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1.
Dermatol Ther (Heidelb) ; 14(1): 83-98, 2024 Jan.
Article in English | MEDLINE | ID: mdl-38183616

ABSTRACT

INTRODUCTION: Hidradenitis suppurativa (HS) has a profound negative impact on patients' health-related quality of life (HRQoL). Here we summarize the evidence on HRQoL and Patient Reported Outcomes (PROs) in patients with HS in real-world settings by conducting a systematic literature review (SLR) of observational studies. METHODS: Data sources included MEDLINE, Embase & PsycINFO between January 1, 2010 and August 29, 2021, and conference proceedings between 2019 and 2021. Identified abstracts were reviewed and screened independently by two reviewers. Eligibility criteria included patients with HS of any severity, sample size ≥ 100, reporting PROs including HRQoL measures. Included studies were critically appraised. RESULTS: Fifty-eight observational studies matched inclusion criteria. Dermatology Life Quality Index (DLQI) was the most commonly utilized instrument: 57% of included studies reported mean baseline DLQI scores, ranging between 8.4 and 16.9, indicating a very large impact on the patients' HRQoL. Higher scores were reported with increasing disease severity and among female patients. Pain was assessed mostly by an 11-point (0-10) numeric rating scale (NRS) with a mean baseline score ranging from 3.6 to 7.7 indicating moderate to high pain levels. There was a negative impact of HS on patients' psychological well-being, based on PRO scores related to depression and anxiety. A high proportion of sexual dysfunction was reported, with a larger impact on women than men. Work productivity and leisure activity were consistently found to be impaired in patients with HS. CONCLUSIONS: All included studies reported a negative impact of HS on patients' lives. A diverse set of disease- and non-disease-specific PRO instruments were utilized highlighting the need for more consistent use of HS-specific validated PRO instruments to assess the impact of HS on the different aspects of patients' HRQoL to allow for data to be more meaningfully interpreted and compared in real-world settings. Patients with HS need better disease management approaches that address the observed low quality of life.


Hidradenitis suppurativa (HS) is a skin disease, which mainly involves the hair follicles, and may greatly affect the health of those with the illness. HS often causes painful or itchy bumps or swelling of the skin, especially in the intimate areas. These occasionally drain and have an odor. When they heal, sometimes they leave dark spots or scars. People with HS can feel depressed, anxious, or embarrassed, among other things. In this study, we looked at how existing studies measured the impact of HS on the physical, mental, and social quality of people's lives. When searching the Internet, we found 58 publications on studies around this topic. Across all of the studies, HS had a large negative effect on patients' quality of life. We found that the groups of people which were impacted more by HS had worse cases of the disease. Patients with more severe HS felt higher levels of pain. Women were also affected more than men. Many studies showed that patients with HS often felt depressed and anxious. Three studies showed that HS greatly affected women's sexual health. Many patients said that HS made it hard to work and do things for fun. More and better treatments are needed since HS can have such a big impact on people's lives.

2.
Pharmacol Res ; 153: 104663, 2020 03.
Article in English | MEDLINE | ID: mdl-31987993

ABSTRACT

Previous studies have recommended that probiotics may have blood pressure (BP)-lowering effects. However, they examined all probiotic strains (multi/single probiotics) simultaneously. In respect to strain specificity properties of probiotic, the aim of the present study was to systematically investigate the role of Lactobacillus plantarum as an anti-hypertensive agent by performing a meta-analysis of randomized controlled trials. PubMed, Scopus, Cochrane Library and Google Scholar were used from inception until October 2018 to identify eligible trials. We used random-effects model as the preferable method to assess the combined treatment effect. We further conducted sensitivity analysis and stratified analysis. Seven studies with 653 participants were included in the meta-analysis. The pooled weighted mean difference (WMD) with the random effects model showed a significant effects of Lactobacillus plantarum supplementation on improvement of SBP with no statistically significant heterogeneity (WMD: -1.58 mmHg, 95 % CI: -3.05 to 0.11) (heterogeneity P = 0.14; I² = 36 %). The overall effect in the DBP showed significant pooled estimates (WMD: -0.92 mmHg, 95 % CI: -1.49 to -0.35) with a complete homogeneity between the studies (heterogeneity P = 0.46; I² = 0 %). The findings of the present meta-analysis study support the use of Lactobacillus plantarum supplementation for lowering systolic and diastolic blood pressure. The clinical significance of blood pressure-lowering effect of Lactobacillus Plantarum supplementation is not considerable; however, given the overarching benefits evident and concurrent lack of specific side effects, further trials are warranted to clarify the effects of Lactobacillus Plantarum probiotics particularly for hypertensive patients.


Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Hypertension/drug therapy , Lactobacillus plantarum , Probiotics/therapeutic use , Antihypertensive Agents/administration & dosage , Dietary Supplements , Humans , Probiotics/administration & dosage , Randomized Controlled Trials as Topic , Treatment Outcome
3.
Eur J Nutr ; 59(4): 1313-1328, 2020 Jun.
Article in English | MEDLINE | ID: mdl-31781857

ABSTRACT

PURPOSE: Type 2 diabetes mellitus represents a significant health problem. Many studies have reported that intensive nutritional intervention by itself or in addition to medications is the best method to improve glycaemic control in type 2 diabetes mellitus. However, in clinical practice, dietary education is not implemented as an integral part in the management of type 2 diabetes mellitus. The purpose of this systematic review and meta-analysis is to analyse the scientific evidence concerning the role of nutritional intervention in the glycaemic control of type 2 diabetes mellitus. METHODS: We searched Pubmed, Scopus, Cochrane Library and Web of Science databases from inception till May 2019 for randomised controlled trials (RCTs) that include dietary interventions in the management of patients with type 2 diabetes mellitus. RESULTS: A total of 28 studies were included. Our results demonstrated that lifestyle interventions significantly lowered glycosylated haemoglobin (HbA1c) levels compared to the usual care for patients with type 2 diabetes mellitus, overall weighted mean difference, WMD = - 0.51 (- 0.67, - 0.35). Strategies combining individualized and group-based activities were the most effective, WMD = - 0.95 (- 1.24, - 0.66). Most of stratified analyses did not totally resolve heterogeneity, but improvement in HbA1c levels has been consistently observed. CONCLUSIONS: The available evidence from RCTs shows that lifestyle intervention is more effective than the standard care regarding the glycaemic control of type 2 diabetic patients, particularly when there is a weight loss. It is time to translate this evidence to the primary health care practice. The protocol of the present systematic review was registered in PROSPERO, registration number CRD42018090469.


Subject(s)
Diabetes Mellitus, Type 2/diet therapy , Diet/methods , Glycemic Control/methods , Life Style , Humans
4.
J Obstet Gynaecol Can ; 41(1): 76-88.e7, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30585167

ABSTRACT

OBJECTIVES: The most effective preterm birth (PTB) intervention is unknown for women who are at risk of PTB due to a history of conization. The objective of this systematic review was to determine whether PTB interventions, progesterone, cerclage, and pessary decrease the risk of PTB compared to no treatment in singleton-and separately in twin-pregnancies of women with history of conization. METHODS: We searched Cochrane Central, MEDLINE, EMBASE, CINAHL, and ClinicalTrials.gov from January 1994 until May 2017. In duplicate, we reviewed titles, abstracts, full texts, extracted data, and assessed quality. We included RCTs and observational studies. Our primary outcomes were PTB <34 weeks, PTB <37 weeks, and neonatal mortality. We performed random effects meta-analyses and generated ORs with 95% CIs. RESULTS: We screened 762 nonduplicate titles and abstracts and assessed 91 full texts. After contacting authors, we included nine studies. Women in the cerclage group were more likely to have a short cervix or another risk factor for PTB, raising the possibility of confounding by indication. In women with a history of conization and a singleton who received a cerclage compared to those who did not, the ORs of PTB <34 weeks was 3.99 (95% CI 0.67-23.62, three studies, I2 = 65%); of PTB <37 weeks was 2.10 (95% CI 0.87-5.05, four studies, I2 = 0%); and of neonatal mortality was 8.33 (95% CI 0.22-320.38, two studies, I2 = N/A). We did not find any studies comparing either progesterone or pessary to no treatment. Data for twins were very scarce. CONCLUSION: In women with a previous conization and a current singleton gestation, the existing evidence, which is likely limited due to confounding by indication, does not support cerclage or other interventions used to try to decrease PTB.


