scholarly journals O29 IDENTIFYING PREDICTORS OF VENTRAL HERNIA RECURRENCE: SYSTEMATIC REVIEW AND META-ANALYSIS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Samuel Parker ◽  
Sue Mallet ◽  
Laura Quinn ◽  
Christopher Wood ◽  
Richard Boulton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ventral Hernia ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Current Evidence ◽  
Future Research ◽  
Chronic Obstructive ◽  
Co Morbidity ◽  
Current Evidence Base

Abstract Aim Ventral hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence. Material and Methods PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool). Results Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III–IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence. Conclusions This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research.

scholarly journals Identifying predictors of ventral hernia recurrence: systematic review and meta-analysis

BJS Open ◽  
2021 ◽  
Vol 5 (2) ◽  
Author(s):  
S G Parker ◽  
S . Mallett ◽  
L Quinn ◽  
C P J Wood ◽  
R W Boulton ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ventral Hernia ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Hernia Recurrence ◽  
Current Evidence ◽  
Future Research ◽  
Chronic Obstructive ◽  
Co Morbidity ◽  
Current Evidence Base

Abstract Background Ventra hernias are increasing in prevalence and many recur despite attempted repair. To date, much of the literature is underpowered and divergent. As a result there is limited high quality evidence to inform surgeons succinctly which perioperative variables influence postoperative recurrence. This systematic review aimed to identify predictors of ventral hernia recurrence. Methods PubMed was searched for studies reporting prognostic data of ventral hernia recurrence between 1 January 1995 and 1 January 2018. Extracted data described hernia type (primary/incisional), definitions of recurrence, methods used to detect recurrence, duration of follow-up, and co-morbidity. Data were extracted for all potential predictors, estimates and thresholds described. Random-effects meta-analysis was used. Bias was assessed with a modified PROBAST (Prediction model Risk Of Bias ASsessment Tool). Results Screening of 18 214 abstracts yielded 274 individual studies for inclusion. Hernia recurrence was defined in 66 studies (24.1 per cent), using 41 different unstandardized definitions. Three patient variables (female sex, age 65 years or less, and BMI greater than 25, 30, 35 or 40 kg/m2), five patient co-morbidities (smoking, diabetes, chronic obstructive pulmonary disease, ASA grade III–IV, steroid use), two hernia-related variables (incisional/primary, recurrent/primary), six intraoperative variables (biological mesh, bridged repair, open versus laparoscopic surgery, suture versus mesh repair, onlay/retrorectus, intraperitoneal/retrorectus), and six postoperative variables (any complication, surgical-site occurrence, wound infection, seroma, haematoma, wound dehiscence) were identified as significant prognostic factors for hernia recurrence. Conclusion This study summarized the current evidence base for predicting ventral hernia recurrence. Results should inform best practice and future research.

Exercise therapy for whiplash-associated disorders: a systematic review and meta-analysis

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Bruno Chrcanovic ◽  
Johan Larsson ◽  
Eva-Maj Malmström ◽  
Hans Westergren ◽  
Birgitta Häggman-Henrikson
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Exercise Therapy ◽  
Full Text ◽  
Meta Analysis ◽  
Current Evidence ◽  
Positive Effects ◽  
Current Evidence Base ◽  
Whiplash Associated Disorders ◽  
Neck Disability

Abstract Objectives Acute as well as chronic pain syndromes are common after whiplash trauma and exercise therapy is proposed as one possible intervention strategy. The aim of the present systematic review was to evaluate the effect of exercise therapy in patients with Whiplash-Associated Disorders for the improvement of neck pain and neck disability, compared with other therapeutic interventions, placebo interventions, no treatment, or waiting list. Content The review was registered in Prospero (CRD42017060356) and conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A literature search in PubMed, Scopus and Cochrane from inception until January 13, 2020 was combined with a hand search to identify eligible randomized controlled studies. Abstract screening, full text assessment and risk of bias assessment (Cochrane RoB 2.0) were conducted by two independent reviewers. Summary The search identified 4,103 articles. After removal of duplicates, screening of 2,921 abstracts and full text assessment of 100 articles, 27 articles that reported data for 2,127 patients were included. The included articles evaluated the effect of exercise therapy on neck pain, neck disability or other outcome measures and indicated some positive effects from exercise, but many studies lacked control groups not receiving active treatment. Studies on exercise that could be included in the random-effect meta-analysis showed significant short-term effects on neck pain and medium-term effects on neck disability. Outlook Despite a large number of articles published in the area of exercise therapy and Whiplash-Associated Disorders, the current evidence base is weak. The results from the present review with meta-analysis suggests that exercise therapy may provide additional effect for improvement of neck pain and disability in patients with Whiplash-Associated Disorders.

