Cytokines as Early Markers of Colorectal Anastomotic Leakage: A Systematic Review and Meta-Analysis

Purpose.Colorectal anastomotic leakage (CAL) is one of the most severe complications after colorectal surgery. This meta-analysis evaluates whether systemic or peritoneal inflammatory cytokines may contribute to early detection of CAL.Methods. Systematic literature search was performed in the acknowledged medical databases according to the PRISMA guidelines to identify studies evaluating systemic and peritoneal levels of TNF, IL-1β, IL-6, and IL-10 for early detection of CAL. Means and standard deviations of systemic and peritoneal cytokine levels were extracted, respectively, for patients with and without CAL. The meta-analysis of the mean differences was carried out for each postoperative day using Review Manager.Results.Seven articles were included. The meta-analysis was performed with 5 articles evaluating peritoneal cytokine levels. Peritoneal levels of IL-6 were significantly higher in patients with CAL compared to patients without CAL on postoperative days 1, 2, and 3 (P<0.05). Similar results were found for peritoneal levels of TNF but on postoperative days 3, 4, and 5 (P<0.05). The articles regarding systemic cytokine levels did not report any significant difference accordingly.Conclusion.Increased postoperative levels of peritoneal IL-6 and TNF are significantly associated with CAL and may contribute to its early detection.

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Comparing iStent versus CyPass with or without phacoemulsification in patients with glaucoma: a meta-analysis

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622318820850 ◽

2019 ◽

Vol 10 ◽

pp. 204062231882085 ◽

Cited By ~ 1

Author(s):

Ali Mahdavi Fard ◽

Sangita P. Patel ◽

Leili Pourafkari ◽

Nader D. Nader

Keyword(s):

Intraocular Pressure ◽

Meta Analysis ◽

Cochrane Review ◽

Cataract Extraction ◽

Lowering Effect ◽

The Mean ◽

Mean Differences ◽

Review Manager

Bacground: The aim of this study was to conduct a meta-analysis to compare the overall intraocular pressure (IOP)-lowering effect of iStent or CyPass as isolated procedures or in combination with cataract extraction. Materials and methods: Cochrane review manager 5.3 software (RevMan® 5.3) was used for a meta-analysis of IOPs and the number of antiglaucoma medications in six groups according to the type and number of stents and whether the procedure was isolated or in combination with cataract extraction. Main results: A total of 33 out of 446 publications retrieved have been enrolled. The mean changes in IOP in the groups with one iStent and more than two iStents with concurrent cataract extraction were −3.78 ± 0.53 mmHg and −3.89 ± 0.73 mmHg, respectively. The mean differences in IOP in the groups with one iStent and more than two iStents without concurrent cataract extraction were −3.96 ± 0.25 mmHg and −7.48 ± 0.55 mmHg, respectively. The mean changes in IOP in the groups with CyPass implantation with and without concurrent cataract extraction were −4.97 ± 1.38 mmHg and −8.96 ± 0.16 mmHg, respectively. Conclusions: Both iStent and CyPass either in combination with cataract extraction or as isolated procedures effectively decrease IOP. This effect is greatest with isolated implantation of CyPass followed by multiple iStents and then single iStent implantation and lasts up to 2 years.

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Copper Concentrations in Breast Cancer: A Systematic Review and Meta-Analysis

Current Medicinal Chemistry ◽

10.2174/0929867326666190918120209 ◽

2020 ◽

Vol 27 (37) ◽

pp. 6373-6383 ◽

Cited By ~ 1

Author(s):

Leila Jouybari ◽

Faezeh Kiani ◽

Farhad Islami ◽

Akram Sanagoo ◽

Fatemeh Sayehmiri ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Breast Tissue ◽