Subject(s)
Cerclage, Cervical/methods , Cervix Uteri/pathology , Pessaries , Premature Birth/prevention & control , Progesterone/therapeutic use , Progestins/therapeutic use , Administration, Intravaginal , Cervical Length Measurement , Cervix Uteri/surgery , Conization/adverse effects , Female , Humans , Pregnancy , Pregnancy, Twin , Risk Factors
5.
Biomed Pharmacother ; 106: 956-965, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30119268

ABSTRACT

BACKGROUND: Leukotrienes are important lipid mediators of inflammation arising from arachidonic acid cascade. They are implicated in vascular inflammation and produced in different pathologic conditions as atherosclerosis, stroke and myocardial infarction. Different studies have investigated the role of leukotriene receptor antagonist (LTRA) in reducing some cardiovascular events, especially in animals. We conducted a systematic review of both in vivo animal and human studies to determine the potential role of leukotriene receptor antagonist in reducing cardiovascular and cerebrovascular events. METHODS: Data sources: Pubmed, Embase and Cochrane database. DATA EXTRACTION: Two reviewers independently screened potentially eligible articles and extracted relevant data. RESULTS: A total of 28 studies were included, of which 26 were conducted in animals, and 2 in humans. CONCLUSIONS: All animal studies reported that using a leukotriene receptor antagonist brings to a reduction of either myocardial infarction, ischemic stroke, or atherosclerosis risk. Similar results were obtained from two clinical trials on humans, suggesting a potential role of montelukast in reducing some cardiovascular diseases.


Subject(s)
Acetates/therapeutic use , Cardiovascular Diseases/prevention & control , Cardiovascular System/drug effects , Cerebrovascular Disorders/prevention & control , Leukotriene Antagonists/therapeutic use , Quinolines/therapeutic use , Acetates/adverse effects , Animals , Cardiovascular Diseases/etiology , Cardiovascular Diseases/metabolism , Cardiovascular Diseases/physiopathology , Cardiovascular System/metabolism , Cardiovascular System/physiopathology , Cerebrovascular Disorders/etiology , Cerebrovascular Disorders/metabolism , Cerebrovascular Disorders/physiopathology , Clinical Trials as Topic , Cyclopropanes , Humans , Leukotriene Antagonists/adverse effects , Quinolines/adverse effects , Risk Factors , Sulfides
6.
BMC Pregnancy Childbirth ; 18(1): 14, 2018 01 08.
Article in English | MEDLINE | ID: mdl-29310610

