scholarly journals Erectile dysfunction and penile rehabilitation after pelvic fracture: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e045117
Author(s):  
Florian A Schmid ◽  
Ulrike Held ◽  
Daniel Eberli ◽  
Hans-Christoph Pape ◽  
Sascha Halvachizadeh
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Literature Search ◽  
Meta Analysis ◽  
P Value ◽  
Systematic Literature Search ◽  
Rehabilitation Therapy ◽  
Increased Risk ◽  
Before And After ◽  
Penile Rehabilitation

ObjectiveTo investigate the rate of erectile dysfunction (ED) after pelvic ring fracture (PRF).DesignSystematic review and meta-analysis.MethodsA systematic literature search of the Cochrane, EMBASE, MEDLINE, Scopus and Web of Science Library databases was conducted in January 2020. Included were original studies performed on humans assessing ED after PRF according to the 5-item International Index of Erectile Function (IIEF-5) questionnaire and fracture classification following Young and Burgess, Tile or Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association. Furthermore, interventional cohort studies assessing the effect of penile rehabilitation therapy with phosphodiesterase-5-inhibitors (PDE-5-I) on IIEF-5 scores compared before and after treatment were included. Results were presented as forest plots of proportions of patients with ED after PRF or mean changes on IIEF-5 questionnaires before and after penile rehabilitation. Studies not included in the quantitative analysis were narratively summarised. Risk of bias assessment was conducted using the revised tool for the Quality Assessment on Diagnostic Accuracy Studies.ResultsThe systematic literature search retrieved 617 articles. Seven articles were included in the qualitative analysis and the meta-analysis. Pooled proportions revealed 37% of patients with ED after suffering any form of PRF (result on probability scale pr=0.37, 95% CI: 0.26 to 0.50). Patients after 3 months of penile rehabilitation therapy reported a higher IIEF-5 score than before (change score=6.5 points, 95% CI: 2.54 to 10.46, p value=0.0013).ConclusionDespite some heterogeneity and limited high-quality research, this study concludes that patients suffering from any type of PRF have an increased risk of developing ED. Oral intake of PDE-5-I for the purpose of penile rehabilitation therapy increases IIEF-5 scores and may relevantly influence quality-of-life in these patients.PROSPERO registration numberCRD42020169699.

scholarly journals Prediction of mortality in adult patients with sepsis using six biomarkers: a systematic review and meta-analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Andreas Pregernig ◽  
Mattia Müller ◽  
Ulrike Held ◽  
Beatrice Beck-Schimmer
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Meta Analysis ◽  
Advanced Glycation Endproducts ◽  
Adult Patients ◽  
Cochrane Library ◽  
Systematic Literature Search ◽  
Prognostic Information ◽  
Prediction Of Mortality ◽  
Mean Differences

Abstract Background Angiopoietin-1 (Ang-1) and 2 (Ang-2), high mobility group box 1 (HMGB1), soluble receptor for advanced glycation endproducts (sRAGE), soluble triggering receptor expressed on myeloid cells 1 (sTREM1), and soluble urokinase-type plasminogen activator receptor (suPAR) have shown promising results for predicting all-cause mortality in critical care patients. The aim of our systematic review and meta-analysis was to assess the prognostic value of these biomarkers for mortality in adult patients with sepsis. Methods A systematic literature search of the MEDLINE, PubMed, EMBASE, and Cochrane Library databases, for articles in English published from 01.01.1990 onwards, was conducted. The systematic review focused exclusively on observational studies of adult patients with sepsis, any randomized trials were excluded. For the meta-analysis, only studies which provide biomarker concentrations within 24 h of admission in sepsis survivors and nonsurvivors were included. Results are presented as pooled mean differences (MD) between nonsurvivors and survivors with 95% confidence interval for each of the six biomarkers. Studies not included in the quantitative analysis were narratively summarized. The risk of bias was assessed in all included studies using the Quality in Prognosis Studies (QUIPS) tool. Results The systematic literature search retrieved 2285 articles. In total, we included 44 studies in the qualitative analysis, of which 28 were included in the meta-analysis. The pooled mean differences in biomarker concentration (nonsurvivors − survivors), measured at onset of sepsis, are listed as follows: (1) Ang-1: − 2.9 ng/ml (95% CI − 4.1 to − 1.7, p < 0.01); (2) Ang-2: 4.9 ng/ml (95% CI 2.6 to 7.1, p < 0.01); (3) HMGB1: 1.2 ng/ml (95% CI 0.0 to 2.4, p = 0.05); (4) sRAGE: 1003 pg/ml (95% CI 628 to 1377, p < 0.01); (5) sTREM-1: 87 pg/ml (95% CI 2 to 171, p = 0.04); (6) suPAR: 5.2 ng/ml (95% CI 4.5 to 6.0, p < 0.01). Conclusions Ang-1, Ang-2, and suPAR provide beneficial prognostic information about mortality in adult patients with sepsis. The further development of standardized assays and the assessment of their performance when included in panels with other biomarkers may be recommended. Trial registration This study was recorded on PROSPERO, prospective register of systematic reviews, under the registration ID: CRD42018081226

