“Immediate Lymphatic Reconstruction for Prevention of Secondary Lymphedema: A Meta-Analysis”

2021 ◽  
Author(s):  
Magnus J. Chun ◽  
Fouad Saeg ◽  
Anna Meade ◽  
Taruni Kumar ◽  
Eman A. Toraih ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Secondary Lymphedema

scholarly journals Cell therapy as a treatment of secondary lymphedema: a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Hector Lafuente ◽  
Ibon Jaunarena ◽  
Eukene Ansuategui ◽  
Arantza Lekuona ◽  
Ander Izeta
Keyword(s):  
Systematic Review ◽  
Clinical Studies ◽  
Meta Analysis ◽  
Cell Types ◽  
Lymphatic Drainage ◽  
Secondary Lymphedema ◽  
Disease Outcomes ◽  
Underlying Mechanisms ◽  
Preclinical And Clinical Studies ◽  
Positive Effect

Abstract Background Lymphedema, the accumulation of interstitial fluid caused by poor lymphatic drainage, is a progressive and permanent disease with no curative treatment. Several studies have evaluated cell-based therapies in secondary lymphedema, but no meta-analysis has been performed to assess their efficacy. Methods We conducted a systematic review and meta-analysis of all available preclinical and clinical studies, with assessment of their quality and risk of bias. Results A total of 20 articles using diverse cell types were selected for analysis, including six clinical trials and 14 pre-clinical studies in three species. The meta-analysis showed a positive effect of cell-based therapies on relevant disease outcomes (quantification of edema, density of lymphatic capillaries, evaluation of the lymphatic flow, and tissue fibrosis). No significant publication bias was observed. Conclusion Cell-based therapies have the potential to improve secondary lymphedema. The underlying mechanisms remain unclear. Due to relevant heterogeneity between studies, further randomized controlled and blinded studies are required to substantiate the use of these novel therapies in clinical practice.

scholarly journals LYMPHOVENOUS ANASTOMOSIS FOR THE TREATMENT OF LYMPHEDEMA: A SYSTEMATIC REVIEW OF THE LITERATURE AND META-ANALYSIS

Lymphology ◽  
2021 ◽  
Vol 53 (4) ◽  
Author(s):  
E Nacchiero ◽  
M Maruccia ◽  
R Elia ◽  
F Robusto ◽  
G Giudice ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Subgroup Analysis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Clinical Stage ◽  
Anatomical Site ◽  
Stage Duration ◽  
Secondary Lymphedema ◽  
Lymphovenous Anastomosis ◽  
Microsurgical Procedure

Lymphovenous anastomosis (LVA) has been described as an effective treatment for early stages of lymphedema (LE). The aim of this study was to deepen the evaluation of the effectiveness of LVA by performing a meta-analysis to provide information about its utility in specific anatomical sites, clinical stages, duration of lymphedema, and surgical technique. A systematic literature search using PubMed/Medline, Google Scholar, and Cochrane Database was performed in November 2019. Only original studies in which exclusively LVA was performed for primary and/or secondary lymphedema in humans were eligible for data extraction. A meta-analysis was performed on articles with a well-defined endpoint and a subgroup analysis was conducted in relation to surgical technique, duration of lymphedema, stage of pathology. Forty-eight studies, including 6 clinical trials and 42 low-risk bias observational studies were included in our meta-analysis. 1,281 subjects were included and the majority of articles reported a pre-post analysis. Lymphaticovenular anastomosis appears to result effectively in treatment of lymphedema with an odds ratio of 0.07 (CI: 0.04, 0.13, p<0.001). All subgroup meta-analyses were statistically significant for LVAs specifically with regard to anatomical site, clinical stage, duration of LE, or type of microsurgical procedure (p<0.05). Our meta-analysis confirmed the efficacy of LVAs for the treatment of lymphedema, even when subgroup analysis was performed for clinical stage, duration of pathology, anatomical site of lymphedema, or type of microsurgical procedure. Further prospective trials with a common clearly defined outcome measure are warranted for an unbiased evaluation.

