Pooled OR Research Articles

Predictors of in-hospital mortality among patients with pulmonary tuberculosis: a protocol of systematic review and meta-analysis of observational studies

IntroductionTuberculosis (TB) continues to be a major public health issue worldwide, with 1.4 million deaths occurring annually. There is uncertainty regarding which factors are associated with in-hospital mortality among patients...

Coffee and caffeine intake and risk of urinary incontinence: a meta-analysis of observational studies.

BackgroundPrevious results from studies on the relationship between coffee/caffeine consumption and risk of urinary incontinence (UI) are inconclusive. We aim to assess this association using a meta-analysis of observational studies.MethodsPertinent studies were identified by searching electronic database (Embase, PubMed and Web of Science) and carefully reviewing the reference lists of pertinent articles until July 2015. Random-effects models were used to derive the summary ORs and corresponding 95 % CIs.ResultsSeven studies (one case-control, two cohort and four cross-sectional) were included in our meta-analysis. The summary ORs for any versus non-consumption were 0.75 (95 % CI 0.54–1.04) for coffee and 1.29 (95 % CI 0.94–1.76) for caffeine consumption. Compared with individuals who never drink coffee, the pooled OR of UI was 0.99 (95 % CI 0.83–1.18) for regular coffee/caffeine drinkers. Coffee/caffeine consumption was not associated with moderate to severe UI (OR 1.18, 95 % CI 0.88–1.58). In stratified analyses by gender, no significant association was found between UI risk and coffee/caffeine consumption in both men (OR 0.99, 95 % CI 0.42–2.32) and women (OR 0.92, 95 % CI 0.80–1.06). By subtype, the pooled ORs were 1.01 (95 % CI 0.86–1.19) for stress UI, 0.99 (95 % CI 0.84–1.16) for urge UI and 0.93 (95 % CI 0.79–1.10) for mixed UI.ConclusionsThis meta-analysis found no evidence for an association between coffee/caffeine consumption and the risk of UI.

Association Between Factor V Leiden Mutation, Small for Gestational Age, and Preterm Birth: A Systematic Review and Meta-Analysis.

To estimate the association of a maternal factor V Leiden (FVL) mutation with SGA and preterm birth. We performed a search of PubMed, Embase, Scopus, CINAHL, and the Cochrane Library from inception to April 2016 for cohort and case-control studies of women with FVL mutation and associated outcomes of SGA and preterm birth that included a reference group without FVL mutation. Additional studies were identified from reference lists of relevant research and review articles. Two authors (JKB, AMO) independently examined the abstracts of the potentially eligible studies, and full texts of eligible studies were retrieved for further evaluation. Disagreements were resolved by consensus. We identified 42 studies suitable for inclusion in the meta-analysis. Thirty-two studies evaluated SGA, and 18 studies assessed preterm birth. Study quality was assessed using the Newcastle Ottawa Scale. A random effects model with inverse variance weighting was used to calculate pooled ORs and 95% CIs. Subgroup analyses were performed by study design. The overall OR associating FVL mutation with SGA was significant (OR 1.40, 95% CI 1.18 to 1.67). Analysis of 13 cohort studies resulted in an OR of 1.20 (95% CI 1.03 to 1.41), and data from 19 case-control studies yielded an OR of 1.86 (95% CI 1.35 to 2.56). There was no significant association between FVL mutation and preterm birth (OR 1.17, 95% CI 1.00 to 1.37) when all groups were studied, but the association was significant for case-control studies alone (OR 1.40, 95% CI 1.05 to 1.86). There is an increased risk for SGA in pregnancies complicated by FVL mutation in both cohort and case-control study designs. The risk of preterm birth with FVL mutation is less clear, although there is conflicting evidence from cohort and case-control studies regarding the risk of preterm birth associated with FVL mutation.

