A systematic review and meta-analysis comparing the efficacy of cyanoacrylate ablation over endovenous thermal ablation for treating incompetent saphenous veins

2021 ◽  
pp. 026835552110087
Author(s):  
Julong Guo ◽  
Fan Zhang ◽  
Jianming Guo ◽  
Lianrui Guo ◽  
Yongquan Gu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Thermal Ablation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Compression Stocking ◽  
Number Needed To Treat ◽  
Saphenous Veins ◽  
Significant Difference ◽  
Endovenous Thermal Ablation

Objectives The aim of this study was to systemically review and analyze the efficacy of cyanoacrylate ablation (CA) in comparison with endovenous thermal ablation (ETA) for the treatment of incompetent saphenous veins. Methods A systematic literature search was conducted using databases of Pubmed, Embase, and Cochrane Library from the times of their inception to April 2020. Studies were selected based on inclusion and exclusion criteria after assessing the risk of bias in comparative studies with Cochrane and rating quality of evidence with the GRADE methodology. The meta-analysis was carried out using the Review Manager 5.4 program to conduct homogeneity tests. Results One cohort study and three randomized controlled trials (RCT), including a total of 1457 participants were included in the meta-analysis. ETA included endovenous laser ablation (ELVA) and radiofrequency ablation (RFA) in the selected studies. Comparison between CA and a combination of EVLA and RFA or RFA alone were carried out in two of RCTs, while comparison between CA with EVLA was conducted in one RCT and the cohort study. There was no statistical difference in closure rates between CA and ETA after pooled analysis. Similar symptom alleviation observed between different groups. However, the CA group showed a lower ecchymosis rate than RFA and a significantly lower incidence of adverse events, such as ecchymosis, phlebitis and paresthesia, than EVLA. Compared with ETA, the patients received CA treatment exhibited lower pain scores in a shorter procedure duration without needing compression stocking, returned to normal life sooner, and had significantly better quality of care. There was no significant difference in the number needed to treat for additional therapy after three months of follow-up between groups. Conclusions This meta-analysis indicates that CA has better overall outcomes than ETA and offers superior clinical benefits in the treatment of incompetent saphenous veins.

scholarly journals Laparoscopy versus mini-laparotomy peritoneal catheter insertion of ventriculoperitoneal shunts: a systematic review and meta-analysis

2016 ◽  
Vol 41 (3) ◽  
pp. E7 ◽  
Author(s):  
Mingliang He ◽  
Leping Ouyang ◽  
Shengwen Wang ◽  
Meiguang Zheng ◽  
Anmin Liu
Keyword(s):  
Systematic Reviews ◽  
Operative Time ◽  
Meta Analysis ◽  
Catheter Insertion ◽  
Cochrane Library ◽  
Number Needed To Treat ◽  
Shunt Failure ◽  
Peritoneal Catheter ◽  
Significant Difference ◽  
Mini Laparotomy

OBJECTIVE Ventriculoperitoneal (VP) shunt treatment is the main treatment method for hydrocephalus. The traditional operative approach for peritoneal catheter insertion is mini-laparotomy. In recent years, laparoscopy-assisted insertion has become increasingly popular. It seems likely that use of an endoscope could lower the incidence of shunt malfunction. However, there is no consensus about the benefits of laparoscopy-assisted peritoneal catheter insertion. METHODS A systematic search was performed using the PubMed, Embase, ScienceDirect, and Cochrane Library databases. A manual search for reference lists was conducted. The protocol was prepared according to the interventional systematic reviews of the Cochrane Handbook, and the article was written on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. RESULTS Eleven observational trials and 2 randomized controlled trials were included. Seven operation-related outcome measures were analyzed, and 3 of these showed no difference between operative techniques. The results of the meta-analysis are as follows: in the laparoscopy group, the rate of distal shunt failure was lower (OR 0.41, 95% CI 0.25–0.67; p = 0.0003), the absolute effect is 7.11% for distal shunt failure, the number needed to treat is 14 (95% CI 8–23), operative time was shorter (mean difference [MD], −12.84; 95% CI −20.68 to −5.00; p = 0.001), and blood loss was less (MD −9.93, 95% CI −17.56 to −2.31; p = 0.01). In addition, a borderline statistically significant difference tending to laparoscopic technique was observed in terms of hospital stay (MD −1.77, 95% CI −3.67 to 0.13; p = 0.07). CONCLUSIONS To some extent, a laparoscopic insertion technique could yield a better prognosis, mainly because it is associated with a lower distal failure rate and shorter operative time, which would be clinically relevant.

