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Prospective non-randomized studies in Orthopaedics and Traumatology: systematic assessment of its methodological quality

Pignataro,Gustavo Soriano; Lins,Theophilo Asfora; Oliveira,Jose Renato Assis Lemos Marques de; Moraes,Vinicius Ynoe de; Okamura,Aldo; Belloti,Joao Carlos; Faloppa,Flavio
Fonte: Sociedade Brasileira de Ortopedia e Traumatologia Publicador: Sociedade Brasileira de Ortopedia e Traumatologia
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 EN
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55.95%
In surgical interventions, randomization and blinding may be difficult to implement. In this situation, non-randomized prospective studies (EPNR) can generate the best evidence. The objective of this study is to evaluate, by means of the scale proposed by Downs & Black, the quality of EPNR published in our country and to assess the interobserver reproducibility of this scale. EPNR published in Acta Ortopedica Brasileira and Revista Brasileira de Ortopedia until 2011 and prior to 2006 were included. Two of us independently applied the Downs & Black scale. The studies were stratified by period of publication, journal and type of intervention. The scores obtained were considered to assess the reliability of the scale and groups comparison. 59 studies were considered, seven excluded during the assessments. There were no differences between the scores, except for the type of intervention, which showed better methodological quality for studies involving clinical interventions (p < 0.001). The correlation coefficient for the Downs & Black score was 0.79 (95% CI 0.65 to 0.88), demonstrating good reliability. EPNR present methodological quality similar when stratified by the periodic publication and publication period. Studies with clinical interventions have better methodological quality. The Downs & Black scale shows good interobserver reproducibility.

Anxiety and inhibition of panic attacks within translational and prospective research contexts

Cabral,Ruan; Nardi,Antonio Egídio
Fonte: Associação de Psiquiatria do Rio Grande do Sul Publicador: Associação de Psiquiatria do Rio Grande do Sul
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 EN
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Basic research involving animal models is an important tool to improve our understanding of clinical conditions related with anxiety and panic attacks. In fact, animal models have been used to study several paradigms on analogous and homologous elements of human anxiety phenomena. However, the direct transposition (translation) to clinical practice of the results obtained with animal models may be restricted by the different constructs used to describe and explain empirical evidence of anxiety phenomena among humans. We aimed to analyze whether theoretical assumptions on the potential inhibitory effects of anxiety on panic could be observed among humans in prospective studies designed to analyze the relationship between anxiety and panic. A systematic literature review including papers published in English language between 1997 and 2011 was undertaken on the MEDLINE database. The search yielded a total of 257 articles, of which 11 were included in the review. In three studies, the global dimension of the anxiety sensitivity construct worked as a facilitator of panic attacks. Six studies showed a positive correlation between the AS-Physical Concerns subfactor and the occurrence of panic attacks, whereas two studies found a greater effect of the AS-Mental Incapacitation Concerns subfactor on panic. There was no evidence that anxiety might act as an inhibitor of panic attacks in humans...

A systematic review and meta-analysis of prospective studies on the association between maternal cigarette smoking and preterm delivery

Shah, Nirav R.; Bracken, Michael B.
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/2000 EN
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We have attempted to quantify the most up-to-date estimate of the association between cigarette smoking by the mother and preterm delivery. Studies were selected for inclusion in this review if they were prospective, reported data stratified across at least two levels of maternal smoking, and defined preterm delivery on the basis of gestational age. In a meta-analysis we combined results from multiple studies that reported on preterm delivery and maternal smoking during pregnancy. Pooled odds ratios were computed for various strata of smoking intensity with the Mantel-Haenszel fixed-effects model. Twenty studies met all inclusion criteria and were included in meta-analysis. The pooled point estimate from 20 prospective studies on any maternal smoking versus no maternal smoking was 1.27 (95% confidence interval, 1.21-1.33). Subgroup analyses stratifying maternal smoking on number of cigarettes per day suggest a dose-response relationship at low to moderate levels of smoking, which was not further increased at high levels of smoking. A nonsignificant level of publication bias appears to exist in the smoking-preterm delivery literature. Cigarette smoking is a preventable risk factor that is associated with preterm delivery. Consistent results across many study populations and research designs and evidence of a dose-response relationship support its causal role in preterm delivery.