Meta-analysis and systematic review of the cardiotoxicity of TAS-102.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16053-e16053 ◽  
Author(s):  
Carlos Alberto Lopez ◽  
Elham Azimi-Nekoo ◽  
Su Yun Chung ◽  
James Newman ◽  
Janice Shen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
Phase I ◽  
Phase Ii ◽  
Literature Search ◽  
Meta Analysis ◽  
Phase Iii ◽  
Cardiac Events ◽  
Phase Ii Studies ◽  
Increased Risk

e16053 Background: Fluoropyrimidines such as 5-FU and capecitabine are known to be cardiotoxic drugs. TAS-102 (trifluridine-tipiracil) is a novel oral fluoropyrimidine that was recently FDA approved to treat gastric and colon cancer. However, the incidence of cardiac related events of TAS-102 is not fully ascertained. We performed a meta-analysis and systematic review to determine the incidence of cardiotoxic events associated with TAS-102. Methods: We performed a literature search through PubMed, Embase, and Web of Science to identify any publications in any language up to December 31st, 2019 where TAS-102 (and equivalent terms such as “trifluridine-tipiracil” and “Lonsurf”) was used. These were then manually reviewed to identify any publications reporting cardiac events. Randomized controlled trials (RCTs) were included for meta-analysis to determine the incidence of cardiotoxic events, which were summarized as pooled odds ratios (OR) when compared to placebo. Non-randomized, non-controlled clinical trials (phase I and phase II studies) were included in the systematic review but excluded from the pooled OR calculation. Results: 869 publications were identified in the initial literature search, of which 17 trials (3 Phase III studies, 6 Phase II studies, and 8 phase I studies) met inclusion criteria. A total of 1,877 patients among 4 RCTs were included in the meta-analysis. Compared with placebo, TAS-102 did not increase the risk of myocardial infarction (OR 1.97 95% CI [0.22-17.89]), hypertension (OR 0.73 95% CI [0.37, 1.44]), palpitations (OR 1.51 95% CI [0.30, 7.56]), cardio-pulmonary arrest (OR 0.83 95% CI [0.11-6.32]), or syncope (OR 1.50 95% CI [0.06-37.14]). Among the 1,252 patients receiving TAS-102, the overall incidence of cardiovascular events was low, with hypertension being the most common side effect (21 events), followed by palpitations (6 events), cardiopulmonary arrest (2 events), and myocardial infarction (3 events), though there was no statistically significant increased risk compared to placebo. No deaths were reported. Conclusions: Unlike other fluoropyrimidines, TAS-102 appears to be a cardiogentle drug, with no increased risk of cardiac events compared to placebo. Since fluoropyrimidines remain the backbone of treatment for gastrointestinal malignancies, TAS-102 can offer an alternative to patients who developed cardiotoxicities from other agents. Prospective studies with consideration of cardiac risk factors are required.

