scholarly journals Use of isotretinoin and risk of depression in patients with acne: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e021549 ◽  
Author(s):  
Changqiang Li ◽  
Jianmei Chen ◽  
Wo Wang ◽  
Ming Ai ◽  
Qi Zhang ◽  
...  
Keyword(s):  
Depressive Disorders ◽  
Retrospective Studies ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Depression Symptoms ◽  
Random Effects Model ◽  
Data Synthesis ◽  
Pooled Data ◽  
Randomised Controlled ◽  
The Cochrane Library

ObjectiveThis study aimed to investigate the association between the use of isotretinoin and the risk of depression in patients with acne.DesignThis was a meta-analysis in which the standardised mean difference (SMD) and the relative risk (RR) were used for data synthesis employing the random-effects model.SettingStudies were identified via electronic searches of PubMed, Embase and the Cochrane Library from inception up to 28 December 2017.ParticipantsPatients with acne.InterventionsStudies comparing isotretinoin with other interventions in patients with acne were included.ResultsTwenty studies were selected. The analysis of 17 studies showed a significant association of the use of isotretinoin with improved symptoms compared with the baseline before treatment (SMD = −0.33, 95% CI −0.51 to −0.15, p<0.05;I2=76.6%, p<0.05)). Four studies were related to the analysis of the risk of depression. The pooled data indicated no association of the use of isotretinoin with the risk of depressive disorders (RR=1.15, 95% CI 0.60 to 2.21, p=0.14). The association of the use of isotretinoin with the risk of depressive disorders was statistically significant on pooling retrospective studies (RR=1.39, 95% CI 1.05 to 1.84, p=0.02), but this association was not evident on pooling prospective studies (RR=0.85, 95% CI 0.60 to 2.21, p=0.86).ConclusionsThis study suggested an association of the use of isotretinoin in patients with acne with significantly improved depression symptoms. Future randomised controlled trials are needed to verify the present findings.

scholarly journals Proportion of NAFLD patients with normal ALT value in overall NAFLD patients: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Xuefeng Ma ◽  
Shousheng Liu ◽  
Jie Zhang ◽  
Mengzhen Dong ◽  
Yifen Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Method ◽  
Case Reports ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Hepatic Inflammation ◽  
Normal Alt ◽  
Study Type ◽  
The Cochrane Library

Abstract Background: ALT value is often used to reflect the hepatic inflammation and injury in NAFLD patients, but many studies proved that ALT values were normal in many NAFLD patients. The aim of this study was to identify the summarized proportion of NAFLD patients with normal ALT value in the overall NAFLD patients. Methods: Electronic databases PubMed, EMBASE, Ovid, and the Cochrane Library were searched for potential studies published from January 1, 2000 to September 30, 2019. Studies that have reported the number of NAFLD or NASH patients with normal and abnormal ALT value were included and analyzed. Abstracts, reviews, case reports, and letters were excluded. Results: A total of 11 studies with 4084 patients were included for assessing the summarized proportion of NAFLD patients with normal ALT in overall NAFLD patients. As the results shown, the summarized proportion of NAFLD patients with normal ALT value in overall NAFLD patients was 25% (95%CI: 20%-31%) which was calculated by the random-effects model. The summarized proportion of NASH patients with normal ALT value in overall NASH patients was 19% (95%CI: 13%-27%). Subgroup analysis includes region, study type, diagnostic method, and group size were conducted to investigate the resource of heterogeneity in the summarized proportion of NAFLD and NASH patients with normal ALT value. Conclusions: 25% NAFLD patients and 19% NASH patients possess the normal ALT value in the clinical manifestation. The value of ALT in the clinical diagnosis of NAFLD and NASH remains need be further testified.

scholarly journals Face mask use in the Community for Reducing the Spread of COVID-19: a systematic review

2020 ◽  
Author(s):  
Daniela Coclite ◽  
Antonello Napoletano ◽  
Silvia Gianola ◽  
Andrea Del Monaco ◽  
Daniela D'Angelo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Experimental Studies ◽  
Community Setting ◽  
Face Mask ◽  
Cochrane Library ◽  
Case Scenario ◽  
Materials Used ◽  
Randomised Controlled ◽  
The Cochrane Library

