Effect of Obesity on Survival of Women With Epithelial Ovarian Cancer: A Systematic Review and Meta-Analysis of Observational Studies

2011 ◽  
Vol 21 (9) ◽  
pp. 1525-1532 ◽  
Author(s):  
Hyun-Sik Yang ◽  
Chan Yoon ◽  
Seung-Kwon Myung ◽  
Sang Min Park
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Epithelial Ovarian Cancer ◽  
Meta Analysis ◽  
Early Adulthood ◽  
Harmful Effect ◽  
Advanced Ovarian Cancer ◽  
Final Analysis ◽  
Cochrane Central Register ◽  
Central Register

ObjectiveAlthough obesity is shown to be a risk factor for epithelial ovarian cancer, its role as a prognostic factor has been remained inconclusive. In this study, available evidences on this matter to date have been assembled for a meta-analysis to determine the effect of obesity on the survival of patients with epithelial ovarian cancer.Materials and MethodsEligible studies published up to December 2010 were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, and manual review of relevant bibliography to look for additional studies was done. Adjusted hazard ratios (HRs) from individual studies were pooled using a random-effects model.ResultsTen cohort studies of 331 screened articles were included in the final analysis. The meta-analysis showed overweight or obesity at early adulthood to be associated with higher mortality among patients with ovarian cancer (HR, 1.60; 95% confidence interval, 1.10–2.34). Among patients with advanced ovarian cancer, premorbid obesity was associated with worse prognosis (HR, 1.45; 95% confidence interval, 1.09–1.93). However, there was no significant relationship between prognosis and obesity around the time of diagnosis.ConclusionsThis study suggests a possible relationship between obesity at early adulthood and higher mortality among patients with ovarian cancer. Further studies are needed to elucidate the harmful effect of obesity on the survival of patients with ovarian cancer.

scholarly journals 1183. Effect of Chlorhexidine Bath on the Prevention of Ventilator-associated Pneumonia: A Meta-Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S424-S424
Author(s):  
Mark Jay M Robles
Keyword(s):  
Confidence Interval ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Ventilator Associated Pneumonia ◽  
Antiseptic Solution ◽  
Central Register ◽  
Before And After ◽  
Effective Product ◽  
Study Designs ◽  
Before And After Study

Abstract Background Ventilator-associated pneumonia, defined as pneumonia occurring more than 48 hours after patients have been intubated and received mechanical ventilation, represents one of the most important nosocomial infections in critically ill patients. Chlorhexidine, an antiseptic solution, is a safe and effective product with broad antiseptic activity. This meta-analysis would like to investigate if Chlorhexidine bathing significantly reduced the incidence of Ventilator-associated pneumonia. Methods We searched PubMed and Cochrane Central Register database to check for all published studies related to the reduction of VAP with the application of chlorhexidine bath vs. control. Various study designs such as randomized controlled trials, Before-and-After study were included in this meta-analysis. Results This meta-analysis analyzed eight studies. One hundred Thirty-nine (139) events developed in the chlorhexidine group over 33,030 patient-days which were significantly lower compared with 183 in the soap and water group over 35,213 patient-days. The overall incidence of Ventilator-associated Pneumonia (VAP) with the application of chlorhexidine was significantly reduced by 23% with a pooled Risk Ratio (RR) of 0.77 with 95% Confidence Interval (CI): 0.62–0.96; I2 = 52%. In the subgroup analysis, a more significant outcome was observed using Before-and-After study as the research design (pooled RR 0.63, 95% Confidence Interval (CI): 0.48–0.83, I2 = 31%). Daily chlorhexidine bath generated a more favorable outcome, compared with every other day application as evident on the pooled RR 0.78, 95% confidence interval (CI): 0.62–0.98, I2=59% Conclusion This meta-analysis clearly favors the use of daily chlorhexidine bath in the prevention of ventilator-associated pneumonia. Disclosures All authors: No reported disclosures.

