Newcastle-Ottawa Scale Checklist Research Articles

Investigating the Association Between Traffic-related Air Pollution (PM2.5 and Benzene) and the Risk of Asthma: A Systematic Review and Meta-analysis

Background and aims: Asthma is a chronic disease that causes respiratory system inflammation. Recently, traffic-related air pollution (TRAP), especially particulate matter (PM2.5) and benzene, has been considered a factor that may increase the risk of asthma. This study investigated the association between TRAP (PM2.5 and benzene) and asthma risk. Methods: In this systematic review and meta-analysis, the relevant published data were collected by searching the Cochrane Library, Web of Science, ScienceDirect, Scopus, PubMed, and Google Scholar databases up to November 2022. The study quality was evaluated using the Newcastle-Ottawa Scale checklist. The data were analyzed using Stata software (version 14), and the significance level in this meta-analysis study was considered to be<0.05. Results: In the first search, 4,909 and 4,825 studies were extracted for PM2.5 and benzene, respectively. After evaluating and considering the search criteria, 25 and 4 studies remained for PM2.5 and benzene, respectively. For PM2.5, the odds ratio (OR) for developing asthma in the TRAP-exposed group compared to the unexposed group was 1.11 (95% confidence interval [CI]: 1.04-1.19, P=0.002). For benzene, the OR of developing asthma in the exposed group was 1.19 when compared to the unexposed group (95% CI: 1.10-1.29, P<0.001). Conclusion: Based on this review study, there was a positive association between TRAP exposure and the development of asthma. The results confirmed that PM2.5 and benzene increase the risk of asthma.

The association between the Helicobacter pylori infection and the occurrence of gestational diabetes: a systematic review and meta-analysis

BackgroundThis meta-analysis aims to establish a more precise association between gestational diabetes mellitus (GDM) incidence and H. pylori infection by amalgamating findings from prior case–control and cohort studies.MethodsTo identify relevant studies, we conducted a comprehensive search using the Excerpta Medica Database (Embase), PubMed (Medline), Web of Science (ISI), and Scopus from January 1990 to November 2022. The screening process involved reviewing the entire text, abstracts, and titles of retrieved articles. Subsequently, data extraction was performed from the selected articles, and their quality was assessed using the Newcastle–Ottawa Scale checklist. Version 17 of STATA software was utilized for the analysis, with relative risks (RR) calculated along with their 95% confidence intervals (CI) to quantify the impact of the included studies.ResultsThis meta-analysis included eight observational and analytical studies. The combined risk of gestational diabetes mellitus (GDM) in pregnant women with H. pylori infection was found to be 1.97 times higher compared to pregnant women without infection (RR: 1.97; 95% CI 1.57–2.47; I2 = 0.00%; P = 0.84).ConclusionPregnant women with H. pylori infection are at an increased risk of developing gestational diabetes.

Management of Iatrogenic Medial Collateral Ligament Injury in Primary Total Knee Arthroplasty: A Systematic Review.

The medial collateral ligament (MCL) injury is one of the possible complications of primary total knee arthroplasty (TKA), which can lead to coronal-plane instability that requires surgical revision. Injured MCL can result in joint instability and polyethylene wear. Different strategies have been proposed for MCL reconstruction based on the location of the injury. However, there is a lack of clarity regarding the optimal method for handling an iatrogenic MCL injury throughout a TKA. A PRISMA flow diagram was used to guide the systematic literature review. An extensive search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar. Newcastle Ottawa scale checklist was used to assess the methodological quality of the articles. A total of 19 qualitative studies, including non-cadaveric patients with MCL injury during TKA, were identified after analyzing the full text of the articles. All included studies were either retrospective, observational cohort or case series. A total of 486 patients were studied to gather information on the methods used to repair the MCL and their results. Most injuries arose in the tibial attachment, which surgeons mostly realized during the final stages of surgery. Used techniques can be categorized into three main groups: Primary repair, Repair with augmentation, and changing prosthesis characteristics. This systematic review demonstrated that the most popular management of iatrogenic MCL injury was using suture anchors, staples, screws and washers, and more constrained prostheses. The proper method should be decided considering the site of the MCL injury.

