Apical periodontitis and cardiovascular disease in adults: a systematic review with meta-analysis

BACKGROUND: A potential relationship between oral health and cardiovascular diseases has been proposed. However, uncertainty remains as to whether there is sufficient data to support this association. This review aims to appraise the relationship between apical periodontitis and cardiovascular disease based on data from observational studies. METHODS: The databases Medline (via PubMed) and EMBASE (via Scopus) were searched up to August 2020 for observational studies (case-control, cross-sectional, and cohort) assessing the association of apical periodontitis with cardiovascular disease among adults. Pooled relative risk/odds ratio and 95% confidence interval (CI) were estimated using a random-effects model. Sensitivity analyses and random-effects meta-regressions were performed. RESULTS: The initial search yielded 2537 documents, of which 15 were eligible for inclusion, including 8 cross-sectional studies, 5 case-control studies, and 2 cohort studies. The majority of studies enrolled both men and women, with mean age ranging from 41 to 66 years. In cross-sectional studies, the presence of apical periodontitis was significantly associated with cardiovascular disease with a combined odds ratio of 1.53 (95% CI: 1.02-2.29, p = 0.039; I2 = 75.0%; p < 0.001). In the case-control studies, the combined odds ratio did not show a significant association of apical periodontitis with cardiovascular disease (OR = 1.24; 95% CI: 0.67-2.29, p = 0.494; I2 = 82.1%; p < 0.001). The pooled risk ratio from the 2 cohort studies showed (RR = 1.27; 95% CI: 0.71-2.27, p = 0.413; I2 = 69.1%; p = 0.072) also showed no significant association between apical periodontitis and cardiovascular disease. These results should be interpreted with caution due to the high heterogeneity. CONCLUSIONS: Data derived from cross-sectional studies suggest a weak association between apical periodontitis and cardiovascular disease. As the results were not consistent across study designs, further research is recommended, namely longitudinal studies with long-term follow-up. REGISTRATION: PROSPERO database (CRD42020204379).info:eu-repo/semantics/publishedVersio

Skin autofluorescence–indicated advanced glycation end products as predictors of cardiovascular and all-cause mortality in high-risk subjects: a systematic review and meta-analysis

Background Chronic deposits of advanced glycation end products produced by enzymatic glycation have been suggested as predictors of atherosclerotic-related disorders. This study aimed to estimate the relationship between advanced glycation end products indicated by skin autofluorescence levels and the risk of cardiovascular and all-cause mortality based on data from observational studies. Methods and Results We systematically searched Medline, Embase, the Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and the Web of Science databases from their inceptions until November 2017 for observational studies addressing the association of advanced glycation end products by skin autofluorescence levels with cardiovascular and all-cause mortality. The DerSimonian and Laird random-effects method was used to compute pooled estimates of hazard ratios and their respective 95% confidence intervals for the risk of cardiovascular and all-cause mortality associated with levels of advanced glycation end products by skin autofluorescence. Ten published studies were included in the systematic review and meta-analysis. Higher skin autofluorescence levels were significantly associated with a higher pooled risk estimate for cardiovascular mortality (hazard ratio: 2.06; 95% confidence interval, 1.58-2.67), which might not be important to moderate heterogeneity (I2=34.7%; P=0.163), and for all-cause mortality (hazard ratio: 1.91; 95% confidence interval, 1.42-2.56) with substantial heterogeneity (I2=60.8%; P=0.0.18). Conclusions Our data suggest that skin autofluorescence levels could be considered predictors of all-cause mortality and cardiovascular mortality in patients at high and very high risk.Cavero-Redondo and Martínez-Hortelano are supported by a grant from the Universidad de Castilla-La Mancha (FPU13/ 01582 and PREDUCLM16/14, respectively). Soriano-Cano is supported by a grant from Spanish Ministry of Economy, Industry, and Competitiveness (Fi 17/332). Garrido-Miguel and Berlanga-Macías are supported by a grant from the Spanish Ministry of Education, Culture, and Sport (FPU15/ 03847 and FPU16/02380, respectively).info:eu-repo/semantics/publishedVersio

Effects of Milk and Dairy Product Consumption on Type 2 Diabetes: Overview of Systematic Reviews and Meta-Analyses.