Velcro Ties in Early Postoperative Pediatric Tracheostomy Care: A Systematic Review and Meta-analysis

2020 ◽  
pp. 019459982096472
Author(s):  
Brent A. Chang ◽  
Joshua Gurberg ◽  
Erin Ware ◽  
Kimberly Luu
Keyword(s):  
Meta Analysis ◽  
Prospective Trial ◽  
Final Analysis ◽  
Cochrane Central Register ◽  
Limited Data ◽  
Cochrane Database ◽  
Central Register ◽  
Significant Difference ◽  
Randomized Prospective Trial ◽  
The Difference

Objective To systematically review the literature to determine the difference in complications between standard twill and Velcro ties following pediatric tracheostomy. Data Sources MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL Plus were searched up to August 2020. Review Methods Two authors independently screened articles for eligibility. Retrospective and prospective studies were included as long as there was a direct comparison between twill and Velcro ties. Quantitative and qualitative analysis was performed. The main outcomes were skin-related complications and accidental decannulation. Results Three studies were included in the final analysis: 1 randomized prospective trial and 2 retrospective studies. There were 238 patients total (137 twill, 101 Velcro). Combined analysis showed skin-related complications in 23% of the Velcro group and 44% of the twill group. Meta-analysis for skin-related complications showed no significant difference when comparing Velcro with standard twill ties (risk ratio, 0.53 [95% CI, 0.24-1.17]; P = .12, n = 238 participants from 3 studies, I2 = 66%). Accidental decannulation rates were overall low and comparable between groups (1.0% of twill, 1.4% of Velcro). Conclusion Based on limited data, skin-related complications were not statistically different between Velcro and twill ties. Accidental decannulation is rare with Velcro and standard twill ties, and both are viable options following pediatric tracheostomy.

scholarly journals Mesothelin as a biomarker for ovarian carcinoma: a meta-analysis

2016 ◽  
Vol 88 (2) ◽  
pp. 923-932 ◽  
Author(s):  
KRISTIAN MADEIRA ◽  
EDUARDO R. DONDOSSOLA ◽  
BRUNA F. DE FARIAS ◽  
CARLA S. SIMON ◽  
MARIA C.M. ALEXANDRE ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Ovarian Tissue ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Cochrane Central Register ◽  
Central Register ◽  
Quantitative Systematic Review ◽  
Comprehensive Search ◽  
Sensitivity Specificity

The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.

Oncologic outcomes and morbidity following heated intraperitoneal chemotherapy at cytoreductive surgery for primary epithelial ovarian cancer: A systematic review and meta-analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17093-e17093 ◽  
Author(s):  
Genevieve Bouchard-Fortier ◽  
Maria Christine Cusimano ◽  
Rouhi Fazelzad ◽  
Lin Lu ◽  
Taymaa May ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Intraperitoneal Chemotherapy ◽  
Cytoreductive Surgery ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Postoperative Death ◽  
Heated Intraperitoneal Chemotherapy ◽  
Primary Epithelial Ovarian Cancer ◽  
Grade 3

e17093 Background: Heated intraperitoneal chemotherapy (HIPEC) following cytoreductive surgery in the treatment of primary epithelial ovarian cancer (EOC) after neoadjuvant chemotherapy was associated with a significant 12 months improved overall survival (OS) in a well-designed randomized controlled trial. Nonetheless, there remains uncertainty about the benefit and safety of HIPEC in ovarian cancer. The aim of this review was to assess efficacy and safety of HIPEC in primary EOC. Methods: We conducted a systematic search in Medline, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, from inception to February 22nd 2018 for observational and randomized studies of patients with primary EOC undergoing HIPEC at cytoreductive surgery with no language restrictions . We assessed risk of bias with the Institute of Health Economics Quality Appraisal Checklist for single-arm studies, and Newcastle-Ottawa Quality Scale for double-arm studies. We determined the pooled proportion of 30-day grade 3-4 morbidity, reoperation, and postoperative death. Results: Thirty-five articles including 1937 patients with primary EOC met inclusion criteria. Timing of HIPEC and type of chemotherapy regimens were not consistent between studies. There was significant variation in the reported OS of patients treated with HIPEC at cytoreductive surgery for primary EOC (3-year OS:48-77%; 5-year OS:17-72%). Thirteen articles were including in a meta-analysis to determine to the safety of HIPEC. The pooled proportions for 30-day Grade 3-4 morbidity, 30-day reoperation, and 30-day postoperative death were 33.0% (95% CI 23.0-45.0), 9.0% (95% CI 5.0-17.0) and 3.0% (95% CI 1.0-5.0) respectively. Conclusions: The use of HIPEC in primary EOC is associated with significant morbidity. There is significant heterogeneity in current literature. Higher quality, large prospective randomized control trials are needed to further support the benefit of HIPEC at cytoreductive surgery in the first-line treatment of primary EOC.

