ABSTRACT
BACKGROUND: Hypertension is a recognized risk factor for Parkinson's disease (PD). The renin-angiotensin system (RAS) inhibitors are widely used to treat hypertension. However, the association of RAS inhibitor use with PD has still been an area of controversy. METHODS: Thus, we conducted a meta-analysis to investigate the relationship between RAS inhibitor use and PD. PUBMED and EMBASE databases were searched for articles published up to Oct 2023. All studies that examined the relationship between RAS inhibitor use and the incidence of PD were included. RESULTS: Seven studies with total 3,495,218 individuals met our inclusion criteria for this meta-analysis. Overall, RAS inhibitor use was associated with a reduction in PD risk (OR = 0.88, 95%CI = 0.79-0.98) compared with the controls. When restricted the analysis to individuals with RAS inhibitor use indication, RAS inhibitor exposure was also associated with a decreased risk of PD (OR = 0.76, 95%CI = 0.62-0.92). Pooled results of cohort studies also did support a protective role of angiotensin converting enzyme inhibitors (ACEIs) (OR = 0.97, 95%CI = 0.89-1.07) users and angiotensin II receptor blockers (ARBs) (OR = 0.8, 95%CI = 0.63-1.02) in PD. CONCLUSION: Overall, RAS inhibitor use as a class is associated with a reduction in PD risk. However, the findings of ACEIs and ARBs may be limited by small sample size. Future well-designed studies considering the classification by inhibitor type, duration, dose, or property of BBB penetration of RAS inhibitors are needed to clarify the contribution of these exposure parameters on the risk of PD.
ABSTRACT
Objective@#To explore correlations between physical activity (PA), sedentary behavior (SB) and physical posture disorders in primary school students, and to provide reference for the prevention and correction of adverse body posture in this group.@*Methods@#From September to December 2020, 206 children from 4 primary schools in Chaoyang District of Beijing were selected by multistage stratified cluster random sampling method. Body posture and PA were assessed using a body posture tester and a triaxial accelerometer. Children s Leisure Activity Questionnaire was used to investigate SB.@*Results@#The detection rate of abnormal body posture in primary school students was 76.70%. PA showed positive assocation with high and low shoulder, X/O leg, pelvis forward, spine curvature and comprehensive evaluation ( β =0.17, 0.21, 0.19, 0.24, 0.19, P <0.05). SB had significant negative linear correlation with high and low shoulder, X/O leg,pelvis forward, spine curvature and comprehensive evaluation ( β = -0.24 , -0.22, -0.36, -0.24, -0.27, P <0.05). In the combination analysis, children with high PA plus low SB ( OR=2.12, 95%CI= 1.46-3.37, P <0.05) and children with low PA plus high SB had the highest and lowest advantages of qualified rate of body posture assessment,respectively. Compare with low SB and low PA( OR=1.71, 95%CI=1.41-2.74, P <0.05), high PA and high SB ( OR=1.85, 95%CI=1.38-2.86, P <0.05) had higher qualified rate of body posture assessment.@*Conclusion@#Physical activity shows positive effects on physical posture while sedentary behavior shows negative effects on physical posture. The combination of PA and SB has a counteracting or synergistic interaction effect.
ABSTRACT
BACKGROUND: The relationship between surgeon volume and outcomes in spine surgery is unclear and published studies report inconsistent results. Therefore, a dose-response meta-analysis was conducted to clarify the influence of surgeon volume on outcomes in spine surgery. METHODS: PubMed, Embase, and The Cochrane Library were systematically searched without language limitation for observational studies which investigated the relationship between surgeon volume and outcomes in spine surgery. The primary outcome was postoperative morbidity and the secondary outcomes consisted of mortality, length of hospital stay, readmission, and hospital costs. For binary variable and continuous variable, odds ratios (ORs) with 95% CIs and weighted mean differences (WMDs) with 95% CIs were pooled respectively. Additionally, a dose-response meta-analysis was performed for the primary outcome. RESULTS: Eleven studies with 1,986,545 patients were included in the current meta-analysis. Pooled estimate indicated that a higher surgeon volume was associated with lower postoperative morbidity (OR, 0.62; 95% CI: 0.52-0.75; I2=93.9%), lower mortality (OR, 0.76; 95% CI: 0.66-0.87; I2=0), shorter length of hospital stay (WMD, -7.07; 95% CI: -7.08 to -7.06; I2=100%), less readmission (OR, 0.78; 95% CI: 0.72-0.85; I2=93.1%), and lower hospital costs (WMD, -25,497.47; 95% CI: -25,528.43 to -25,466.51; I2=100%). Dose-response analysis suggested a nonlinear relationship between surgeon volume and postoperative morbidity (P for nonlinearity less than 0.00001). CONCLUSIONS: The current evidence indicate that higher surgeon volume is associated with lower morbidity and mortality, shorter length of hospital stay, less readmission, and lower hospital costs in spine surgery.
