Scapular dyskinesis increases the risk of future shoulder pain by 43% in asymptomatic athletes: a systematic review and meta-analysis

BackgroundIt is unclear whether the presence of scapular dyskinesis increases the risk of developing shoulder pain in asymptomatic athletes.ObjectivesTo determine whether the presence of scapular dyskinesis in asymptomatic athletes increases the risk of developing shoulder pain by systematic review and meta-analysis.MethodsA systematic search was conducted in the Cochrane Library, Embase, PubMed, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database and SPORTDiscus. Prospective studies that assessed athletes for scapular dyskinesis and recorded incidents of shoulder pain were included. Study quality was assessed using the Downs and Black checklist. Meta-analysis was conducted to derive a pooled risk ratio (RR) for the development of shoulder pain in athletes with scapular dyskinesis compared with those without scapular dyskinesis.ResultsFive studies were included with a total of 419 athletes. Of the athletes with scapular dyskinesis, 35% (56/160) experienced shoulder pain during the follow-up, whereas 25% (65/259) of athletes without scapular dyskinesis experienced symptoms. The presence of scapular dyskinesis at baseline indicated a 43% increased risk of a shoulder pain event over a 9 to 24 months follow-up (RR=1.43, 95% CI 1.05 to 1.93).ConclusionsAthletes with scapular dyskinesis have 43% greater risk of developing shoulder pain than those without scapular dyskinesis.

Download Full-text

EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211004277 ◽

2021 ◽

pp. 174749302110042

Author(s):

Grace Mary Turner ◽

Christel McMullan ◽

Olalekan Lee Aiyegbusi ◽

Danai Bem ◽

Tom Marshall ◽

...

Keyword(s):

Systematic Review ◽

Stroke Risk ◽

Meta Analysis ◽

Vitamin K Antagonists ◽

Cochrane Library ◽

Control Group ◽

Large Sample Size ◽

Hazard Ratios ◽

Increased Risk ◽

The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

Download Full-text

Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa794 ◽

2020 ◽

Author(s):

Isabelle Holscher ◽

Tijs J van den Berg ◽

Koen M A Dreijerink ◽

Anton F Engelsman ◽

Els J M Nieveen van Dijkum

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Meta Analysis ◽

Cochrane Library ◽

Weighted Mean ◽

Curative Surgery ◽

Endocrine Society ◽

Time To Recurrence ◽

The Cochrane Library

Abstract Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 < 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs). Results A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.

Download Full-text

SURG-16. SUPRATOTAL VERSUS GROSS TOTAL RESECTION OF GLIOBLASTOMA: A SYSTEMATIC REVIEW

Neuro-Oncology ◽

10.1093/neuonc/noz175.1017 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi243-vi243

Author(s):

Christina Jackson ◽

John Choi ◽

Carrie Price ◽

Chetan Bettegowda ◽

Michael Lim ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Gross Total Resection ◽

Cochrane Library ◽

Study Quality ◽

Total Resection ◽

Significant Difference ◽

Definition Of ◽

Supratotal Resection ◽

The Cochrane Library

Abstract INTRODUCTION Due to the infiltrative nature of glioblastoma(GBM) outside of the contrast enhancing region in the peritumoral zone, there is increasing movement to perform supratotal resections (SpTR) by extending the edge of resection beyond the contrast enhancing portion of the tumor. However, there is currently no consensus on the potential survival benefit of SpTR in GBM as compared to gross total resection (GTR). METHODS Therefore, we performed a systematic review using PRISMA guidelines and performed a comprehensive literature search on Pubmed, EMBASE, The Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov, from inception to August 16, 2018, to identify articles comparing overall survival (OS) after SpTR versus GTR. Furthermore, we assessed study quality using the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS We identified 8902 unique citations, of which 11 articles and 2 abstracts met study inclusion criteria. 925 patients underwent SpTR out of a total of 2137 patients. 9 of the 13 studies demonstrated improved survival with SpTR compared to GTR (median improvement in OS of 10.5 months), with no significant difference in post-operative complication rate. Conversely, one abstract found worsened outcomes with SpTR compared to GTR (median decrease in OS of 4 months). However, overall study quality was poor, with 12 of the 13 studies of level IV evidence and one study of level IIIb evidence. We were unable to perform a meta-analysis due to significant clinical and methodological heterogeneity amongst the studies (e.g. differences in adjuvant therapy and lack of standardization of definition of supratotal resection). CONCLUSIONS Our systematic review indicates that SpTR may be associated with improved OS compared to GTR for GBM. However, this is limited by poor study quality and significant clinical and methodological heterogeneity amongst the studies. There is need for prospective clinical trials to further establish standardized guidelines for SpTR in GBM.