The association between mode of childbirth delivery and early childhood caries: A comprehensive systematic review and meta-analysis.

Early childhood caries (ECC), also known as dental caries, poses a significant challenge to the oral health and overall well-being of young children. This study aims to investigate the potential relationship between the mode of delivery and the odds of ECC. We conducted a meticulous systematic review and meta-analysis, gathering studies from reputable databases, including Web of Science, Scopus, PubMed, Cochrane, Google Scholar, and Embase. The selected studies underwent rigorous evaluation for heterogeneity, utilizing statistical tests such as the Chi-square test, I2, meta-regression analysis, sensitivity analysis, and subgroup analysis. We assessed the presence of publication bias using Begg's and Egger's tests, while the quality of the articles was evaluated using the Newcastle-Ottawa Scale checklist. Our analysis included a robust dataset of 24 studies conducted between 1997 and 2024, involving a total of 71,732 participants. The meta-analysis revealed an odds ratio of 1.05 (95% CI: 0.86-1.30; P-value = 0.610) for dental caries in children born via cesarean section. Importantly, we found no evidence of publication bias, as indicated by non-significant results from Begg's test (P-value = 0.568) and Egger's test (P-value = 0.807). Meta-regression analysis did not identify any significant associations between the study variables and the observed heterogeneity (P > 0.10). Sensitivity analysis further confirmed the stability of the study results, with no significant changes detected. In conclusion, our comprehensive meta-analysis provides compelling evidence that there is no significant association between the mode of delivery and the odds of ECC. These findings enhance our understanding of this important topic and have implications for clinical practice and public health interventions.

Prevalence of depression in infertile men: a systematic review and meta-analysis

BackgroundGenerally, infertile men hide their depression, which can threaten their health and lower their quality of life. Given the role of depression and its impact on people's health, this systematic review and meta-analysis aimed to investigate the prevalence of depression in infertile men.MethodsThis research is a systematic review and meta-analysis based on preferred reporting items for systematic reviews and meta-analyses (PRISMA). Using the keywords of "Depression", "Emotional Depression", "Infertility", "Prevalence", and "Epidemiology", all English language articles were searched in international databases (PubMed, Cochran library, Web of sciences, Scopus, Embase, PsyINFO, and Google scholar) by two reviewers independently and without considering the time limit until September 2022. Title, abstract, full text and quality of each study were evaluated by two reviewers independently using the Newcastle–Ottawa Scale checklist. The results were analyzed using programming language and R software, and I2 test and Egger's Test were used to check heterogeneity and publication bias, respectively.ResultsTwenty-two studies were included in the systematic part of this study; and 8 different measurement tools were used to identify depression. Then, based on the possibility of meta-analysis, 18 studies were included in 4 subgroups. Given the heterogeneity of the articles, random effect model was used. The overall prevalence of depression in infertile men was 18.30%. The lowest and highest overall prevalence of depression in men was reported to be 14.04% and 23.63% in the Zung Self-Rating Depression Scale (ZDS) and the Depression Anxiety Stress Scales (DASS) tools, respectively. The overall prevalence of depression among infertile men was reported to be 18.55% and 16.75% using the Beck Depression Inventory (BDI) and the Hospital Anxiety and Depression Scale (HADS) tools, respectively.ConclusionBased on the findings of this study, the significant prevalence of depression in infertile men requires a specific attention and planning. The study revealed varying degrees of depression among infertile men, emphasizing the importance of assessing their mental health, specifically in terms of depression, during infertility treatments as a hidden variable. It is strongly recommended to develop training programs for health service providers to effectively utilize diagnostic tools in this particular field.

The association between periodontal disease and risk of adverse maternal or neonatal outcomes: A systematic review and meta-analysis of analytical observational studies.

