scholarly journals The Evidence for Efficacy of Osteoporosis Treatment in Men with Primary Osteoporosis: A Systematic Review and Meta-Analysis of Antiresorptive and Anabolic Treatment in Men

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Peter Schwarz ◽  
Niklas Rye Jorgensen ◽  
Leif Mosekilde ◽  
Peter Vestergaard
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Fragility Fractures ◽  
Life Time ◽  
Osteoporosis Treatment ◽  
Fracture Prevention ◽  
Primary Osteoporosis ◽  
Osteoporosis Therapy ◽  
Anabolic Treatment

Purpose. Fragility fractures in men constitute a major worldwide public health problem with a life-time risk of 13%. It cannot be directly inferred that antiosteoporotic drugs effective in women have the same effect in men. Our aim was to appraise the existing evidence for efficacy of osteoporosis treatment in men.Methods. This study was a systematic review of the published literature on the clinical efficacy of medical osteoporosis therapy in the reduction of fracture risk in men (age>50 years). Studies included were randomised, placebo-controlled trials of men.Results. Five BMD studies of antiresorptive treatment were included. All studies showed an increase in BMD, but there was only a nonsignificant trend in the reduction of clinical fractures. Three BMD studies of anabolic treatment with teriparatide were also included. These showed a significant mean increase in spine BMD and for vertebral fractures a non-significant trend towards a reduction was seen.Conclusion. The evidence of medical osteoporosis treatment in men is scant and inconclusive due to the lack of prospective RCT studies with fracture prevention as primary end point. So far, all evidence is based on BMD increases in small RCT studies showing BMD increases comparable to those reported in postmenopausal women.

scholarly journals A Systematic Review and Meta-Analysis of Pharmacogenetic Studies in Patients with Chronic Kidney Disease

2021 ◽  
Vol 22 (9) ◽  
pp. 4480
Author(s):  
Maria Tziastoudi ◽  
Georgios Pissas ◽  
Georgios Raptis ◽  
Christos Cholevas ◽  
Theodoros Eleftheriadis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Response To Treatment ◽  
Genotype Distribution ◽  
Global Public Health ◽  
High Prevalence ◽  
Additive Inheritance

Chronic kidney disease (CKD) is an important global public health problem due to its high prevalence and morbidity. Although the treatment of nephrology patients has changed considerably, ineffectiveness and side effects of medications represent a major issue. In an effort to elucidate the contribution of genetic variants located in several genes in the response to treatment of patients with CKD, we performed a systematic review and meta-analysis of all available pharmacogenetics studies. The association between genotype distribution and response to medication was examined using the dominant, recessive, and additive inheritance models. Subgroup analysis based on ethnicity was also performed. In total, 29 studies were included in the meta-analysis, which examined the association of 11 genes (16 polymorphisms) with the response to treatment regarding CKD. Among the 29 studies, 18 studies included patients with renal transplantation, 8 involved patients with nephrotic syndrome, and 3 studies included patients with lupus nephritis. The present meta-analysis provides strong evidence for the contribution of variants harbored in the ABCB1, IL-10, ITPA, MIF, and TNF genes that creates some genetic predisposition that reduces effectiveness or is associated with adverse events of medications used in CKD.

scholarly journals Anemia as a risk factor for tuberculosis: a systematic review and meta-analysis

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Yemataw Gelaw ◽  
Zegeye Getaneh ◽  
Mulugeta Melku
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Infectious Diseases ◽  
Low Socioeconomic Status ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Major Public Health Problem ◽  
Double Burden ◽  
Mesh Terms

