IMPORTANCEThe prevalence of overweight (body mass index [BMI] = 25-29.9 [calculated as weight in kilograms divided by height in meters squared]) and obesity (BMI Ն30) is increasing among patients with cystic fibrosis (CF). However, it is unclear whether there is a benefit associated with increasing weight compared with the reference range (ie, normal) in CF. OBJECTIVETo evaluate the association of altered BMI or body composition and clinical outcomes in patients with CF. DATA SOURCES For this systematic review and meta-analysis, the literature search was conducted November 2, 2020, of 3 databases: MEDLINE (via PubMed), Embase, and Cochrane Central Register of Controlled Trials. STUDY SELECTION Patients older than 2 years diagnosed with CF with altered body composition or BMI were compared with patients having the measured parameters within the reference ranges.Records were selected by title, abstract, and full text; disagreements were resolved by consensus.Cohort studies and conference abstracts were eligible; articles with no original data and case reports were excluded. DATA EXTRACTION AND SYNTHESISTwo authors independently extracted data, which were validated by a third author. Studies containing insufficient poolable numerical data were included in the qualitative analysis. A random-effects model was applied in all analyses. MAIN OUTCOMES AND MEASURES Pulmonary function, exocrine pancreatic insufficiency (PI),and CF-related diabetes (CFRD) were investigated as primary outcomes. Odds ratios (ORs) or weighted mean differences (WMDs) with 95% CIs were calculated. The hypothesis was formulated before data collection. RESULTSOf 10 524 records identified, 61 met the selection criteria and were included in the qualitative analysis. Of these, 17 studies were included in the quantitative synthesis. Altogether, 9114 patients were included in the systematic review and meta-analysis. Overweight (WMD, -8.36%; 95% CI, -12.74% to -3.97%) and obesity (WMD, -12.06%; 95% CI, -23.91% to -0.22%) were associated with higher forced expiratory volume in the first second of expiration compared with normal weight.The odds for CFRD and PI were more likely in patients of normal weight (OR, 1.49; 95% CI, 1.10 to 2.00) than in those who were overweight (OR, 4.40; 95% CI, 3.00 to 6.45). High heterogeneity was shown in the analysis of pulmonary function (I 2 = 46.7%-85.9%).
The emergence of SARS-CoV-2 affected care both for acute and chronic health conditions. Majority of the patients with cardiac implantable electronic devices (CIEDs) have multiple comorbidities, which can influence their response to COVID-19. An online survey consisting of 45 multiple-choice question was designed for CIED patients assessing comorbidities and overall health condition during September -December 2020. A multivariate analysis based on principal axis factoring (PAF) was performed on the eligible 184 survey response. Three factors were identified. Ten-year survival rates were calculated with Charlson Comorbidity Index. The extracted factors explained 66.1% of the cumulative variance and were consistent with medical literature data.
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