A systematic review and meta-analysis of treatment modalities for anterior accessory saphenous vein insufficiency

2021 ◽  
pp. 026835552110609
Author(s):  
Tamana Alozai ◽  
Eline Huizing ◽  
Michiel A. Schreve ◽  
Michael C. Mooij ◽  
Clarissa J. van Vlijmen ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Meta Analysis ◽  
Clinical Severity ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Success Rates ◽  
Methodologic Quality ◽  
Venous Clinical Severity Score ◽  
Anatomic Success

Objective To investigate and compare the outcomes of the available treatment modalities for anterior accessory saphenous vein (AASV) incompetence. Methods A systematic literature search was performed in MEDLINE, Embase, and the Cochrane Library. Studies reporting the outcomes of patients who were treated for primary AASV incompetence were included. The methodologic quality of the articles was assessed using the Methodological Index for Non-Randomized Studies (MINORS). A random-effects model was used to estimate anatomic success, defined as AASV occlusion. The secondary outcomes were pain during and after treatment, venous clinical severity score, quality of life, esthetic result, time to return to daily activities, and complications. Results The search identified 860 articles, of which 16 met the inclusion criteria. A total of 609 AASVs were reported. The included studies were of poor or moderate quality according to MINORS score. The pooled anatomic success rates were 91.8% after endovenous laser ablation and radiofrequency ablation (EVLA, RFA, 11 studies), 93.6% after cyanoacrylate closure (3 studies), and 79.8% after sclerotherapy (2 studies). The non-pooled anatomic success rate was 97.9% after phlebectomy and 82% after CHIVA. Paresthesia was seen after EVLA in 0.7% of patients (6 studies). Phlebitis was seen in 2.6% of patients after RFA (2 studies), 27% after sclerotherapy (1 study), and 12% after the phlebectomy (1 study). Deep venous thrombosis and skin burn did not occur. Conclusion Treatment of AASV incompetence is safe and effective. Despite limited evidence, occlusion of the AASV can be achieved with endovenous thermal ablation and cyanoacrylate. There does not appear to be a benefit of EVLA compared to RFA regarding treatment efficacy. Phlebectomy shows promising results if the saphenofemoral junction is competent. Lower results are seen after sclerotherapy and CHIVA. However, studies with sufficient sample sizes of solely treatment of AASV incompetence are needed to draw firm conclusions.

Mobile Phone Use and Risk of Tumors: A Meta-Analysis

2009 ◽  
Vol 27 (33) ◽  
pp. 5565-5572 ◽  
Author(s):  
Seung-Kwon Myung ◽  
Woong Ju ◽  
Diana D. McDonnell ◽  
Yeon Ji Lee ◽  
Gene Kazinets ◽  
...  
Keyword(s):  
Mobile Phone ◽  
Random Effects ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Case Control ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Mobile Phone Use ◽  
Methodologic Quality

Purpose Case-control studies have reported inconsistent findings regarding the association between mobile phone use and tumor risk. We investigated these associations using a meta-analysis. Methods We searched MEDLINE (PubMed), EMBASE, and the Cochrane Library in August 2008. Two evaluators independently reviewed and selected articles based on predetermined selection criteria. Results Of 465 articles meeting our initial criteria, 23 case-control studies, which involved 37,916 participants (12,344 patient cases and 25,572 controls), were included in the final analyses. Compared with never or rarely having used a mobile phone, the odds ratio for overall use was 0.98 for malignant and benign tumors (95% CI, 0.89 to 1.07) in a random-effects meta-analysis of all 23 studies. However, a significant positive association (harmful effect) was observed in a random-effects meta-analysis of eight studies using blinding, whereas a significant negative association (protective effect) was observed in a fixed-effects meta-analysis of 15 studies not using blinding. Mobile phone use of 10 years or longer was associated with a risk of tumors in 13 studies reporting this association (odds ratio = 1.18; 95% CI, 1.04 to 1.34). Further, these findings were also observed in the subgroup analyses by methodologic quality of study. Blinding and methodologic quality of study were strongly associated with the research group. Conclusion The current study found that there is possible evidence linking mobile phone use to an increased risk of tumors from a meta-analysis of low-biased case-control studies. Prospective cohort studies providing a higher level of evidence are needed.