Abstract Background Tuberculosis is a major public health problem caused by Mycobacterium tuberculosis, occurring predominantly in population with low socioeconomic status. It is the second most common cause of death from infectious diseases. Tuberculosis becomes a double burden among anemic patients. Anemia increases an individual’s susceptibility to infectious diseases including tuberculosis by reducing the immunity level. Therefore, the purpose of this study was to determine whether anemia is a risk factor for tuberculosis. Method Relevant published articles were searched in electronic databases like PubMed, Google Scholar, EMBASE, and Cochrane Library using the following MeSH terms: risk factor, predictors, tuberculosis, TB, Anaemia, Anemia, hemoglobin, Hgb, and Hb. Articles written in the English, observational studies conducted on the incidence/prevalence of tuberculosis among anemic patients, or papers examined anemia as risk factors for tuberculosis were included. From those studies meeting eligibility criteria, the first author’s name, publication year, study area, sample size and age of participants, study design, and effect measure of anemia for tuberculosis were extracted. The data were entered using Microsoft Excel and exported to Stata version 11 for analysis. The random-effects model was applied to estimate the pooled OR and HR, and 95% CI. The sources of heterogeneity were tested by Cochrane I-squared statistics. The publication bias was assessed using Egger’s test statistics. Results A total of 17 articles with a 215,294 study participants were included in the analysis. The odd of tuberculosis among anemic patients was 3.56 (95% CI 2.53–5.01) times higher than non-anemic patients. The cohort studies showed that the HR of tuberculosis was 2.01 (95% CI 1.70–2.37) times higher among anemic patients than non-anemic patients. The hazard of tuberculosis also increased with anemia severity (HR 1.37 (95% CI 0.92–2.05), 2.08 (95% CI 1.14–3.79), and 2.66 (95% CI 1.71–4.13) for mild, moderate, and severe anemia, respectively). Conclusion According to the current systematic review and meta-analysis, we can conclude that anemia was a risk factor for tuberculosis. Therefore, anemia screening, early diagnose, and treatment should be provoked in the community to reduce the burden of tuberculosis.

scholarly journals DHEA as a Biomarker of Stress: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Frédéric Dutheil ◽  
Sarah de Saint Vincent ◽  
Bruno Pereira ◽  
Jeannot Schmidt ◽  
Farès Moustafa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Stress ◽  
Acute Stress ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Main Peak ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Two Measures

Background: Psychosocial stress is a significant public health problem inducing consequences for quality of life. Results about the use of dehydroepiandrosterone (DHEA) as a biomarker of acute stress are conflicting. We conducted a systematic review and meta-analysis to demonstrate that DHEA levels could be a biomarker of stress.Methods: PubMed, Cochrane Library, Embase, and ScienceDirect databases were searched on March 19, 2021 using the keywords “acute stress” AND “DHEA” OR “Dehydroepiandrosterone.” Articles needed to describe our primary outcome, i.e., induction of acute stress and at least two measures of DHEA.Results: We included 14 studies, with a total of 631 participants, in our meta-analysis. The DHEA levels increased overtime after acute stress [standardized mean difference (SMD) = 1.56, 95%CI = 1.13–1.99]. Stratification by time showed a main peak at the end of stress (SMD = 2.43, 95%CI = 1.59–3.27), followed by a progressive decrease (coefficient = −0.11, 95%CI = −0.19 to −0.17, p = 0.020). There was no significant change 1 h after the end of acute stress. Metaregressions showed an impact of mental stress (SMD = 2.04, 95%CI = 1.43–2.65), sex (SMD = 0.02, 95%CI = 0.00–0.04), age (SMD = −0.12, 95%CI = −0.2 to −0.05), and obesity (SMD = 0.31, 95%CI = −0.00 to 0.63). There was no difference whatever the type of fluid (blood or saliva) and the measurement technique used.Conclusions: DHEA is a biomarker of acute stress, with a short-term increase (1 h). DHEA increases following acute mental stress, whatever the type and duration of mental stress. Women, young people, and obese individuals had a higher response. Blood and saliva measures were comparable.

scholarly journals Prevalence and risk factors associated with birth asphyxia among neonates delivered in Ethiopia: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255488
Author(s):  
Ritbano Ahmed ◽  
Hassen Mosa ◽  
Mohammed Sultan ◽  
Shamill Eanga Helill ◽  
Biruk Assefa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Grey Literature ◽  
Birth Asphyxia ◽  
Public Health Problem ◽  
Cochrane Library ◽  
Chronic Hypertension ◽  
Factors Associated ◽  
Pooled Prevalence