scholarly journals Microplastic contamination of salt intended for human consumption: a systematic review and meta-analysis

2020 ◽  
Vol 2 (12) ◽  
Author(s):  
Evangelos Danopoulos ◽  
Lauren Jenner ◽  
Maureen Twiddy ◽  
Jeanette M. Rotchell
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Future Research ◽  
Human Consumption ◽  
Inclusion Criteria ◽  
Research Findings ◽  
Human Health Effects ◽  
Potential Human Health

Abstract Microplastics (MPs) are an emerging contaminant ubiquitous in the environment. There is growing concern regarding potential human health effects, a major human exposure route being dietary uptake. We have undertaken a systematic review (SR) and meta-analysis to identify all relevant research on MP contamination of salt intended for human consumption. Three thousand nine hundred and nineteen papers were identified, with ten fitting the inclusion criteria. A search of the databases MEDLINE, EMBASE and Web of Science, from launch date to September 2020, was conducted. MP contamination of salt varied significantly between four origins, sea salt 0–1674 MPs/kg, lake salt 8–462 MPs/kg, rock and well salt 0–204 MPs/kg. The majority of samples were found to be contaminated by MPs. Corresponding potential human exposures are estimated to be 0–6110 MPs per year (for all origins), confirming salt as a carrier of MPs. A bespoke risk of bias (RoB) assessment tool was used to appraise the quality of the studies, with studies demonstrating moderate to low RoB. These results suggest that a series of recurring issues need to be addressed in future research regarding sampling, analysis and reporting to improve confidence in research findings.

scholarly journals A Systematic Review and Meta-Analysis of Buyang Huanwu Decoction in Animal Model of Focal Cerebral Ischemia

2013 ◽  
Vol 2013 ◽  
pp. 1-13 ◽  
Author(s):  
Rui-li Wei ◽  
Hai-juan Teng ◽  
Bo Yin ◽  
Yang Xu ◽  
Yue Du ◽  
...  
Keyword(s):  
Systematic Review ◽  
Focal Cerebral Ischemia ◽  
Meta Analysis ◽  
Cell Types ◽  
Experimental Stroke ◽  
Current Evidence ◽  
Future Research ◽  
Neuroprotective Effects ◽  
Buyang Huanwu Decoction ◽  
Therapy Strategy

Buyang Huanwu Decoction (BHD) is a well-known Chinese herbal prescription for ischemic stroke. The objective of this systematic review and meta-analysis is to provide the current evidence for neuroprotective effects of BHD and its possible mechanisms in animal models of focal ischemia. A systematic literature search, through October 2012, was performed using six databases. The outcome measures assessed were infarct size and/or neurological score. Fifty-six studies with 1270 animals that met the inclusion criteria were identified. The median score for methodological quality was 3 with a range of 2 to 6. Compared with vehicle or no treatment controls, BHD gave a 37% improvement in outcome for all doses ranging from 1.0 g/kg to 60 g/kg at each time point that BHD was administered (P<0.01). Efficacy was higher in mouse models that utilized suture occlusion and temporary ischemia. The neuroprotective effects of BHD are involved in multiple mechanisms and act upon multiple cell types. In conclusion, BHD possesses substantial neuroprotective effects in experimental stroke probably as a result of the multitarget therapy strategy typically utilized in traditional Chinese medicine. Future research should examine the presence of possible experimental bias and an in-depth study of herbal compound preparations.

