Effect of consumption of animal milk compared to infant formula for non-breastfed/mixed-fed infants 6–11 months of age: a systematic review (protocol)

IntroductionPrevalence rates of breastfeeding remain low even though the World Health Organization (WHO) and the American Academy of Pediatrics recommend exclusive breast feeding for the first 6 months of life in combination with appropriate complementary feeding beyond six 6 months of age. There have been several studies that address the implication of drinking animal milk and/or infant formula on children’s health and development when breast feeding is not offered during the first year of life. Vast improvements have been made in infant formula design, which may increase its benefits compared with animal’s milk. The objective of this review is therefore to synthesise the most recent evidence on the effects of the consumption of animal milk compared with infant formula in non-breastfed or mixed breastfed infants aged 6–11 months.Methods and analysisWe will conduct a systematic review and meta-analysis of studies that assessed the effect of animal milk compared with formula or mixed-fed (breastmilk and formula) on infants aged 6–11 months. The primary outcomes of interest include anaemia, gastrointestinal blood loss, weight for age, height for age and weight for height. We will include randomised and non-randomised studies with a control group. We will use the Cochrane risk of bias tools to assess the risk of bias. We will use meta-analysis to pool findings if the identified studies are conceptually homogenous and data are available from more than one study. We will assess the overall quality of evidence using the Grading of Recommendations Assessment, Development, and Evaluation approach.Ethics and disseminationThis is a systematic review, so no patients will be directly involved in the design or development of this study. The findings from this systematic review will be disseminated to relevant patient populations and caregivers and will guide the WHO’s recommendations on formula consumption versus animal milk in infants aged 6–11 months.Trial registration numberCRD42020210925.

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Tolerability of statin-based management of patients with a history of statin-associated muscle symptoms: protocol for a systematic review

BMJ Open ◽

10.1136/bmjopen-2021-052341 ◽

2021 ◽

Vol 11 (8) ◽

pp. e052341

Author(s):

Fanny Villoz ◽

Christina Lyko ◽

Cinzia Del Giovane ◽

Nicolas Rodondi ◽

Manuel R Blum

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Mean Difference ◽

Control Group ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Clinical Issue ◽

Standard Data ◽

Evaluation Approach ◽

History Of

IntroductionStatin-associated muscle symptoms (SAMSs) are a major clinical issue in the primary and secondary prevention of cardiovascular events. Current guidelines advise various approaches mainly based on expert opinion. We will lead a systematic review and meta-analysis to explore the tolerability and acceptability and effectiveness of statin-based therapy management of patients with a history of SAMS. We aim to provide evidence on the tolerability and different strategies of statin-based management of patients with a history of SAMS.Methods and analysisWe will conduct a systematic review of randomised controlled trials (RCTs) and non-randomised studies with a control group. We will search in Data sources MEDLINE, EMBASE, Cochrane Central Register of Controlled Clinical Trials, Scopus, Clinicaltrials.gov and Proquest from inception until April 2021. Two independent reviewers will carry out the study selection based on eligibility criteria. We will extract data following a standard data collection form. The reviewers will use the Cochrane Collaboration’s tools and Newcastle-Ottawa Scale to appraise the study risk of bias. Our primary outcome will be tolerability and our secondary outcomes will be acceptability and effectiveness. We will conduct a qualitative analysis of all included studies. In addition, if sufficient and homogeneous data are available, we will conduct quantitative analysis. We will synthesise dichotomous data using OR with 95% CI and continuous outcomes by using mean difference or standardised mean difference (with 95% CI). We will determine heterogeneity visually with forest plots and quantitatively with I2 and Q-test. We will summarise the confidence in the quantitative estimate by using Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationAs a systematic review of literature without collection of new clinical data, there will be no requirement for ethical approval. We will disseminate findings through peer-reviewed publications.PROSPERO registration numberCRD42020202619.

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A systematic review and meta-analysis for association of Helicobacter pylori colonization and celiac disease

PLoS ONE ◽

10.1371/journal.pone.0241156 ◽

2021 ◽

Vol 16 (3) ◽

pp. e0241156

Author(s):

Fazel Isapanah Amlashi ◽

Zahra Norouzi ◽

Ahmad Sohrabi ◽

Hesamaddin Shirzad-Aski ◽

Alireza Norouzi ◽

...

