The effect of 0.01% atropine on ocular axial elongation for myopia children: a meta-analysis

2021 ◽  
Author(s):  
Yan Yu ◽  
Jiasu Liu

Objectives: This meta-analysis aimed to identify the therapeutic effect of 0.01% atropine with on ocular axial elongation for myopia children. Methods: We searched PubMed, Cochrane Library, and CBM databases from inception to July 2021. Meta-analysis was conducted using STATA version 14.0 and Review Manager version 5.3 softwares. We calculated the weighted mean differences(WMD) to analyze the change of ocular axial length (AL) between orthokeratology combined with 0.01% atropine (OKA) and orthokeratology (OA) alone. The Cochran's Q-statistic and I2 test were used to evaluate potential heterogeneity between studies. To evaluate the influence of single studies on the overall estimate, a sensitivity analysis was performed. We also performed sub group and meta-regression analyses to investigate potential sources of heterogeneity. We conducted Begger's funnel plots and Egger's linear regression tests to investigate publication bias. Results: Nine studies that met all inclusion criteria were included in this meta-analysis. A total of 191 children in OKA group and 196 children in OK group were assessed. The pooled summary WMD of AL change was -0.90(95%CI=-1.25~-0.55) with statistical significance(t=-5.03, p<0.01), which indicated there was obvious difference between OKA and OK in myopic children. Subgroup analysis also showed that OKA treatment resulted in significantly less axial elongation compared to OK treatment alone according to SER. We found no evidence for publication bias. Conclusions:  Our meta-analysis indicates 0.01% atropine atropine is effective in slowing axial elongation in myopia children with orthokeratology.

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Runqing Li ◽  
Junjie Liu ◽  
Yushan Li ◽  
Quanxian Wang

Abstract Background Published studies have shown contradictory results regarding the relationship between somatometric parameters and varicoceles. We performed a systematic review and meta-analysis to investigate the possible effects of age, height, weight, and body mass index (BMI) on the presence and severity of varicoceles. Methods Databases including EMBASE, MEDLINE, PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Web of Science, and Google Scholar were systematically searched to identify relevant articles published up to March 2020. Two researchers independently identified eligible articles and extracted data. Cochran’s Q statistic and I2 statistics were used to assess heterogeneity. Meta-analysis was performed using StataSE 12.0 software (StataCorp LP, USA). Random-effects models were used to obtain the weighted mean differences (WMDs) and 95% confidence intervals (CIs). Publication bias was assessed using Begg’s funnel plot and Egger’s regression test. Results The search strategy produced 272 articles, of which 18 articles were eligible according to the inclusion/exclusion criteria. A total of 56,325 patients with varicocele and 1,334,694 patients without varicocele were included in the meta-analysis to evaluate the effect of somatometric parameters on the presence and severity of varicocele. The overall results demonstrated that the presence of varicoceles was significantly associated with height (WMD = 1.41, 95% CI = 1.07 to 1.74, P < 0.001) and inversely correlated with BMI (WMD = − 1.35, 95% CI = -1.67 to − 1.03, P < 0.001) but not with age (WMD = -0.93, 95% CI = -2.19 to 0.33, P = 0.149) or weight (WMD = 0.24, 95% CI = -2.24 to 2.72, P = 0.850). The severity of varicocele was inversely correlated with increased BMI but not with age. Conclusion The presence of varicoceles was significantly associated with height and inversely correlated with BMI.


Author(s):  
Mariana Feijó ◽  
Roberta V L Martins ◽  
Sílvia Socorro ◽  
Luísa Pereira ◽  
Sara Correia

