METHODS: This review was conducted following the PRISMA guidelines and included studies up to March 2024 from PubMed, Embase, and Web of Science. Eligible studies were longitudinal, including prospective cohorts, nested case-controls, and post-hoc analyses of RCTs that reported stroke outcomes in relation to PPI use. Data were synthesized using random-effects meta-analysis models in R software version 4.3.
RESULTS: Our search yielded 41 studies encompassing over 800,000 participants globally. Meta-analysis of 14 observational studies revealed a slight but non-significant increased stroke risk among patients with prior CVD (pooled HR = 1.222, 95% CI: 0.963 to 1.481, I² = 78%). In contrast, analysis of 15 studies without prior CVD showed a modestly increased risk (pooled HR = 1.15, 95% CI: 1.023 to 1.288, I² = 98%). Five RCTs involving patients with CVD reported a pooled RR of 1.158 (95% CI: 0.914 to 1.466), indicating no significant risk increase.
CONCLUSION: The association between PPI use and stroke risk appears modest and is influenced by the presence of cardiovascular conditions. Clinical decision-making should consider individual patient risk profiles, and further high-quality studies are needed to guide safer PPI prescribing practices.
MATERIALS AND METHODS: This review uses the methodological framework of Arksey and O'Malley. A total of 19 studies were selected from 9456 studies screened from the electronic databases.
RESULTS: Majority of the studies reported no association between saturated fat (SFA) and monounsaturated fat (MUFA) with CHD. Meanwhile, seven out of 12 studies reported inverse association between polyunsaturated fat (PUFA) and risk of CHD whilst 67% of the studies found that trans-fat intake was positively associated with CHD risk.
CONCLUSIONS: This review finds that all the types of dietary fat have different effects on the risk of CHD. Nevertheless, intakes of healthy fat such as MUFA and PUFA in controlled amounts are expected to reduce CHD risk. In addition, the divergence of findings found between studies might be due to the methodological inconsistencies. More robust research is needed to determine the actual dietary determinants of CHD as it will provide important information for future development of dietary intervention.
RECENT FINDINGS: Methods of acquisition and analysis of BPV and cognitive measurements and their relationship were extracted from selected articles. Of 656 studies identified, 53 articles were selected. Twenty-five evaluated long-term (LTBPV), nine mid-term (MTBPV), 12 short-term (STBPV) and nine very short-term BPV (VSTBPV) with conflicting findings on the relationship between BPV and cognition. Variations existed in devices, period and procedure for acquisition. The studies also utilized a wide range of methods of BPV calculation. Thirteen cognitive assessment tools were used to measure global cognition or domain functions which were influenced by the population of interest. The interpretation of available studies was hence limited by heterogeneity. There is an urgent need for standardization of BPV assessments to streamline research on BPV and cognition. Future studies should also establish whether BPV could be a potential modifiable risk factor for cognitive decline, as well as a marker for treatment response.
METHODS: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis.
RESULTS: A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed.
DISCUSSION: Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups.
HIGHLIGHTS: A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.
MATERIALS AND METHODS: This retrospective study analysed 119 COVID-19 patients admitted to Al-Sultan Abdullah Hospital (HASA) from March until December 2020. Demographics, medical histories, admission laboratory results, electrocardiogram (ECG), echocardiogram (echo), were captured from the hospitals' health records. Myocardial injury is an injury to the myocardium that can be diagnosed by elevated cardiac troponin T or I level above the 99th percentile upper reference limit (URL), an abnormal ECG, and an abnormal echo. Data were analysed using Statistical Package for Social Sciences (SPSS) Version 27.
RESULTS: From this study, it was founded that the prevalence of myocardial injury is 36.1% (43 subjects out of 119). The risk factors are older age (odds ratio, 2.347; p=0.028), males (odds ratio, 2.019; p=0.125), Indians (odds ratio, 3.659; p=0.296), hypertension (odds ratio, 2.776; p=0.009), diabetes mellitus (odds ratio, 1.732; p=0.155) and category 4 and 5 COVID-19 patients (odds ratio, 2.325; p=0.038).
CONCLUSION: Myocardial injury is prevalent among patients affected by COVID-19 and is associated with older age, hypertension and category 4 and 5 COVID-19. The researchers suggested conducting a more thorough investigation of the sizable population in multiple settings and conducting a prospective study where all infected COVID-19 patients have to undergo several tests, such as ECG, troponin T, and echocardiogram.
PURPOSE: The primary goal of osteoporosis management is to prevent fragility fractures, which occur from falls from standing height or less in individuals over fifty. However, the management of bone health optimization is often neglected in patients undergoing elective surgeries, such as arthroplasty and spinal surgeries. The objective of this article is to link all these three conditions into a TRIAD so that surgeons and physicians can collaborate more effectively, utilizing similar principles and strategies for better management.
METHODOLOGY: Clinical approaches based on country-specific guidelines are commonly used to manage osteoporosis. However, skeletal assessments are rarely conducted before or after elective procedures, leading to overlooked conditions such as osteoporosis, osteopenia, and fragility fracture risk factors. These three conditions are illustrated from the patient case study shown, to highlight the importance of not neglecting bone health optimization in high risk individuals undergoing elective surgery, with underlying osteopenia and multiple risk factors who sustained fragility fracture intraoperatively.
RESULT: Patients undergoing elective surgeries often have their bone health neglected, leading to a higher incidence of complications such as aseptic loosening and peri-prosthetic fractures due to poor bone quality and density. Bone health assessment and optimization therefore is essential in patients with osteoporosis, osteopenia with clinical risk factors, and patients with history of fragility fracture, to ensure implants sit on bone with good density and quality to minimize the complications.