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Celiac Disease ◽

Publication Bias ◽

Meta Analysis ◽

Protective Role ◽

Negative Association ◽

Risk Of Bias ◽

Control Group ◽

Synthesis Methods

Background and objectives Based on some previous observational studies, there is a theory that suggests a potential relationship between Helicobacter pylori (H. pylori) colonization and celiac disease (CeD); however, the type of this relationship is still controversial. Therefore, we aimed to conduct a systematic review and meta-analysis to explore all related primary studies to find any possible association between CeD and human H. pylori colonization. Data sources Studies were systematically searched and collected from four databases and different types of gray literature to cover all available evidence. After screening, the quality and risk of bias assessment of the selected articles were evaluated. Synthesis methods Meta-analysis calculated pooled odds ratio (OR) on the extracted data. Furthermore, heterogeneity, sensitivity, subgroups, and publication bias analyses were assessed. Results Twenty-six studies were included in this systematic review, with a total of 6001 cases and 135512 control people. The results of meta-analysis on 26 studies showed a significant and negative association between H. pylori colonization and CeD (pooled OR = 0.56; 95% CI = 0.45–0.70; P < 0.001), with no publication bias (P = 0.825). The L’Abbé plots also showed a trend of having more H. pylori colonization in the control group. Among subgroups, ORs were notably different only when the data were stratified by continents or risk of bias; however, subgroup analysis could not determine the source of heterogeneity. Conclusions According to the meta-analysis, this negative association might imply a mild protective role of H. pylori against celiac disease. Although this negative association is not strong, it is statistically significant and should be further considered. Further investigations in both molecular and clinic fields with proper methodology and more detailed information are needed to discover more evidence and underlying mechanisms to clear the interactive aspects of H. pylori colonization in CeD patients. Systematic review registration number (PROSPERO) CRD42020167730 https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=167730.

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Effect of Maternal Postpartum and Infant Intermittent Vitamin D Supplementation on Infant Vitamin D Status: A Systematic Review and Meta-Analysis of Trials (P11-089-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz048.p11-089-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Author(s):

Karen O'Callaghan ◽

Mahgol Taghivand ◽

Anna Zuchniak ◽

Akpevwe Onoyovwi ◽

Jill Korsiak ◽

...

Keyword(s):

Vitamin D ◽

Meta Analysis ◽

Vitamin D Supplementation ◽

Small Sample ◽

Risk Of Bias ◽

World Health ◽

Control Group ◽

Cochrane Central Register ◽

Vitamin D Status ◽

Statistical Heterogeneity

Abstract Objectives To determine the response of infant (≤ 1 year) circulating 25-hydroxyvitamin D (25(OH)D) to maternal postpartum or infant intermittent vitamin D supplementation in comparison to current recommendations of direct daily oral infant supplementation (400 IU/d). Methods MEDLINE, MEDLINE In-Process, Embase, the Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials were searched up to December 4th 2018. A systematic search of online trial registries for unpublished, ongoing, or planned trials was also completed. Risk of bias was assessed using the Cochrane Risk Assessment Tool. Meta-analysis was limited to trials with a control group of infants receiving 400 IU vitamin D/d. A weighted mean difference (WMD) and 95% confidence interval (CI) was generated using infant 25(OH)D as a continuous outcome. Random-effects models accounted for within- and between-study variability. Statistical heterogeneity was quantified with the I2 statistic. Results A total of 28 trials were included, representing data from all 6 World Health Organization world regions. Of the 25 trials that specified a calciferol form, the majority (88%) employed vitamin D3. Six trials (21%) had an overall low risk of bias. Six trials qualified for meta-analysis, stratified by maternal (n = 4) and infant (n = 2) administration. Maternal supplementation resulted in a modestly lower infant vitamin D status than daily infant supplementation (WMD =-7.3 nmol/L; 95% CI: -14.0 to -0.6; I2 = 37%, P = 0.17). Comparison of infant intermittent bolus dosing to daily supplementation was limited by a small sample size and substantial heterogeneity, resulting in a wide CI (WMD = 10.2 nmol/L; 95% CI: -42.9 to 63.3; I2 = 96%, P < 0.001). Safety outcomes, including effects on calcium homeostasis, were inconsistently reported. Four ongoing trials were identified as potential contributors to future reviews. Conclusions Evidence to support the use of specific alternative maternal or infant regimens to substitute for current daily infant vitamin D supplementation is weak and inconsistent. Dose-ranging, adequately powered trials are required to establish the efficacy and safety of feasible alternative strategies to prevent infant vitamin D deficiency Funding Sources SickKids C-GCH Growth and Development Fellowship.