Complications and Mortality Associated with Temporary Abdominal Closure Techniques: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 83 (2) ◽  
pp. 191-216 ◽  
Author(s):  
Adam Cristaudo ◽  
Scott Jennings ◽  
Ronny Gunnarsson ◽  
Alan Decosta
Keyword(s):  
Systematic Review ◽  
Open Abdomen ◽  
Meta Analysis ◽  
Final Analysis ◽  
Fascial Closure ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Temporary Abdominal Closure ◽  
Abdominal Closure ◽  
Central Register

Temporary abdominal closure (TAC) techniques are routinely used in the open abdomen. Ideally, they should prevent evisceration, aid in removal of unwanted fluid from the peritoneal cavity, facilitate in achieving safe definitive fascial closure, as well as prevent the development of intra-abdominal complications. TAC techniques used in the open abdomen were compared with negative pressure wound therapy (NPWT) to identify which was superior. A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines involving Medline, Excerpta Medica, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Clinicaltrials.gov. All studies describing TAC technique use in the open abdomen were eligible for inclusion. Data were analyzed per TAC technique in the form of a meta-analysis. A total of 225 articles were included in the final analysis. A meta-analysis involving only randomized controlled trials showed that NPWT with continuous fascial closure was superior to NPWT alone for definitive fascial closure [mean difference (MD): 35% ± 23%; P = 0.0044]. A subsequent meta-analysis involving all included studies confirmed its superiority across outcomes for definitive fascial closure (MD: 19% ± 3%; P < 0.0001), perioperative (MD: -4.0% ± 2.4%; P = 0.0013) and in-hospital (MD: -5.0% ± 2.9%; P = 0.0013) mortality, entero-atmospheric fistula (MD: 22.0% ± 1.8%; P = 0.0041), ventral hernia (MD: -4.0% ± 2.4%; P = 0.0010), and intra-abdominal abscess (MD: -3.1% ± 2.1%; P = 0.0044). Therefore, it was concluded that NPWT with continuous fascial traction is superior to NPWT alone.

Impact of doxorubicin on survival in advanced ovarian cancer.

1995 ◽  
Vol 13 (3) ◽  
pp. 726-732 ◽  
Author(s):  
R P A'Hern ◽  
M E Gore
Keyword(s):  
Ovarian Cancer ◽  
Combination Therapy ◽  
Confidence Interval ◽  
Alkylating Agent ◽  
Standard Treatment ◽  
Meta Analysis ◽  
Advanced Ovarian Cancer ◽  
Basic Drugs ◽  
Similar Magnitude ◽  
The Impact

PURPOSE Our study examined the impact of the addition of doxorubicin to ovarian cancer regimens in general, while removing the confounding influence of other drugs. MATERIALS AND METHODS We performed an overview using the data from two large analyses, the Advanced Ovarian Cancer Trialists Group (AOCTG [Br Med J 303:884-893, 1991] and Williams et al [Seminars in Oncol 19:120-128, 1992 (suppl 2)]) and the Ovarian Cancer Meta-Analysis Project (OCMP [J Clin Oncol 9:1668-1674, 1991]). RESULTS Our data suggest that the addition of doxorubicin significantly improves survival (hazards ratio, 0.85; 95% confidence interval [CI], 0.76 to 0.95; P = .003) and that the size of this benefit is of a similar magnitude to that of platinum. CONCLUSION The implication of our results is that the basic drugs for the standard treatment of advanced ovarian should be a combination of platinum and doxorubicin. The addition of an alkylating agent may add toxicity and lead to a dose reduction of these two drugs. In view of recent data on combination therapy with paclitaxel and platinum, it would be appropriate to compare this regimen with a combination of doxorubicin and platinum.

