Do Breast Implants Influence Breastfeeding? A Meta-Analysis of Comparative Studies

2018 ◽  
Vol 34 (3) ◽  
pp. 424-432 ◽  
Author(s):  
Fengrui Cheng ◽  
Shuiping Dai ◽  
Chiyi Wang ◽  
Shaoxue Zeng ◽  
Junjie Chen ◽  
...  
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Exclusive Breastfeeding ◽  
Comparative Studies ◽  
Meta Analysis ◽  
Breast Implants ◽  
Cochrane Central Register ◽  
Periareolar Incision ◽  
Breastfeeding Rate ◽  
Aesthetic Breast

Background: Aesthetic breast implant augmentation surgery is the most popular plastic surgery worldwide. Many women choose to receive breast implants during their reproductive ages, although the long-term effects are still controversial. Research aim: We conducted a meta-analysis to assess the influence of aesthetic breast augmentation on breastfeeding. We also compared the exclusive breastfeeding rates of periareolar versus inframammary incision. Methods: A systematic search for comparative studies about breast implants and breastfeeding was performed in PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, Scopus, and Web of Science through May 2018. Meta-analysis was conducted with a random-effects model (or fixed effects, if heterogeneity was absent). Results: Four cohorts and one cross-sectional study were included. There was a significant reduction in the exclusive breastfeeding rate for women with breast implants compared with women without implants, pooled relative risk = 0.63, 95% confidence interval [0.46, 0.86], as well as the breastfeeding rate, pooled relative risk = 0.88, 95% confidence interval [0.81, 0.95]. There was no evidence that periareolar incision was associated with a reduction in the exclusive breastfeeding rate, pooled relative risk = 0.84, 95% confidence interval [0.45, 1.58]. Conclusion: Participants with breast implants are less likely to establish breastfeeding, especially exclusive breastfeeding. Periareolar incision does not appear to reduce the exclusive breastfeeding rate.

scholarly journals Post-extubation oxygenation strategies in acute respiratory failure: a systematic review and network meta-analysis

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Hideto Yasuda ◽  
Hiromu Okano ◽  
Takuya Mayumi ◽  
Chihiro Narita ◽  
Yu Onodera ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Relative Risk ◽  
Confidence Interval ◽  
Acute Respiratory Failure ◽  
Meta Analysis ◽  
Positive Pressure ◽  
Cochrane Central Register ◽  
Short Term ◽  
Short Term Mortality ◽  
Registration Number

Abstract Background High-flow nasal cannula oxygenation (HFNC) and noninvasive positive-pressure ventilation (NPPV) possibly decrease tracheal reintubation rates better than conventional oxygen therapy (COT); however, few large-scale studies have compared HFNC and NPPV. We conducted a network meta-analysis (NMA) to compare the effectiveness of three post-extubation respiratory support devices (HFNC, NPPV, and COT) in reducing the mortality and reintubation risk. Methods The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Ichushi databases were searched. COT, NPPV, and HFNC use were assessed in patients who were aged ≥ 16 years, underwent invasive mechanical ventilation for > 12 h for acute respiratory failure, and were scheduled for extubation after spontaneous breathing trials. The GRADE Working Group Approach was performed using a frequentist-based approach with multivariate random-effect meta-analysis. Short-term mortality and reintubation and post-extubation respiratory failure rates were compared. Results After evaluating 4631 records, 15 studies and 2600 patients were included. The main cause of acute hypoxic respiratory failure was pneumonia. Although NPPV/HFNC use did not significantly lower the mortality risk (relative risk [95% confidence interval] 0.75 [0.53–1.06] and 0.92 [0.67–1.27]; low and moderate certainty, respectively), HFNC use significantly lowered the reintubation risk (0.54 [0.32–0.89]; high certainty) compared to COT use. The associations of mortality with NPPV and HFNC use with respect to either outcome did not differ significantly (short-term mortality and reintubation, relative risk [95% confidence interval] 0.81 [0.61–1.08] and 1.02 [0.53–1.97]; moderate and very low certainty, respectively). Conclusion NPPV or HFNC use may not reduce the risk of short-term mortality; however, they may reduce the risk of endotracheal reintubation. Trial registration number and date of registration PROSPERO (registration number: CRD42020139112, 01/21/2020).

scholarly journals Convalescent plasma therapy for COVID-19 patients: a protocol of a prospective meta-analysis of randomized controlled trials