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Biological effects of amniotic membrane on diabetic foot wounds: a systematic review

Journal of Wound Care ◽

10.12968/jowc.2018.27.sup2.s19 ◽

2018 ◽

Vol 27 (Sup2) ◽

pp. S19-S25 ◽

Cited By ~ 9

Author(s):

André Oliveira Paggiaro ◽

Andriws Garcia Menezes ◽

Alexandra Donizetti Ferrassi ◽

Viviane Fernandes De Carvalho ◽

Rolf Gemperli

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Amniotic Membrane ◽

Diabetic Foot ◽

Biological Effects ◽

Meta Analysis ◽

Healing Process ◽

Intervention Group ◽

Risk Of Bias ◽

Control Group

Objective: The amniotic membrane has biological properties that are beneficial to the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse the scientific evidence found in literature on the use of the amniotic membrane to stimulate DFU healing. Method: A systematic review of amniotic membrane's influence was undertaken, using the search terms ‘placenta’ ‘diabetic foot’ ‘amnion’ and biological dressing’, assessing the outcomes ‘wound healing’ and ‘wound healing time’, in DFU. Following the inclusion and exclusion criteria, randomised controlled trials (RCT) were identified, and the risk of bias was analysed according to the Cochrane risk of bias tool. We conducted a meta-analysis of the two outcomes to evaluate the level of evidence. Results: We identified six clinical trials, with a total of 331 patients. The most common risks of bias in the studies were selection, attrition, and detection biases. From the meta-analysis, the difference of the intervention group (amnion) in relation to the control group was statistically significant. We found that wound healing in the group treated with amniotic membrane occurs 2.32 times more often and is 32 days faster in comparison with the group that used conventional dressings. Conclusion: There is statistical evidence to support the effectiveness of amniotic membrane in comparison with other conventional dressings. In addition, there is a clear tendency for the use of amniotic membrane treatment to result in a larger number of DFUs healing at a quicker rate.

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Physically Active Lessons Meta-Analysis - Norris et al. POST-PRINT

10.31234/osf.io/xdusz ◽

2019 ◽

Author(s):

Emma Norris ◽

Tommy van Steen ◽

Artur Direito ◽

Emmanuel Stamatakis

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Health Outcomes ◽

Educational Outcomes ◽

Meta Analysis ◽

Grey Literature ◽

Risk Of Bias ◽

Control Group ◽

Physically Active ◽

Meta Analyses

Objective: This review provides the first meta-analysis of the effects of physically active lessons on lesson-time and overall physical activity (PA), as well as health, cognition and educational outcomes. Design: Systematic review and meta-analysis. Six meta-analyses pooled effects on lesson-time PA, overall PA, in-class educational and overall educational outcomes, cognition and health outcomes. Meta-analyses were conducted using the metafor package in R. Risk of bias was assessed using the Cochrane tool for risk of bias. Data sources: PubMed, Embase, PsycINFO, ERIC and Web of Science, grey literature and reference lists were searched in December 2017 and April 2019. Studies eligibility criteria: Physically active lessons compared to a control group in a randomised or non-randomised design, within single component interventions in general school populations. Results: 42 studies (39 in preschool or elementary school settings, 27 randomised controlled trials) were eligible for inclusion in the systematic review and 37 of them were included across the six meta-analyses (n=12,663). Physically active lessons were found to produce large, significant increases in lesson-time PA (d=2.33; 95%CI 1.42, 3.25: k=16) and small, significant effects on overall PA (d= 0.32, 95%CI 0.18, 0.46: k=8). A large, significant effect was shown on lesson-time educational outcomes (d=0.81; 95%CI 0.47, 1.14: k=7) and a small, significant effect on overall educational outcomes (d=0.36, 95%CI [0.09, 0.63], k=25). No effects were seen on cognitive (k=3) or health outcomes (k=3). 25/42 studies had high risk of bias in at least 2 domains. Conclusion: In elementary and preschool settings, when physically active lessons were added into the curriculum they had a positive impact on both physical activity and educational outcomes. These findings support policy initiatives encouraging the incorporation of physically active lessons into teaching in elementary and preschool settings.

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Effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis

10.21203/rs.2.12592/v3 ◽

2019 ◽

Author(s):

Weili Wang ◽

Kuang-Huei Chen ◽

Ying-Chieh Pan ◽

Szu-Nian Yang ◽

Yuan-Yu Chan

Keyword(s):