Download Full-text

Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-019-0917-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Yuan Chen ◽

Xinlei Chen ◽

Yali Zhang ◽

Fangjie Zhou ◽

Jiaxin Deng ◽

...

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Mineral Trioxide Aggregate ◽

Systemic Review ◽

Permanent Teeth ◽

Cochrane Library ◽

Success Rates ◽

The Cochrane Library

Abstract Background Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. Methods Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. Results Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. Conclusions Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

Download Full-text

Effect of Digoxin Therapy on Mortality in Patients With Atrial Fibrillation: An Updated Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.731135 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaoxu Wang ◽

Yi Luo ◽

Dan Xu ◽

Kun Zhao

Keyword(s):

Atrial Fibrillation ◽

Meta Analysis ◽

Cochrane Library ◽

Clinical Effects ◽

Hazard Ratios ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

The Cochrane Library

Background: Whether digoxin is associated with increased mortality in atrial fibrillation (AF) remains controversial. We aimed to assess the risk of mortality and clinical effects of digoxin use in patients with AF.Methods: PubMed, Embase, and the Cochrane library were systematically searched to identify eligible studies comparing all-cause mortality of patients with AF taking digoxin with those not taking digoxin, and the length of follow-up was at least 6 months. Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted and pooled.Results: A total of 29 studies with 621,478 patients were included. Digoxin use was associated with an increased risk of all-cause mortality in all patients with AF (HR 1.17, 95% CI 1.13–1.22, P < 0.001), especially in patients without HF (HR 1.28, 95% CI 1.11–1.47, P < 0.001). There was no significant association between digoxin and mortality in patients with AF and HF (HR 1.06, 95% CI 0.99–1.14, P = 0.110). In all patients with AF, regardless of concomitant HF, digoxin use was associated with an increased risk of sudden cardiac death (SCD) (HR 1.40, 95% CI 1.23–1.60, P < 0.001) and cardiovascular (CV) mortality (HR 1.27, 95% CI 1.08–1.50, P < 0.001), and digoxin use had no significant association with all-cause hospitalization (HR 1.13, 95% CI 0.92–1.39, P = 0.230).Conclusion: We conclude that digoxin use is associated with an increased risk of all-cause mortality, CV mortality, and SCD, and it does not reduce readmission for AF, regardless of concomitant HF. Digoxin may have a neutral effect on all-cause mortality in patients with AF with concomitant HF.Systematic Review Registration:https://www.crd.york.ac.ukPROSPERO.

Download Full-text

Use of Antibiotics and Risk of Cancer: A Systematic Review and Meta-Analysis of Observational Studies

Cancers ◽

10.3390/cancers11081174 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1174 ◽

Cited By ~ 8

Author(s):

Fausto Petrelli ◽

Michele Ghidini ◽

Antonio Ghidini ◽

Gianluca Perego ◽

Mary Cabiddu ◽

...

Keyword(s):

Systematic Review ◽

Observational Studies ◽

Meta Analysis ◽

Antibiotic Use ◽

Cochrane Library ◽

Cancer Occurrence ◽

Incident Cancer ◽

Increased Risk ◽

The Cochrane Library ◽

Risk Of Cancer

The association between antibiotic use and risk of cancer development is unclear, and clinical trials are lacking. We performed a systematic review and meta-analysis of observational studies to assess the association between antibiotic use and risk of cancer. PubMed, the Cochrane Library and EMBASE were searched from inception to 24 February 2019 for studies reporting antibiotic use and subsequent risk of cancer. We included observational studies of adult subjects with previous exposure to antibiotics and available information on incident cancer diagnoses. For each of the eligible studies, data were collected by three reviewers. Risk of cancer was pooled to provide an adjusted odds ratio (OR) with a 95% confidence interval (CI). The primary outcome was the risk of developing cancer in ever versus non-antibiotic users. Cancer risk’s association with antibiotic intake was evaluated among 7,947,270 participants (n = 25 studies). Overall, antibiotic use was an independent risk factor for cancer occurrence (OR 1.18, 95%CI 1.12–1.24, p < 0.001). The risk was especially increased for lung cancer (OR 1.29, 95%CI 1.03–1.61, p = 0.02), lymphomas (OR 1.31, 95%CI 1.13–1.51, p < 0.001), pancreatic cancer (OR 1.28, 95%CI 1.04–1.57, p = 0.019), renal cell carcinoma (OR 1.28, 95%CI 1.1–1.5, p = 0.001), and multiple myeloma (OR 1.36, 95%CI 1.18–1.56, p < 0.001). There is moderate evidence that excessive or prolonged use of antibiotics during a person’s life is associated with slight increased risk of various cancers. The message is potentially important for public health policies because minimizing improper antibiotic use within a program of antibiotic stewardship could also reduce cancer incidence.

