Initiation of Enteral Feeding After Necrotizing Enterocolitis

2017 ◽  
Vol 28 (01) ◽  
pp. 044-050 ◽  
Author(s):  
Hiromu Miyake ◽  
Yuhki Koike ◽  
Shogo Seo ◽  
Alison Hock ◽  
Yong Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Necrotizing Enterocolitis ◽  
Enteral Feeding ◽  
Meta Analysis ◽  
Analysis Data ◽  
Adverse Outcomes ◽  
Antibiotic Administration ◽  
Recurrence Rates ◽  
Feeding Groups ◽  
Prisma Statement

Introduction Management of necrotizing enterocolitis (NEC) consists of cessation of enteral feeding, intravenous antibiotic administration, and supportive treatment. There is no evidence-based recommendation regarding when to restart feeding after a NEC episode. We performed a systematic review and meta-analysis to examine the effect of timing of enteral feeding reinitiation on NEC recurrence. Methods MEDLINE, Embase, Google scholar, and Cochrane databases were searched. Human studies evaluating enteral feeding timing with a primary outcome of NEC recurrence were included. A total of 2,257 titles or abstracts were screened, and 47 full-text articles were analyzed. A systematic review and meta-analysis comparing NEC recurrence and other associated outcomes between early (<5 days after NEC diagnosis) and delayed (>5 days) initiation of enteral feeding after NEC were performed according to the PRISMA statement. The meta-analysis data were analyzed using RevMan 5.3 to estimate odds ratios (ORs) with 95% confidence intervals (CIs). Results Two retrospective observational studies met the inclusion criteria, comprising 56 cases in which enteral feeding was started early and 35 cases of delayed enteral feeding initiation. There were no randomized controlled trials (RCTs). The recurrence rates of NEC were unchanged between early (5.4%) and delayed (8.6%) enteral feeding groups (pooled OR = 0.61; 95% CI: 0.12–3.16; p = 0.56; I 2 = 0%). Catheter-related sepsis (pooled OR = 0.20; 95% CI: 0.01–3.29; p = 0.26; I 2 = 67%) and post-NEC stricture (pooled OR = 0.28; 95% CI: 0.07–1.18; p = 0.08; I 2 = 23%) rates were not different between early and delayed enteral feeding groups. Conclusion Initiating early enteral feeding, within 5 days of NEC diagnosis, is not associated with adverse outcomes, including NEC recurrence. In addition, catheter-related sepsis and post-NEC stricture rates were unchanged between early and delayed enteral feeding groups after NEC. However, the quality of the evidence from the review of literature is suboptimal. A further RCT is needed to confirm these results.

scholarly journals Earlier re-initiation of enteral feeding after necrotizing enterocolitis decreases recurrence or stricture: a systematic review and meta-analysis

2020 ◽  
Vol 40 (11) ◽  
pp. 1679-1687
Author(s):  
Ekta U. Patel ◽  
Dulaney A. Wilson ◽  
Emily A. Brennan ◽  
Aaron P. Lesher ◽  
Rita M. Ryan
Keyword(s):  
Systematic Review ◽  
Necrotizing Enterocolitis ◽  
Enteral Feeding ◽  
Meta Analysis

scholarly journals COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (7) ◽  
pp. 3554
Author(s):  
Kai Wei Lee ◽  
Sook Fan Yap ◽  
Yun Fong Ngeow ◽  
Munn Sann Lye
Keyword(s):  
Systematic Review ◽  
Laboratory Testing ◽  
Meta Analysis ◽  
Clinical Signs ◽  
Adverse Outcomes ◽  
People Living With Hiv ◽  
Common Symptom ◽  
Chest Imaging ◽  
Wide Range ◽  
Epidemiological Characteristics

COVID-19 is a global health emergency. People living with human immunodeficiency virus (PLHIV) have concerns about whether they have a higher risk of getting the infection and suffer worse COVID-19 outcomes. Findings from studies on these questions have largely been inconsistent. We aimed to determine the epidemiological characteristics, clinical signs and symptoms, blood parameters, and clinical outcomes among PLHIV who contracted COVID-19. Relevant studies were identified through Medline, Cinahl, and PubMed databases. A random-effects model was used in meta-analyses with a 95% confidence interval. Eighty-two studies were included in the systematic review and sixty-seven studies for the meta-analysis. The pooled incidence proportion of COVID-19 among PLHIV was 0.9% (95% CI 0.6%, 1.1%) based on the data from seven cohort studies. Overall, 28.4% were hospitalised, of whom, 2.5% was severe-critical cases and 3.5% needed intensive care. The overall mortality rate was 5.3%. Hypertension was the most commonly reported comorbidity (24.0%). Fever (71.1%) was the most common symptom. Chest imaging demonstrated a wide range of abnormal findings encompassing common changes such as ground glass opacities and consolidation as well as a spectrum of less common abnormalities. Laboratory testing of inflammation markers showed that C-reactive protein, ferritin, and interleukin-6 were frequently elevated, albeit to different extents. Clinical features as well as the results of chest imaging and laboratory testing were similar in highly active antiretroviral therapy (HAART)-treated and non-treated patients. PLHIV were not found to be at higher risk for adverse outcomes of COVID-19. Hence, in COVID-19 management, it appears that they can be treated the same way as HIV negative individuals. Nevertheless, as the pandemic situation is rapidly evolving, more evidence may be needed to arrive at definitive recommendations.

scholarly journals Serum albumin concentrations are associated with disease severity and outcomes in coronavirus 19 disease (COVID-19): a systematic review and meta-analysis