Reference Lists ◽

Meta Analysis ◽

Cancer Risks ◽

Hair Samples ◽

Significant Difference ◽

Mean Differences ◽

Very High

: Breast cancer is the most common neoplasm, comprising 16% of all women's cancers worldwide. Research of Copper (Cu) concentrations in various body specimens have suggested an association between Cu levels and breast cancer risks. This systematic review and meta-analysis summarize the results of published studies and examine this association. We searched the databases PubMed, Scopus, Web of Science, and Google Scholar and the reference lists of relevant publications. The Standardized Mean Differences (SMDs) between Cu levels in cancer cases and controls and corresponding Confidence Intervals (CIs), as well as I2 statistics, were calculated to examine heterogeneity. Following the specimens used in the original studies, the Cu concentrations were examined in three subgroups: serum or plasma, breast tissue, and scalp hair. We identified 1711 relevant studies published from 1984 to 2017. There was no statistically significant difference between breast cancer cases and controls for Cu levels assayed in any studied specimen; the SMD (95% CI) was -0.01 (-1.06 - 1.03; P = 0.98) for blood or serum, 0.51 (-0.70 - 1.73; P = 0.41) for breast tissue, and -0.88 (-3.42 - 1.65; P = 0.50) for hair samples. However, the heterogeneity between studies was very high (P < 0.001) in all subgroups. We did not find evidence for publication bias (P = 0.91). The results of this meta-analysis do not support an association between Cu levels and breast cancer. However, due to high heterogeneity in the results of original studies, this conclusion needs to be confirmed by well-designed prospective studies.

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Efficacy and safety of sprifermin injection for knee osteoarthritis treatment: a meta-analysis

Arthritis Research & Therapy ◽

10.1186/s13075-021-02488-w ◽

2021 ◽

Vol 23 (1) ◽

Author(s):

Ni Zeng ◽

Xin-Yuan Chen ◽

Zhi-Peng Yan ◽

Jie-Ting Li ◽

Tao Liao ◽

...

Keyword(s):

Adverse Events ◽

Knee Osteoarthritis ◽

Meta Analysis ◽

Placebo Treatment ◽

Cartilage Volume ◽

Cartilage Thickness ◽

Random Effects Models ◽

Structural Progression ◽

Significant Difference ◽

Mean Differences

Abstract Objective To perform a meta-analysis comparing the structural progression and clinical symptom outcomes as well as adverse events experienced from intra-articular injections of sprifermin compared to a placebo treatment for patients with knee osteoarthritis (KOA). Method We systematically searched the literature for studies that compared long-term outcomes between sprifermin and placebo injections for KOA treatment. Meta-analysis was performed with RevMan5.3 using an inverse variance approach with fixed or random effects models. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Results Eight studies were included. Overall, there was significantly less improvement of WOMAC total scores in patients receiving sprifermin, compared with the placebo (mean difference (MD) = 3.23, 95% CI 0.76–5.69; I2 = 0%; P = 0.01). Further, sprifermin injection patients gained more, and lost less, cartilage thickness and volume in total femorotibial joint (cartilage thickness: standardized mean differences (SMD) = 0.55, 95% CI 0.26–0.84; I2 = 78%; P = 0.0002; cartilage volume: SMD = 0.39, 95% CI 0.20–0.58; I2 = 49%; P < 0.0001). Changes in the cartilage surface morphology of the medial tibio-femoral joint (MD = −0.30, 95% CI −0.44 to −0.16; I2 = 0%; P < 0.0001) and patello-femoral joint (MD = −0.22; 95% CI −0.37 to −0.07; I2 = 0%; P = 0.004) showed a significant difference between the sprifermin and placebo injections. Moreover, there were no significant differences between sprifermin and the placebo in the risk of treatment-emergent adverse events (OR = 1.05; 95% CI 0.52–2.14; I2 = 48%; P = 0.89). Conclusion The data from the included studies provide strong evidence to determine the effect of intra-articular sprifermin on joint structure in individuals with KOA and show no specific adverse effects. Nevertheless, intra-articular sprifermin did not likely have any positive effect on symptom alleviation.

