Surgical Technique in Distal Pancreatectomy: A Systematic Review of Randomized Trials

Despite recent improvements in surgical technique, the morbidity of distal pancreatectomy remains high, with pancreatic fistula being the most significant postoperative complication. A systematic review of randomized controlled trials (RCTs) dealing with surgical techniques in distal pancreatectomy was carried out to summarize up-to-date knowledge on this topic. The Cochrane Central Registry of Controlled Trials, Embase, Web of Science, and Pubmed were searched for relevant articles published from 1990 to December 2013. Ten RCTs were identified and included in the systematic review, with a total of 1286 patients being randomized (samples ranging from 41 to 450). The reviewers were in agreement for application of the eligibility criteria for study selection. It was not possible to carry out meta-analysis of these studies because of the heterogeneity of surgical techniques and approaches, such as varying methods of pancreas transection, reinforcement of the stump with seromuscular patch or pancreaticoenteric anastomosis, sealing with fibrin sealants and pancreatic stent placement. Management of the pancreatic remnant after distal pancreatectomy is still a matter of debate. The results of this systematic review are possibly biased by methodological problems in some of the included studies. New well designed and carefully conducted RCTs must be performed to establish the optimal strategy for pancreatic remnant management after distal pancreatectomy.

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The Effect of Acupuncture in Breast Cancer–Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis

Integrative Cancer Therapies ◽

10.1177/1534735419866910 ◽

2019 ◽

Vol 18 ◽

pp. 153473541986691 ◽

Cited By ~ 3

Author(s):

Tsai-Ju Chien ◽

Chia-Yu Liu ◽

Ching-Ju Fang

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Randomized Controlled Trials ◽

Large Scale ◽

Meta Analysis ◽

Lymphatic Drainage ◽

Controlled Trials ◽

Breast Cancer Patients ◽

Eligibility Criteria ◽

Randomized Controlled

Background: Breast cancer–related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (−1.90; 95% confidence interval = −5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.

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Systematic review and meta-analysis comparing three techniques for pancreatic remnant closure following distal pancreatectomy

British Journal of Surgery ◽

10.1002/bjs.9653 ◽

2014 ◽

Vol 102 (1) ◽

pp. 4-15 ◽

Cited By ~ 59

Author(s):

H. Zhang ◽

F. Zhu ◽

M. Shen ◽

R. Tian ◽

C. J. Shi ◽

...

Keyword(s):

Systematic Review ◽

Distal Pancreatectomy ◽

Meta Analysis ◽

Pancreatic Remnant

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Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis

British Journal of Sports Medicine ◽

10.1136/bjsports-2017-097892 ◽

2018 ◽

Vol 52 (16) ◽

pp. 1040-1046 ◽

Cited By ~ 13

Author(s):

Nadine Rasenberg ◽

Henrik Riel ◽

Michael S Rathleff ◽

Sita M A Bierma-Zeinstra ◽

Marienke van Middelkoop

Keyword(s):

Systematic Review ◽

Conservative Treatment ◽

Meta Analysis ◽

Heel Pain ◽

Controlled Trials ◽

Cochrane Central Register ◽

Foot Orthoses ◽

Short Term ◽

Eligibility Criteria ◽

Plantar Heel Pain

BackgroundPlantar heel pain (PHP) is common. Foot orthoses are often applied as treatment for PHP, even though there is little evidence to support this.ObjectiveTo investigate the effects of different orthoses on pain, function and self-reported recovery in patients with PHP and compare them with other conservative interventions.DesignSystematic review and meta-analysis.Data sourcesA systematic literature search was conducted in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL and Google Scholar up to January 2017.Eligibility criteria for selecting studiesRandomised controlled trials comparing foot orthoses with a control (defined as no intervention, sham or other type of conservative treatment) reporting on pain, function or self-reported recovery in patients with PHP.ResultsTwenty studies investigating eight different types of foot orthoses were included in the review. Most studies were of high quality. Pooled data from six studies showed no difference between prefabricated orthoses and sham orthoses for pain at short term (mean difference (MD) of 0.26 (95% CI −0.09 to 0.60)). No difference was found between sham orthoses and custom orthoses for pain at short term (MD 0.22 (95% CI −0.05 to 0.50)), nor was there a difference between prefabricated orthoses and custom orthoses for pain at short term (MD 0.03 (95% CI −0.15 to 0.22)). For the majority of other interventions, no significant differences were found.ConclusionsFoot orthoses are not superior for improving pain and function compared with sham or other conservative treatment in patients with PHP.PROSPERO registration numberCRD42015029659.

