Meta-analysis Of Risk Factors Research Articles

Meta-analysis of risk factors for recurrent pulmonary thromboembolism

To evaluate the risk factors of recurrent pulmonary thromboembolism (PTE) through Meta-analysis. Chinese Journal Full-text Database, Chinese Biomedical Database, PubMed and Foreign Medical Journal Full-Text Service were searched for the paper relating to the risk factors of recurrent PTE from January 1995 to May 2011. And the references of these studies were also examined. Observational studies (cohort & case control) were assessed according to the method of quality assessment suggested within the references. Randomized control trials (RCTs) were assessed by the Jadad scale. Software RevMan 5.1 was used to examine the heterogeneity of trials. The fixed or random effect model was pooled to calculate the risk ratio (RR). And the results were expressed by RR (95%CI). Forty-two trials including 36 909 cases of PTE and/or deep vein thrombosis were analyzed. And the following factors were relative to recurrence: elevated D-dimer (1.77 (1.34 - 2.36), P = 0.000), idiopathic PTE (1.82 (1.61 - 2.05), P = 0.000), right ventricular dysfunction (RVD) (persistent RVD vs RVD regression (8.71 (2.38 - 31.91), P = 0.001); persistent RVD vs non-RVD (2.45 (1.26 - 4.76), P = 0.008), short anticoagulation duration (1.73 (1.32 - 2.28), P = 0.000), increased endogenous thrombin generation capacity (1.89 (1.39 - 2.56), P = 0.000), elevated factor VIII (1.96(1.40 - 2.74), P = 0.000), positive antiphospholipid antibodies (5.64 (4.09 - 7.77), P = 0.000), anti-thrombin defect (2.45 (1.26 - 4.76), P = 0.008) and males (1.47 (1.06 - 2.03), P = 0.020), etc. When multiple factors co-existed, the risk of recurrence became more obvious. Elevated D-dimer, idiopathic PTE and many other factors may influence the recurrence of pulmonary embolism. And most recurrent patients have two or more factors.

Frequency of nonsteroidal anti-inflammatory drug-associated ulcers.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used for treatment of orthopedic diseases, inflammatory diseases, etc., and low-dose aspirin is a common antiplatelet therapy given mainly for secondary prevention of atherothrombosis (e.g., myocardial infarction and cerebral infarction). As to the history of NSAID-induced gastric mucosal injury in Japan, the first case of an aspirin-induced gastric ulcer was reported as early as 1934. Based on a meta-analysis of risk factors for peptic ulcers, Helicobacter pylori infection and NSAIDs are the main etiologies of peptic ulcers. NSAIDs alone increase the odds ratio for ulcer development to 19.4 and that for ulcer bleeding to 4.85. In fact, the Japan Rheumatism Foundation reported in 1991 that active gastric ulcers and active duodenal ulcers were detected in 15.5 and 1.9% of 1008 patients, respectively, taking oral NSAIDs for 3months or longer. In Japan, which is becoming an increasingly aged society, the numbers of patients taking NSAIDs and low-dose aspirin are expected to increase dramatically in the future. It is hoped that accumulation of evidence on gastrointestinal risk will allow many patients to rationally avoid gastrointestinal complications while receiving the benefits of NSAIDs and low-dose aspirin.

P1336 A meta-analysis of risk factors for mortality in patients with emphysematous pyelonephritis

P1336 A meta-analysis of risk factors for mortality in patients with emphysematous pyelonephritis

Meta analysis of risk factors for colorectal cancer.

To study the risk factors for colorectal cancer in China. A meta-analysis of the risk factors of colorectal cancer was conducted for 14 case-control studies, and reviewed 14 reports within 13 years which included 5034 cases and 5205 controls. Dersimonian and Laird random effective models were used to process the results. Meta analysis of the 14 studies demonstrated that proper physical activities and dietary fibers were protective factors (pooled OR<0.8), while fecal mucohemorrhage, chronic diarrhea and polyposis were highly associated with colorectal cancer (all pooled OR>4). The stratified results showed that different OR values of some factors were due to geographic factors or different resources. Risks of colorectal cancer are significantly associated with the histories of intestinal diseases or relative symptoms, high lipid diet, emotional trauma and family history of cancers. The suitable physical activities and dietary fibers are protective factors.

Evidence-based management of ectopic pregnancy

Ectopic pregnancy occurs when the conceptus implants outside the normal site within the uterine cavity. The most common site is within the Fallopian tube (98.3%), followed by abdominal (1.4%), ovarian (0.15%) and cervical (0.15%) implantation. Considering tubal ectopic pregnancies, 80% occur at the ampulla and 12% at the isthmus; 6% are fimbrial and 2% are interstitial. Approximately 5% to 5.7% of all clinical pregnancies from assisted reproductive technology (ART) in 1988–92 were ectopic; however, in 1995 the incidence was less at 2.8%. A meta-analysis of risk factors that predispose to ectopic pregnancy is depicted in Table 1. However, this meta-analysis does not control for the interplay of risk factors (multivariate analysis), including the impact of control group data and consequent problems of data collection (e.g. the incidence of pelvic inflammatory disease (PID) in the ectopic group is laparoscopically derived whereas it is derived from the history in the control group).

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.