Systematic Review Of Cohort Studies Research Articles

Strategies and Safety in Iliosacral Screw Placement

Background L5 nerve radiculopathy is a serious complication associated with iliosacral (IS) screw fixation, a procedure often performed to stabilize pelvic fractures. The proximity of the L5 nerve root to the S1 sacral segment introduces significant risk, particularly when sacral dysmorphism or complex anatomy is involved. Despite advances in surgical techniques, the potential for nerve injury remains a critical concern during IS screw placement. Purpose/Hypothesis This study aims to evaluate the risks associated with L5 nerve injury during IS screw fixation and identify factors that increase the likelihood of complications, particularly in cases involving sacral dysmorphism. The hypothesis is that proper preoperative planning, sacral anatomy assessment, and improved surgical techniques can minimize the risk of L5 nerve injury during IS screw fixation. Study/Design This is a systematic review of cohort studies, methodology papers, reviews, and cadaver studies from SCOPUS and PubMed that investigate the relationship between sacral anatomy and L5 nerve root injury during IS screw fixation. Methods A comprehensive search was conducted using the keywords “L5 nerve radiculopathy” and “Iliosacral Screw Fixation.” Studies published within the last 15 years were included. Papers involving animal models or published in languages other than English were excluded. A total of 122 studies were identified, of which 15 were selected for detailed review based on their relevance to L5 nerve injury during IS screw fixation. The studies were analyzed for sacral anatomy variations, surgical techniques, and complications. Results The studies identified key factors that increase the risk of L5 nerve injury, including sacral dysmorphism, sacral morphology, and improper preoperative planning. Malpositioning of screws in the S1 sacral segment was associated with the highest risk of L5 nerve injury, particularly in cases involving dysmorphic sacra. Cadaver studies revealed that L5 nerve root proximity to the S1 segment significantly limits the margin for error, while imaging studies highlighted the importance of preoperative identification of osseous corridors. Improved techniques, such as the use of guidewires and triangulation methods, were found to enhance the accuracy of IS screw placement. Conclusion L5 nerve root injury is a major risk during IS screw fixation, particularly in cases with complex sacral anatomy. Preoperative planning that accounts for sacral morphology, along with the adoption of advanced surgical techniques such as the triangulation method by Zheng and Zao and guidewire use, is essential to minimize the risk of nerve injury. Further research should focus on improving intraoperative navigation and refining surgical techniques to enhance patient outcomes in sacral fixation procedures.

Gender, Ethnicity, and Socioeconomic Inequalities in Physical Activity Throughout the Life Course: A Systematic Review of Cohort Studies.

This study aimed to assess longitudinal changes in physical activity inequalities according to gender, socioeconomic status, and ethnicity throughout the life course. We searched PubMed, Embase, Web of Science, and Scopus databases for cohort studies addressing trajectories or monitoring physical activity at a minimum of 2 time points, presenting stratified estimates for at least 1 dimension of inequality (gender, socioeconomic status, or ethnicity). Main methodological characteristics and physical activity point estimates were extracted, enabling interpretation of the stability or increasing/decreasing inequalities over time. Out of the 22 included studies in the review, none were designed or presented with specific aims addressing changes in physical activity according to the dimension of inequalities throughout the life course. Therefore, the main results and interpretation were performed according to available information. Males consistently showed a higher prevalence of physical activity than females. We observed both an increase and stability in gender inequality during childhood, followed by an increase in the transition from childhood to adolescence. During adolescence, both increase and stability in gender inequality were identified, with mixed results observed during adulthood, and in later life stages, in a limited number of studies. There is no or very limited evidence regarding ethnicity and socioeconomic status inequalities throughout the life course. Although none of the studies directly measured inequalities, an early emergence of gender inequalities was observed. Future research should include these dimensions as well as other social identities to enhance the understanding of inequalities throughout the life course.