Dairy product consumption has been related to type 2 diabetes (T2D) incidence, although data from epidemiological studies have shown mixed results regarding the association of dairy products and T2D risk. This overview of systematic reviews and meta-analyses aimed to examine the scientific literature available on the association between dairy product consumption and T2D risk. A literature search was conducted in the MEDLINE (via PubMed), EMBASE, Cochrane Central Database of Systematic Reviews, and Web of Science databases from their inception to April, 2018. Forest plots summarized the risk ratios (RRs) reported by meta-analyses on high compared with low and dose-response dairy product consumption. The risk of bias was assessed using the AMSTAR2 tool. We included 12 meta-analyses, reporting data from 4-22 cohort studies and from 4-23 populations. The participants' ages ranged from 20 to 88 y, and participants were followed up for from 4 to 30 y. Studies included 64,227-566,875 participants and reported 4810-44,474 cases of T2D. Most studies reported an inverse association between T2D incidence and dairy product consumption, especially for 1) total dairy products (range: 0.86-0.91), 2) low-fat dairy products (range: 0.81-0.83), 3) low-fat milk (RR: 0.82), and 4) yogurt (range: 0.74-0.86). Dose-response analyses showed a decreased T2D risk for 1) 200-400 g/d of total dairy products (range: 0.93-0.97) and 2) 200 g/d of low-fat dairy products (range: 0.88-0.91). Total dairy product consumption is associated with a lower risk of T2D, especially for yogurt and low-fat dairy consumption. The association with cheese is moderate. Moreover, dose-response analyses showed that the risk of T2D decreased by each unit increase in consumption of total dairy products and low-fat dairy products

Milk and Dairy Product Consumption and Risk of Mortality: An Overview of Systematic Reviews and Meta-Analyses.

The effect of dairy product consumption on health has received substantial attention in the last decade. However, a number of prospective cohort studies have shown contradictory results, which causes uncertainty about the effects of dairy products on health. We conducted an overview of existing systematic reviews and meta-analyses to examine the association between dairy product consumption and all-cause mortality risk. A literature search was conducted in MEDLINE (via PubMed), EMBASE, the Cochrane Central Database of Systematic Reviews, and the Web of Science databases from their inception to April, 2018. We evaluated the risk of bias of each study included using the AMSTAR 2 tool. The risk ratios (RRs) for each meta-analysis were displayed in a forest plot for dose-response and for high compared with low dairy consumption. The initial search retrieved 2154 articles; a total of 8 meta-analyses were finally included after applying the inclusion and exclusion criteria. The number of included studies in each meta-analysis ranged from 6 to 26 cohort studies, which reported data from 6-28 populations. The sample sizes varied across studies from 24,466 participants reporting 5092 mortality cases to 938,817 participants reporting 126,759 mortality cases. After assessing the risk of bias, 25% of the studies were categorized as acceptable, 25% as good, and 50% as very good. The RRs reported by the meta-analyses ranged from 0.96 to 1.01 per 200 g/d of dairy product consumption (including total, high-fat, low-fat, and fermented dairy products), from 0.99 to 1.01 per 200-244 g/d of milk consumption, and from 0.99 to 1.03 per 10-50 g/d of cheese consumption. The RR per 50 g/d of yogurt consumption was 0.97 (95% CI: 0.85, 1.11). In conclusion, dairy product consumption is not associated with risk of all-cause mortality. This study was registered in PROSPERO as CRD42018091856

Lifetime predictors of stroke in subjects without a diagnosis of hypertension: the aerobics center longitudinal study

Background and purpose: Although several studies have assessed the importance of traditional risk factors in predicting stroke, none have concurrently addressed the stroke-predicting ability of these risk factors across the lifespan of subjects without a hypertension (HTN) diagnosis. Thus, this study aimed to assess the importance of blood-pressure-related risk indicators, cardiorespiratory fitness (CRF), weight status, diabetes mellitus (DM), and lifestyle factors as predictors of stroke in different stages of life among non-hypertensive subjects.Materials and methods: This study was a long-term follow-up study including 33,254 men and 10,598 women from the Aerobics Center Longitudinal Study (ACLS) who were 18-100 years old and did not have a HTN diagnosis at baseline. Logistic regression models were constructed using forward selection procedures for each age category, with stroke occurrence as the dependent variable, and pulse pressure (PP), mean arterial pressure (MAP), systolic blood pressure (SBP), smoking status, CRF, drinking behavior, DM status, and weight status as potential predictors.Results: In total, 507 subjects had a stroke during an average follow-up period of 17 years (range= 1-34 years). Logistic regression models showed that MAP values (P=0.043) in those aged 19-39 years; SBP (P < 0.001), CRF (P=0.001), weight status (P=0.005), and alcohol consumption (P=0.001) in those 40-60 years old; and CRF (P=0.002), weight status (P=0.005), and DM status (P=0.037) in those over 60 years old were predictors of stroke.Conclusion: These findings suggest that, among individuals without a baseline HTN diagnosis, classic modifiable risk factors for stroke change across different stages of life