The aim of this meta-analysis was to find the association between periodontal disease (PD) and the risk of adverse pregnancy outcomes, including Pre-eclampsia (PE), premature rupture of the amniotic sac, gestational diabetes (GDM), or low birth weight (LBW) in pregnant women, which should be investigated in a systematic meta-analysis. Studies that reported the association between PD and pregnancy or neonatal outcomes and were published from January 1990 to December 2022, were identified by an extensive search in PubMed (Medline), Scopus, Web of Sciences, and Medline (Elsevier). After retrieving the studies, the screening stage was performed based on their titles, abstracts, and full texts, and after selecting the final articles, their information was extracted and their quality was assessed using the Newcastle Ottawa Scale checklist. Pregnant women with PD had a 1.39 higher chance of developing GDM than those who did not have the infection (risk ratio [RR]: 1.39; 95% confidence interval [CI]: 1.21-1.61; I square: 49.67%; p: 0.03). Additionally, the pooled RRof LBW was 2.19, which indicates that pregnant women with PD had a 2.19-fold higher risk of LBW than pregnant women who do not have the infection (RR: 2.19; 95% CI: 1.82-2.64; I square: 0.00%; p: 0.65). The relationship between the risk of PE and the existence of PD was examined in 33 cohort and case-control studies for this meta-analysis. These results were combined, and the pooled RR was 1.43. This indicates that pregnant women with PD are 1.43 times more likely to experience PE than pregnant women without PD (RR: 1.43; 95% CI: 1.32-1.54; I square: 82.64%; p: 0.00). According to the findings of the current meta-analysis, PD may contribute to a higher risk of poor maternal and newborn outcomes in pregnant women.

The relation between obesity and breast cancer risk in women by considering menstruation status and geographical variations: a systematic review and meta-analysis

Given the increase in the incidence of breast cancer during the past decades, several studies have investigated the effects of variables on breast cancer, especially obesity. This systematic review and meta-analysis aims to evaluate any effects of obesity on breast cancer risk in women, before and after menopause, and in different continents.All forms of relevant literature examining any association between obesity and breast cancer, including cohort, case–control, and cross-sectional studies, were identified in the PubMed, Scopus, EMBASE, and Web of Science databases from January 1, 1990 until January 13, 2023. Body mass index (BMI) > 30 was used to indicate obesity. Every type of breast cancer was examined as outcome factors. The quality of the papers was evaluated using the Newcastle–Ottawa scale checklist. The Egger and Begg test was used to evaluate publication bias. To assess any extra impact of each research on the final measurement, a sensitivity analysis was carried out.One hundred and two studies were included in this meta-analysis. Respectively, 48 and 67 studies reported associations between obesity and breast cancer in pre and post menopausal women. Combining all studies, the pooled OR of the association between obesity and breast cancer in pre-menopausal women was OR = 0.93 CI: (0.85–1.1), (I2 = 65.4%), and for post-menopausal woman, OR = 1.26 CI: (1.19–1.34), (I2 = 90.5%).Obesity has a protective role in breast cancer among pre-menopausal women, but this relationship is statistically significant only in European women. The chance of developing breast cancer increases in post-menopausal women who are obese. This relationship is significant among Asian, North American, African and European women.

Risk Factors for the Occurrence of Asymptomatic Brain Lesions in Patients with β-Thalassemia: a Systematic Review and Meta-Analysis.

Several factors, including increased platelet aggregation, decreased platelet survival, decreased antithrombotic factors cause a hypercoagulable state in thalassemia patients. This is the first meta-analysis designed to summarize the association of age, splenectomy, gender, and serum ferritin and hemoglobin levels with the occurrence of asymptomatic brain lesions in thalassemia patients using MRI. This systematic review and meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist. We searched four major databases and included eight articles for this review. The quality of the included studies was assessed based on the Newcastle-Ottawa Scale checklist. Meta-analysis was performed using STATA 13. Odds ratio (OR) and standardized mean difference (SMD) were considered as effect sizes for comparing the categorical and continuous variables, respectively. The pooled OR for splenectomy in patients with brain lesions compared to those without lesions was 2.25 (95% CI 1.22 - 4.17, p = 0.01). The pooled analysis for SMD of age between patients with/without brain lesions was statistically significant, 0.4 (95% CI 0.07 - 0.73, p = 0.017). The pooled OR for the occurrence of silent brain lesions was not statistically significant in males compared to females, 1.08 (95% CI 0.62 - 1.87, p = 0.784). The pooled SMD of Hb and serum ferritin in positive brain lesions compared to negatives were 0.01 (95% CI -0.28, 0.35, p = 0.939) and 0.03 (95% CI -0.28, 0.22, p = 0.817), respectively, which were not statistically significant. Older age and splenectomy are risk factors for developing asymptomatic brain lesions in β-thalassemia patients. Physicians should consider a careful assessment of high-risk patients for starting prophylactic treatment.