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Effects of Acute Heat and Cold Exposures at Rest or during Exercise on Subsequent Energy Intake: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu13103424 ◽

2021 ◽

Vol 13 (10) ◽

pp. 3424

Author(s):

Juliette Millet ◽

Julien Siracusa ◽

Pierre-Emmanuel Tardo-Dino ◽

David Thivel ◽

Nathalie Koulmann ◽

...

Keyword(s):

Energy Intake ◽

Meta Analysis ◽

Controlled Trials ◽

Small Decrease ◽

Eligibility Criteria ◽

Randomized Controlled ◽

Ovid Medline ◽

Study Selection ◽

Ad Libitum ◽

Rest And Exercise

The objective of this meta-analysis was to assess the effect of acute heat/cold exposure on subsequent energy intake (EI) in adults. We searched the following sources for publications on this topic: PubMed, Ovid Medline, Science Direct and SPORTDiscus. The eligibility criteria for study selection were: randomized controlled trials performed in adults (169 men and 30 women; 20–52 years old) comparing EI at one or more meals taken ad libitum, during and/or after exposure to heat/cold and thermoneutral conditions. One of several exercise sessions could be realized before or during thermal exposures. Two of the thirteen studies included examined the effect of heat (one during exercise and one during exercise and at rest), eight investigated the effect of cold (six during exercise and two at rest), and three the effect of both heat and cold (two during exercise and one at rest). The meta-analysis revealed a small increase in EI in cold conditions (g = 0.44; p = 0.019) and a small decrease in hot conditions (g = −0.39, p = 0.022) for exposure during both rest and exercise. Exposures to heat and cold altered EI in opposite ways, with heat decreasing EI and cold increasing it. The effect of exercise remains unclear.

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Workplace programmes for supporting breast-feeding: a systematic review and meta-analysis

Public Health Nutrition ◽

10.1017/s1368980020004012 ◽

2020 ◽

pp. 1-13

Author(s):

Xueying Tang ◽

Peta Patterson ◽

Kristen MacKenzie-Shalders ◽

Louise A van Herwerden ◽

Jo Bishop ◽

...

Keyword(s):

Systematic Review ◽

Breast Feeding ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Controlled Trials ◽

Eligibility Criteria ◽

Positive Direction ◽

The Usa ◽

Expectant Fathers ◽

Randomised Controlled

Abstract Objective: To critically review the literature regarding workplace breast-feeding interventions and to assess their impact on breast-feeding indicators. Design: A systematic review and meta-analysis was conducted. Electronic searches for workplace intervention studies to support breast-feeding, without restriction on language or study design, were performed in PubMed, CENTRAL, CINAHL, Embase, Web of Science, Business Source Complete, ProQuest-Sociology and ProQuest-Social Science to 13 April 2020. A meta-analysis of the pooled effect of the programmes on breast-feeding indicators was conducted. Results: The search identified 10 215 articles; fourteen studies across eighteen publications met eligibility criteria. Programmes were delivered in the USA (n 10), Turkey (n 2), Thailand (n 1) or Taiwan (n 1). There were no randomised controlled trials. The pooled OR for exclusive breast-feeding at 3 or 6 months for participants v. non-participants of three non-randomised controlled studies was 3·21 (95 % CI 1·70, 6·06, I2 = 22 %). Despite high heterogeneity, other pooled outcomes were consistently in a positive direction with acceptable CI. Pooled mean duration of breast-feeding for five single-arm studies was 9·16 months (95 % CI 8·25, 10·07). Pooled proportion of breast-feeding at 6 months for six single-arm studies was 0·76 (95 % CI 0·66, 0·84) and breast-feeding at 12 months for three single-arm studies was 0·41 (95 % CI 0·22, 0·62). Most programmes were targeted at mothers; two were targeted at expectant fathers. Conclusions: Workplace programmes may be effective in promoting breast-feeding among employed mothers and partners of employed fathers. However, no randomised controlled trials were identified, and better-quality research on workplace interventions to improve breast-feeding is needed.

