scholarly journals Evolution of Stage 1 Twin-to-Twin Transfusion Syndrome (TTTS): Systematic Review and Meta-Analysis

2016 ◽  
Vol 19 (3) ◽  
pp. 207-216 ◽  
Author(s):  
Asma Khalil ◽  
Emily Cooper ◽  
Rosemary Townsend ◽  
Basky Thilaganathan
Keyword(s):  
Laser Surgery ◽  
Case Reports ◽  
Meta Analysis ◽  
Survival Rates ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Definitive Answer ◽  
Registration Number ◽  
The Cochrane Library ◽  
Stage 1

Objectives: The natural history of stage 1 Twin-to-twin transfusion syndrome (TTTS) remains unclear and its optimal management is yet to be established. The main aims of this meta-analysis were to quantify the incidence of progression in stage 1 TTTS and to ascertain survival in these pregnancies.Methods: MEDLINE, EMBASE, and The Cochrane Library were searched. Reference lists within each article were hand-searched for additional reports. The outcomes included incidence of progression and survival in stage 1 TTTS. Randomized controlled trials, cohort and case-control studies were included. Case reports, studies including three or fewer cases of stage 1 TTTS, and editorials were excluded. Proportion meta-analysis was used for analysis (Registration number: CRD42016036190).Results: The search yielded 3,085 citations; 18 studies were included in the review (172 pregnancies to assess progression and 433 pregnancies to assess the survival). The pooled incidence of progression in stage 1 TTTS was 27% [95% CI 16–39%]. The pooled overall survival, double survival and at least one survival in the pregnancies managed expectantly were 79% [95% CI 62–92%], 70% [95% CI 54–84%] and 87% [95% CI 69–98%], respectively. In those undergoing amnioreduction, the corresponding figures were 77% [95% CI 68–85%], 67% [95% CI 57–76%] and 86% [95% CI 76–94%], respectively. The survival rates were 68% [95% CI 54–81%], 54% [95% CI 36–72%], and 81% [95% CI 69–90%], when laser surgery was performed.Conclusions: The optimal initial management of stage 1 TTTS remains in equipoise. The ongoing randomized trial comparing immediate laser surgery versus conservative management should provide a definitive answer.

scholarly journals Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xuefeng Ma ◽  
Shousheng Liu ◽  
Jie Zhang ◽  
Mengzhen Dong ◽  
Yifen Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Method ◽  
Case Reports ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Hepatic Inflammation ◽  
Normal Alt ◽  
Study Type ◽  
The Cochrane Library

Abstract Background: ALT value is often used to reflect the hepatic inflammation and injury in NAFLD patients, but many studies proved that ALT values were normal in many NAFLD patients. The aim of this study was to identify the summarized proportion of NAFLD patients with normal ALT value in the overall NAFLD patients. Methods: Electronic databases PubMed, EMBASE, Ovid, and the Cochrane Library were searched for potential studies published from January 1, 2000 to September 30, 2019. Studies that have reported the number of NAFLD or NASH patients with normal and abnormal ALT value were included and analyzed. Abstracts, reviews, case reports, and letters were excluded. Results: A total of 11 studies with 4084 patients were included for assessing the summarized proportion of NAFLD patients with normal ALT in overall NAFLD patients. As the results shown, the summarized proportion of NAFLD patients with normal ALT value in overall NAFLD patients was 25% (95%CI: 20%-31%) which was calculated by the random-effects model. The summarized proportion of NASH patients with normal ALT value in overall NASH patients was 19% (95%CI: 13%-27%). Subgroup analysis includes region, study type, diagnostic method, and group size were conducted to investigate the resource of heterogeneity in the summarized proportion of NAFLD and NASH patients with normal ALT value. Conclusions: 25% NAFLD patients and 19% NASH patients possess the normal ALT value in the clinical manifestation. The value of ALT in the clinical diagnosis of NAFLD and NASH remains need be further testified.

