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Objective To assess the cumulative incidence of restenosis and stroke after stenting for cervical carotid artery stenosis. Methods We reviewed PubMed, ScienceDirect, and scopus and included all studies reporting restenosis after stenting. The cumulative incidence of restenosis at 6 and 12 months was calculated. We also estimated the cumulative incidence of ipsilateral stroke within 30 days after stenting. Random effect meta-analysis and metaregression were performed using relevant study level covariates. Sources of heterogeneity were investigated. Results Among 7765 records, 40 studies were selected. 15 943 patients and 16 337 carotid arteries were considered. The overall pooled cumulative incidence of restenosis >50% at 12 months was 5.7% (95% CI 3.8% to 8.6%), >70% at 12 months was 5.2% (95% CI 3.3% to 8.2%), >50% at 6 months was 3.9% (95% CI 2.2% to 6.8%), and ipsilateral stroke within 30 days after stenting was 1.6% (95% CI 1.0% to 2.5%) without association with the use of an embolic protection device. We did not identify any relevant source of heterogeneity of the cumulative incidence of restenosis >50% at 12 months. Mean age explained 80.9% (R²=80.9%, p=0.01) of heterogeneities of restenosis >70% at 12 months. The presence of hostile neck explained 53.9% (R²=53.9%, p=0.03) of heterogeneities of restenosis >50% at 6 months. Conclusion This meta-analysis showed a low cumulative rate of restenosis at 12 months and ipsilateral stroke within 30 days after stenting. Older patients and those with hostile neck present a lower risk of in-stent restenosis. The use of an embolic protection device was not associated with a lower risk of stroke. [ABSTRACT FROM AUTHOR]

Highlights • Adverse perinatal events can disturb brain development during intra-uterine life, at birth and in the first days of life. • There is very little work assessing association between perinatal factors and the onset of epilepsy in tropical countries. • Home birth, complicated delivery, and premature birth are most studied and raise the risk of epilepsy in tropical regions. Abstract Most people with epilepsy live in tropical countries. Perinatal factors seem to play a significant role in the occurrence of epilepsy. Available data provide different and sometimes contradictory conclusions on the role and the burden of these factors. The aim of our study was to evaluate the effect of these perinatal factors on the development of epilepsy in tropical countries. The main databases were screened, regardless the language, for all eligible studies published up to March 2017. Exposures were perinatal factors whilst the disease was epilepsy. After selection and data extraction, we calculated a pooled measure of association for each perinatal factor using fixed or random-effect models. We tested the heterogeneity and the publication bias. The degree of significance was 5%. We screened 22,581 articles and identified 13 studies. Among the perinatal factors studied, home birth (OR 1.36, 95%CI: 1.21–1.54), complicated delivery (OR 2.10, 95%CI: 1.05–4.20) and premature birth (OR 2.80, 95%CI: 2.07–3.78) were associated with the occurrence of epilepsy. The attributable risk of premature birth and home birth was estimated to be responsible for 17% and 20% of the cases of epilepsy, respectively, in tropical countries. Despite the limited number of studies identified, we demonstrated that some perinatal factors are risk factors for epilepsy in tropical countries. The three most studied risk factors are modifiable. Therefore, prevention strategies should target them. Further studies are essential to improve the understanding of the burden of these factors in the development of epilepsy. [ABSTRACT FROM AUTHOR]