Bevacizumab Addition in Neoadjuvant Treatment Increases the Pathological Complete Response Rates in Patients with HER-2 Negative Breast Cancer Especially Triple Negative Breast Cancer: A Meta-Analysis

BackgroundNeoadjuvant therapy is administered to breast cancer patients as an induction process before surgery or radiotherapy to reduce tumor size. Human epidermal growth factor receptor-2 (HER-2) negative breast cancer lacks effective standard target therapy. Bevacizumab has a controversial role in the treatment of breast cancer and we conduct a meta-analysis to evaluate the value of adding bevacizumab in neoadjuvant regimen.MethodsPotentially eligible studies were retrieved using PubMed, EMBASE and Medline. Clinical characteristics of patients and statistical data with pathological complete response (pCR) data were collected. Then a meta-analysis model was established to investigate the correlation between administration of bevacizumab in neoadjuvant therapy and pCR rates in HER-2 negative breast cancer.ResultsSeven eligible studies and 5408 patients were yielded. The pCR rates for “breast” or “breast plus lymph node” were similar. In subgroup analysis, we emphasized on patients with triple-negative breast cancer (TNBC). In the criterion of “lesions in breast” the pooled ORs was 1.55 [1.29, 1.86], P<0.00001 and regarding to the evaluation criterion of “lesions in breast and lymph nodes”, the pooled ORs was 1.48 [1.23, 1.78], P<0.0001, in favor of bevacizumab administration.ConclusionAccording to our pooled results, we finally find that bevacizumab addition as a neoadjuvant chemotherapy component, for induction use with limited cycle to improve the pCR rates and patients may avoid long-term adverse event and long-term invalid survival improvement. Especially in subgroup analysis, pCR rates could be improved significantly and physicians could consider bevacizumab with caution. As patients could avoid the adverse event caused by long-term using of bevacizumab, long-term quality of life improvement may be achieved, especially in TNBC.

Hepatitis B vaccine response in obesity: A meta-analysis

BackgroundHepatitis B vaccination is critical in preventing hepatitis B virus (HBV) infection and transmission. However, the impact of obesity on immune response to hepatitis B vaccine remains unclear. MethodsWe performed a meta-analysis of the literature and summarized the results of immune response to hepatitis B vaccine among persons with and without obesity. We used Pubmed, Embase, Web of Science and Cochrane Library to identify all related studies between January 1973 and November 2015. Unadjusted and adjusted pooled OR and 95% CI were calculated by fixed-effect model or random-effect model according to the heterogeneity of the selected studies. ResultsTotally, 16 studies contributed to the present meta-analysis. Fifteen of them provided absolute numbers of non-responders in obese group and non-obese group. Overall, we found that the obese population was significantly associated with non-response to hepatitis B vaccination (adjusted OR: 2.46, 95% CI: 1.50–4.03). Significant heterogeneity was present in most of the pooled analyses, but was markedly reduced when analyses were restricted to study reports with uniform criteria of obesity and restricted to study in adults. No publication bias was observed in the present analysis. ConclusionsThe present meta-analysis suggested that obesity is significantly associated with the decreased response to hepatitis B vaccines. Future studies should be performed to unravel this relationship in order to prevent HBV infection and transmission.

Faecal carriage of antibiotic resistant Escherichia coli in asymptomatic children and associations with primary care antibiotic prescribing: a systematic review and meta-analysis.

BackgroundThe faecal reservoir provides optimal conditions for the transmission of resistance genes within and between bacterial species. As key transmitters of infection within communities, children are likely important contributors to endemic community resistance. We sought to determine the prevalence of antibiotic-resistant faecal Escherichia coli from asymptomatic children aged between 0 and 17 years worldwide, and investigate the impact of routinely prescribed primary care antibiotics to that resistance.MethodsA systematic search of Medline, Embase, Cochrane and Web of Knowledge databases from 1940 to 2015. Pooled resistance prevalence for common primary care antibiotics, stratified by study country OECD status. Random-effects meta-analysis to explore the association between antibiotic exposure and resistance.ResultsThirty-four studies were included. In OECD countries, the pooled resistance prevalence to tetracycline was 37.7 % (95 % CI: 25.9–49.7 %); ampicillin 37.6 % (24.9–54.3 %); and trimethoprim 28.6 % (2.2–71.0 %). Resistance in non-OECD countries was uniformly higher: tetracycline 80.0 % (59.7–95.3 %); ampicillin 67.2 % (45.8–84.9 %); and trimethoprim 81.3 % (40.4–100 %). We found evidence of an association between primary care prescribed antibiotics and resistance lasting for up to 3 months post-prescribing (pooled OR: 1.65, 1.36–2.0).ConclusionsResistance to many primary care prescribed antibiotics is common among faecal E. coli carried by asymptomatic children, with higher resistance rates in non-OECD countries. Despite tetracycline being contra-indicated in children, tetracycline resistance rates were high suggesting children could be important recipients and transmitters of resistant bacteria, or that use of other antibiotics is leading to tetracycline resistance via inter-bacteria resistance transmission.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-016-1697-6) contains supplementary material, which is available to authorized users.

