EP.WE.824Effect of bariatric surgery on gut permeability in humans: a systematic review

Abstract Aims Altered intestinal permeability (“leaky gut”) is associated with obesity. Several mechanisms have been suggested to explain the harmful sequalae that follow permeability change such as inflammation, alteration to the microbiome and onset of insulin resistance. Studies describe bariatric surgery as having varying effects on intestinal permeability. We aim to summarise and review the literature. Methods A systematic review was performed using MEDLINE, EMBASE, and Scopus to identify studies in humans that investigated permeability change after bariatric surgery. Results 5 studies were identified, all cohort. Heterogeneity precluded meta-analysis. All calculated permeability change following oral intake of different sugar solutions. Two studies described a reduction in gastroduodenal permeability post sleeve gastrectomy (SG), one from an increased baseline compared to lean controls. Two described an increase in small intestinal permeability after “malabsorptive” operations (biliopancreatic diversion and duodenal switch). Two found decreased small intestinal permeability at one month post Roux-en-Y gastric bypass and six months post SG. One including only SG had opposite findings of increased small intestinal permeability at 6 months. The only colonic change reported was increased permeability also 6 months post SG. Conclusion Research found both increased and decreased permeability of the small intestine. Two studies found reduced gastroduodenal permeability post operatively. Evidence regarding the effect of bariatric surgery on the permeability of the gastrointestinal tract and specifically the colon is limited and follow up, operation type and small numbers limit meaningful comparison. Further study into this crucial aspect of obesity both before and after surgery is needed.

Download Full-text

The Changes in Cervical Biomechanics After CTDR and Its Association With Heterotopic Ossification: A Systematic Review and Meta-analysis

Global Spine Journal ◽

10.1177/2192568220922949 ◽

2020 ◽

pp. 219256822092294

Author(s):

Nicholas Hui ◽

Kevin Phan ◽

Mei-Yi Lee ◽

Jack Kerferd ◽

Telvinderjit Singh ◽

...

Keyword(s):

Systematic Review ◽

Heterotopic Ossification ◽

Meta Analysis ◽

Total Disc Replacement ◽

Final Analysis ◽

Spinal Segment ◽

Functional Spinal Unit ◽

Before And After ◽

Cadaver Studies

Study Design: A systematic review and meta-analysis. Objectives: Cervical total disc replacement (CTDR) can preserve range of motion (ROM) of the operated spinal segment in cadaver studies. Evidence is less clear in clinical trials. The present study aims to investigate the differences in cervical biomechanics before and after CTDR and its association with heterotopic ossification (HO) development. Method: Articles that reported the rate of HO and ≥1 difference in cervical biomechanics were included in quantitative analyses. We pooled the mean difference (MD) of cervical biomechanics before and after CTDR. Subgroup analyses and metaregression analyses were conducted to identify potential contributors to heterogeneity. Results: Of the 599 studies screened, 35 studies were included in the final analysis. In comparison with preoperative values, ROM of the spinal segment inferior (MD: 0.38; 95% CI: 0.02 to 0.74) and superior (MD: 0.43; 95% CI: 0.12 to 0.75) to the surgical spinal segment, functional spinal unit (FSU) angle (MD: 2.23; 95% CI: 1.11 to 3.35), and C2/C7 Cobb angle (MD: 3.49; 95% CI: 1.73 to 5.25) significantly increased after CTDR. In contrast, FSU and cervical ROM at baseline were no different from follow-up. On multivariable meta-regression analyses, HO and ROM-limiting HO were not associated with changes in cervical biomechanics. Single-level CTDR and duration of follow-up were associated with changes in cervical biomechanics. Conclusion: Our study reported the pooled mean of biomechanics at baseline and final follow-up and their differences. The changes in biomechanics were not associated with the rates of HO and ROM-limiting HO.