Background A number of primary studies in Ethiopia address the prevalence of birth asphyxia and the factors associated with it. However, variations were seen among those studies. The main aim of this systematic review and meta-analysis was carried out to estimate the pooled prevalence and explore the factors that contribute to birth asphyxia in Ethiopia. Methods Different search engines were used to search online databases. The databases include PubMed, HINARI, Cochrane Library and Google Scholar. Relevant grey literature was obtained through online searches. The funnel plot and Egger’s regression test were used to see publication bias, and the I-squared was applied to check the heterogeneity of the studies. Cross-sectional, case-control and cohort studies that were conducted in Ethiopia were also be included. The Joanna Briggs Institute checklist was used to assess the quality of the studies and was included in this systematic review. Data entry and statistical analysis were carried out using RevMan 5.4 software and Stata 14. Result After reviewing 1,125 studies, 26 studies fulfilling the inclusion criteria were included in the meta-analysis. The pooled prevalence of birth asphyxia in Ethiopia was 19.3%. In the Ethiopian context, the following risk factors were identified: Antepartum hemorrhage(OR: 4.7; 95% CI: 3.5, 6.1), premature rupture of membrane(OR: 4.0; 95% CI: 12.4, 6.6), primiparas(OR: 2.8; 95% CI: 1.9, 4.1), prolonged labor(OR: 4.2; 95% CI: 2.8, 6.6), maternal anaemia(OR: 5.1; 95% CI: 2.59, 9.94), low birth weight(OR = 5.6; 95%CI: 4.7,6.7), meconium stained amniotic fluid(OR: 5.6; 95% CI: 4.1, 7.5), abnormal presentation(OR = 5.7; 95% CI: 3.8, 8.3), preterm birth(OR = 4.1; 95% CI: 2.9, 5.8), residing in a rural area (OR: 2.7; 95% CI: 2.0, 3.5), caesarean delivery(OR = 4.4; 95% CI:3.1, 6.2), operative vaginal delivery(OR: 4.9; 95% CI: 3.5, 6.7), preeclampsia(OR = 3.9; 95% CI: 2.1, 7.4), tight nuchal cord OR: 3.43; 95% CI: 2.1, 5.6), chronic hypertension(OR = 2.5; 95% CI: 1.7, 3.8), and unable to write and read (OR = 4.2;95%CI: 1.7, 10.6). Conclusion According to the findings of this study, birth asphyxia is an unresolved public health problem in the Ethiopia. Therefore, the concerned body needs to pay attention to the above risk factors in order to decrease the country’s birth asphyxia. Review registration PROSPERO International prospective register of systematic reviews (CRD42020165283).

scholarly journals Pharmacological and behavioural interventions to promote smoking cessation in adults with schizophrenia and bipolar disorders: a systematic review and meta-analysis of randomised trials

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e027389 ◽  
Author(s):  
Robert Pearsall ◽  
Daniel J Smith ◽  
John R Geddes
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Smoking Cessation ◽  
Serious Mental Illness ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Public Health Problem ◽  
Controlled Trials ◽  
Major Public Health Problem ◽  
Randomised Controlled

ObjectiveSmoking in people with serious mental illness is a major public health problem and contributes to significant levels of morbidity and mortality. The aim of the review was to systematically examine the efficacy of methods used to aid smoking cessation in people with serious mental illness.MethodA systematic review and meta-analysis of randomised controlled trials to compare the effectiveness and safety of pharmacological and behavioural programmes for smoking cessation in people with serious mental illness. Electronic databases were searched for trials to July 2018. We used the Cochrane Collaboration’s tool for assessing the risk of bias.ResultsTwenty-eight randomised controlled trials were identified. Varenicline increased the likelihood of smoking cessation at both 3 months (risk ratio (RR) 3.56, 95% CI 1.82 to 6.96, p=0.0002) and at 6 months (RR 3.69, 95% CI 1.08 to 12.60, p=0.04). Bupropion was effective at 3 months (RR 3.96, 95% CI 1.86 to 8.40, p=0.0003), especially at a dose of 300 mg/day, but there was no evidence of effect at 6 months (RR 2.22, 95% CI 0.52 to 9.47, p=0.28). In one small study, nicotine therapy proved effective at increasing smoking cessation up to a period of 3 months. Bupropion used in conjunction with nicotine replacement therapy showed more effect than single use. Behavioural and bespoke interventions showed little overall benefit. Side effects were found to be low.ConclusionThe new information of this review was the effectiveness of varenicline for smoking cessation at both 3 and 6 months and the lack of evidence to support the use of both bupropion and nicotine products for sustained abstinence longer than 3 months. Overall, the review found relatively few studies in this population.

scholarly journals Association between birth interval and wasting in children under 5 years of age in Ethiopia: a systematic review and meta-analysis protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037976
Author(s):  
Mesfin Wudu Kassaw ◽  
Ayele Mamo Abebe ◽  
Biruk Beletew Abate ◽  
Ayelign Mengesha Kassie ◽  
Murat Açık
Keyword(s):  
Systematic Review ◽  
Birth Interval ◽  
Meta Analysis ◽  
Geographical Area ◽  
Public Health Problem ◽  
Joint Estimation ◽  
Hard Copy ◽  
P Value ◽  
Pooled Prevalence ◽  
Debre Berhan