Abstract 1751: Coffee and tea intake and risk of endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2)

Abstract Background: Endometrial cancer (EC) is the most common gynecological malignancy in developed countries. Well-known risk factors for EC include obesity and elevated levels of estrogen and insulin. Coffee and tea are the most widely consumed beverages in the world, after water. Both are a complex mixture of chemicals with potential antimutagenic and antioxidant properties. Previous studies have reported an inverse association between coffee consumption and circulating levels of estrogen and C-peptide, a marker of insulin secretion, both involved in endometrial carcinogenesis. The presence of antioxidants and other chemopreventive compounds in coffee and tea may have an anticarcinogenic effect. Thus, coffee and tea drinking may decrease the risk of EC. Objective: To examine the association between coffee and tea intake and endometrial cancer risk. Patients and Methods: We combined individual-level data from 24 epidemiologic studies (10 Cohort studies, 14 Case-Control studies) from the Epidemiology of Endometrial Cancer (E2C2) Consortium and performed a pooled analysis of 11,424 endometrial cancer cases and 28,388 controls. Logistic regression models were used to calculate ORs and the corresponding 95% CI. All models were adjusted for potential confounders. Results and Conclusions: Increased coffee consumption was associated with a reduced risk of endometrial cancer: compared to non-coffee drinkers, the pooled OR for those who drank more than 1 cup of coffee per day was 0.79 (95%CI = 0.71-0.87, p = 5.48×10−6). The association is mainly observed in cohort studies and remains significant after adjusting for potential confounders. We found no association between tea consumption and endometrial cancer risk. Citation Format: Marta Crous-Bou, Epidemiology of Endometrial Cancer Consortium (E2C2), Immaculata De Vivo. Coffee and tea intake and risk of endometrial cancer in the Epidemiology of Endometrial Cancer Consortium (E2C2). [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1751.

An updated systematic review and meta-analysis on the association between Helicobacter pylori infection and iron deficiency anemia.

We conducted an updated systematic review and meta-analysis to examine the prevalence of depleted iron stores among persons infected with Helicobacter pylori compared to uninfected ones. We also assessed the impact of anti-H.pylori eradication therapy plus iron therapy on ferritin and hemoglobin levels compared to iron therapy alone. A literature search was conducted using the databases Medline, the Cochrane Library, Cochrane Central Register of Controlled Trials, EMBASE, and the Science Citation Index Expanded. Observational studies with methodological quality score of 13 (median score) and above, on a scale of 0-16, and all randomized controlled trials (RCTs) were eligible for the meta-analyses. Pooled point estimates and 95% confidence intervals (CI) were obtained using the random effects model. Compared to uninfected persons, H.pylori-infected individuals showed increased likelihood of iron deficiency anemia (14 observational studies); pooled OR 1.72 (95% CI 1.23-2.42); iron deficiency (pooled OR 1.33; 95% CI 1.15-1.54; 30 studies); and anemia (pooled OR 1.15; 95% CI 1.00-1.32; 23 studies). Meta-analyses of seven RCTs showed increased ferritin, standardized mean difference (SMD) 0.53 (95% 0.21-0.85), but not hemoglobin, SMD 0.36 (95% -0.07 to 0.78), Pv=.1, following anti-H.pylori eradication therapy plus iron therapy as compared with iron therapy alone. Significant heterogeneity was found among studies, as well as evidence of publication bias. Current evidence indicates increased likelihood of depleted iron stores in relation to H.pylori infection. H.pylori eradication therapy, added to iron therapy, might be beneficial in increasing ferritin and hemoglobin levels.