Download Full-text

Are digital technology interventions effective to reduce loneliness in older adults? A systematic review and meta-analysis

10.1101/2020.08.27.20183012 ◽

2020 ◽

Cited By ~ 1

Author(s):

Syed Ghulam Sarwar Shah ◽

David Nogueras ◽

Hugo Cornelis van Woerden ◽

Vasiliki Kiparoglou

Keyword(s):

Systematic Review ◽

Older Adults ◽

Clinical Trials ◽

English Language ◽

Data Extraction ◽

Meta Analysis ◽

Future Research ◽

Before And After ◽

Quasi Experimental

Objective: To review the latest literature on the effectiveness of DTIs in reducing loneliness in (older) adults. Data Sources: Electronic searches in PubMed, Medline, CINAHL, EMBASE and Web of Science covering publication period from 1 January 2010 to 31 July 2019. Subjects: Adult men and women Design: Systematic review and meta-analysis Main Outcome Measure: Loneliness. Study Selection: Primary studies that used DTIs for tackling loneliness in adults (aged ≥18 years) with follow-up measurements at least three months or more and publication in the English language. Data Extraction and Synthesis: Two researchers independently screened articles and extracted data on several variables: participants, interventions, comparators and outcomes. Data was extracted on the primary outcome i.e. loneliness measured at the baseline and follow-up measurements at three, four, six and twelve months after the intervention. Results: Six studies were selected from 4939 articles screened. Selected studies included 5 clinical trials (4 RCTs and 1 quasi experimental study) and one before and after study, which enrolled 646 participants (men =154 (24%), women =427 (66%), no gender information =65 (10%) with average age between 73 and 78 years (SD 6-11). Five clinical trials were included in the meta-analysis and standardised mean differences (SMD) were calculated for each trial and pooled across studies using a random effects model. The overall effect estimates were not statistically significant in follow-up measurements at three months (SMD= 0.02, 95% CI= -0.36, 0.40; P=0.92), four months (SMDs= -1.11, 95% CI= -2.60, 0.38; P=0.14) and six months (SMD= -0.11, 95% CI= -0.54, 0.32; P=0.61). The quality of evidence was very low to moderate in these trials. Conclusions: There is insufficient evidence to make conclusions that DTIs are effective in reducing loneliness in older adults. Future research may consider RCTs with larger sample sizes and longer duration of interventions and follow-up.

Download Full-text

Prognosis of Regenerative Endodontic Procedures in Mature Teeth: A Systematic Review and Meta-Analysis of Clinical and Radiographic Parameters

Materials ◽

10.3390/ma14164418 ◽

2021 ◽

Vol 14 (16) ◽

pp. 4418

Author(s):

Pantaleo Scelza ◽

Fabiano Gonçalves ◽

Isleine Caldas ◽

Fernanda Nunes ◽

Emanuelle Stellet Lourenço ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Periapical Lesion ◽

Immature Teeth ◽

Radiographic Parameters ◽

Sensitivity Tests ◽

High Incidence ◽

Before And After ◽

Meta Analyses

This work aimed to investigate the use of Regenerative Endodontic Procedures (REP) on the treatment of pulp necrosis in mature teeth through systematic review and meta-analysis of evidence on clinical and radiographic parameters before and after REP. A search was performed in different databases on 9 September 2020, including seven clinical studies and randomized controlled trials (RCT). The methodological quality was assessed using Revised Cochrane risk-of-bias (RoB 2) and Before-and-After tools. Meta-analyses were performed to evaluate the success incidences regarding the reduction of periapical lesion and recovery of sensitivity. The certainty of the evidence was assessed using GRADE. Meta-analysis showed a high overall success of 0.95 (0.92, 0.98) I2 = 6%, with high periapical lesion reduction at 12 months (0.93 (0.86, 0.96) I2 = 37%) and by the end of follow-up (0.91 (0.83, 0.96) I2 = 13%). Lower incidences of positive sensitivity response were identified for the electrical (0.58 (0.46, 0.70) I2 = 51%) and cold tests (0.70 (0.54, 0.84) I2 = 68%). The calculated levels of REP success were similar to those reported for immature teeth. With a very low certainty of evidence, the meta-analysis showed a high incidence of REP’s success for mature teeth with necrotic pulp evidenced by periapical lesion reduction and moderate positive responses to sensitivity tests.

