Prior Tonsillectomy and the Risk of Breast Cancer in Females: A Systematic Review and Meta-analysis

BackgroundExposure to recurrent infections in childhood was linked to an increased risk of cancer in adulthood. There is also evidence that a history of tonsillectomy, a procedure often performed in children with recurrent infections, is linked to an increased risk of leukemia and Hodgkin lymphoma. Tonsillectomy could be directly associated with cancer risk, or it could be a proxy for another risk factor such as recurrent infections and chronic inflammation. Nevertheless, the role of recurrent childhood infections and tonsillectomy on the one hand, and the risk of breast cancer (BC) in adulthood remain understudied. Our study aims to verify whether a history of tonsillectomy increases the risk of BC in women.MethodsA systematic review was performed using PubMed, Google Scholar, Scopus, Embase, and Web of Science databases from inception to January 25, 2022, to identify the studies which assessed the association between the history of tonsillectomy and BC in females. Odds ratio (OR) was calculated using the random/fixed-effects models to synthesize the associations between tonsillectomy and BC risk based on heterogeneity.ResultsEight studies included 2252 patients with breast cancer of which 1151 underwent tonsillectomy and 5314 controls of which 1725 had their tonsils removed. Patients with a history of tonsillectomy showed a higher subsequent risk of developing BC (OR, 1.24; 95% CI: 1.11-1.39) as compared to patients without a history of tonsillectomy. Influence analyses showed that no single study had a significant effect on the overall estimate or the heterogeneity.ConclusionsOur study revealed that a history of tonsillectomy is associated with an increased risk of breast cancer. These findings underscore the need for frequent follow-ups and screening of tonsillectomy patients to assess for the risk of BC

Spaceflight associated neuro-ocular syndrome (SANS): a systematic review, implications for the sans case definition

Astronauts undergoing long-duration space flights (LDSF) often experience a unique set of neuro-ocular findings known as Spaceflight Associated Neuro-ocular Syndrome (SANS). However, the exact mechanisms and the true incidence of SANS remain unclear. This paper aims to review the existing literature on SANS, focusing on its incidence and sequence of findings, and to provide a comprehensive understanding of this condition. Studies reporting SANS and optic disc edema in astronauts from PubMed, Scopus, and WOS have been collected. Eligible studies were selected based on stringent inclusion criteria. Statistical analysis utilized R software with random effect models for them, and heterogeneity was assessed using I2 and chi-squared tests. Our study includes 19 studies that met the inclusion criteria, which encompassed 294 participants. Included studies revealed that optic disc edema and choroidal folds were highly prevalent, with proportions of 75% and 71%, respectively. Hyperopic shifts (95%CI 0.51, 0.76, I2 = 0%) were also statistically significant, appearing gradually and persisting even after astronauts returned to Earth. This study provides a comprehensive assessment of SANS in astronauts. The study suggests that the current clinical definition of SANS may underestimate its true incidence and proposes the inclusion of quantitative metrics to enhance sensitivity and accuracy in diagnosis.</p

Muscle Sonography in Inclusion Body Myositis: A Systematic Review and Meta-Analysis of 944 Measurements

Inclusion body myositis (IBM) is a slowly progressive muscle weakness of distal and proximal muscles, which is diagnosed by clinical and histopathological criteria. Imaging biomarkers are inconsistently used and do not follow international standardized criteria. We conducted a systematic review and meta-analysis to investigate the diagnostic value of muscle ultrasound (US) in IBM compared to healthy controls. A systematic search of PubMed/MEDLINE, Scopus and Web of Science was performed. Articles reporting the use of muscle ultrasound in IBM, and published in peer-reviewed journals until 11 September 2021, were included in our study. Seven studies were included, with a total of 108 IBM and 171 healthy controls. Echogenicity between IBM and healthy controls, which was assessed by three studies, demonstrated a significant mean difference in the flexor digitorum profundus (FDP) muscle, which had a grey scale value (GSV) of 36.55 (95% CI, 28.65&ndash;44.45, p &lt; 0.001), and in the gastrocnemius (GC), which had a GSV of 27.90 (95% CI 16.32&ndash;39.48, p &lt; 0.001). Muscle thickness in the FDP showed no significant difference between the groups. The pooled sensitivity and specificity of US in the differentiation between IBM and the controls were 82% and 98%, respectively, and the area under the curve was 0.612. IBM is a rare disease, which is reflected in the low numbers of patients included in each of the studies and thus there was high heterogeneity in the results. Nevertheless, the selected studies conclusively demonstrated significant differences in echogenicity of the FDP and GC in IBM, compared to controls. Further high-quality studies, using standardized operating procedures, are needed to implement muscle ultrasound in the diagnostic criteria