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1.
Min ChengZunsong Hu PhD Xiangfeng LuJianfeng Huang MD Dongfeng Gu 《The Canadian journal of cardiology》2014
Background
The association between habitual caffeine intake with incident atrial fibrillation (AF) was unknown. We conducted a meta-analysis to investigate the association between chronic exposure of caffeine and the risk of AF and to evaluate the potential dose-response relation.Methods
We searched PubMed, EMBASE, and the Cochrane Library up to November 2013 and references of relevant retrieved articles. Prospective cohort studies were included with relative risk (RR) or hazard ratio and 95% confidence intervals (CIs) for AF according to coffee/caffeine intake.Results
Six prospective cohort studies with 228,465 participants were included. In the primary meta-analysis, caffeine exposure was weakly associated with a reduced risk of AF (RR, 0.90; 95% CI, 0.81-1.01; P = 0.07; I2 = 73%). In subgroup analyses, pooled results from studies with adjustment of potential confounders showed an 11% reduction for low doses (RR, 0.89; 95% CI, 0.80-0.99, P = 0.032; I2 = 30.9%, P = 0.227) and 16% for high doses (RR, 0.84; 95% CI, 0.75-0.94, P = 0.002; I2 = 24.1%, P = 0.267) of caffeine consumption in AF risk. An inverse relation was found between habitual caffeine intake and AF risk (P for overall trend = 0.015; P for nonlinearity = 0.27) in dose-response meta-analysis and the incidence of AF decreased by 6% (RR, 0.94; 95% CI, 0.90-0.99) for every 300 mg/d increment in habitual caffeine intake.Conclusions
It is unlikely that caffeine consumption causes or contributes to AF. Habitual caffeine consumption might reduce AF risk. 相似文献2.
Chun Shing Kwok Ashish Pradhan Muhammad A. Khan Simon G. Anderson Bernard D. Keavney Phyo Kyaw Myint Mamas A. Mamas Yoon K. Loke 《International journal of cardiology》2014
Background
Bariatric surgery has been shown to improve cardiovascular risk factors but long term benefits for survival and cardiovascular events are still uncertain.Methods
We searched MEDLINE and EMBASE for parallel group studies that evaluated the clinical outcomes associated with bariatric surgery as compared to non-surgical treatment. Relevant studies were pooled using random effects meta-analysis for risk of myocardial infarction, stroke, cardiovascular events and mortality.Results
14 studies met the inclusion criteria, which included 29,208 patients who underwent bariatric surgery and 166,200 nonsurgical controls (mean age 48 years, 30% male, follow up period ranged from 2 years to 14.7 years). Four studies were considered at moderate–high risk of bias, whilst ten studies were at moderate or lower risk of bias. Compared to nonsurgical controls there was more than 50% reduction in mortality amongst patients who had bariatric surgery (OR 0.48 95% CI 0.35–0.64, I2 = 86%, 14 studies). In pooled analysis of four studies with adjusted data, bariatric surgery was associated with a significantly reduced risk of composite cardiovascular adverse events (OR 0.54 95% CI 0.41–0.70, I2 = 58%). Bariatric surgery was also associated with significant reduction in specific endpoints of myocardial infarction (OR 0.46 95% CI 0.30–0.69, I2 = 79%, 4 studies) and stroke (OR 0.49 95% CI 0.32–0.75, I2 = 59%, 4 studies).Conclusions
Data from observational studies indicates that patients undergoing bariatric surgery have a reduced risk of myocardial infarction, stroke, cardiovascular events and mortality compared to non-surgical controls. Future randomized studies should investigate whether these observations are reproduced in a clinical trials setting. 相似文献3.