The relationship between mental health and employment: a systematic review of cohort studies

Abstract Background Knowledge on the bi-directional association between employment status and mental health is important, as it affects multiple dimensions of our daily lives, both at the individual and societal level. Given that the mental health status and employment situation of individuals are likely to change over time, there is an important need for longitudinal data to better understand causality patterns in this association and the underlying mechanisms. Methods A systematic review was carried out based on the PRISMA guidelines in 3 electronic databases: PubMed, Embase, and PsycInfo. Studies eligible for inclusion were cohort studies, involving the general population, and assessing the relationship between employment status and mental health longitudinally. Results In total, 3,733 studies were identified and 36 met the inclusion criteria. The eleven studies focusing on the social causation hypothesis highlighted the negative long-term impact of unemployment and unstable employment on mental health. Four studies observed mental health improvements upon re-entering employment, although limited and in more specific contexts. The fourteen studies focusing on the health selection hypothesis found a lower probability for individuals with mental health problems in finding and maintaining employment. Finally, the eleven studies assessing the two hypothesis simultaneously found that mental health problems were both a consequence of and risk factor for poor employment status, although some important moderating factors, such as gender differences, influence the direction and strength of the association. Conclusions This review underscores the bi-directional association between the employment status and mental health of individuals, highlighting the need to develop targeted prevention (e.g. mental health support in the workplace) and interventions strategies (e.g. supported employment programs) in both the mental health and labor market systems. Key messages • The bidirectional link between employment and mental health highlights the need for concurrent responses to break the vicious cycle between poor mental health and social exclusion. • To reduce the clinical and social burden of mental health problems, gender differences must be taken into account in mental health and employment support practices and policies.

Association of cataract surgery with risk of dementia: a meta-analysis and systematic review of cohort studies with 720,075 participants.

Association of cataract surgery with risk of dementia: a meta-analysis and systematic review of cohort studies with 720,075 participants.

Indications and scientific support for supratentorial unilateral decompressive craniectomy for different subgroups of patients: A scoping review.

Even though supratentorial unilateral decompressive craniectomy (DC) has become the gold standard neurosurgical procedure aiming to provide long term relief of intractable intracranial hypertension, its indication has only been validated by high-quality evidence for traumatic brain injury and malignant middle cerebral artery infarction. This scoping review aims to summarize the available evidence regarding DC for these two recognized indications, but also for less validated indications that we may encounter in our daily clinical practice. A scoping review was conducted on Medline / Pubmed database from inception to present time looking for articles focused on 7 possible indications for DC indications. Studies' level of evidence was assessed using Oxford University level of evidence scale. Studies' quality was assessed using Newcastle-Ottawa scale for systematic reviews of cohort studies and Cochrane Risk of Bias Tool for randomized controlled trials. Two randomized trials (level 1b) reported the possible efficacy of unilateral DC and the mitigated efficiency of bifrontal DC in the trauma setting. Five systematic reviews meta-analyses (level 2a) supported DC for severely injured young patients with acute subdural hematoma probably responsible for intraoperative brain swelling, while one randomized controlled trial (level 1b) showed comparable efficacy of DC and craniotomy for ASH with intraoperative neutral brain swelling. Three randomized controlled trials (level 1b) and two meta-analyses (level 1a and 3a) supported DC efficacy for malignant ischemic stroke. One systematic review (level 3a) supported DC efficacy for malignant meningoencephalitis. One systematic review meta-analysis (level 3a) supported DC efficacy for malignant cerebral venous thrombosis. The mitigated results of one randomized trial (level 1b) did not allow to conclude for DC efficacy for intracerebral hemorrhage. One systematic review (level 3a) reported the possible efficacy of primary DC and the mitigated efficacy of secondary DC for aneurysmal subarachnoid hemorrhage. Too weak evidence (level 4) precluded from drawing any conclusion for DC efficacy for intracranial tumors. To date, there is some scientific background to support clinicians in the decision making for DC for selected cases of severe traumatic brain injury, acute subdural hematoma, malignant ischemic stroke, malignant meningoencephalitis, malignant cerebral venous thrombosis, and highly selected cases of aneurysmal subarachnoid hemorrhage.