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Systematic Review and Meta-analysis of Endoscopic vs Microscopic Stapes Surgery for Stapes Fixation

Otolaryngology ◽

10.1177/0194599821990669 ◽

2021 ◽

pp. 019459982199066

Author(s):

Sandra Ho ◽

Prayag Patel ◽

Daniel Ballard ◽

Richard Rosenfeld ◽

Sujana Chandrasekhar

Keyword(s):

Postoperative Complications ◽

Meta Analysis ◽

Stapes Surgery ◽

Chorda Tympani Nerve ◽

Stapes Fixation ◽

Operative Outcomes ◽

Significant Difference ◽

The Mean ◽

Postoperative Vertigo ◽

Hearing Outcomes

Objective To systematically review the current literature regarding the operative outcomes of stapes surgery for stapes fixation via the endoscopic and microscopic approaches. Data Sources PubMed, Embase, and Web of Science. Review Methods An electronic search was conducted with the keywords “endoscop* or microscop*” and “stapes surgery or stapedectomy or stapedotomy or otosclerosis or stapes fixation.” Studies were included if they compared endoscopy with microscopy for stapes surgery performed for stapes fixation and evaluated hearing outcomes and postoperative complications. Articles focusing on stapes surgery other than for stapes fixation were excluded. Results The database search yielded 1317 studies; 12 remained after dual-investigator screening for quantitative analysis. The mean MINORS score was 18 of 24, indicating a low risk of bias. A meta-analysis demonstrated no statistically significant difference between the groups with regard to operative time, chorda tympani nerve manipulation or sacrifice, or postoperative vertigo. There was a 2.6-dB mean improvement in the change in air-bone gap in favor of endoscopic stapes surgery and a 15.2% increased incidence in postoperative dysgeusia in the microscopic group, but the studies are heterogeneous. Conclusions Endoscopic stapes surgery appears to be a reasonable alternative to microscopic stapes surgery, with similar operative times, complications, and hearing outcomes. Superior visibility with the endoscope was consistently reported in all the studies. Future studies should have standardized methods of reporting visibility, hearing outcomes, and postoperative complications to truly establish if endoscopic stapes surgery is equivalent or superior to microscopic stapes surgery.

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EXPRESS: Comparison of Mothership versus Drip-and-Ship Models in treating patients with Acute Ischemic Stroke: A systematic review and meta-analysis

International Journal of Stroke ◽

10.1177/17474930211013285 ◽

2021 ◽

pp. 174749302110132

Author(s):

Ahmed Mohamed ◽

Nida Fatima ◽

Ashfaq Shuaib ◽

Maher Saqqur

Keyword(s):

Functional Outcome ◽

Meta Analysis ◽

Critical Time ◽

Functional Independence ◽

Models Of Care ◽

Randomized Control Trials ◽

Symptomatic Intracerebral Hemorrhage ◽

Significant Difference ◽

The Mean ◽

Randomized Control

Introduction There is controversy if direct to comprehensive center âmothershipâ (MS) or stopping at primary center for thrombolysis before transfer to comprehensive center âdrip-and- shipâ (DS) are best models of treatment of acute stroke. In this study, we compare MS and DS models to evaluate the best option of functional outcome. Methods Studies between 1990 and 2020 were extracted from online electronic databases. We compared the clinical outcomes, critical time measurements, functional independence and mortality were then compared. Results A total of 7,824 patientsâ data were retrieved from 13 publications (3 randomized control trials and 10 retrospective ones). 4,639 (59.3%) patients were treated under MS model and 3,185 (40.7%) followed the DS model with mean age of 70.01Â±3.58 vs. 69.03Â±3.36; p< 0 .001, respectively. The National Institute Health Stroke Scale was 15.57Â±3.83 for the MS and 15.72Â±2.99 for the DS model (p=<0.001). The mean symptoms onset-to-puncture time was significantly shorter in the MS group compared to the DS (159.69 min vs. 223.89 min; p=<0.001, respectively). Moreover, the collected data indicated no significant difference between symptomâs onset to intravenous (IV) thrombolysis time and stroke onset-to-successful recanalization time (p=0.205 and p=<0.001, respectively). Patients had significantly worse functional outcome [modified rankin score (mRS)] (3-6) at 90-days in the DS model [Odds Ratio (OR): 1.47, 95% Confidence Interval (CI): 1.13-1.92, p<0.004] and 1.49-folds higher likelihood of symptomatic intracerebral hemorrhage (OR: 1.49, 95%CI: 1.22-1.81, p<0.0001) compared to MS. However, there were no statistically significant difference in terms of mortality (OR: 1.16, 95%CI: 0.87-1.55, p=0.32) and successful recanalization (OR: 1.12, 95%CI: 0.76-1.65, p=0.56) between the two models of care. Conclusion Patients in the MS model have significantly improved functional independence and recovery. Further studies are needed as the data from prospectively randomized studies is not of sufficient quality to make definite recommendations.