What is the global prevalence of depression among men who have sex with men? A systematic review and meta-analysis

BackgroundDepression due to stigma resulting from their sexual identity, isolation, social exclusion, and insufficient access to care and counseling services has become a health problem among men who have sex with men (MSM).ObjectivesThis study aimed to determine the global prevalence of depression among MSM as a systematic review and meta-analysis.MethodsThis study was a systematic review and meta-analysis performed in five steps of search strategy, screening and selecting articles, data extraction, evaluation of the risk of bias, and meta-analysis. In this study, the determined keywords were searched in the databases of PubMed, Scopus, Embase, and Web of Science from January 1913 to July 2021 to find the initial articles, from which data were extracted according to the set checklist in the data extraction stage. Finally, the studies were included in the present meta-analysis according to the inclusion and exclusion criteria, to be evaluated using the Newcastle Ottawa scale checklist. I Square and Q Cochrane were also used to assess the degree of heterogeneity. The analyses were performed using the random-effects model in STATA 16.ResultsThe results showed the quality score of the majority of cross-sectional studies included in the meta-analysis (62 studies) was equal to six or seven (moderate), and five ones had a high-quality score. After combining these studies, the pooled prevalence of depression among MSM in the world was 35% (95% CI 31%–39%, I square; 98.95%, P-value < 0.001). Population subgroup analysis showed the pooled prevalence of depression among MSM living with HIV was 47% (95% CI 39%-55%, I square; 95.76%, P-value < 0.001). Continent subgroup analysis showed the highest pooled prevalence of depression among Asian MSM at 37% (95% CI 31%-43%, I square; 99.07%, P-value < 0.001). Also, in the subgroup analysis of the sampling method, the pooled prevalence in the studies which used the respondent-driven sampling method was equal to 34% (95% CI 25%-43%, I square; 99.32%, P-value < 0.001). Sensitivity analysis revealed the pooled prevalence of depression in studies included in the meta-analysis was near or around the pooled estimate.ConclusionThe pooled prevalence of depression among MSM was almost three times higher than the general male population. Therefore, particular and therapeutic interventions such as screening, and harm reduction programs for mental disorders, especially depression, are suggested to be considered in service packages.

Global prevalence of polypharmacy among the COVID-19 patients: a comprehensive systematic review and meta-analysis of observational studies

BackgroundPolypharmacy has traditionally been defined in various texts as the use of 5 or more chronic drugs, the use of inappropriate drugs, or drugs that are not clinically authorized. The aim of this study was to evaluate the prevalence of polypharmacy among the COVID-19 patients, and the side effects, by systematic review and meta-analysis.MethodsThis study was performed by systematic review method and in accordance with PRISMA 2020 criteria. The protocol in this work is registered in PROSPERO (CRD42021281552). Particular databases and repositories have been searched to identify and select relevant studies. The quality of articles was assessed based on the Newcastle–Ottawa Scale checklist. Heterogeneity of the studies was measured using the I2 test.ResultsThe results of meta-analysis showed that the prevalence of polypharmacy in 14 studies with a sample size of 189,870 patients with COVID-19 is 34.6% (95% CI: 29.6–40). Studies have shown that polypharmacy is associated with side effects, increased morbidity and mortality among patients with COVID-19. The results of meta-regression analysis reported that with increasing age of COVID-19 patients, the prevalence of polypharmacy increases (p < 0.05).DiscussionThe most important strength of this study is the updated search to June 2022 and the use of all databases to increase the accuracy and sensitivity of the study. The most important limitation of this study is the lack of proper definition of polypharmacy in some studies and not mentioning the number of drugs used for patients in these studies.ConclusionPolypharmacy is seen in many patients with COVID-19. Since there is no definitive cure for COVID-19, the multiplicity of drugs used to treat this disease can affect the severity of the disease and its side effects as a result of drug interactions. This highlights the importance of controlling and managing prescription drugs for patients with COVID-19.

