scholarly journals The Effectiveness of Exercise on Cognitive Performance in Individuals with Known Vascular Disease: A Systematic Review

2019 ◽  
Vol 8 (3) ◽  
pp. 294 ◽  
Author(s):  
Alyssa Brunt ◽  
David Albines ◽  
Diana Hopkins-Rosseel
Keyword(s):  
Systematic Review ◽  
Resistance Training ◽  
Vascular Disease ◽  
Cognitive Performance ◽  
Dose Response ◽  
Cognitive Impairments ◽  
Positive Association ◽  
Cardiovascular Fitness ◽  
Healthy Elderly ◽  
Increased Risk

Patients with known vascular disease are at increased risk for cognitive impairments. Exercise has been shown to improve cognition in healthy elderly populations and those with mild cognitive impairments. We explored the literature to understand exercise as a modality to improve cognition in those with vascular disease, focusing on dose-responses. A systematic review was conducted through 2017 using Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane, Ovid Embase, and Ovid MEDLINE databases. Eligible studies examined effects of exercise on memory and cognition in cardiovascular (CVD) or cerebrovascular disease (CBVD). Data extracted included group characteristics, exercise dosage and outcomes measures employed. Twenty-two studies (12 CVD, 10 CBVD) met the inclusion criteria. Interventions included aerobic, resistance, or mixed training, with neuropsychological test batteries assessing cognition. In CVD populations, five studies demonstrated improved cardiovascular fitness and cognition with aerobic training, and another seven studies suggested a dose-response. In CBVD trials, four studies reported improved cognition, with no effects observed in the fifth study. Another study found enhanced cognition with resistance training and four demonstrated a positive association between functional capacity and cognition following combined aerobic and resistance training. Exercise is able to positively affect cognitive performance in those with known vascular disease. There is evidence to suggest a dose–response relationship. Further research is required to optimize prescription.

scholarly journals Impact of depression on clinical outcomes following percutaneous coronary intervention: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e026445 ◽  
Author(s):  
Wen Yi Zhang ◽  
Nan Nan ◽  
Xian Tao Song ◽  
Jin Fan Tian ◽  
Xue Yao Yang
Keyword(s):  
Systematic Review ◽  
Percutaneous Coronary Intervention ◽  
Meta Analysis ◽  
Positive Association ◽  
Coronary Intervention ◽  
Adverse Outcomes ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Assessment Time

ObjectivesThe objective of this meta-analysis was to assess whether depression in percutaneous coronary intervention (PCI) patients is associated with higher risk of adverse outcomes.DesignSystematic review and meta-analysis.MethodsEMBASE, PubMed, CINAHL and PsycINFO were searched as data sources. We selected prospective cohort studies evaluating the relationship between depression and any adverse medical outcome, including all-cause mortality, cardiac mortality and non-fatal events, from inception to 28 February 2019. Two reviewers independently extracted information and calculated the risk of cardiovascular events in patients with preoperative or postoperative depression compared with non-depressed patients.ResultsEight studies (n=3297) met our inclusion criteria. Most studies found a positive association between depression and adverse cardiovascular outcomes. Meta-analysis yielded an aggregate risk ratio of 1.57 (95% CI 1.28 to 1.92, p<0.0001) for the magnitude of the relation between depression and adverse outcomes.ConclusionsOur systematic review and meta-analysis suggests that depression is associated with an increased risk of worse clinical outcome or mortality in patients undergoing PCI. Assessment time and length of follow-up do not have a significant effect on this conclusion.

Abstract 124: Association Between Low Bone Mineral Density and Risk of Peripheral Vascular Disease: A Systematic Review and Meta-analysis

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Sikarin Upala ◽  
Anawin Sanguankeo
Keyword(s):  
Bone Mineral Density ◽  
Systematic Review ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Bone Mineral ◽  
Observational Studies ◽  
Meta Analysis ◽  
Peripheral Vascular ◽  
Mineral Density ◽  
Increased Risk

