scholarly journals A New Therapy for Vitiligo Using Fire Needles: A Systematic Review of Evidence from 3618 Subjects

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Ying Luo ◽  
Wei Qian ◽  
Ting Dai ◽  
Yi Ru ◽  
Xiaoying Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Evidence ◽  
Meta Analysis ◽  
Cytokine Level ◽  
Controlled Trials ◽  
Recurrence Rates ◽  
Randomized Controlled ◽  
Fire Needle ◽  
Larger Sample

Introduction. Fire needle therapy has been reported as an effective treatment for vitiligo. However, current clinical evidence has not been systematically evaluated. The aim of this study was to determine whether fire needle therapy is effective and safe for treating vitiligo. Methods. Seven databases were searched until October 2019 for randomized controlled trials on fire needle therapy, with and without conventional treatments, versus any type of conventional therapy for treating vitiligo. The RevMan 5.3.5 software was used to perform meta-analysis of the included studies. Results. Forty-seven trials comprising 3618 patients were included. Fire needle combined with conventional vitiligo treatments had a higher efficacy (risk ratio (RR): 1.55, 95% confidence interval (CI): 1.46–1.65, P<0.00001 and RR: 1.41, 95% CI: 1.24–1.61, P<0.00001, respectively) and a greater effect on restoring the color of the area of the skin lesion (mean difference (MD): 3.40, 95% CI: 2.11–4.69, P<0.00001), increasing the pigment point of vitiligo (MD: 0.83, 95% CI: 0.54–1.13, P<0.00001) and improving the cytokine level (MD: 8.10, 95% CI: 6.94–9.27, P<0.00001) and effectual time (MD: −4.76, 95% CI: −7.33 to −2.19, P=0.0003) than traditional methods. Limb lesions (RR: 1.60, 95% CI: 1.31–1.95, P<0.00001) were more effectively treated when the treatments included fire needles, whereas the therapeutic effect of fire needles on either the head and neck (RR: 1.13, 95% CI: 0.78–1.64, P=0.52) or torso lesions (RR: 1.22, 95% CI: 0.82–1.81, P=0.33) was not significantly different compared to that without fire needles. No statistically significant differences in adverse effects (RR: 1.15, 95% CI: 0.89–1.49, P=0.28) and recurrence rates (RR: 0.90, 95% CI: 0.17–4.92, P=0.91) during the follow-up period were observed between treatment with and without fire needles. Conclusions. Fire needle therapy combined with other conventional treatments is useful in treating vitiligo. Further studies with larger sample sizes should be performed to make a conclusive judgment. This trial is registered with CRD42018094918.

scholarly journals The comparison between total hip arthroplasty and hemiarthroplasty in patients with femoral neck fractures: a systematic review and meta-analysis based on 25 randomized controlled trials

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xiumei Tang ◽  
Duan Wang ◽  
Ying Liu ◽  
Jiali Chen ◽  
Zongke Zhou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Total Hip Arthroplasty ◽  
Meta Analysis ◽  
Femoral Neck Fractures ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Acetabular Erosion

Abstract Background We performed an updated systematic review and meta-analysis which enrolled 25 prospective randomized controlled trials (RCTs) to compare the outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fractures (FNFs). Methods We searched English databases which included PubMed, Embase (vis OvidSP), The Cochrane Library, and Web of Science, and Chinese databases Chinese National Knowledge Infrastructure (CNKI), VIP, Wang Fang, and China Biology Medicine Disc (CBM) in July 2020. The quality of each study was assessed according to the Cochrane Collaboration’s Risk of Bias. Risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were pooled with random-effects models. Data regarding baseline characteristics, hospital and surgery outcomes, clinical outcomes, patients’ quality of life, common complications, prothesis-related complications, mortality, and costs were reported. Results A total of 25 RCTs involving 3223 patients (1568 THA and 1655 HA) were included. THA had longer hospital length (WMD = 0.721, P < 0.0001) and surgery time (WMD = 20.044, P < 0.0001), and more blood loss compared with HA (WMD = 69.109, P < 0.0001). THA showed better ratings in the Harris Hip Score during follow-up periods between 1 and 5 years while no differences within 6 months and after 9 years. THA was associated with higher quality-of-life EuroQol-5 Dimension (EQ-5D) scores after 2 years of surgery but no difference within 1 year. There was no difference in common complications. THA had significant higher rate of dislocation (WMD = 1.897, P = 0.002) and lower acetabular erosion (WMD = 0.030, P = 0.001). For mortality, there was no difference during all the follow-up periods except for slightly higher 2-year mortality after surgery. Conclusion This meta-analysis demonstrates that THA has better medium-term functional results and quality of life and lower acetabular erosion rate, while HA shows better in reducing hospital stay, surgery time, and blood loss and also has lower dislocation rate.

scholarly journals Efficacy of Auricular Acupressure for Chronic Low Back Pain: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2017 ◽  
Vol 2017 ◽  
pp. 1-14 ◽  
Author(s):  
Li-Hua Yang ◽  
Pei-Bei Duan ◽  
Qing-Mei Hou ◽  
Shi-Zheng Du ◽  
Jin-Fang Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Acupressure