Clinical vs. autopsy diagnostic discrepancies in the intensive care unit: a systematic review and meta-analysis of autopsy series.

The aim of this study was to assess whether there is a discrepancy between clinical and autopsy-based diagnoses in adult intensive care unit (ICU) patients. We conducted a systematic review of cohort studies reporting on conventional autopsy-confirmed missed diagnoses. The discrepancy rate was per study calculated by dividing the number of patients with a missed diagnosis by the number of autopsies. Missed diagnoses were classified according to the Goldman classification as 'major' and 'minor' with major missed diagnoses further differentiated into Class I missed diagnoses (i.e., diagnoses that may have altered therapy or survival) and Class II missed diagnoses (i.e., diagnoses that would not have altered therapy or survival). Class I missed diagnoses constitute the primary outcome of interest. Pooled estimates for discrepancy rates (95% confidence intervals) were calculated using a mixed-effects logistic regression model with 'study' as random effect. Meta-regression was used to assess relationships between major discrepancy rates and autopsy rates, start year of study, and ICU type. Forty-two studies were identified totaling 6305 analyzed autopsies and 1759 patients with missed diagnoses. The pooled discrepancy rates for Class I and major missed diagnoses were 6.5% (5-8.5) and 19.3% (15.3-24), respectively. Meta-regression analysis revealed that autopsy rate was inversely associated with discrepancy rate. Class I discrepancy rates did not change over time. Burn and trauma ICUs had lower discrepancy rates as compared to medical ICUs, possibly because of higher autopsy rates. Missed diagnoses remain common in ICUs. A higher autopsy rate does not reveal more major diagnostic errors. These data support a clinically driven autopsy policy rather than a systematic autopsy policy.

Association Between Iron, Folate, and Zinc Deficiencies During Pregnancy and Low Birth Weight: Systematic Review of Cohort Studies.

Iron, folate, and zinc deficiencies during the gestational period may be associated with negative perinatal outcomes, such as low birth weight (LBW), but these relationships are not yet fully established in the scientific literature and require further investigation. To systematically review the scientific production to investigate the association between iron, folate, and zinc deficiencies during pregnancy and LBW. The search was carried out using high-sensitivity descriptors in the English, Portuguese, and Spanish languages, combined with Boolean operators, adapted to each of the following indexed databases: MEDLINE via PubMed, Embase, LILACS via BVS, CENTRAL, and Web of Science. The eligibility criteria followed the PECOS (population, exposure, comparator, outcome, study) strategy. Data extraction was performed using an Excel spreadsheet with the study variables of interest. Subsequently, the information was analyzed and summarized in a table. The Newcastle-Ottawa Scale was used to perform the risk-of-bias analysis. A total of 21 042 references were identified, of which 7169 related to folate, 6969 to iron, and 6904 to zinc. After eligibility criteria application, 37 articles were included in this study, of which 18 referred to zinc nutritional status, 10 related to iron, and 9 related to folate. Studies of iron (40%), folate (66.66%), and zinc (50%) revealed a positive association between deficiencies of these micronutrients and LBW. The overall methodological quality of the studies included in this review was considered high. Iron, folate, and zinc deficiencies are still present during gestation. Nevertheless, the association between deficiencies of these micronutrients and LBW is still contradictory, and more studies are needed, as is efficient nutritional monitoring before and during gestation. PROSPERO registration no. CRD42021284683.