scholarly journals The relationship between delivery mode and postpartum depression: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
ZhuLiduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Depression ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Depression Symptoms ◽  
Delivery Mode ◽  
Significant Difference ◽  
The Relationship

Abstract Background: To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods: We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreements were resolved by discussion with a third author. We used the Newcastle-Ottawa Scale and GRADE methods to assess the quality of the included studies and evidences. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results: The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio =1.29; 95% CI: 1.11-1.51). Conclusions: The findings supported a relationship between delivery mode and postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD.r Trial registration: The protocol of this systematic review was registered in the PROSPERO under the number CRD42019148154.

A Comprehensive Systematic Review In Search Of Evidence for Pragmatic Altercations in Simplified Denture

2020 ◽  
pp. 232020682095396
Author(s):  
Saloni Kachhara ◽  
Deepak Nallaswamy ◽  
Dhanraj M. Ganapathy ◽  
Subhabrata Maiti
Keyword(s):  
Meta Analysis ◽  
Cochrane Library ◽  
Complete Dentures ◽  
Significant Difference ◽  
Related Quality ◽  
Health Related ◽  
Pubmed Search ◽  
Boolean Search ◽  
Gothic Arch

Aim: To explore the evidence available to evaluate if simplified dentures could be as effective as the conventional complete dentures. Materials and Methods: A total of 1,482 articles were obtained using keywords in a Boolean search operator in the PubMed search engine, Google Scholar and Cochrane Library. Duplicates were removed and the remaining articles were subjected to a title analysis which yielded a total of 20. Further analysis of the article abstracts led to an exclusion of four articles. The remaining 16 articles were subjected to full text analysis which finally yielded a total of 11 articles. Results: The cumulative results of the meta-analysis for oral health-related quality of life, patient satisfaction and professional quality of denture show no significant difference ( P > .05) between conventional and simplified dentures. Conclusion: Based on the available evidence adjusted for the potential literature/geographic bias, we conclude that the conventional procedures in complete denture fabrication such as facebow and gothic arch tracing do not improve the quality of the denture outcome from patients’ perspective and simplified dentures are equally effective as conventional complete dentures.

scholarly journals Effect of vitamins C and E supplementation onHelicobacter pylorieradication: a meta-analysis

2011 ◽  
Vol 106 (11) ◽  
pp. 1632-1637 ◽  
Author(s):  
Guogang Li ◽  
Lan Li ◽  
Chaohui Yu ◽  
Li Chen
Keyword(s):  
Methodological Quality ◽  
Eradication Rate ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Cochrane Library ◽  
Significant Difference ◽  
H Pylori ◽  
Randomised Controlled

Vitamins C and E can act as potent antioxidants to reduce the damage caused by reactive oxygen species in gastric mucosa. Whether vitamin supplements forHelicobacter pylorieradication regimen could improve the rate of eradication remains uncertain. Therefore, we performed a meta-analysis to evaluate the efficacy of vitamins C and E supplementation for the eradication ofH. pylori. Searches were conducted in the databases PubMed, EMBASE and Cochrane Library. Randomised controlled trials (RCT) that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Of the six RCT included, five had a low methodological quality. Of the six RCT, three compared the efficacy of the eradication regimenv.eradication regimen plus vitamins C and E. The result of the meta-analysis showed a non-significant difference in the eradication rate ofH. pyloribetween the two groups (risk ratio (RR) 0·93,P = 0·76). Another three RCT compared the eradication regimenv.eradication regimen plus vitamin C only, and there too there was no significant difference in the eradication rate (RR 0·83,P = 0·32). In conclusion, vitamins C and/or E supplements to theH. pylorieradication regimen could not improve the eradication rate. However, currently available data do not draw a definitive conclusion about the effectiveness of antioxidant vitamins onH. pylorieradication, owing to the small sample size and low-to-moderate methodological quality.