Abstract Endocrine-disrupting chemicals have become an issue of scientific and public discussion. Vinclozolin (VNZ) is a fungicide that competitively antagonizes the binding of natural androgens to their receptor, disturbing the function of tissues that are sensitive to these hormones, as is the case of the male reproductive organs. A systematic review with meta-analyses of rodent studies was conducted to answer the following question: Does exposure to VNZ affect sperm parameters and testicular/epididymal weight? The methodology was prespecified according to the Cochrane Handbook for Systematic Reviews and PRISMA recommendations. Sixteen articles met the inclusion criteria, comprising a total of 1189 animals. The risk of publication bias was assessed using the Trim and Fill adjustment, funnel plot, and Egger regression test. Heterogeneity and inconsistency across the findings were tested using the Q-statistic and I2 of Higgins, respectively. Sensitivity was also analyzed. Statistical analysis was performed on Comprehensive Meta-Analysis software (Version 2.0), using random models and weighted mean differences along with a 95% confidence interval. Sperm motility, counts, daily sperm production (evidence of publication bias), and epididymis weight were decreased in VNZ-treated animals. Exposure length and dose, as well as the time point of exposure, influenced the obtained results. Despite the moderate/high heterogeneity observed, the sensitivity analysis overall demonstrated the robustness of the findings. The quality scores of the included studies were superior to 4 in a total of 9, then classified as good. The obtained data corroborate the capability of VNZ exposure to disrupt spermatogenic output and compromise male fertility.


2020 ◽  
Author(s):  
Amer Alsaied ◽  
Nazmul Islam ◽  
Lukman Thalib

Abstract Background: Necrotizing Enterocolitis (NEC) is a major cause of morbidity and mortality in the Neonatal Intensive Care Unit (NICU), yet the global incidence of NEC has not been systematically evaluated. We conducted a systematic review and meta-analysis of cohort studies reporting the incidence of NEC in infants with Very Low Birth Weight (VLBW).Methods: The databases searched included PubMed, MEDLINE, the Cochrane Library, EMBASE and grey literature. Eligible studies were cohort or population-based studies of newborns including registry data reporting incidence of NEC. Data were extracted from the selected papers included incidence of NEC cases and size of population at risk, author and publication details, follow up period covered by the study, location and setting of the study and whether it was VLBW infants or preterm infants. Additionally, risk of bias assessment of the included studies were carried out using a validated tool. Bias adjusted Quality Effect Model (QEM) were used to pool the estimates. In the presence of substantial heterogeneity, Random Effect Models (REM) were used as an additionally sensitivity analyses. The heterogeneity between studies were evaluated using the Cochrane Q statistics and Higgin’s I2 value. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. Funnel plots as appropriate for ratio measures were used to assess publication bias. Results: A systematic and comprehensive search of databases identified 27 cohort studies reporting the incidence of NEC. The pooled estimate of the global incidence of NEC was 6.0% (95% CI: 4.0%-9.0%). There were substantial heterogeneity (I2 = 100%) between studies. Funnel plots showed no evidence of publication bias.Conclusion: Seven out of 100 of all VLBW infants in NICU are likely to develop NEC. However, there were considerable heterogeneity between studies. High quality studies assessing incidence of NEC along with associated risk factors are warranted.


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261092
Author(s):  
Hua Feng ◽  
Xiujuan Xiong ◽  
Zhuo Chen ◽  
Qunying Xu ◽  
Zhongwei Zhang ◽  
...  

Background To determine the prevalence of food allergy (FA) and factors associated with these occurrences in different populations from different regions. Materials and methods The literature search will be conducted via Pubmed, Embase, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Vip and Wanfang databases. Ratio rate (RR), odds ratio (OR) and 95% confidence intervals (CIs) will be adopted to evaluate prevalence and factors for FA in different populations from different regions. When the heterogeneity is small (I2<50%), the fixed effect model will be analyzed, otherwise, random effects model analysis will be performed. When the heterogeneity is large (I2≥50%), Meta regression will be used to explore the sources of inter-study heterogeneity. When the heterogeneity is large (I2≥50%) and the results are statistically significant (P<0.05), subgroup analysis will be analyzed based on age, gender, race/region, literature quality and other factors. Funnel plots will be used to reflect reporting bias and the Begg’s test will be used to test the symmetry of the funnel plots. When publication bias occurs, “cut-and-fill” method will be adopted to adjust publication bias. And sensitivity analysis will be performed for all outcome indicators. Discussion This meta-analysis will evaluate the prevalence of FA and factors associated with these occurrences in different populations from different regions on the basis of existing evidences. Our study may be crucial to analyze similarities and differences regarding FA between different individuals from diverse regions and eventually define preventive or diagnostic approaches specifically tailored to certain populations and regions. Systematic review registration OSF registration number: 10.17605/OSF.IO/VQXU9


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chenting Hou ◽  
Hui Li ◽  
Jiangfeng Li ◽  
Jinjian Li ◽  
Hui Peng ◽  
...  