scholarly journals Coagulopathy in patients with Coronavirus Disease 2019 (COVID-19): A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiaolin Zhang ◽  
Xue Yang ◽  
Hongmei Jiao ◽  
Xinmin Liu
Keyword(s):  
Systematic Review ◽  
Literature Search ◽  
Meta Analysis ◽  
Statistical Analyses ◽  
Systematic Literature Search ◽  
Coagulation Parameters ◽  
Coagulation Abnormalities ◽  
D Dimer

Patients with COVID-19 frequently manifest coagulation abnormalities and thrombotic events. In this meta-analysis, we aimed to explore the role of coagulopathy on the severity differences in patients with COVID-19. We conducted systematic literature search via Pubmed, Embase, Cochrane, WanFang Database, CNKI, and medRxiv from December 1, 2019 to May 1, 2020, to identify all original studies that reports on coagulation parameters (D-dimer, PLT, PT, APTT, and FIB) during COVID-19 infection. Thereafter, we compared the coagulation parameters between less severe and more severe cases. All Statistical analyses were performed via Stata14.0 software. A total of 3,952 confirmed COVID-19 infected patients were included from 25 studies. Patients with severe COVID-19 infection exhibited significantly higher levels of D-dimer, PT, and FIB (SMD 0.83, 95% CI: 0.70-0.97, I2 56.9%; SMD 0.39, 95% CI: 0.14-0.64, I2 77.9%; SMD 0.35, 95% CI: 0.17-0.53, I2 42.4% respectively). However, difference in PLT and APTT levels between less severe and more severe patients was not statistically significant (SMD-0.26, 95% CI: -0.56-0.05, I2 82.2%; SMD-0.14,95% CI: -0.45-0.18, I2 75.5% respectively) This meta-analysis revealed coagulopathy is associated with the severity of COVID-19. Notably, D-dimer, PT, and FIB are the dominant parameters that should be considered in evaluating coagulopathy in COVID-19 patients.

scholarly journals Association between the use of protease inhibitors in highly active antiretroviral therapy and incidence of diabetes mellitus and/or metabolic syndrome in HIV-infected patients: A systematic review and meta-analysis

2017 ◽  
Vol 29 (5) ◽  
pp. 443-452 ◽  
Author(s):  
Jose Echecopar-Sabogal ◽  
Lorenzo D’Angelo-Piaggio ◽  
Diego M Chanamé-Baca ◽  
Cesar Ugarte-Gil
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Metabolic Syndrome ◽  
Protease Inhibitors ◽  
Highly Active Antiretroviral Therapy ◽  
Meta Analysis ◽  
P Value ◽  
Inclusion Criteria ◽  
Highly Active ◽  
Increased Risk

This systematic review and meta-analysis tries to determine whether there is an association between the use of protease inhibitors (PIs) and the incidence of diabetes mellitus (DM) and/or metabolic syndrome (MS) in HIV-infected patients. A systematic literature search was performed using MEDLINE/PubMed, CENTRAL, LILACS, and EMBASE. Included articles were observational studies published on or prior to November 2015 that met specific inclusion criteria. Pooled relative risks (RRs) and hazard ratios (HRs) were calculated. Nine articles met the inclusion criteria, describing 13,742 HIV patients. Use of PIs was associated with the development of MS (RR: 2.11; 95% CI 1.28–3.48; p-value 0.003). No association between the use of PIs and development of DM was found: the HR for the incidence of DM among patients using PIs was 1.23 (95% CI 0.66–2.30; p-value: 0.51) and the RR was 1.25 (95% CI 0.99–1.58; p-value 0.06). Use of PIs in HIV-infected patients is associated with an increased risk of MS. No evidence of an increased risk of DM was found. However, because MS is a precursor to DM, it is possible that studies with a longer follow-up duration are needed in order to detect an association between PI use and onset of DM.

scholarly journals MP85-08 PENILE REHABILITATION FOR POST-PROSTATECTOMY ERECTILE DYSFUNCTION: A COCHRANE SYSTEMATIC REVIEW AND META-ANALYSIS