Changes in prevalence and incidence of dementia and risk factors for dementia: an analysis from cohort studies

Some cohort studies have reported a decline in dementia prevalence and incidence over time, although these findings have not been consistent across studies. We reviewed evidence on changes in dementia prevalence and incidence over time using published population-based cohort studies that had used consistent methods with each wave and aimed to quantify associated changes in risk factors over time using population attributable fractions (PAFs). We searched for systematic reviews of cohort studies examining changes in dementia prevalence or incidence over time. We searched PubMed for publications from database inception up to Jan 12, 2023, using the search terms "systematic review" AND "dementia" AND ("prevalence" OR "incidence"), with no language restrictions. We repeated this search on March 28, 2024. From eligible systematic reviews, we searched the references and selected peer-reviewed publications about cohort studies where dementia prevalence or incidence was measured in the same geographical location, at a minimum of two timepoints, and that reported age-standardised prevalence or incidence of dementia. Additionally, data had to be from population-based samples, in which participants' cognitive status was assessed and where validated criteria were used to diagnose dementia. We extracted summary-level data from each paper about dementia risk factors, contacting authors when such data were not available in the published paper, and calculated PAFs for each risk factor at all available timepoints. Where possible, we linked changes in dementia prevalence or incidence with changes in the prevalence of risk factors. We identified 1925 records in our initial search, of which five eligible systematic reviews were identified. Within these systematic reviews, we identified 71 potentially eligible primary papers, of which 27 were included in our analysis. 13 (48%) of 27 primary papers reported change in prevalence of dementia, ten (37%) reported change in incidence of dementia, and four (15%) reported change in both incidence and prevalence of dementia. Studies reporting change in dementia incidence over time in Europe (n=5) and the USA (n=5) consistently reported a declining incidence in dementia. One study from Japan reported an increase in dementia prevalence and incidence and a stable incidence was reported in one study from Nigeria. Overall, across studies, the PAFs for less education or smoking, or both, generally declined over time, whereas PAFs for obesity, hypertension, and diabetes generally increased. The decrease in PAFs for less education and smoking was associated with a decline in the incidence of dementia in the Framingham study (Framingham, MA, USA, 1997-2013), the only study with sufficient data to allow analysis. Our findings suggest that lifestyle interventions such as compulsory education and reducing rates of smoking through country-level policy changes could be associated with an observed reduction, and therefore future reduction, in the incidence of dementia. More studies are needed in low-income and middle-income countries, where the burden of dementia is highest, and continues to increase. National Institute for Health and Care Research Three Schools' Dementia Research Programme.

Incidence of Sudden Cardiac Death in Low- and Middle-Income Countries: A Systematic Review of Cohort Studies.

Sudden cardiac death (SCD) is a leading cause of mortality worldwide and, in recent years, has become an urgent public health concern in low- and middle-income countries (LMICs). Data from LMICs, however, remains limited. As such, the aim of this article is to systematically review the current literature on the incidence of SCD in LMICs to inform policymakers and identify potential research gaps. A search of PubMed and Embase was utilized to capture the targeted condition, outcome, and setting. Only peer-reviewed cohort studies in LMICs reporting SCD incidence estimates in the general population of individuals aged ≥1 year were eligible for selection. Papers providing incidence data for specific types of SCD, including sudden coronary death or death from sudden cardiac arrest, were also included. After deduplication, 1941 citations were identified and screened. Seven studies representing four countries-Cameroon, China, India, and Iran-met the criteria for inclusion and were considered in our analysis. The crude incidence rate for SCD ranged from 19.9 to 190 cases per 100,000 person-years, while age-adjusted rates ranged from 33.6 to 230 cases per 100,000 person-years. There was notable variability in methods utilized to ascertain SCD cases. These findings suggest that the incidence of all-cause SCD in LMICs and may exceed that of high-income countries; however, observed disparities may be partly attributable to differences in case ascertainment methods. Additional research is needed to better understand the true incidence of SCD in developing countries. It is crucial that future studies across regions utilize standard diagnostic criteria and methodology for identifying SCD, which would provide a framework by which to compare outcomes between settings.

