Triclosan-Coated Sutures Reduce the Risk of Surgical Site Infections: A Systematic Review and Meta-analysis

2015 ◽  
Vol 36 (2) ◽  
pp. 169-179 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
Nalini Singh ◽  
Aila Nica Bandong ◽  
Gilbert Madriaga
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Random Effects ◽  
Meta Analysis ◽  
Surgical Site Infections ◽  
Sensitivity Analyses ◽  
Publication Type ◽  
Random Effects Models ◽  
Meta Regression ◽  
Meta Analyses

OBJECTIVETo analyze available evidence on the effectiveness of triclosan-coated sutures (TCSs) in reducing the risk of surgical site infection (SSI).DESIGNSystematic review and meta-analysis.METHODSA systematic search of both randomized (RCTs) and nonrandomized (non-RCT) studies was performed on PubMed Medline, OVID, EMBASE, and SCOPUS, without restrictions in language and publication type. Random-effects models were utilized and pooled estimates were reported as the relative risk (RR) ratio with 95% confidence interval (CI). Tests for heterogeneity as well as meta-regression, subgroup, and sensitivity analyses were performed.RESULTSA total of 29 studies (22 RCTs, 7 non-RCTs) were included in the meta-analysis. The overall RR of acquiring an SSI was 0.65 (95% CI: 0.55–0.77; I2=42.4%, P=.01) in favor of TCS use. The pooled RR was particularly lower for the abdominal surgery group (RR: 0.56; 95% CI: 0.41–0.77) and was robust to sensitivity analysis. Meta-regression analysis revealed that study design, in part, may explain heterogeneity (P=.03). The pooled RR subgroup meta-analyses for randomized controlled trials (RCTs) and non-RCTs were 0.74 (95% CI: 0.61–0.89) and 0.53 (95% CI: 0.42–0.66), respectively, both of which favored the use of TCSs.CONCLUSIONThe random-effects meta-analysis based on RCTs suggests that TCSs reduced the risk of SSI by 26% among patients undergoing surgery. This effect was particularly evident among those who underwent abdominal surgery.Infect Control Hosp Epidemiol 2015;36(2): 1–11

scholarly journals Leishmanicidal effects of resveratrol and its derivatives: a systematic review and meta-Analysis

2020 ◽  
Author(s):  
Nasrin Amiri Dashatan ◽  
Marzieh Ashrafmansouri ◽  
Mehdi Koushki ◽  
Nayebali Ahmadi
Keyword(s):  
Systematic Review ◽  
Publication Bias ◽  
Data Extraction ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Protective Effects ◽  
Random Effects Models ◽  
Important Health ◽  
Mean Differences ◽  
Meta Analyses

Abstract Background Leishmaniasis is one of the most important health problems worldwide. The evidence has suggested that resveratrol and its derivatives have anti-leishmanial effects; however, the results are inconsistent and inconclusive. The aim of this study was to assess the effect of resveratrol and its derivatives on the Leishmania viability through a systematic review and meta-analysis of available relevant studies. Methods The electronic databases PubMed, ScienceDirect, Embase, Web of Science and Scopus were queried between October 2000 and April 2020 using a comprehensive search strategy. The eligible articles selected and data extraction conducted by two reviewers. Mean differences of IC50 (concentration leading to reduction of 50% of Leishmania) for each outcome was calculated using random-effects models. Sensitivity analyses and prespecified subgroup were conducted to evaluate potential heterogeneity and the stability of the pooled results. Publication bias was evaluated using the Egger’s and Begg’s tests. We also followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for this review. Results Ten studies were included in the meta-analysis. We observed that RSV and its derivatives had significant reducing effects on Leishmania viability in promastigote [24.02 µg/ml; (95% CI 17.1, 30.8); P < 0.05; I2 = 99.8%; P heterogeneity = 0.00] and amastigote [18.3 µg/ml; (95% CI 13.5, 23.2); P < 0.05; I2 = 99.6%; P heterogeneity = 0.00] stages of Leishmania. A significant publication bias was observed in the meta-analysis. Sensitivity analyses showed a similar effect size while reducing the heterogeneity. Subgroup analysis indicated that the pooled effects of leishmanicidal of resveratrol and its derivatives were affected by type of stilbenes and Leishmania species. Conclusions Our findings clearly suggest that the strategies for the treatment of leishmaniasis should be focused on natural products such as RSV and its derivatives. Further study is needed to identify the mechanisms mediating this protective effects of RSV and its derivatives in leishmaniasis.