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The effectiveness and safety of LMWH for preventing thrombosis in patients with spinal cord injury: a meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02412-7 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Ze Lin ◽

Yun Sun ◽

Hang Xue ◽

Lang Chen ◽

Chenchen Yan ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Venous Thrombosis ◽

Meta Analysis ◽

Therapeutic Effects ◽

Significant Difference ◽

Cord Injury ◽

Review Manager ◽

Evident Difference

Abstract Background Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are commonly used for preventing venous thrombosis of the lower extremity in patients with traumatic spinal cord injury. Although, LMWH is the most commonly used drug, it has yet to be established whether it is more effective and safer than UFH. Further, a comparison of the effectiveness of LMWH in preventing thrombosis at different locations and different degrees of spinal cord injury has also not been clearly defined. Materials and methods Cohort studies comparing the use of LMWH and UFH in the prevention of lower limb venous thrombosis in patients with spinal cord injury were identified using PubMed. The risk of bias and clinical relevance of the included studies were assessed using forest plots. The Newcastle-Ottawa quality assessment scale was used to evaluate the quality of the included studies. The main results of the study were analyzed using Review Manager 5.3. Results A total of five studies were included in this meta-analysis. Four studies compared the effectiveness and safety of LMWH and UFH in preventing thrombosis in patients with spinal cord injury. No significant differences were found between the therapeutic effects of the two drugs, and the summary RR was 1.33 (95% CI 0.42–4.16; P = 0.63). There was also no significant difference in the risk of bleeding between the two medications, and the aggregate RR was 0.78 (95% CI 0.55–1.12; P = 0.18). When comparing the efficacy of LMWH in preventing thrombosis in different segments and different degrees of spinal cord injury, no significant differences were found. Conclusions The results of this analysis show that compared with UFH, LMWH has no obvious advantages in efficacy nor risk prevention, and there is no evident difference in the prevention of thrombosis for patients with injuries at different spinal cord segments.

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The effect of 0.01% atropine on ocular axial elongation for myopia children: a meta-analysis

10.1101/2021.08.17.456658 ◽

2021 ◽

Author(s):

Yan Yu ◽

Jiasu Liu

Keyword(s):

Publication Bias ◽

Meta Analysis ◽

Statistical Significance ◽

Cochrane Library ◽

Axial Elongation ◽

Funnel Plots ◽

Mean Differences ◽

Q Statistic ◽

Regression Tests ◽

Review Manager

Objectives: This meta-analysis aimed to identify the therapeutic effect of 0.01% atropine with on ocular axial elongation for myopia children. Methods: We searched PubMed, Cochrane Library, and CBM databases from inception to July 2021. Meta-analysis was conducted using STATA version 14.0 and Review Manager version 5.3 softwares. We calculated the weighted mean differences(WMD) to analyze the change of ocular axial length (AL) between orthokeratology combined with 0.01% atropine (OKA) and orthokeratology (OA) alone. The Cochran's Q-statistic and I2 test were used to evaluate potential heterogeneity between studies. To evaluate the influence of single studies on the overall estimate, a sensitivity analysis was performed. We also performed sub group and meta-regression analyses to investigate potential sources of heterogeneity. We conducted Begger's funnel plots and Egger's linear regression tests to investigate publication bias. Results: Nine studies that met all inclusion criteria were included in this meta-analysis. A total of 191 children in OKA group and 196 children in OK group were assessed. The pooled summary WMD of AL change was -0.90(95%CI=-1.25~-0.55) with statistical significance(t=-5.03, p<0.01), which indicated there was obvious difference between OKA and OK in myopic children. Subgroup analysis also showed that OKA treatment resulted in significantly less axial elongation compared to OK treatment alone according to SER. We found no evidence for publication bias. Conclusions: Our meta-analysis indicates 0.01% atropine atropine is effective in slowing axial elongation in myopia children with orthokeratology.