scholarly journals Trans-oral incisionless fundoplication vs stretta, two recognized endoluminal anti-reflux therapies; a systematic review and meta-analysis

2018 ◽  
Vol 5 (3) ◽  
pp. 765
Author(s):  
Reece-Bolton Obuobi ◽  
Yirupaiahgari Viswanath ◽  
Rajeev Sathasivam ◽  
Gopinath Bussa ◽  
Talvinder Gill ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Lower Oesophageal Sphincter ◽  
Treatment Modalities ◽  
Cochrane Library ◽  
Western World ◽  
Sphincter Pressure ◽  
Stretta Procedure ◽  
Related Quality

Gastro-oesophageal reflux disease (GORD) is common with a prevalence of 10-20% in the Western World. During the last two decades, amongst introduced several endo-luminal techniques, evidence has emerged about the efficacy and safety of two treatment modalities for GORD; 'Stretta' procedure and trans-oral incisionless fundoplication (TIF)' or EsophyX. Author in this study aim to conduct a systematic review of published 'level 1' evidence, to evaluate all evidence on the efficacy of Stretta procedure and TIF (EsophyX) for the management of GORD. A robust literature that included RCT trials only, searched on MEDLINE, EMBASE, and Cochrane library was undertaken from January 2007 until January 2017. The outcomes were normalisation of oesophageal pH values, augmentation of lower oesophageal sphincter pressure (LESP), health-related quality of life (HRQOL) score, and ability to stop or reduce PPI after procedure. For quality assurance purposes, two researchers were involved in the data collection process and its analysis. Author collected data from 9 RCT trials, 3 for Stretta and 6 for EsophyX. From the Stretta trials 101 patients were recruited, 92 patients were analyzed.  Of the EsophyX trials, 3 of six papers were from single trial. A total of 296 patients were included and 203 were analysed. The pooled results show both stretta and esophyX significantly improved GORD symptoms. In a meta-analysis of trials, author found that both Stretta and EsophyX significantly improves GERD-HRQL score and enables patients to reduce or stop PPI intake compared with sham/PPI therapy alone. The overall quality of evidence is superior for EsophyX than it is for Stretta.

Comparing the treatment response of great saphenous and small saphenous vein incompetence following surgery and endovenous laser ablation: a retrospective cohort study

2011 ◽  
Vol 27 (3) ◽  
pp. 128-134 ◽  
Author(s):  
D Carradice ◽  
N Samuel ◽  
T Wallace ◽  
F A K Mazari ◽  
J Hatfield ◽  
...  
Keyword(s):  
Cohort Study ◽  
Laser Ablation ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Short Form ◽  
Clinical Severity ◽  
Endovenous Laser Ablation ◽  
Surgical Ligation ◽  
Venous Clinical Severity Score

Objective Many venous trials mix patients with great saphenous vein (GSV) and small saphenous vein (SSV) diseases. There is no evidence that both respond similarly to treatment and our aim was to test this assumption. Method This cohort study compares patients with isolated GSV and SSV incompetence following treatment with open surgical ligation or endovenous laser ablation (EVLA). Outcomes included: quality of life (QoL; Aberdeen Varicose Vein Questionnaire [AVVQ]; Short Form 36 [SF36]; Euroqol [EQ5D]; and Venous Clinical Severity Score [VCSS]). Results A total of 370 patients with no differences in baseline QoL, underwent treatment. Despite equivalent morbidity, SSV sufferers had a lower VCSS ( P < 0.001). Following surgery, SSV patients scored higher (worse) on AVVQ ( P = 0.045) than GSV sufferers, but lower (better) following EVLA ( P = 0.042). Conclusion The morbidity associated with SSV incompetence is greater than suggested by its clinical severity and responds differently following treatment to that of the GSV. Trials should consider patients with GSV and SSV reflux separately. EVLA may offer additional benefits to SSV sufferers.