scholarly journals Prevalence and incidence of cancer related lymphedema in low and middle-income countries: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Eric Torgbenu ◽  
Tim Luckett ◽  
Mark A. Buhagiar ◽  
Sungwon Chang ◽  
Jane L Phillips
Keyword(s):  
Systematic Review ◽  
Cancer Treatment ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Middle Income ◽  
Considerable Heterogeneity ◽  
Secondary Lymphedema ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Arm Lymphedema

Abstract Background Little is known about the prevalence and incidence in low and middle-income countries (LMICs) of secondary lymphedema due to cancer. This study aims to estimate the prevalence and incidence in LMICs of secondary lymphedema related to cancer and/or its treatment(s) and identify risk factors. Method A systematic review and meta-analysis was conducted. Medline, EMBASE and CINAHL were searched in June 2019 for peer-reviewed articles that assessed prevalence and/or incidence of cancer-related lymphedema in LMICs. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Estimates of pooled prevalence and incidence estimates were calculated with 95% confidence intervals (CI), with sub-group analyses grouping studies according to: country of origin, study design, risk of bias, setting, treatment, and lymphedema site and measurement. Heterogeneity was measured using X ² and I 2 , with interpretation guided by the Cochrane Handbook for Systematic Reviews. Results Of 8766 articles, 36 were included. Most reported on arm lymphedema secondary to breast cancer treatment (n=31), with the remainder reporting on leg lymphedema following gynecological cancer treatment (n=5). Arm lymphedema was mostly measured by arm circumference (n=16/31 studies), and leg lymphedema through self-report (n=3/5 studies). Eight studies used more than one lymphedema measurement. Only two studies that measured prevalence of leg lymphedema could be included in a meta-analysis (pooled prevalence =10.0%, 95%CI 7.0 – 13.0, I 2 =0%). The pooled prevalence of arm lymphedema was 27%, with considerable heterogeneity (95%CI 20.0 – 34.0, I 2 =94.69%, n =13 studies). The pooled incidence for arm lymphedema was 21%, also with considerable heterogeneity (95%CI 15.0 – 26.0, I 2 =95.29%, n =11 studies). There was evidence that higher BMI (>25) was associated with increased risk of arm lymphedema (OR: 1.98, 95%CI 1.45 – 2.70, I 2 =84.0%, P< 0.0001, n =4 studies). Conclusion Better understanding the factors that contribute to variability in cancer-related arm lymphedema in LMICs is an important first step to developing targeted interventions to improve quality of life. Standardising measurement of lymphedema globally and better reporting would enable comparison within the context of information about cancer treatments and lymphedema care.

scholarly journals Prevalence and incidence of cancer related lymphedema in low and middle-income countries: A systematic review and meta-analysis.

2020 ◽  
Author(s):  
Eric Torgbenu ◽  
Tim Luckett ◽  
Mark A. Buhagiar ◽  
Sungwon Chang ◽  
Jane L. Phillips
Keyword(s):  
Systematic Review ◽  
Cancer Treatment ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Middle Income ◽  
Considerable Heterogeneity ◽  
Secondary Lymphedema ◽  
Middle Income Countries ◽  
Pooled Prevalence ◽  
Arm Lymphedema

