The Impact of Steatosis on the Outcome of Liver Transplantation: A Meta-Analysis

Background and Aims. Liver transplantation is one of the most effective treatments for end-stage liver disease as well as for cases of acute liver failure. Facing organ donor shortage, liver transplant teams had to use marginal organs. Thus, increasing availability is a key concern of donor liver grafts including steatotic livers. However, the use of steatotic liver is still controversial. The aim of this systematic review and meta-analysis was to analyze the impact of steatosis on the outcome of liver transplantation. Methods. We searched PubMed, Cochrane Library, Embase, Web of knowledge, and so on for studies published through May 31, 2018, in which patients experienced liver transplantation using fatty liver. All studies extracted outcome indicators, and we draw conclusions by contrasting outcome indicators in different groups of steatosis. Odds ratios and 95% confidence intervals were calculated. P<0.05 was considered as statistically significant difference. Results. 19 publications were included. There was no significant difference between the group of no steatosis and mild group in primary nonfunction rate (P=0.605) or early graft dysfunction rate (P=0.44). The PNF rate was significantly higher in moderate group (P=0.003) and severe group (P <0.001) compared with that in no steatosis group. The same results were seen in early graft dysfunction rate. However, graft survival rate and patient survival rate did not differ between groups. Conclusions. Livers with mild steatosis, even with moderate or severe steatosis, could be suitable donor under strict control of transplant conditions.

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Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

The American Surgeon ◽

10.1177/0003134821989034 ◽

2021 ◽

pp. 000313482198903

Author(s):

Mitsuru Ishizuka ◽

Norisuke Shibuya ◽

Kazutoshi Takagi ◽

Hiroyuki Hachiya ◽

Kazuma Tago ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Meta Analysis ◽

Cochrane Library ◽

Random Effects Models ◽

Significant Difference ◽

The Cochrane Library ◽

The Impact ◽

The Relationship ◽

Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

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Early Graft Dysfunction after Live Donor Liver Transplantation: It’s time to redefine?

Journal of Clinical and Experimental Hepatology ◽

10.1016/j.jceh.2021.03.007 ◽

2021 ◽

Author(s):

Viniyendra Pamecha ◽

Bramhadatta Pattnaik ◽

Piyush Kumar Sinha ◽

Nilesh Sadashiv Patil ◽

Shridhar Vasantrao Sasturkar ◽

...

Keyword(s):

Liver Transplantation ◽

Live Donor Liver Transplantation ◽

Live Donor ◽

Graft Dysfunction ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Live Donor Liver ◽

Early Graft ◽

Early Graft Dysfunction

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Associations Between the Use of Renin–Angiotensin System Inhibitors and the Risks of Severe COVID-19 and Mortality in COVID-19 Patients With Hypertension: A Meta-Analysis of Observational Studies

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.609857 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiao-Ce Dai ◽

Zhuo-Yu An ◽

Zi-Yang Wang ◽

Zi-Zhen Wang ◽

Yi-Ren Wang

Keyword(s):

