Cranial Base Angle in Patients With Cleft Lip and Palate—A Systematic Review and Meta-Analysis

2021 ◽  
pp. 105566562110535
Author(s):  
Chandnee Murugan ◽  
Vignesh Kailasam
Keyword(s):  
Systematic Review ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Cranial Base ◽  
Class I ◽  
Base Angle ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Ottawa Scale

Background: Diverse findings have been reported for the cranial base angle (CBA) in patients with CLP (cleft lip and palate) and non-CLP controls. Objective: The aim of this study is to assess and evaluate the CBA in patients with CLP and non-CLP controls. Methods: Data from PubMed, OVID Technologies, Inc., Cochrane, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Scopus, Web of Science, and EMBASE for Excerpta Medica dataBASE (EMBASE) with relevant terms was extracted until December 31, 2020. Inclusion criteria were data of patients with non-syndromic unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). In the case of UCLP and BCLP, patients with craniofacial syndromes were excluded. The study proposal was registered with PROSPERO (Registration number: CRD42021228632). Results: Fifteen studies with a total of 2032 participants were included for the systematic review and 14 studies with a total of 1972 participants were included for the meta-analysis. The risk of bias was assessed using the Modified Newcastle Ottawa scale under seven domains by two authors. Thirteen studies were graded as “good” and two as “satisfactory.” The CBA in patients with CLP were greater than the non CLP Class I controls in six of the 15 studies. CBA was greater in patients with CLP than non-CLP controls by 1.21° (95% CI of 0.19-2.22). Meta-analysis reported considerable heterogeneity (I2 = 86%). Anterior (ACB) and posterior cranial base (PCB) lengths were shorter in patients with CLP than in the non-cleft Class I controls by 2.14 mm (95% CI of 0.99-3.30) and 2.06 mm (95% CI of 1.52-2.60), respectively. Conclusion: Most studies were graded as good. Patients with CLP had greater CBA and shorter ACB and PCB lengths when compared to non-CLP controls.

scholarly journals Epidemiology of placenta previa accreta: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e031193 ◽  
Author(s):  
Eric Jauniaux ◽  
Lene Grønbeck ◽  
Catey Bunce ◽  
Jens Langhoff-Roos ◽  
Sally L Collins
Keyword(s):  
Systematic Review ◽  
Placenta Previa ◽  
Data Extraction ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Placenta Accreta Spectrum ◽  
Obstetric Population ◽  
Ottawa Scale

ObjectiveTo estimate the prevalence and incidence of placenta previa complicated by placenta accreta spectrum (PAS) and to examine the different criteria being used for the diagnosis.DesignSystematic review and meta-analysis.Data sourcesPubMed, Google Scholar, ClinicalTrials.gov and MEDLINE were searched between August 1982 and September 2018.Eligibility criteriaStudies reporting on placenta previa complicated by PAS diagnosed in a defined obstetric population.Data extraction and synthesisTwo independent reviewers performed the data extraction using a predefined protocol and assessed the risk of bias using the Newcastle-Ottawa scale for observational studies, with difference agreed by consensus. The primary outcomes were overall prevalence of placenta previa, incidence of PAS according to the type of placenta previa and the reported clinical outcomes, including the number of peripartum hysterectomies and direct maternal mortality. The secondary outcomes included the criteria used for the prenatal ultrasound diagnosis of placenta previa and the criteria used to diagnose and grade PAS at birth.ResultsA total of 258 articles were reviewed and 13 retrospective and 7 prospective studies were included in the analysis, which reported on 587 women with placenta previa and PAS. The meta-analysis indicated a significant (p<0.001) heterogeneity between study estimates for the prevalence of placenta previa, the prevalence of placenta previa with PAS and the incidence of PAS in the placenta previa cohort. The median prevalence of placenta previa was 0.56% (IQR 0.39–1.24) whereas the median prevalence of placenta previa with PAS was 0.07% (IQR 0.05–0.16). The incidence of PAS in women with a placenta previa was 11.10% (IQR 7.65–17.35).ConclusionsThe high heterogeneity in qualitative and diagnostic data between studies emphasises the need to implement standardised protocols for the diagnoses of both placenta previa and PAS, including the type of placenta previa and grade of villous invasiveness.PROSPERO registration numberCRD42017068589

scholarly journals Extracorporeal membrane oxygenation (ECMO) in patients with severe COVID-19 adult respiratory distress syndrome: a systematic review and meta-analysis