Risk of Suicide Mortality Among Cancer Patients: A Meta-Analysis of Observational Studies

2017 ◽  
Vol 41 (S1) ◽  
pp. S290-S291 ◽  
Author(s):  
R. Calati ◽  
V. Di Mattei ◽  
P. Courtet
Keyword(s):  
Suicide Risk ◽  
Meta Analysis ◽  
Suicide Mortality ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Patients With Cancer ◽  
Competing Interest ◽  
Trim And Fill ◽  
Meta Analyses ◽  
The Cochrane Library

IntroductionSuicide rates among patients with cancer are higher than ones in the general population.ObjectiveThis meta-analysis aims to estimate the suicide risk in patients with cancer.MethodsWe searched Medline, PsycINFO, and the Cochrane library to identify articles published before July 1, 2016, examining the association between suicide [death (SD), attempt (SA), ideation (SI)] and any form of diagnosed cancer.ResultsWe initially identified 4880 records and after unsuitable studies were removed, our search yielded 102 publications of which 14 were used in the meta-analyses. Patients with cancer had higher risk of SD (seven studies, 247.869 participants; odds ratio [OR] = 1.52, 95% CI = 1.22–1.89, P = 0.0002) compared with those without cancer (among case-control studies focused on SD versus living controls). Among studies focused on SD versus other deaths, patients with cancer had higher risk of SD (two studies, 23.839 participants; OR = 1.53, 95% CI = 1.03–2.27, P = 0.03). No difference has been detected for risk of SA (four studies, 8.147.762 participants) and for SI (two studies, 37.879 participants).Since publication bias was detected, the “trim and fill” method was applied. The majority of the included studies have a high quality at the STROBE statement.ConclusionThe assessment of suicide risk in this population is crucial.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals TLR9 Rs352140 polymorphism contributes to a decreased risk of bacterial meningitis: evidence from a meta-analysis

2020 ◽  
Vol 148 ◽  
Author(s):  
Haiyi Xue ◽  
Huan Peng ◽  
Jiaoming Li ◽  
Mingming Li ◽  
Song Lu
Keyword(s):  
Bacterial Meningitis ◽  
Genetic Model ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Cochrane Library ◽  
Case Control Studies ◽  
China National Knowledge Infrastructure ◽  
Knowledge Infrastructure ◽  
Increased Risk ◽  
The Cochrane Library

Abstract Some studies have suggested that the Toll-like receptor 9 polymorphism (TLR9 rs352140) is closely related to the risk of bacterial meningitis (BM), but this is subject to controversy. This study set out to estimate whether the TLR9 rs352140 polymorphism confers an increased risk of BM. Relevant literature databases were searched including PubMed, Embase, the Cochrane Library and China National Knowledge Infrastructure (CNKI) up to August 2020. Seven case-control studies from four publications were enrolled in the present meta-analysis. Odds ratios (OR) and confidence intervals (95% CI) were calculated to estimate associations between BM risk and the target polymorphism. Significant associations identified were allele contrast (A vs. G: OR 0.66, 95% CI 0.59–0.75, P = 0.000), homozygote comparison (AA vs. AG/GG: OR 0.62, 95% CI 0.49–0.78, P = 0.000), heterozygote comparison (A vs. G: OR 0.74, 95% CI 0.61–0.91, P = 0.005), recessive genetic model (AA vs. AG/GG: OR 0.78, 95% CI 0.65–0.93, P = 0.006) and dominant genetic model (AA vs. AG/GG: OR 0.70, 95% CI 0.57–0.85, P = 0.000). The findings indicate that, in contrast to some studies, the TLR9 rs352140 polymorphism is associated with a decreased risk for BM.

scholarly journals Nephrotoxicity in patients with solid tumors treated with anti-PD-1/PD-L1 monoclonal antibodies: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Han Li ◽  
Jinsheng Xu ◽  
Yaling Bai ◽  
Shenglei Zhang ◽  
Meijuan Cheng ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Solid Tumors ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Programmed Death ◽  
Registration Number ◽  
Programmed Death 1 ◽  
The Cochrane Library