IntroductionAccording to the UNICEF, WHO and World Bank joint estimation, 1 in every 13 children suffered from wasting globally. The highest burden of undernutrition recorded in Asia and Africa. Wasting remains a considerable public health problem in Ethiopia despite the introduction of exhaustive nutritional programmes. As reported in the literature, the prevalence of wasting in Ethiopia has remained high over the last four decades. In Ethiopia, more than one-third of child deaths are associated with malnutrition. The current nutritional interventions implemented in Ethiopia need to be evidence based. For this purpose, systematic review is preferable as it can present a more reliable and precise estimate than individual studies. The aim of this review is to assess the pooled prevalence of wasting and its association with birth interval in Ethiopia.MethodologyStudies published after 20 January 2012 will be retrieved from databases, mainly PubMed/Medline, Scopus, Embase, CINAHL and HINARI. The articles retrieved from databases will be selected after reading the title, abstract and full text. Three reviewers will independently assess the quality of each study using both the Joanna Briggs Institute and Ottawa Scale critical appraisal checklists. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist will be used to maintain scientific strength. Funnel plots, Egger’s test and Begg’s test will be used to deal with publication bias, and I2, forest plots and Cochrane’s Q square statistics will be used for heterogeneity. Potential causes of heterogeneity will be explored through sensitivity and subgroup analyses. Because heterogeneity among studies is inevitable, given the wide geographical area and variety of study designs, the Der-Simonian and Laird random-effects model will be used. The presence of a statistical association between birth interval and wasting will be declared if the p value is <0.05 with the 95% CI.Ethics and disseminationEthical issues will not be applicable to this review and meta-analysis. This review and meta-analysis will report the pooled prevalence of wasting and its association with birth interval in Ethiopia. Effort will be made to publish the findings in a peer-reviewed journal such as the Ethiopian Journal of Health and Development, and the findings will be presented at national conferences. A hard copy will also be sent to Woldia University and Debre Berhan University.

scholarly journals Fracture prevention by screening for high fracture risk: a systematic review and meta-analysis

2019 ◽  
Vol 31 (2) ◽  
pp. 251-257 ◽  
Author(s):  
T. Merlijn ◽  
K.M.A. Swart ◽  
H.E. van der Horst ◽  
J.C. Netelenbos ◽  
P.J.M. Elders
Keyword(s):  
Systematic Review ◽  
Fracture Risk ◽  
Meta Analysis ◽  
Fracture Prevention ◽  
High Fracture

scholarly journals Diagnosis and therapy of osteoporosis in geriatric trauma patients: an update

2016 ◽  
Vol 1 (2) ◽  
pp. 65-71 ◽  
Author(s):  
Deborah Schray ◽  
Ulla Stumpf ◽  
Christian Kammerlander ◽  
Wolfgang Böcker ◽  
Carl Neuerburg
Keyword(s):  
Secondary Prevention ◽  
Medical Condition ◽  
Fragility Fractures ◽  
Osteoporosis Treatment ◽  
Fracture Liaison Service ◽  
Subsequent Treatment ◽  
Geriatric Trauma ◽  
Hospital Treatment ◽  
Trauma Patients ◽  
Osteoporosis Therapy

AbstractDemographic changes confront clinicians with an increasing number of orthogeriatric patients. These patients present with comorbidities, which force their surgeons to take into consideration their medical condition. A major risk factor for fractures in orthogeriatric patients is osteoporosis in combination with frailty. To prevent subsequent fractures in these patients, we need to pay attention to adequate osteoporosis treatment in orthogeriatric patients. There is a huge treatment gap. In Germany, 77% of patients with osteoporosis are not treated adequately. Even after fragility fractures, a low percentage of patients receive a specific osteoporosis therapy. Secondary prevention is of great importance in the treatment of these patients. Diagnostics and treatment should be already initiated with the admission to the hospital. Treatment decisions need to be made individually based on the risk profile of the patients. After discharge, it is important to involve the patients’ general practitioners and to follow up on patients regularly to improve their compliance and to ensure adequate therapy. Establishing a fracture liaison service helps coordinating osteoporosis treatment during hospitalization and after discharge. Subsequent fractures can be reduced; therefore, it is an effective service for secondary prevention. The present article provides an overview of how an efficient identification and subsequent treatment of osteoporosis can be achieved in aged trauma patients.

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