Clinical characteristics of XP11.2 translocation/TFE3 gene fusion renal cell carcinoma: a systematic review and meta-analysis of observational studies.

BackgroundRenal cell carcinoma (RCC) associated with Xp11.2 translocation/TFE3 gene fusion (Xp11.2 RCC) is a rare subtype of RCC which is firstly described as a distinct entity in 2004 so that clinical characteristics of Xp11.2 RCC in different gender and age are unknown. The purpose of systematic review and meta-analysis is to provide a comprehensive assessment on them.MethodsMEDLINE, EMBASE and Cochrane databases were searched for studies which evaluate the clinical characteristics of Xp11.2 RCC. The literature published between July 2004 and May 2014 was searched.ResultsA total of 15 studies with 147 participants were included. The meta-analysis demonstrated that number of patients of all age in female was higher than in male with pooled OR of 3.93(95 % CI = 1.66–9.34). However, incidence of distant metastases (OR = 0.34, 95 % CI = 0.12–1.57) and lymphatic metastases (OR = 0.51, 95 % CI = 0.14–1.91), tumor stage (OR = 0.85, 95 % CI = 0.34–2.15) and overall survival (OS) (OR = 0.46, 95 % CI = 0.05–4.34) between male and female were comparable. Incidence in female was higher than in male with pooled OR of 5.13(95 % CI = 1.67–15.72) in adults, while in children no gender-related predominance (OR = 1.19, 95 % CI = 0.38–3.72) was observed. In addition, incidence of distant metastases (OR = 1.00, 95 % CI = 0.13–7.84) and lymphatic metastases (OR = 1.00, 95 % CI = 0.07–13.67) and tumor stage (OR = 1.94, 95 % CI = 0.20–19.03) between children and adults were comparable. Survival curves presented comparable outcomes between male and female (P = 0.707) as well as between children and adults (P = 0.383).ConclusionsFemale patients with Xp11.2 RCC in adults exhibit a high incidence compared to male, but not in children. Comparable clinical characteristics including incidence of distant and lymphatic metastases, tumor stage and prognosis is presented between male and female as well as between children and adults.

Consumption of fruit and vegetables and risk of frailty: a dose-response analysis of 3 prospective cohorts of community-dwelling older adults

Background: Consuming fruit and vegetables (FVs) may protect against frailty, but to our knowledge no study has yet assessed their prospective dose-response relation.Objective: We sought to examine the dose-response association between FV consumption and the risk of frailty in older adults.Design: Data were taken from 3 independent cohorts of community-dwelling older adults: the Seniors-ENRICA (Study on Nutrition and Cardiovascular Risk Factors in Spain) cohort (n = 1872), Three-City (3C) Bordeaux cohort (n = 581), and integrated multidisciplinary approach cohort (n = 473). Baseline food consumption was assessed with a validated computerized diet history (Seniors-ENRICA) or with a food-frequency questionnaire (3C Bordeaux and AMI). In all cohorts, incident frailty was assessed with the use of the Fried criteria. Results across cohorts were pooled with the use of a random-effects model.Results: During a mean 2.5-y follow-up, 300 incident frailty cases occurred. Fully adjusted models showed that the pooled ORs (95% CIs) of incident frailty comparing participants who consumed 1, 2, or ≥3 portions of fruit/d to those with no consumption were, respectively, 0.59 (0.27, 0.90), 0.58 (0.29, 0.86), and 0.48 (0.20, 0.75), with a P-trend of 0.04. The corresponding values for vegetables were 0.69 (0.42, 0.97), 0.56 (0.35, 0.77), and 0.52 (0.13, 0.92), with a P-trend < 0.01. When FVs were analyzed together, the pooled ORs (95% CIs) of incident frailty were 0.41 (0.21, 0.60), 0.47 (0.25, 0.68), 0.36 (0.18, 0.53), and 0.31 (0.13, 0.48), with a P-trend < 0.01 for participants who consumed 2, 3, 4, or ≥5 portions/d, respectively, compared with those who consumed ≤1 portion/d. An inverse dose-response relation was also found between the baseline consumption of fruit and risk of exhaustion, low physical activity, and slow walking speed, whereas the consumption of vegetables was associated with a decreased risk of exhaustion and unintentional weight loss.Conclusions: Among community-dwelling older adults, FV consumption was associated with a lower short-term risk of frailty in a dose-response manner, and the strongest association was obtained with 3 portions of fruit/d and 2 portions of vegetables/d.