Samantha Morais Sandra Rodrigues Liliana Amorim Bárbara Peleteiro Nuno Lunet 《Digestive and liver disease》2014,46(11):1031-1037
Background
The evaluation of specific risk factors for early endpoints in the gastric carcinogenesis pathway may further contribute to the understanding of gastric cancer aetiology.Aims
To quantify the relation between smoking and intestinal metaplasia through systematic review and meta-analysis.Methods
Articles providing data on the association between smoking and intestinal metaplasia were identified in PubMed®, Scopus® and Web of Science™, searched until April 2014, and through backward citation tracking. Summary odds ratio estimates and 95% confidence intervals were computed using the DerSimonian and Laird method. Heterogeneity was quantitatively assessed using the I2 statistic.Results
A total of 32 articles were included in this systematic review and 19 provided data for meta-analysis. Smoking was defined as ever vs. never (crude estimates, six studies, summary odds ratio = 1.54, 95% confidence interval: 1.12–2.12, I2 = 67.4%; adjusted estimates, seven studies, summary odds ratio = 1.26, 95% confidence interval: 0.98–1.61, I2 = 65.0%) and current vs. non-smokers (crude estimates, seven studies, summary odds ratio = 1.27, 95% confidence interval: 0.88–1.84, I2 = 73.4%; adjusted estimates, two studies, summary odds ratio 1.49, 95% confidence interval: 0.99–2.25, I2 = 0.0%).Conclusion
The weak and non-statistically significant association found through meta-analysis of the available evidence does not confirm smoking as an independent risk factor for intestinal metaplasia. 相似文献4.
Purpose of Review
To review the extent of treatment success or failure with the xanthine oxidoreductase inhibitors allopurinol and febuxostat and indicate how the dosage of urate-lowering therapy (ULT) may be modified to increase the response in the majority of patients with gout.Recent Findings
Gout flares are associated with serum concentrations of urate above 0.42 mmol/L (7 mg/dL). Achieving and maintaining serum urate below 0.36 mmol/L is considered an effective response to ULT. On an intention to treat basis, clinical trials indicate that allopurinol at daily doses of 100 to 300 mg decreases serum urate adequately in only about 40% of gout patients while febuxostat 80 mg daily reduces serum urate adequately in approximately 70% of gout patients. Higher doses of ULT may be required in patients receiving concomitant diuretics. The addition of a uricosuric agent to allopurinol and febuxostat therapy significantly increases the proportion of patients achieving adequate lowering of serum urate. Finally, carriers of a genetic variant of the transporter, ABCG2 (BCRP), have a decreased response to allopurinol.Summary
Careful examination of medication adherence, titration of doses, and the addition of uricosuric agents increase the percentage of patients responding to allopurinol and febuxostat.5.
Georges Khoueiry Nidal Abi Rafeh Erinmarie Sullivan Faisal Saiful Zehra Jaffery David N. Kenigsberg Subramaniam C. Krishnan Sanjaya Khanal Soad Bekheit Marcin Kowalski 《Heart & lung : the journal of critical care》2013
Introduction
Omega-3 polyunsaturated fatty acids (PUFA) have demonstrated to have antiarrhythmic properties. However, randomized studies have shown inconsistent results.Objective
We aimed to analyze the effect of omega-3 PUFA on preventing potentially fatal ventricular arrhythmias and sudden cardiac death.Methods
Randomized trials comparing omega-3 PUFA to placebo and reporting sudden cardiac death (SCD) or first implanted cardioverter-defibrillator (ICD) event for ventricular tachycardia or fibrillation were included in this study. A meta-analysis using a random effects model was performed and results were expressed in terms of Odds Ratio (OR) and 95% Confidence Interval (CI) after evaluating for interstudy heterogeneity using I2. The reported data were extracted on the basis of the intention-to-treat principle.Results
A total of 32,919 patients were included in nine trials; 16,465 patients received omega-3 PUFA and 16,454 received placebo. When comparing omega-3 PUFA to placebo, there was nonsignificant risk reduction of SCD or ventricular arrhythmias (OR = 0.82 [95% CI: 0.60–1.21], p = 0.21 I2 = 49.7%).Conclusion
Dietary supplementation with omega-3 PUFA does not affect the risk of SCD or ventricular arrhythmias. 相似文献6.