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Yiannis Philippou ◽  
Jae Hung Jung ◽  
Martin Steggall ◽  
Caitlin Bakker ◽  
Philipp Dahm
Keyword(s):  
Systematic Review ◽  
Erectile Dysfunction ◽  
Meta Analysis ◽  
Cochrane Systematic Review ◽  
Penile Rehabilitation

scholarly journals Enough with the madness: a systematic review and meta-analysis of hydroxychloroquine for COVID-19

2021 ◽  
Vol 13 (2) ◽  
pp. 186-220
Author(s):  
André Santos ◽  
◽  
Érica Gonçalves ◽  
Ananda Oliveira ◽  
Douglas Lima ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Meta Analysis ◽  
Standard Of Care ◽  
P Value ◽  
Serious Adverse Events ◽  
Risk Of Death ◽  
Increased Risk ◽  
Significant Difference

Objective: Because of preliminary results from in vitro studies, hydroxychloroquine (HCQ) and chloroquine (CQ) have been proposed as possible treatments for COVID-19, but the clinical evidence is discordant. This study aims to evaluate the safety and efficacy of CQ and HCQ for the treatment of COVID-19. Methods: A systematic review with meta-analysis was performed. An electronic search was conducted in four databases for randomized controlled trials that compared HCQ or CQ with standard-of-care. A complementary search was performed. A quantitative synthesis of clinical outcomes was performed using the inverse variance method adjusting for a random-effects model. Results: In total, 16 studies were included. The meta-analysis found no significant difference between intervention and control groups in terms of mortality at the most extended follow-up (RR = 1.09, CI95% = 0.99-1.19, p-value = 0.08), patients with negative PCR results (RR = 0.99, CI95% = 0.89-1.10, p-value = 0.86), or serious adverse events (RR = 2.21, CI95% = 0.89-5.47, p-value = 0.09). HCQ was associated with an increased risk of adverse events (RR = 2.28, CI95% = 1.36-2.83, p-value < 0.01). The quality of evidence varied from very low to high. Conclusion: There is no evidence that HCQ reduces the risk of death or improves cure rates in patients with COVID-19, but it might be associated with an increased risk of adverse events

scholarly journals Association between retirement and mortality: working longer, living longer? A systematic review and meta-analysis

2020 ◽  
Vol 74 (5) ◽  
pp. 473-480
Author(s):  
Ranu Sewdas ◽  
Astrid de Wind ◽  
Sari Stenholm ◽  
Pieter Coenen ◽  
Ilse Louwerse ◽  
...  
Keyword(s):  
Systematic Review ◽  
Regression Analysis ◽  
Early Retirement ◽  
Literature Search ◽  
Meta Analysis ◽  
Systematic Literature Search ◽  
Random Effects Models ◽  
Risk Of Mortality ◽  
Meta Regression ◽  
Meta Regression Analysis

AimThis study summarised available evidence on the association between early and on-time retirement, compared with continued working, and mortality. Moreover, this study investigated whether and to what extent gender, adjustment for demographics and prior health status influence this association.MethodsA systematic literature search of longitudinal studies was conducted. A qualitative analysis of the included studies was performed, followed by a meta-regression analysis to assess the influence of gender, prior health and demographics. Random-effects models were used in a meta-analysis to estimate the pooled effects for relevant subgroups identified in the meta-regression.ResultsIn total, 25 studies were included. Adjustment for prior health and demographics influenced the association between retirement and mortality (p<0.05). The results of the meta-analysis of 12 studies are presented for ‘insufficiently adjusted’ and ‘fully adjusted’ subgroups. There was no association between early retirement and mortality compared with working until retirement (fully adjusted subgroup: HR 1.05, 95% CI 0.87 to 1.28). On-time retirement was associated with a higher risk of mortality compared with working beyond retirement (insufficiently adjusted subgroup: HR 1.56, 95% CI 1.41 to 1.73). However, in the subgroup that adjusted for prior health, on-time retirement was not associated with mortality (HR 1.12, 95% CI 0.98 to 1.28).ConclusionEarly retirement was not associated with a higher risk of mortality. On-time retirement was associated with a higher risk of mortality, which might reflect the healthy worker effect. It is important to consider information on prior health and demographics when studying the association between retirement and mortality to avoid biased findings.

