scholarly journals Does early surgery improve outcomes for periprosthetic fractures of the hip and knee? A systematic review and meta-analysis

2021 ◽  
Author(s):  
L. Farrow ◽  
A. D. Ablett ◽  
H. W. Sargeant ◽  
T. O. Smith ◽  
A. T. Johnston
Keyword(s):  
Systematic Review ◽  
Large Scale ◽  
Meta Analysis ◽  
The Elderly ◽  
Outcome Evaluation ◽  
Periprosthetic Fractures ◽  
Early Surgery ◽  
Perioperative Outcomes ◽  
Inclusion Criteria ◽  
Delayed Surgery

Abstract Introduction Previous evidence has established that early surgery is beneficial to improve outcomes for individuals with native hip fractures in the elderly population. Patients who sustain a periprosthetic fracture have been demonstrated to have similar demographics and outcomes as those with native fractures around the hip and knee. We therefore set out to determine if there is a similar difference in perioperative outcomes between early and delayed surgery for periprosthetic fractures of the hip and knee through a systematic review and meta-analysis. Methods Literature search outputs were screened for studies meeting the inclusion criteria. The groups of early surgery and delayed surgery were defined by study authors. The primary outcome measure was 30 day mortality. Where there was sufficient study homogeneity, a random-effects meta-analysis was performed. Individual study risk of bias was assessed using the ROBINS-I criteria, with the GRADE criteria used for independent outcome evaluation. The review protocol was registered on PROSPERO prior to commencement (Registration number CRD42019149360). Results The inclusion criteria was met in 11 studies (n = 3006). Mean time to surgery from admission for reporting studies was 64 h. 59.6% patients underwent early surgery as defined by the study authors. We identified a significantly lower risk of 30 day mortality for those with early surgery versus delayed surgery (RR 0.21; 95% CI 0.05, 0.90; p = 0.04, n = 2022). There were also significantly better outcomes for early versus delayed surgery regarding: medical complications, length of stay, transfusion risk, and reoperation. The quality of evidence for all the individual outcomes was low or very low. Conclusions There is evidence that delaying surgery in those with periprosthetic fractures of the hip and knee has a deleterious impact on mortality and other important patient outcomes. There are, however, notable limitations to the existing available literature, with further appropriately designed large-scale studies required to confirm these findings.

Early versus delayed surgery for paediatric supracondylar humeral fractures in the absence of vascular compromise

2018 ◽  
Vol 100-B (12) ◽  
pp. 1535-1541 ◽  
Author(s):  
L. Farrow ◽  
A. D. Ablett ◽  
L. Mills ◽  
S. Barker
Keyword(s):  
Open Reduction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Humeral Fractures ◽  
Perioperative Outcomes ◽  
Inclusion Criteria ◽  
Delayed Surgery ◽  
Significant Difference ◽  
Vascular Compromise ◽  
Supracondylar Humeral Fractures

Aims We set out to determine if there is a difference in perioperative outcomes between early and delayed surgery in paediatric supracondylar humeral fractures in the absence of vascular compromise through a systematic review and meta-analysis. Materials and Methods A literature search was performed, with search outputs screened for studies meeting the inclusion criteria. The groups of early surgery (ES) and delayed surgery (DS) were classified by study authors. The primary outcome measure was open reduction requirement. Meta-analysis was performed in the presence of sufficient study homogeneity. Individual study risk of bias was assessed using the Risk of Bias in Non-Randomised Studies – of Interventions (ROBINS-I) criteria, with the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) criteria used to evaluate outcomes independently. Results A total of 12 studies met the inclusion criteria (1735 fractures). Pooled mean time to surgery from injury was and 10.7 hours for ES and 91.8 hours for DS. On meta-analysis there was no significant difference between ES versus DS for the outcome of open reduction requirement. There was also no significant difference for the outcomes: Iatrogenic nerve injury, pin site infection, and re-operation. The quality of evidence for all the individual outcomes was low or very low. Conclusions There is no evidence that delaying supracondylar fracture surgery negatively influences outcomes in the absence of vascular compromise. There are, however, notable limitations to the existing available literature.

scholarly journals Immediate versus delayed surgery for hip fractures in the elderly patients: a protocol for a systematic review and meta-analysis