scholarly journals Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion

2019 ◽  
Vol 22 (3) ◽  
pp. 318-332 ◽  
Author(s):  
Rupesh Kotecha ◽  
Arjun Sahgal ◽  
Muni Rubens ◽  
Antonio De Salles ◽  
Laura Fariselli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stereotactic Radiosurgery ◽  
Random Effects ◽  
Local Control ◽  
Pituitary Adenomas ◽  
Meta Analysis ◽  
Random Effects Models ◽  
Review Reports ◽  
Meta Analyses ◽  
Non Functioning Pituitary Adenomas

Abstract Background This systematic review reports on outcomes and toxicities following stereotactic radiosurgery (SRS) for non-functioning pituitary adenomas (NFAs) and presents consensus opinions regarding appropriate patient management. Methods Using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic review was performed from articles of ≥10 patients with NFAs published prior to May 2018 from the Medline database using the key words “radiosurgery” and “pituitary” and/or “adenoma.” Weighted random effects models were used to calculate pooled outcome estimates. Results Of the 678 abstracts reviewed, 35 full-text articles were included describing the outcomes of 2671 patients treated between 1971 and 2017 with either single fraction SRS or hypofractionated stereotactic radiotherapy (HSRT). All studies were retrospective (level IV evidence). SRS was used in 27 studies (median dose: 15 Gy, range: 5–35 Gy) and HSRT in 8 studies (median total dose: 21 Gy, range: 12–25 Gy, delivered in 3–5 fractions). The 5-year random effects local control estimate after SRS was 94% (95% CI: 93.0–96.0%) and 97.0% (95% CI: 93.0–98.0%) after HSRT. The 10-year local control random effects estimate after SRS was 83.0% (95% CI: 77.0–88.0%). Post-SRS hypopituitarism was the most common treatment-related toxicity observed, with a random effects estimate of 21.0% (95% CI: 15.0–27.0%), whereas visual dysfunction or other cranial nerve injuries were uncommon (range: 0–7%). Conclusions SRS is an effective and safe treatment for patients with NFAs. Encouraging short-term data support HSRT for select patients, and mature outcomes are needed before definitive recommendations can be made. Clinical practice opinions were developed on behalf of the International Stereotactic Radiosurgery Society (ISRS).

Risk of Depression in Patients With Psoriatic Disease: A Systematic Review and Meta-Analysis

2020 ◽  
pp. 120347542097747
Author(s):  
Aysha Lukmanji ◽  
Robert B. Basmadjian ◽  
Isabelle A. Vallerand ◽  
Scott B. Patten ◽  
Karen L. Tang
Keyword(s):  
Systematic Review ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Future Research ◽  
Random Effects Models ◽  
Psoriatic Disease ◽  
Meta Regression ◽  
Meta Analyses ◽  
Psoriasis Severity