Effect of multicomponent exercise in cognitive impairment: a systematic review and meta‑analysis

Resumen Antecedentes: El ejercicio físico multicomponente es el tipo de intervención física más recomendable en los mayores. adultos Los datos experimentales sugieren la relevancia del eje músculo-cerebro y la relación entre el músculo contracción y liberación del factor neurotrófico derivado del cerebro, sin embargo, el impacto de esta relación en la cognición sigue sin estar claro, especialmente en personas con un diagnóstico de deterioro cognitivo. Este estudio evalúa el efecto de multicomponente ejercicio físico sobre la cognición global en personas con deterioro cognitivo leve o demencia. Métodos: Se buscaron ensayos controlados aleatorios publicados hasta enero de 2021 en tres bases de datos electrónicas. (PubMed, Scopus y base de datos Cochrane). Datos sobre ejercicios incluidos en la intervención multicomponente (resistencia, fuerza, equilibrio o flexibilidad), la inclusión del ejercicio aeróbico y el cambio en la cognición global fueron extraído. El tamaño del efecto se representó como una diferencia de medias estandarizada. El riesgo de sesgo fue evaluado por RoB2 herramienta. Resultados: Se incluyeron un total de 8 estudios. El tamaño del efecto general sugirió un efecto del ejercicio multicomponente en cognición global. Sin embargo, el análisis de subgrupos mostró un efecto solo cuando se incluyó el ejercicio aeróbico en el intervención. No se encontraron efectos cuando el deterioro cognitivo leve y la demencia se evaluaron por separado. Conclusión: Este estudio sugiere que el ejercicio físico multicomponente podría tener un efecto sobre la cognición global en personas con deterioro cognitivo leve o demencia solo cuando se incluye ejercicio aeróbico en la intervención. Nuestro Los resultados apoyan la inclusión de programas estructurados de ejercicio físico en el manejo de personas con trastornos cognitivos. discapacidad. Palabras clave: Deterioro cognitivo, Actividad física, Tratamiento no farmacológico, MetanálisisQ1Q1Abstract Background: Multicomponent physical exercise is the most recommended type of physical intervention in older adults. Experimental data suggest the relevance of the muscle-brain axis and the relationship between muscle contraction and release of brain-derived neurotrophic factor, however, the impact of this relationship on cognition remains unclear, especially in people with diagnosis of cognitive impairment. This study assesses the effect of multicomponent physical exercise on global cognition in people with mild cognitive impairment or dementia. Methods: Randomized controlled trials published until January 2021 were searched across three electronic databases (PubMed, Scopus, and Cochrane Database). Data about exercises included in the multicomponent intervention (endurance, strength, balance, or flexibility), the inclusion of aerobic exercise, and the change in global cognition were extracted. The effect size was represented as a standardized mean difference. Risk of bias was assessed by the RoB2 tool. Results: A total of 8 studies were included. The overall effect size suggested an effect of multicomponent exercise on global cognition. However, the subgroup analysis showed an effect only when aerobic exercise was included in the intervention. No effect when mild cognitive impairment and dementia were assessed separately was found. Conclusion: This study suggests that multicomponent physical exercise could have an effect on global cognition in people with mild cognitive impairment or dementia only when aerobic exercise is included in the intervention. Our results support the inclusion of structured physical exercise programs in the management of people with cognitive impairment. Keywords: Cognitive impairment, Physical activity, Non-pharmacological treatment, Meta-analysishttps://orcid.org/0000-0001-5680-7880https://scholar.google.com/citations?view_op=search_authors&mauthors=carlos+alberto+cano-gutierrez&hl=es&oi=aohttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000054895N/AA1S

Effect of exercise on bone health in children and adolescents with cancer during and after oncological treatment: A systematic review and meta-analysis