Angiotensin Converting Enzyme ◽

Observational Studies ◽

Meta Analysis ◽

Severe Disease ◽

Host Cells ◽

Cochrane Library ◽

Converting Enzyme ◽

Significant Difference ◽

Duration Of Hospitalization ◽

The Impact

Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) share a target receptor with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The use of ACEIs/ARBs may cause angiotensin-converting enzyme 2 receptor upregulation, facilitating the entry of SARS-CoV-2 into host cells. There is concern that the use of ACEIs/ARBs could increase the risks of severe COVID-19 and mortality. The impact of discontinuing these drugs in patients with COVID-19 remains uncertain. We aimed to assess the association between the use of ACEIs/ARBs and the risks of mortality and severe disease in patients with COVID-19. A systematic search was performed in PubMed, EMBASE, Cochrane Library, and MedRxiv.org from December 1, 2019, to June 20, 2020. We also identified additional citations by manually searching the reference lists of eligible articles. Forty-two observational studies including 63,893 participants were included. We found that the use of ACEIs/ARBs was not significantly associated with a reduction in the relative risk of all-cause mortality [odds ratio (OR) = 0.87, 95% confidence interval (95% CI) = 0.75–1.00; I2 = 57%, p = 0.05]. We found no significant reduction in the risk of severe disease in the ACEI subgroup (OR = 0.95, 95% CI = 0.88–1.02, I2 = 50%, p = 0.18), the ARB subgroup (OR = 1.03, 95% CI = 0.94–1.13, I2 = 62%, p = 0.48), or the ACEI/ARB subgroup (OR = 0.83, 95% CI = 0.65–1.08, I2 = 67%, p = 0.16). Moreover, seven studies showed no significant difference in the duration of hospitalization between the two groups (mean difference = 0.33, 95% CI = −1.75 to 2.40, p = 0.76). In conclusion, the use of ACEIs/ARBs appears to not have a significant effect on mortality, disease severity, or duration of hospitalization in COVID-19 patients. On the basis of the findings of this meta-analysis, there is no support for the cessation of treatment with ACEIs or ARBs in patients with COVID-19.

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Comparing the impact of different exercise interventions on fatigue in individuals with COPD: A systematic review and meta-analysis

Chronic Respiratory Disease ◽

10.1177/1479973119894855 ◽

2019 ◽

Vol 16 ◽

pp. 147997311989485 ◽

Cited By ~ 1

Author(s):

Lok Sze Katrina Li ◽

Stacey Butler ◽

Roger Goldstein ◽

Dina Brooks

Keyword(s):

Meta Analysis ◽

Interval Training ◽

Cochrane Library ◽

Chronic Obstructive ◽

Obstructive Pulmonary Disease ◽

Exercise Interventions ◽

Significant Difference ◽

Related Quality ◽

Type Of Exercise ◽

The Impact

To systematically review randomized controlled trials that compared the effectiveness of different types of exercise on the symptom of fatigue in individuals with chronic obstructive pulmonary disease (COPD). MEDLINE, EMBASE, EMcare, PsychINFO, and Cochrane library were searched from inception to October 2018. Studies were included if individuals with COPD were randomized into two or more physical exercise interventions that reported fatigue. Of the 395 full-texts reviewed, 17 studies were included. Fifteen studies reported the impact of exercise on health-related quality of life with fatigue as a subdomain. Reduction in fatigue was observed following endurance, resistance, or a combination of both exercises. There was no significant difference between continuous and interval training ( n = 3 studies, pooled standardized mean difference (SMD) = −0.17, 95% CI = −0.47, 0.12, p = 0.25) or between endurance and resistance training ( n = 3 studies, SMD = −0.35, 95% CI = −0.72, 0.01, p = 0.07) on fatigue in people with COPD. Fatigue reduction is not usually a primary outcome of exercise interventions, but it is frequently a secondary domain. The type of exercise did not influence the impact of exercise on fatigue, which was reduced in endurance, resistance, or a combination of both exercises, enabling clinicians to personalize training to match targeted outcomes.

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Neutrophil‐to‐lymphocyte ratio is a predictor of early graft dysfunction following living donor liver transplantation

Liver International ◽

10.1111/liv.14103 ◽

2019 ◽

Vol 39 (8) ◽

pp. 1545-1556 ◽

Cited By ~ 7

Author(s):

Hye‐Mee Kwon ◽

Young‐Jin Moon ◽

Kyeo‐Woon Jung ◽

Yong‐Seok Park ◽

In‐Gu Jun ◽

...

Keyword(s):

Liver Transplantation ◽

Living Donor ◽

Living Donor Liver Transplantation ◽

Neutrophil To Lymphocyte Ratio ◽

Graft Dysfunction ◽

Donor Liver ◽

Donor Liver Transplantation ◽

Lymphocyte Ratio ◽

Early Graft ◽

Early Graft Dysfunction

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Impact of Dispatcher-Assisted Bystander Cardiopulmonary Resuscitation with Out-of-Hospital Cardiac Arrest: A Systemic Review and Meta-Analysis

Prehospital and Disaster Medicine ◽

10.1017/s1049023x20000588 ◽

2020 ◽

Vol 35 (4) ◽

pp. 372-381

Author(s):

Junhong Wang ◽

Hua Zhang ◽

Zongxuan Zhao ◽

Kaifeng Wen ◽

Yaoke Xu ◽

...