VP35 Effectiveness and Safety of Cyanoacrylate Ablation for Varicose Veins

2019 ◽  
Vol 35 (S1) ◽  
pp. 85-85
Author(s):  
Esther García-Carpintero ◽  
Montserrat Carmona ◽  
Juan Pablo ◽  
Chalco Orrego ◽  
Jesús González-Enríquez ◽  
...  
Keyword(s):  
Varicose Veins ◽  
Case Series ◽  
Pooled Analysis ◽  
Clinical Severity ◽  
Cochrane Library ◽  
Lower Probability ◽  
Promising Alternative ◽  
First Choice ◽  
Venous Clinical Severity Score

IntroductionTreatment of varicose veins is currently performed by different interventionist alternatives that include surgical, endothermal and non-thermal ablation therapies. The main guidelines recommended endovenous thermal treatment as the first choice therapy; however present side effects related to thermal energy. Non-tumescent endovenous ablation techniques such as cyanoacrylate ablation (CA) started to develop to avoid these problems. The objective of this study is to assess the effectiveness and safety of CA for saphenous vein incompetence.MethodsA systematic review with meta-analysis was carried out. The search of scientific literature was performed in Medline, Embase, Cochrane library, CDR, WoS and Scopus databases. GRADE methodology was used to assess the quality of the evidence and Cochrane risk of bias tool to assess methodological quality of randomized control trials (RCT). Pooled risk ratio was calculated using a random effects model.ResultsTwo RCTs and one non-RCT comprising 1,077 participants were included. Additionally, 10 case series were included for safety assessment. Pooled analysis of closure rates by the two RCTs indicated there were not significant differences between CA and radiofrequency ablation (RFA) or endovenous laser ablation (EVLA). Improvements in venous clinical severity score were reported by all comparative studies without significant differences among groups. The most frequently reported adverse events were ecchymosis, phlebitis, paraesthesia, and thrombosis. The pooled analysis showed significant differences only in ecchymosis rates, with lower probability of ecchymosis in CA groups. CA treatment showed lower pain rates and shorter intervention times and recovery compared to endothermal therapies.ConclusionsThe effectiveness of CA devices in the treatment of varicose veins is comparable to EVLA and RFA, while the rates of adverse effects are lower. Despite the limitations of the evidence, CA may be a promising alternative to existing treatments, with the advantages of better patient comfort.

Midterm Outcome of Mechanochemical Endovenous Ablation for the Treatment of Great Saphenous Vein Insufficiency

2016 ◽  
Vol 24 (1) ◽  
pp. 149-155 ◽  
Author(s):  
Marianne E. Witte ◽  
Suzanne Holewijn ◽  
Ramon R. van Eekeren ◽  
Jean-Paul de Vries ◽  
Clark J. Zeebregts ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Clinical Severity ◽  
Time Intervals ◽  
Disease Specific ◽  
Anatomic Success

Purpose: To report the midterm results of mechanochemical ablation (MOCA) for treating great saphenous vein (GSV) insufficiency. Methods: In a 1-year period, 85 consecutive patients (median age 51.4 years; 71 women) undergoing MOCA with polidocanol in 104 limbs were enrolled in a prospective registry. The patients were evaluated at baseline and during follow-up (4 weeks and 1, 2, and 3 years) using duplex ultrasound, the CEAP (clinical, etiologic, anatomic and pathophysiologic) classification, the Venous Clinical Severity Score (VCSS), the RAND Short Form 36-Item Health Survey (RAND-SF36), and the Aberdeen Varicose Vein Questionnaire (AVVQ). Primary outcome measures were clinical and anatomic success. Secondary outcome measures included general and disease-specific quality of life and reinterventions. Results: Technical success (99%) was achieved in all but 1 patient in whom technical problems with the device led to conversion to another method for treatment of 2 limbs. After a median follow-up of 36 months (interquartile range 12.5, 46.3), recanalization occurred in 15 (15%) of 102 successfully treated vein segments. Anatomic success was 92%, 90%, and 87% after 1, 2, and 3 years, respectively. The VCSS improved at all time intervals compared to the preprocedure median. The clinical success at 3 years was 83%. The AVVQ and RAND-SF36 scores showed an improvement at all time intervals compared to baseline values. Between 12 and 36 months, however, a significant deterioration was observed in VCSS, which was accompanied by worsening of disease-specific and general quality of life. Conclusion: In the longest follow-up of MOCA to date, this study shows MOCA to be an effective treatment modality for GSV insufficiency at midterm follow-up, but clinical results seem to drop over time.