ABSTRACT

BACKGROUND: Probiotics are living microorganisms that, when administered in adequate amounts, confer a health benefit. It has been speculated that probiotics might help prevent preterm birth, but in two previous systematic reviews possible major increases in this risk have been suggested. Our objective was to perform a systematic review and meta-analysis of the risk of preterm birth and other adverse pregnancy outcomes in pregnant women taking probiotics, prebiotics or synbiotics. METHODS: We searched six electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Web of Science's Core collection and BIOSIS Preview) up to September 2016 and contacted authors for additional data. We included randomized controlled trials in which women with a singleton pregnancy received a probiotic, prebiotic or synbiotic intervention. Two independent reviewers extracted data using a piloted form and assessed the risk of bias using the Cochrane risk of bias tool. We used random-effects meta-analyses to pool the results. RESULTS: We identified 2574 publications, screened 1449 non-duplicate titles and abstracts and read 160 full text articles. The 49 publications that met our inclusion criteria represented 27 studies. No study used synbiotics, one used prebiotics and the rest used probiotics. Being randomized to take probiotics during pregnancy neither increased nor decreased the risk of preterm birth < 34 weeks (RR 1.03, 95% CI 0.29-3.64, I2 0%, 1017 women in 5 studies), preterm birth < 37 weeks (RR 1.08, 95% CI 0.71-1.63, I2 0%, 2484 women in 11 studies), or most of our secondary outcomes, including gestational diabetes mellitus. CONCLUSIONS: We found no evidence that taking probiotics or prebiotics during pregnancy either increases or decreases the risk of preterm birth or other infant and maternal adverse pregnancy outcomes. TRIAL REGISTRATION: We prospectively published the protocol for this study in the PROSPERO database ( CRD42016048129 ).


Subject(s)
Prebiotics , Pregnancy Outcome , Premature Birth/epidemiology , Probiotics/therapeutic use , Diabetes, Gestational/epidemiology , Female , Humans , Pregnancy , Randomized Controlled Trials as Topic
7.
Women Health ; 58(10): 1094-1111, 2018.
Article in English | MEDLINE | ID: mdl-29120272

ABSTRACT

Several epidemiologic studies and clinical trials have demonstrated the value of balanced nutrition during pregnancy. This study aimed to examine the degree of adherence to nutritional recommendations among 1,175 pregnant Spanish women and the factors associated with such adherence to pre-pregnancy and during the first half of pregnancy. Data were collected during June 2004-March 2007 and included socio-demographic and lifestyle factors. Crude and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) were computed using logistic regression models to identify factors associated with adherence to dietary recommendations. Before pregnancy, slightly less than one quarter of the pregnant women (21 percent) did not meet the recommended intake of both vegetables and cereals, and 50 percent did not meet the recommended intake of fruits. Yet most of the participants exceeded the recommended values for proteins. During pregnancy, the adherence for all food types decreased. Factors associated with adherence to the nutritional recommendations were similar before and during pregnancy. Adherence to the Spanish Society of Community Nutrition dietary recommendations was lower among pregnant women who were younger, from a low social class, smokers, and had a low level of physical activity. These findings suggest that nutritional education should become an essential part of antenatal care.


Subject(s)
Diet , Guidelines as Topic , Life Style , Nutritional Requirements , Patient Compliance/statistics & numerical data , Preconception Care , Pregnant Women , Adult , Diet Surveys , Female , Fruit , Health Education , Humans , Maternal Nutritional Physiological Phenomena , Nutrition Surveys , Pregnancy , Socioeconomic Factors , Spain/epidemiology , Surveys and Questionnaires , Vegetables
8.
J Obstet Gynaecol Can ; 39(12): 1192-1202, 2017 Dec.
Article in English | MEDLINE | ID: mdl-29197486