Background Previous systematic reviews have assessed the prevalence and odds ratio (OR) of depression for patients with psoriatic disease. Due to probable bidirectional effects, prevalence and prevalence ORs are difficult to interpret. No prior reviews have quantified the relative risk (RR) of depression following a diagnosis of psoriatic disease. Objective To estimate the RR of depression in individuals with psoriasis and in psoriatic arthritis (PsA), clear-to-moderate psoriasis, and moderate-to-severe psoriasis subgroups. Methods Observational studies investigating the risk of depression in adults with psoriatic disease were systematically searched for in Medline, EMBASE, PsycINFO, and CINAHL databases; 4989 unique references were screened. Studies that reported measures of incident depression in psoriasis patients were included. Thirty-one studies were included into the systematic review, of which 17 were meta-analyzed. Random effects models were employed to synthesize relevant data. Sources of heterogeneity were explored with subgroup analysis and meta-regression. Results Seventeen studies were included in meta-analyses. The pooled RR of depression in psoriasis patients compared to nonpsoriasis controls was 1.48 (95% CI: 1.16-1.89). Heterogeneity was high (I2 = 99.8%). Subgroup analysis and meta-regression did not indicate that PsA status or psoriasis severity (clear-to-mild, moderate-to-severe) were sources of heterogeneity. No evidence of publication bias was found. Conclusions This review demonstrates that the risk of depression is greater in patients with psoriasis and PsA. Future research should focus on developing strategies to address the mental health needs of this patient population for depression, including primary prevention, earlier detection, and treatment strategies.

Effect of postoperative coffee consumption on postoperative ileus after abdominal surgery: An updated systematic review and meta-analysis (protocol) v1

2021 ◽  
Author(s):  
Jun Watanabe ◽  
Atsushi Miki ◽  
Kazuhiko Kotani ◽  
Naohiro Sata
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Postoperative Ileus ◽  
Meta Analysis ◽  
Coffee Consumption ◽  
Random Effects Models ◽  
Assessment Development ◽  
Evaluation Approach ◽  
Meta Analyses ◽  
Analysis Protocol

Introduction: Coffee, a popular and cheap beverage worldwide, may have an important effect on postoperative ileus (POI). However, previous systematic reviews have not clarified whether the effect is due to caffeine or coffee itself, or shortening hospital stay. We will aim to assess the effect of postoperative coffee consumption on POI. Methods: Studies evaluating the effect of postoperative coffee consumption will be searched using the electronic databases and the trial registries. Meta-analyses will be performed using random-effects models. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to assess the certainty of evidence.

scholarly journals The Application of Meta-Analytic Models with Multiple Random Effects: A Systematic Review

2019 ◽  
Author(s):  
Belén Fernández ◽  
Laleh Jamshidi ◽  
Lies Declercq ◽  
S. Natasha Beretvas ◽  
Patrick Onghena ◽  
...  
Keyword(s):  
Systematic Review ◽  
Data Structure ◽  
Random Effects ◽  
Multilevel Models ◽  
Meta Analysis ◽  
Simulation Studies ◽  
Random Effects Models ◽  
Sophisticated Model ◽  
Meta Analyses ◽  
Study Participants

In meta-analysis, study participants are nested within studies, leading to a multilevel data structure. The traditional random effects model can be considered as a model with a random study effect, but additional random effects can be added in order to account for dependent effects sizes within or across studies. The goal of this systematic review is three-fold. First, we will describe how multilevel models with multiple random effects (i.e., hierarchical three-, four-, five-level models or cross-classified random effects models) are applied in meta-analysis. Second, we will illustrate how in some specific three-level meta-analyses, a more sophisticated model could have been used to deal with additional dependencies in the data. Third and last, we will describe the distribution of the characteristics of three-level meta-analyses (e.g., distribution of the number of outcomes across studies or which dependencies are typically modeled) so that future simulation studies can simulate more realistic conditions. Results showed that four- or five-level or cross-classified random effects models are not often used although they might account better for the meta-analytic data structure of the analyzed datasets. Also, we have found that the simulation studies done on multilevel meta-analysis with multiple random factors could have used more realistic simulation factor conditions. The implications of these results are discussed and further suggestions are given.

scholarly journals Daily sodium consumption and CVD mortality in the general population: systematic review and meta-analysis of prospective studies