PP44 Effectiveness Of Insulin Glargine Versus Detemir In Type 1 Diabetes

2018 ◽  
Vol 34 (S1) ◽  
pp. 82-83
Author(s):  
Thales Silva ◽  
Paulo Henrique Ribeiro Fernandes Almeida ◽  
Vânia Araújo ◽  
Augusto Guerra ◽  
Francisco Acurcio ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Weight Gain ◽  
Latin American ◽  
Glycated Hemoglobin ◽  
Meta Analysis ◽  
Severe Hypoglycemia ◽  
Cochrane Library ◽  
Significant Difference

Introduction:The use of long-acting insulin analogues have been reported in patients with type 1 diabetes mellitus who exhibit important oscillations of their daily blood glucose, although the therapeutic benefits are lacking. The aim of this study was to evaluate the effectiveness and safety of the insulin analogue glargine compared detemir to support health decision-making.Methods:We performed a systematic review with meta-analysis of observational studies (cohort and registry), available in the MEDLINE (Pubmed), Latin American and Caribbean Health Sciences (LILACS), EMBASE and Cochrane Library databases (accessed August 2017), including research in the electronic journal Diabetes Care and gray literature. Several combinations of terms were used, including disease terms, interventions and type of study. The results evaluated were: glycated hemoglobin; weight gain; occurrence of severe hypoglycemia; total insulin dose; and, fasting capillary glycemia. Methodological quality was assessed using the Newcastle scale. The meta-analyses were performed in Review Manager® 5.2 software using a random effects model. Protocol number CRD42017054925 (International Prospective Register of Ongoing Systematic Reviews).Results:A total of 705 publications, eight cohort studies were included. The quality of included studies was classified as high. In the meta-analysis, the results for episodes of severe hypoglycemia (p = 0.002), measurements of fasting capillary glycemia (p = 0.01), and weight gain (p = 0.001) were favorable for detemir. The glycated hemoglobin endpoint (p = 0.49, heterogeneity = 89 percent) revealed high heterogeneity and no statistically significant difference between groups, showing no difference between the interventions for glycemic control.Conclusions:Although some results are favorable to detemir, it was not possible to identify significant differences in effectiveness and safety between the two analogues evaluated, requiring new long term studies and better quality of methodological studies.

scholarly journals Effects of Dexamethasone on Post-Operative Cognitive Dysfunction and Delirium in Adults Following General Anaesthesia: A Meta-Analysis of Randomised Controlled Trials

2019 ◽  
Author(s):  
Li-Qin Li ◽  
Cong Wang ◽  
Mei-Dan Fang ◽  
Hong-Yu Xu ◽  
Hong-Liu Lu ◽  
...  
Keyword(s):  
Placebo Group ◽  
General Anesthesia ◽  
Cognitive Dysfunction ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Dexamethasone Group ◽  
Significant Difference