PON1 L55M polymorphism might contribute to the risk of cancer.

The results involved in correlation of PON1 L55M polymorphism and cancer risk are still inconsistent and controversial. Therefore, we performed this comprehensive meta-analysis for the effects of PON1 L55M polymorphism and cancer risk. We carried out a database search in PubMed (Medline) and EMBASE covering all published articles. The strength of association between PON1 L55M polymorphism and cancer risk was estimated by pooled ORs with corresponding 95% confidence intervals (CI). Twenty-one independent case-control studies concerned with association between PON1 L55M polymorphism and cancer risk were finally included in this meta-analysis. We found that there was a statistical significance between PON1 L55M polymorphism and cancer risk (OR=1.21, 95% CI: 1.04-1.40). In stratified analyses by site of cancer, statistically significant increased breast cancer risk was found (OR=2.04, 95% CI: 1.29-3.21). In stratified analyses by ethnicity, statistically significant increased cancer risk was found in Caucasian populations (OR=1.25, 95% CI: 1.03-1.51). In stratified analyses by source of control, significant increased cancer risk was found in hospital-based studies (OR=1.26, 95% CI: 1.10-1.44). This meta-analysis suggested that PON1 L55M polymorphism might increase the risk of cancer.

Does negative pressure wound therapy applied to closed incisions following ventral hernia repair prevent wound complications and hernia recurrence? A systematic review and meta-analysis

Despite advances in surgical technique, ventral hernia repair (VHR) remains associated with significant postoperative wound complications. A systematic review and meta-analysis was performed to identify whether the application of negative pressure wound therapy to closed incisions (iNPWT) following VHR reduces the risk of postoperative wound complications and hernia recurrence. The PubMed/MEDLINE, EMBASE and SCOPUS databases were searched for studies published through October 2015. Publications that met the following criteria were included: adult patients undergoing VHR; comparison of iNPWT with conventional dressings; and documentation of wound complications and/or hernia recurrence. The methodological quality of included studies was independently assessed using the Methodological Index for Non-Randomized Studies guidelines. Outcomes assessed included surgical site infection (SSI), wound dehiscence, seroma, and hernia recurrence. Meta-analysis was performed to obtain pooled ORs. Five retrospective cohort studies including 477 patients undergoing VHR were included in the final analysis. The use of iNPWT decreased SSI (OR 0.33 [95% CI 0.20 to 0.55]; P<0.0001), wound dehiscence (OR 0.21 [95% CI 0.08 to 0.55]; P=0.001) and ventral hernia recurrence (OR 0.24 [95% CI 0.08 to 0.75]; P=0.01). There was no statistically significant difference in the incidence of seroma formation (OR 0.59 [95% CI 0.27 to 1.27]; P=0.18). For patients undergoing VHR, current evidence suggests a decreased incidence in wound complications using incisional NPWT compared with conventional dressings.