Cognitive impairment increases in older people living with HIV: a systematic review of cohort studies

The progressive increase in HIV infection among older adults requires constant research and monitoring, given that geriatric syndromes associated with HIV comorbidities have become an important public health problem. We reported this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and it has a central question: Is the incidence of cognitive impairment higher in older patients living with HIV than in their seronegative peers? The following databases were searched for this review: MEDLINE/PubMed, EMBASE, LILACS, Web of Science, and Scopus. The inclusion criteria were studies whose samples were ≥ 50% patients aged ≥ 50 years, with and without HIV, and a main outcome related to the incidence of cognitive impairment. Only cohort studies with follow-up lasting ≥ 24 months were considered. Three reviewers independently screened the documents for eligibility criteria, extracted the data, assessed the risk of bias (Newcastle-Ottawa Scale), and evaluated the quality of evidence. A narrative synthesis was prepared. In total, 10 798 trials were screened, 8884 were excluded, 14 were analyzed, and 5 were included in this review. Only 1 applied cognitive assessment tests; the rest used secondary data from the medical records. Most found that the incidence of cognitive disorders was higher among older people living with HIV, which highlights the need for public policies aimed at primary and secondary prevention strategies. Further research from other countries is still required. PROSPERO register (CRD42022321914).

Effect of SARS-CoV-2 infection during pregnancy on maternal and perinatal mortality: A systematic review of cohort studies

Effect of SARS-CoV-2 infection during pregnancy on maternal and perinatal mortality: A systematic review of cohort studies

Understanding the Causes of Frailty Using a Life-Course Perspective: A Systematic Review.

(1) Background: Few studies have examined risk factors of frailty during early life and mid-adulthood, which may be critical to prevent frailty and/or postpone it. The aim was to identify early life and adulthood risk factors associated with frailty. (2) Methods: A systematic review of cohort studies (of at least 10 years of follow-up), using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). A risk of confounding score was created by the authors for risk of bias assessment. Three databases were searched from inception until 1 January 2023 (Web of Science, Embase, PubMed). Inclusion criteria were any cohort study that evaluated associations between any risk factor and frailty. (3) Results: Overall, a total of 5765 articles were identified, with 33 meeting the inclusion criteria. Of the included studies, only 16 were categorized as having a low risk of confounding due to pre-existing diseases. The long-term risk of frailty was lower among individuals who were normal weight, physically active, consumed fruits and vegetables regularly, and refrained from tobacco smoking, excessive alcohol intake, and regular consumption of sugar or artificially sweetened drinks. (4) Conclusions: Frailty in older adults might be prevented or postponed with behaviors related to ideal cardiovascular health.

Incidence of cancer for patients after bariatric surgery: evidence from 33 cohort studies

BackgroundWith the rising prevalence of severe obesity, bariatric surgery has emerged as a crucial treatment option. As the number of surgeries performed worldwide increases, there has been growing interest in the impact of bariatric surgery on cancer incidence. While several studies have examined this relationship, the topic remains controversial. ObjectivesWe conducted this systematic review of cohort studies with meta-analysis to evaluate the effect of bariatric surgery versus nonsurgical treatment on overall cancer incidence. However, the effects may vary when focusing on specific cancer types, surgical procedures, or gender, so we conducted additional subgroup analyses. SettingA meta-analysis. University hospital. MethodsThe Cochrane, Embase, PubMed, and Web of Science databases were searched for studies from 1 January 2000 to 1 December 2022. Meta-analysis was conducted to evaluate the pooled effect and further implemented subgroup analysis stratified by cancer type, operation type, and sex. ResultsAll cohort studies were included in this meta-analysis from 18,216 studies. The overall cancer incidence demonstrated a significant decrease in the group with bariatric surgery (odds ratios [OR] = .56, P = .000, 95% CI .46 to .68). In subgroup analysis, similar decrease effect was found in 9 cancers. Furthermore, the incidence of cancer decreased significantly in male (OR = .66, P = .001, 95% CI .51 to .85) and female patients (OR = .63, P = .000, 95% CI .57 to .69) and patients undergoing gastric bypass (OR = .46, P = .000, 95% CI .33 to .63) or sleeve gastrectomy (OR = .44, P = .001, 95% CI .27 to .70). ConclusionsIn the overall analysis, bariatric surgery could reduce the incidence of cancer significantly. Further large-scale well-matched studies are needed to verify the protective effect of bariatric surgery on cancer incidence.

