The association between congenital heart disease and the risk of Autism spectrum disorders or attention-deficit/hyperactivity disorder among children: a meta-analysis

Background and objective. To our knowledge, this is the first meta-analysis conducted about the association between congenital heart disease (CHD) and the risk of attention-deficit/hyperactivity disorder (ADHD) or autism spectrum disorders (ASD) based on observational studies.Methods PubMed, Web of Science, and Scopus were systematically searched from the earliest possible year to December 2020. Heterogeneity was conducted using the chi-square test and its quantity was measured using the I2 statistic. The publication bias was assessed using Egger's and Begg's line regression tests. The results were reported using the odds ratio (OR) estimated with its 95% confidence interval (CI) using a random-effects model. Results. In total, 812 citations were included in the search initial until December 2020 with 467,164 children. Based on the random effect model, the estimated OR of the risk of ASD associated with CHD was OR=1.35 (95% CI: 1.17, 1.52; 6 studies; I2=0.0%) and the risk of ADHD associated with CHD was OR=3.04 (95% CI: 1.58, 4.49; 15 studies; I2=88.1%). Conclusions. Our findings suggested that CHD is a risk factor for ASD and ADHD. Therefore, Screening for ASD and ADHD should be considered among young children with CHD.

Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: an application of the Protection Motivation Theory.

This study was conducted to predict the preventive behaviours of healthcare workers (HCWs) towards COVID-19 based on the Protection Motivation Theory (PMT). This cross-sectional and analytical study was conducted on 761 HCWs in Hamadan, Iran, using multi-stage random sampling. The preventive behaviours against COVID-19 among HCWs were assessed at a relatively desirable level. Based on the PMT, threat and coping appraisal were predictors of protection motivation to conduct COVID-19 preventive behaviours (P<0.001). The intention was also predictive of COVID-19 preventive behaviours (P<0.001). Consideration of personnel's self-efficacy and their knowledge regarding the effectiveness of protective behaviours in designing staff training programmes are recommended.

Prevalence of hepatitis C virus infection among high-risk groups in Iran: a systematic review and meta-analysis.

OBJECTIVES: Determination of the true burden of hepatitis C virus (HCV) infection among high-risk groups relies heavily on occurrence measures such as prevalence, which are vital for implementation of preventive action plans. Nevertheless, up-to-date data on the prevalence of HCV infection remain scarce in Iran. This study aimed to review the relevant literature systematically and determine the pooled prevalence of HCV infection among high-risk groups in Iran. STUDY DESIGN: Systematic review & meta-analysis. METHODS: In 2016, electronic scientific databases including PubMed, Scopus, Web of Science and local databases were searched using a detailed search strategy with language restricted to English and Farsi. The reference lists of the studies included in this review were also screened. Data were reviewed and extracted independently by two authors. A random effects model was used to estimate the pooled prevalence. Sources of heterogeneity among the studies were determined using subgroup analysis and meta-regression. RESULTS: In total, 1817 records were identified in the initial search, and 46 records were included in the meta-analysis. The overall prevalence of HCV among high-risk groups was 32.3%. The prevalence was 41.3% in injection drug users (IDUs), 22.9% in prisoners, 16.2% in drug-dependent individuals and 24.6% in drug-dependent prisoners. Subgroup and meta-regression analyses revealed that geographical location and year of publication were the probable sources of heterogeneity. CONCLUSION: This meta-analysis found a high prevalence of HCV among high-risk groups in Iran, particularly among IDUs. There is a need for prevention strategies to reduce the burden of HCV infection among high-risk groups, particularly IDUs.

Global incidence and mortality rates in pancreatic cancer and the association with the Human Development Index: decomposition approach.

OBJECTIVES: Pancreatic cancer has a lower morbidity yet higher case fatality rates (CFRs) compared with other gastrointestinal cancers. The effects of socio-economic components on pancreatic cancer rates have been acknowledged; however, the effects of the Human Development Index (HDI) inequality are not. In this study, we aimed to determine the contribution of important socio-economic components on pancreatic cancer rates using a decomposition approach. STUDY DESIGN: Global ecological study. METHODS: Incidence and mortality rates of pancreatic cancer were obtained for 172 countries from GLOBOCAN and the United Nations Development Program. The World Bank database was also used to obtain the HDI and its gradient for 169 countries. Inequality in pancreatic cancer age-specific incidence and mortality rates was calculated according to the HDI using the concentration index (CI). We decomposed the CI to determine main contributors of the inequality. RESULTS: The CI for incidence and mortality of pancreatic cancer in both genders according to the HDI was 0.26 (95% confidence interval: 0.21-0.30) and 0.25 (95% confidence interval: 0.21-0.30), respectively, which indicated more concentrated inequality in advantaged countries. About 80% of the inequality sources were predicted by socio-economic component in both rates of pancreatic cancer. The main contributors to inequality were the mean years of schooling, life expectancy at birth, expected years of schooling, and urbanization. CONCLUSION: Global inequalities exist in pancreatic cancer incidence and mortality rates according to the HDI; in addition, inequality was more concentrated in countries with higher score of HDI.