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lajos Szakó ◽  
Nelli Farkas ◽  
Szabolcs Kiss ◽  
Szilárd Váncsa ◽  
Noémi Zádori ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Organ Failure ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Plasma Therapy ◽  
Monthly Basis ◽  
Randomized Controlled

Abstract Background Coronavirus disease 2019 (COVID-19) is an infection with possible serious consequences. The plasma of recovered patients might serve as treatment, which we aim to assess in the form of a prospective meta-analysis focusing on mortality, multi-organ failure, duration of intensive care unit stay, and adverse events. Methods A systematic search was conducted to find relevant registered randomized controlled trials in five trial registries. A comprehensive search will be done continuously on a monthly basis in MEDLINE (via PubMed), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science to find the results of previously registered randomized controlled trials. The selection will be done by two independent authors. Data extraction will be carried out by two other independent reviewers. Disagreements will be resolved by a third investigator. An update of the search of the registries and the first search of the databases will be done on the 21st of July. Data synthesis will be performed following the recommendations of the Cochrane Collaboration. In the case of dichotomous outcomes (mortality and organ failure), we will calculate pooled risk ratios with a 95% confidence interval (CI) from two-by-two tables (treatment Y/N, outcome Y/N). Data from models with multivariate adjustment (hazard ratios, odds ratio, risk ratio) will be preferred for the analysis. P less than 0.05 will be considered statistically significant. In the case of ICU stay, weighted mean difference with a 95% confidence interval will be calculated. Heterogeneity will be tested with I2, and χ2 tests. Meta-analysis will be performed if at least 3 studies report on the same outcome and population. Discussion Convalescent plasma therapy is a considerable alternative in COVID-19, which we aim to investigate in a prospective meta-analysis.

scholarly journals A Meta-Analysis of the Efficacy of Hyaluronic Acid Eye Drops for the Treatment of Dry Eye Syndrome

2021 ◽  
Vol 18 (5) ◽  
pp. 2383
Author(s):  
Yun-Jung Yang ◽  
Won-Young Lee ◽  
Young-jin Kim ◽  
Yeon-pyo Hong
Keyword(s):  
Hyaluronic Acid ◽  
Confidence Interval ◽  
Dry Eye ◽  
Test Scores ◽  
Meta Analysis ◽  
Mean Difference ◽  
Dry Eye Syndrome ◽  
Eye Drops ◽  
Cochrane Central Register ◽  
Standard Mean Difference

Hyaluronic acid (HA) is commonly used for treating dry eye syndrome (DES). This meta-analysis was performed to compare the efficacies of HA- and non-HA-based eye drops, including saline and conventional artificial tears (ATs), for the treatment of dry eye disease. Eight databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, DBpia, KoreaMed, KMBASE, RISS, KISS) were searched for studies comparing the efficacies of HA- and non-HA-based ATs in patients with DES published up to September 2020. Two independent reviewers assessed the quality and extracted the relevant data. The mean differences of Schirmer’s (SH) test scores, tear breakup times (TBUT), corneal fluorescein staining scores (Oxford scale, 0–4), and ocular surface disease indexes were calculated. The standard mean difference and 95% confidence interval were calculated using a random effect model. Nineteen studies, including 2078 cases, were included. HA eye drops significantly improved tear production compared with non-HA-based eye drops (standard mean difference (SMD) 0.18; 95% confidence interval (CI) 0.03, 0.33). In a subgroup analysis, the SH test scores and TBUT values after using HA significantly increased compared to those measured after using saline (SMD 0.27; 95% CI 0.05, 0.49 and SMD 0.28; 95% CI 0.03, 0.52, respectively). Based on these results, HA eye drops may be superior to non-HA eye drops including normal saline and ATs. Further research is needed to assess the efficacies stratified by age, treatment duration, the severity of dry eye, and optimal dosages.