Objective
Serum uric acid (SUA) levels have been used to predict cardiovascular and all-cause mortality event, but the data have yielded conflicting results. We investigated whether SUA was an independent predictor for cardiovascular or all-cause mortality with prospective studies by meta-analysis.Methods
Pubmed and Embase were searched without language restrictions for publications available till April 2013. Only prospective studies on cardiovascular or all-cause mortality related to SUA levels were included. Pooled adjust relative risk (RR) and corresponding 95% confidence intervals (CI) were calculated separately for the highest vs. lowest category or the lowest vs. middle category.Results
For the highest SUA, eleven studies with 172,123 participants were identified and analyzed. Elevated SUA increased risk of all-cause mortality (RR 1.24; 95% CI 1.09–1.42) and cardiovascular mortality (RR 1.37; 95% CI 1.19–1.57). Subgroup analyses showed that elevated SUA significantly increase the risk of all-cause mortality among men (RR 1.23; 95% CI 1.08–1.42), but not in women (RR 1.05; 95% CI 0.79–1.39). Risk of cardiovascular mortality appeared to be more pronounced among women (RR 1.35; 95% CI 1.06–1.72). The association between extremely low SUA and mortality was reported in three studies; we did not perform a pooled analysis because of high degree of heterogeneity in these studies.Conclusions
Baseline SUA level is an independent predictor for future cardiovascular mortality. Elevated SUA appears to significantly increase the risk of all-cause mortality in men, but not in women. Whether low SUA levels are predictors of mortality is still inconclusive. 相似文献7.
Background
Cardiovascular risk is inconsistent in the normal-weight, overweight, and obese individuals due to metabolic abnormality. We aimed to investigate combined effects of obesity and metabolic abnormality on the risk of cardiovascular disease and mortality.Methods
The MEDLINE, EMBASE, Cochrane library, and references of relevant original articles prior to May 2013 were searched for prospective studies investigating cardiovascular risk and death associated with combined effects of obesity and metabolic syndrome or insulin resistance. Pooled relative risks (RR) and 95% confidence intervals (CI) were calculated using random-effects or fixed-effect models when appropriate.Results
Fourteen perspective studies with a total of 299,059 participants and 12,125 cases of incident CVD, 2130 cases of CVD death, and 7071 cases of all-cause death were included in the meta-analysis. Compared with healthy normal-weight individuals, metabolically healthy overweight (MHOW) and obese (MHOB) individuals showed increased risk for CVD events, which appeared much stronger during the long-term follow-up period of > 15 years, with pooled RR of 1.47 (95% CI 1.37–1.58) in MHOW and 2.00 (95% CI 1.79–2.24) in MHOB. Normal-weight but metabolically abnormal individuals were at increased risk for CVD (pooled RR 1.81, 95% CI 1.56–2.10), CVD-related death (pooled RR 1.55, 95% CI 1.16–2.08), and all-cause death (pooled RR 1.27, 95% CI 1.10–1.47). Metabolically abnormal obese individuals were at the highest risk for CVD and mortality.Conclusion
Individuals with metabolic abnormality, although at normal-weight, had an increased risk of CVD and mortality. Healthy overweight and obese persons had higher risk, which refuted the notion that metabolically healthy obese phenotype is a benign condition. 相似文献8.