Systematic Review ◽

Sleep Quality ◽

Sleep Problems ◽

Meta Analysis ◽

Risk Of Bias ◽

Cochrane Library ◽

Control Group ◽

Serious Adverse Events ◽

Positive Effects ◽

Meta Analyses

Abstract Objectives To examine the effectiveness and safety of yoga for women with sleep problems by performing a systematic review and meta-analysis.Methods Medline/PubMed, Clincalkey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia severity index (ISI), or objective instruments, such as polysomnography, actigraphy, and safety of the intervention. For each outcome, standardized mean difference (SMD) and 95% confidence intervals (CIs) were determined. Results Nineteen studies including 1832 participants were included in this systematic review. Meta-analyses revealed positive effects of yoga using PSQI or ISI scores in 16 randomized control trials (RCTs) compared with the control group in improving sleep quality in women, PSQI (SMD = −0.54; 95% CI = −0.89 to −0.19 ; P = 0.003). However, three RCTs revealed no effects of yoga compared with the control group in reducing the severity of insomnia in women using ISI (SMD = −0.13; 95% CI = −0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = −0.15 ; 95% CI = −0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri-or postmenopausal women using PSQI (SMD = −0.31; 95% CI = −0.95 to 0.33; P = 0.34).Yoga was not associated with serious adverse events. Discussion This systematic review and meta-analysis found that yoga intervention in some groups of women was beneficial in managing sleep problems. Despite certain disadvantages in methodology in the included studies, yoga may be recommended as a complementary therapy to women.

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Steroid therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2021.1716 ◽

2021 ◽

Author(s):

Tarun Krishna Boppana ◽

Saurabh Mittal ◽

Karan Madan ◽

Anant Mohan ◽

Vijay Hadda ◽

...

Keyword(s):

Systematic Review ◽

Mechanical Ventilation ◽

Randomized Controlled Trials ◽

Steroid Therapy ◽

Meta Analysis ◽

Risk Of Bias ◽

Treatment Modalities ◽

Control Group ◽

Controlled Trials ◽

Randomized Controlled

There is an urgent need for effective treatment modalities for coronavirus disease 2019 (COVID-19). Data for the use of steroids in COVID-19 is emerging. We conducted this systematic review and meta-analysis to estimate the effectiveness of steroid administration in mortality reduction due to COVID-19 compared to the control group. A systematic search of the Pubmed and Embase databases was performed to extract randomized controlled trials (RCTs) regarding the use of steroid therapy for COVID-19. An overall and subgroup (based upon the type of steroid) pooled mortality analysis was performed, and odds ratios were reported. Cochrane risk of bias assessment tool was used to assess the risk of bias. Heterogeneity was assessed using the I2 statistic. Six RCTs, including 7707 patients, were selected for review. Three trials reported 28-day mortality, and two trials reported 21-day mortality, and one trial reported in-hospital mortality. There were 730 deaths among 2837 participants in the steroid group while 1342 deaths among 4870 patients randomized to the control group (Odds ratio 0.76, 95% confidence interval 0.58-1.00, p=0.05). The effect was significant in patients on oxygen or mechanical ventilation. There was no difference in the various preparations and doses of the steroids. There was heterogeneity among the trials as the I2 value was 53%, with a p-value of 0.06. There was no indication of increased serious adverse events. This meta-analysis of RCTs demonstrated that the use of systemic corticosteroids is associated with a reduction in all-cause mortality in patients with COVID-19 on oxygen or mechanical ventilation.

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The best treatment option(s) for adult and elderly patients with chronic primary musculoskeletal pain: a protocol for a systematic review and network meta-analysis

Systematic Reviews ◽

10.1186/s13643-019-1174-6 ◽

2019 ◽

Vol 8 (1) ◽

Cited By ~ 2

Author(s):

Helen Koechlin ◽

Ben Whalley ◽

Nicky J. Welton ◽

Cosima Locher

Keyword(s):

Systematic Review ◽

Musculoskeletal Pain ◽

Emotional Distress ◽

Treatment Option ◽

Functional Disability ◽

Meta Analysis ◽

Risk Of Bias ◽

Control Group ◽

Efficacy And Safety ◽

Safety Outcomes

Abstract Background Chronic primary musculoskeletal pain (CPMP) is one subcategory of the new classification of chronic primary pain for the upcoming ICD-11, defined as chronic pain in the muscles, bones, joints, or tendons that persists or recurs for more than 3 months and is associated with significant emotional distress or functional disability. An array of pharmacological, psychological, physical, complementary, and rehabilitative interventions is available for CPMP, for which previous research has demonstrated varying effect sizes with regard to effectiveness in pain reduction and other main outcomes. This highlights the need for the synthesis of all available evidence. The proposed network meta-analysis will compare all available interventions for CPMP to determine the best treatment option(s) with a focus on efficacy and safety of interventions. Methods We are interested in comparing interventions of the following types: psychological, pharmacological, physical, complementary, and rehabilitative interventions. We will include all randomized controlled trials that compare one intervention with another, or with a control group, in the treatment of CPMP. Primary efficacy outcomes will be pain intensity, emotional distress, and functional disability. Safety outcomes extracted will include proportion of patients with treatment-emergent adverse events, unwanted events, or drop-out rates due to side effects. Published and unpublished trials will be sought through the search of all relevant databases and trial registries. At least two independent reviewers of the team will select the references and extract data independently. We will assess the risk of bias of each individual study using the Cochrane risk of bias assessment tool. We will conduct a network meta-analysis to synthesize all evidence for each outcome. We will fit our model primarily within a Bayesian framework. Discussion CPMP is a disabling condition for which several interventions exist. To our knowledge, this is the first network meta-analysis to systematically compare all available evidence. This is required by national health institutions to inform their decisions about the best available treatment option(s) with regard to efficacy and safety outcomes. Systematic review registration PROSPERO CRD42018096114