Objectives. To identify the efficacy of auricular acupressure on pain and disability for chronic LBP by systematic review.Methods. A search of randomized controlled trials was conducted in four English medical electronic databases and three Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.Results. A total of 7 trials met the inclusion criteria, of which 4 had the low risk of bias. The findings of this study showed that, for the immediate effect, auricular acupressure had large, significant effects in improving pain within 12 weeks. As for the follow-up effect, the pooled estimates also showed promising effect at 4-week follow-up after 4-week intervention (standardized mean difference = −1.13, 95% CI (-1.70,-0.56),P<0.001). But, for the disability level, the therapeutic effect was not significant (mean difference = −1.99, 95% CI (-4.93, 0.95),P=0.18). No serious adverse effects were recorded.Conclusions. The encouraging evidence of this study indicates that it is recommended to provide auricular acupressure to patients with chronic low back pain. However, a more accurate estimate of the effect will require further rigorously designed large-scale RCTs on chronic LBP for improving pain and disability.

scholarly journals Behavioral interventions for sleep disturbances in children with neurological and neurodevelopmental disorders: a systematic review and meta-analysis of randomized controlled trials

SLEEP ◽  
2020 ◽  
Vol 43 (9) ◽  
Author(s):  
Natalie L Phillips ◽  
Teleri Moore ◽  
Arthur Teng ◽  
Naomi Brookes ◽  
Tonya M Palermo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Neurodevelopmental Disorders ◽  
Functional Outcomes ◽  
Behavioral Interventions ◽  
Sleep Disturbances ◽  
Meta Analysis ◽  
Sleep Onset ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Study Objectives Sleep disturbances are common and associated with negative functional and health consequences in children with neurological and neurodevelopmental disorders (NNDDs) and represent an important potential target for behavioral interventions. This systematic review examined the efficacy of behavioral sleep interventions (BSIs) for children with NNDDs and comorbid sleep disturbances. Methods A systematic search of MEDLINE, EMBASE, PsychINFO, and CENTRAL was conducted in April 2019. Randomized controlled trials (RCTs) of BSI for children with NNDDS were included. Meta-analysis and GRADE quality ratings were performed on sleep and secondary functional outcomes (cognition, academics, and behavior). Results Nine RCTs were identified (n = 690; Mage = 8.39 ± 2.64years; 71.11% male). The quality of the evidence was predominantly rated as moderate. Posttreatment improvements in sleep were found on self-reported sleep disturbances (total sleep disturbance [standardized mean difference, i.e. SMD = 0.89], night wakings [SMD = 0.52], bedtime resistance [SMD = 0.53], parasomnias [SMD = 0.34], sleep anxiety [SMD = 0.50]) and self-reported sleep patterns (sleep duration [SMD = 0.30], sleep onset duration [SMD = 0.75]) and (2) objectively measured actigraphic sleep patterns (total sleep time [MD = 18.09 min; SMD = 0.32], sleep onset latency [MD = 11.96 min; SMD = 0.41]). Improvements in sleep (self-reported, not actigraphy) were maintained at follow-up, but few studies conducted follow-up assessments resulting in low-quality evidence. Reduction in total behavioral problems (SMD = 0.48) posttreatment and attention/hyperactivity (SMD = 0.28) at follow-up was found. Changes in cognition and academic skills were not examined in any studies. Conclusions BSIs improve sleep, at least in the short term, in children with NNDDs. Benefits may extend to functional improvements in behavior. More rigorous RCTs involving placebo controls, blinded outcome assessment, longer follow-up durations, and assessment of functional outcomes are required.

Interventions for smoking cessation with supporting of health staff in low - and middle-income countries: a systematic review and meta-analysis study

2021 ◽  
Vol 30 (9) ◽  
pp. 68-82
Author(s):  
Do Thi Thanh Toan ◽  
Chun Huang- Erick Wan ◽  
Nguyen Thu Anh ◽  
Pham Ngoc Yen ◽  
Luu Ngoc Minh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Resource Limited Settings ◽  
Middle Income ◽  
Middle Income Countries ◽  
Randomized Controlled ◽  
Resource Limited

The level of smoking cessation support in hospitals are low, especially in resource limited settings. Current healthcare systems are not well organized to address the issue. This review aimed to evaluate the effectiveness of smoking cessation interventions initiated in health facilities in resource-limited settings. A systematic review using meta-analysis techniques was applied. Bibliographic databases included PubMed, Medline, LILACS, the United States Clinical Trials and the Cochrane Collaboration Library. Eligibility criteria included smoking cessation intervention studies were published in English or Vietnamese, from the year 1990 to 2018. Study designs were randomized controlled trials, quasi-randomized controlled trials, cohort studies and before and after studies. Populations were limited to those in low and middle-income countries. Interventions were limited smoking cessation programs conducted in health facilities. 17 studies had included for the reviewing. 12 studies had been assessed to the meta-analysis. The proportion of successful smoking cessation in 6 months follow-up were range from 11.7% to 62.2% for the intervention group. In 12 months, follow-up, the abstinence rate ranges from 13.6% to 73%. The popularly of medical staff support the intervention was the physicians (8/17, 47.1%) and doctor (5/17, 29.4%). The evidence from our study suggests that the abstinence rate can be affected by the supporting of medical staff follow the smoking cessation (SC) program.