Introduction
Hyperuricemia may be associated with an increased risk of stroke, but to date results from prospective studies have been inconsistent. This study aimed to evaluate the association between hyperuricemia and risk of stroke incidence and mortality by performing a meta-analysis.Materials and methods
Studies were identified by searching multiple electronic databases through July 13, 2013, and by reviewing reference lists of obtained articles. Prospective studies reported a multivariate-adjusted estimate, represented as relative risk (RRs) with 95% confidence intervals (CIs) for the association between hyperuricemia and risk of stroke incidence and mortality were eligible. A random-effects model was used to compute the pooled risk estimate.Results
A total of fourteen articles including results from 15 prospective studies with 22,571 cases of stroke and 1,042,358 participants were included in the meta-analysis. Overall, presence of hyperuricemia was associated with a significantly greater risk of both stroke incidence (RR, 1.22; 95% CI, 1.02–1.46) and mortality (RR, 1.33; 95% CI, 1.24–1.43). In addition, the pooled estimate of multivariate RRs of stroke incidence and mortality were 1.08 (95% CI: 0.85–1.38); 1.26 (95% CI: 1.14–1.40) among men and 1.25 (95% CI: 1.04–1.46); 1.41 (95% CI: 1.31–1.52) among women respectively.Conclusions
Results from this meta-analysis indicate that hyperuricemia may modestly increase the risks of both stroke incidence and mortality. Future studies should explore whether hyperuricemia is a modifiable risk factor for stroke. 相似文献9.
Rafael Golpe Olalla Castro-AñónLuis A. Pérez-de-Llano MD PhD Carlos González-JuanateyCamino Muñiz-Fernández RN Ana Testa-FernándezRuth Pérez-Fernández MD 《Heart & lung : the journal of critical care》2014
Objective
To assess the value of the six-minute walk test (6MWT) to predict outcome in non-group 1 pulmonary hypertension (PH).Background
Distance walked during 6MWT has been widely used as a prognostic test in pulmonary arterial hypertension (group 1 pulmonary hypertension); however, little is known regarding its prognostic value in other groups of PH.Methods
This was a retrospective study of 60 patients diagnosed of PH, Dana Point classification groups 2–5. 6MWT and echocardiography were performed in all cases.Results
Forty patients (66.6%) were females. Mean age was 70.8 ± 10.7 years (range: 32–85). Seven patients died after a mean follow-up of 23.2 ± 16.7 months. Distance <400 m during 6MWT was associated with a higher risk for death (RR: 4.39; 95% CI: 1.13-17.05; p = 0.03) and for clinical deterioration (death or need for hospitalization) (RR: 2.76; 95% CI: 1.18–6.42; p = 0.02).Conclusions
6MWT is useful to predict outcome in non-group 1 PH. 相似文献10.
Zheng Wang Song-tao Lai Li Xie Jian-dong Zhao Ning-yi Ma Ji Zhu Zhi-gang Ren Guo-liang Jiang 《Diabetes research and clinical practice》2014
Aims
Recent epidemiological studies indicated that use of metformin might decrease the risk of various cancers among patients with type 2 diabetes mellitus (T2DM). However, its influence on pancreatic cancer was controversial. Therefore, we did a meta-analysis of currently available observational studies on the issue.Methods
We did a PubMed and ISI Web of Science search for observational articles. The pooled relative risk (RR) was estimated using a random-effect model. Heterogeneity was evaluated using I2 statistic. Subgroup analysis was performed to explore the source of heterogeneity and confirm the overall estimates. Publication bias was also examined.Results
The analysis included 11 articles (13 studies) comprising 10 cohort studies and 3 case–control studies. Use of metformin was associated with a significant lower risk of pancreatic cancer [RR 0.63, 95% confidence internal (CI) 0.46–0.86, p = 0.003]. In a total 11 subgroup analyses, 5 provided the consistent result with pooled effect estimates of overall analysis. No publication bias was detected by Begg's (Z = −0.79, p = 0.428) and Egger's test (t = −0.92, p = 0.378).Conclusions
From present observational studies, use of metformin appears to be associated with a reduced risk of pancreatic cancer in patients with T2DM. Further investigation is needed. 相似文献11.