Abstract Background To compare the postoperative safety, efficacy, predictability, visual quality and biomechanics after implantation of Artisan vs. Artiflex phakic intraocular lenses (PIOLs). Methods Pubmed, Embase, Cochrane Library were conducted up from January 2000 to February 2020. Comparative clinical studies reporting in accordance with the eligibility criteria were included in this meta-analysis. The pooled weighted mean differences (WMDs) and odds ratios (ORs) with corresponding 95% confidence intervals were calculated. Results Comparative trials with myopia patients were selected in this review. The pooled WMD and OR estimates statistical significance in terms of postoperative best corrected visual acuity (BCVA), efficacy, postoperative spherical equivalence (SE), predictability, contrast sensitivity and mean intraocular higher-order aberrations (HOA) (mm) for a 6-mm pupil, manifesting that Artiflex PIOL showed evident beneficial effect for correcting myopia compared to Artisan PIOL. There was no significant difference in the incidence of complications between the two groups. Conclusion Both of two techniques were safe and effective for myopia and compared to Artisan PIOL, Artiflex PIOL had significant improvement in efficacy, predictability, contrast sensitivityand HOA, except safety and complications in the treatment of moderate to high myopia.


2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Haizhen Lu ◽  
Chengwen Zheng ◽  
Yanmei Zhong ◽  
Linhao Cheng ◽  
Yi Zhou

Background. Hyperemesis gravidarum (HG) is a common gastrointestinal disease afflicting gravidas. It usually results in hospital admission in early pregnancy. Objective. Through a meta-analysis, this study intended to explore acupuncture’s clinical efficacy in treating HG. Materials and Methods. A comprehensive search of PubMed, the Cochrane Library, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang Database, and China Science and Technology Journal (VIP) for published clinical randomized controlled trials (RCTs) of acupuncture for treating HG was conducted from the date of database creation to 20th January 2021. We also searched grey literature in four databases: Chinese Cochrane Center, Chinese Clinical Trial Registry, GreyNet International, and Open Grey from their inception to 20th January 2021. Two authors independently screened the literature, extracted data, and evaluated the quality of the literature with Cochrane Handbook 5.1.0 and Review Manager 5.2 software. Review Manager 5.2 and STATA 12.0 software were applied to analyze data. Heterogeneity analysis was performed by the Cochran Chi-square test and I2 statistic. Egger’s tests together with funnel plots were used to identify publication bias. Results. A total of 16 trials covering 1043 gravidas were included. Compared with the conventional treatment, acupuncture had a significantly higher effective rate (OR: 8.11, 95% CI: 5.29∼12.43; P < 0.00001 ), a higher conversion rate of urine ketone (RR: 1.36, 95% CI: 1.15∼1.60; P = 0.0003 ), an improvement rate of nausea and vomiting (OR: 26.44, 95% CI: 3.54∼197.31; P = 0.001 ), and a relatively higher improvement rate of food intake (RR: 1.17, 95% CI: 1.01∼1.36; P = 0.04 ). Acupuncture also shortened hospitalization time and manifested with a lower pregnancy termination rate and fewer adverse events. Nevertheless, no statistical variation in the improvement of nausea intensity, vomiting episodes, and lassitude symptom, recurrence rate, and serum potassium was observed. Conclusion. Our study suggested that acupuncture was effective in treating HG. However, as the potential inferior quality and underlying publication bias were found in the included studies, there is a need for more superior-quality RCTs to examine their effectiveness and safety. PROSPERO registration number: CRD42021232187.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Tracey J McGaughey ◽  
Emily A Fletcher ◽  
Sachin A Shah