Association between Diabetes Mellitus and the Risk of Herpes Zoster: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Chun-Ta Huang ◽  
Chi-Yu Lee ◽  
Heng-You Sung ◽  
Shu-Jung Liu ◽  
Po-Chih Liang ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Herpes Zoster ◽  
Relative Risk ◽  
General Population ◽  
Confidence Interval ◽  
Varicella Vaccination ◽  
Cochrane Central Register ◽  
Case Control Studies ◽  
Increased Risk

Abstract Context Individuals with diabetes mellitus (DM) are susceptible to various infections. Objective We estimated the risk of herpes zoster (HZ) among individuals with DM compared to individuals in the general population. Data Sources We searched the PubMed, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trails, Cumulative Index to Nursing and Allied Health Literature and PerioPath databases from their inception to January 30, 2021 for studies on the risk of HZ in individuals with DM. Study Selection Two authors independently screened all articles identified. Data Extraction The same two authors independently extracted the data. Four case-control studies and 12 cohort studies were included. Data Synthesis Meta-analyses were performed using fixed and mixed-effects models. In the pooled analysis, individuals with DM had a higher risk of developing HZ (pooled relative risk: 1.38, 95% confidence interval: 1.21–1.57) than individuals in the general population. The results were consistent in subgroup analyses stratified by type of diabetes, age, and study design. In individuals with DM, cardiovascular disease had an additive effect on increasing the risk of HZ (pooled relative risk: 1.19, 95% confidence interval: 1.11–1.28). There was a linear dose-response association between age and the risk of HZ in individuals with DM. Conclusion Individuals with DM have an increased risk of HZ compared to the general population. Varicella vaccination should be provided to individuals with DM regardless of their age, prioritizing older adults and those with cardiovascular disease. Varicella vaccination policies for individuals with DM should be updated based on the evidence.

scholarly journals Lower Risk of Recurrence After Mesh Repair Versus Non-Mesh Sutured Repair in Open Umbilical Hernia Repair: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 108 (3) ◽  
pp. 187-193 ◽  
Author(s):  
T. Bisgaard ◽  
R. Kaufmann ◽  
M. W. Christoffersen ◽  
P. Strandfelt ◽  
L. L. Gluud
Keyword(s):  
Relative Risk ◽  
Confidence Interval ◽  
Randomized Controlled Trials ◽  
Mesh Repair ◽  
Umbilical Hernia ◽  
Meta Analysis ◽  
Seroma Formation ◽  
Controlled Trials ◽  
Randomized Controlled

Background and Aims: The use of mesh repair in a small- or middle-sized umbilical hernia remains controversial, and evidence is based on only few and small heterogeneous randomized trials. The primary aim was to assess differences, if any, in recurrence (clinical and reoperation), and secondary aim was to assess differences in infections, seroma formation, hematomas, chronic pain, cosmetic result, and quality of life. Method: A systematic review (predefined search strategy) and meta-analyses were conducted based on pre-study strict and well-defined methodology. The literature search was completed on 1 January 2018. The study protocol was registered in PROSPERO. Results: Five randomized controlled trials were identified (mesh repair, n = 326 versus non-mesh sutured repair, n = 330) and 602 records were excluded. Randomized controlled trials included patients with defect diameters of ⩾1 to 4 cm. Mesh repair reduced the risk of recurrence compared with sutured repair with a relative risk of 0.28 (95% confidence interval = 0.13–0.58, I2 = 0%, number needed to treat = 13 patients). Additional analyses found no differences between the two surgical techniques regarding infection (relative risk = 0.80, 95% confidence interval = 0.36–1.79), seroma formation (relative risk = 1.38, 95% confidence interval = 0.57–3.32), or hematomas (relative risk = 0.55, 95% confidence interval = 0.23–1.30). Lack of sufficient data precluded meta-analysis evaluating risk of seroma formation, hematomas, chronic pain, cosmetic result, and quality of life. Conclusion: Mesh repair is recommended for umbilical hernia of ⩾1 to 4 cm. More evidence is needed for the optimal placement of the mesh (sublay or onlay) and the role of mesh in patients with an umbilical hernia <1 cm.

scholarly journals Coffee Consumption and Risk of Dementia and Alzheimer’s Disease: A Dose-Response Meta-Analysis of Prospective Studies

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1501 ◽  
Author(s):  
Susanna Larsson ◽  
Nicola Orsini
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Relative Risk ◽  
Confidence Interval ◽  
Dose Response ◽  
Prospective Studies ◽  
Linear Trend ◽  
Meta Analysis ◽  
Coffee Consumption ◽  
Increased Risk