2014 ◽  
Vol 18 (4) ◽  
pp. 695-704 ◽  
Author(s):  
Rosana Poggio ◽  
Laura Gutierrez ◽  
María G Matta ◽  
Natalia Elorriaga ◽  
Vilma Irazola ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
General Population ◽  
Prospective Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Meta Regression ◽  
Cvd Mortality

AbstractObjectiveThe purpose of the present study was to determine whether elevated dietary Na intake could be associated with CVD mortality.DesignWe performed a systematic review and meta-analysis of prospective studies representing the general population. The adjusted relative risks and their 95 % confidence intervals were pooled by the inverse variance method using random-effects models. Heterogeneity, publication bias, subgroup and meta-regression analyses were performed.SettingsMEDLINE (since 1973), Embase (since 1975), the Cochrane Library (since 1976), ISI Web of Science, Google Scholar (until September 2013) and secondary referencing were searched for inclusion in the study.SubjectEleven prospective studies with 229 785 participants and average follow-up period of 13·37 years (range 5·5–19 years).ResultsHigher Na intake was significantly associated with higher CVD mortality (relative risk=1·12; 95 % CI 1·06, 1·19). In the sensitivity analysis, the exclusion of studies with important relative weights did not significantly affect the results (relative risk=1·08; 95 % CI 1·01, 1·15). The meta-regression analysis showed that for every increase of 10 mmol/d in Na intake, CVD mortality increased significantly by 1 % (P=0·016). Age, hypertensive status and length of follow-up were also associated with increased CVD mortality.ConclusionsHigher Na intake was associated with higher CVD mortality in the general population; this result suggests a reduction in Na intake to prevent CVD mortality from any cause.

Alternative Tendon Coaptations to the Pulvertaft Weave Technique: A Systematic Review and Meta-Analysis of Biomechanical Studies

Hand ◽  
2021 ◽  
pp. 155894472110432
Author(s):  
Emily M. Graham ◽  
Jeremie D. Oliver ◽  
Russell Hendrycks ◽  
Dino Maglic ◽  
Shaun D. Mendenhall
Keyword(s):  
Systematic Review ◽  
Yield Strength ◽  
Random Effects ◽  
Meta Analysis ◽  
Dichotomous Data ◽  
Inverse Variance ◽  
Significant Difference ◽  
Alternative Techniques ◽  
Meta Analyses

Background The Pulvertaft weave technique (PT) is frequently used during tendon repairs and transfers. However, this technique is associated with limitations. In this systematic review and meta-analysis, quantitative and qualitative analyses were performed on in vitro, biomechanical studies that compared the PT with alternative techniques. Methods Articles included for qualitative and/or qualitative analysis were identified following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the meta-analysis were analyzed either as continuous data with inverse variance and random effects or as dichotomous data using a Mantel-Haenszel analysis assuming random effects to calculate an odds ratio. Results A comprehensive electronic search yielded 8 studies meeting inclusion criteria for meta-analysis. Two studies with a total of 65 tendon coaptations demonstrated no significant difference in strength between the PT and traditional side-to-side (STS) techniques ( P = .92). Two studies with a total of 43 tendon coaptations showed that the STS with 1 weave has a higher yield strength than the PT ( P = .03). Two studies with a total of 62 tendon repairs demonstrated no significant difference in strength between the PT and the step-cut (SC) techniques ( P = .70). The final 2 studies included 46 tendon repairs and demonstrated that the wrap around (WA) technique has a higher yield strength than the PT ( P < .001). Conclusions The STS, SC, and WA techniques are preferred for improving tendon form. The STS and WA techniques have superior yield strengths than the PT, and the SC technique withstands similar stress to failure as the PT.

scholarly journals Natriuretic peptide-guided treatment for heart failure: a systematic review and meta-analysis