Risks of Venous Thromboembolism After Cesarean Sections: A Meta-Analysis

Cesarean sections (CS) are believed to be associated with greater risks of postpartum VTE. Our objective was to systematically review the evidence on this association and on the absolute risk of VTE following CS. We searched PubMed, Embase, and conference proceedings from 1980 to November 2015 for reports on the associations of delivery methods with postpartum VTE and on the incidence of VTE following CS. Studies on thrombophilia or recurrent VTE were excluded, and the search was restricted to prospective studies when assessing the incidence of VTE. Pooled relative and absolute risks were estimated with random effects models. The search retrieved 28 mostly retrospective observational studies comparing risks of VTE following CS and following vaginal deliveries (VD) (> 53,000 VTE events) and 32 prospective studies reporting risks of VTE following CS (218 VTE events). Compared with VD, the relative risk of VTE following CS ranged from 1 to 22, with a meta-analytic OR of 3.7 (95%CI, 3.0-4.6). Adjustment for age and BMI had a marginal influence on the estimated pooled OR. Associations were observed for both elective and emergency CS, with stronger estimates of associations for emergency CS. The pooled incidence was 2.6 VTE per 1,000 CS (95%CI, 1.7-3.5) and was greater in studies with a longer and better follow-up in the postpartum period (4.3 per 1,000 CS). The risk of VTE was fourfold greater following CS than following VD; seemed independent of other VTE risk factors; and was greater following emergency CS than following elective CS. On average, three in 1,000 women will develop a VTE following CS.

A meta-analysis of MMP-9 promoter -1562 C/T polymorphism on susceptibility of chronic periodontitis.

BackgroundAlthough many studies have focused on the association of the MMP-9 promoter −1562 C/T polymorphism with the susceptibility and/or severity of chronic periodontitis (CP), results have been inconsistent. Therefore, a meta-analysis of all eligible studies was performed to derive a more precise estimation of the association between this polymorphism and CP risk.MethodsAll relevant studies were identified through a database search in PubMed, Medline, and Web of Science. All the full-text studies with appropriate analytical design, published in English, which evaluated the association of MMP-9 promoter −1562C/T polymorphism with CP risk using validated genotyping methods, and with non-duplicated data were selected for this study. A fixed-effect model was used to calculate pooled ORs in the absence of heterogeneity across included trials (P > 0.1 and I2 < 50 %), otherwise the random-effect model was applied.ResultsIn an overall meta-analysis, pooled ORs revealed that T variant in the MMP-9 promoter −1562 C/T polymorphism was associated with a significantly decreased risk for CP under all comparison models. In subgroup analyses by ethnicity, pooled ORs showed that a significant association of the MMP-9 promoter −1562 C/T polymorphism with CP risk was only detected in Caucasians and Asians but not in mixed population. In the subgroup analysis by severity of CP, pooled ORs indicated that T allele of the MMP-9 promoter −1562 C/T polymorphism was associated with decreased susceptibility to severe CP while there was no significant association between this polymorphism and moderate CP.ConclusionsOur meta-analysis showed that T allele in the MMP-9 promoter −1562 C/T polymorphism might be a protective factor for CP, especially in Caucasians and Asians. Moreover, there was a significant association of the MMP-9 promoter −1562 C/T polymorphism with decreased susceptibility to severe CP, while the allelic and/or genotype distributions of this polymorphism were not associated with moderate CP.Electronic supplementary materialThe online version of this article (doi:10.1186/s40064-016-2135-3) contains supplementary material, which is available to authorized users.

Body burden of persistent organic pollutants on hypertension: a meta-analysis.

Except the known risk factors for hypertension, several studies have suggested that exposure to persistent organic pollutants (POPs), endocrine disrupting chemicals, could be associated with an increased risk of hypertension. In this study, we performed a meta-analysis to summarize the existing epidemiological studies to investigate the association between POPs concentration and risk of hypertension. Based on comprehensive literature search results (PubMed, EMBASE, and KoreaMed), a meta-analysis of 11 articles was performed using a random-effects model. While we observed no significant association between the sum of non-dioxin-like PCBs and the risk of hypertension (OR = 1.00; 95% CI 0.89, 1.12), the sum of dioxin-like PCBs was associated with a significantly increased risk of hypertension (OR = 1.45; 95% CI 1.00, 2.12). High p,p'-DDE level was also significantly associated with the increased risk of hypertension. When subgroup analyses were carried out for studies which analyzed POPs concentrations using high-resolution gas chromatography/high-resolution mass spectrometry, the overall pooled estimate ORs increased with decreased heterogeneity, providing it as a possible heterogeneity source (OR = 1.36; 95% CI 1.21, 1.52; I (2) = 42.8%; p = 0.045). This study suggested that the concentration of certain POPs, especially dioxin-related compounds, was associated with the risk of hypertension.