ABSTRACT

OBJECTIVES: To systematically examine the evidence around the combination of interventions to prevent preterm birth. METHODS: Without language restrictions, we searched clinicaltrials.gov and five electronic databases (Medline, EMBASE, CINAHL, Cochrane CENTRAL, and Web of Science) up to July 7, 2016. We included randomized and non-randomized studies where asymptomatic women at risk of preterm birth received any combination of progesterone, cerclage, or pessary compared with either one or no intervention. Primary outcomes were preterm birth <34 and <37 weeks and neonatal death. Two independent reviewers extracted data using a piloted form and assessed risk and direction of bias. We pooled data with unlikely or unclear bias using random-effects meta-analyses. Comparisons with likely bias (e.g., confounding by indication) were not pooled. RESULTS: We screened 1335 results and assessed 154 full texts, including seven studies. In singletons, we found no differences in preterm birth <34 weeks when comparing pessary & progesterone with pessary alone (RR 1.30, 95% CI 0.70-2.42) or progesterone alone (RR 1.16, 95% CI 0.79-1.72). Similarly, we found no differences in preterm birth <37 weeks when comparing cerclage & progesterone with cerclage alone (RR 1.04, 95% CI 0.56-1.93) or with progesterone alone (RR 0.82, 95% CI 0.57-1.19) nor between pessary & progesterone and pessary alone (RR 1.04, 95% CI 0.62-1.74). No data were available for neonatal death in singletons. CONCLUSIONS: Despite being a common clinical practice, evidence to support the combined use of multiple versus single interventions for preventing preterm birth is scarce.


Subject(s)
Cerclage, Cervical , Pessaries , Premature Birth/prevention & control , Progesterone/therapeutic use , Progestins/therapeutic use , Female , Humans , Pregnancy
9.
BMC Pregnancy Childbirth ; 17(1): 397, 2017 Nov 29.
Article in English | MEDLINE | ID: mdl-29187166

ABSTRACT

BACKGROUND: Given the controversy around mode of delivery, our objective was to assess the evidence regarding the safest mode of delivery for actively resuscitated extremely preterm cephalic/non-cephalic twin pairs before 28 weeks of gestation. METHODS: We searched Cochrane CENTRAL, MEDLINE, EMBASE and  http://clinicaltrials.gov from January 1994 to January 2017. Two reviewers independently screened titles, abstracts and full text articles, extracted data and assessed risk of bias. We included randomized controlled trials and observational studies. Our primary outcome was a composite of neonatal death (<28 days of life) and severe brain injury in survivors (intraventricular hemorrhage grade ≥ 3 or periventricular leukomalacia). We performed random-effects meta-analyses, generating odds ratios with 95% confidence intervals for the first and second twin separately, and for both twins together. We assessed the risk of bias using a modified Newcastle Ottawa Scale (NOS) for observational studies and used Grading of Recommendations Assessment, Development and Evaluation approach (GRADE). RESULTS: Our search generated 2695 articles, and after duplicate removal, we screened 2051 titles and abstracts, selecting 113 articles for full-text review. We contacted 36 authors, and ultimately, three observational studies met our inclusion criteria. In cephalic/non-cephalic twin pairs delivered by caesarean section compared to vaginal birth at 24+0-27+6 weeks the odds ratio for our composite outcome of neonatal death and severe brain injury for the cephalic first twin was 0.35 (95% CI 0.00-92.61, two studies, I2 = 76%), 1.69 for the non-cephalic second twin (95% CI 0.04-72.81, two studies, I2 = 55%) and 0.83 for both twins (95% CI 0.05-13.43, two studies, I2 = 56%). According to the modified Newcastle Ottawa Scale we assessed individual study quality as being at high risk of bias and according to GRADE the overall evidence for our primary outcomes was very low. CONCLUSION: Our systematic review on the safest mode of delivery for extremely preterm cephalic/non-cephalic twin pairs found very limited existing evidence, without significant differences in neonatal death and severe brain injury by mode of delivery.


Subject(s)
Breech Presentation/therapy , Delivery, Obstetric/methods , Infant, Extremely Premature , Pregnancy, Twin , Version, Fetal/adverse effects , Adult , Brain Injuries, Traumatic/etiology , Cesarean Section/adverse effects , Cesarean Section/methods , Delivery, Obstetric/adverse effects , Female , Humans , Infant, Newborn , Perinatal Death/etiology , Pregnancy , Twins , Version, Fetal/methods , Young Adult
10.
Pediatrics ; 140(1)2017 Jul.
Article in English | MEDLINE | ID: mdl-28759410