Keyword(s):

Cardiac Arrest ◽

Cardiopulmonary Resuscitation ◽

Neurological Outcome ◽

Meta Analysis ◽

Systemic Review ◽

Cochrane Library ◽

Significant Difference ◽

Bystander Cardiopulmonary Resuscitation ◽

The Impact ◽

Hospital Cardiac Arrest

AbstractObjective:This systemic review and meta-analysis was conducted to explore the impact of dispatcher-assisted bystander cardiopulmonary resuscitation (DA-BCPR) on bystander cardiopulmonary resuscitation (BCPR) probability, survival, and neurological outcomes with out-of-hospital cardiac arrest (OHCA).Methods:Electronically searching of PubMed, Embase, and Cochrane Library, along with manual retrieval, were done for clinical trials about the impact of DA-BCPR which were published from the date of inception to December 2018. The literature was screened according to inclusion and exclusion criteria, the baseline information, and interested outcomes were extracted. Two reviewers assessed the methodological quality of the included studies. Pooled odds ratio (OR) and 95% confidence interval (CI) were calculated by STATA version 13.1.Results:In 13 studies, 235,550 patients were enrolled. Compared with no dispatcher instruction, DA-BCPR tended to be effective in improving BCPR rate (I2 = 98.2%; OR = 5.84; 95% CI, 4.58-7.46; P <.01), return of spontaneous circulation (ROSC) before admission (I2 = 36.0%; OR = 1.17; 95% CI, 1.06-1.29; P <.01), discharge or 30-day survival rate (I2 = 47.7%; OR = 1.25; 95% CI, 1.06-1.46; P <.01), and good neurological outcome (I2 = 30.9%; OR = 1.24; 95% CI, 1.04-1.48; P = .01). However, no significant difference in hospital admission was found (I2 = 29.0%; OR = 1.09; 95% CI, 0.91-1.30; P = .36).Conclusion:This review shows DA-BPCR plays a positive role for OHCA as a critical section in the life chain. It is effective in improving the probability of BCPR, survival, ROSC before admission, and neurological outcome.

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Early Graft Dysfunction Evaluation by Indocyanine Green Plasma Clearance Rate in the Immediate Postoperative Period After Liver Transplantation

Transplantation Proceedings ◽

10.1016/j.transproceed.2020.02.025 ◽

2020 ◽

Vol 52 (5) ◽

pp. 1336-1339

Author(s):

Esteban Horacio Gonzalez ◽

Lucas Souto Nacif ◽

Alex Jones Flores Cassenote ◽

Rafael Soares Pinheiro ◽

Vinicius Rocha-Santos ◽

...

Keyword(s):

Liver Transplantation ◽

Indocyanine Green ◽

Postoperative Period ◽

Clearance Rate ◽

Plasma Clearance ◽

Graft Dysfunction ◽

Early Graft ◽

Early Graft Dysfunction

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Acupuncture Treatments for Post-stroke Depression: A Systematic Review and Network Meta-analysis

10.21203/rs.3.rs-951353/v1 ◽

2021 ◽

Author(s):

Lam Wai Ching ◽

Hui Juan Li ◽

Jianwen Guo ◽

Liang Yao ◽

Janita Chau ◽

...

Keyword(s):

