Alcohol consumption and risk of tuberculosis: a systematic review and meta-analysis.

OBJECTIVE: To perform a systematic review and meta-analysis of the association between alcohol consumption and risk of tuberculosis (TB). METHODS: Medline, EMBASE and Web of Science were searched for observational studies from 2005 to April 2018. Reference lists of included studies were screened. RESULTS: Forty-nine studies were included. Compared with people with low or no alcohol intake, the risk of TB in people with high or any alcohol consumption was increased by relative odds of 1.90 (95%CI 1.63-2.23). Substantial levels of heterogeneity were seen (I² = 82%); however, there was no evidence of publication bias (P = 0.54). Sensitivity analysis restricted to studies using no alcohol drinking as a reference group found a slightly lower but still increased risk (OR 1.60, 95%CI 1.39-1.84). Subgroup analyses revealed no significant differences in relation to study design and quality, geographic location, publication year or adjustment for confounders. A pooled analysis of a further four studies reporting hazard ratios (HRs) found a nearly three-fold increase in risk of TB in relation to alcohol consumption during follow-up (HR 2.81, 95%CI 2.12-3.74). An exposure-response analysis showed that for every 10-20 g daily alcohol intake, there was a 12% increase in TB risk. CONCLUSION: Alcohol consumption is an important risk factor for the development of TB.

Economic evaluation of docetaxel-gemcitabine versus vinorelbine-cisplatin combination as front-line treatment of patients with advanced/metastatic non-small-cell lung cancer in Greece: a cost-minimization analysis.

BACKGROUND: An economic evaluation was undertaken, alongside a randomized phase III study, to assess docetaxel-gemcitabine (DG) relative to vinorelbine-cisplatin (VC) combination as front-line treatment of patients with advanced/metastatic non-small-cell lung cancer. METHODS: No differences were found in efficacy, thus a cost-minimization analysis was carried out. Treatment cost accounts for the administration of first- and second-line chemotherapy, for concomitant medications, for laboratory and biochemical examinations, and for hospitalizations due to adverse events. Unit prices used reflect 2008 and are common among National Health Service hospitals in Greece. RESULTS: The mean total cost of therapy in the DG group [14045 euros, 95% uncertainty interval (UI) 12628 euros-15390 euros], was significantly higher than in the VC group (8143 euros, 95% UI 7314 euros-9067 euros). CONCLUSIONS: Even though the combination VC has similar effectiveness compared with DG in patients with metastatic lung cancer, it is associated with a lower overall treatment cost and hence, it is preferable from an economic perspective. However, it should be noted that although VC is associated with lower cost, it is also more toxic than DG regimen, a significant parameter that should be considered in clinical decisions.

The role of dairy products and non alcoholic beverages in bone fractures among schoolage children.

In order to assess consumption of the calcium rich dairy products, intake of non alcoholic beverages and physical activity as risk factors for bone fractures among schoolage children, a case control study was undertaken in Athens, Greece. During 1995 one hundred children 7 to 14 years old (74 boys and 26 girls) with single uncomplicated fractures of the upper and lower extremities and no evidence of coexisting metabolic condition affecting bone fragility were compared with 100 age- and gender-matched controls. The analysis was undertaken by modeling the data through conditional logistic regression. Several indicators point to an increased risk of fractures among physically active children, although none of the individual variables was statistically significant. Somatometric factors were not related to fractures, although children with more advanced stage of development at Tanner's scale were apparently at increased risk. Intake of dairy products and of carbonated non cola beverages was not related to the occurrence of fractures. By contrast, intake of non carbonated beverages, mainly fruit juices, and of cola beverages were significantly associated with elevated risks of fractures [for an increase of one-half can per day, the odds ratios and associated 95% confidence intervals were 1.6 (1.2 to 2.3) and 1.7 (1.2 to 2.6) respectively]. In the absence of other common elements between cola and non carbonated beverages the positive associations of these beverages, with bone fractures probably reflect the increased rehydration needs of active children who are also at high risk for injuries.

Hazards of baby walkers in a European context.

OBJECTIVES: To identify conditions related to baby walker injuries in a Greek population. DESIGN: Analysis of all baby walker related injuries recorded during a 12 month period by the childhood injury surveillance system established in one of the two teaching hospitals for children serving the population of Athens. SETTING: Emergency clinics of A Kyriakou Children's Hospital in Athens, Greece. SUBJECTS: 49 babies with baby walker related injuries brought to the emergency clinics during the period May 1994 to April 1995. RESULTS: The incidence of these injuries was 16 per thousand person years of users, or 3.5 per thousand babies per year. More boys than girls were brought to the hospital for these injuries and the incidence density was highest during the ninth and 10th month of age. Falls from heights, particularly stairs, were the most frequent cause of baby walker related injuries, especially among younger babies. The majority of these injuries were of minor severity, but three babies had bone fractures and one had a second degree facial burn. Six babies required hospitalization and for seven others, a follow up visit was needed. The higher proportion of hospitalization among girls than boys raises the possibility that boys with minor injuries are more frequently brought to the hospital. CONCLUSIONS: Baby walkers impart a significant risk of injury from a consumer product that provides no clearly identifiable benefit. As most baby walker injuries happen on stairs, modifications in product design are required to reduce these injuries. Moreover, parents should be forcefully advised of the risks and predisposing conditions, if baby walkers are to be used at all.