Bleomycin-Induced Pneumonitis in the Treatment of Ovarian Sex Cord–Stromal Tumors: A Systematic Review and Meta-analysis

2015 ◽  
Vol 25 (9) ◽  
pp. 1593-1598 ◽  
Author(s):  
Nicolas Delanoy ◽  
Nicolas Pécuchet ◽  
Elizabeth Fabre ◽  
Pierre Combe ◽  
Karine Juvin ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Pulmonary Function ◽  
Meta Analysis ◽  
Standards Of Care ◽  
Cochrane Central Register ◽  
Stromal Tumors ◽  
Dose Monitoring ◽  
Central Register ◽  
Male Germ Cell Tumor ◽  
Sex Cord Stromal Tumors

ObjectiveAdult ovarian sex cord–stromal tumors (SCSTs) are a rare histological subtype of ovarian cancer associated with a favorable prognosis. Bleomycin-containing regimens are standards of care, although pneumonitis may cause potentially fatal dose-limiting toxicity. We aimed to evaluate the safety of bleomycin in SCST treatment.MethodsWe performed a systematic literature review of all studies of bleomycin therapy for SCSTs that were referenced in MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials and published from 1986 to 2014.ResultsEight studies totaling 221 patients were included. Rates of pneumonitis (7.7%; 95% confidence interval, 4.2–11.2) and mortality (1.8%; 95% confidence interval, 0.1–3.6) related to bleomycin were significant. However, these results were very similar to those reported for men who were treated with bleomycin for a male germ cell tumor, suggesting that women with ovarian SCSTs are not particularly vulnerable to bleomycin lung toxicity. The main risk factors of bleomycin-induced pneumonitis are high cumulative bleomycin dose (>400 U or mg), age older than 40 years, and impaired renal function. Whether granulocyte colony-stimulating factor is a risk factor remains controversial.ConclusionsBleomycin-induced pneumonitis frequently occurs in patients with SCSTs and lacks effective treatment. Prevention lies in limiting cumulative bleomycin dose, monitoring pulmonary function during treatment, discontinuing bleomycin at the onset of pulmonary symptoms or if pulmonary function is impaired, and avoiding bleomycin in older patients.

scholarly journals Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lajos Szakó ◽  
Nelli Farkas ◽  
Szabolcs Kiss ◽  
Szilárd Váncsa ◽  
Noémi Zádori ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Organ Failure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plasma Therapy ◽  
Monthly Basis ◽  
Randomized Controlled

Abstract Background Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. Methods A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I2, and χ2 tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. Discussion Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis.

scholarly journals A Meta-Analysis of the Efficacy of Hyaluronic Acid Eye Drops for the Treatment of Dry Eye Syndrome

2021 ◽  
Vol 18 (5) ◽  
pp. 2383
Author(s):  
Yun-Jung Yang ◽  
Won-Young Lee ◽  
Young-jin Kim ◽  
Yeon-pyo Hong
Keyword(s):  
Hyaluronic Acid ◽  
Confidence Interval ◽  
Dry Eye ◽  
Test Scores ◽  
Meta Analysis ◽  
Mean Difference ◽  
Dry Eye Syndrome ◽  
Eye Drops ◽  
Cochrane Central Register ◽  
Standard Mean Difference

Hyaluronic acid (HA) is commonly used for treating dry eye syndrome (DES). This meta-analysis was performed to compare the efficacies of HA- and non-HA-based eye drops, including saline and conventional artificial tears (ATs), for the treatment of dry eye disease. Eight databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, DBpia, KoreaMed, KMBASE, RISS, KISS) were searched for studies comparing the efficacies of HA- and non-HA-based ATs in patients with DES published up to September 2020. Two independent reviewers assessed the quality and extracted the relevant data. The mean differences of Schirmer’s (SH) test scores, tear breakup times (TBUT), corneal fluorescein staining scores (Oxford scale, 0–4), and ocular surface disease indexes were calculated. The standard mean difference and 95% confidence interval were calculated using a random effect model. Nineteen studies, including 2078 cases, were included. HA eye drops significantly improved tear production compared with non-HA-based eye drops (standard mean difference (SMD) 0.18; 95% confidence interval (CI) 0.03, 0.33). In a subgroup analysis, the SH test scores and TBUT values after using HA significantly increased compared to those measured after using saline (SMD 0.27; 95% CI 0.05, 0.49 and SMD 0.28; 95% CI 0.03, 0.52, respectively). Based on these results, HA eye drops may be superior to non-HA eye drops including normal saline and ATs. Further research is needed to assess the efficacies stratified by age, treatment duration, the severity of dry eye, and optimal dosages.

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