Abstract Background Several studies have investigated the effects of dexamethasone on postoperative cognitive dysfunction (POCD) or postoperative delirium (POD); however, their conclusions have not been consistent. So we conducted a meta-analysis to determine the effects of dexamethasone on POCD/POD in adults following general anesthesia. Methods Cochrane Central Register of Controlled Trials (CENTRAL, 2018, Issue 11 of 12) in the Cochrane Library (searched November 17, 2018); MEDLINE OvidSP (1946 to November 16, 2018); and Embase OvidSP (1974 to November 16, 2018) were searched for randomized controlled trials that evaluated the incidence of POCD/POD following dexamethasone administration, in adults (age ≥18 years) under general anesthesia. We used the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework to assess the quality of evidence. Results Five studies were included (three studies/855 participants in dexamethasone group and 538 participants in placebo group for the incidence of POCD, and two studies/410 participants in dexamethasone group and 420 participants in placebo group for the incidence of POD). There was no significant difference between the dexamethasone group and the placebo group in terms of the incidence of POCD in 30 days after surgery (RR 1.00; 95% CI [0.51, 1.96], P = 1.00, I2 = 77%) or in the incidence of POD (RR 0.96; 95% CI [0.68, 1.35], P = 0.80, I2 = 0%). However, both analyses had some limitations since evidence remains limited and clinical heterogeneity, and we considered the quality of the evidence for the postoperative incidence of POCD and POD to be very low. Conclusions This meta-analysis revealed that prophylactic dexamethasone did not reduce the incidence of POCD and POD. Trials of alternative prevent strategies for POCD/POD, and a better understanding of the pathophysiology of those complex syndrome, are still needed to make progress of this field. Trial registration number: This study is registered with PROSPERO, 23 October 2018, number CRD42018114552.

scholarly journals The relationship between delivery mode and postpartum depression: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Yu-Xin Chen ◽  
Pei Zhao ◽  
Zhu Liduzi Jiesisibieke ◽  
Pei-En Chen ◽  
Tao-Hsin Tung ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postpartum Depression ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Depression Symptoms ◽  
Delivery Mode ◽  
Significant Difference ◽  
The Relationship

Abstract Background To assess the relationship between delivery mode and postpartum depression and to examine whether cesarean section (CS) has a higher risk of postpartum depression than vaginal delivery (VD). Methods We searched the Cochrane Library, PubMed, and EMBASE from inception to 30 April 2019 without language limitations. Then two authors independently selected the studies, assessed the quality of the included studies, and extracted data. Any disagreements were resolved by discussion with a third author. Next, we used the Newcastle-Ottawa Scale and GRADE methods are used to evaluate the quality of the included studies and evidences, respectively. This study had four included cohort studies data and carried out fixed-effect model meta-analysis. Results The findings demonstrated a significant difference in the risk of postpartum depression between CS and VD. Compared with the control group, the CS group was associated with a higher prevalence of postpartum depression symptoms (Risk Ratio = 1.29; 95% CI: 1.11–1.51). Conclusions The results showed that delivery mode has nonnegligible effects on the risk of postpartum depression. Particularly, we found that CS is associated with a higher risk of postpartum depression compared with VD. Therefore, we ought to encourage pregnant women who are without medical indication of CS to select VD. Trial registration: The protocol of this systematic review was registered in PROSPERO under the number CRD42019148154.

scholarly journals Efficacy of Qigong Exercise for Treatment of Fatigue: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Rui Wang ◽  
Xueyan Huang ◽  
Yeqi Wu ◽  
Dai Sun
Keyword(s):  
Meta Analysis ◽  
Chronic Fatigue ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Patients With Cancer ◽  
Fatigue Syndrome ◽  
Knowledge Infrastructure ◽  
Standard Mean Difference ◽  
Significant Difference

Objective: Several studies suggested that Qigong exercise (QE) can relieve fatigue in patients diagnosed with various diseases. Our review aimed to evaluate the efficacy of QE for alleviating fatigue.Methods: A related literature search was performed in the PubMed, Web of Science, Embase, Cochrane Library, China Biology Medicine disc (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, and VIP data bases from inception to November 2020. Information on fatigue, malaise, tiredness, and Qigong research data was collected.Results: Sixteen randomized controlled trials (RCTs) were reported in patients with cancer (n = 4), chronic fatigue syndrome (n = 2), and other diseases (n = 10). The QE groups showed significant improvements in total fatigue intensity [15 RCTs, p < 0.00001; standard mean difference (SMD) −0.69 (−0.95 to −0.44)]. The QE groups did not show significant improvement in quality of life [4 RCTs, p = 0.08; SMD 0.53 (−0.07 to 1.14)]. The statistically significant difference of the subgroup analyses (different primary diseases, QE types, and study quality) also remained unchanged.Conclusion: The findings of this meta-analysis indicate that QE may be beneficial for improving fatigue in patients diagnosed with various diseases. Considering the limitations of the study, we draw a very cautious conclusion regarding the resulting estimate of the effect. Further studies are warranted to better understand the benefits of QE in primary medical care.