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. Findings: Our search identified 35 studies, including 3 randomised controlled trials (RCTs) (4017 patients), 10 comparative studies (18984 patients), 13 predictive models, 9 laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favour of wearing face masks versus no mask, but not at statistically significant levels (adjusted OR 0.90, 95%CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95%CI 0.09-0.67) in favour of mask versus no mask. Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomised trials on face mask effectiveness are needed to inform evidence-based policies.

scholarly journals Liver Chemistries in COVID-19 Patients with Survival or Death: A Meta-Analysis

2020 ◽  
Author(s):  
Qing-Qing Xing ◽  
Xuan Dong ◽  
Yan-Dan Ren ◽  
Wei-Ming Chen ◽  
Dan-Yi Zeng ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Early Warning ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Close Monitoring ◽  
Random Effects Model ◽  
Hepatocellular Injury ◽  
Liver Impairment ◽  
Pooled Data ◽  
Risk Of Death

ABSTRACTBackground and AimsAlthough abnormal liver chemistries are linked to higher risk of death related to coronavirus disease (COVID-19), liver manifestations may be diverse and even confused. Thus, we performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19 patients with death or survival.MethodsWe searched PubMed, Google Scholar, medRxiv, bioRxiv, Cochrane Library, Embase, and three Chinese electronic databases through April 22, 2020. We analyzed pooled data on liver chemistries stratified by the main clinical outcome of COVID-19 using a fixed or random-effects model.ResultsIn the meta-analysis of 18 studies, which included a total of 2,862 patients, the pooled mean alanine aminotransferase (ALT) was 30.9 IU/L in the COVID-19 patients with death and 26.3 IU/L in the COVID-19 patients discharged alive (p < 0.0001). The pooled mean aspartate aminotransferase (AST) level was 45.3 IU/L in the COVID-19 patients with death while 30.1 IU/L in the patients discharged alive (p < 0.0001). Compared with the discharged alive cases, the dead cases tended to have lower albumin levels but longer prothrombin time, and international standardized ratio.ConclusionsIn this meta-analysis, according to the main clinical outcome of COVID-19, we comprehensively described three patterns of liver impairment related to COVID-19, hepatocellular injury, cholestasis, and hepatocellular disfunction. Patients died from COVID-19 tend to have different liver chemistries from those are discharged alive. Close monitoring of liver chemistries provides an early warning against COVID-19 related death.Lay SummaryAbnormal liver chemistries are linked to higher risk of death related to coronavirus disease (COVID-19). We performed a meta-analysis of 18 studies that included a total of 2,862 patients with COVID-19. We noted that patients died from COVID-19 tend to have different liver chemistries from those are discharged alive and close monitoring of liver chemistries provides early warning against COVID-19 related death.

scholarly journals Cortisol as a predictor of psychological therapy response in depressive disorders: Systematic review and meta-analysis

2017 ◽  
Vol 210 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Susanne Fischer ◽  
Rebecca Strawbridge ◽  
Andres Herane Vives ◽  
Anthony J. Cleare
Keyword(s):  
Systematic Review ◽  
Depressive Disorders ◽  
Meta Analysis ◽  
Therapy Response ◽  
Psychological Therapy ◽  
Cochrane Library ◽  
Symptom Change ◽  
End Of Treatment ◽  
Pre Treatment ◽  
The Cochrane Library

BackgroundMany patients with depressive disorders demonstrate resistance to psychological therapy. A frequent finding is hypothalamic–pituitary–adrenal (HPA) axis alterations. As cortisol is known to modulate cognitive processes, those patients may be less likely to profit from psychological therapy.AimsTo conduct a systematic review and meta-analysis on cortisol as a predictor of psychological therapy response.MethodThe Cochrane Library, EMBASE, MEDLINE and PsycINFO databases were searched. Records were included if they looked at patients with any depressive disorder engaging in psychological therapy, with a pre-treatment cortisol and a post-treatment symptom measure.ResultsEight articles satisfied our selection criteria. The higher the cortisol levels before starting psychological therapy, the more symptoms patients with depression experienced at the end of treatment and/or the smaller their symptom change.ConclusionsOur findings suggest that patients with depression with elevated HPA functioning are less responsive to psychological therapy.