Spontaneous bladder rupture and associated factors during pregnancy:a systematic review and metanalysis protocol

IntroductionSpontaneous bladder rupture during pregnancy is a potentially life-threatening event requiring immediate surgery to reduce morbidity and mortality. This systematic review aims to identify associated factors of spontaneous bladder rupture...

Effects of Hypertonic Sodium Lactate on Intracranial Pressure in Patients with Traumatic Brain Injury: A Systematic Review and Metanalysis on Clinical Trial Studies

Introduction: Intracranial pressure (ICP) elevation leading to cerebral edema is a critical condition that should be identified and treated immediately. In this study, we systematically reviewed the articles investigating the role of hypertonic sodium lactate (HSL) in patients with traumatic brain injury. Method: PubMed, Scopus, EMBASE, and Web of Science were searched to find published articles on the effects of HSL on ICP in patients with a traumatic brain injury until December 2020. Animal studies, case reports, and studies, including liver and renal failure patients, cardiac dysfunction, or hypovolemic shock, were excluded. The Newcastle–Ottawa Scale checklist was used to assess the methodological quality of eligible articles. Information was gathered based on the following: Demographic data, methods, intervention, and outcomes. Results: Our initial search with the predefined search strategy proceeded 113 studies. Finally, seven studies were eligible for systematic review, which three of them were eligible for meta-analysis. A random meta-analysis of three articles comparing ICP before and after the infusion of HSL showed a reduced ICP following the use of HSL in traumatic brain injuries (P=0.015). Conclusion: Our study demonstrated hypertonic sodium lactate's undeniable role in managing increased ICP in patients with brain injury. Nevertheless, conducting more clinical studies for assessing the possible side effects of HSL seems crucial.

Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis.

SummaryThe outbreak of the novel coronavirus disease 2019 (COVID‐19) changed lifestyles worldwide and subsequently induced individuals’ sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID‐19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta‐analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID‐19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline and Newcastle–Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta‐analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%–29%) for female participants and 27% (95% CI 24%–30%) for male participants. Although in both gender subgroups, patients with COVID‐19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta‐regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.

Impact of COVID-19-Related Fear and Anxiety on Job Attributes

The coronavirus disease 2019 (COVID-19) pandemic has had different effects on different occupations. The present study was designed to systematically review the available evidence to investigate the pandemic on occupational effects. The academic databases of Scopus, PubMed Central, ProQuest, Science Direct, and ISI Web of Knowledge were searched systematically between December 2019 and February 2021. COVID-19-related fear, concern, worry, anxiety, and stress in combination with job-related MeSH terms were used to search the databases. The methodological quality of included papers was assessed using the Newcastle Ottawa Scale checklist. To synthesize data, a qualitative synthesis of findings was performed due to the small number of included studies (n = 4) and the heterogeneity of the assessed outcomes. Four studies were included in the final analysis. All four studies were cross-sectional, collected the data online, and comprised 1654 participants from four different countries. Fear of COVID-19 was associated with increased future career anxiety, perceived job insecurity, organizational and professional turnover intentions, and decreased job satisfaction. COVID-19 Anxiety Syndrome was associated with scores on the Work and Social Adjustment Scale. As so few studies have been conducted, there are no conclusive findings. More studies using valid and reliable measures to assess fear/anxiety related to COVID-19 and its' association with job attributes are needed. It is also recommended that these associations are examined in variety of different jobs.

Relationship between blood group and risk of infection and death in COVID-19: a live meta-analysis.