ABSTRACT

CONTEXT: Late-preterm infants born at 34 to 36 weeks' gestation have increased risks of various health problems. Health service utilization (HSU) of late-preterm infants has not been systematically summarized before. OBJECTIVES: To summarize the published literature on short- and long-term HSU by late-preterm infants versus term infants from infancy to adulthood after initial discharge from the hospital. DATA SOURCES: We searched Medline, Embase, the Cumulative Index to Nursing and Allied Health Literature, and PsycINFO. STUDY SELECTION: Cohort and case-control studies that compared HSU (admissions, emergency department visits, etc) between late-preterm infants and term infants were included. DATA EXTRACTION: Data extracted included study design, setting, population, HSU, covariates, and effect estimates. RESULTS: Fifty-two articles were included (50 cohort and 2 case-control studies). Meta-analyses with random effect models that used the inverse-variance method found that late-preterm infants had higher chances of all-cause admissions than term infants during all the time periods. The magnitude of the differences decreased with age from the neonatal period through adolescence, with adjusted odds ratios from 2.34 (95% confidence intervals 1.19-4.61) to 1.09 (1.05-1.13) and adjusted incidence rate ratios from 2.62 (2.52-2.72) to 1.14 (1.11-1.18). Late-preterm infants had higher rates of various cause-specific HSU than term infants for jaundice, infection, respiratory problems, asthma, and neurologic and/or mental health problems during certain periods, including adulthood. LIMITATIONS: Considerable heterogeneity existed and was partially explained by the variations in the adjustment for multiple births and gestational age ranges of the term infants. CONCLUSIONS: Late-preterm infants had higher risks for all-cause admissions as well as for various cause-specific HSU during the neonatal period through adolescence.


Subject(s)
Child Health Services/statistics & numerical data , Adolescent , Child , Child, Preschool , Gestational Age , Humans , Infant , Infant, Newborn , Infant, Premature , Term Birth , Time Factors
11.
Matern Child Health J ; 20(6): 1296-304, 2016 06.
Article in English | MEDLINE | ID: mdl-26971269

ABSTRACT

Background Inadequate maternal nutrition is regarded as one of the most important indicators of fetal growth. The aim of this study was to analyze the associated risk of having a small for gestational age (SGA) infant according to the mother's dairy intake during the first half of pregnancy. Methods A prospective cohort study was performed using 1175 healthy pregnant women selected from the catchment area of Virgen de las Nieves University Hospital, Granada (Spain). SGA was defined as neonates weighing less than the 10th percentile, adjusted for gestational age. Factors associated with SGA were analyzed using logistic regression models. Population attributable fractions of SGA according to dairy intake were estimated. Results Dairy intake among women who gave birth to SGA infants was 513.9, versus 590.3 g/day for women with appropriate size for gestational age infants (P = 0.003). An increased intake of dairy products by 100 g/day during the first half of pregnancy decreased the risk of having a SGA infant by 11.0 %, aOR = 0.89 (0.83, 0.96). A dose-response gradient between dairy intake and SGA was observed. Conclusions An inadequate intake of dairy products is associated with a higher risk of SGA. Our results suggest a possible causal relation between dairy intake during pregnancy and the weight of the newborn, although we cannot discard residual confounding. These results should be further supported by properly designed studies.


Subject(s)
Dairy Products , Infant, Small for Gestational Age , Milk , Adult , Animals , Body Mass Index , Female , Humans , Infant , Infant, Low Birth Weight , Infant, Newborn , Logistic Models , Maternal Nutritional Physiological Phenomena , Pregnancy , Premature Birth/etiology , Prospective Studies , Risk Factors , Spain/epidemiology , Young Adult
12.
Occup Environ Med ; 73(2): 134-44, 2016 02.
Article in English | MEDLINE | ID: mdl-26644457