Abstract Background Little is known about the prevalence and incidence in low and middle-income countries (LMICs) of secondary lymphedema due to cancer. This study aims to estimate the prevalence and incidence in LMICs of secondary lymphedema related to cancer and/or its treatment(s) and identify risk factors. Method A systematic review and meta-analysis was conducted. Medline, EMBASE and CINAHL were searched in June 2019 for peer-reviewed articles that assessed prevalence and/or incidence of cancer-related lymphedema in LMICs. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies. Estimates of pooled prevalence and incidence estimates were calculated with 95% confidence intervals (CI), with sub-group analyses grouping studies according to: country of origin, study design, risk of bias, setting, treatment, and lymphedema site and measurement. Heterogeneity was measured using X ² and I 2 , with interpretation guided by the Cochrane Handbook for Systematic Reviews. Results Of 8766 articles, 36 were included. Most reported on arm lymphedema secondary to breast cancer treatment (n=31), with the remainder reporting on leg lymphedema following gynecological cancer treatment (n=5). Arm lymphedema was mostly measured by arm circumference (n=16/31 studies), and leg lymphedema through self-report (n=3/5 studies). Eight studies used more than one lymphedema measurement. Only two studies that measured prevalence of leg lymphedema could be included in a meta-analysis (pooled prevalence =10.0%, 95%CI 7.0 – 13.0, I 2 =0%). The pooled prevalence of arm lymphedema was 27%, with considerable heterogeneity (95%CI 20.0 – 34.0, I 2 =94.69%, n =13 studies). The pooled incidence for arm lymphedema was 21%, also with considerable heterogeneity (95%CI 15.0 – 26.0, I 2 =95.29%, n =11 studies). There was evidence that higher BMI (>25) was associated with increased risk of arm lymphedema (OR: 1.98, 95%CI 1.45 – 2.70, I 2 =84.0%, P< 0.0001, n =4 studies). Conclusion Better understanding the factors that contribute to variability in cancer-related arm lymphedema in LMICs is an important first step to developing targeted interventions to improve quality of life. Standardising measurement of lymphedema globally and better reporting would enable comparison within the context of information about cancer treatments and lymphedema care.

The effects of low-ratio n-6/n-3 PUFA on biomarkers of inflammation: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Yali Wei ◽  
Yan Meng ◽  
Na Li ◽  
Qian Wang ◽  
Liyong Chen
Keyword(s):  
Systematic Review ◽  
Fatty Acid ◽  
Polyunsaturated Fatty Acid ◽  
Meta Analysis ◽  
Chain Polyunsaturated Fatty Acid ◽  
Inflammation Markers ◽  
Pufa Supplementation ◽  
Long Chain

The purpose of the systematic review and meta-analysis was to determine if low-ratio n-6/n-3 long-chain polyunsaturated fatty acid (PUFA) supplementation affects serum inflammation markers based on current studies.

Chronic Pain: Fundamental Scientific Considerations, Specifically for Legal Claims

2013 ◽  
Vol 18 (1) ◽  
pp. 1-18 ◽  
Author(s):  
Robert J. Barth
Keyword(s):  
Health Outcomes ◽  
Pain Perception ◽  
Driving Forces ◽  
Psychological Treatment ◽  
Dominant Role ◽  
Meta Analysis ◽  
General Medicine ◽  
Pain Syndrome ◽  
Problematic Relationship

Abstract Scientific findings have indicated that psychological and social factors are the driving forces behind most chronic benign pain presentations, especially in a claim context, and are relevant to at least three of the AMA Guides publications: AMA Guides to Evaluation of Disease and Injury Causation, AMA Guides to Work Ability and Return to Work, and AMA Guides to the Evaluation of Permanent Impairment. The author reviews and summarizes studies that have identified the dominant role of financial, psychological, and other non–general medicine factors in patients who report low back pain. For example, one meta-analysis found that compensation results in an increase in pain perception and a reduction in the ability to benefit from medical and psychological treatment. Other studies have found a correlation between the level of compensation and health outcomes (greater compensation is associated with worse outcomes), and legal systems that discourage compensation for pain produce better health outcomes. One study found that, among persons with carpal tunnel syndrome, claimants had worse outcomes than nonclaimants despite receiving more treatment; another examined the problematic relationship between complex regional pain syndrome (CRPS) and compensation and found that cases of CRPS are dominated by legal claims, a disparity that highlights the dominant role of compensation. Workers’ compensation claimants are almost never evaluated for personality disorders or mental illness. The article concludes with recommendations that evaluators can consider in individual cases.

Sign in / Sign up

Export Citation Format

Share Document