2021 ◽  
Author(s):  
Panagiotis Paliogiannis ◽  
Arduino Aleksander Mangoni ◽  
Michela Cangemi ◽  
Alessandro Giuseppe Fois ◽  
Ciriaco Carru ◽  
...  
Keyword(s):  
Systematic Review ◽  
Serum Albumin ◽  
Disease Severity ◽  
Meta Analysis ◽  
Severe Disease ◽  
Geographic Area ◽  
Adverse Outcomes ◽  
Poor Outcome ◽  
Standard Mean Difference ◽  
Meta Regression Analysis

AbstractCoronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the most threatening pandemic in modern history. The aim of this systematic review and meta-analysis was to investigate the associations between serum albumin concentrations and COVID-19 disease severity and adverse outcomes. A systematic literature search was conducted in PubMed, from inception to October 30, 2020. Sixty-seven studies in 19,760 COVID-19 patients (6141 with severe disease or poor outcome) were selected for analysis. Pooled results showed that serum albumin concentrations were significantly lower in patients with severe disease or poor outcome (standard mean difference, SMD: − 0.99 g/L; 95% CI, − 1.11 to − 0.88, p < 0.001). In multivariate meta-regression analysis, age (t =  − 2.13, p = 0.043), publication geographic area (t = 2.16, p = 0.040), white blood cell count (t =  − 2.77, p = 0.008) and C-reactive protein (t =  − 2.43, p = 0.019) were significant contributors of between-study variance. Therefore, lower serum albumin concentrations are significantly associated with disease severity and adverse outcomes in COVID-19 patients. The assessment of serum albumin concentrations might assist with early risk stratification and selection of appropriate care pathways in this group.

447 What Age is Best to Perform Myringoplasty?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Wilks ◽  
R Mcleod ◽  
V Unadkat
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Cochrane Library ◽  
Clear Correlation ◽  
Success Rates ◽  
Prisma Statement ◽  
Transitional Point ◽  
The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

scholarly journals Children Born with Congenital Heart Defects and Growth Restriction at Birth: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (9) ◽  
pp. 3056 ◽  
Author(s):  
Ali Ghanchi ◽  
Neil Derridj ◽  
Damien Bonnet ◽  
Nathalie Bertille ◽  
Laurent J. Salomon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Congenital Heart Defects ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Congenital Heart ◽  
Heart Defects ◽  
Data Extraction ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Growth Restriction

Newborns with congenital heart defects tend to have a higher risk of growth restriction, which can be an independent risk factor for adverse outcomes. To date, a systematic review of the relation between congenital heart defects (CHD) and growth restriction at birth, most commonly estimated by its imperfect proxy small for gestational age (SGA), has not been conducted. Objective: To conduct a systematic review and meta-analysis to estimate the proportion of children born with CHD that are small for gestational age (SGA). Methods: The search was carried out from inception until 31 March 2019 on Pubmed and Embase databases. Studies were screened and selected by two independent reviewers who used a predetermined data extraction form to obtain data from studies. Bias was assessed using the Critical Appraisal Skills Programme (CASP) checklist. The database search identified 1783 potentially relevant publications, of which 38 studies were found to be relevant to the study question. A total of 18 studies contained sufficient data for a meta-analysis, which was done using a random effects model. Results: The pooled proportion of SGA in all CHD was 20% (95% CI 16%–24%) and 14% (95% CI 13%–16%) for isolated CHD. Proportion of SGA varied across different CHD ranging from 30% (95% CI 24%–37%) for Tetralogy of Fallot to 12% (95% CI 7%–18%) for isolated atrial septal defect. The majority of studies included in the meta-analysis were population-based studies published after 2010. Conclusion: The overall proportion of SGA in all CHD was 2-fold higher whereas for isolated CHD, 1.4-fold higher than the expected proportion in the general population. Although few studies have looked at SGA for different subtypes of CHD, the observed variability of SGA by subtypes suggests that growth restriction at birth in CHD may be due to different pathophysiological mechanisms.

scholarly journals Efficacy and safety of instantaneous wave-free ratio in patients undergoing coronary revascularisation: protocol for a systematic review

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017868
Author(s):  
Joey S.W. Kwong ◽  
Sheyu Li ◽  
Wan-Jie Gu ◽  
Hao Chen ◽  
Chao Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Coronary Revascularisation ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Collection Form ◽  
Randomised Controlled ◽  
Meta Analyses

IntroductionEffective selection of coronary lesions for revascularisation is pivotal in the management of symptoms and adverse outcomes in patients with coronary artery disease. Recently, instantaneous ‘wave-free’ ratio (iFR) has been proposed as a new diagnostic index for assessing the severity of coronary stenoses without the need of pharmacological vasodilation. Evidence of the effectiveness of iFR-guided revascularisation is emerging and a systematic review is warranted.Methods and analysisThis is a protocol for a systematic review of randomised controlled trials and controlled observational studies. Electronic sources including MEDLINE via Ovid, Embase, Cochrane databases and ClinicalTrials.gov will be searched for potentially eligible studies investigating the effects of iFR-guided strategy in patients undergoing coronary revascularisation. Studies will be selected against transparent eligibility criteria and data will be extracted using a prestandardised data collection form by two independent authors. Risk of bias in included studies and overall quality of evidence will be assessed using validated methodological tools. Meta-analysis will be performed using the Review Manager software. Our systematic review will be performed according to the guidance from the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Ethics and disseminationEthics approval is not required. Results of the systematic review will be disseminated as conference proceedings and peer-reviewed journal publication.Trial registration numberThis protocol is registered in the International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42017065460.

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