and meta-analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e18571-e18571
Author(s):  
Benjamin C Garden ◽  
Beatrice Nardone ◽  
Shenhong Wu ◽  
Dennis P. West ◽  
Romala Emmanuel ◽  
...  
Keyword(s):  
Systematic Review ◽  
Multiple Myeloma ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Significant Risk ◽  
High Grade ◽  
Increased Risk ◽  
Significant Difference ◽  
Grade 3

e18571 Background: Indications of lenalidomide (Len) include treatment of multiple myeloma (MM) in combination with dexamethasone (Dex) and myelodyplastic syndrome (MDS). The reported incidence and risk of rash varies widely and has been inconsistently reported in trials. Therefore, we conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing rash. Methods: Relevant studies were identified from PubMed (1998-2011), abstracts presented at ASCO conferences (2004-2011) and the Web of Science database (1998-2011). Eligible studies were limited to prospective Phase II-III clinical trials in which patients received daily Len doses of either 10mg or 25 mg with or without 40mg of Dex. Incidence, relative risk (RR), and 95% confidence intervals (CI) were calculated using random-effects or fixed-effects models based on heterogeneity of included studies. Results: Data from a total of 1,127 patients in 15 trials were available for analysis. The overall incidence of all-grade and high-grade (grade ≥3) rash was 29.9% (95% CI: 24.8- 35.5) and 3.8% (95% CI: 2.7-5.5), respectively. Len was associated with increased risk of all-grade rash (RR=1.7, 95% CI: 1.3-2.3; P<0.001) when compared to patients treated with a placebo and Dex. Risk of high-grade rash was increased (RR=3.7, 95% CI: 0.8-16.0) with a trend toward statistical significance (P=0.08). No significant difference in incidence of all-grade rash between patients receiving LEN doses of 10mg or 25mg (25.6%, 95% CI: 19.6-32.8% vs. 30.8%, 95% CI: 24.7-37.7%, respectively, p=0.28) was observed. Similarly, no difference was observed between patients receiving LEN monotherapy or in combination with Dex (31.0%, 95% CI: 26.6-43.3% and 23.8%, 95% CI: 14.9-35.8%, respectively, p=0.17). Conclusions: Patients with MM or MDS who are treated with Len are at significant risk for developing rash. The risk appears to be independent of LEN dosage or in combination with Dex. Further studies for prevention and treatment of this untoward toxicity are needed in order to maintain patient’s quality of life and minimize the need for dose modification, all of which may impact clinical outcome.

Pruritus in patients treated with targeted cancer therapies: Systematic review and meta-analysis.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e13571-e13571
Author(s):  
Courtney J. Ensslin ◽  
Alyx C. Rosen ◽  
Shenhong Wu ◽  
Mario E. Lacouture
Keyword(s):  
Systematic Review ◽  
Targeted Therapies ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Significant Risk ◽  
Cancer Therapies ◽  
Fixed Effects Model ◽  
Increased Risk ◽  
Targeted Cancer Therapies ◽  
American Society

e13571 Background: Pruritus is a disabling symptom that has been anecdotally described in patients treated with targeted cancer therapies, and reports on its incidence vary. The overall risk to develop pruritus in these patients has not been systematically ascertained. We conducted a systematic review and meta-analysis of the literature to determine the incidence and risk of developing pruritus among patients treated with targeted therapies. Methods: Databases from PubMed and Web of Science from January 1998 until July 2012 and abstracts presented at the American Society of Clinical Oncology annual meetings from 2004 through 2012 were searched to identify relevant studies. The incidence and relative risk (RR) of pruritus were calculated using random-effects or fixed-effects model depending on the heterogeneity of included studies. Results: Of 5,065 studies initially identified, a total of 20,532 patients from 144 studies were included for analysis. The summary incidences of all-grade and high-grade pruritus were 17.4% (95% confidence interval (CI): 16.0%-19.0%) and 1.4% (95% CI: 1.2%-1.6%). From randomized controlled trials, patients treated with targeted therapies had a significantly increased risk of developing all-grade pruritus, with an overall RR of 2.59 (95% CI: 2.03-3.30, p<0.001); there was a significant variation among different classes of drugs (P<0.001). Conclusions: There is a significant risk of developing pruritus in cancer patients receiving targeted therapies. In order to prevent suboptimal dosing and reductions in quality of life, these patients should be counseled and treated against this disabling event.

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