Modifiable risk factors in relation to changes in BMI and fatness: what have we learned from prospective studies of school-aged children?

Must, A; Barish, EE; Bandini, LG
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
EN
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Considerable interest and resources are currently being directed to primary and secondary prevention of childhood obesity among school-aged children. Intervention studies in this age group have yielded mixed results, begging the question as to whether the correct targets for intervention have been identified. To evaluate the evidence base, we reviewed prospective observational studies published in English between 1990–2007 that reported weight or fatness changes in relation to diet, physical activity, and sedentary behavior. Sugar-sweetened beverage consumption emerged as the most consistent dietary factor in association with subsequent increases in weight status or fatness. Other foods and eating patterns showed less consistent associations and when associations were present, magnitudes were generally small. This may reflect the known limitations of standard dietary methodology to assess meal patterns and dietary intake. Findings for physical activity showed more consistent inverse associations with fatness outcomes than for weight status, and as was found for dietary factors, magnitudes of association were modest. Sedentary behavior effects on weight status differ by gender in many studies, with many, but not all, showing greater positive associations among girls. The lack of consistency observed in the studies of sedentary behaviors may reflect the range of variable definitions...

Coffee Consumption and Risk of Gastric Cancer: A Large Updated Meta-Analysis of Prospective Studies

Xie, Feiyue; Wang, Dan; Huang, Zhifang; Guo, Yajun
Fonte: MDPI Publicador: MDPI
Tipo: Artigo de Revista Científica
Publicado em 18/09/2014 EN
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The potential role of coffee consumption in the development of various types of cancer has been extensively investigated in epidemiologic studies. How coffee consumption may modulate risk of gastric cancer, however, remains a subject open for investigation. To better quantify this relation, we quantitatively summarized evidence from prospective studies. Eligible studies were identified on PubMed databases. The summary risk estimates were obtained using the random-effects model. Subgroup, sensitivity and dose-response analyses were conducted. The present meta-analysis included 12 prospective cohort studies. A pooled analysis of these studies suggested that coffee consumption (highest vs. lowest consumption) was not associated with risk of gastric cancer (RR = 1.12, 95% CI = 0.93–1.36). In the subgroup analysis, significant increased risk was detected in the U.S. studies (RR = 1.36, 95% CI = 1.06–1.74) and in the studies with <10 years of follow-up (RR = 1.24, 95% CI = 1.00–1.54), and the greatest increase in risk was observed in those studies without adjustment for smoking (RR = 1.48, 95% CI = 1.13–1.93). There was some evidence of publication bias (P for Egger’s test = 0.03). Cumulative evidence from prospective studies suggests that coffee consumption is not associated with risk of gastric cancer. The observed positive results may be confounded by smoking and need further investigation.

Comorbidity and survival among women with ovarian cancer: evidence from prospective studies

Jiao, Yi-Sheng; Gong, Ting-Ting; Wang, Yong-Lai; Wu, Qi-Jun
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Publicado em 29/06/2015 EN
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The relationship between comorbidity and ovarian cancer survival has been controversial so far. Therefore, we conducted a meta-analysis to summarize the existing evidence from prospective studies on this issue. Relevant studies were identified by searching the PubMed, EMBASE, and ISI Web of Science databases through the end of January 2015. Two authors independently performed the eligibility evaluation and data abstraction. Random-effects models were used to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival. Eight prospective studies involving 12,681 ovarian cancer cases were included in the present study. The summarized HR for presence versus absence of comorbidity was 1.20 (95% CI = 1.11–1.30, n = 8), with moderate heterogeneity (I2 = 31.2%, P = 0.179). In addition, the summarized HR for the highest compared with the lowest category of the Charlson’s comorbidity index was 1.68 (95% CI = 1.50–1.87, n = 2), without heterogeneity (I2 = 0%, P = 0.476). Notably, a significant negative impact of comorbidity on ovarian cancer survival was observed in most subgroup analyses stratified by the study characteristics and whether there was adjustment for potential confounders. In conclusion...