scholarly journals Coronavirus Disease 2019 and Gastrointestinal Involvement: A Systematic Review

Medicinus ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 62
Author(s):  
Moryella Monica ◽  
Andree Kurniawan
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Intestinal Flora ◽  
Gastrointestinal Symptoms ◽  
Good Evidence ◽  
World Health ◽  
Current Evidence ◽  
Future Research ◽  
Gastrointestinal Involvement

<p><strong>Introduction: </strong>The World Health Organization (WHO) announced the Coronavirus 2019 (COVID-19) as a Public Health Emergency of International Concern (PHEIC) toward the end of January 2020. There is still limited evidence to explain the gastrointestinal involvement in COVID-19. In this study, we aimed to further investigate current evidence describing the gastrointestinal involvement in COVID-19 patients.</p><p><strong>Methods: </strong>This systematic review has been registered in PROSPERO (CRD42020181584). A systematic search of literature for observational and randomized controlled trial was conducted in PubMed, PubMed central, and Google Scholar through April 16, 2020. Two reviewers independently searched and selected. The risk of bias was evaluated using the Newcastle-Ottawa Quality assessment tool.<strong> </strong></p><p><strong>Results: </strong>A total of 1,480 articles were screened from which 12 articles with 5584 subjects were selected. SARS-CoV-2 can invade human body by binding to angiotensin converting enzyme 2 (ACE-2) receptor which also located to small intestinal epithelial cells, crypt cells and colon. The virus itself may cause disorders of the intestinal flora. The diagnosis should be based on a set of symptoms diarrhoea, nausea, vomiting, abdominal discomfort or pain, combined with positivity of faecal PCR test. Treatment of COVID-19 mainly is supportive care. The probiotic may modulate the gut microbiota to alter the gastrointestinal symptoms and reduced enteritis, ventilator associated pneumonia, and reverse certain side effect of antibiotics<strong>.</strong></p><p><strong>Conclusion: </strong>Our synthesis of literature showed that there was no good evidence yet in overall area of gastrointestinal manifestations in COVID-19. Future research is needed to explore all areas, especially in mechanism and treatments</p>

scholarly journals Can we predict the severe course of COVID-19 – a systematic review and meta-analysis of indicators of clinical outcome?

2020 ◽  
Author(s):  
Stephan Katzenschlager ◽  
Alexandra J. Zimmer ◽  
Claudius Gottschalk ◽  
Juergen Grafeneder ◽  
Alexander Seitel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cerebrovascular Disease ◽  
Odds Ratio ◽  
Clinical Decision Making ◽  
Troponin I ◽  
Assessment Tool ◽  
Meta Analysis ◽  
Icu Admission ◽  
Co Morbidity

AbstractBackgroundCOVID-19 has been reported in over 40million people globally with variable clinical outcomes. In this systematic review and meta-analysis, we assessed demographic, laboratory and clinical indicators as predictors for severe courses of COVID-19.MethodsWe systematically searched multiple databases (PubMed, Web of Science Core Collection, MedRvix and bioRvix) for publications from December 2019 to May 31st 2020. Random-effects meta-analyses were used to calculate pooled odds ratios and differences of medians between (1) patients admitted to ICU versus non-ICU patients and (2) patients who died versus those who survived. We adapted an existing Cochrane risk-of-bias assessment tool for outcome studies.ResultsOf 6,702 unique citations, we included 88 articles with 69,762 patients. There was concern for bias across all articles included. Age was strongly associated with mortality with a difference of medians (DoM) of 13.15 years (95% confidence interval (CI) 11.37 to 14.94) between those who died and those who survived. We found a clinically relevant difference between non-survivors and survivors for C-reactive protein (CRP; DoM 69.10, CI 50.43 to 87.77), lactate dehydrogenase (LDH; DoM 189.49, CI 155.00 to 223.98), cardiac troponin I (cTnI; DoM 21.88, CI 9.78 to 33.99) and D-Dimer (DoM 1.29mg/L, CI 0.9 - 1.69). Furthermore, cerebrovascular disease was the co-morbidity most strongly associated with mortality (Odds Ratio 3.45, CI 2.42 to 4.91) and ICU admission (Odds Ratio 5.88, CI 2.35 to 14.73).DiscussionThis comprehensive meta-analysis found age, cerebrovascular disease, CRP, LDH and cTnI to be the most important risk-factors in predicting severe COVID-19 outcomes and will inform decision analytical tools to support clinical decision-making.SummaryIn this systematic review we meta-analyzed 88 articles for risk factors of ICU admission and mortality in COVID-19. We found age, cerebrovascular disease, CRP, LDH and cTnI are the most important risk-factors for ICU admission or mortality.