Anterior Cruciate Ligament Reconstruction Alone Versus With Lateral Extra-articular Tenodesis With Minimum 2-Year Follow-up: A Meta-analysis and Systematic Review of Randomized Controlled Trials

2021 ◽  
pp. 036354652110049
Author(s):  
James Randolph Onggo ◽  
Hari Krishnan Rasaratnam ◽  
Mithun Nambiar ◽  
Jason Derry Onggo ◽  
Vishal Pai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cruciate Ligament Reconstruction ◽  
Randomized Controlled ◽  
Anterior Cruciate

Background: Lateral extra-articular tenodesis (LEAT) aims to improve anterolateral stability of the injured knee during anterior cruciate ligament reconstruction (ACLR) surgery. Inconclusive evidence surrounding the efficacy and safety of LEAT has propelled clinical interest and ongoing discussions. Purpose: To establish level 1 evidence by assessing randomized controlled trials (RCTs) with minimum 2-year follow-up that directly compared ACLR with LEAT (LEAT group) and ACLR alone (non-LEAT group) in terms of clinical outcomes and complications. Study Design: Meta-analysis and systematic review; Level of evidence, 1. Methods: Meta-analysis was performed with a multidatabase search (Cochrane, EMBASE, OVID Medline, PubMed, and Web of Science) according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines on September 9, 2020. Data from published RCTs meeting inclusion criteria were extracted and analyzed with an inverse variance statistical model. Results: A total of 7 RCTs were included, consisting of 517 LEAT and 589 non-LEAT patients. Only autografts were used for ACLR and LEAT. A variety of LEAT techniques and autograft fixation methods were used. We found improved stability (residual positive pivot shift: risk ratio [RR], 0.59; 95% CI, 0.39-0.88; P = .01) and better clinical outcomes (International Knee Documentation Committee [IKDC] score: mean difference [MD], 2.31; 95% CI, 0.54-4.09; P = .01; and Lysholm score: MD, 2.71; 95% CI, 0.68-4.75; P = .009) in the LEAT than non-LEAT group. Graft rerupture rate was 3 times less likely (RR, 0.31; 95% CI, 0.17-0.58; P < .001) in the LEAT group than the non-LEAT group. Conclusion: Good-quality evidence is available to support the efficacy of LEAT in improving anterolateral knee stability and reducing graft reruptures in primary ACLR. LEAT should be considered in patients with high risk factors. Although Lysholm and IKDC scores were statistically better in the LEAT group, these are unlikely to be clinically significant. Future studies should aim to identify patient populations that would best benefit from LEAT with ACLR.

Mortality Rates After Paclitaxel-Coated Device Use in Patients With Occlusive Femoropopliteal Disease: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
pp. 152660282110235
Author(s):  
Krystal Dinh ◽  
Alexandra M. Limmer ◽  
Andy Z. L. Chen ◽  
Shannon D. Thomas ◽  
Andrew Holden ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Occlusive Disease ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Increased Risk ◽  
All Cause Mortality

Purpose: A late increased mortality risk has been reported in a summary level meta-analysis of patients with femoropopliteal artery occlusive disease treated with paclitaxel-coated angioplasty balloons and stents. However, at the longer follow up timepoints that analysis was limited by small trial numbers and few participants. The aim of this study was to report an updated summary level risk of all-cause mortality after treatment with paclitaxel-coated devices in that same patient group. Materials and Methods: We performed a systematic review and meta-analysis of randomized controlled trials to investigate the mortality outcomes associated with paclitaxel-coated devices used to treat patients with occlusive disease of femoropopliteal arteries (last search date December 10, 2020). The single primary endpoint was all-cause mortality. Results: We identified 34 randomized controlled trials (7654 patients; 84% intermittent claudication). There were 622 deaths among 4147 (15.0%) subjects in the paclitaxel device group and 475 deaths among 3507 (13.5%) subjects in the noncoated control group [relative risk ratio (RR) 1.07, 95% confidence interval (CI) 0.96 to 1.20, p=0.20, I2=0%). All-cause mortality was similar between groups at 12 months (34 studies, 7654 patients; RR 0.99, 95% CI 0.81 to 1.22, p=0.94, I2=0%), 24 months (20 studies, 3799 patients; RR 1.16, 95% CI 0.87 to 1.55, p=0.31, I2=0%), and 60 months (9 studies, 2288 patients; RR 1.19, 95% CI 0.98 to 1.45, p=0.08, I2=0%). Conclusion: This updated meta-analysis with included additional trials and larger patient numbers shows no evidence of increased risk of all-cause mortality in patients treated with paclitaxel-coated devices, compared with uncoated devices for femoropopliteal disease at all time points to 60 months. There is therefore no justification to limit their use, or alter regulatory body follow-up recommendations in this patient population. Systematic Review Registration: CRD42020216140.

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