H. RALPH Schumacher Jr. Michael A. Becker Robert L. Wortmann Patricia A. MacDonald Barbara Hunt Janet Streit Christopher Lademacher Nancy Joseph‐Ridge 《Arthritis care & research》2008,59(11):1540-1548
Objective
To compare the urate‐lowering efficacy and safety of febuxostat, allopurinol, and placebo in a large group of subjects with hyperuricemia and gout, including persons with impaired renal function.Methods
Subjects (n = 1,072) with hyperuricemia (serum urate level ≥8.0 mg/dl) and gout with normal or impaired (serum creatinine level >1.5 to ≤2.0 mg/dl) renal function were randomized to receive once‐daily febuxostat (80 mg, 120 mg, or 240 mg), allopurinol (300 or 100 mg, based on renal function), or placebo for 28 weeks.Results
Significantly (P ≤ 0.05) higher percentages of subjects treated with febuxostat 80 mg (48%), 120 mg (65%), and 240 mg (69%) attained the primary end point of last 3 monthly serum urate levels <6.0 mg/dl compared with allopurinol (22%) and placebo (0%). A significantly (P < 0.05) higher percentage of subjects with impaired renal function treated with febuxostat 80 mg (4 [44%] of 9), 120 mg (5 [45%] of 11), and 240 mg (3 [60%] of 5) achieved the primary end point compared with those treated with 100 mg of allopurinol (0 [0%] of 10). Proportions of subjects experiencing any adverse event or serious adverse event were similar across groups, although diarrhea and dizziness were more frequent in the febuxostat 240 mg group. The primary reasons for withdrawal were similar across groups except for gout flares, which were more frequent with febuxostat than with allopurinol.Conclusion
At all doses studied, febuxostat more effectively lowered and maintained serum urate levels <6.0 mg/dl than did allopurinol (300 or 100 mg) or placebo in subjects with hyperuricemia and gout, including those with mild to moderately impaired renal function. 相似文献12.
Scot H. Simpson Ahmed S. AbdelmoneimDima Omran BSc Travis R. Featherstone BSc 《The American journal of medicine》2014
Background
Randomized controlled trials have shown that ≤100 mg aspirin daily is not effective for primary prevention of cardiovascular events in diabetes; however, clinical and pharmacologic evidence suggests these patients need >100 mg for adequate antiplatelet activity. Although high on-treatment platelet reactivity (HTPR) could explain the lack of benefit, prevalence of HTPR in diabetes is not known. This systematic review examined the relationship between daily aspirin dose and prevalence of HTPR in patients with diabetes.Methods
Three electronic databases were searched until May 2013 using database-appropriate terms for aspirin, resistance, and diabetes. Studies were included if prevalence of HTPR was reported according to daily dose and diabetes status. Patients were stratified by daily aspirin dose and the weighted mean prevalence across studies was calculated. Where appropriate, pooled relative risks (RR) were calculated using a random-effects model.Results
Data were available from 31 studies that enrolled 2147 diabetic patients. Overall, prevalence of HTPR was 21.9% (95% confidence interval [CI], 15.2%-28.5%) in diabetic patients and 15.8% (95% CI, 11.4%-20.3%) in nondiabetic patients (pooled RR 1.36; 95% CI, 1.08-1.71; I2 56%). Prevalence appeared to be dose related, with 398 (23.6%) of 1689 diabetic patients using ≤100 mg daily having HTPR compared with 64 (12.3%) of 518 diabetic patients using 101-325 mg daily (pooled RR 1.70; 95% CI, 1.07-2.72; I2 0%).Conclusions
Although these observations should be verified in a clinical trial, the possibility that 1 in 4 patients have HTPR with doses commonly used in diabetes could have significant implications on overall effectiveness of aspirin. 相似文献13.