Background: Previous studies have suggested that osteoporosis and coronary heart disease have shared common risk factors. Some studies also suggested that low bone mineral density (BMD) also increased risk of peripheral vascular disease (PVD) or stroke. However, few longitudinal studies did not find significant association between these two conditions. We performed a systematic review and meta-analysis to explore association between low BMD and risk of PVD or stroke from prospective studies. Methods: We comprehensively searched the databases of PubMed/MEDLINE, EMBASE, and Cochrane Databases from their dates of inception to December 2015. The inclusion criteria were published prospective observational studies of PVD, stroke, BMD, osteoporosis, or fractures. Two authors independently assessed the quality of the articles and extracted the data. The primary outcome of interest was risk of new PVD or stroke events comparing between low BMD and normal BMD groups. Results: From 36 full-text articles, five observational studies involving 3,287 participants were included in the meta-analysis based on the random-effects model. There was increased risk of new peripheral vascular disease or stroke events in groups with low BMD compared with normal BMD controls with pooled hazard risk (HR) of 3.10 (95% CI: 1.32-7.23). In the subgroup analysis of fracture as a risk factor, there was no significant difference in risk of PVD or stroke in group with pooled HR of 1.17 (95% CI: 0.78-1.75). Conclusions: Low BMD is associated with increased risk of PVD and stroke from the meta-analysis of prospective observational studies. Clinicians should be aware of the close association between these two conditions. Early identification of PVD in patients with low BMD should be performed.

Opioids and the Risk of Motor Vehicle Collision: A Systematic Review

2021 ◽  
pp. 875512252110599
Author(s):  
Silvia J. Leon ◽  
Aaron Trachtenberg ◽  
Derek Briscoe ◽  
Maira Ahmed ◽  
Ingrid Hougen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Dose Response ◽  
Motor Vehicle ◽  
Motor Vehicle Collision ◽  
Prescription Opioid ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Opioid Prescription ◽  
Vehicle Collision ◽  
Increased Risk

Background: Opioid analgesics are among the most commonly prescribed medications, but questions remain regarding their impact on the day-to-day functioning of patients including driving. We set out to perform a systematic review on the risk of motor vehicle collision (MVC) associated with prescription opioid exposure. Method: We searched Medline, PubMed, EMBASE, Scopus, and TRID from January 1990 to August 31, 2021 for primary studies assessing prescribed opioid use and MVCs. Results: We identified 14 observational studies that met inclusion criteria. Among those, 8 studies found an increased risk of MVC among those participants who had a concomitant opioid prescription at the time of the MVC and 3 found no significant increase of culpability of fatal MVC. The 3 studies that evaluated the presence of a dose-response relationship between the dose of opioids taken and the effects on MVC risk reported the existence of a dose-response relationship. Due to the heterogeneity of the different studies, a quantitative meta-analysis to sum evidence was deemed unfeasible. Our review supports increasing evidence on the association between motor vehicle collisions and prescribed opioids. This research would guide policies regarding driving legislation worldwide. Conclusion: Our review indicates that opioid prescriptions are likely associated with an increased risk of MVCs. Further studies are warranted to strengthen this finding, and investigate additional factors such as individual opioid medications, opioid doses and dose adjustments, and opioid tolerance for their effect on MVC risk.

Fish intake, n-3 fatty acid body status, and risk of cognitive decline: a systematic review and a dose–response meta-analysis of observational and experimental studies

2021 ◽  
Author(s):  
Rena I Kosti ◽  
Maria I Kasdagli ◽  
Andreas Kyrozis ◽  
Nicola Orsini ◽  
Pagona Lagiou ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fatty Acid ◽  
Executive Functions ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Dose Response ◽  
Experimental Studies ◽  
Fish Intake ◽  
Risk Of Bias ◽  
The Impact

Abstract Context Randomized controlled trials (RCTs) testing supplementation with eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids have failed to provide evidence supporting a suggested inverse association between fish intake and dementia risk. Objective Dose–response analyses were conducted to evaluate associations between fish intake, all-cause dementia or Alzheimer’s Disease (AD), and the effect of EPA/DHA supplementation on cognitive performance. Data Sources PubMed, Scopus and Web of Science databases were searched for original research evaluating either associations between fish intake and dementia or AD, or the impact of EPA and/or DHA supplementation on the risk of cognitive decline. Data Extraction Data were collected on study characteristics and methods; number of cases/deaths (for observational studies); categories of exposure; model covariates; risk estimates from the most-adjusted model; type and dosage of supplementation (from RCTs); fatty acid levels in blood; and differences in cognition test results before and after supplementation. Risk of bias was assessed through the ROBINS-E and RoB2.0 tools for observational and experimental studies, respectively. Data Analysis Weighted mixed-effects models were applied, allowing for the inclusion of studies with 2 levels of exposure. Based on findings with low/moderate risk of bias, fish intake of up to 2 portions (250 g) per week was associated with a 10% reduction (95% confidence interval [CI]: 0.79, 1.02, Ν = 5) in all-cause dementia and a 30% reduction (95% CI: 0.54, 0.89, Ν = 3) in AD risk. Changes in EPA and DHA body status had a positive impact on participants’ executive functions, but not on their overall cognitive performance. Conclusion The protection offered by fish intake against cognitive decline levels off at intakes higher than 2 portions/week and likely relates to the impact of EPA and DHA on the individual’s executive functions, although there remain questions about the mechanisms linking the short- and long-term effects. Systematic Review Registration PROSPERO registration no. CRD42019139528.