scholarly journals Effectiveness of Antalgic Therapies in Patients with Vertebral Bone Metastasis: A Protocol for a Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (8) ◽  
pp. 3991
Author(s):  
Antonio Jose Martin-Perez ◽  
María Fernández-González ◽  
Paula Postigo-Martin ◽  
Marc Sampedro Pilegaard ◽  
Carolina Fernández-Lao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Metastasis ◽  
Data Extraction ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Pharmacological Intervention ◽  
Vertebral Metastasis ◽  
Randomized Controlled Clinical Trials

There is no systematic review that has identified existing studies evaluating the pharmacological and non-pharmacological intervention for pain management in patients with bone metastasis. To fill this gap in the literature, this systematic review with meta-analysis aims to evaluate the effectiveness of different antalgic therapies (pharmacological and non-pharmacological) in the improvement of pain of these patients. To this end, this protocol has been written according to the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols (PRISMA-P) and registered in PROSPERO (CRD42020135762). A systematic search will be carried out in four international databases: Medline (Via PubMed), Web of Science, Cochrane Library and SCOPUS, to select the randomized controlled clinical trials. The Risk of Bias Tool developed by Cochrane will be used to assess the risk of bias and the quality of the identified studies. A narrative synthesis will be used to describe and compare the studies, and after the data extraction, random effects model and a subgroup analyses will be performed according to the type of intervention, if possible. This protocol aims to generate a systematic review that compiles and synthesizes the best and most recent evidence on the treatment of pain derived from vertebral metastasis.

scholarly journals A Comparison of Lung Ultrasound and Computed Tomography in the Diagnosis of Patients with COVID-19: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1351
Author(s):  
Mengshu Wang ◽  
Xufei Luo ◽  
Ling Wang ◽  
Janne Estill ◽  
Meng Lv ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Interstitial Pneumonia ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Receiver Operating Curve ◽  
Cochrane Library ◽  
Molecular Tests ◽  
Specificity And Sensitivity

Background Lung ultrasound (LUS) and computed tomography (CT) can both be used for diagnosis of interstitial pneumonia caused by coronavirus disease 2019 (COVID-19), but the agreement between LUS and CT is unknown. Purpose to compare the agreement of LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19. Materials and Methods We searched PubMed, Cochrane library, Embase, Chinese Biomedicine Literature, and WHO COVID-19 databases to identify studies that compared LUS with CT in the diagnosis of interstitial pneumonia caused by COVID-19. We calculated the pooled overall, positive and negative percent agreements, diagnostic odds ratio (DOR) and the area under the standard receiver operating curve (SROC) for LUS in the diagnosis of COVID-19 compared with CT. Results We identified 1896 records, of which nine studies involving 531 patients were finally included. The pooled overall, positive and negative percentage agreements of LUS for the diagnosis of interstitial pneumonia caused by COVID-19 compared with CT were 81% (95% confidence interval [CI] 43–99%), 96% (95% CI, 80–99%, I2 = 92.15%) and 80% (95%CI, 60–92%, I2 = 92.85%), respectively. DOR was 37.41 (95% CI, 9.43–148.49, I2 = 63.9%), and the area under the SROC curve was 0.94 (95% CI, 0.92–0.96). The quality of evidence for both specificity and sensitivity was low because of heterogeneity and risk of bias. Conclusion The level of diagnostic agreement between LUS and CT in the diagnosis of interstitial pneumonia caused by COVID-19 is high. LUS can be therefore considered as an equally accurate alternative for CT in situations where molecular tests are not available.

scholarly journals Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5171
Author(s):  
Yusuke Handa ◽  
Kenya Okada ◽  
Hiroshi Takasaki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grade System ◽  
Cochrane Library ◽  
Forward Head Posture ◽  
Quality Of Evidence ◽  
Head Posture ◽  
Head Extension ◽  
The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

scholarly journals Association of dyslipidemia with the severity and mortality of coronavirus disease 2019 (COVID-19): a meta-analysis

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Yanli Liu ◽  
Yilong Pan ◽  
Yuyao Yin ◽  
Wenhao Chen ◽  
Xiaodong Li
Keyword(s):  
Fixed Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Risk Of Death ◽  
Potential Association ◽  
Increased Risk ◽  
Language Restriction ◽  
Newcastle Ottawa Scale