2017 ◽  
Vol 6 (1) ◽  
Author(s):  
Thomas Klestil ◽  
Christoph Röder ◽  
Christoph Stotter ◽  
Birgit Winkler ◽  
Stefan Nehrer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Elderly Patients ◽  
Hip Fractures ◽  
Meta Analysis ◽  
The Elderly ◽  
Delayed Surgery

scholarly journals Association between Oral Hygiene and Metabolic Syndrome: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (13) ◽  
pp. 2873
Author(s):  
Cornelia Melinda Adi Santoso ◽  
Fera Ketti ◽  
Taufan Bramantoro ◽  
Judit Zsuga ◽  
Attila Nagy
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Oral Hygiene ◽  
Reference Lists ◽  
Meta Analysis ◽  
Tooth Brushing ◽  
Inclusion Criteria ◽  
Poor Oral Hygiene ◽  
Dental Visits ◽  
Substantial Heterogeneity

Emerging evidence has linked poor oral hygiene to metabolic syndrome (MetS), but previously, no summary of evidence has been conducted on the topic. This systematic review and meta-analysis aims to evaluate the associations of oral hygiene status and care with MetS. A systematic search of the PubMed and Web of Science databases from inception to March 17, 2021, and examination of reference lists was conducted to identify eligible observational studies. A random-effects model was applied to pool the effects of oral hygiene status and care on MetS. Thirteen studies met the inclusion criteria and had sufficient methodological quality. Good oral hygiene status (OR = 0.30 (0.13–0.66); I2 = 91%), frequent tooth brushing (OR = 0.68 (0.58–0.80); I2 = 89%), and frequent interdental cleaning (OR = 0.89 (0.81–0.99); I2 = 27%) were associated with a lower risk of MetS. Only one study examined the association between dental visits and MetS (OR = 1.10 (0.77–1.55)). Our findings suggested that there might be inverse associations of oral hygiene status, tooth-brushing frequency, and interdental cleaning with MetS. However, substantial heterogeneity for tooth-brushing frequency and inconsistent results for oral hygiene status in subgroup analyses were observed. There was insufficient evidence for the association between dental visits and MetS. Further longitudinal studies are needed to investigate these associations.

scholarly journals Caffeine and Cognitive Functions in Sports: A Systematic Review and Meta-Analysis

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 868
Author(s):  
Jorge Lorenzo Calvo ◽  
Xueyin Fei ◽  
Raúl Domínguez ◽  
Helios Pareja-Galeano
Keyword(s):  
Systematic Review ◽  
Reaction Time ◽  
Cognitive Performance ◽  
Cognitive Functions ◽  
Web Of Science ◽  
Meta Analysis ◽  
Caffeine Intake ◽  
Inclusion Criteria ◽  
Research Protocols ◽  
The Relationship

Cognitive functions are essential in any form of exercise. Recently, interest has mounted in addressing the relationship between caffeine intake and cognitive performance during sports practice. This review examines this relationship through a structured search of the databases Medline/PubMed and Web of Science for relevant articles published in English from August 1999 to March 2020. The study followed PRISMA guidelines. Inclusion criteria were defined according to the PICOS model. The identified records reported on randomized cross-over studies in which caffeine intake (as drinks, capsules, energy bars, or gum) was compared to an identical placebo situation. There were no filters on participants’ training level, gender, or age. For the systematic review, 13 studies examining the impacts of caffeine on objective measures of cognitive performance or self-reported cognitive performance were selected. Five of these studies were also subjected to meta-analysis. After pooling data in the meta-analysis, the significant impacts of caffeine only emerged on attention, accuracy, and speed. The results of the 13 studies, nevertheless, suggest that the intake of a low/moderate dose of caffeine before and/or during exercise can improve self-reported energy, mood, and cognitive functions, such as attention; it may also improve simple reaction time, choice reaction time, memory, or fatigue, however, this may depend on the research protocols.

scholarly journals Factors affecting the incidence of postoperative periprosthetic fractures following primary and revision hip arthroplasty: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Christos Bissias ◽  
Angelos Kaspiris ◽  
Athanasios Kalogeropoulos ◽  
Konstantinos Papoutsis ◽  
Nikolaos Natsioulas ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Revision Arthroplasty ◽  
Female Gender ◽  
Periprosthetic Fractures ◽  
Factors Affecting ◽  
Potential Risk Factors ◽  
Grade 3