Shoichi Kuramitsu Shinjo Sonoda Hiroyoshi Yokoi Masashi Iwabuchi Yuji Nishizaki Tomohiro Shinozaki Takenori Domei Makoto Hyodo Katsumi Inoue Shinichi Shirai Kenji Ando Masakiyo Nobuyoshi 《Atherosclerosis》2014
Objective
The long-term coronary arterial response of biodegradable polymer biolimus-eluting stents (BES) remains unclear. We sought to evaluate the coronary arterial response of biodegradable polymer BES at 5 years after stent implantation using optical coherence tomography (OCT) as compared with that of durable polymer sirolimus-eluting stents (SES) and bare-metal stents (BMS).Methods
Five-year follow-up OCT was performed in 30 patients with 33 stents (10 with 12 BES; 10 with 11 SES; 10 with 10 BMS). Quantitative parameters and qualitative characteristics of the neointima were evaluated. A total of 5178 struts (BES, n = 2056; SES, n = 1410; BMS, n = 1712) were analyzed.Results
Uncovered struts were found in 15 out of 2055 struts in the BES (weighted estimate 0.01%, 95% confidence intervals [CI]: 0.00–0.33%) and 54 out of 1410 struts in the SES (0.11%, 95% CI: 0.00–3.33%) (odds ratio [OR] 0.12, 95% CI: 0.01–1.95, p = 0.13). None of 1712 struts were uncovered in the BMS. Cross-sectional qualitative analysis of neointimal tissue showed that the frequency of lipid-laden neointima tended to be lower in the BES (2.26%, 95% CI: 0.38–12.3%) compared with the SES (9.90%, 95% CI: 4.37–20.9%; OR 0.21, 95% CI 0.03–1.16, p = 0.07), and was similar to the BMS (2.23%, 95% CI: 0.54–8.74%; OR 0.98, 95% CI 0.13–7.14, p = 0.98).Conclusions
Biodegradable polymer BES shows a favorable coronary arterial response compared with SES, but different response with BMS at 5 years follow-up. The observed frequency of in-stent neoatherosclerosis within BES was similar to BMS and tended to be lower than SES. 相似文献14.
Na LiYue-Jin Yang PhD MD Qian ZhangChen Jin MD Hong WangHai-Yan Qian PhD MD 《The Canadian journal of cardiology》2013
Background
So far, relatively few studies have addressed the use of stem cells to treat patients with refractory angina. Moreover, the results of current studies were discrepant. The objective of this meta-analysis was to evaluate the efficacy and safety of this treatment on a relatively large scale.Methods
Studies were identified through PubMed, CENTRAL, EMBASE, reviews, and reference lists of relevant papers. The weighted mean difference was calculated with random-effect models for net changes in exercise tolerance and angina frequency, and odds ratio (OR) with fixed-effect models for myocardial infarction (MI) and death.Results
Five randomized controlled trials, with a total of 381 patients, were included in the analysis. Compared with the controls, patients who received stem cell therapy had a significant improvement in exercise tolerance of 61.3 seconds (95% confidence interval [CI], 18.1-104.4; P = 0.005; I2 = 58%); an obvious reduction in angina frequency of 7.3 episodes per week (95% CI, −13.4 to −1.2; P = 0.02; I2 = 93%); and lower risk of MI, with an OR of 0.37 (95% CI, 0.14-0.95; P = 0.04; I2 = 0%). No difference was detected for the risk of death (OR, 0.33; 95% CI, 0.08-1.39; P = 0.13; I2 = 20%).Conclusions
Stem cell therapy appears to be effective and safe in the management of patients with refractory angina. The findings need confirmation in larger-scale studies with longer follow-up. 相似文献15.
Victor L. Serebruany Daniel Aradi Moo Hyun Kim Dirk Sibbing 《International journal of cardiology》2013
Context
Aggressive antiplatelet strategies unquestionably cause extra hemorrhagic risks. Bleeding episodes are associated with poor outcomes including increased mortality. However, lack of uniform reporting and adjudication of bleeding events might prevent objective evaluation of the efficacy/safety profile of antithrombotic agents.Objective
We analyzed the bleeding rates by several previously used bleeding scales (TIMI, GUSTO, ACUITY, and BARC) after cangrelor in recent head-to-head randomized, controlled clinical trials (RCTs).Results
Data for meta-analyses were pooled from 3 RCTs (CHAMPION-PLATFORM, CHAMPION-PCI and CHAMPION-PHOENIX) including 25,106 patients. In addition, the bleeding risks were also assessed from the small (n = 210) BRIDGE RCT. Cangrelor caused a significantly increased risk for major bleeding at 48 h according to the ACUITY scale (RR: 1.51, 95% CI: 1.32–1.72, p < 0.00001); however, this impact was less prominent according to less sensitive bleeding scales (GUSTO severe: RR: 1.21, 95% CI: 0.70–2.11, p = 0.49; TIMI major: RR: 1.00, 95% CI: 0.59–1.68, p = 0.99). There was also an obvious trend towards an increased risk for any transfusions (RR: 1.31, 95% CI: 0.97–1.77, p = 0.08) and TIMI major + minor bleeding events (RR: 1.30, 95% CI: 0.96–1.76, p = 0.09).Conclusions
Cangrelor on top of aspirin or/and clopidogrel increases the risk for early bleeding events after PCI; however, it largely depends on the bleeding definition used, and how this excess risk of bleeding was captured. The bleeding hazard needs to be verified in the ongoing FDA secondary cangrelor review. 相似文献16.
