Objective: To evaluate the contemporary growth rate of small abdominal aortic aneurysms (AAAs) in view of recent epidemiological changes, such as decreasing smoking rates and establishment of population screening programmes.
Data Sources: MEDLINE, CENTRAL, PsycINFO, Web of Science Core Collection, and OpenGrey databases.
Review Methods: Systematic review following the PRISMA guidelines. In October 2021, databases were queried for studies reporting on AAA growth rates published from 2015 onwards. The primary outcome was contemporary AAA growth rates in mm/year. Data were pooled in a random effects model meta-analysis, and heterogeneity was assessed through the I statistic. GRADE assessment of the findings was performed. The protocol was published in PROSPERO (CRD42022297404).
Results: Of 8 717 titles identified, 43 studies and 28 277 patients were included: 1 241 patients from randomised controlled trials (RCTs), 23 941 from clinical observational studies, and 3 095 from radiological or translational research studies. The mean AAA growth rate was 2.38 mm/year (95% CI 2.16 - 2.60 mm/year; GRADE = low), with meta-regression analysis adjusted for baseline diameter showing an increase of 0.08 mm/year (95% CI 0.024 - 0.137 mm/year; p = .005) for each millimetre of increased baseline diameter. When analysed by study type, the growth rate estimated from RCTs was 1.88 mm/year (95% CI 1.69 - 2.06 mm/year; GRADE = high), while it was 2.31 mm/year (95% CI 1.95 - 2.67 mm/year; GRADE = moderate) from clinical observational studies, and 2.85 mm/year (95% CI 2.44 - 3.26 mm/year; GRADE = low) from translational and radiology based studies (p < .001). Heterogeneity was high, and small study publication bias was present (p = .003), with 27 studies presenting a moderate to high risk of bias. The estimated growth rate from low risk studies was 2.09 mm/year (95% CI 1.87 - 2.32; GRADE = high).
Conclusion: This study estimated a contemporaneous AAA growth rate of 2.38 mm/year, being unable to demonstrate any clinically meaningful AAA growth rate reduction concomitant with changed AAA epidemiology. This suggests that the RESCAN recommendations on small AAA surveillance are still valid. However, sub-analysis results from RCTs and high quality study data indicate potential lower AAA growth rates of 1.88 - 2.09 mm/year, findings that should be validated in a high quality prospective registry.
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http://dx.doi.org/10.1016/j.ejvs.2023.09.039 | DOI Listing |
Nat Med
January 2025
Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
Flooding greatly endangers public health and is an urgent concern as rapid population growth in flood-prone regions and more extreme weather events will increase the number of people at risk. However, an exhaustive analysis of mortality following floods has not been conducted. Here we used 35.
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January 2025
Xijing Hospital of Digestive Diseases, Air Force Medical University (Fourth Military Medical University), 127 Changle West Road, Xi'an, 710032, Shaanxi, China.
Background And Aims: Small gastric subepithelial tumors (SETs) in the stomach can be managed through surveillance or resection. However, it is still controversial how often the lesion would progress if left untreated. This study aimed to evaluate the progression rate of small SETs and identify risk factors influencing tumor growth.
View Article and Find Full Text PDFPoult Sci
December 2024
Department of Biochemistry, College of Sciences, King Saud University, Riyadh, Saudi Arabia.
This study evaluated the effect of wheat germ oil (WGO), Bacillus subtilis, and their combination on growth performance, immune response, nutrient digestibility, intestinal microbial, oxidative status, and gene expression in heat-stressed broilers. Four hundred one-day-old male Ross 308 broilers were distributed into five pens (20 birds/pen) in four experimental groups: a control (CON) without additives, WGO group fed diet with WGO at 200 mg.kg, BS group fed diet with B.
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December 2024
School of Pharmacy, Naval Medical University, Shanghai, 200433, China.
Bitter acids (BA) are main component of Humulus lupulus L. (hops). They are known for beer brewing and have various biological and pharmacological properties, especially the bone-protective effect confirmed by our previous in vivo study.
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January 2025
Department of Biology, College of Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
Background: Samh (Mesembryanthemum forsskalii, M. cryptanthum) belongs to Aizoaceae family and is found in northern Saudi Arabia, primarily in desert or dry shrubland habitats. M.
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