Introduction: New evidence suggests central systolic blood pressure (cSBP) is a superior predictor of adverse cardiovascular outcomes as compared to peripheral systolic blood pressure (pSBP). Additionally, augmentation index (AI) provides a surrogate assessment of vascular stiffness. We performed a meta-analysis to assess the impact of antihypertensive drug classes on cSBP and AI. METHODS: Search terms related to blood pressure and AI were used to identify relevant articles in PubMed, Cochrane Library and CINAHL limited to randomized trials in humans and publications in English. Appropriate data on cSBP, pSBP and AI were extracted along with other study characteristics. Weighted mean differences (WMD) between the pSBP and cSBP with 95% confidence intervals (CI) were calculated using the DerSimonian-Laird random-effects methodology. For AI, the WMD from baseline was determined. Further, the data was sorted by antihypertensive class (angiotensin converting enzyme inhibitors (ACE-Is), angiotensin II receptor blockers (ARBs), beta-blockers (BBs), calcium channel blockers (CCBs) and diuretics) to determine their impact on cSBP and AI. Subgroup analyses were performed to assess robustness of results by limiting to the fixed-effects model, a primary diagnosis of hypertension, and excluding studies with JADAD scores < 3. Publication bias was assessed using the Egger’s statistic and visual inspection of funnel plots. Statistical heterogeneity was assessed using the I2 statistic. RESULTS: Fifty-one and 58 studies incorporating 4381 and 3716 unique subjects were included for cSBP and AI respectively. Overall, antihypertensives reduced pSBP more than cSBP (2.52mmHg, 95%CI 1.35 to 3.69; I2 =21.9%). ACE-Is, ARBs, CCBs and diuretics reduced cSBP and pSBP in a similar manner (-2.40mmHg, 95%CI -4.89 to 0.08; 1.12mmHg, 95%CI -2.25 to 4.49; 1.01mmHg, 95%CI -2.17 to 4.19; 0.65mmHg, 95%CI -2.47 to 3.77 respectively). BBs posed a significantly greater reduction in pSBP as compared to cSBP (5.19mmHg, 95%CI 3.21 to 7.18). The change in AI from baseline was (-3.09, 95%CI -3.90 to -2.28; I2 =84.5%). A significant reduction in AI was seen with ACE-Is, ARBs, CCB and diuretics (-5.61, 95%CI -6.95 to -4.27; -5.28, 95%CI -8.61 to -1.95; -5.36, 95%CI -6.95 to -3.77; -3.24, 95%CI -5.45 to -1.03 respectively). BBs reduced AI non-significantly (-0.32, 95% CI -1.48 to 0.84). While the Egger’s statistic showed a lack of publication bias (p>0.125), it cannot be ruled out based on visual inspection of funnel plots. CONCLUSIONS: BBs are not as beneficial in reducing cSBP as opposed to ACE-Is, ARBs, CCBs and diuretics. In contrast, ACE-Is, ARBs, CCBs and diuretics significantly reduce AI, which is not evident with BB therapy. The views expressed in this material are those of the author(s), and do not reflect the official policy or position of the U.S. Government, the Department of Defense, or the Department of the Air Force.


2020 ◽  
Author(s):  
Amer Alsaied ◽  
Nazmul Islam ◽  
Lukman Thalib

Abstract Background: Necrotizing Enterocolitis (NEC) is a major source of morbidity and mortality in the Neonatal Intensive Care Unit (NICU), yet the global incidence is not systematically evaluated. We conducted a systematic review and Meta-Analysis of cohort studies reporting the incidence of NEC in infants with Very Low Birth Weight (VLBW).Methods: The databases searched included PubMed, MEDLINE, the Cochrane Library, EMBASE and grey literature. Eligible studies were cohort or population-based studies of newborns including registry data reporting incidence of NEC. Data were extracted from the selected papers and variables extracted included author and publication details, time period covered by the study, location and setting of the study and whether it was VLBW infants or preterm infants, incidence or number on NEC cases and size of population at risk were extracted from the selected papers. Additionally, risk of bias assessment of the included studies were carried out using a validated tool. Bias adjusted Quality Effect Model (QEM) were used to pool the estimates. Due to substantial heterogeneity, Random Effect Model (REM) estimates were also evaluated. The heterogeneity between studies were evaluated using the Cochrane Q statistics and Higgin’s I2 value. Subgroup analysis and meta-regression were used to explore the sources of heterogeneity. Funnel plots as appropriate for ratio measures were used to assess publication bias.Results: A systematic and comprehensive search of databases identified 27 cohort studies reporting the incidence of NEC. The pooled estimate of the global incidence of NEC was 6.0% (95% CI: 4.0%-9.0%). There were substantial heterogeneity (I2 = 100%) between studies. Funnel plots showed no evidence of publication bias.Conclusion: The incidence of NEC vary considerably, although meta-regression failed provide evidence for any substantial regional variation. High quality studies along with detailed risk factors of NEC is warranted, to predict and NEC.