Anastomotic Leaks After Restorative Resections for Rectal Cancer Compromise Cancer Outcomes and Survival.

Anastomotic leaks after restorative resections for rectal cancer may lead to worse long-term outcomes. The purpose of this study was to evaluate the best current evidence assessing anastomotic leaks in rectal cancer resections with curative intent and their impact on survival and cancer recurrence. A meta-analysis was performed using MEDLINE, EMBASE, and Cochrane search engines for relevant studies published between January 1982 and January 2015. Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was used to screen and select relevant studies for the review using key words "colorectal surgery; colorectal neoplasm; rectal neoplasm" and "anastomotic leak." Anastomotic leak groups were compared with nonanastomotic leak groups. ORs were calculated from binary data for local recurrence, distant recurrence, and cancer-specific mortality. A random-effects model was then used to calculate pooled ORs with 95% CIs. Eleven studies with 13,655 patients met the inclusion criteria. This included 5 prospective cohort and 6 retrospective cohort studies. Median follow-up was 60 months. Higher cancer-specific mortality was noted in the leak group with an OR of 1.30 (95% CI, 1.04-1.62; p < 0.05). Local recurrences were more likely in rectal cancer resections complicated by anastomotic leaks (OR = 1.61 (95% CI, 1.25-2.09); p < 0.001). Distant recurrence was not more likely in the anastomotic leak group (OR = 1.07 (95% CI, 0.87-1.33); p = 0.52). All 11 studies are level 3 evidence cohort studies. Additional sensitivity analyses were performed to minimize cross-study heterogeneity. Anastomotic leaks after restorative resections for rectal cancer adversely impact cancer-specific mortality and local recurrence.

Association between subjective social status and cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis

ObjectiveTo determine the association between subjective social status (SSS), or the individual's perception of his or her position in the social hierarchy, and the odds of coronary artery disease (CAD),...

Community pharmacy-delivered interventions for public health priorities: a systematic review of interventions for alcohol reduction, smoking cessation and weight management, including meta-analysis for smoking cessation

ObjectivesTo systematically review the effectiveness of community pharmacy-delivered interventions for alcohol reduction, smoking cessation and weight management.DesignSystematic review and meta-analyses. 10 electronic databases were searched from inception to May 2014.Eligibility...

The clinicopathological significance of FHIT hypermethylation in non-small cell lung cancer, a meta-analysis and literature review.

Emerging evidence indicates that FHIT is a candidate tumor suppressor in non-small cell lung cancer (NSCLC). However, the correlation between FHIT hypermethylation and clinicopathological characteristics of NSCLC remains unclear. Thus, we conducted a meta-analysis to quantitatively evaluate the effects of FHIT hypermethylation on the incidence of NSCLC and clinicopathological characteristics. Final analysis of 1717 NSCLC patients from 16 eligible studies was performed. FHIT hypermethylation was found to be significantly higher in NSCLC than in normal lung tissue, the pooled OR from 8 studies including 735 NSCLC and 708 normal lung tissue, OR = 5.45, 95% CI = 2.15–13.79, p = 0.0003. FHIT hypermethylation was also correlated with sex status, smoking status, as well as pathological types. We did not find that FHIT hypermethylation was correlated with the differentiated types or clinical stages in NSCLC patients. However, patients with FHIT hypermethylation had a lower survival rate than those without, HR = 1.73, 95% CI = 1.10–2.71, p = 0.02. The results of this meta-analysis suggest that FHIT hypermethylation is associated with an increased risk and worsen survival in NSCLC patients. FHIT hypermethylation, which induces the inactivation of FHIT gene, plays an important role in the carcinogenesis and clinical outcome and may serve as a potential drug target of NSCLC.

Point-of-sale tobacco promotion and youth smoking: a meta-analysis

IntroductionPrevious systematic reviews have found consistent evidence of a positive association between exposure to point-of-sale (POS) tobacco promotion and increased smoking and smoking susceptibility among children and adolescents. No meta-analysis...