Age at menarche and endometrial cancer risk: a dose-response meta-analysis of prospective studies

Gong, Ting-Ting; Wang, Yong-Lai; Ma, Xiao-Xin
Fonte: Nature Publishing Group Publicador: Nature Publishing Group
Tipo: Artigo de Revista Científica
Publicado em 11/09/2015 EN
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45.97%
Evidence between age at menarche and endometrial cancer risk have been controversial. Therefore, we conducted a meta-analysis of prospective studies to analyze the aforementioned association. Relevant studies were identified by searching PubMed and EMBASE databases until the end of June 2015. A random-effects model was used to estimate summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between menarcheal age and endometrial cancer risk. Our meta-analysis included eight prospective studies involving 4553 subjects with endometrial cancer. The summarized RRs of endometrial cancer for menarcheal age were 0.68 (95%CI = 0.58–0.81, I2 = 41.9%, P = 0.099, n = 8) when comparing women with oldest category of menarcheal age with women with youngest category of menarcheal age. Notably, there was an 4% reduction in risk for per 2 years delay in menarcheal age (summarized RR = 0.96; 95%CI = 0.94–0.98, I2 = 45.7%, P = 0.101, n = 6). Additionally, significant inverse associations were consistent within all stratified analyses. There was no evidence of publication bias or significant heterogeneity between subgroups detected by meta-regression analyses. Our findings support the hypothesis that late menarcheal age is inversely associated with endometrial cancer risk. Further larger prospective or pooled studies are warranted to fully adjust for potential confounders and distinguish whether the associations differ by histological subtypes of endometrial cancer.

Do mass media campaigns improve physical activity? a systematic review and meta-analysis

Abioye, Ajibola I; Hajifathalian, Kaveh; Danaei, Goodarz
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
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Background: Mass media campaigns are frequently used to influence the health behaviors of various populations. There are currently no quantitative meta-analyses of the effect of mass media campaigns on physical activity in adults. Methods: We searched six electronic databases from their inception to August 2012 and selected prospective studies that evaluated the effect of mass media campaigns on physical activity in adults. We excluded studies that did not have a proper control group or did not report the uncertainties of the effect estimates. Two reviewers independently screened the title/abstracts and full articles. We used random-effects models to pool effect estimates across studies for 3 selected outcomes. Results: Nine prospective cohorts and before-after studies that followed-up 27,601 people over 8 weeks to 3 years met the inclusion criteria. Based on the pooled results from these studies, mass media campaigns had a significant effect on promoting moderate intensity walking (pooled relative risk (RR) from 3 studies=1.53, 95% Confidence Interval: 1.25 to 1.87), but did not help participants achieve sufficient levels of physical activity [4 studies pooled RR=1.02, 95% CI: 0.91 to 1.14)]. The apparent effect of media campaigns on reducing sedentary behavior (pooled RR=1.15...

Social Capital and Health: A Review of Prospective Multilevel Studies

Murayama, Hiroshi; Fujiwara, Yoshinori; Kawachi, Ichiro
Fonte: Japan Epidemiological Association Publicador: Japan Epidemiological Association
Tipo: Artigo de Revista Científica
EN_US
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Background: This article presents an overview of the concept of social capital, reviews prospective multilevel analytic studies of the association between social capital and health, and discusses intervention strategies that enhance social capital. Methods: We conducted a systematic search of published peer-reviewed literature on the PubMed database and categorized studies according to health outcome. Results: We identified 13 articles that satisfied the inclusion criteria for the review. In general, both individual social capital and area/workplace social capital had positive effects on health outcomes, regardless of study design, setting, follow-up period, or type of health outcome. Prospective studies that used a multilevel approach were mainly conducted in Western countries. Although we identified some cross-sectional multilevel studies that were conducted in Asian countries, including Japan, no prospective studies have been conducted in Asia. Conclusions: Prospective evidence from multilevel analytic studies of the effect of social capital on health is very limited at present. If epidemiologic findings on the association between social capital and health are to be put to practical use, we must gather additional evidence and explore the feasibility of interventions that build social capital as a means of promoting health.