The relationship between ABO blood group and the incidence of coronavirus disease 2019 (COVID-19) infection and death has been investigated in several studies. The reported results were controversial, so the objective of the present study was to assess the relationship between different blood groups and the onset and mortality of COVID-19 infection using a meta-analysis method. We searched relevant databases using appropriate MeSH terms. We screened articles on the bases of titles, abstracts and full text, and articles that met the inclusion criteria were selected. Quality assessment was done with the Newcastle-Ottawa scale checklist. The estimated frequency of COVID-19 infection and death in terms of ABO blood group and the overall estimate of the odds ratio between blood group with COVID-19 infection and death was calculated with 95% confidence interval. The pooled frequency of blood groups A, B, O and AB among COVID-19–infected individuals was estimated as 36.22%, 24.99%, 29.67% and 9.29% respectively. The frequency of blood groups A, B, O and AB among patients who died of COVID-19 infection was estimated as 40%, 23%, 29% and 8% respectively. The odds ratio of COVID-19 infection for blood group A versus the other blood groups was estimated as 1.16 (95% confidence interval (CI), 1.02–1.33). The corresponding figures for blood groups O and AB versus other blood groups were estimated as 0.73 (95% CI, 0.60–0.88) and 1.25 (95% CI, 0.84–1.86) respectively. This meta-analysis showed that individuals with blood group A are at higher risk for COVID-19 infection while those with blood group O are at lower risk. Although the odds ratio of death for AB blood group was nonsignificant, it was considerable.

Patient safety culture assessment in Iran using the “Hospital survey on patient safety culture” tool: A systematic review and meta-analysis

BackgroundPaying attention to patient safety is a crucial aspect of the healthcare provision delivery. Integrating and coordinating the different parts of the health system can ensure a safe, high-quality and efficient care. Patient safety culture (PSC) is a broad, complex and multi-dimensional conceptual framework. In recent years, several studies have been conducted to evaluate PSC using the “Hospital Survey on Patient Safety Culture” (HSOPSC) tool. The aim of this study was to examine the level of PSC in Iranian hospitals. MethodsISI/Web of Sciences (WoS), PubMed/MEDLINE, Embase, CINAHL, PsychINFO and Scopus as well as Iranian databases including MagIran and SID were searched from January 2000 to July 2018. The Newcastle-Ottawa Scale checklist was used to assess the quality of the studies. The mean score of the participants' responses for each dimension of the questionnaire was calculated using the DerSimonian-Laird's random model with a 95% confidence interval. ResultsIn the current systematic review and meta-analysis, 27 studies conducted between 2012 and 2017 were included. The participants were 9264. Low scores (in the range 37.79–65.43) were found, especially when compared to other countries such as Lebanon, Turkey and the USA. ConclusionOur results showed that in Iran the level of PSC is low and requires special attention from healthcare managers and providers. PSC should be a very important priority in Iran's health sector. Health decision- and policy-makers should pay particular attention to offering training programs to promote and develop PSC.

Association between chemokine CXC ligand 12 gene polymorphism (rs1746048) and coronary heart disease: A MOOSE-compliant meta-analysis.

Recently a large number of investigations have implicated the association between the chemokine CXC ligand 12 gene polymorphism (rs1746048) and risk of coronary heart disease (CHD), but the results remain debatable. The aim of our study was to provide more compelling evidence for the relationship between rs1746048 and CHD risk. Studies eligible for this meta-analysis were identified through electronic search of PubMed, EMBASE, and CNKI. Two authors performed independent literature review and study quality assessment by using the Newcastle–Ottawa Scale checklist. The odds ratios (ORs) with 95% confidence intervals (CIs) were pooled in a specific genetic model to assess the association. The meta-analysis of 48,852 patients and 64,386 controls from 12 studies showed that patients with rs1746048 had 1.11 times of high risk in developing CHD (OR = 1.11; 95% CI = 1.09–1.14; P < .005; I2 = 35.8%). The increased risk of CHD was also found in both Asian (OR = 1.07; 95%CI = 1.02–1.12; P < .005; I2 = 40.6%) and Caucasian populations (OR = 1.14; 95% CI = 1.10–1.18; P < .005; I2 = 22.2%). The results of our meta-analysis suggested that chemokine CXC ligand 12 gene polymorphism (rs1746048) may be linked with susceptibility to CHD.

Obstructive sleep apnea increases the risk of cardiac events after percutaneous coronary intervention: a meta-analysis of prospective cohort studies.