Author(s):  
Roja Rahimi ◽  
Shekoufeh Nikfar ◽  
Masoud Sadeghi ◽  
Mohammad Abdollahi ◽  
Reza Heidary Moghaddam ◽  
...  

Background: It has been found that there is a link between hypertension and elevated risk of Alzheimer’s disease (AD). Herein, a meta-analysis based on randomized clinical trials (RCTs) was used to assess the effect of antihypertensive drugs on cognition and behavioral symptoms of AD patients. Method: The three databases – PubMed/Medline, Scopus, and Cochrane Library- were searched up to March 2020. The quality of the studies included in the meta-analysis was evaluated by the Jadad score. Clinical Global Impression of Change (CGIC) included in two studies, Mini-Mental State Examination (MMSE) included in three studies, and Neuropsychiatric Inventory (NPI) in three studies were the main outcomes in this systematic review. Results: Out of 1506 studies retrieved in the databases, 5 RCTs included and analyzed in the meta-analysis. The pooled mean differences of CGIC, MMSE, and NPI in patients with AD receiving antihypertensive drugs compared to placebo was -1.76 with (95% CI = -2.66 to -0.86; P=0.0001), 0.74 (95% CI = 0.20 to 1.28; P= 0.007), and -9.49 (95% CI = -19.76 to 0.79; P = 0.07), respectively. Conclusion: The findings of the present meta-analysis show that antihypertensive drugs may improve cognition and behavioral symptoms of patients with AD. However, more well-designed RCTs with similar drugs are needed to achieve more conclusive results.


2021 ◽  
Vol 11 (7) ◽  
pp. 677
Author(s):  
Jeong Yee ◽  
Hamin Kim ◽  
Yunhee Heo ◽  
Ha-Young Yoon ◽  
Gonjin Song ◽  
...  

Purpose: Cytochrome P450 (CYP) is involved in the metabolism of statins; CYP3A5 is the main enzyme responsible for lipophilic statin metabolism. However, the evidence of the association between CYP3A5*3 polymorphism and the risk of statin-induced adverse events remains unclear. Therefore, this study aimed to perform a systematic review and meta-analysis to investigate the relationship between the CYP3A5*3 polymorphism and the risk of statin-induced adverse events. Methods: The PubMed, Web of Science, and EMBASE databases were searched for qualified studies published until August 2020. Observational studies that included the association between statin-induced adverse events and the CYP3A5*3 polymorphism were reviewed. The odds ratios (ORs) and 95% confidence intervals (CIs) were evaluated to assess the strength of the relationship. The Mantel–Haenszel method was used to provide the pooled ORs. Heterogeneity was estimated with I2 statistics and publication bias was determined by Begg’s and Egger’s test of the funnel plot. Data analysis was performed using Review Manager (version 5.4) and R Studio (version 3.6). Results: In total, data from 8 studies involving 1614 patients were included in this meta-analysis. The CYP3A5*3 polymorphism was found to be associated with the risk of statin-induced adverse events (*3/*3 vs. *1/*1 + *1/*3: OR = 1.40, 95% CI = 1.08–1.82). For myopathy, the pooled OR was 1.30 (95% CI: 0.96–1.75). The subgroup analysis of statin-induced myopathy revealed a trend, which did not achieve statistical significance. Conclusions: This meta-analysis demonstrated that the CYP3A5*3 polymorphism affected statin-induced adverse event risk. Therefore, CYP3A5 genotyping may be useful to predict statin toxicity.


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