Survival rate of AIDS disease and mortality in HIV-infected patients: a meta-analysis.

BACKGROUND: The life expectancy of patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) reported by several epidemiological studies is inconsistent. This meta-analysis was conducted to estimate the survival rate from HIV diagnosis to AIDS onset and from AIDS onset to death. METHODS: The electronic databases PubMed, Web of Science and Scopus were searched to February 2016. In addition, the reference lists of included studies were checked to identify further references, and the database of the International AIDS Society was also searched. Cohort studies addressing the survival rate in patients diagnosed with HIV/AIDS were included in this meta-analysis. The outcomes of interest were the survival rate of patients diagnosed with HIV progressing to AIDS, and the survival rate of patients with AIDS dying from AIDS-related causes with or without highly active antiretroviral therapy (HAART). The survival rate (P) was estimated with 95% confidence intervals based on random-effects models. RESULTS: In total, 27,862 references were identified, and 57 studies involving 294,662 participants were included in this meta-analysis. Two, 4-, 6-, 8-, 10- and 12-year survival probabilities of progression from HIV diagnosis to AIDS onset were estimated to be 82%, 72%, 64%, 57%, 26% and 19%, respectively. Two, 4-, 6-, 8- and 10-year survival probabilities of progression from AIDS onset to AIDS-related death in patients who received HAART were estimated to be 87%, 86%, 78%, 78%, and 61%, respectively, and 2-, 4- and 6-year survival probabilities of progression from AIDS onset to AIDS-related death in patients who did not receive HAART were estimated to be 48%, 26% and 18%, respectively. Evidence of considerable heterogeneity was found. The majority of the studies had a moderate to high risk of bias. CONCLUSION: The majority of HIV-positive patients progress to AIDS within the first decade of diagnosis. Most patients who receive HAART will survive for >10 years after the onset of AIDS, whereas the majority of the patients who do not receive HAART die within 2 years of the onset of AIDS.

The association between hot flushes and smoking in midlife women: a meta-analysis.

BACKGROUND: Several epidemiological studies have investigated the association between hot flushes and smoking, but the results are inconsistent. This meta-analysis was performed to estimate an overall effect of former smoking and current smoking on the risk of hot flushes in midlife women. METHODS: We searched PubMed, Web of Science, and Scopus for observational studies addressing the association between hot flushes and smoking until March 2015. Data were independently extracted and analyzed using odds ratio with 95% confidence intervals (CI) based on the random-effects model. RESULTS: We identified 621 references and included eight studies with 27 054 participants. The odds ratio of an association between hot flushes and former smoking was estimated as 1.31 (95% CI 1.22-1.41) and that of current smoking was estimated as 1.97 (95% CI 1.81-2.14). No evidence of heterogeneity and publication bias was observed. CONCLUSION: The findings from this meta-analysis indicated that former and current smoking are associated with an increased risk of hot flushes. However, more evidence based on large, prospective cohort studies is required to provide stronger evidence whether former and current smoking may be associated with an increased risk of hot flushes.

The effect of body mass index on endometrial cancer: a meta-analysis.

BACKGROUND: Several epidemiological studies have investigated the association between body mass index (BMI) and endometrial cancer in recent years. This up-to-date meta-analysis was conducted to obtain an overall effect estimate based on current evidence. STUDY DESIGN: A meta-analysis was conducted until March 2015. METHODS: Major electronic databases including PubMed, Web of Science, and Scopus were searched. The reference lists and related scientific conference databases were searched for additional data. Cohort and case-control studies addressing the association between BMI and endometrial cancer were included. The exposure of interest was overweight and obesity. The outcome of interest was endometrial cancer of any type confirmed pathologically. The effect measure of choice was rate ratio (RR) for cohort studies and odds ratio (OR) for case-control studies. The random effect model was reported. RESULTS: Of 6241 retrieved references, 40 studies were included in the meta-analysis including 20 prospective cohort studies and 20 case-control studies involving 32,281,242 participants. The results of both cohort and case-control studies showed a significant association. Based on random effect model, compared to normal weight people, the estimated RR and OR of endometrial cancer was 1.34 (95% CI: 1.20, 1.48) and 1.43 (95% CI: 1.30, 1.56) for the overweight and 2.54 (95% CI: 2.27, 2.81) and 3.33 (95% CI: 2.87, 3.79) for the obese, respectively. CONCLUSIONS: The results of this meta-analysis indicated that BMI is strongly associated with an increased risk of endometrial cancer. Further investigations are required to expect the pathophysiology of the endometrial cancer caused by overweight and obesity.