Social Mobility and Tooth Loss: A Systematic Review and Meta-analysis

2021 ◽  
pp. 002203452110292
Author(s):  
R.K. Celeste ◽  
A. Darin-Mattsson ◽  
C. Lennartsson ◽  
S. Listl ◽  
M.A. Peres ◽  
...  

This study systematically reviews the evidence of the association between life course social mobility and tooth loss among middle-aged and older people. PubMed, Scopus, Embase, and Web of Science were systematically searched in addition to gray literature and contact with the authors. Data on tooth loss were collated for a 4-category social mobility variable (persistently high, upward or downward mobility, and persistently low) for studies with data on socioeconomic status (SES) before age 12 y and after age 30 y. Several study characteristics were extracted to investigate heterogeneity in a random effect meta-analysis. A total of 1,384 studies were identified and assessed for eligibility by reading titles and abstracts; 21 original articles were included, of which 18 provided sufficient data for a meta-analysis with 40 analytical data sets from 26 countries. In comparison with individuals with persistently high social mobility, the pooled odds ratios (ORs) for the other categories were as follows: upwardly mobile, OR = 1.73 (95% CI, 1.53 to 1.95); downwardly mobile, OR = 2.52 (95% CI, 2.19 to 2.90); and persistently low, OR = 3.96 (95% CI, 3.13 to 5.03). A high degree of heterogeneity was found( I2 > 78%), and subgroup analysis was performed with 17 study-level characteristics; however, none could explain heterogeneity consistently in these 3 social mobility categories. SES in childhood and adulthood is associated with tooth loss, but the high degree of heterogeneity prevented us from forming a robust conclusion on whether upwardly or downwardly mobile SES may be more detrimental. The large variability in effect size among the studies suggests that contextual factors may play an important role in explaining the difference in the effects of low SES in different life stages (PROSPERO CRD42018092427).

2021 ◽  
Vol 10 (11) ◽  
pp. 2490
Author(s):  
Giulio Francesco Romiti ◽  
Bernadette Corica ◽  
Gregory Y. H. Lip ◽  
Marco Proietti

Background: In patients with COVID-19, cardiovascular complications are common and associated with poor prognosis. Among these, an association between atrial fibrillation (AF) and COVID-19 has been described; however, the extent of this relationship is unclear. The aim of this study is to investigate the epidemiology of AF in COVID-19 patients and its impact on all-cause mortality. Methods: A systematic review and meta-analysis were performed and reported according to PRISMA guidelines, and a protocol for this study was registered on PROSPERO (CRD42021227950). PubMed and EMBASE were systematically searched for relevant studies. A random-effects model was used to estimate pooled odds ratios (OR) and 95% confidence intervals (CI). Results: Overall, 31 studies were included in the analysis, with a total number of 187,716 COVID-19 patients. The prevalence of AF was found to be as high as 8% of patients with COVID-19 (95% CI: 6.3–10.2%, 95% prediction intervals (PI): 2.0–27.1%), with a high degree of heterogeneity between studies; a multiple meta-regression model including geographical location, age, hypertension, and diabetes showed that these factors accounted for more than a third of the heterogeneity. AF COVID-19 patients were less likely to be female but more likely older, hypertensive, and with a critical status than those without AF. Patients with AF showed a significant increase in the risk of all-cause mortality (OR: 3.97, 95% CI: 2.76–5.71), with a high degree of heterogeneity. A sensitivity analysis focusing on new-onset AF showed the consistency of these results. Conclusions: Among COVID-19 patients, AF is found in 8% of patients. AF COVID-19 patients are older, more hypertensive, and more likely to have a critical status. In COVID-19 patients, AF is associated with a 4-fold higher risk of death. Further studies are needed to define the best treatment strategies to improve the prognosis of AF COVID-19 patients.


2021 ◽  
Author(s):  
Rashidul Alam Mahumud ◽  
Mohammad Afshar Ali ◽  
Satyajit Kundu ◽  
Md Ashfikur Rahman ◽  
Joseph Kihika Kamara ◽  
...  

