RESUMO
BACKGROUND: The association between metabolic syndrome (MS) and bladder cancer (BC) was not fully investigated, and most primary studies and pooled analyses were only focused on certain specific components. OBJECTIVE: To further investigate this issue and obtain more precise findings, we conducted this updated evidence synthesis of published studies, which involved not only MS components but also the MS in its entirety. MATERIALS AND METHODS: We searched the PubMed, EMBASE, and Web of Science databases for observational studies on the association between BC susceptibility and/or mortality, and MS and its components. We extracted data from included studies, evaluated heterogeneity, and performed meta-analytic quantitative syntheses. RESULTS: A total of 95 studies with 97,795,299 subjects were included in the present study. According to the results, MS significantly increased the risk of BC (risk ratio [RR]=1.11, 95% CI=1.00-1.23); diabetes significantly increased the risk of BC (RR=1.29, 95% CI=1.19-1.39) and associated with poor survival (RR=1.24, 95% CI=1.08-1.43). Excessive body weight was associated with increased susceptibility (RR=1.07, 95% CI=1.02-1.12), recurrence (RR=1.46, 95% CI=1.18-1.81), and mortality (RR=1.17, 95% CI=1.00-1.37). As indicated by cumulative meta-analysis, sample size was inadequate for the association between BC susceptibility and MS, the association between BC recurrence and excessive body weight, and the association between BC survival and diabetes. The sample size of the meta-analysis was enough to reach a stable pooled effect for other associations. CONCLUSION: Diabetes and excessive body weight as components of MS are associated with increased susceptibility and poor prognosis of BC. Uncertainty remains concerning the impact of overall MS, hypertension, and dyslipidemia on BC susceptibility and prognosis, for which further investigations are needed.
RESUMO
Treatment strategies for small side branch compromise related to main vessel stenting are not well investigated and not established.This study is to compare the clinical prognosis of different strategies for bifurcations with or without percutaneous coronary intervention (PCI) of small side branch after it compromised.A total of 119 consecutive bifurcation subjects from January 2013 to March 2015 were enrolled, all bifurcations were characterized by small side branch (1.5âmm ≤side branch diameter ≤2.5âmm). Subjects were assigned into side branch treatment (SBT) group and nonside branch treatment group (NSBT) according to whether advanced treatment of side branch was taken or not after it compromised. Major adverse cardiovascular event (MACE) was evaluated, so were the CCS angina and NYHA heart function classification.SBT subjects were associated with longer procedure time (46.7 vs 19.6âmin, Pâ<â.001) and more complications (18.9% vs 0.0%, Pâ<â.001). 12 MACEs were followed including 4 in SBT group and 8 in NSBT group (10.8% vs 9.8%, Pâ=â1.00). There were no significant difference between 2 groups regarding the CCS and NYHA classification, neither were the calculated classification improvement rate, respectively. In subgroup analysis for true and nontrue bifurcations, no statistical difference was found in terms of the MACE rate, the CCS, and NYHA classification improvement rate.Nontreatment of side branch will not increase the risk of MACE and will not worsen the CCS and NYHA classification when small side branch compromises during the bifurcation PCI.