Coffee consumption is associated with a reduced risk of several diseases but uncertainty remains about the influence of coffee consumption on the risk of dementia. We performed a dose-response meta-analysis to summarize the prospective data on coffee consumption and associated risk of dementia and Alzheimer’s disease. We identified studies by searching PubMed (from January 1966) and Web of Science (from January 1945) through 4 October 2018 and by scrutinizing the reference lists of pertinent publications. Two researchers independently reviewed the literature. Results were combined using a restricted cubic spline random-effects dose-response meta-analysis based on a one-stage approach. Eight relevant prospective studies were identified. These studies included 7486 dementia cases diagnosed among 328,885 individuals during an average follow-up of 4.9–25 years. Meta-analysis of all eight studies indicated no statistically significant association between coffee consumption and the risk of dementia and no deviations from a linear trend (p = 0.08). The relative risk of dementia per 1 cup/day increment of coffee consumption was 1.01 (95% confidence interval (CI) 0.98–1.05; p = 0.37). Meta-analysis of five studies that focused on Alzheimer’s disease revealed no association between coffee consumption and Alzheimer’s disease and no deviations from a linear trend (p = 0.79). The relative risk of Alzheimer’s disease per 1 cup/day increment of coffee consumption was 1.01 (95% confidence interval 0.95–1.07; p = 0.80). These results do not support an association between coffee consumption and an increased risk of overall dementia or Alzheimer’s disease specifically, but further research on the association of coffee consumption with dementia risk is needed.

scholarly journals Arthroscopic debridement has lower re-operation rates than arthrotomy in the treatment of acute septic arthritis of the knee: a meta-analysis

2019 ◽  
Vol 4 (6) ◽  
pp. 307-312
Author(s):  
Taufiq Panjwani ◽  
Keng Lin Wong ◽  
Si Heng Sharon Tan ◽  
Glen Liau ◽  
Narendra Vaidya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Knee Joint ◽  
Septic Arthritis ◽  
Functional Outcome ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Arthroscopic Debridement ◽  
Pertinent Data ◽  
Operation Rate

ImportanceSeptic arthritis of the native knee joint is the most common bacterial joint infection. The management involves prompt surgical debridement and joint irrigation by arthroscopy or arthrotomy. This is the first systematic review and meta-analysis to compare arthroscopic debridement with arthrotomy for septic arthritis of native knee joint.ObjectiveThe purpose of this systematic review and meta-analysis is to compare re-operation rates, length of inpatient hospital stay (LOS) and functional outcome between arthroscopy and arthrotomy in the treatment of acute septic arthritis of the native knee joint.Evidence reviewThis study was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, Embase and Cochrane Central Register of Controlled Trials databases were searched from database inception to 31 May 2019. All original studies that compared re-operation rates and LOS between arthroscopy and arthrotomy for septic arthritis of knee were included. The research question and eligibility criteria were established a priori. Pertinent data were extracted and random-effects model was used to pool the data where possible.FindingsA total of seven studies with 1089 knees were included, of which 723 underwent arthroscopic surgery and 366 knees underwent arthrotomy. The relative risk of re-operation was significantly lower in the arthroscopy group with a pooled relative risk of 0.69 (95% CI 0.56 to 0.86; p=0.0006). All studies reported shorter LOS and one study reported better functional outcomes in the arthroscopy group as compared with arthrotomy. However, the data could not be quantitatively synthesised due to variation in reporting among the studies included.Conclusions and relevanceBased on the available evidence, we conclude that arthroscopy for the treatment of septic arthritis of the knee results in a lower re-operation rate than arthrotomy. It cannot be concluded whether arthroscopic treatment results in shorter LOS or better functional outcome as compared with arthrotomy.Level of evidenceIV

scholarly journals 1183. Effect of Chlorhexidine Bath on the Prevention of Ventilator-associated Pneumonia: A Meta-Analysis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S424-S424
Author(s):  
Mark Jay M Robles
Keyword(s):  
Confidence Interval ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Ventilator Associated Pneumonia ◽  
Antiseptic Solution ◽  
Central Register ◽  
Before And After ◽  
Effective Product ◽  
Study Designs ◽  
Before And After Study

