06 September 2018 In General Health

OBJECTIVE: Premenstrual syndrome (PMS) is a very common disorder worldwide which carries an important economic burden. We conducted a systematic review and a meta-analysis to assess the role of alcohol in the occurrence of PMS.

METHODS: We searched MEDLINE, EMBASE, the five regional bibliographic databases of the WHO, the Proceedings database and the Open Access Thesis and Dissertations (OATD) from inception to May 2017. We also reviewed the references of every article retrieved and established personal contact with researchers to trace further publications or reports. We did not include any language limitations. Studies were included if: (1) they presented original data from cohort, case-control or cross-sectional studies, (2) PMS was clearly defined as the outcome of interest, (3) one of the exposure factors was alcohol consumption, (4) they provided estimates of odds ratios, relative risks, or any other effect measure and their confidence intervals, or enough data to calculate them.

RESULTS: We identified 39 studies of which 19 were eligible. Intake of alcohol was associated with a moderate increase in the risk of PMS (OR=1.45, 95% CI: 1.17 to 1.79). Heavy drinking yielded a larger increase in the risk than any drinking (OR=1.79, 95% CI: 1.39 to 2.32).

DISCUSSION: Our results suggest that alcohol intake presents a moderate association with PMS risk. Future studies should avoid cross-sectional designs and focus on determining whether there is a threshold of alcohol intake under which the harmful effect on PMS is non-existent.

27 July 2018 In Cardiovascular System

BACKGROUND: Although it is well established that heavy alcohol consumption increases the risk of hypertension, the risk associated with low levels of alcohol intake in men and women is unclear.

METHODS AND RESULTS: We searched Medline and Embase for original cohort studies on the association between average alcohol consumption and incidence of hypertension in people without hypertension. Random-effects meta-analyses and metaregressions were conducted. Data from 20 articles with 361 254 participants (125 907 men and 235 347 women) and 90 160 incident cases of hypertension (32 426 men and 57 734 women) were included. In people drinking 1 to 2 drinks/day (12 g of pure ethanol per drink), incidence of hypertension differed between men and women (relative riskwomen vs men=0.79; 95% confidence interval, 0.67-0.93). In men, the risk for hypertension in comparison with abstainers was relative risk=1.19 (1.07-1.31; I(2)=59%), 1.51 (1.30-1.76), and 1.74 (1.35-2.24) for consumption of 1 to 2, 3 to 4, and 5 or more standard drinks per day, respectively. In women, there was no increased risk for 1 to 2 drinks/day (relative risk=0.94; 0.88-1.01; I(2)=73%), and an increased risk for consumption beyond this level (relative risk=1.42; 1.22-1.66).

CONCLUSIONS: Any alcohol consumption was associated with an increase in the risk for hypertension in men. In women, there was no risk increase for consumption of 1 to 2 drinks/day and an increased risk for higher consumption levels. We did not find evidence for a protective effect of alcohol consumption in women, contrary to earlier meta-analyses.

18 May 2018 In Cancer

BACKGROUND: Cancer is a major public health problem worldwide, and the number of incident cases increases every year expected to reach 17.1 million a year by 2020. There is evidence that people who adhere to the Mediterranean Diet (MediD) have lower incidence of cancer. However, cancers' location and culture studies seem to affect the MediD impact. We aimed to review these discrepant findings.

MATERIALS AND METHODS: A critical review from a focused literature search was conducted. A literature search of controlled trials from: EMBASE (1970-), MEDLINE (1950-) and PsycINFO (1960-) was undertaken. Two authors (DF and YB) independently extracted the data.

RESULTS: Out of 785 abstracts identified only 583 publications focused solely on MediD and cancer. Of these, 46 were clinical trials published since 2007. Twenty-eight trials with a total of 570,262 participants are included in accordance with inclusion criteria. Only four reported the MediD does not reduce the risk of cancer. Of the negative studies, three were undertaken in non-Mediterranean populations. Cancers of the digestive tract were studied in 11 studies. Except for pancreatic cancer, all other sites along the digestive tract demonstrated significantly reduced rate with the MediD.

CONCLUSION: The MediD is associated with reduction in overall cancer rates as well as significantly lower rates of digestive tract cancers. These effects may be accentuated in the Mediterranean countries themselves. Further studies are needed to support or refute the effects of the MediD on other cancer types.

03 May 2018 In Pregnant Women
OBJECTIVES: To determine the effects of low-to-moderate levels of maternal alcohol consumption in pregnancy on pregnancy and longer-term offspring outcomes. SEARCH STRATEGY: Medline, Embase, Web of Science and Psychinfo from inception to 11 July 2016. SELECTION CRITERIA: Prospective observational studies, negative control and quasiexperimental studies of pregnant women estimating effects of light drinking in pregnancy (=32 g/week) versus abstaining. Pregnancy outcomes such as birth weight and features of fetal alcohol syndrome were examined. DATA COLLECTION AND ANALYSIS: One reviewer extracted data and another checked extracted data. Random effects meta-analyses were performed where applicable, and a narrative summary of findings was carried out otherwise. MAIN RESULTS: 24 cohort and two quasiexperimental studies were included. With the exception of birth size and gestational age, there was insufficient data to meta-analyse or make robust conclusions. Odds of small for gestational age (SGA) and preterm birth were higher for babies whose mothers consumed up to 32 g/week versus none, but estimates for preterm birth were also compatible with no association: summary OR 1.08, 95% CI (1.02 to 1.14), I2 0%, (seven studies, all estimates were adjusted) OR 1.10, 95% CI (0.95 to 1.28), I2 60%, (nine studies, includes one unadjusted estimates), respectively. The earliest time points of exposure were used in the analysis. CONCLUSION: Evidence of the effects of drinking =32 g/week in pregnancy is sparse. As there was some evidence that even light prenatal alcohol consumption is associated with being SGA and preterm delivery, guidance could advise abstention as a precautionary principle but should explain the paucity of evidence
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