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Hany Hasan Elsayed ◽  
Aly Sherif Hassaballa ◽  
Taha Aly Ahmed ◽  
Mohammed Gumaa ◽  
Hazem Youssef Sharkawy
Keyword(s):  
Systematic Review ◽  
Risk Ratio ◽  
Mortality Risk ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Random Effect ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Venovenous Ecmo ◽  
Ottawa Scale

Abstract Background COVID 19 is the most recent cause of adult respiratory distress syndrome (ARDS). Extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients failing conventional mechanical ventilation, but its role is still controversial. We conducted a systematic review and meta-analysis on ECMO for COVID-associated ARDS to study its outcome. Main body CENTRAL, MEDLINE/PubMed, Cochrane Library, and Scopus were systematically searched from inception to May 28, 2020. Studies reporting five or more patients with COVID-19 infection treated venovenous with ECMO were included. The main outcome assessed was mortality and ICU/hospital discharge. Baseline, procedural, outcome, and validity data were systematically appraised and pooled with random-effect methods. The validity of all the included observational studies was appraised with the Newcastle Ottawa scale. Meta-regression and publication bias were tested. This trial was registered with PROSPERO under registration number CRD42020183861. From 1647 initial citations, 34 full-text articles were analyzed and 12 studies were selected, including 194 patients with confirmed COVID-19 infection requiring ICU admission and venovenous ECMO treatment. Median Newcastle-Ottawa scale was 6 indicating acceptable study validity. One hundred thirty-six patients reached an endpoint of weaning from ECMO with ICU/hospital discharge or death while the rest were still on ECMO or in the ICU. The median Berlin score for ARDS prior to starting ECMO was III. Patients received mechanical ventilation before ECMO implementation for a median of 4 days and ECMO was maintained for a median of 13 days. In hospital and short-term mortality were highly variable among the included studies ranging between 0 and 100%. Random-effect pooled estimates suggested an overall in-hospital mortality risk ratio of 0.49 (95% confidence interval 0.259 to 0.721; I2 = 94%). Subgroup analysis according to country of origin showed persistent heterogeneity only in the 7 Chinese studies with pooled estimate mortality risk ratio of 0.66 (I2 = 87%) (95% CI = 0.39-0.93), while the later larger studies coming from the USA showed pooled estimate mortality risk ratio of 0.41 (95% CI 0.28-0.53) with homogeneity (p=0.67) similar to France with a pooled mortality risk ratio of 0.26 (95% CI 0.08-0.43) with homogeneity (p=0.86). Meta-regression showed only younger age as a predictor of mortality (p=0.02). Publication bias was excluded by visualizing the funnel plot of standard error, Egger’s test with p=0.566, and Begg and Mazumdar test with p=0.373. Conclusion The study included the largest number of patients with outcome findings of ECMO in this current pandemic. Our findings showed that the use of venovenous ECMO at high-volume ECMO centers may be beneficial for selected COVID 19 patients with severe ARDS. However, none of the included studies involve prospective randomized analyses; and therefore, all the included studies were of low or moderate quality according to the Newcastle-Ottawa scale. In the current era and environment of the pandemic, it will likely be very challenging to conduct a prospective randomized trial of ECMO versus no-ECMO for COVID-19. Therefore, the information contained in this systematic review of the literature is valuable and provides important guidance. Trial registration The study protocol link is at www.crd.yorl.ac.uk/PROSPERO under registration number CRD42020183861.

scholarly journals What does my neighbourhood have to do with my weight? A protocol for systematic review and meta-analysis of the association between neighbourhood socioeconomic status and body weight