Association between childhood obesity and infertility in later life: a systematic review of cohort studies

BackgroundThe global prevalence of childhood obesity has exhibited a troubling surge in recent years. Due to the raised questions regarding its potential correlation with infertility in adulthood, this systematic review has been undertaken to explore the relationships between childhood obesity, and infertility later in life.MethodsA comprehensive search was performed in three international databases (PubMed, Web of Science, and Scopus). All cohort (retrospective or prospective), case-cohort, and nested case-control studies until April 2022 which assessed the association of obesity in children and adolescents with male and female infertility indicators in later life were included. The quality of the included studies was assessed by Newcastle-Ottawa quality assessment checklists.ResultOut of the initial 32,501 documents, eleven eligible studies with a total sample size of 498,980 participants were included. Five studies focused on the number of offspring and indicated that obesity, especially in adolescence had an association with later life lower number of children, nulliparity, and childlessness in both men and women. Concerning conceiving problems, two studies showed that obesity before age 12 increased the risk of female fertility problems in the future. Two studies reported that obesity in early life raised the risk of impaired female reproductive system such as menstrual or ovulatory problems. As well as females, a study discovered that obesity in men during their 20s was linked to an elevated risk of low sperm motility and poor sperm morphology. Another study has reported men with higher pre-pubertal BMI had lower sex hormone-binding globulin; however, the same association was not seen between childhood BMI and semen quality.ConclusionThe evidence suggests a positive association between childhood obesity with infertility indicators in later life. Childhood weight reduction strategies are suggested to be implemented in societies in order to reduce infertility rates in later life.

Effects of Preoperative Chronic Steroid Use on Postoperative Outcomes in Orthopedic Surgery: A Systematic Review and Meta-Analysis.

Higher rates of postoperative complications have been found in preoperative chronic steroid users. However, the effects of preoperative chronic steroid use on outcomes in orthopedic surgery were unclear. We performed a systematic review of cohort studies examining the effects of chronic steroid use on postoperative outcomes following orthopedic surgery and searched PubMed, Embase, and CENTRAL through 29 April 2023. We included 17 studies with 1,546,562 patients. No increase in 30-day mortality (adjusted odds ratio (aOR) 1.40, 95% confidence interval (CI) 0.64-3.09) and composite thromboembolic events (aOR 1.61, 95% CI 0.99-2.63) but increases in 30-day overall complications (aOR 1.42, 95% CI 1.16-1.75), wound dehiscence (aOR 2.91, 95% CI 1.49-5.66), infectious complications (any infection (aOR 1.61, 95% CI 1.44-1.80), sepsis (aOR 2.07, 95% CI 1.34-3.21), superficial surgical site infection (SSI) (aOR 1.73, 95% CI 1.03-2.89) and deep SSI (aOR 1.96, 95% CI 1.26-3.05)), re-admission (aOR 1.62, 95% CI 1.48-1.77), both 30-day (aOR 1.28, 95% CI 1.03-1.59) and 1-year re-operation (aOR 1.78, 95% CI 1.09-2.92), pulmonary embolism (aOR 5.94, 95% CI 1.52-23.29), and deep vein thrombosis (aOR 2.07, 95% CI 1.24-3.46) were detected in preoperative steroid users. An increased risk of adverse outcomes following orthopedic surgery in chronic steroid users was found.