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Does aerobic exercise reduce postpartum depressive symptoms? a systematic review and meta-analysis

British Journal of General Practice ◽

10.3399/bjgp17x692525 ◽

2017 ◽

Vol 67 (663) ◽

pp. e684-e691 ◽

Cited By ~ 19

Author(s):

Ruth Victoria Pritchett ◽

Amanda J Daley ◽

Kate Jolly

Keyword(s):

Systematic Review ◽

Depressive Symptoms ◽

Aerobic Exercise ◽

Meta Analysis ◽

Risk Of Bias ◽

World Health ◽

Cochrane Library ◽

Group Exercise ◽

Postpartum Depressive Symptoms ◽

Health Organization

BackgroundThere is currently no specific guidance on the role of exercise in managing postpartum depression in the UK and US, and international guidance is inconsistent.AimTo assess the effectiveness of aerobic exercise on postpartum depressive symptoms.Design and settingSystematic review and meta-analysis. There was no restriction to study site or setting.MethodThe databases MEDLINE, EMBASE, Cochrane Library, PsycINFO, SportDiscus, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched. Titles and abstracts, then full-text articles, were screened against inclusion criteria: RCTs measuring depressive symptoms in mothers ≤1 year postpartum; and interventions designed to increase aerobic exercise compared with usual care or other comparators. Included studies were assessed using the Cochrane Collaboration’s risk of bias tool. Meta-analysis was conducted. Pre-planned subgroup analyses explored heterogeneity.ResultsThirteen RCTs were included, with 1734 eligible participants. Exercise significantly reduced depressive symptoms when all trials were combined (standardised mean difference −0.44; 95% confidence interval = −0.75 to −0.12). Exploration of heterogeneity did not find significant differences in effect size between women with possible depression and in general postpartum populations; exercise only and exercise with co-interventions; and group exercise and exercise counselling.ConclusionThis systematic review provides support for the effectiveness of exercise in reducing postpartum depressive symptoms. Group exercise, participant-chosen exercise, and exercise with co-interventions all may be effective interventions. These results should be interpreted with caution because of substantial heterogeneity and risk of bias.

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Acupuncture combined with medication for opioid use disorder in adults: a protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-034554 ◽

2020 ◽

Vol 10 (6) ◽

pp. e034554

Author(s):

Zhihan Chen ◽

Rui Wang ◽

Min Zhang ◽

Yitong Wang ◽

Yulan Ren

Keyword(s):

Systematic Review ◽

Assessment Tool ◽

Meta Analysis ◽

Opioid Use Disorder ◽

Risk Of Bias ◽

Control Group ◽

Opioid Use ◽

Bias Assessment ◽

Assess Quality ◽

Randomised Controlled

IntroductionOpioid use disorder (OUD) is a worldwide health problem. Clinical trials indicated that acupuncture combined with medication is effective in OUD, however, there are different conclusions presented by previous trials. This study is designed to evaluate the efficacy and safety of acupuncture combined with medication in OUD.Methods and analysisPubMed, CENTRAL, Embase, Web of Science, CINAHL, PsycINFO, ProQuest Dissertation and Theses, AMED, OpenGrey, Clinicaltrials.gov and who.int/trialsearch will be searched in September 2019 without a language restriction. Randomised controlled trials (RCTs) and quasi-RCTs which included participants with OUD receiving acupuncture therapy combined with medication versus control group will be included in this study. Two reviewers will independently screen studies, extract data, assess risk of bias by the Cochrane risk of bias assessment tool and assess quality of evidence by Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Any disagreements will be arbitrated by the third reviewer. Data synthesis and analysis will be conducted by using RevMan V.5.3. Subgroup analyses, sensitivity analysis, meta-regression and reporting bias assessment will be conducted if necessary and appropriate.Ethics and disseminationOn account of the nature of this systematic review and meta-analysis, ethical approval is not required. The results will be published in a peer-reviewed journal.PROSPERO registration numberCRD42019123436.

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