Objective: To gain further insight on the association between human toxocariasis and epilepsy in light of the new evidence in the last years. Methods: A systematic review was conducted without date and language restriction in the following electronic databases: MEDLINE (PubMed), Ingenta Connect, Science Direct (Elsevier), RefDoc, Scopus, HighWire, Scielo and the database of the Institute of Neuroepidemiology and Tropical Neurology of the Limoges University (IENT). Two investigators independently conducted the search up to November 2017. A pooled odds ratio (OR) was estimated using a random effects model. Meta-regression was conducted to investigate potential sources of heterogeneity. Results: Database search produced 204 publications. Eleven case-control studies were included that were carried out in 13 countries worldwide. A total number of 4740 subjects were considered (2159 people with epilepsy and 2581 people without epilepsy). The overall pooled OR was 1.69 (95% CI 1.42–2.01) for the association between epilepsy and Toxocara spp. seropositivity. A positive association was constantly reported in the restricted analysis (WB as confirmatory or diagnostic test, younger population, and population–based studies). Meta-regression showed no statistically significant association between covariates and outcome. Conclusion: The updated meta-analysis provides epidemiological evidence of a positive association between Toxocara seropositivity and epilepsy. New surveys supported the association, mainly population-based studies. On this basis, health strategies to reduce the impact of Toxocara spp are strongly advised. Further research should be performed to understand the physiopathological mechanisms of toxocara-associated epileptogenesis. [ABSTRACT FROM AUTHOR]

Background: We reviewed studies that analyzed cysticercosis (CC), neurocysticercosis (NCC) and epilepsy across Latin America, Asia and Sub-Saharan Africa, to estimate the odds ratio and etiologic fraction of epilepsy due to CC in tropical regions. Methodology: We conducted a systematic review of the literature on cysticercosis and epilepsy in the tropics, collecting data from case-control and cross-sectional studies. Exposure criteria for CC included one or more of the following: serum ELISA or EITB positivity, presence of subcutaneous cysts (both not verified and unverified by histology), histology consistent with calcified cysts, and brain CT scan consistent with NCC. A common odds-ratio was then estimated using meta-analysis. Principal findings: 37 studies from 23 countries were included (n = 24,646 subjects, 14,934 with epilepsy and 9,712 without epilepsy). Of these, 29 were case-control (14 matched). The association between CC and epilepsy was significant in 19 scientific articles. Odds ratios ranged from 0.2 to 25.4 (a posteriori power 4.5–100%) and the common odds ratio was 2.7 (95% CI 2.1–3.6, p <0.001). Three subgroup analyses performed gave odds ratios as: 2.2 (EITB-based studies), 3.2 (CT-based studies), 1.9 (neurologist-confirmed epilepsy; door-to-door survey and at least one matched control per case). Etiologic fraction was estimated to be 63% in the exposed group among the population. Significance: Despite differences in findings, this meta-analysis suggests that cysticercosis is a significant contributor to late-onset epilepsy in tropical regions around the world, and its impact may vary depending on transmission intensity. [ABSTRACT FROM AUTHOR]

To elucidate whether physical activity (PA) and sport increase the risk of developing amyotrophic lateral sclerosis (ALS), a literature review of epidemiological studies was conducted according to the Meta-analysis of Observational Studies in Epidemiology guidelines. Six databases (Pubmed, Scopus, ScienceDirect, IngentaConnect, Refdoc and the Cochrane database) were searched to April 2014. Experts were asked to identify studies in press. Studies of interest were examined for their level of evidence and synthetized using Armon's classification for exogenous risk factors for ALS. Of 37 epidemiological works included in the review, two (5.5 %) provided class I evidence, and five (13.5 %) class II. Others offered evidence of class III (n = 8, 21.6 %), IV (n = 16, 43.2 %) and V (n = 6, 16.2 %). Results were stratified according to type of exposure: (1) PA related to sport and work (n = 14), (2) soccer and American football (n = 9), (3) occupation (n = 12), (4) proxies of PA (n = 2). Among articles which considered 'PA related to sport and work', two class I studies and one class II study concluded that PA is not a risk factor for ALS. This evidence establishes (level A) that PA is not a risk factor for ALS. As regards 'occupational related activity' a level of evidence of U was obtained (it is unknown whether the professional category 'physical worker' is a risk factor for ALS). Football/soccer may be considered as a possible risk factor for ALS (level C) and there is a need for further research taking into account the numerous confounding factors that may arise in this field. [ABSTRACT FROM AUTHOR]