Safety of Discontinuation of Oral Anticoagulants in Patients with Atrial Fibrillation following Ablation: A Systematic Review and Meta-analysis

Abstract The safety of discontinuing oral anticoagulants (OACs) in patients with atrial fibrillation (AF) following ablation remains controversial. The European Society of Cardiology stated that the long-term continuation of anticoagulants beyond 2 months following ablation should be based on the patient’s stroke risk profile; however, the decision remains challenging considering the lack of explicit guidelines. Furthermore, a worldwide survey showed that some centers implement a policy of withdrawing OAC therapy even in the majority of patients at high risk of thromboembolic events. To address this issue, we conducted a systematic review to investigate the safety of discontinuing OACs in patients with AF following ablation. A systematic review of cohort studies was performed. A comprehensive search for relevant literature was conducted using predefined keywords in five scientific databases (PubMed, ClinicalKey, Cochrane, EBSCOhost, and ScienceDirect). Studies that compared the incidence of thromboembolic events in the off-OAC group and on-OAC group were considered. Duplicated articles were removed. Eight studies (n = 16037) were retained for the final analysis. These studies were published between 2010 and 2021. Overall, there was no difference in the incidence of thromboembolic events between the off-OAC and on-OAC groups (odds ratio [OR] 0.81; 95% confidence interval [CI] 0.52–1.29) with lower bleeding risk in patients who discontinued OAC compared to those who remained on OAC (OR 0.30; 95% CI 0.15–0.62). Patients who discontinued OAC after AF ablation generally had a similar incidence of thromboembolism (TE) to patients who remained on OAC. This review indicates that the risk-benefit ratio favors the discontinuation of OAC in patients with successful AF ablation. However, randomized controlled trials with larger samples involving a more generalizable population are warranted to address the safety and efficacy of OAC discontinuation in patients with AF undergoing catheter ablation.

The irony of drinking to health and happiness

In testing the relationship between alcohol consumption in young people and depression in young adulthood, in The Lancet Psychiatry, Gemma Hammerton and colleagues 1 Hammerton G Lewis G Heron J Fernandes G Hickman M Lewis G The association of alcohol dependence and consumption during adolescence with depression in young adulthood, in England: a prospective cohort study. Lancet Psychiatry. 2023; (published online June 1.)https://doi.org/10.1016/S2215-0366(23)00138-4 Google Scholar address a very important question. Depression causes an enormous public health burden. WHO identifies depression as affecting more than 4% of the world's population and causing substantial disability. 2 WHODepression and other common mental disorders: global health estimates. World Health Organization, Geneva2017 Google Scholar Understanding how modifiable risk factors, such as alcohol consumption, influence the onset of depression in adulthood is therefore a crucial question for epidemiology to tackle. The Avon Longitudinal Study of Parents and Children (ALSPAC) is a highly appropriate data resource to use to address this question. ALSPAC is well placed in the UK's catalogue of large birth cohort studies, sitting between the 1970 British Cohort Study and the Millennium Cohort Study, uniquely assessing the development of children born in the 1990s. I was involved in a systematic review of available evidence on the adult outcomes of late adolescent alcohol consumption, 3 McCambridge J McAlaney J Rowe R Adult consequences of late adolescent alcohol consumption: a systematic review of cohort studies. PLoS Med. 2011; 8e1000413 Crossref PubMed Scopus (313) Google Scholar which concluded that the area needed more high-quality prospective cohort studies, and Hammerton and colleagues' work strongly contributes to this need. The association of alcohol dependence and consumption during adolescence with depression in young adulthood, in England: a prospective cohort studyPsychosocial or behavioural interventions that reduce the risk of alcohol dependence during adolescence could contribute to preventing depression in young adulthood. Full-Text PDF Open Access

Pulmonary Tuberculosis Coinfected with COVID-19 Compounded by Bacterial Superinfection: A Case Report and Critical Appraisal of The Evidence Regarding Its Mortality