Tuhina Neogi Clara Chen Jingbo Niu Christine Chaisson David J. Hunter Yuqing Zhang 《The American journal of medicine》2014
Objectives
Although beer and liquor have been associated with risk of incident gout, wine has not. Yet anecdotally, wine is thought to trigger gout attacks. Further, how much alcohol intake is needed to increase the risk of gout attack is not known. We examined the quantity and type of alcohol consumed on risk of recurrent gout attacks.Methods
We conducted a prospective Internet-based case-crossover study in the US among participants with gout and who had at least one attack during the 1 year of follow-up. We evaluated the association of alcohol intake over the prior 24 hours as well as the type of alcoholic beverage with risk of recurrent gout attack, adjusting for potential time-varying confounders.Results
This study included 724 participants with gout (78% men, mean age 54 years). There was a significant dose-response relationship between amount of alcohol consumption and risk of recurrent gout attacks (P <.001 for trend). The risk of recurrent gout attack was 1.36 (95% confidence interval [CI], 1.00-1.88) and 1.51 (95% CI, 1.09-2.09) times higher for >1-2 and >2-4 alcoholic beverages, respectively, compared with no alcohol consumption in the prior 24 hours. Consuming wine, beer, or liquor was each associated with an increased risk of gout attack.Conclusions
Episodic alcohol consumption, regardless of type of alcoholic beverage, was associated with an increased risk of recurrent gout attacks, including potentially with moderate amounts. Individuals with gout should limit alcohol intake of all types to reduce the risk of recurrent gout attacks. 相似文献17.
Xin Duan Wei Zhang Xingxing Dong Ming Liu Yu Gao Fuguo Huang Jian Li Zhou Xiang 《Seminars in arthritis and rheumatism》2013
Objectives
Total shoulder arthroplasty (TSA) and hemiarthroplasty (HA) are treatment choices for end-stage shoulder osteoarthritis. The decision of whether to use TSA or HA is controversial. The objective of this study was to compare the effects of TSA and HA for shoulder osteoarthritis.Methods
We conducted a search for clinical studies that had been published in any language in December 2012 or before. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and several other databases. Randomized and quasi-randomized controlled clinical studies that evaluated different methods were included. At least two review authors independently performed the study selection, data collection, and data extraction. The software Revman 5.1 was used for the statistical analysis.Results
This study included 4 clinical trials. Two of the trials were published clinical trials, and the other 2 clinical trials were presented as unpublished abstracts. A total of 146 patients with 153 shoulders were included in the trials. Compared with HA, TSA presents with a higher UCLA shoulder scale (MD 3.10, 95% CI 1.13–5.08) and a higher ASES (MD 10.17, 95% CI 1.40–18.87). There was no significant difference between TSA and HA for revision (RR 0.35, 95% CI 0.10–1.19), WOOS (MD 9.10, 95% CI −2.72 to 20.92), and incidence of instability (RR 0.88, 95% CI 0.19–3.98). HA had a lower operation time (MD 39.00, 95% CI 17.05–60.95).Conclusion
The available evidence suggests that TSA is more effective than HA for patients with shoulder arthritis. 相似文献18.