Abstract Objectives The increasing number of hip arthroplasties (HA), due to the growing elderly population, is associated with the risk of femoral periprosthetic fractures (FPFs). The purpose of this study was to identify potential risk factors for the development of FPFs after HA. Methods A systematic review was conducted in five data bases (Medline, Embase, Cochrane, Cinahl, ICTRP) according to the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines up to May 2019, using the key words “risk factor,” “periprosthetic fracture,” and “hip replacement or arthroplasty.” Meta-analysis of the clinical outcomes of HA and subgroup analysis based on the factors that were implicated in FPFs was performed. Results Sixteen studies were included (sample size: 599,551 HA patients, 4253 FPFs, incidence 0.71%). Risk factors statistically associated with increased incidence of FPFs were female gender (+ 40%), previous revision arthroplasty surgery (× 3 times), and the presence of rheumatoid arthritis (× 2.1 times), while osteoarthritis (− 57%), cement application (− 59%), and insertion of Biomet (− 68%) or Thompson’s prosthesis (− 75%) were correlated with low prevalence of FPFs. Obesity, cardiac diseases, advanced age, bad general health (ASA grade ≥ 3), and use of Exeter or Lubinus prosthesis were not linked to the appearance of FPFs. Conclusion This meta-analysis suggested that female gender, rheumatoid arthritis, and revision arthroplasty are major risk factors for the development of FPFs after a HA. In those patients, frequent follow-ups should be planned. Further prospective studies are necessary to clarify all the risk factors contributing to the appearance of FPFs after HA.

scholarly journals Effectiveness of Oral Nutritional Supplements on Older People with Anorexia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 835
Author(s):  
Mengqi Li ◽  
Si Zhao ◽  
Shuang Wu ◽  
Xiufen Yang ◽  
Hui Feng
Keyword(s):  
Systematic Review ◽  
Body Weight ◽  
Older People ◽  
Energy Intake ◽  
Meta Analysis ◽  
Nutritional Supplements ◽  
The Elderly ◽  
Randomized Controlled ◽  
Oral Nutritional Supplements ◽  
Positive Effect

Background: Nutrition plays an important role in maintaining the overall health of older people. Inadequate intake may lead to impaired body function, higher morbidity, and mortality. Oral nutritional supplements (ONS) showed positive effect on the nutritional status of the elderly; however, systematic evidence is currently lacking on the effect of ONS on the elderly with anorexia. Aims: The current systematic review and meta-analysis included randomized controlled trial (RCT) articles to investigate the effectiveness of ONS on the main aspects of anorexia of aging (AA). Methods: By using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method, researchers independently searched PubMed/MEDLINE, EMBASE, CINAHL, PsycINFO, the Cochrane Library, China National Knowledge Infrastructure (CNKI) and other gray literature resources for publications that met the inclusion criteria by October 2020. The Cochrane Risk of Bias Tools were used for quality assessment. The inverse-variance method was used for the fixed model (FM) while the DerSimonian–Laird method was used for the random model (RM). Respective 95% confidence intervals (95% CIs), mean difference (MD) or standardized mean difference (SMD) was used for indices in terms of effect size (ES). Results: 2497 records were found through the systematic search, while 17 RCTs (n = 1204) were included, with a mean age of 81.9 years (range: 74–87 years). Supplementation occurred in the morning, mid-day, and evening, while the times varied from one to three times a day. The results of meta-analysis showed that, generally, ONS had a positive effect on the overall appetite, MD = 0.18, 95% CI (0.03, 0.33), p = 0.02, and consumption, MD = 1.43, 95% CI (0.01, 2.86), p = 0.05; but not significant in terms of other aspects of appetite: hunger, p = 0.73; fullness, p = 0.60; desire to eat, p = 0.80; preoccupation, p = 0.15. Additionally, it showed an increase in the overall energy intake, SMD = 0.46, 95% CI (0.29, 0.63), p < 0.001, in protein intake, SMD = 0.59, 95% CI (0.16, 1.02), p = 0.007, and in fat intake, MD = 3.47, 95% CI (1.98, 4.97), p < 0.001, while no positive effect was found on carbohydrates intake, p = 0.06. Significance differences were also found in the body weight, SMD = 0.53, 95% CI (0.41, 0.65), p < 0.001, and body mass index (BMI), MD = 0.53, 95% CI (0.12, 0.95), p = 0.01. Moreover, subgroup analyses were conducted according to the nutrient density with no positive results showed except for the low-density ONS on overall energy intake. Conclusions: The results of the present study indicated that ONS had beneficial effects on overall appetite, energy intake, body weight and BMI.

