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1.
Front Neurol ; 15: 1331300, 2024.
Article in English | MEDLINE | ID: mdl-38725648

ABSTRACT

Introduction: Stroke is a significant global health concern, and numerous studies have established a link between depression and an increased risk of stroke. While many investigations explore this link, some overlook its long-term effects. Depression may elevate stroke risk through physiological pathways involving nervous system changes and inflammation. This systematic review and meta-analysis aimed to assess the association between depression and stroke. Methodology: We conducted a comprehensive search of electronic databases (PubMed, Embase, Scopus, and PsycINFO) from inception to 9 April 2023, following the Preferred Reporting Items for Systemic Review and Meta-analysis (PRISMA) and Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. We included all articles assessing the association between different stroke types and depression, excluding post-stroke depression. Two investigators independently extracted data and assessed quality using the Newcastle-Ottawa Scale and Cochrane Risk of Bias tool, utilizing a random-effects model for data synthesis. The primary outcome was the association of depression with stroke, with a secondary focus on the association of antidepressants with stroke. Results: The initial search yielded 10,091 articles, and 44 studies were included in the meta-analysis. The pooled analysis revealed a significant association between depression and stroke risk, with an overall hazard ratio of 1.41 (95% CI 1.32, 1.50; p < 0.00001), indicating a moderately positive effect size. Subgroup analyses showed consistent associations with ischemic stroke (HR = 1.30, 95% CI 1.13, 1.50; p = 0.007), fatal stroke (HR = 1.39, 95% CI 1.24, 1.55; p < 0.000001), and hemorrhagic stroke (HR = 1.33, 95% CI 1.01, 1.76; p = 0.04). The use of antidepressants was associated with an elevated risk of stroke (HR = 1.28, 95% CI 1.05, 1.55; p = 0.01). Conclusion and relevance: This meta-analysis indicates that depression moderately raises the risk of stroke. Given the severe consequences of stroke in individuals with depression, early detection and intervention should be prioritized to prevent it. Systematic review registration: Prospero (CRD42023472136).

2.
Cureus ; 15(11): e48673, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38090418

ABSTRACT

Hepatocellular carcinoma (HCC) is the most common primary cancer of liver tissue and is often caused by chronic liver diseases. The Barcelona Clinic Liver Cancer (BCLC) staging system is commonly used to determine the stage and prognosis of HCC. Transarterial chemoembolization (TACE) is the recommended first-line therapy for intermediate-stage HCC (patients who have asymptomatic, multi-nodular hepatocellular carcinoma). Over the past 10 years, the combination of TACE with immune checkpoint inhibitors, such as Camrelizumab, has shown promising results in treating HCC. We conducted a systematic review and meta-analysis following PRISMA guidelines. A comprehensive search of PubMed, MEDLINE, Elsevier, Scopus, ATC abstracts, and the Cochrane Central Register of Controlled Trials (CENTRAL) databases was performed to identify relevant studies on the effectiveness of TACE combined with Camrelizumab in the treatment of HCC. Study selection, data extraction, and quality assurance were conducted by independent investigators. From 1023 identified citations, six studies were included in the final analysis. The combined results of these studies showed a complete response rate of 7.35%, a partial response rate of 37.10%, stable disease in 28.76% of patients, an objective response rate of 46.13%, a disease control rate of 77.19%, and progression-free survival of 6.2 months. The combination of TACE and Camrelizumab appears to be a safe and effective treatment option for patients with advanced, recurrent, and unresectable HCC. However, the included studies had limitations such as retrospective design and small sample sizes. Further research is needed to validate and expand on these findings.

3.
Am J Cardiol ; 199: 85-91, 2023 07 15.
Article in English | MEDLINE | ID: mdl-37269781

ABSTRACT

Mineralocorticoid receptor antagonists (MRAs) are known to improve clinical outcomes in heart failure, particularly heart failure with reduced ejection fraction. However, the effect of MRAs on the incidence of and recurrence of atrial fibrillation (AF) is not well established. Therefore, databases, such as PubMed, EMBASE, and Cochrane Central, were searched from inception to September 2021 for randomized controlled trials of MRAs with AF as an outcome. Risk ratios (RRs) with 95% confidence interval (CIs) were combined using the random-effects model. A total of 10 randomized controlled trials (n = 11,356) were included. Our pooled analysis demonstrates that MRAs reduce the risk of AF occurrence by 23% compared with the control therapy (RR 0.77, 95% CI 0.65 to 0.91, p = 0.003, I2 = 40%). Subgroup analysis demonstrated that MRAs reduced the risk of both new-onset AF (RR 0.84, 95% CI 0.61 to 1.16, p = 0.28, I2 = 43%) and recurrent AF (RR 0.73, 95% CI 0.59 to 0.90, p = 0.004, I2 = 26%) similarly; p interaction = 0.48. Our meta-analysis concludes that MRAs reduce the risk of development of AF overall, with consistent effects in new-onset and recurrent AF.