Abstract ObjectivesThe highly transmissible COVID-19 delta variant (DV) has contributed to the surge in cases and has now been exacerbated the worldwide public health crisis. Several COVID-19 vaccines play a significant role in a high degree of protection against DV. The primary purpose of this meta-analysis is to estimate the pooled effectiveness of the COVID-19 vaccines against DV in terms of risk ratio (RR) among fully vaccinated, compared to unvaccinated populations.MethodsWe carried out a systematic review with meta-analysis of original studies focused on COVID-19 vaccines effectiveness of COVID-19 vaccines against B.1.617.2 clinical perspective among fully COVID-19 vaccinated populations, compared to placebo (unvaccinated populations), published before September 30, 2021. Eleven studies containing data of 17.2 million participants were identified and included in our study. Pooled estimates of COVID-19 vaccines effectiveness (i.e., risk ratio, RR) against delta variant with 95% confidence intervals were assessed using random-effect models. Publication bias was assessed using Egger's regression test and funnel plot to investigate potential sources of heterogeneity and identify any differences in study design.ResultsA total population of 17.2 million (17,200,341 peoples) were screened for the COVID-19 vaccines' effectiveness against delta variant. We found 61.13% of study population were fully vaccinated with 2-dose of COVID-19 vaccines. Weighted pooled incidence of COVID-19 infection was more than double (20.07%) among unvaccinated populations, compared to the fully vaccinated population (8.16%). Overall, the effectiveness of COVID-19 vaccine against DV was 85% (RR = 0.15, 95% CI: 0.07-0.31). The effectiveness of COVID-19 vaccines varied slidably by study designs, 87% (RR = 0.13, 95% CI: 0.06-0.30) and 84% (RR = 0.16, 95% CI:0.02, 1.64) for cohort and case-control studies, respectively. ConclusionEffectiveness COVID-19 vaccines were noted to offer higher protection against delta variant among populations who received two vaccine doses compared with unvaccinated populations. This finding would help efforts to maximise vaccine coverage (i.e., at least 60 to 70% of the population) with two doses among vulnerable populations to have herd immunity to breat the chain of transmission and gain greater overall population protection more rapidly.


2021 ◽  
Vol 53 (12) ◽  
pp. 801-809
Author(s):  
Ji Jin ◽  
Peirong Lu

AbstractDiabetes confers an increased risk of microvascular complications, including retinopathy. However, whether prediabetes is also related to retinopathy has not been comprehensively examined. We performed a meta-analysis to evaluate the relationship between prediabetes and retinopathy. This meta-analysis included relevant observational studies from Medline, Embase, and Web of Science databases. A random-effect model after incorporation of the intra-study heterogeneity was selected to pool the results. Subgroup analyses were applied to evaluate the influences of study characteristics on relationship. Nine cross-sectional studies including 14 751 community dwelling adult participants were included; 3847 (26.1%) of them were prediabetic. Results showed that prediabetes was associated with a higher prevalence of retinopathy compared to normoglycemia [odds ratio (OR): 1.55, 95% confidence interval (CI): 1.10–2.20, p=0.01, I2=34%]. Sensitivity analysis by excluding one study at a time showed consistent result (OR: 1.35 to 1.73, p all<0.05). Subgroup analysis showed study characteristics such as definition of prediabetes, country of study, sample size, mean age of participants, or univariate or multivariate analyses may not significantly affect the association (p for subgroup difference all>0.05). Current evidence suggests that patients with prediabetes may be associated with higher prevalence of retinopathy as compared to those with normoglycemia. Although prospective cohort studies are needed to validate these findings, results of our meta-analysis highlighted the importance of early prevention of retinopathy in patients with prediabetes.


2019 ◽  
Vol 42 (2) ◽  
pp. e150-e157 ◽  
Author(s):  
R Gupta ◽  
S Gupta ◽  
S Sharma ◽  
D N Sinha ◽  
R Mehrotra

Abstract Background The association of smokeless tobacco (SLT) with stroke has been dealt with in only a few reviews. The present meta-analysis aims to present the updated comprehensive summary risk of stroke in adult SLT users along with sub group analysis. Methods A systematic literature search for articles evaluating risk of stroke in SLT users was conducted. The study characteristics and risk estimates were extracted independently by two authors (RG and SG). Random-effect model was used to estimate the summary relative risks. Results The overall risk of stroke in SLT users was found to be significantly higher (1.17, 95% CI 1.04–1.30) compared to non-users, especially for users in Southeast Asian region. The results remained unchanged even after strict adjustment for smoking (1.18, 95% CI 1.04–1.32). SLT users had 1.34 times or 13.4% higher risk of fatal stroke, though risk of nonfatal stroke was not enhanced. Significantly higher risk of stroke was seen in users of chewing tobacco (1.35, 95% CI 1.20–1.50) in comparison to non-chewers. Gender-based analysis showed enhanced risk of fatal stroke in both male and female users. SLT-attributable fraction of fatal stroke was highest for India at 14.8%. Conclusion The significant higher risk of stroke with SLT use, even after adjustment for smoking, emphasizes the imperative need to include SLT cessation advice for control and prevention of stroke.