Lai-Chu See PhD Chang-Fu Kuo I-Jun Chou Meng-Jiun ChiouKuang-Hui Yu MD 《Seminars in arthritis and rheumatism》2013
Objectives
The purpose of this study was to estimate the sex- and age-specific incidence rates of major autoimmune rheumatic diseases (ARDs) in Taiwan using a population longitudinal database.Methods
A health insurance database containing the records of 1,000,000 beneficiaries of Taiwan National Health Insurance from 2005 to 2009 was used.Results
Between 2005 and 2009, the overall incidence rate of the major ARDs was 29.8 (95% CI = 28.3–31.3) per 100,000 person-years. Among the ARDs studied, the incidence of rheumatoid arthritis (RA; per 100,000 person-years) was highest (17.2, 95% CI = 16.1–18.4) and was followed by Sjögren's syndrome (11.8, 95% CI = 10.8–12.7), systemic lupus erythematosus (SLE; 7.2, 95% CI = 6.5–8.0), systemic sclerosis (SS; 1.1, 95% CI = 0.8–1.4), vasculitis (1.0, 95% CI = 0.7–1.3), Behçet disease (0.9, 95% CI = 0.6–1.1), dermatomyositis (DM; 0.7, 95% CI = 0.5–1.0), and polymyositis (PM; 0.6, 95% CI = 0.4–0.8). Females had a higher incidence ratio than did males, but a significant female/male incidence ratio was only observed for SLE (8.5, 95% CI = 6.1–12.0), Sjögren's syndrome (6.0, 95% CI = 4.8–7.6), RA (3.0, 95% CI = 2.6–3.5), and SS (2.6, 95% CI = 1.4–4.6).Conclusions
ARDs are three to four times more common among women than among men in the Chinese population of Taiwan. The incidence of RA was the highest, followed by Sjögren's syndrome and SLE, while the incidence of Behçet disease was the lowest in this study. This nationwide, population-based, longitudinal epidemiological study of ARDs in Taiwan provides data for future global comparisons and may provide clues as to the etiology of these diseases. 相似文献19.
Changyang LinHuapeng Yu MD Huizhen FanZhongli Li Dr 《Heart & lung : the journal of critical care》2014
Introduction
To determine the effectiveness of noninvasive ventilation (NIV) in the management of postextubation respiratory failure.Methods
Databases including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to find relevant trials. Randomized and quasi-randomized trials studying NIV in adult patients with postextubation respiratory failure were included. Effects on primary outcomes (i.e., reintubation rate, and ICU or/and hospital mortality) were accessed in this meta-analysis.Results
Ten trials involving 1382 patients were included: two used NIV in patients with established postextubation respiratory failure, and eight used NIV immediately after extubation. The use of NIV following extubation for patients (n = 302) with established respiratory failure did not decrease the reintubation rate (relative risk [RR] 1.02, 95% confidence interval [CI] 0.83-1.25) and ICU mortality (RR 1.14, 95% CI 0.43-3.00), compared to standard medical therapy (SMT). Early application of NIV after extubation (n = 1080) also did not decrease the reintubation rate (RR 0.75, 95% CI 0.45-1.15) significantly. However, in the planned extubation subgroup (n = 849), there were significant reductions in the reintubation rate (RR 0.65, 95% CI 0.46-0.93), ICU mortality rate (RR 0.41, 95% CI 0.21-0.82), and hospital mortality rate (RR 0.59, 95% CI 0.38-0.93) compared to SMT.Conclusion
Current evidence suggests that the use of NIV in patients with established postextubation respiratory failure should be monitored cautiously. Early use of NIV can benefit patients with planned extubation by decreasing the reintubation rate and the ICU and hospital mortality rates. 相似文献20.
Chi Zhang Ying-Yi Qin Qi Chen Hong Jiang Xian-Zhen Chen Chun-Li Xu Pei-Juan Mao Jia He Yu-Hao Zhou 《International journal of cardiology》2014