Clinical Trials ◽

Randomized Clinical Trials ◽

Rating Scale ◽

Meta Analysis ◽

Cochrane Library ◽

Depression Symptoms ◽

Post Stroke ◽

Significant Difference ◽

Post Stroke Depression ◽

The Impact

Abstract Background: Depression is one of the most common complications after stroke, with a prevalence of 30-33%. Patients with post-stroke depression (PSD) usually experience anxiety, hopelessness, and insomnia, which have a negative impact on their daily activities and post-stroke rehabilitation. In this review, we aimed to explore the impact of acupuncture in alleviating symptoms of PSD and to evaluate the difference in effectiveness between acupuncture combined with pharmacotherapies and various non-pharmacotherapies in order to provide guides and advice for clinical personnel. Methods: Six databases (Cochrane Library, PubMed, EMBASE, China National Knowledge Infrastructure, Wanfang Database, Chongqing VIP Database) and two clinical trials registration platforms were searched from inception to May 2021. Randomized clinical trials (RCTs) comparing needle-based acupuncture with pharmacotherapy, and other non-pharmacotherapy or invalid group were included. Two independent reviewers identified eligible studies. Two reviewers independently abstracted and recorded data into a pre-made form. A Bayesian network meta-analysis (NMA) was conducted to assess and compare different techniques using RStudio 3.6.0. The primary outcome was the change in scores of scales measuring depressive symptoms. The secondary outcomes were changes in serotonin levels and in quality of life. Results: Fifty-nine RCTs were included. The results of this NMA showed that compared with western medicine (WM), acupuncture alone or with repetitive transcranial magnetic stimulation (RTMS), Traditional Chinese medicine (TCM) alone or with WM, were superior for alleviating depression symptoms. Compared to Usual Care, acupuncture alone or plus other therapies could significantly decrease scores of the Hamilton Depression Rating scale. However, there was no significant difference found among acupuncture, WM, TCM with AC plus any of other treatment.Conclusions: The results of this study indicate that acupuncture alone or combined with other therapies appear to be effective in improving depression symptoms of stroke survivors. Moreover, in comparison with WM, acupuncture alone or plus RTMS, TCM, TCM with WM, or WM, were more effective in improving depression symptoms. Also, acupuncture with RTMS seems to be the most effective with the highest probability.

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Association of Hypothyroidism and Mortality in the Elderly Population: A Systematic Review and Meta-Analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgz186 ◽

2019 ◽

Vol 105 (6) ◽

pp. 2068-2080 ◽

Cited By ~ 3

Author(s):

Tou-Yuan Tsai ◽

Yu-Kang Tu ◽

Kashif M Munir ◽

Shu-Man Lin ◽

Rachel Huai-En Chang ◽

...

Keyword(s):

Cardiovascular Mortality ◽

Elderly Population ◽

Meta Analysis ◽

The Elderly ◽

Current Evidence ◽

Cochrane Library ◽

Overt Hypothyroidism ◽

Significant Difference ◽

All Cause Mortality ◽

The Impact

Abstract Context The evidence of whether hypothyroidism increases mortality in the elderly population is currently inconsistent and conflicting. Objective The objective of this meta-analysis is to determine the impact of hypothyroidism on mortality in the elderly population. Data Sources PubMed, Embase, Cochrane Library, Scopus, and Web of Science databases were searched from inception until May 10, 2019. Study Selection Studies evaluating the association between hypothyroidism and all-cause and/or cardiovascular mortality in the elderly population (ages ≥ 60 years) were eligible. Data Extraction Two reviewers independently extracted data and assessed the quality of the studies. Relative risk (RR) was retrieved for synthesis. A random-effects model for meta-analyses was used. Data Synthesis A total of 27 cohort studies with 1 114 638 participants met the inclusion criteria. Overall, patients with hypothyroidism experienced a higher risk of all-cause mortality than those with euthyroidism (pooled RR = 1.26, 95% CI: 1.15-1.37); meanwhile, no significant difference in cardiovascular mortality was found between patients with hypothyroidism and those with euthyroidism (pooled RR = 1.10, 95% CI: 0.84-1.43). Subgroup analyses revealed that overt hypothyroidism (pooled RR = 1.10, 95% CI: 1.01-1.20) rather than subclinical hypothyroidism (pooled RR = 1.14, 95% CI: 0.92-1.41) was associated with increased all-cause mortality. The heterogeneity primarily originated from different study designs (prospective and retrospective) and geographic locations (Europe, North America, Asia, and Oceania). Conclusions Based on the current evidence, hypothyroidism is significantly associated with increased all-cause mortality instead of cardiovascular mortality among the elderly. We observed considerable heterogeneity, so caution is needed when interpreting the results. Further prospective, large-scale, high-quality studies are warranted to confirm these findings.

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