Abstract Background Ventilator-associated pneumonia, defined as pneumonia occurring more than 48 hours after patients have been intubated and received mechanical ventilation, represents one of the most important nosocomial infections in critically ill patients. Chlorhexidine, an antiseptic solution, is a safe and effective product with broad antiseptic activity. This meta-analysis would like to investigate if Chlorhexidine bathing significantly reduced the incidence of Ventilator-associated pneumonia. Methods We searched PubMed and Cochrane Central Register database to check for all published studies related to the reduction of VAP with the application of chlorhexidine bath vs. control. Various study designs such as randomized controlled trials, Before-and-After study were included in this meta-analysis. Results This meta-analysis analyzed eight studies. One hundred Thirty-nine (139) events developed in the chlorhexidine group over 33,030 patient-days which were significantly lower compared with 183 in the soap and water group over 35,213 patient-days. The overall incidence of Ventilator-associated Pneumonia (VAP) with the application of chlorhexidine was significantly reduced by 23% with a pooled Risk Ratio (RR) of 0.77 with 95% Confidence Interval (CI): 0.62–0.96; I2 = 52%. In the subgroup analysis, a more significant outcome was observed using Before-and-After study as the research design (pooled RR 0.63, 95% Confidence Interval (CI): 0.48–0.83, I2 = 31%). Daily chlorhexidine bath generated a more favorable outcome, compared with every other day application as evident on the pooled RR 0.78, 95% confidence interval (CI): 0.62–0.98, I2=59% Conclusion This meta-analysis clearly favors the use of daily chlorhexidine bath in the prevention of ventilator-associated pneumonia. Disclosures All authors: No reported disclosures.

scholarly journals Do low-dose corticosteroids improve survival or shock reversal from septic shock in adults? Meta-analysis with trial sequential analysis

2018 ◽  
Vol 46 (7) ◽  
pp. 2513-2524 ◽  
Author(s):  
Rui Xu ◽  
Qian Wang ◽  
Yan Huang ◽  
Ling Wu ◽  
Qi Liu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Relative Risk ◽  
Confidence Interval ◽  
Sequential Analysis ◽  
Low Dose ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Control Group ◽  
Shock Reversal

Objective This meta-analysis with trial sequential analysis (TSA) was performed to determine whether low-dose corticosteroids (LDCs) can improve survival or shock reversal from septic shock in adults. Methods A literature search was performed using several databases (Medline, Cochrane Library, Embase, and Chinese Biological Medical Database) until 23 October 2017. The systematic review was registered in PROSPERO. Results Nine randomized controlled trials (RCTs) (n = 1182) were included. LDC intervention improved 7-day shock reversal compared with the control group (relative risk, 1.36; TSA-adjusted 95% confidence interval, 1.20–1.54). LDCs had no statistically significant effects on gastrointestinal bleeding or superinfection. LDCs did not reduce 28-day mortality from septic shock (relative risk, 0.96; TSA-adjusted 95% confidence interval, 0.74–1.24). The TSA indicated that RCTs of about 3000 patients would be needed to draw definitive conclusions; similar results were obtained in a subgroup analysis of nonresponders. Conclusions LDCs improve 7-day shock reversal. However, whether LDCs improve 28-day survival from septic shock in adults remains unclear. The results of well-designed larger RCTs are needed.

scholarly journals Quilting Sutures in Rhytidectomy: A Systematic Review of the Literature

2019 ◽  
Vol 40 (11) ◽  
pp. 1157-1164 ◽  
Author(s):  
Anthony Ballan ◽  
Samer Jabbour ◽  
Youssef El Rayess ◽  
Khalil Jabbour ◽  
Lena El Hachem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Postoperative Complications ◽  
Confidence Interval ◽  
Meta Analysis ◽  
Control Group ◽  
Published Data ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Safety And Efficacy

Abstract Background Different technical variations exist for the utilization of quilting sutures (QS) in rhytidectomy. No systematic review or meta-analysis of the studies describing the use of QS in facelifts has been published to date to the authors’ knowledge. Objectives The objective of this study was to summarize all the published data regarding the utilization of QS in rhytidectomy, compare QS techniques, and evaluate their effect on postoperative complications. Methods On April 1, 2019, a systematic search of the Medline, Embase, and Cochrane databases was conducted. All the studies describing the usage of QS in facelifts were included in this review. Studies reporting hematoma rate in a QS group and a control group were included in the meta-analysis part of this study. Results The initial search of the databases yielded 93 results. Four trials were included in the systematic review and 2 were included in the meta-analysis. The total number of included patients with QS was 527. Two studies employed internal QS and the remaining studies utilized external QS. The meta-analysis found a lower rate of hematoma in the QS group (relative risk, 0.02; 95% confidence interval = 0.00-0.13; P &lt; 0.0001). Conclusions QS can be applied either internally or externally and are very effective in reducing hematomas after facelifts. QS could be a great asset in facelifts but should be utilized with caution because additional work is needed to confirm their safety and efficacy. Level of Evidence: 2

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