scholarly journals Comparison of complications attributable to enteral and parenteral nutrition in predicted severe acute pancreatitis: a systematic review and meta-analysis

2010 ◽  
Vol 103 (9) ◽  
pp. 1287-1295 ◽  
Author(s):  
Maxim S. Petrov ◽  
Kevin Whelan
Keyword(s):  
Acute Pancreatitis ◽  
Parenteral Nutrition ◽  
Severe Acute Pancreatitis ◽  
Meta Analysis ◽  
Tube Feeding ◽  
Infectious Complications ◽  
Cochrane Library ◽  
Randomised Controlled ◽  
The Cochrane Library ◽  
Complications And Mortality

Enteral nutrition (EN) reduces infectious complications and mortality compared with parenteral nutrition (PN) in patients with predicted severe acute pancreatitis. However, to date the complications attributable to the administration of EN and PN in this patient group have not been comprehensively studied. The aim of the study was to systematically review the complications related to the use of nutrition in patients with predicted severe acute pancreatitis receiving EN v. PN. The Cochrane Library, MEDLINE and Scopus were searched. Randomised controlled trials (RCT) of EN v. PN in predicted severe acute pancreatitis were selected. Pooled estimates of complications were expressed as OR with corresponding 95 % CI. Data from five RCT were meta-analysed. Diarrhoea occurred in six of ninety-two (7 %) patients receiving PN and twenty-four of eighty-two (29 %) patients receiving EN (OR 0·20; 95 % CI 0·09, 0·43; P < 0·001). Hyperglycaemia developed in twenty-one of ninety-two (23 %) patients receiving PN and nine of eighty-two (11 %) receiving EN (OR 2·59; 95 % CI 1·13, 5·94; P = 0·03). Given a significant reduction in infectious complications and mortality associated with the use of EN over PN that has been consistently demonstrated in previous studies, the former should be the treatment of choice in acute pancreatitis. Further clinical studies should investigate the strategies to mitigate the complications of enteral tube feeding in patients with acute pancreatitis.

scholarly journals Dental Bulk-Fill Resin Composites Polymerization Efficiency: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (6) ◽  
pp. 149
Author(s):  
Reem A. Ajaj ◽  
Nada J. Farsi ◽  
Lama Alzain ◽  
Nour Nuwaylati ◽  
Raneem Ghurab ◽  
...  
Keyword(s):  
Data Extraction ◽  
Meta Analysis ◽  
Relevant Information ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Inclusion Criteria ◽  
Medical Subject Headings ◽  
Future Studies ◽  
Comprehensive Search ◽  
The Cochrane Library

Dental Bulk-Fill Composites (BFCs) and Bulk-Fill Flowables (BFFs) were introduced in the market to facilitate efficient bulk filling of cavities up to 5 mm. The aim of this study was to synthesize the literature investigating their polymerization efficiency. A comprehensive search of PubMed and the Cochrane Library from 2010 to January 2019 was performed using the medical subject headings. Screening of the titles, abstracts and full text was performed. Data extraction for relevant information was done on the included studies. Clinically relevant parameters were selected to present the study estimates (meta-analysis) using a random effects model for polymerization efficiency (Degree of Conversion (DC) and Depth of Cure (DoC)). Twenty one studies fulfilled the inclusion criteria and were included in the analysis reporting seven BFCs and nine BFFs. Ten materials reported acceptable DC values of above 55% and ten materials reported adequate DoC values. Most of the stated materials reported adequate DC and DoC values in at least one investigation with BFFs showing higher and more acceptable values compared to packable BFCs. It is suggested that future studies be carried out using a standard methodology following the ISO 4049 standard and manufacturer’s instructions to compare results.