2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Da Yao ◽  
Qing Chang ◽  
Qi-Jun Wu ◽  
Shan-Yan Gao ◽  
Huan Zhao ◽  
...  

Objective. Nowadays, body mass index (BMI) is used to evaluate the risk stratification of obesity-related pregnancy complications in clinics. However, BMI cannot reflect fat distribution or the proportion of adipose to nonadipose tissue. The objective of this study is to evaluate the association of maternal first or second trimester central obesity with the risk of GDM. Research Design and Methods. We searched in PubMed, Embase, and Web of Science for English-language medical literature published up to 12 May 2019. Cohort studies were only included in the search. Abdominal subcutaneous fat thickness, waist circumference, waist-hip ratio or body fat distribution were elected as measures of maternal central obesity, and all diagnostic criteria for GDM were accepted. The random effect meta-analysis was performed to evaluate the relationship between central obesity and the risk of GDM. Results. A total of 11 cohort studies with an overall sample size of 27,675 women and 2,226 patients with GDM were included in the analysis. The summary estimate of GDM risk in the central obesity pregnant women was 2.76 (95% confidence interval [CI]: 2.35–3.26) using the adjusted odds ratio (OR). The degree of heterogeneity among the studies was low (I2=14.4, P=0.307). The subgroup analyses showed that heterogeneity was affected by selected study characteristics (methods of exposure and trimesters). After adjusting for potential confounds, the OR of adjusted BMI was significant (OR=3.07, 95% CI: 2.35–4.00). Conclusions. Our findings indicate that the risk of GDM was positively associated with maternal central obesity.


Thrombosis ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-18 ◽  
Author(s):  
Antonio Gómez-Outes ◽  
Ana Isabel Terleira-Fernández ◽  
Gonzalo Calvo-Rojas ◽  
M. Luisa Suárez-Gea ◽  
Emilio Vargas-Castrillón

Background. New oral anticoagulants (NOAC; rivaroxaban, dabigatran, apixaban) have become available as an alternative to warfarin anticoagulation in non-valvular atrial fibrillation (NVAF). Methods. MEDLINE and CENTRAL, regulatory agencies websites, clinical trials registers and conference proceedings were searched to identify randomised controlled trials of NOAC versus warfarin in NVAF. Two investigators reviewed all studies and extracted data on patient and study characteristics along with cardiovascular outcomes. Relative risks (RR) and 95% confidence intervals (CI) were estimated using a random effect meta-analysis. Results. Three clinical trials in 50,578 patients were included. The risk of non-hemorrhagic stroke and systemic embolic events (SEE) was similar with the NOAC and warfarin (RR=0.93; 95% CI=0.83–1.04), while the risk of intracranial bleeding (ICB) with the NOAC was lower than with warfarin (RR = 0.46; 95% CI = 0.33–0.65). We found differences in the effect size on all strokes and SEE depending on geographic region as well as on non-hemorrhagic stroke, SEE, bleeding and mortality depending on time in therapeutic range. Conclusion. The NOAC seem no more effective than warfarin for prevention of nonhemorrhagic stroke and SEE in the overall NVAF population, but are generally associated with a lower risk of ICB than warfarin.


2020 ◽  
Author(s):  
Nan Hu ◽  
Ke Xu ◽  
Chao Gong ◽  
Xizhen Xu

Abstract Background: To investigate the bidirectional association between tooth loss and hypertensionMethods: PubMed, EMBASE, OVID were searched through May, 2020. Longitudinal and cross-sectional studies reporting the association between tooth loss and hypertension were included. We quantitatively analyzed the basic framework and study characteristics, and then pooled estimate effects with 95% confidence intervals (CIs) of outcomes of each included studies using random-effects meta-analysis.Results: This systematic review included sixteen studies involving about 188,000 participants. Quantitatively summarized results suggested, compared to individuals who have lost fewer than ten teeth, there was no significantly difference in the incidence of hypertension among participants who lost more than ten teeth (OR: 1.09, 95%CI: 0.93,1.28). Besides, there is no significant difference of incident hypertension between individuals who ever lost teeth and never lost teeth (OR:1.03, 95% CI: 0.85,1.25). There was a significant association between hypertension and incidence of tooth loss (OR: 1.33, 95% CI: 1.04,1.70). Subgroup analysis by study design, age, gender ratio and religion showed statistically significant association between hypertension and incidence of tooth loss in specific subgroups.Conclusions: This meta-analysis identified hypertension as a significantly risk factor of tooth loss while tooth loss was not an efficient predictor for incident hypertension. Considering the limited number of available researches and drawback of cross-sectional studies, more high-quality prospective studies of large sample sizes are needed to understand details of this bidirectional association. Since both tooth loss and hypertension are worldwide problems, our study provides new and comprehensive evidence for the prevention in oral complication of hypertensive patients.