Of decrements and disorders: assessing impairments in neurodevelopment in prospective studies of environmental toxicant exposures

Sagiv, Sharon K; Kalkbrenner, Amy E; Bellinger, David C
Fonte: BioMed Central Publicador: BioMed Central
Tipo: Artigo de Revista Científica
EN_US
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55.99%
Prenatal and early life neurodevelopment is exquisitely sensitive to insult from environmental exposures. Identifying the effects of environmental toxicants on neurodevelopmental disorders is particularly important from a public health perspective because many of these exposures are modifiable and may be targeted for intervention. Studying these associations in prospective cohort studies that measure quantitative, dimensional traits related to neurodevelopmental disorders, using standardized instruments such as psychometric tests or rating scales, mitigates many of the challenges that arise when studying clinically diagnosed disorders. We consider validity and feasibility impacts resulting from this design approach, including: 1) enhanced prospective exposure assessment with high quality environmental measures during developmentally relevant windows; 2) reduced bias because studies of continuous outcomes do not recruit cases and controls and are therefore not vulnerable to control selection bias; 3) enhanced statistical power because traits are measured on all individuals in the cohort and power is not limited by the number of cases; 4) reduced outcome misclassification because measuring quantitative traits avoids lumping together individuals with very heterogeneous phenotypes into one category. We use autism spectrum disorders (ASD) as an example to illustrate the advantages of this approach. Investigating the determinants of neurodevelopmental disorders – particularly modifiable determinants such as environmental toxicant exposures – is of great public health importance...

Anger, suicidal ideation & attempted suicide: A prospective study

Goldney, R.; Winefield, A.; Saebel, J.; Winefield, H.; Tiggemann, M.
Fonte: W B SAUNDERS CO Publicador: W B SAUNDERS CO
Tipo: Artigo de Revista Científica
Publicado em //1997 EN
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55.91%
Anger, aggression, or hostility, or an emotional state consistent with these terms, has been accepted as being of fundamental importance to our understanding of suicidal behavior. However, the presumed association has not been investigated thoroughly in prospective studies. The results of the present 8-year longitudinal examination of anger with oneself and with society and its relationship to emerging suicidal ideation and attempted suicide in adolescents entering adulthood provide, at best, only equivocal support for such an association.; Robert Goldney, Anthony Winefield, Judith Saebel, Helen Winefield, Marika Tiggeman

Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies

Prospective Studies Collaboration
Fonte: Lancet Publishing Group Publicador: Lancet Publishing Group
Tipo: Artigo de Revista Científica
Publicado em //2002
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BACKGROUND: The age-specific relevance of blood pressure to cause-specific mortality is best assessed by collaborative meta-analysis of individual participant data from the separate prospective studies. METHODS: Information was obtained on each of one million adults with no previous vascular disease recorded at baseline in 61 prospective observational studies of blood pressure and mortality. During 12.7 million person-years at risk, there were about 56000 vascular deaths (12000 stroke, 34000 ischaemic heart disease [IHD], 10000 other vascular) and 66000 other deaths at ages 40-89 years. Meta-analyses, involving "time-dependent" correction for regression dilution, related mortality during each decade of age at death to the estimated usual blood pressure at the start of that decade. FINDINGS: Within each decade of age at death, the proportional difference in the risk of vascular death associated with a given absolute difference in usual blood pressure is about the same down to at least 115 mm Hg usual systolic blood pressure (SBP) and 75 mm Hg usual diastolic blood pressure (DBP), below which there is little evidence. At ages 40-69 years, each difference of 20 mm Hg usual SBP (or, approximately equivalently, 10 mm Hg usual DBP) is associated with more than a twofold difference in the stroke death rate...