Download Full-text

Alcohol use disorders before and after bariatric surgery: a systematic review and meta-analysis

Annals of Translational Medicine ◽

10.21037/atm.2018.03.16 ◽

2018 ◽

Vol 6 (8) ◽

pp. 148-148 ◽

Cited By ~ 12

Author(s):

Hamza Azam ◽

Sara Shahrestani ◽

Kevin Phan

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Alcohol Use ◽

Meta Analysis ◽

Alcohol Use Disorders ◽

Before And After

Download Full-text

Effect of exercise training before and after bariatric surgery: A systematic review and meta‐analysis

Obesity Reviews ◽

10.1111/obr.13296 ◽

2021 ◽

Author(s):

Alice Bellicha ◽

Marleen A. Baak ◽

Francesca Battista ◽

Kristine Beaulieu ◽

John E. Blundell ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Exercise Training ◽

Meta Analysis ◽

Before And After

Download Full-text

Comparison of Efficacy among Three Radiofrequency Ablation Techniques for Treating Knee Osteoarthritis: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147424 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7424

Author(s):

Shih-Hsiang Chou ◽

Po-Chih Shen ◽

Cheng-Chang Lu ◽

Zi-Miao Liu ◽

Yin-Chun Tien ◽

...

Keyword(s):

Systematic Review ◽

Radiofrequency Ablation ◽

Knee Osteoarthritis ◽

Baseline Level ◽

Meta Analysis ◽

Cochrane Library ◽

Invasive Treatment ◽

Knee Oa ◽

Before And After

Radiofrequency ablation (RFA) was first introduced for treating knee osteoarthritis (OA) in 2010 and has emerged as a minimally invasive treatment option. Three RFA techniques have been adopted for treating knee OA, including conventional, pulsed, and cooled RFA. However, the efficacy among different RFA techniques in the treatment of knee OA is still unclear. Three electronic databases were systematically searched for relevant articles, including PubMed, Embase, and Cochrane Library. A meta-analysis of articles that investigated the use of RFA techniques in the treatment of knee OA was conducted to pool the effect size in pain before and after treatment. A total of 20 eligible articles (including 605 patients) were included for our meta-analysis. After treatment, the patients had significant improvements in pain for all three RFA techniques when compared with the baseline level for the 1, 3-, and 6-month follow-ups (p < 0.00001). However, there were no significant differences in the efficacy among the three RFA techniques for all follow-up visits (p > 0.05). The three RFA techniques demonstrated a significant improvement in pain for up to 6 months after treatment. Comparing the efficacy of the three RFA techniques in the treatment of knee OA, our results showed that no significant differences in pain relief among the three RFA techniques were observed at the 1-, 3-, 6, and 12-month follow-up visits.

Download Full-text

Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: A Systematic Review and Meta-Analysis of 917 Patients with a Minimum of Three Years Follow-Up

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2017.07.672 ◽

2017 ◽

Vol 225 (4) ◽

pp. e57

Author(s):

Saeed Shoar ◽

Catherine Wong ◽

Jun L. Levine ◽

Zhamak Khorgami

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Meta Analysis ◽

Morbidly Obese ◽

Term Outcome ◽

Long Term Outcome ◽

Obese Adolescents

Download Full-text

Is Adherence to Follow-Up After Bariatric Surgery Necessary? A Systematic Review and Meta-Analysis

Obesity Surgery ◽

10.1007/s11695-021-05857-1 ◽

2022 ◽

Author(s):

Beata M. M. Reiber ◽

Rosalie Barendregt ◽

Ralph de Vries ◽

Sjoerd C. Bruin ◽

Donald L. van der Peet

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Weight Loss ◽

Gastric Bypass ◽

Full Text ◽

Laparoscopic Gastric Bypass ◽

Meta Analysis ◽

Gastric Sleeve ◽

Current Form

AbstractThe association of adherence to follow-up (FU) after laparoscopic gastric bypass — and gastric sleeve with weight loss (WL) is unclear. The aim of this study was to evaluate this association. Fourteen full text articles were included in the systematic review. Eight studies were included in the meta-analysis concerning FU up to 3 years postoperatively and 3 for the FU between 3 and 10 years postoperatively. Results showed a significant association between adherence to FU 0.5 to 3 years postoperatively and percentage excess WL (%EWL) but did not demonstrate a significant association between FU > 3 years postoperatively and total WL (%TWL). In conclusion, adherence to FU may not be associated with WL and therefore stringent lifelong FU in its current form should be evaluated.

Download Full-text