Recent studies have shown an association between obstructive sleep apnea (OSA) and coronary artery disease; however, the association between OSA and cardiac outcomes in patients after percutaneous coronary intervention (PCI) remains undetermined. PubMed, EMBASE, and CENTRAL were searched from inception to July 2016 for cohort studies that followed up with patients after PCI, and evaluated their overnight sleep patterns within 1month for major adverse cardiac events (MACEs) as primary outcomes including cardiac death, non-fatal myocardial infarction (MI), and coronary revascularization and secondary outcomes including re-admission for heart failure and stroke. Outcomes data were pooled using fixed-effect meta-analysis, and heterogeneity was assessed with the I 2 statistics. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale checklist, and publication bias was evaluated by a visual investigation of funnel plots. We identified seven pertinent studies including 2465 patients from 178 related articles. OSA was associated with MACEs (odds ratio [OR], 1.52, 95% confidence interval [CI], 1.20-1.93, I 2=29%), which included cardiac death (OR 2.05, 95% CI, 1.15-3.65, I 2=0%), non-fatal MI (OR 1.59, 95% CI, 1.14-2.23, I 2=15%), and coronary revascularization (OR 1.69, 95% CI, 1.28-2.23, I 2=0%). However, OSA was not associated with re-admission for heart failure (OR 1.71, 95% CI, 0.99-2.96, I 2=0%) and/or stroke (OR 1.68, 95% CI, 0.91-3.11, I 2=0%) according to the pooled results. In patients after PCI, OSA appears to increase the risk of cardiac death, non-fatal MI, and coronary revascularization.

The impact of sperm protamine deficiency and sperm DNA damage on human male fertility: a systematic review and meta-analysis.

Existing literature suggests evidence that protamine deficiency is related to DNA damage and male fertility. In this meta-analysis, we analyzed the relationship between the ratio of protamine-1 and protamine-2 with male fertility and the association of protamine deficiency with sperm DNA damage. Quality of available cohort studies was evaluated using the Newcastle-Ottawa Scale checklist. Summary effect estimates with 95% confidence intervals (CI) were derived using a random effects model. The effect of the protamine ratio on male fertility was analyzed in nine studies demonstrating a significantly higher value of the protamine ratio in subfertile men (n=633) when compared with controls (n=453, SMD=0.46, 95% CI 0.25-0.66, Z=4.42, p<0.00001). Both protamine mRNA (SMD=0.45, 95% CI 0.11-0.79, Z=2.63, p=0.009) and protein ratio (SMD=0.46, 95% CI 0.25-0.68, Z=4.22, p<0.0001) showed significantly increased values in subfertile patients. The association between protamine deficiency and DNA damage was analyzed in 12 studies (n=845) exhibiting a combined overall correlation coefficient (COR) of 0.53 (95% CI 0.28-0.71, Z=3.87, p<0.001). Protamine deficiency measured by CMA3 staining was significantly associated with sperm DNA damage (COR=0.71, 95% CI 0.48-0.85, Z=4.87, p<0.001), whereas the P1/P2 ratio was not (COR=0.17, 95% CI -0.16 to 0.46, Z=0.99, p=0.33). It is concluded that the protamine ratio represents a suitable biomarker for the assessment of sperm quality and protamine deficiency is closely related with sperm DNA damage.

Prognostic value of FGF23 among patients with end-stage renal disease: a systematic review and meta-analysis.

Prognostic value of FGF23 in end-stage renal disease (ESRD) patients is controversial. A systematic review was conducted to quantify the association between elevated FGF23 and overall mortality among ESRD patients. MEDLINE, EMBASE, PubMed and reference lists were searched. Quality of the included studies was evaluated using Newcastle-Ottawa Scale checklist. Pooled effects were calculated as hazard ratio using fixed-effect models, and chi-square test was used for heterogeneity testing. Seven studies (1406 patients) were included. Patients were at mean age of 62.3. Mean follow-up was 29.4 months. From the pooled analysis, elevated FGF23 was significantly associated with increased all-cause mortality (hazard ratio: 1.53; 95% CI: 1.05-2.25). p-value for heterogeneity was 0.10, I(2) = 48%. ESRD patients with elevated FGF23 concentration have higher risk of death.