scholarly journals Risk of Lower Eyelids Malposition in Subciliary Compared to Transconjunctival Approach in Maxillofacial Fractures Management: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 7 (17) ◽  
pp. 2953-2957
Author(s):  
I Gusti Putu Hendra Sanjaya ◽  
Agus Roy Rusly Hariantana Hamid ◽  
I Made Suka Adnyana ◽  
I Gusti Ayu Putri Purwanthi ◽  
Paulina Magdalena ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Open Access Journal ◽  
Cochrane Library ◽  
Transconjunctival Approach ◽  
Maxillofacial Fractures ◽  
Subciliary Approach ◽  
Randomised Controlled ◽  
The Cochrane Library

BACKGROUND: Both subciliary and transconjunctival approaches have been used for decades to visualise the site of the maxillofacial fracture. The most common complication following those procedures is lower eyelids malposition. AIM: This meta-analysis will analyse which approach (subciliary and transconjunctival approaches) is more favourable to decrease lower eyelids malposition incidence. METHOD: This meta-analysis was conducted based on PRISMA guidelines. The electronic search was conducted using keywords (“Lower Eyelids Malposition” OR “Complications” OR “Ectropion” OR “Entropion”) AND (Transconjunctival) AND (Subciliary) AND (Maxillofacial Fractures) in PubMed, The Cochrane Library, and Directory of Open Access Journal (DOAJ). This review included full-text studies (observational and randomised controlled trials) in English comparing subciliary and transconjunctival approach in patients with maxillofacial fractures in the last 10 years. The data collected were the type of fractures and approaches, ectropion and entropion incidence as well as follow-up duration. The risk of bias was assessed using Joanna Briggs Institute critical appraisal checklist. Statistical analysis was done using Review Manager 5.3 (Cochrane, Denmark). RESULT: This study included 3 cohort studies and 2 Randomized Controlled Trial (RCT) studies from 2012 to 2017 with a total of 574 samples. Subciliary approach had a significant higher ectropion incidence when compared to transconjunctival approach (RR = 4.64, 95% CI: 1.68-12.81, p = 0.003). There was also a significant reduction of entropion incidence in patients with subciliary approach compared to transconjunctival approach (RR = 0.16, 95% CI: 0.04 – 0.69, p = 0.01). CONCLUSION: There was no superiority between one procedure toward another since each procedure related to different lower eyelids malpositions.

scholarly journals Dezocine prevents sufentanil-induced cough during general anesthesia induction: a meta-analysis of randomised controlled trials

2019 ◽  
Author(s):  
Zhencheng Xiong ◽  
Ping Yi ◽  
Jipeng Song ◽  
Mingsheng Tan
Keyword(s):  
General Anesthesia ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Vital Signs ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Anesthesia Induction ◽  
China National Knowledge Infrastructure ◽  
Randomised Controlled ◽  
The Cochrane Library

Abstract Background Sufentanil is one of the opioids currently used to induce general anesthesia, and cough is one of the most common complications. Many drugs have been used to prevent sufentanil-induced cough (SIC), and dezocine is one of them. The purpose of our meta-analysis is to evaluate the efficacy of dezocine on SIC.Methods We searched multiple databases including PubMed, Embase, ScienceDirect, the Cochrane Library, and China National Knowledge Infrastructure databases (CNKI) to identify studies that met the inclusion criteria. This meta-analysis focused on the incidence and severity of SIC after dezocine intervention, as well as adverse effects.Results Five randomised controlled trials (RCTs) were identified, including 890 patients. Each study was a comparison of dezocine with an equal volume of 0.9% saline. When the injection dose of dezocine was 0.1 mg/kg, the incidence (pooled risk ratio [RR]=0.03, [95% CI: 0.02 to 0.07], P<0.00001, I2=0%) and severity (mild: RR=0.07, [95% CI: 0.03 to 0.18], P<0.00001, I2=0%; moderate: RR=0.05, [95% CI: 0.02 to 0.16], P<0.00001, I2=0%; severe: RR=0.04, [95% CI: 0.01 to 0.16], P<0.00001, I2=0%) of SIC were significantly decreased. There were no statistically significant differences in vital signs between the two groups based on the results of the pooled analysis.Conclusion This meta-analysis showed that dezocine significantly reduced the incidence and severity of SIC in the induction of general anesthesia, but had no significant effect on vital signs. More high-quality RCTs are needed to complement existing conclusions.