Download Full-text

Efficacy and Safety of Ocriplasmin Use for Vitreomacular Adhesion and Its Predictive Factors: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.759311 ◽

2022 ◽

Vol 8 ◽

Author(s):

Xi Chen ◽

Min Li ◽

Ran You ◽

Wei Wang ◽

Yanling Wang

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Cochrane Library ◽

Vitreomacular Adhesion ◽

Model Risk ◽

Increased Risk ◽

The Cochrane Library ◽

The Impact ◽

Safe Approach ◽

Risk Ratios

Symptomatic vitreomacular adhesion (sVMA) impedes visual acuity and quality. Ocriplasmin is a recombinant protease, which may be injected into the vitreous cavity to treat this condition, yet controversy remains with respect to its effectiveness and safety, particularly its patient selection standard. In this systematic review, the PubMed, Embase, and the Cochrane Library were searched to identify studies published prior to August 2020 on the impact of ocriplasmin treatment on VMA release, macular hole (MH) closure, and/or related adverse events (AEs). Data were pooled using a random-effects model. Risk ratios (RRs) with 95% CIs were calculated. Of 1,186 articles reviewed, 5 randomized controlled trials and 50 cohort studies were ultimately included, representing 4,159 patients. Ocriplasmin significantly increased the rate of VMA release (RR, 3.61; 95% CI, 1.99–6.53; 28 days after treatment) and MH closure (RR, 3.84; 95% CI, 1.62–9.08; 28 days after treatment) and was associated with visual function improvement. No increased risk for overall AEs was seen in ocriplasmin treatment. The proportion of VMA release and MH closure in patients was 0.50 and 0.36, respectively. VMA release was more likely in patients with absence of epiretinal membrane (ERM). Patients with smaller MH diameter were more likely to achieve MH closure. Evidence from included studies suggests that ocriplasmin is a suitable and safe approach for treating sVMA. ERM and MH status are important factors when considering ocriplasmin treatment.

Download Full-text

Abstract 12620: Effect of Sacubitril-valsartan on the Incidence Arrhythmias in Patients With Heart Failure With Reduced Ejection Fraction: A Systematic Review and Meta Analysis

Circulation ◽

10.1161/circ.142.suppl_3.12620 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Edgar E Acuna Morin ◽

Jennifer Maning ◽

Sunita Mahabir ◽

Mariana Ramirez ◽

Sandra Chaparro

Keyword(s):

Systematic Review ◽

Biventricular Pacing ◽

Meta Analysis ◽

Nyha Class ◽

Cochrane Library ◽

Loop Recorder ◽

Reduced Ejection Fraction ◽

Patients With Heart Failure ◽

The Cochrane Library

Introduction: Sacubitril-Valsartan (ARNI) has known mortality benefit in patients with HFrEF. Nevertheless, little is known of its influence on arrhythmias. The purpose of this study was to investigate its net effect on the incidence of arrhythmias in patients with HFrEF through a systematic review and meta-analysis of published literature. Methods: We searched Medline, Embase & the Cochrane library through April 15th, 2020 for studies including patients with EF 40% or lower treated with ACEI or ARB and transitioned to ARNI, reporting the incidence of any arrhythmias or ICD shocks in patients with either an ICD, CRT, pacemaker or loop recorder. The primary outcome was the incidence of sustained VT, while the secondary outcomes were the incidence of nonsustained VT (NSVT), appropriate ICD shocks, biventricular pacing (BiV-pacing) in patients with CRT, and episodes of atrial tachycardia or fibrillation (AT/AF) > 30 seconds. The Newcastle-Ottawa tool was used to assess studies. A random-effects meta-analysis was performed using pooled proportions and heterogeneity was examined using I2 statistics. Statistical analyses were carried out using Review Manager 5.3 by Cochrane. Results: 330 subjects were pooled from three studies (two retrospective and one prospective). Mean age was 68±9.7. 79% were males. 74% had ischemic cardiomyopathy. Mean EF was 29% and mean NYHA Class was 2.4. ICD was implanted in 51%, of whom 44% had CRT. Mean follow-up time was 11±1.7 months. The odds ratio (OR) for sustained VT, was 0.59 ( p=0.08 ). For NSVT was 0.65 ( p=0.008* ), appropriate ICD shocks 0.59 ( p=0.09 ), BiV-pacing 2.59 ( p=<0.00001* ), and for episodes of AT/AF > 30s. 0.62 ( p=0.03* ). All in favor of ARNI. Conclusions: This meta-analysis demonstrates that in patients with HFrEF who transition from ACEI or ARB to ARNI, there is a tendency of decreasing ventricular & atrial arrhythmias, appropriate ICD shocks, as well as tendency towards increasing BiV-pacing in patients with CRT.