scholarly journals Immune capacity determines outcome following surgery or trauma: a systematic review and meta-analysis

2019 ◽  
Vol 46 (5) ◽  
pp. 979-991 ◽  
Author(s):  
Ruiyi Jia ◽  
Moran Zhou ◽  
Camilla S. L. Tuttle ◽  
Andrea B. Maier
Keyword(s):  
Systematic Review ◽  
Cytokine Production ◽  
Meta Analysis ◽  
Production Capacity ◽  
Immunological Response ◽  
Positive Association ◽  
Sufficient Information ◽  
Increased Risk ◽  
Significant Difference ◽  
Initial Injury

Abstract Purpose Immunological functions are altered following physical injury. The magnitude of the immunological response is dependent on the initial injury. However, variability in the immune response exists within and between patients where only some patients are at risk of developing complications such as systemic inflammatory response syndrome after injury. This systematic review and meta-analysis assessed whether lipopolysaccharide (LPS) induced cytokine production capacity of leucocytes can be used as a functional test to predict the risk of developing complications after injury. Methods Medline, Embase and Web of Science were systematically searched to identify articles that investigated the association between LPS induced cytokine production capacity in leucocytes and any clinical outcome after surgery or trauma. Where sufficient information was supplied, a meta-analysis was performed to determine the overall clinical outcomes. Results A total of 25 articles out of 6765 abstracts identified through the literature search were included in this review. Most articles described a positive association between cytokine production capacity and the development of inflammatory complications (n = 15/25). Coincidingly, the meta-analysis demonstrated that TNFα (Hedges g: 0.63, 95% CI 0.23, 1.03), IL-6 (Hedges g: 0.76, 95% CI 0.41, 1.11) and IL-8 (Hedges g: 0.93, 95% CI 0.46, 1.39) production capacity was significantly higher, one day after injury, in patients who developed inflammatory complications compared to patients who did not following trauma or surgical intervention. No significant difference was observed for IL-1β. Conclusion The associations of elevated LPS-induced cytokine production capacity with the risk of developing inflammatory complications are consistent with previous theories that proposed excessive inflammation is accompanied by anti-inflammatory mechanisms that results in a period of immunosuppression and increased risk of secondary complications. However, immunological biomarkers for risk stratification is still a developing field of research where further investigations and validations are required.

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Parity and risk of type 2 diabetes: a systematic review and dose-response meta-analysis

2016 ◽  
Vol 175 (5) ◽  
pp. R231-R245 ◽  
Author(s):  
Peiyun Li ◽  
Zhilei Shan ◽  
Li Zhou ◽  
Manling Xie ◽  
Wei Bao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Dose Response ◽  
Meta Analysis ◽  
Epidemiologic Studies ◽  
Diabetes Risk ◽  
Cross Sectional ◽  
Nulliparous Women ◽  
Increased Risk

Objective Epidemiologic studies regarding the association between parity and risk of type 2 diabetes have yielded inconsistent results. Therefore, we performed a systematic review and dose-response meta-analysis to determine the relation between parity and type 2 diabetes risk. Methods We searched PubMed and Embase for published epidemiologic studies that assessed the relation between parity and risk of type 2 diabetes up to 31 March 2016. A dose-response random-effects model was used to combine study-specific relative risks (RRs) and 95% confidence intervals (CIs). Potential sources of heterogeneity were explored by meta-regression and subgroup analyses. Results Seven cohort studies, 1 case-control study and 9 cross-sectional studies including 296 923 participants were eligible for inclusion. The combined RR for the highest versus lowest category of parity indicated a 54% increment in type 2 diabetes risk (95% CI: 29–83%). In the cubic spline model, a nonlinear association was found between parity and risk of type 2 diabetes (P = 0.02 for nonlinearity). Compared with nulliparous women, the estimated RR (95% CI) of type 2 diabetes for women with one to seven children was 1.01 (0.96–1.07), 1.08 (1.00–1.16), 1.20 (1.12–1.30), 1.32 (1.22–1.42), 1.37 (1.27–1.48), 1.39 (1.26–1.52) and 1.39 (1.23–1.57) respectively. Conclusions Higher parity is significantly associated with an increased risk of type 2 diabetes. Further studies are warranted to fully adjust for the potential confounders and explore the causality between parity and type 2 diabetes risk.