CONCLUSION: By combining osteoporosis, fragility fractures, and bone health optimization into a TRIAD, "Lee's TRIAD," surgeons and physicians can collaborate more effectively, utilizing similar principles and strategies for better management.
METHODS: To evaluate the prevalence, risk factors, and adverse outcomes of bacterial vaginosis among pregnant women, a comprehensive systematic review was conducted based on the preferred reporting items for systematic review and meta-analyses (PRISMA) criteria. PubMed, ScienceDirect, ClinicalTrials.gov and Cochrane database searches were conducted independently by two authors until May 13th, 2023.
RESULTS: The search strategies yielded a total of 2237 records; among them, 12 studies met the inclusion criteria and were included in the qualitative synthesis. Majority of the included studies demonstrated a high prevalence of BV among African women. The risk of developing BV during pregnancy was highest among women with multiple sexual partners. Additionally, factors including age, socioeconomic status, unhygienic practices, ethnicity, 2nd trimester, spontaneous abortion, vaginal douching, symptoms, and history of sexually transmitted infections (STIs) were also associated with a higher prevalence of BV. Overall, 7 studies reported adverse outcomes during pregnancy which was directly associated with BV. Based on the review, it was found that PROM, PTB, and LBW were the most frequently reported adverse outcomes in pregnant women with BV.
CONCLUSION: In summary, the high prevalence of bacterial vaginosis necessitates a global surveillance approach to delineate the health risks imposed on both mother and child, and promote cost-effective strategic measures to alleviate the undesired consequences of BV during pregnancy.
METHODS: We searched CINAHL, Medline, Global Health, Embase, and WHO COVID-19 in October 2023 for studies reporting the SARS-CoV-2 reinfection incidence during the Omicron period. The quality of the included studies was assessed using the Joanna Briggs Institute checklists. Random effects meta-analyses were conducted to estimate the incidence, and requirement of hospitalisation of SARS-CoV-2 reinfections. Symptomatic severity of reinfections and case fatality rates were analysed narratively.
RESULTS: Thirty-six studies were included. The reinfection cumulative incidence during the Omicron period was 3.35% (95% CI = 1.95-5.72%) based on data from 28 studies. The cumulative incidence was higher in 18-59-year-old adults (6.62% (95% CI = 3.22-13.12%)) compared to other age groups and in health care workers (9.88% (95% CI = 5.18-18.03%)) compared to the general population (2.48% (95% CI = 1.34-4.54%)). We estimated about 1.81% (95% CI = 0.18-15.87%) of the reinfected cases required hospitalisation based on limited and highly variable data.
CONCLUSIONS: There was an increased risk of reinfections during the Omicron period compared to the pre-Omicron period. The incidence was higher in 18-59-year-old adults and health care workers and generally less severe during the Omicron period. However, data were limited on disease severity and long-term outcomes.
REGISTRATION: PROSPERO: CRD42023482598.
SYSTEMATIC REVIEW REGISTRATION: OSF; https://doi.org/10.17605/OSF.IO/HEFCP.
METHODS: We followed the Joanna Briggs Institute guideline for the conduct of this scoping review. We searched MEDLINE, Embase, LILACS and study registers from inception to 14 March 2022. We included cross-sectional and cohort studies in populations representing a geographically-defined unit (urban or rural) in LMICs, and with data on CVH metrics i.e. all health or clinical factors (cholesterol, blood pressure, glycemia and body mass index) and at least one health behavior (smoking, diet or physical activity). We report findings following the PRISMA-Scr extension for scoping reviews.
RESULTS: We included 251 studies; 85% were cross-sectional. Most studies (70.9%) came from just ten countries. Only 6.8% included children younger than 12 years old. Only 34.7% reported seven metrics; 25.1%, six. Health behaviors were mostly self-reported; 45.0% of studies assessed diet, 58.6% physical activity, and 90.0% smoking status.
CONCLUSIONS: We identified a substantial and heterogeneous body of research presenting CVH metrics in LMICs. Few studies assessed all components of CVH, especially in children and in low-income settings. This review will facilitate the design of future studies to bridge the evidence gap. This scoping review protocol was previously registered on OSF: https://osf.io/sajnh.
METHODS: A comprehensive search was conducted across PubMed, Embase, and Web of Science, covering studies published up to September 30, 2024. We included peer-reviewed observational studies evaluating the link between cannabis consumption and the risk of asthma diagnosis. Data synthesis employed a random-effects meta-analysis to account for heterogeneity. R statistical software (version 4.4) was used for statistical analyses.
RESULTS: The search yielded 8 relevant studies after screening 1,887 records. The pooled odds ratio (OR) for the association between cannabis consumption and the risk of asthma diagnosis was 1.31, 95% confidence interval (CI): 1.19-1.44, indicating greater odds of having asthma compared to non-users. Moderate heterogeneity was observed (I² = 46%), and sensitivity analysis confirmed the robustness of the findings.
CONCLUSION: This systematic review and meta-analysis identifies a significant association between cannabis use and greater odds of having asthma. These findings emphasize the importance of raising awareness about the potential respiratory risks associated with cannabis use. Future research should prioritize identifying moderating factors, such as the frequency and mode of cannabis consumption, to enhance understanding of this association and provide a stronger evidence base for potential public health interventions.
CLINICAL TRIAL NUMBER: Not applicable.