Subject(s)
Atrial Fibrillation , Heart Failure , Humans , Mineralocorticoid Receptor Antagonists/therapeutic use , Atrial Fibrillation/epidemiology , Atrial Fibrillation/drug therapy , Heart Failure/epidemiology , Heart Failure/prevention & control , Heart Failure/drug therapy , Incidence , Odds Ratio
4.
Foods ; 12(4)2023 Feb 07.
Article in English | MEDLINE | ID: mdl-36832794

ABSTRACT

We previously reported a sustainable food waste management approach to produce an acceptable organic liquid fertiliser for recycling food waste called "FoodLift." This study follows our previous work to evaluate the macronutrients and cation concentrations in harvested structural parts of lettuce, cucumber, and cherry tomatoes produced using food waste-derived liquid fertiliser (FoodLift) and compare them against commercial liquid fertiliser (CLF) under hydroponic conditions. N and P concentrations in the structural parts of lettuce and the fruit and plant structural parts of cucumber appear to be similar between FoodLift and CLF (p > 0.05), with significantly different N concentrations in the various parts of cherry tomato plants (p < 0.05). For lettuce, N and P content varied from 50 to 260 g/kg and 11 to 88 g/kg, respectively. For cucumber and cherry tomato plants, N and P concentrations ranged from 1 to 36 g/kg and 4 to 33 g/kg, respectively. FoodLift was not effective as a nutrient source for growing cherry tomatoes. Moreover, the cation (K, Ca, and Mg) concentrations appear to significantly differ between FoodLift and CLF grown plants (p < 0.05). For example, for cucumber, Ca content varied from 2 to 18 g/kg for FoodLift grown plants while Ca in CLF-grown cucumber plants ranged from 2 to 28 g/kg. Overall, as suggested in our previous work, FoodLift has the potential to replace CLF in hydroponic systems for lettuce and cucumber. This will lead to sustainable food production, recycling of food waste to produce liquid fertiliser, and will promote a circular economy in nutrient management.

5.
J Family Med Prim Care ; 12(11): 2805-2826, 2023 Nov.
Article in English | MEDLINE | ID: mdl-38186804

ABSTRACT

Introduction: Preterm birth is linked to various complications in both infancy and adulthood. We assessed the association between preterm birth and hypertension in adulthood. Materials and Methods: PubMed, EMBASE, and Cochrane CENTRAL Register were searched for randomized controlled trials (RCT) comparing systolic and diastolic blood pressures in individuals born preterm and those born full-term, from inception till April 11th, 2022. Data were extracted, pooled, and analyzed. Forest plots were created for a visual demonstration. Results: Twenty-eight studies were included in our meta-analysis. SBP and DBP across all categories (Mean, Ambulatory, Daytime, and Nighttime) were higher in the preterm group compared to the term group. Mean SBP, mean ambulatory SBP, mean daytime SBP and mean nighttime SBP were 4.26 mmHg [95% CI: 3.09-5.43; P < 0.00001], 4.53 mmHg [95% CI: 1.82-7.24; P = 0.001], 4.51 mmHg [95% CI: 2.56-6.74; P < 0.00001], and 3.06 mmHg [95% CI: 1.32-4.80; P = 0.0006] higher in the preterm group, respectively. Mean DBP, mean ambulatory DBP, mean daytime DBP, and mean nighttime DBP were 2.32 mmHg [95% CI: 1.35-3.29; P < 0.00001], 1.54 mmHg [95% CI 0.68-2.39; P = 0.0004], 1.74 mmHg [95% CI: 0.92-2.56; P < 0.0001], and 1.58 mmHg [95% CI: 0.34-2.81; P = 0.01] higher in the preterm group, respectively. Conclusion: Our observations suggest that individuals who were born preterm may have higher blood pressures as compared to those who were born full-term.

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