SummaryBackground Programmed death-1 (PD-1) and programmed death ligand 1 (PD-L1) have dramatically improved cancer therapy for many patients. Adverse kidney effects have been found to be an important complication but have unclear mechanisms. Methods We searched Embase, PubMed, and the Cochrane Library to identify potential eligible studies. All included studies were randomized controlled trials (RCTs) examining patients with solid tumors treated with anti-PD-1/PD-L1 monoclonal antibodies (mAbs) and/or chemotherapy. The relative risk (RR) was used to assess the risk of nephrotoxic events. Results We included 27 clinical trials (15,063 patients). Compared with chemotherapy, the RR of all-grade nephritis was significantly increased with anti-PD-1/PD-L1 mAbs (RR = 2.77, 95% CI: 1.09–6.99, P = 0.03). Furthermore, anti-PD-1/PD-L1 mAbs plus chemotherapy can significantly increase the RR of all-grade nephritis (RR = 2.99, 95% CI: 1.07–8.35, P = 0.04). There was also a significant increase in the RRs of all-grade increased blood creatinine (RR = 1.88, 95% CI: 1.24–2.86, P = 0.003) and acute kidney injury (AKI) (RR =3.35, 95% CI: 1.48–7.60, P = 0.004). Conclusions Anti-PD-1/PD-L1 mAbs can significantly increase nephrotoxicity in patients with solid tumors, especially when combined with chemotherapy. During the application of these drugs, we should remain aware of nephrotoxicity for better efficacy. Trial registration number and date of registration Not applicable.

scholarly journals Prevalence of post-traumatic stress symptoms among people influenced by coronavirus disease 2019 outbreak: A meta-analysis

2021 ◽  
Vol 64 (1) ◽  
Author(s):  
Dan Qiu ◽  
Yilu Li ◽  
Ling Li ◽  
Jun He ◽  
Feiyun Ouyang ◽  
...  
Keyword(s):  
Sample Size ◽  
Traumatic Stress ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Post Traumatic Stress ◽  
Stress Symptoms ◽  
Pooled Prevalence ◽  
Registration Number ◽  
Post Traumatic ◽  
The Cochrane Library

Abstract Background As one of the most widely researched consequence of traumatic events, the prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from coronavirus disease 2019 (COVID-19) outbreak varies greatly across studies. This review aimed at examining the pooled prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from COVID-19 outbreak. Methods Systematic searches of databases were conducted for literature published on PubMed, EMBASE, Web of Science, the Cochrane Library, PsycArticle, and Chinese National Knowledge Infrastructure until October 14, 2020. Statistical analyses were performed using R software (PROSPERO registration number: CRD42020180309). Results A total of 106,713 people exposed to the trauma resulting from the COVID-19 outbreak were identified in the 76 articles, of which 33,810 were reported with post-traumatic stress symptoms. The pooled prevalence of post-traumatic stress symptoms among people exposed to the trauma resulting from COVID-19 outbreak was 28.34%, with a 95% confidence interval of 23.03-34.32%. Subgroup analysis indicated that older age, male and bigger sample size were associated with higher prevalence of post-traumatic stress symptoms. After controlling for other factors, the results of meta-regression showed that the influence of gender and sample size on prevalence is no longer significant. Conclusions Symptoms of post-traumatic stress disorder (PTSD) were very common among people exposed to the trauma resulting from COVID-19 outbreak. Further research is needed to explore more possible risk factors for post-traumatic stress symptoms and identify effective strategies for preventing PTSD-related symptoms among people exposed to the trauma resulting from COVID-19 outbreak.

scholarly journals Serum Homocysteine Levels in Men with and without Erectile Dysfunction: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Andrea Sansone ◽  
Angelo Cignarelli ◽  
Massimiliano Sansone ◽  
Francesco Romanelli ◽  
Giovanni Corona ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Serum Homocysteine ◽  
Registration Number ◽  
The Cochrane Library ◽  
Time Restriction ◽  
Random Effect Models