Download Full-text

Effectiveness of Colorectal Cancer Screening Promotion Using E-Media Decision Aids: A Systematic Review and Meta-Analysis

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18158190 ◽

2021 ◽

Vol 18 (15) ◽

pp. 8190

Author(s):

Nur Suhada Ramli ◽

Mohd Rizal Abdul Manaf ◽

Mohd Rohaizat Hassan ◽

Muhamad Izwan Ismail ◽

Azmawati Mohammed Nawi

Keyword(s):

Colorectal Cancer ◽

Systematic Review ◽

Meta Analysis ◽

Decision Aids ◽

Cochrane Library ◽

Crc Screening ◽

Screening Participation ◽

The Cochrane Library ◽

Cancer Screening Promotion

Colorectal cancer (CRC)-screening reduces mortality, yet remains underutilized. The use of electronic media (e-media) decision aids improves saliency and fosters informed decision-making. This systematic review aimed to determine the effectiveness of CRC-screening promotion, using e-media decision aids in primary healthcare (PHC) settings. Three databases (MEDLINE, Web of Science, and the Cochrane Library) were searched for eligible studies. Studies that evaluated e-media decision aids compared to usual care or other conditions were selected. Quality was assessed by using Cochrane tools. Their effectiveness was measured by CRC-screening completion rates, and meta-analysis was conducted to calculate the pooled estimates. Ten studies involving 9393 patients were included in this review. Follow-up durations spanned 3–24 months. The two types of decision-aid interventions used were videos and interactive multimedia programs, with durations of 6–15 min. Data from nine feasible studies with low or some risk of bias were synthesized for meta-analysis. A random-effects model revealed that CRC-screening promotion using e-media decision aids were almost twice as likely to have screening completion than their comparisons (OR 1.62, 95% CI: 1.03–2.62, p < 0.05). CRC-screening promotion through e-media has great potential for increasing screening participation in PHC settings. Thus, its development should be prioritized, and it should be integrated into existing programs.

Download Full-text

Tracheotomy in COVID-19 Patients: A Systematic Review and Meta-analysis of Weaning, Decannulation, and Survival

Otolaryngology ◽

10.1177/0194599820984780 ◽

2021 ◽

pp. 019459982098478

Author(s):

Daniel A. Benito ◽

Daniel E. Bestourous ◽

Jane Y. Tong ◽

Luke J. Pasick ◽

Robert T. Sataloff

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Meta Analysis ◽

Weighted Average ◽

Cochrane Library ◽

Current State ◽

Ventilation Weaning ◽

The Cochrane Library ◽

Mechanical Ventilation Weaning

Objectives A systematic review and meta-analysis was conducted to determine the cumulative incidences of decannulation and mechanical ventilation weaning in patients with coronavirus disease 2019 (COVID-19) who have undergone a tracheotomy. Weighted average mean times to tracheotomy, to decannulation, and to death were calculated from reported or approximated means. Data Sources PubMed, SCOPUS, CINAHL, and the Cochrane library. Review Methods Studies were screened by 3 investigators independently. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Studies including patients with COVID-19 who underwent a tracheotomy were identified. Studies without reported mechanical ventilation weaning or decannulation were excluded. Data were pooled using a random-effects model. Results After identifying 232 unique studies, 18 articles encompassing outcomes for 3234 patients were ultimately included for meta-analysis, with a weighted mean follow-up time of 28.6 ± 6.2 days after tracheotomy. Meta-analysis revealed that 55.0% of tracheotomized patients were weaned successfully from mechanical ventilation (95% CI, 47.4%-62.2%). Approximately 34.9% of patients were decannulated successfully, with a mean decannulation time of 18.6 ± 5.7 days after tracheotomy. The pooled mortality in tracheotomized patients with COVID-19 was 13.1%, with a mean time of death of 13.0 ± 4.0 days following tracheotomy. Conclusion At the current state of the coronavirus pandemic, over half of patients who have required tracheotomies are being weaned off of mechanical ventilation. While 13.1% patients have died prior to decannulation, over a third of all tracheotomized patients with COVID-19 reported in the literature have undergone successful decannulation.

Download Full-text