Background: Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled effect of exercise interventions following frequency, intensity, time and type prescriptions.Objective: This systematic review and meta-analysis aimed to synthesise evidence regarding the effectiveness of exercise interventions on bone health in children and adolescents with cancer during and after oncological treatment.Methods: A systematic search was conducted in the MEDLINE (via PubMed), Web of Science and Scopus databases from November 2021 to January 2022. Randomised controlled trials (RCTs) and non-RCTs reporting pre-post changes of the effectiveness of exercise interventions on DXA-measured bone parameters in young population (1–19 years) during or after oncological treatment were included. Pooled (ESs) and 95% confidence intervals (95%CIs) were calculated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed.Results: A total of eight trials with 341 participants were included. The meta-analyses did not reveal a statistically significant increase in whole body areal bone mineral density (ES = 0.10; 95%CI: −0.14, 0.34), lumbar spine (ES = 0.03; 95%CI: −0.21, 0.26) or femoral neck (ES = 0.10; 95%CI: −0.37, 0.56). Similarly, during the oncological treatment phase the ES was 0.04 (95%CI: −0.17, 0.25) and after the ES was 0.07 (95%CI: −0.20, 0.33).Conclusion: To date, exercise interventions have been inappropriate and therefore, ineffective to illustrate any beneficial effect on bone health in children and adolescents with cancer during and after oncological treatment.Systematic Review Registration: PROSPERO registration number: CRD4202231087

Differences in quality of life and fitness level among men and women in the adulthood: a cross-sectional analysis

Abstract Background This study aimed to examine the associations between physical fitness components and health-related quality of life (HRQoL) among adults stratified by sex and age. In addition, we aimed to examine whether these associations change based on socioeconomic, clinical, and biochemical characteristics. Methods A total of 297 participants aged 47.41 (standard deviation: 9.08) years from the “Validity of a Model of Accelerated Vascular Aging as a Cardiovascular Risk Index in Healthy Adults: the EVasCu cross-sectional study” were included in this analysis. HRQoL, physical fitness, socioeconomic status (SES), waist circumference, and blood pressure were measured. Additionally, blood samples were extracted to determine cholesterol, triglyceride, and glycated hemoglobin A1c (HbA1c) levels. Analyses of covariance (ANCOVAs) were estimated to test mean differences in physical and mental health-related health measures (HRQoL) between fitness categories (fixed factors) by sex and age categories. Results The physical HRQoL was related to the levels of fitness parameters among women, independent of age, while for men, it was related to better levels of general fitness and cardiorespiratory fitness among men aged < 50 and men aged ≥ 50, respectively. In contrast, mental HRQoL was related to cardiorespiratory fitness only among women aged < 50 years; speed/agility and flexibility among men aged < 50 years; and general fitness, strength, and flexibility among men aged ≥ 50 years. These data did not change when SES, clinical variables, or biochemical determinations were included in the analyses, neither for the physical nor for the mental HRQoL. Conclusion Gender and age are important factors to be considered when analysing health indicators and influences in the population. In addition, SES, clinical characteristics, and biochemical parameters do not seem to influence the relationship between HRQoL and fitness

School-based interventions modestly increase physical activity and cardiorespiratory fitness but are least effective for youth who need them most: an individual participant pooled analysis of 20 controlled trials

Objectives To determine if subpopulations of students benefit equally from school-based physical activity interventions in terms of cardiorespiratory fitness and physical activity. To examine if physical activity intensity mediates improvements in cardiorespiratory fitness. Design Pooled analysis of individual participant data from controlled trials that assessed the impact of school-based physical activity interventions on cardiorespiratory fitness and device-measured physical activity. Participants Data for 6621 children and adolescents aged 4–18 years from 20 trials were included. Main outcome measures Peak oxygen consumption (VO2Peak mL/kg/min) and minutes of moderate and vigorous physical activity. Results Interventions modestly improved students’ cardiorespiratory fitness by 0.47 mL/kg/min (95% CI 0.33 to 0.61), but the effects were not distributed equally across subpopulations. Girls and older students benefited less than boys and younger students, respectively. Students with lower levels of initial fitness, and those with higher levels of baseline physical activity benefitted more than those who were initially fitter and less active, respectively. Interventions had a modest positive effect on physical activity with approximately one additional minute per day of both moderate and vigorous physical activity. Changes in vigorous, but not moderate intensity, physical activity explained a small amount (~5%) of the intervention effect on cardiorespiratory fitness. Conclusions Future interventions should include targeted strategies to address the needs of girls and older students. Interventions may also be improved by promoting more vigorous intensity physical activity. Interventions could mitigate declining youth cardiorespiratory fitness, increase physical activity and promote cardiovascular health if they can be delivered equitably and their effects sustained at the population level