The relationship between maternal and umbilical cord androgen levels and Polycystic Ovary Syndrome in adolescence: A prospective cohort study

Hickey, M.; Sloboda, D.; Atkinson, H.; Doherty, D.; Franks, S.; Norman, R.; Newnham, J.; Hart, R.
Fonte: Endocrine Society Publicador: Endocrine Society
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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Context: The prenatal antecedents of polycystic ovary syndrome (PCOS) are not known, but prenatal androgen exposure is thought to contribute. This has not previously been investigated in large prospective studies of normal human pregnancy. Objective: The aim of the study was to establish the prospective relationship between early life androgen exposure and PCOS in adolescence. Design and Setting: A prospective cohort study was conducted in the general community. Patients or Other Participants: Atotal of 2900 pregnant women were recruited at 18 wk gestation. Prenatal androgen exposure was measured from maternal blood samples (at 18 and 34–36 wk) and umbilical cord blood. Timed (d 2–5 menstrual cycle) blood samples were collected, clinical hyperandrogenism was assessed, and transabdominal ultrasound examination of ovarian morphology was performed in 244 unselected girls from the Raine cohort aged 14–17 yr. Main Outcome Measure(s): We examined the relationship between early life androgen exposure and PCOS in adolescence. Results: We did not observe a statistically significant relationship between early life androgen exposure and PCOS in adolescence. Conclusions: This is the first prospective study to evaluate the relationship between prenatal androgen exposure and PCOS in adolescence in normal pregnancy. Our findings do not support the hypothesis that maternal androgens...

Implementation of a hospital oral care protocol and recording of oral mucositis in children receiving cancer treatment: a retrospective and a prospective study

Qutob, A.; Allen, G.; Gue, S.; Revesz, T.; Logan, R.; Keefe, D.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
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PURPOSE: This retrospective/prospective study was carried out to implement a standardized hospital oral care protocol and record the incidence of oral mucositis for inpatients with childhood cancer. METHODS: The implementation process included stages of collaboration, consultation, education, and evaluation. The retrospective part of the study documented the existing hospital oral care protocol and audited medical records of all pediatric patients diagnosed with cancer over a 12-month period. The frequency of recorded oral mucositis and the rate of referral to the pediatric dentistry department were assessed. Following evaluation of the retrospective study, the literature was searched to create a new hospital oral care protocol. Referral to the dental department was standardized and frequent in-service presentations were given to staff. The oral mucositis scale was recorded daily for all inpatients, and compliance rates were assessed. RESULTS: Fifty-nine patients’ medical records were audited during the retrospective study. Oral mucositis prevalence was clearly documented at 34%, while an additional 20% lacked a definitive diagnosis. During the prospective study, 38 patients were followed and had a verified incidence of oral mucositis of 33%. The rate of compliance of implementing the oral mucositis scale improved from 41% during the first 4 months to 87% during last 3 months. Referral rates to the dental department increased from 53% during the retrospective study to 100% during the prospective study. CONCLUSIONS: Mutual understanding and collaboration between the oncology and dental departments in hospitals is crucial for standardizing patient care and for improving oral care standards.; Akram F. Qutob...

Circulating fatty acids and prostate cancer risk: individual participant meta-analysis of prospective studies

Crowe, F.L.; Appleby, P.N.; Travis, R.C.; Barnett, M.; Brasky, T.M.; Bueno-de-Mesquita, H.B.; Chajes, V.; Chavarro, J.E.; Chirlaque, M.D.; English, D.R.; Gibson, R.A.; Giles, G.G.; Goodman, G.E.; Henning, S.M.; Kaaks, R.; King, I.B.; Kolonel, L.N.; Krista
Fonte: Oxford University Press (OUP) Publicador: Oxford University Press (OUP)
Tipo: Artigo de Revista Científica
Publicado em //2014 EN
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65.95%
BACKGROUND: Individual studies have suggested that some circulating fatty acids are associated with prostate cancer risk, but have not been large enough to provide precise estimates of associations, particularly by stage and grade of disease. METHODS: Principal investigators of prospective studies on circulating fatty acids and prostate cancer were invited to collaborate. Investigators provided individual participant data on circulating fatty acids (weight percent) and other characteristics of prostate cancer cases and controls. Prostate cancer risk by study-specific fifths of 14 fatty acids was estimated using multivariable-adjusted conditional logistic regression. All statistical tests were two-sided. RESULTS: Five thousand and ninety-eight case patients and 6649 control patients from seven studies with an average follow-up of 5.1 (SD = 3.3) years were included. Stearic acid (18:0) was inversely associated with total prostate cancer (odds ratio [OR] Q5 vs Q1 = 0.88, 95% confidence interval [CI] = 0.78 to 1.00, P trend = .043). Prostate cancer risk was, respectively, 14% and 16% greater in the highest fifth of eicosapentaenoic acid (20:5n-3) (OR = 1.14, 95% CI = 1.01 to 1.29, Ptrend = .001) and docosapentaenoic acid (22:5n-3) (OR = 1.16...