scholarly journals Assessment of changes in efficacy of antimalarials: a systematic review and network meta-regression

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
S W Youdom ◽  
R S Tchouenkou ◽  
E-P Ndong-Nguema ◽  
L K Basco
Keyword(s):  
Systematic Review ◽  
Uncomplicated Malaria ◽  
Data Science ◽  
Meta Analysis ◽  
Decision Makers ◽  
Inclusion Criteria ◽  
Antimalarial Drug Resistance ◽  
Consistency Model ◽  
Meta Regression ◽  
Methodological Studies

Abstract Background The fight against diseases such as malaria requires the synthesis of evidence from existing studies to inform decision makers. Indeed, at a cross road of antimalarial drug resistance, several artemisinin-based combination therapies (ACT) with multiple doses are available to fight uncomplicated malaria. However, little is known on how these combinations are combined as well as how different formulations are tested. Methods A systematic review was performed to identify randomized trials. Articles were sought by hand-searching and scanning references. Additional covariates effect on treatment outcome was assessed, and a modeling approach to reduce heterogeneity among trials was evaluated. We explored one single interaction effect for all treatment with age as the main covariate in a meta-regression. A Bayesian analysis was used to implement the consistency and inconsistency models under the WinBUGS software. Ranking measure was used to obtain a hierarchy of the competing interventions. Results In total, 77 articles meet the inclusion criteria with 15 combinations tested in 36,000 patients. Results were compared to that of frequentist approach and presented according to the Prisma NMA checklist. The consistency model showed a good performance than the inconsistency model under the hypothesis of homogeneity. It was found that compared to artemether-lumefantrine, the dihydro-artemisinin-piperaquine was more effective before (B, OR = 1.83; 95% CI = 1.31-2.56) and after (A, OR = 1.70; 95% CI = 1.20-2.43) covariate adjustment, and occupied the top rank. Conclusions The application of the methods described here may be helpful to gain better understanding of treatment efficacy and improve future decisions in malaria programs. Based on the available evidence, this study demonstrated the superiority of DHAP among currently recommended ACT in preventing as well as treating uncomplicated malaria. Key messages Choosing the best therapy requires data triangulation and data science. Network meta-analysis could be a solution but need more methodological studies.

scholarly journals Glycemic Index of Gluten-Free Bread and Their Main Ingredients: A Systematic Review and Meta-Analysis

Foods ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 506
Author(s):  
Bernardo Romão ◽  
Ana Luísa Falcomer ◽  
Gabriela Palos ◽  
Sandra Cavalcante ◽  
Raquel Braz Assunção Botelho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Glycemic Index ◽  
Resistant Starch ◽  
Web Of Science ◽  
Meta Analysis ◽  
Gluten Free ◽  
Inclusion Criteria ◽  
Glycemic Profile

This study aimed to perform a systematic review and meta-analysis of the glycemic index (GI) of gluten-free bread (GFB) and its main ingredients. The systematic review followed PRISMA guidelines, using seven electronic databases (PubMed, EMBASE, Scopus, Science Direct, Web of Science, gray literature research with Google Scholar, and patents with Google Patent tool), from inception to November 2020. Eighteen studies met the inclusion criteria evaluating 132 GFB samples. Five articles tested GI in vivo, eleven in vitro; and two studies tested both methods. The analysis showed that 60.7% (95% CI: 40.2–78.1%) of the samples presented high glycemic indexes, evidencing a high glycemic profile for GFB. Only 18.2% (95% CI: 11.7–27.2%) of the bread samples presented in the studies were classified as a low GI. Meta-analysis presented moderate/low heterogenicity between studies (I2 = 61% and <1% for both high and low GIs) and reinforced the proportion of high GIs. Lower GIs were found in formulations based on Colocasia esculenta flour or enriched with fiber, yogurt and curd cheese, sourdough, psyllium, hydrocolloids, enzymes, fructans, and resistant starch, highlighting the efficacy of these ingredients to lower GFBs’ GI. GFB tends to present high GI, impacting the development of chronic diseases when consumed.

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