Background: The WHO has declared COVID-19 as a global pandemic. However, Indonesia is also challenged by high burden of tuberculosis (TB). In this study, reported an active pulmonary TB case coinciding with COVID-19 but deceased due to bacterial infection. There is a need to further explore this new problem in developing countries to determine the prognosis of COVID-19 patients with tuberculosis infection.Methods: A comprehensive literature search was conducted by using databases such as The Cochrane Library, PubMed, Google Scholar, EBSCO-Host, and Scopus, including systematic reviews of cohort studies, cohorts, and case controls. As many as 309 studies were identified, after screening for duplicates and against the inclusion and exclusion criteria, three studies were included for critical appraisal.Results: The meta-analysis by Gao et al included two studies with an odds ratio (OR) of 1.4 [95% CI=0.1-18.93], the cohort study by Sy et al reported a relative risk (RR) of 2.17 [95% CI=1.4-3.37], and Motta et al showed that COVID-19 patients with tuberculosis had a mortality rate of 11.8% [95% CI=7.75-15.45]. Conclusion: TB has yet to be an identified as a major predictor of increased mortality in COVID-19 patients but can be considered a predictor of increased severity in COVID-19 patients. Studies with a bigger sample size and better study design are suggested to obtain new evidence.

Are health behaviors associated with mental health among tertiary education students? A systematic review of cohort studies

Objective To evaluate the association between health behaviors with mental health among tertiary education students. Methods Six databases were searched until September 2021 for prospective cohort studies evaluating the association between health behavior(s) (dietary intake, physical activity, sedentary behavior, alcohol intake, sleep, smoking or illicit drug use) and mental health. Two independent reviewers screened records for inclusion, extracted data and completed risk of bias assessments. Results 33 studies were included (14 assessed sleep, 14 alcohol intake, 13 physical activity, 8 smoking, 6 sedentary behavior, 4 diet, 1 illicit drug use). A consistent association between poor sleep, and physical inactivity with increased risk of poor psychological wellbeing, and between poor sleep and increased mental ill-health related outcomes was demonstrated. Conclusion Findings suggest interventions to address poor sleep and physical inactivity among students may positively impact mental health. Further research of other health behaviors, and their association with mental health, is required.

Hemolytic disease of the fetus and newborn: systematic literature review of the antenatal landscape

BackgroundPrevention of pregnancy-related alloimmunization and the management of hemolytic disease of the fetus and newborn (HDFN) has significantly improved over the past decades. Considering improvements in HDFN care, the objectives of this systematic literature review were to assess the prenatal treatment landscape and outcomes of Rh(D)- and K-mediated HDFN in mothers and fetuses, to identify the burden of disease, to identify evidence gaps in the literature, and to provide recommendations for future research.MethodsWe performed a systematic search on MEDLINE, EMBASE and clinicaltrials.gov. Observational studies, trials, modelling studies, systematic reviews of cohort studies, and case reports and series of women and/or their fetus with HDFN caused by Rhesus (Rh)D or Kell alloimmunization. Extracted data included prevalence; treatment patterns; clinical outcomes; treatment efficacy; and mortality.ResultsWe identified 2,541 articles. After excluding 2,482 articles and adding 1 article from screening systematic reviews, 60 articles were selected. Most abstracted data were from case reports and case series. Prevalence was 0.047% and 0.006% for Rh(D)- and K-mediated HDFN, respectively. Most commonly reported antenatal treatment was intrauterine transfusion (IUT; median frequency [interquartile range]: 13.0% [7.2–66.0]). Average gestational age at first IUT ranged between 25 and 27 weeks. weeks. This timing is early and carries risks, which were observed in outcomes associated with IUTs. The rate of hydrops fetalis among pregnancies with Rh(D)-mediated HDFN treated with IUT was 14.8% (range, 0–50%) and 39.2% in K-mediated HDFN. Overall mean ± SD fetal mortality rate that was found to be 19.8%±29.4% across 19 studies. Mean gestational age at birth ranged between 34 and 36 weeks.ConclusionThese findings corroborate the rareness of HDFN and frequently needed intrauterine transfusion with inherent risks, and most births occur at a late preterm gestational age. We identified several evidence gaps providing opportunities for future studies.