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Platelet-Rich Fibrin in Third Molar Surgery: Systematic Review and Meta-Analysis Protocol

Craniomaxillofacial Trauma & Reconstruction ◽

10.1177/19433875211016203 ◽

2021 ◽

pp. 194338752110162

Author(s):

Gaston A. Salas ◽

Shuheng A. Lai ◽

Francisca Verdugo-Paiva ◽

Roberto A. Requena

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Grey Literature ◽

Third Molar ◽

Risk Of Bias ◽

Third Molar Surgery ◽

Controlled Trials ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Platelet Rich Fibrin

Objective: The objective of this systematic review is to assess the effectiveness and safety of platelet-rich fibrin (PRF) in third molar surgery. Data Sources: A comprehensive search strategy is meant to be used in an attempt to identify all relevant randomized controlled trials (RCTs), ongoing investigation reported in specialty congresses and trials regardless of language or publication status (published, unpublished, in press and in progress). Searches will be conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, the International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov , US National Institutes of Health (NIH), grey literature and in specialized congresses and conferences. Eligibility Criteria: We will include randomized trials evaluating the effect of PRF on wound healing after third molar surgery. Two reviewers will independently screen each study for eligibility, data extraction and risk of bias assessment using Cochrane “risk of bias” tool. We will pool the results using meta-analysis and will apply the GRADE system to assess the certainty of the evidence for each outcome. Ethics and Dissemination: As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived.

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Do Distracted Driving Laws Impact Cell Phone Usage on (Preventable) Outcomes While Driving: A Systematic Review of the Last 20 Years?

Proceedings of IMPRS ◽

10.18060/24531 ◽

2020 ◽

Vol 3 ◽

Author(s):

Nudar Bhuiya ◽

Lisa Hollister ◽

Thein Zhu

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Distracted Driving ◽

Review Of Literature ◽

Eligibility Criteria ◽

Strategy Study ◽

Fatal Crashes ◽

Study Selection ◽

Prisma Statement ◽

Potential Impact

Background/Objective: Distracted driving due to cellphone use can lead to serious and fatal consequences. In 2017, an estimated 14% of all distraction-affected fatal crashes in the U.S. were related to the driver’s cellphone use. Many states have passed distracted driving laws to help reduce the number of unfortunate outcomes related to a driver’s cellphone use. It is important to evaluate whether these laws are truly effective at building safer roads. The main objective of this proposed study is to execute a systematic review of literature published in the last 20 years in order to further the understanding of how distracted driving laws affect drivers’ cellphone usage and its associated outcomes. Proposed Methods: A systematic review will be conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement established by Moher et al. The various steps that will be taken to properly select and analyze articles include eligibility criteria, information sources and search strategy, study selection, evaluation of selected articles, data collection, and summary measures. Expected Results: After implementing the various steps from the PRISMA statement, certain articles will be selected to fulfill the research objective. It is expected that most of the publications selected for this systematic review will be in support of distracted driving laws. It is also expected that these laws are in fact effective at reducing drivers’ cellphone use and various negative outcomes, such as crashes. Conclusions/Potential Impact: A systematic review will be completed utilizing the proposed protocol written in the summer of 2020. If needed, additional details and changes will be applied to the protocol before the study officially begins. This systematic review may help us gain an understanding of the effects of distracted driving laws, which may impact the approach to creating future policies and interventions intended to promote safer driving roads.

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Does robotic-assisted unicompartmental knee arthroplasty have lower complication and revision rates than the conventional procedure? A systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044778 ◽

2021 ◽

Vol 11 (8) ◽

pp. e044778

Author(s):

Yifeng Sun ◽

Wei Liu ◽

Jian Hou ◽

Xiuhua Hu ◽

Wenqiang Zhang

Keyword(s):

Systematic Review ◽

Knee Arthroplasty ◽

Unicompartmental Knee Arthroplasty ◽

Meta Analysis ◽

Surgical Techniques ◽

Complication Rates ◽

Case Control Studies ◽

Eligibility Criteria ◽

Robotic Assisted ◽

Unicompartmental Knee

ObjectiveWe conducted this systematic review and meta-analysis of studies on patients who underwent unicompartmental knee arthroplasty (UKA) to compare the complication rates, revision rates and non-implant-specific complications between robotic-assisted and conventional UKA.DesignSystematic review and meta-analysis.Data sourcesThe PubMed, Embase, Web of Science and Cochrane databases were searched up to 30 June 2020.Eligibility criteriaCase–control studies comparing robotic-assisted and conventional UKA.Data extraction and synthesisData from all eligible articles were independently extracted by two authors. We analysed the differences in outcomes between robotic-assisted and conventional UKA by calculating the corresponding 95% CIs and pooled relative risks (RRs). Heterogeneity was assessed using the χ2 and I2 tests. All analyses were performed using the ‘metafor’ package of R V.3.6.2 software.ResultsA total of 16 studies involving 50 024 patients were included in the final meta-analysis. We found that robotic-assisted UKA had fewer complications (RR: 0.52, 95% CI: 0.28 to 0.96, p=0.036) and lower revision rates (RR: 0.42, 95% CI: 0.20 to 0.86, p=0.017) than conventional UKA. We observed no significant differences in non-implant-specific complications between the two surgical techniques (RR: 0.80, 95% CI: 0.61 to 1.04, p=0.96). No publication bias was found in this meta-analysis.ConclusionsThis study provides evidence that robotic-assisted UKA has fewer complications and lower revision rates than conventional UKA; however, owing to important limitations, the results lack reliability, and more studies are required.PROSPERO registration numberCRD42021246927.