2020 ◽  
pp. 01-09
Author(s):  
Sandeep Grover ◽  
Dalton N ◽  
Siddharth Sarkar

Background and aims: Conferences provide an opportunity to present findings to an audience of experts in the field and get feedback for putting the research in context. Since conference proceedings provide limited space for presenting the findings, research publications are able to provide a better platform for the wider reach, scrupulous peer evaluation, and temporal consolidation of the medical scientific material. This review attempts to collate the studies which have evaluated the abstract publication ratio of the conference presentations. Methods: The systematic review and meta-analysis included peer reviewed publications which quantitatively reported the publication rate of conference presentations. Results: A total of 28 studies were included, with sample sizes ranging from 82 to 1897 abstracts (total 17,172 abstracts). The publication rate ranged from 3.8% to 78.0%, with weighted mean publication rate of 41.8% (95% confidence interval of 34.1% to 49.5%). Oral presentations had a greater chance of being published as compared to poster presentations (odds ratio of 2.693, 95% confidence intervals of 1.285 to 5.646). There was high degree of heterogeneity in the findings. Conclusions: A small proportion of the conference presentations ispublished. Efforts should be made to improve the abstract publication ratio to improve the wider dissemination of the available research.


2021 ◽  
Author(s):  
Jay Ganz ◽  
James E Pustejovsky ◽  
Joe Reichle ◽  
Kimberly Vannest ◽  
Margaret Foster ◽  
...  

This meta-analysis examined social communication outcomes in augmentative and alternative communication (AAC) interventions, or those that involved aided (e.g., speech generating devices, picture point systems) or unaided AAC (e.g., gestures, manual sign language) as a component of intervention, and the extent to which communication outcomes were predicted by participant characteristics. Variables of interest included chronological age, communication mode used prior to intervention, number of words produced and imitation skills of participants prior to intervention. Investigators identified 117 primary studies that implemented AAC interventions with school-aged individuals (up to 22 years) with autism spectrum disorder and/or intellectual disability associated with complex communication needs and assessed social-communication outcomes. All included studies involved single-case experimental designs and met basic study design quality standards. We synthesized findings across studies using two complementary effect size indices, Tau(AB) and the log response ratio, and multi-level meta-analysis with robust variance estimation. With Tau(AB), the overall average effect across 338 participants was 0.72, 95% CI [0.67, 0.76], with a high degree of heterogeneity across studies. With the log response ratio, the overall average effect corresponded to a 538% increase from baseline levels of responding, 95% CI [388%, 733%], with a high degree of heterogeneity across studies and contrasts. Moderator analyses detected few differences in effectiveness when comparing across diagnoses, ages, the number and type of communication modes the participants used prior to intervention, the number of words used by the participants prior to intervention, and imitation use prior to intervention.


Neurology ◽  
2017 ◽  
Vol 89 (12) ◽  
pp. 1220-1228 ◽  
Author(s):  
Jeffrey Z. Wang ◽  
Manav V. Vyas ◽  
Gustavo Saposnik ◽  
Jorge G. Burneo

Objective:We conducted a meta-analysis of the incidence of early and late seizures following ischemic stroke as well as a systematic review of their pharmacologic treatment.Methods:Observational studies that reported incidence of seizures following ischemic stroke and those that reported treatment response to any particular antiepileptic drugs (AEDs) were included. Risk of bias was assessed by predefined study characteristics. Random effects meta-analysis was conducted for all studies where data were available for the incidence of early and late stroke-related seizures. Heterogeneity was measured with I2 statistic and sensitivity analyses were performed using prespecified variables. A qualitative synthesis of studies reporting use of AEDs for stroke-related seizures was performed.Results:Forty-one studies from 10,554 articles were identified; 35 studies reported incidence of stroke-related seizures and 6 studies reported effects of specific AEDs. Most studies were of low to moderate quality. Rate of early seizures was 3.3% (95% confidence interval 2.8%–3.9%, I2 = 92.8%), while the incidence of late seizures or epilepsy was 18 per 1,000 person-years (95% confidence interval 1.5–2.2, I2 = 94.1%). The high degree of heterogeneity could not be explained from the sensitivity analyses. For management of stroke-related seizures, no single AED was found to be more effective over others, though newer AEDs were associated with fewer side effects.Conclusions:The burden of stroke-related seizures and epilepsy due to ischemic stroke is substantial. Further studies are required to determine risk factors for epilepsy following ischemic stroke and optimal secondary prevention.


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