Short sleep duration is associated with risk of future diabetes but not cardiovascular disease: a prospective study and meta-analysis

Holliday, Elizabeth G.; Magee, Christopher A.; Kritharides, Leonard; Banks, Emily; Attia, John
Fonte: Public Library of Science Publicador: Public Library of Science
Tipo: Artigo de Revista Científica Formato: 8 pages
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Epidemiologic studies have observed association between short sleep duration and both cardiovascular disease (CVD) and type 2 diabetes, although these results may reflect confounding by pre-existing illness. This study aimed to determine whether short sleep duration predicts future CVD or type 2 diabetes after accounting for baseline health. Baseline data for 241,949 adults were collected through the 45 and Up Study, an Australian prospective cohort study, with health outcomes identified via electronic database linkage. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals. Compared to 7h sleep, <6h sleep was associated with incident CVD in participants reporting ill-health at baseline (HR=1.38 [95% CI: 1.12-1.70]), but not after excluding those with baseline illness and adjusting for baseline health status (1.03 [0.88-1.21]). In contrast, the risk of incident type 2 diabetes was significantly increased in those with <6h versus 7h sleep, even after excluding those with baseline illness and adjusting for baseline health (HR=1.29 [1.08-1.53], P=0.004). This suggests the association is valid and does not simply reflect confounding or reverse causation. Meta-analysis of ten prospective studies including 447...

Plasma Vitamin D Levels, Menopause, and Risk of Breast Cancer: Dose-Response Meta-Analysis of Prospective Studies

Bauer, Scott R.; Hankinson, Susan E.; Bertone-Johnson, Elizabeth R.; Ding, Eric L.
Fonte: Wolters Kluwer Health Publicador: Wolters Kluwer Health
Tipo: Artigo de Revista Científica
EN_US
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Abstract Previous evidence suggests that higher circulating 25-hydroxyvitamin D (25[OH]D) levels are variably associated with lower breast cancer risk; however, prospective studies and clinical trials have been inconsistent, particularly between older and younger women of differing menopausal status. We conducted a quantitative nonlinear dose-response meta-analysis of prospective studies evaluating the association between circulating 25(OH)D and breast cancer risk, stratified by menopause. A systematic search of MEDLINE and EMBASE included studies published through May 2011. We reviewed references from retrieved articles and contacted relevant investigators for additional data from prospective studies on circulating 25(OH)D levels and incident breast cancers. Prospective studies of circulating vitamin D and breast cancer risk were reviewed, and no language restrictions were imposed. Information on study population, menopausal status, 25(OH)D levels, and relative risk (RR) estimates were extracted using a standardized protocol. A total of 9 prospective studies were included, comprising 5206 cases and 6450 controls. Data were pooled using dose-response random-effects meta-regression models. Identifying nonlinear effects, spline models were optimized for thresholds. The relationship between circulating 25(OH)D and breast cancer risk differed by menopausal status (p = 0.05 for effect modification). While no association was found in premenopausal women...

Dietary energy density and adiposity: Employing bias adjustments in a meta-analysis of prospective studies.