scholarly journals Same-Day Regimen as an Alternative to Split Preparation for Colonoscopy: A Systematic Review with Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Cristina Bucci ◽  
Fabiana Zingone ◽  
Pietro Schettino ◽  
Clelia Marmo ◽  
Riccardo Marmo
Keyword(s):  
Systematic Review ◽  
Adverse Event ◽  
Polyethylene Glycol ◽  
Adverse Events ◽  
Literature Search ◽  
Meta Analysis ◽  
Systematic Literature Search ◽  
Split Dose ◽  
Event Rates ◽  
Convincing Data

Background. Split bowel preparation is the best regimen for colonoscopy. However, the same-day regimen can represent a valid alternative, but its use is limited by concerns about its cleansing ability, and to date, no convincing data support its use for routine colonoscopies. Aim. To evaluate the cleansing, compliance, and adverse event rates of the same-day compared to the split regimen. Results. A systematic literature search and meta-analysis was performed. Ten studies were included for a total of 1807 patients (880 in the same-day group and 927 in the split group). Overall, 85.3% patients in the same-day group vs. 86.3% in the split group had an adequate cleansing. Compliance was high for both, although patients were more compliant with the split than with the same-day prep (89.7% for same-day vs. 96.6% for split regimen). Sleep disturbance was more frequent in the split group, while nausea and vomit were more frequent in the same-day group. In the subgroup analysis, polyethylene glycol obtained a better cleansing rate when given as a split dose, with similar compliance and adverse events rates with both regimens. Conclusion. Split and same-day regimens are both useful in bowel cleaning before colonoscopy with a different pattern of adverse events and better compliance for split preparations. Endoscopists can consider the same-day preparation as a valid alternative, especially when the split preparation does not fit the patients’ needs.

scholarly journals Hypertension is associated with increased mortality and severity of disease in COVID-19 pneumonia: A systematic review, meta-analysis and meta-regression

2020 ◽  
Vol 21 (2) ◽  
pp. 147032032092689 ◽  
Author(s):  
Raymond Pranata ◽  
Michael Anthonius Lim ◽  
Ian Huang ◽  
Sunu Budhi Raharjo ◽  
Antonia Anna Lukito
Keyword(s):  
Systematic Review ◽  
Disease Progression ◽  
Literature Search ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Systematic Literature Search ◽  
Severity Of Disease ◽  
Poor Outcome ◽  
Meta Regression ◽  
Meta Regression Analysis

Objective: To investigate the association between hypertension and outcome in patients with Coronavirus Disease 2019 (COVID-19) pneumonia. Methods: We performed a systematic literature search from several databases on studies that assess hypertension and outcome in COVID-19. Composite of poor outcome, comprising of mortality, severe COVID-19, acute respiratory distress syndrome (ARDS), need for intensive care unit (ICU) care and disease progression were the outcomes of interest. Results: A total of 6560 patients were pooled from 30 studies. Hypertension was associated with increased composite poor outcome (risk ratio (RR) 2.11 (95% confidence interval (CI) 1.85, 2.40), p < 0.001; I2, 44%) and its sub-group, including mortality (RR 2.21 (1.74, 2.81), p < 0.001; I2, 66%), severe COVID-19 (RR 2.04 (1.69, 2.47), p < 0.001; I2 31%), ARDS (RR 1.64 (1.11, 2.43), p = 0.01; I2,0%, p = 0.35), ICU care (RR 2.11 (1.34, 3.33), p = 0.001; I2 18%, p = 0.30), and disease progression (RR 3.01 (1.51, 5.99), p = 0.002; I2 0%, p = 0.55). Meta-regression analysis showed that gender ( p = 0.013) was a covariate that affects the association. The association was stronger in studies with a percentage of males < 55% compared to ⩾ 55% (RR 2.32 v. RR 1.79). Conclusion: Hypertension was associated with increased composite poor outcome, including mortality, severe COVID-19, ARDS, need for ICU care and disease progression in patients with COVID-19.

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