scholarly journals The Preventive Effect of Dysphagia Screening on Pneumonia in Acute Stroke Patients: A Systematic Review and Meta-Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1764
Author(s):  
Seoyon Yang ◽  
Yoo Jin Choo ◽  
Min Cheol Chang
Keyword(s):  
Acute Stroke ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Inclusion Criteria ◽  
Preventive Effect ◽  
Stroke Patients ◽  
Early Screening ◽  
Funnel Plot ◽  
Significant Difference

(1) Background: Dysphagia is common in acute stroke patients and is a major risk factor for aspiration pneumonia. We investigated whether the early detection of dysphagia in stroke patients through screening could prevent the development of pneumonia and reduce mortality; (2) Methods: We searched the PubMed, Embase, Cochrane Library, and Scopus databases for relevant studies published up to November 2021. We included studies that performed dysphagia screening in acute stroke patients and evaluated whether it could prevent pneumonia and reduce mortality rates. The methodological quality of individual studies was evaluated using the Risk Of Bias In Non-randomized Studies of Interventions tool, and publication bias was evaluated by the funnel plot and Egger’s test; (3) Results: Of the 6593 identified studies, six studies met the inclusion criteria for analysis. The screening group had a significantly lower incidence of pneumonia than the nonscreening group did (odds ratio (OR), 0.60; 95% confidence interval (CI), 0.42 to 0.84; p = 0.003; I2, 66%). There was no significant difference in mortality rate between the two groups (OR, 0.61; 95% CI, 0.33 to 1.13; p = 0.11; I2, 93%); (4) Conclusions: Early screening for dysphagia in acute stroke patients can prevent the development of pneumonia.

scholarly journals Quality assessment of weekend discharge: a systematic review and meta-analysis

2020 ◽  
Vol 32 (6) ◽  
pp. 347-355
Author(s):  
Chia-Yu Chiu ◽  
David Oria ◽  
Peter Yangga ◽  
Dasol Kang
Keyword(s):  
Patient Care ◽  
Meta Analysis ◽  
Emergency Department Visits ◽  
Weekend Effect ◽  
Cochrane Library ◽  
Quality Of Patient Care ◽  
Significant Difference ◽  
The Usa

Abstract Purpose Hospital bed utility and length of stay affect the healthcare budget and quality of patient care. Prior studies already show admission and operation on weekends have higher mortality rates compared with weekdays, which has been identified as the ‘weekend effect.’ However, discharges on weekends are also linked with quality of care, and have been evaluated in the recent decade with different dimensions. This meta-analysis aims to discuss weekend discharges associated with 30-day readmission, 30-day mortality, 30-day emergency department visits and 14-day follow-up visits compared with weekday discharges. Data sources PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov were searched from January 2000 to November 2019. Study selection Preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Only studies published in English were reviewed. The random-effects model was applied to assess the effects of heterogeneity among the selected studies. Data extraction Year of publication, country, sample size, number of weekday/weekend discharges, 30-day readmission, 30-day mortality, 30-day ED visits and 14-day appointment follow-up rate. Results of data synthesis There are 20 studies from seven countries, including 13 articles from America, in the present meta-analysis. There was no significant difference in odds ratio (OR) in 30-day readmission, 30-day mortality, 30-day ED visit, and 14-day follow-up between weekday and weekend. However, the OR for 30-day readmission was significantly higher among patients in the USA, including studies with high heterogeneity. Conclusion In the USA, the 30-day readmission rate was higher in patients who had been discharged on the weekend compared with the weekday. However, interpretation should be cautious because of data limitation and high heterogeneity. Further intervention should be conducted to eliminate any healthcare inequality within the healthcare system and to improve the quality of patient care.

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