Wilks, Desiree C.; Mander, Adrian P.; Jebb, Susan A.; Thompson, Simon G.; Sharp, Stephen J.; Turner, Rebecca M.; Lindroos, Anna K.
Fonte: Universidade de Cambridge Publicador: Universidade de Cambridge
Tipo: Artigo de Revista Científica
EN
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RIGHTS : This article is licensed under the BioMed Central licence at http://www.biomedcentral.com/about/license which is similar to the 'Creative Commons Attribution Licence'. In brief you may : copy, distribute, and display the work; make derivative works; or make commercial use of the work - under the following conditions: the original author must be given credit; for any reuse or distribution, it must be made clear to others what the license terms of this work are.; Abstract Background Dietary studies differ in design and quality making it difficult to compare results. This study quantifies the prospective association between dietary energy density (DED) and adiposity in children using a meta-analysis method that adjusts for differences in design and quality through eliciting and incorporating expert opinion on the biases and their uncertainty. Method Six prospective studies identified by a previous systematic literature search were included. Differences in study quality and design were considered respectively as internal and external biases and captured in bias checklists. Study results were converted to correlation coefficients; biases were considered either additive or proportional on this scale. The extent and uncertainty of the internal and external biases in each study were elicited in a formal process by five quantitatively-trained assessors and five subject-matter specialists. Biases for each study were combined across assessors using median pooling and results combined across studies by random-effects meta-analysis. Results The unadjusted combined correlation between DED and adiposity change was 0.06 (95%CI 0.01...

Sugar-sweetened beverage intake before 6 years of age and weight or BMI status among older children: systematic review of prospective studies

Pérez-Morales,Eugenia; Bacardí-Gascón,Montserrat; Jiménez-Cruz,Arturo
Fonte: Nutrición Hospitalaria Publicador: Nutrición Hospitalaria
Tipo: info:eu-repo/semantics/article; journal article; info:eu-repo/semantics/publishedVersion Formato: text/html; application/pdf
Publicado em 01/02/2013 ENG
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The purpose of this study was to conduct a systematic review of prospective studies that examined the association between sugar-sweetened beverage intake before 6y of age and later weight or BMI status among older children. An electronic literature search was conducted in the MEDLINE/PubMed, SciELO, and EBSCO databases of prospective studies published from 2001 to 2011. Seven studies were analyzed. The study population was from 72 to 10,904 children. Three studies showed a consistent association between SSB intake before 6 y of age and increased weight, BMI, or waist circumference later in childhood, one study showed a positive trend of consumption of SSB and childhood obesity and the OR for incidence of overweight by baseline beverage intake was 1.04, another study it was observed that an increase in total sugar intake and sugar from sweets and beverages in children 1-2 y of age and 7-9 y of age have a tendency to increase BMI, and two studies showed no association. In conclusion, although the trend of the reviews studies, indicate an association between sugar-sweetened beverage intake before 6 y of age and increased weight, BMI or waist circumference later in childhood, to date, the results are inconsistent, and the two studies with the higher number of children showed a positive association.

Effectiveness of condoms in preventing sexually transmitted infections

Holmes,King K.; Levine,Ruth; Weaver,Marcia
Fonte: World Health Organization Publicador: World Health Organization
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/06/2004 EN
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In June 2000, the United States National Institutes of Health (NIH) organized a review of the scientific evidence on the effectiveness of condoms in preventing sexually transmitted infections (STIs). The review concluded that condoms were effective in protecting against transmission of HIV to women and men and in reducing the risk of men becoming infected with gonorrhoea. Evidence for the effectiveness of condoms in preventing other STIs was considered to be insufficient. We review the findings of prospective studies published after June 2000 that evaluated the effectiveness of condoms in preventing STIs. We searched Medline for publications in English and included other articles, reports, and abstracts of which we were aware. These prospective studies, published since June 2000, show that condom use is associated with statistically significant protection of men and women against several other types of STIs, including chlamydial infection, gonorrhoea, herpes simplex virus type 2, and syphilis. Condoms may also be associated with protecting women against trichomoniasis. While no published prospective study has found protection against genital human papillomavirus (HPV) infection, two studies reported that condom use was associated with higher rates of regression of cervical intraepithelial neoplasia and clearance of cervical HPV infection in women and with regression of HPV-associated penile lesions in men. Research findings available since the NIH review add considerably to the evidence of the effectiveness of condoms against STIs. Although condoms are not 100% effective...