Abstract Background The numbers of confirmed cases of coronavirus disease 2019 (COVID-19) and COVID-19 related deaths are still increasing, so it is very important to determine the risk factors of COVID-19. Dyslipidemia is a common complication in patients with COVID-19, but the association of dyslipidemia with the severity and mortality of COVID-19 is still unclear. The aim of this study is to analyze the potential association of dyslipidemia with the severity and mortality of COVID-19. Methods We searched the PubMed, Embase, MEDLINE, and Cochrane Library databases for all relevant studies up to August 24, 2020. All the articles published were retrieved without language restriction. All analysis was performed using Stata 13.1 software and Mantel–Haenszel formula with fixed effects models was used to compare the differences between studies. The Newcastle Ottawa scale was used to assess the quality of the included studies. Results Twenty-eight studies involving 12,995 COVID-19 patients were included in the meta-analysis, which was consisted of 26 cohort studies and 2 case–control studies. Dyslipidemia was associated with the severity of COVID-19 (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.11–1.44, P = 0.038, I2 = 39.8%). Further, patients with dyslipidemia had a 2.13-fold increased risk of death compared to patients without dyslipidemia (95% CI 1.84–2.47, P = 0.001, I2 = 66.4%). Conclusions The results proved that dyslipidemia is associated with increased severity and mortality of COVID-19. Therefore, we should monitor blood lipids and administer active treatments in COVID-19 patients with dyslipidemia to reduce the severity and mortality.

scholarly journals Effects of exercise-based pulmonary rehabilitation on adults with asthma: a systematic review and meta-analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhenzhen Feng ◽  
Jiajia Wang ◽  
Yang Xie ◽  
Jiansheng Li
Keyword(s):  
Quality Of Life ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Life Questionnaire ◽  
Asthma Control Questionnaire ◽  
Clinical Trial Registration ◽  
Domain Scores

Abstract Background Pulmonary rehabilitation (PR) has been proposed as an effective method for many respiratory diseases. However, the effects of exercise-based PR on asthma are currently inconclusive. This review aimed to investigate the effects of exercise-based PR on adults with asthma. Methods The PubMed, Embase, Cochrane Library, Web of Science, International Clinical Trials Registry Platform and ClinicalTrials.gov databases were searched from inception to 31 July 2019 without language restriction. Randomized controlled trials (RCTs) investigating the effects of exercise-based PR on adults with asthma were included. Study selection, data extraction and risk of bias assessment were performed by two investigators independently. Meta-analysis was conducted by RevMan software (version 5.3). Evidence quality was rated by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. Results Ten literatures from nine studies (n = 418 patients) were identified. Asthma quality of life questionnaire total scores (MD = 0.39, 95% CI: 0.02 to 0.76) improved significantly in the experimental group compared to control group, including activity domain scores (MD = 0.58, 95% CI: 0.21 to 0.94), symptom domain scores (MD = 0.52, 95% CI: 0.19 to 0.85), emotion domain scores (MD = 0.53, 95% CI: − 0.03 to 1.09) and environment domain scores (MD = 0.56, 95% CI: 0.00 to 1.11). Both the 6-min walk distance (MD = 34.09, 95% CI: 2.51 to 65.66) and maximum oxygen uptake (MD = 4.45, 95% CI: 3.32 to 5.58) significantly improved. However, improvements in asthma control questionnaire scores (MD = − 0.25, 95% CI: − 0.51 to 0.02) and asthma symptom-free days (MD = 3.35, 95% CI: − 0.21 to 6.90) were not significant. Moreover, there was no significant improvement (MD = 0.10, 95% CI: − 0.08 to 0.29) in forced expiratory volume in 1 s. Nonetheless, improvements in forced vital capacity (MD = 0.23, 95% CI: 0.08 to 0.38) and peak expiratory flow (MD = 0.39, 95% CI: 0.21 to 0.57) were significant. Conclusions Exercise-based PR may improve quality of life, exercise tolerance and some aspects of pulmonary function in adults with asthma and can be considered a supplementary therapy. RCTs of high quality and large sample sizes are required. Clinical trial registration: The review was registered with PROSPERO (The website is https://www.crd.york.ac.uk/prospero/, and the ID is CRD42019147107).

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