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The Efficacy of Guanxinning Injection in Treating Angina Pectoris: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2013/282707 ◽

2013 ◽

Vol 2013 ◽

pp. 1-16 ◽

Cited By ~ 5

Author(s):

Yongliang Jia ◽

Siu-wai Leung ◽

Ming-Yuen Lee ◽

Guozhen Cui ◽

Xiaohui Huang ◽

...

Keyword(s):

Systematic Review ◽

Sensitivity Analysis ◽

Angina Pectoris ◽

Randomized Controlled Trials ◽

Subgroup Analysis ◽

Meta Analysis ◽

Controlled Trials ◽

Eligibility Criteria ◽

Randomized Controlled ◽

Study Characteristics

Objective. The randomized controlled trials (RCTs) on Guanxinning injection (GXN) in treating angina pectoris were published only in Chinese and have not been systematically reviewed. This study aims to provide a PRISMA-compliant and internationally accessible systematic review to evaluate the efficacy of GXN in treating angina pectoris.Methods. The RCTs were included according to prespecified eligibility criteria. Meta-analysis was performed to evaluate the symptomatic (SYMPTOMS) and electrocardiographic (ECG) improvements after treatment. Odds ratios (ORs) were used to measure effect sizes. Subgroup analysis, sensitivity analysis, and metaregression were conducted to evaluate the robustness of the results.Results. Sixty-five RCTs published between 2002 and 2012 with 6064 participants were included. Overall ORs comparing GXN with other drugs were 3.32 (95% CI: [2.72, 4.04]) in SYMPTOMS and 2.59 (95% CI: [2.14, 3.15]) in ECG. Subgroup analysis, sensitivity analysis, and metaregression found no statistically significant dependence of overall ORs upon specific study characteristics.Conclusion. This meta-analysis of eligible RCTs provides evidence that GXN is effective in treating angina pectoris. This evidence warrants further RCTs of higher quality, longer follow-up periods, larger sample sizes, and multicentres/multicountries for more extensive subgroup, sensitivity, and metaregression analyses.

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Gelatin tannate for acute diarrhoea and gastroenteritis in children: a systematic review and meta-analysis

Archives of Disease in Childhood ◽

10.1136/archdischild-2018-316385 ◽

2019 ◽

pp. archdischild-2018-316385 ◽

Cited By ~ 1

Author(s):

Ivan D Florez ◽

Javier M Sierra ◽

Laura F Niño-Serna

Keyword(s):

Systematic Review ◽

Adverse Events ◽

Meta Analysis ◽

Grey Literature ◽

Acute Diarrhoea ◽

Stool Frequency ◽

Controlled Trials ◽

Cochrane Central Register ◽

Eligibility Criteria ◽

Randomised Controlled

ObjectiveTo determine the effectiveness and safety of gelatin tannate (GT) for reducing the duration of the acute diarrhoea and gastroenteritis (ADG) in children.DesignSystematic review and meta-analysis.Data sourcesMEDLINE, Embase, CINAHL, Cochrane Central Register of Controlled Trials, LILACS and grey literature, published from inception to October 2018. No language restrictions.Eligibility criteria for selecting studiesRandomised controlled trials in children with ADG, comparing GT with placebo.ResultsOf 797 titles identified, we included three studies (276 children). We performed a random effects model meta-analysis for the main outcome (diarrhoea duration). We did not find significant differences between GT and placebo for diarrhoea duration (mean difference (MD)=−15.85 hours; 95% CI −42.24 to 14.82, I2=92%; three studies), stool frequency at day 2 (MD=0.11 stools/day; 95% CI −0.39 to 0.62: I2=26%; two studies), diarrhoea at day 3 (risk ratio [RR]=0.46; 95% CI 0.06 to 3.47: I2=73%; two studies), vomiting (RR=1.31; 95% CI 0.95 to 1.80: I2=0%; two studies) or adverse events (RR=0.86; 95% CI 0.27 to 2.66: I2=0%; two studies). Most common adverse events included abdominal pain and nausea.ConclusionThe effect of GT was no different to placebo for mean diarrhoea duration (low certainty on the evidence) and stool frequency at day 2 (high certainty) and for the presence of diarrhoea at day 3 (very low certainty) of vomiting (moderate certainty) and of adverse events (low certainty).PROSPERO registration numberCRD42018087902.

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