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Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-020-01271-8 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Haonan Tian ◽

Congman Xie ◽

Min Lin ◽

Hongmei Yang ◽

Aishu Ren

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Risk Of Bias ◽

Controlled Trials ◽

Cochrane Central Register ◽

Canine Retraction ◽

Temporary Anchorage Devices ◽

The Mean ◽

Mean Differences ◽

Implant Anchorage

Abstract Background Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03). Conclusions There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.

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Meta-Analysis: Randomized Trials of Lactobacillus plantarum on Immune Regulation Over the Last Decades

Frontiers in Immunology ◽

10.3389/fimmu.2021.643420 ◽

2021 ◽

Vol 12 ◽

Author(s):

Wei Zhao ◽

Chuantao Peng ◽

Hafiz Arbab Sakandar ◽

Lai-Yu Kwok ◽

Wenyi Zhang

Keyword(s):

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Central Register ◽

Tnf Α ◽

Ifn Γ ◽

The Mean ◽

Regulatory Effects ◽

Mean Differences ◽

Necrosis Factor

Lactobacillus (L.) plantarum strains, belong to lactic acid bacteria group, are considered indispensable probiotics. Here, we performed meta-analysis to evaluate the regulatory effects of L. plantarum on the immunity during clinical trials. This meta-analysis was conducted by searching across four most common literature databases, namely, Cochrane Central Register of Controlled Trials, Web of Science, Embase, and PubMed. Clinical trial articles that met the inclusion and exclusion criteria were analyzed by Review Manager (version 5.3). p-value < 0.05 of the total effect was considered statistically significant. Finally, total of 677 references were retrieved, among which six references and 18 randomized controlled trials were included in the meta-analysis. The mean differences observed at 95% confidence interval: interleukin (IL)-4, −0.48 pg/mL (−0.79 to −0.17; p < 0.05); IL-10, 9.88 pg/mL (6.52 to 13.2; p < 0.05); tumor necrosis factor (TNF)-α, −2.34 pg/mL (−3.5 to −1.19; p < 0.05); interferon (IFN)-γ, −0.99 pg/mL (−1.56 to −0.41; p < 0.05). Therefore, meta-analysis results suggested that L. plantarum could promote host immunity by regulating pro-inflammatory and anti-inflammatory cytokines.

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Efficacy and Safety of Intranasal Ketamine for Acute Pain Management in the Emergency Setting: A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm10173978 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3978

Author(s):

Yee Sin Seak ◽

Junainah Nor ◽

Tuan Hairulnizam Tuan Kamauzaman ◽

Ariff Arithra ◽

Md Asiful Islam

Keyword(s):

Systematic Review ◽

Pain Management ◽

Acute Pain ◽

Meta Analysis ◽

Emergency Setting ◽

Efficacy And Safety ◽

Acute Pain Management ◽

Significant Difference ◽

Mean Differences ◽

Randomised Controlled

Due to overcrowding, personnel shortages, or problematic intravenous (IV) cannulation, acute pain management is often sub-optimal in emergency departments (EDs). The objective of this systematic review and meta-analysis was to evaluate the efficacy and safety of intranasal (IN) ketamine for adult acute pain in the emergency setting. We searched and identified studies up to 21 May 2021 via PubMed, Scopus, Web of Science, Cochrane Database, and Google Scholar. The random-effects model with 95% confidence intervals (CIs) was used to estimate mean differences (MDs) and odds ratios (ORs). The I2 statistic and Cochran’s Q test were used to determine heterogeneity. The protocol was registered in PROSPERO (CRD42020213391). Seven randomised controlled trials were included with a total of 1760 patients. There was no significant difference in pain scores comparing IN ketamine with IV analgesics or placebo at 5 (MD 0.94, p = 0.26), 15 (MD 0.15, p = 0.74), 25 (MD 0.24, p = 0.62), 30 (MD −0.05, p = 0.87), and 60 (MD −0.42, p = 0.53) minutes. There was also no significant difference in the need for rescue analgesics between IN ketamine and IV analgesics (OR 1.66, 95% CI: 0.57−4.86, p = 0.35, I2 = 70%). Only mild adverse effects were observed in patients who received IN ketamine. Our results suggest that IN ketamine is non-inferior to IV analgesics and may have a role in acute pain management among adults in the ED.

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