Objectives. Elevated levels of serum homocysteine (Hcy) have been associated with cardiovascular diseases and endothelial dysfunction, conditions closely associated with erectile dysfunction (ED). This meta-analysis was aimed to assess serum Hcy levels in subjects with ED compared to controls in order to clarify the role of Hcy in the pathogenesis of ED. Methods. Medline, Embase, and the Cochrane Library were searched for publications investigating the possible association between ED and Hcy. Results were restricted by language, but no time restriction was applied. Standardized mean difference (SMD) was obtained by random effect models. Results. A total of 9 studies were included in the analysis with a total of 1320 subjects (489 subjects with ED; 831 subjects without ED). Pooled estimate was in favor of increased Hcy in subjects with ED with a SMD of 1.00, 95% CI 0.65–1.35, p<0.0001. Subgroup analysis based on prevalence of diabetes showed significantly higher SMD in subjects without diabetes (1.34 (95% CI 1.08–1.60)) compared to subjects with diabetes (0.68 (95% CI 0.39–0.97), p<0.0025 versus subgroup w/o diabetes). Conclusions. Results from our meta-analysis suggest that increased levels of serum Hcy are more often observed in subjects with ED; however, increase in Hcy is less evident in diabetic compared to nondiabetic subjects. This study is registered with Prospero registration number CRD42018087558.

scholarly journals The utility of Ki-67 as a prognostic biomarker in pulmonary neuroendocrine tumours: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e031531 ◽  
Author(s):  
Salma Naheed ◽  
Chloe Holden ◽  
Lulu Tanno ◽  
Eleanor Jaynes ◽  
Judith Cave ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neuroendocrine Tumours ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Ki 67 ◽  
Ethical Approval ◽  
Registration Number ◽  
Academic Review ◽  
Reliable Marker ◽  
The Cochrane Library

IntroductionThe omission of the immunohistochemical proliferation marker Ki-67 labelling index (henceforth, simply Ki-67) from the 2015 WHO classification system of pulmonary neuroendocrine tumours (Lung-NETs) as a prognostic and grading criterion remains controversial. This systematic review along with meta-analysis will be conducted to assess the prognostic/grading utility of Ki-67 in Lung-NETs.MethodsThis systematic review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A systematic search of MEDLINE Ovid, Embase, Scopus and the Cochrane Library will be performed from the inception of each database to 28 February 2019 for studies investigating any role of Ki-67 in Lung-NETs. Only full papers published in English detailing survival outcomes and HRs according to Ki-67 will be included. The primary endpoint will be establishing whether Ki-67 is a reliable marker in determining prognosis and thus assessing grade of Lung-NETs patients.Ethics and disseminationEthical approval will not be required as this is an academic review of published literature. Findings will be disseminated through the preparation of a manuscript for publication in a peer-reviewed journal as well as presentation at national and international conferences.PROSPERO registration numberCRD42018093389

scholarly journals Analgesic effects of erector spinae plane block for patients after breast surgery: a systematic review and meta-analysis

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199956
Author(s):  
Hui-fang Li ◽  
Qi-hong Shen ◽  
Xu-yan Zhou ◽  
Xu Shen
Keyword(s):  
Breast Surgery ◽  
Meta Analysis ◽  
Opioid Consumption ◽  
Erector Spinae ◽  
Cochrane Library ◽  
Control Value ◽  
Analgesic Effects ◽  
Erector Spinae Plane Block ◽  
Registration Number ◽  
The Cochrane Library