2019 ◽  
Vol 25 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Julie McLellan ◽  
Clare R Bankhead ◽  
Jason L Oke ◽  
F D Richard Hobbs ◽  
Clare J Taylor ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Natriuretic Peptide ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Individual Outcomes ◽  
All Cause Mortality ◽  
Registration Number ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundGUIDE-IT, the largest trial to date, published in August 2017, evaluating the effectiveness of natriuretic peptide (NP)-guided treatment of heart failure (HF), was stopped early for futility on a composite outcome. However, the reported effect sizes on individual outcomes of all-cause mortality and HF admissions are potentially clinically relevant.ObjectiveThis systematic review and meta-analysis aims to combine all available trial level evidence to determine if NP-guided treatment of HF reduces all-cause mortality and HF admissions in patients with HF.Study selectionEight databases, no language restrictions, up to November 2017 were searched for all randomised controlled trials comparing NP-guided treatment versus clinical assessment alone in adult patients with HF. No language restrictions were applied. Publications were independently double screened and extracted. Fixed-effect meta-analyses were conducted.Findings89 papers were included, reporting 19 trials (4554 participants), average ages 62–80 years. Pooled risk ratio estimates for all-cause mortality (16 trials, 4063 participants) were 0.87, 95% CI 0.77 to 0.99 and 0.80, 95% CI 0.72 to 0.89 for HF admissions (11 trials, 2822 participants). Sensitivity analyses, restricted to low risk of bias, produced similar estimates, but were no longer statistically significant.ConclusionsConsidering all the evidence to date, the pooled effects suggest that NP-guided treatment is beneficial in reducing HF admissions and all-cause mortality. However, there is still insufficient high-quality evidence to make definitive recommendations on the use of NP-guided treatment in clinical practice.Trial registration numberSystematic Review Cochrane Database Number: CD008966.

Systematic Review and Meta-Analysis of Classroom-Wide Social–Emotional Interventions for Preschool Children

2020 ◽  
pp. 027112142093557 ◽  
Author(s):  
Li Luo ◽  
Brian Reichow ◽  
Patricia Snyder ◽  
Jennifer Harrington ◽  
Joy Polignano
Keyword(s):  
Systematic Review ◽  
Preschool Children ◽  
Social Competence ◽  
Random Effects ◽  
Challenging Behavior ◽  
Emotional Competence ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Social Emotional ◽  
Meta Analyses

Background: All children benefit from intentional interactions and instruction to become socially and emotionally competent. Over the past 30 years, evidence-based intervention tactics and strategies have been integrated to establish comprehensive, multitiered, or hierarchical systems of support frameworks to guide social–emotional interventions for young children. Objectives: To review systematically the efficacy of classroom-wide social–emotional interventions for improving the social, emotional, and behavioral outcomes of preschool children and to use meta-analytic techniques to identify critical study characteristics associated with obtained effect sizes. Method: Four electronic databases (i.e., Academic Search Premier, Educational Resource Information Center, PsycINFO, and Education Full Text) were systematically searched in December 2015 and updated in January 2018. “Snowball methods” were used to locate additional relevant studies. Effect size estimates were pooled using random-effects meta-analyses for three child outcomes, and moderator analyses were conducted. Results: Thirty-nine studies involving 10,646 child participants met the inclusion criteria and were included in this systematic review, with 33 studies included in the meta-analyses. Random-effects meta-analyses showed improvements in social competence ( g = 0.42, 95% confidence interval [CI] = [0.28, 0.56]) and emotional competence ( g = 0.33, 95% CI = [0.10, 0.56]), and decreases in challenging behavior ( g = −0.31, 95% CI = [−0.43, −0.19]). For social competence and challenging behavior, moderator analyses suggested interventions with a family component had statistically significant and larger effect sizes than those without a family component. Studies in which classroom teachers served as the intervention agent produced statistically significant but smaller effect sizes than when researchers or others implemented the intervention for challenging behavior. Conclusion: This systematic review and meta-analysis support using comprehensive social–emotional interventions for all children in a preschool classroom to improve their social–emotional competence and reduce challenging behavior.

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