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017567
Author(s):  
Shimels Hussien Mohammed ◽  
Mulugeta Molla Birhanu ◽  
Tesfamichael Awoke Sissay ◽  
Tesfa Dejenie Habtewold ◽  
Balewgizie Sileshi Tegegn ◽  
...  
Keyword(s):  
Systematic Review ◽  
Socioeconomic Status ◽  
Data Extraction ◽  
Meta Analysis ◽  
Cross Sectional ◽  
Registration Number ◽  
Newcastle Ottawa Scale ◽  
Neighbourhood Socioeconomic Status ◽  
Using Data

IntroductionIndividuals living in poor neighbourhoods are at a higher risk of overweight/obesity. There is no systematic review and meta-analysis study on the association of neighbourhood socioeconomic status (NSES) with overweight/obesity. We aimed to systematically review and meta-analyse the existing evidence on the association of NSES with overweight/obesity.Methods and analysisCross-sectional, case–control and cohort studies published in English from inception to 15 May 2017 will be systematically searched using the following databases: PubMed, EMBASE, Web of Sciences and Google Scholar. Selection, screening, reviewing and data extraction will be done by two reviewers, independently and in duplicate. The Newcastle–Ottawa Scale (NOS) will be used to assess the quality of evidence. Publication bias will be checked by visual inspection of funnel plots and Egger’s regression test. Heterogeneity will be checked by Higgins’s method (I2statistics). Meta-analysis will be done to estimate the pooled OR. Narrative synthesis will be performed if meta-analysis is not feasible due to high heterogeneity of studies.Ethics and disseminationEthical clearance is not required as we will be using data from published articles. Findings will be communicated through a publication in a peer-reviewed journal and presentations at professional conferences.PROSPERO registration numberCRD42017063889.

scholarly journals Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies

2018 ◽  
Vol 21 (4) ◽  
pp. 146-154 ◽  
Author(s):  
Amparo Díaz-Román ◽  
Junhua Zhang ◽  
Richard Delorme ◽  
Anita Beggiato ◽  
Samuele Cortese
Keyword(s):  
Systematic Review ◽  
Autism Spectrum Disorders ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Autism Spectrum ◽  
Newcastle Ottawa Scale ◽  
Spectrum Disorders ◽  
Sleep Alterations ◽  
The Impact ◽  
Ottawa Scale

BackgroundSleep problems are common and impairing in individuals with autism spectrum disorders (ASD). Evidence synthesis including both subjective (ie, measured with questionnaires) and objective (ie, quantified with neurophysiological tools) sleep alterations in youth with ASD is currently lacking.ObjectiveWe conducted a systematic review and meta-analysis of subjective and objective studies sleep studies in youth with ASD.MethodsWe searched the following electronic databases with no language, date or type of document restriction up to 23 May 2018: PubMed, PsycInfo, Embase+Embase Classic, Ovid Medline and Web of Knowledge. Random-effects models were used. Heterogeneity was assessed with Cochran’s Q and I2 statistics. Publication (small studies) bias was assessed with final plots and the Egger’s test. Study quality was evaluated with the Newcastle Ottawa Scale. Analyses were conducted using Review Manager and Comprehensive Meta-Analysis.FindingsFrom a pool of 3359 non-duplicate potentially relevant references, 47 datasets were included in the meta-analyses. Subjective and objective sleep outcome measures were extracted from 37 and 15 studies, respectively. Only five studies were based on comorbidity free, medication-naïve participants. Compared with typically developing controls, youth with ASD significantly differed in 10/14 subjective parameters and in 7/14 objective sleep parameters. The average quality score in the Newcastle-Ottawa Scale was 5.9/9.Discussion and clinical implicationsA number of subjective and, to a less extent, objective sleep alterations might characterise youth with ASD, but future studies should assess the impact of pharmacological treatment and psychiatric comorbidities.

scholarly journals Cranial base characteristics in anteroposterior malocclusions: A meta-analysis

2015 ◽  
Vol 86 (4) ◽  
pp. 668-680 ◽  
Author(s):  
Aixiu Gong ◽  
Jing Li ◽  
Zhendong Wang ◽  
Yuan Li ◽  
Fang Hu ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Class Ii ◽  
Cranial Base ◽  
Class I ◽  
Cochrane Library ◽  
Base Length ◽  
Class Iii ◽  
Class Iii Malocclusion ◽  
Base Angle ◽  
Statistical Heterogeneity