KOLABORASI PUSTAKAWAN DALAM PENGAMBILAN KEPUTUSAN KLINIS BERBASIS BUKTI TERKINI (EVIDENCE BASED MEDICINE ): STUDI KASUS DI FAKULTAS KEDOKTERAN, KESEHATAN MASYARAKAT DAN KEPERAWATAN UNIVERSITAS GADJAH MADA

2021 ◽  
Vol 23 (1) ◽  
pp. 67-75
Author(s):  
Sukirno Sukirno
Keyword(s):  
Systematic Review ◽  
Evidence Based Medicine ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Evidence Based ◽  
Randomised Controlled ◽  
The Cochrane Library ◽  
Clinical Queries ◽  
Based Medicine

Evidence Based Medicine (EBM) merupakan pemanfaatan bukti ilmiah berdasarkan penelitian klinis mutakhir yang sahih dalam tatalaksana proses penyembuhan penyakit. Salah satu syarat utama untuk memfasilitasi pengambilan keputusan klinik yang evidence-based, adalah dengan menyediakan bukti-bukti ilmiah yang relevan. Tipe kajian  diutamakan yang berupa hasil review sistematik, meta-analisis, dan randomised controlled trial (RCT). Salah satu dari lima langkah dalam evidence based medicine yaitu yaitu menelusur  bukti  dari sumber database hasil penelitian yang memuat bukti-bukti ilmiah. PubMed Clinical Queries dan The Cochrane Library merupakan database berisi hasil riset sekunder (systematic-review/meta-analysis) yang mensintesis hasil riset primer. Kolaborasi pustakawan dalam pengambilan keputusan klinis yaitu dengan  memberikan pelatihan  atau menelusur artikel hasil penelitian yang akan digunakan dalam pengambilan klinis dari database yang memuat bukti ilmiah.

The Correlation Between Circulating Betatrophin and Insulin Resistance in General Population: A Meta-Analysis

2017 ◽  
Vol 49 (10) ◽  
pp. 760-771 ◽  
Author(s):  
Jinling Xu ◽  
Yanyan Lin ◽  
Hui Zhou ◽  
Linshuang Zhao ◽  
Guangda Xiang
Keyword(s):  
Insulin Resistance ◽  
General Population ◽  
Serum Sample ◽  
Large Scale ◽  
Meta Analysis ◽  
Full Length ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Group I ◽  
The Cochrane Library

AbstractMany inconsistent findings are reported on the correlation between circulating betatrophin and insulin resistance in the different population. The aim of this analysis was to explore the correlation between the level of betatrophin and insulin resistance in the general population. The databases of PubMed, EMBASE, and the Cochrane Library (inception to October 26, 2016) were searched without language restrictions for publications that reported studies on associations between betatrophin and insulin resistance in adults. Subgroup analyses were performed to investigate potential sources of heterogeneity. The pooled effect size was calculated using a random-effects model. Twenty-five studies were included in this meta-analysis. Meta-analysis showed that betatrophin was positively and significantly correlated with insulin resistance (r=0.16, 95% CI: 0.08–0.25). When all participants were divided into DM, GDM, and Non-DM groups, this association was also significant in T2DM, GDM, and Non-DM participants (T2DM: r=0.09, 95% CI: 0.01–0.17; I 2=45.1%; GDM: r=0.39, 95% CI: 0.24–0.55; I 2=0.0%; non-DM: r=0.15, 95% CI: 0.04–0.26; I 2=89.3%), and it was obvious that heterogeneity existed in Non-DM group (I 2=89.3%, p<0.001). Subgroup analysis revealed that gender, serum sample and ELISA kits for full-length betatrophin had significant influence on the association between betatrophin and insulin resistance. In conclusion, the level of circulating betatrophin is positively associated with insulin resistance in the general population, especially in T2DM and GDM patients. Gender, serum sample, and ELISA kits for full-length betatrophin may affect this association. More large-scale studies are needed to determine whether improving insulin resistance concomitantly declines betatrophin levels in different diseases.

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