Music Making Interventions with Adults in the Forensic Setting – A Systematic Review of the Literature – Part II: Case Studies and Good vibrations

2015 ◽  
Vol 7 (4) ◽  
pp. 50
Author(s):  
Biljana V. Coutinho ◽  
Anita L. Hansen ◽  
Leif Waage ◽  
Thomas K. Hillecke ◽  
Julian Koenig
Keyword(s):  
Systematic Review ◽  
Music Therapy ◽  
Case Studies ◽  
Meta Analysis ◽  
Current Evidence ◽  
Future Research ◽  
Music Making ◽  
Prisma Statement ◽  
Forensic Setting ◽  
Set Up

The purpose of this systematic review of international research is to summarize the available literature on active music making interventions with adult offenders in forensic settings (i.e. forensic psychiatry or correctional facilities at different security levels). A systematic search of 13 electronic databases according to the Preferred Reporting Items for Systematic Reviews and Meta- Analysis (PRISMA) statement was employed. 28 articles fitting the inclusion criteria were included in the review. The search revealed mainly qualitative and narrative reports including articles on group music therapy, educational music making, choir interventions, individual music therapy sessions and musical projects. The musical interventions are described in detail to provide therapists with ideas on how to set up session with clients who may be in this particular situation and to help them understand the possible impact of musical interventions in the forensic setting. Furthermore, implications from the current evidence and ideas for future research are discussed. Note: Due to the length of the review it is published in two subsequent issues. This is the second part of the review focusing on case studies and the Good Vibrations program. The first part of the review was published in the previous issue of Music and Medicine focusing on group interventions.

A Systematic Review of the Qualitative Evidence for the Use of Lifestyle Planning in People with Learning Disabilities

1999 ◽  
Vol 3 (3) ◽  
pp. 148-158 ◽  
Author(s):  
D. Rowe ◽  
A. Rudkin
Keyword(s):  
Systematic Review ◽  
Learning Disabilities ◽  
Planning Process ◽  
Evidence Base ◽  
Outcome Data ◽  
Current Evidence ◽  
Future Research ◽  
Eligibility Criteria ◽  
Qualitative Evidence ◽  
Current Evidence Base

Lifestyle planning (LP) for people with learning disabilities is largely supported by qualitative rather than quantitative research. LP is a time-consuming and potentially resource-intensive area of practice which is becoming more prevalent in the UK. We present the first systematic review of the qualitative evidence base for the use of LP in people with learning disabilities. Such evidence concerns the special characteristics of LP and its outcomes in descriptive rather than quantitative terms. Qualitative research is usually aimed at enhancing validity by grounding theory in data collected. Twenty-one studies passed eligibility criteria for inclusion in this review, but only ten provided any outcome data, the others being concerned with process only. A replicable search strategy was employed and the resulting original data sources were critically reviewed with respect to major concepts and categories in the areas of: planning process, choices and preferences, ethics and outcomes. Explicitly person-centred approaches such as essential lifestyle planning are contrasted with more service-led methods such as individual programme planning. There are major methodological limitations in much of the available literature and suggestions for future research to clarify matters are made. The current evidence base suggests that no form of LP has significantly better outcomes than any other form and that it is not clear if LP in general enhances outcomes. Ongoing use of person centred planning in particular is informed by ethical considerations and is evolving in its structure and function.

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