Objective This meta-analysis investigated the analgesic effects of erector spinae plane block (ESPB) in patients undergoing breast surgery. Methods PubMed, Embase, Web of Science, and the Cochrane Library were searched from database establishment to January 31, 2020. Two reviewers independently extracted the data. The primary outcomes were pain scores and opioid consumption during the first 24 hours after surgery. The risk of bias of the included studies was assessed according to the Cochrane Handbook. Results Six randomized controlled trials of 415 patients were included. Compared with the control value, the pain score was significantly lower in the ESPB group at different time points postoperatively. Patients who underwent ESPB required lower opioid consumption (standardized mean difference = −2.02, 95% confidence interval [CI] = −2.85 to −1.20, I2= 91%. The rates of postoperative nausea (risk ratio [RR] = 0.79, 95% CI = 0.48–1.30, I2 = 47%) and postoperative vomiting (RR = 0.76, 95% CI = 0.30–1.96, I2 = 33%) did not differ between the groups. The quality of evidence was low or very low. Conclusions ESPB significantly alleviated pain and reduced opioid consumption after breast surgery. Further research is needed to expand its clinical application. PROSPERO registration number CRD42020167900

Meta-analysis of alcohol consumption and venous thromboembolism

2021 ◽  
Author(s):  
Xingxia Zhang ◽  
Xinrong Chen ◽  
Jie Yang ◽  
Liang Du ◽  
Yong Zhou ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Reference List ◽  
Case Control Studies ◽  
The Difference ◽  
Moderate Alcohol Intake ◽  
The Cochrane Library

Abstract Background The associations of alcohol consumption and venous thromboembolism (VTE) have been investigated widely, but the conclusions were inconsistent. Objective To summarize the relationship of alcohol consumption and VTE. Methods This study has been registered in PROSPERO (ID: CRD42020164567). We searched the PubMed, Embase, Web of Science and the Cochrane Library databases from inception to September 2019 and reviewed the reference list of relevant articles to identify studies assessing the association between alcohol consumption and risk of VTE. Results Fourteen cohorts and four case-control studies were included in the meta-analysis. Compared with non-drinkers, the risk of VTE was decreased (RR: 0.93; 95% confidence interval [CI] 0.88–0.99) for alcohol drinkers. The pooled RRs of VTE were 0.91 (95% CI 0.84–0.99) for low to moderate alcohol intake (0.1–14.0 drinks/week) and 0.91 (95% CI 0.78–1.06) for high alcohol intake (&gt;14.0 drinks/week) compared with non-drinker. Subgroup analysis showed liquor intake might slightly increase the risk of VTE (1.01; 95% CI 0.85–1.21) although the difference was not significant. Conclusions Alcohol consumption in low to moderate was associated with a lower risk of VTE. However, precautions are needed when providing personal drinking advice considering the potential harm of alcohol. Further studies are warranted to determine whether moderate alcohol consumption has a causal role in VTE.

scholarly journals Treatment of Laryngoceles: What Is the Progress over the Last Two Decades?

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Karol Zelenik ◽  
Lucia Stanikova ◽  
Katarina Smatanova ◽  
Michal Cerny ◽  
Pavel Kominek
Keyword(s):  
Case Reports ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Demographic Data ◽  
Surgical Techniques ◽  
Case Series ◽  
Cochrane Library ◽  
External Approach ◽  
Randomized Controlled ◽  
The Cochrane Library

Objectives. To review surgical techniques used in the treatment of laryngoceles over the last two decades and point out developments and trends.Materials and Methods. PubMed, the Cochrane Library, and the JBI Library of Systematic Reviews were searched using the term “laryngocele.” Demographic data, type of laryngocele, presence of a laryngopyocele, type of treatment and need for a tracheotomy were assessed.Results. Overall, data on 86 patients were analyzed, culled from 50 articles, of which 41 were case reports and 9 were case series. No single systematic review or meta-analysis or randomized controlled trial has been published on the topic. Altogether, 71 laryngoceles in 63 patients met the criteria for further analysis focusing on surgical treatment. An external approach was selected in 25/29 (86.2%) cases of combined laryngoceles. Microlaryngoscopic resection using a CO2laser was performed in three cases and endoscopic robotic surgery in one case. The majority of patients with an internal laryngocele, 31/42 (73.8%), were treated using the microlaryngoscopy approach.Conclusions. Microlaryngoscopy involving the use of a CO2laser has become the main therapeutic procedure for the treatment of internal laryngoceles during the past 20 years. An external approach still remains the main therapeutic approach for the treatment of combined laryngoceles.

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