Migraine, cardiovascular disease, and stroke during pregnancy: Systematic review of the literature

Cephalalgia ◽  
2014 ◽  
Vol 35 (2) ◽  
pp. 132-139 ◽  
Author(s):  
Ashley Wabnitz ◽  
Cheryl Bushnell
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Vascular Disease ◽  
Gestational Hypertension ◽  
Cochrane Review ◽  
Review Of The Literature ◽  
Increased Risk ◽  
In Pregnancy

Objective The objective of this article is to review the literature relating migraine, cardiovascular disease, and stroke during pregnancy in order to better define the relationship between migraines and vascular disease. Methods We conducted a systematic review of the literature using Medline and Cochrane Review with the following search terms: migraine AND pregnancy and vascular disease OR myocardial infarction OR heart disease OR stroke OR cerebrovascular disease OR hypertension in pregnancy. We also reviewed the bibliographies of papers identified in this search to obtain additional relevant studies. Results Of the 219 papers obtained with the primary search, we found 17 that were topically relevant. Altogether, there is an increased risk both of gestational hypertension (OR range from 1.23 to 1.68) and preeclampsia (OR range 1.08 to 3.5) in migraineurs compared to nonmigraineurs. In addition, there is an association between an increased risk of ischemic stroke in pregnancy (OR range 7.9 to 30.7), particularly with active migraine. There is also an association between migraine and increased risk of acute myocardial infarction and heart disease (OR 4.9; 95% CI 1.7, 14.2), and thromboembolic events during pregnancy (deep venous thrombosis OR 2.4; 95% CI 1.3, 4.2 and pulmonary embolus OR 3.1; 95% CI 1.7, 5.6). Conclusion In this review, we summarized the association between migraine and risk of vascular disease during pregnancy, based on the available literature. Given the limited amount of data, more research on these associations is needed to determine which women with migraine may be at risk while pregnant.

Associations Between Active School Transport and Physical Activity, Body Composition, and Cardiovascular Fitness: A Systematic Review of 68 Studies

2014 ◽  
Vol 11 (1) ◽  
pp. 206-227 ◽  
Author(s):  
Richard Larouche ◽  
Travis John Saunders ◽  
Guy Edward John Faulkner ◽  
Rachel Colley ◽  
Mark Tremblay
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Body Composition ◽  
Public Health Practice ◽  
Positive Association ◽  
Cardiovascular Fitness ◽  
Quality Of Evidence ◽  
Effective Public Health ◽  
The Impact

Background:The impact of active school transport (AST) on daily physical activity (PA) levels, body composition and cardiovascular fitness remains unclear.Methods:A systematic review was conducted to examine differences in PA, body composition and cardiovascular fitness between active and passive travelers. The Medline, PubMed, Embase, PsycInfo, and ProQuest databases were searched and 10 key informants were consulted. Quality of evidence was assessed with GRADE and with the Effective Public Health Practice Project tool for quantitative studies.Results:Sixty-eight different studies met the inclusion criteria. The majority of studies found that active school travelers were more active or that AST interventions lead to increases in PA, and the quality of evidence is moderate. There is conflicting, and therefore very low quality evidence, regarding the associations between AST and body composition indicators, and between walking to/from school and cardiovascular fitness; however, all studies with relevant measures found a positive association between cycling to/from school and cardiovascular fitness; this evidence is of moderate quality.Conclusion:These findings suggest that AST should be promoted to increase PA levels in children and adolescents and that cycling to/from school is associated with increased cardiovascular fitness. Intervention studies are needed to increase the quality of evidence.

Alcohol consumption as a risk factor for pneumonia: a systematic review and meta-analysis

2010 ◽  
Vol 138 (12) ◽  
pp. 1789-1795 ◽  
Author(s):  
A. V. SAMOKHVALOV ◽  
H. M. IRVING ◽  
J. REHM
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Dose Response ◽  
Meta Analysis ◽  
Alcohol Use Disorders ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Increased Risk

SUMMARYThe aim of this study was to quantify the association between alcohol consumption and incidence of pneumonia and to examine possible pathways. This was done by a systematic review and meta-analyses on the dose–response relationship between alcohol consumption or alcohol-use disorders and the incidence of community-acquired pneumonia (CAP). The relative risk (RR) of CAP increased monotonically with increasing alcohol consumption. Individuals consuming 24, 60, and 120 g of pure alcohol daily demonstrated RRs for incident CAP of 1·12 (95% CI 1·02–1·23), 1·33 (95% CI 1·06–1·67) and 1·76 (95% CI 1·13–2·77), respectively, relative to non-drinkers. Clinically defined alcohol-use disorders were associated with an eightfold increased risk of CAP (RR 8·22, 95% CI 4·85–13·95). In conclusion, alcohol was found to be a risk factor for pneumonia with a clear statistical association, and a monotonic dose–response relationship.

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