ABSTRACT

Epidemiological studies on exposure to pesticides and risk of prostate cancer (PC) provide inconsistent results. We aimed to explore various potential sources of heterogeneity not previously assessed and to derive updated risk estimates from homogenous studies. We searched PubMed, Web of Science and Scopus databases for case-control and cohort studies published from 1985 to April 2014. We assessed the quality of the articles using the Newcastle-Ottawa Scale. Pooled estimates were calculated using random-effects models. Heterogeneity was explored using subset analyses and metaregression. Fifty-two studies were included in the review and 25 in the meta-analysis. No association was found between low exposure to pesticides and PC, but association was significant for high exposure, pooled OR 1.33 (1.02 to 1.63), I(2)=44.8%, p=0.024. Heterogeneity was explained by a number of variables including method used to assess exposure. Pooled OR was weak and non-significant for studies measuring serum pesticide level, 1.12 (0.74 to 1.50), I(2)=0.00%, p=0.966. For studies applying self-reporting of exposure, pooled estimate was 1.34 (0.91 to 1.77), I(2)=0.00%, p=0.493, while a high significant association was detected for grouped exposure assessment, 2.24 (1.36 to 3.11), I(2)=0.00%, p=0.955. In spite of a weak significant association detected when pooling ORs for high occupational exposure to pesticides, the magnitude of the association was related to the method of exposure assessment used by the original studies. A family history-pesticide exposure interaction was also observed for a number of pesticides.


Subject(s)
Occupational Exposure/adverse effects , Pesticides/adverse effects , Prostatic Neoplasms/etiology , Humans , Male , Occupational Exposure/analysis
13.
Cancer Causes Control ; 26(10): 1375-92, 2015 Oct.
Article in English | MEDLINE | ID: mdl-26245248

ABSTRACT

PURPOSE: The results of epidemiological studies about exposure to organochlorine pesticides (OCPs) and risk of prostate cancer (PC) are inconclusive. We conducted a meta-analysis to evaluate the association between exposure to specific OCPs and PC. METHODS: We searched PubMed, Scopus, and Web of science databases for case-control and cohort studies published till March 2015 that provided data about exposure to OCPs and PC. We also contacted authors and hand-searched references of the included articles. We calculated pooled estimates using random effects model and explored heterogeneity between studies. RESULTS: We systematically reviewed 15 articles and based our meta-analysis on 10 articles covering nine case-control studies and a large prospective cohort study. Pooled estimates of PC for highest versus lowest exposed category to p,p'-DDE was 1.02 (0.69-1.35), I (2) = 12.7 %, p = 0.333, trans-nonachlor, 0.88 (0.45-1.31), I (2) = 0.00 %, p = 0.892, oxychlordane, 0.91 (0.46-1.35), hexachlorobenzene, 0.88 (0.18-1.57), I (2) = 36.0 %, p = 0.210 from combining results of studies that applied serum OCPs measurements among the general population. For DDT, stratifying studies by exposed population revealed homogeneity, pooled estimate for serum level measurement for the highest exposed versus the lowest exposed of the general population was 0.81 (0.95-1.26), I (2) = 0.00 %, p = 0.400, and for occupational exposure 1.30 (0.94-1.67), I (2) = 13.4 %, p = 0.315. A positive but also insignificant association was obtained for pooling results for high exposure to lindane among farmers and pesticide applicators, 1.56 (0.82-2.29), I (2) = 41.7 %, p = 0.180. CONCLUSIONS: The existing epidemiological data do not support the hypothesis that exposure to specific OCPs is associated with an increased incidence of PC in the general population.


Subject(s)
Environmental Exposure , Pesticides/adverse effects , Prostatic Neoplasms/epidemiology , Chlordan/adverse effects , Chlordan/analogs & derivatives , Cohort Studies , Dichlorodiphenyl Dichloroethylene/adverse effects , Hexachlorobenzene/adverse effects , Humans , Hydrocarbons, Chlorinated/adverse effects , Male , Occupational Exposure , Prospective Studies
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