ABSTRACT Objective:  To investigate cranial base characteristics in malocclusions with sagittal discrepancies. Materials and Methods:  An electronic search was performed in PubMed, Embase, Web of Science, and the Cochrane Library. A fixed- or random-effect model was applied to calculate weighted mean difference with 95% confidence intervals (CIs) according to statistical heterogeneity. Outcome measures were anterior, posterior, and total cranial base length and cranial base angle. Sensitivity analysis and publication bias were conducted. Results:  Twenty studies that together included 1121 Class I, 1051 Class II, and 730 Class III cases qualified for the final analysis. Class III malocclusion demonstrated significantly reduced anterior (95% CI: −1.74, −0.53; P &lt; .001 vs Class I; 95% CI: −3.30, −2.09; P &lt; .001 vs Class II) and total cranial base length (95% CI: −3.33, −1.36; P &lt; .001 vs Class I; 95% CI: −7.38, −4.05; P &lt; .001 vs Class II). Further, Class II patients showed significantly greater anterior and total cranial base length than did Class I patients (95% CI: 0.51, 1.87; P &lt; .001 for SN; 95% CI: 2.20, 3.30; P &lt; .001 for NBa). Cranial base angle was significantly smaller in Class III than in Class I (95% CI: −3.14, −0.93; P &lt; .001 for NSBa; 95% CI: −2.73, −0.68; P  =  .001 for NSAr) and Class II malocclusions (95% CI: −5.73, −1.06; P  =  .004 for NSBa; 95% CI: −6.11, −1.92; P &lt; .001 for NSAr) and greater in Class II than in Class I malocclusions (95% CI: 1.38, 2.38; P &lt; .001 for NSBa). Conclusions:  This meta-analysis showed that anterior and total cranial base length and cranial base angle were significantly smaller in Class III malocclusion than in Class I and Class II malocclusions, and that they were greater in Class II subjects compared to controls.

scholarly journals Metabolic Syndrome and Its Components in Patients with COVID-19: Severe Acute Respiratory Syndrome (SARS) and Mortality. A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 (12) ◽  
pp. 162
Author(s):  
Sergio Rico-Martín ◽  
Julián F. Calderón-García ◽  
Belinda Basilio-Fernández ◽  
María Zoraida Clavijo-Chamorro ◽  
Juan F. Sánchez Muñoz-Torrero
Keyword(s):  
Systematic Review ◽  
Metabolic Syndrome ◽  
Severe Acute Respiratory Syndrome ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Newcastle Ottawa Scale ◽  
Abstract Screening ◽  
The Relationship ◽  
Metabolic Comorbidities ◽  
Ottawa Scale

Recent meta-analysis studies have reported that metabolic comorbidities such as diabetes, obesity, dyslipidaemia and hypertension are associated with higher risk of severe acute respiratory syndrome (SARS) and mortality in patients with COVID-19. This meta-analysis aims to investigate the relationship between metabolic syndrome (MetS) and its components with SARS and mortality in COVID-19 patients. Methods: A systematic search was conducted in the several databases up until 1 September 2021. Primary observational longitudinal studies published in peer review journals were selected. Two independent reviewers performed title and abstract screening, extracted data and assessed the risk of bias using the Newcastle–Ottawa Scale. Results: The random effects meta-analysis showed that MetS was significantly associated with SARS with a pooled OR (95% CI) of 3.21 (2.88–3.58) and mortality with a pooled OR (95% CI) of 2.32 (1.16–4.63). According to SARS, the pooled OR for MetS was 2.19 (1.71–2.67), p < 0.001; significantly higher than the hypertension component. With regard to mortality, although the pooled OR for MetS was greater than for its individual components, no significant differences were observed. Conclusions: this meta-analysis of cohort studies, showed that MetS is better associated to SARS and mortality in COVID-19 patients than its individual components.

scholarly journals Efficacy and safety of tocilizumab in the management of COVID-19: A systematic review and meta-analysis of observational studies

2021 ◽  
Author(s):  
Gollapalle L Viswanatha ◽  
CH K V L S N Anjana Male ◽  
Hanumanthappa Shylaja
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Standard Of Care ◽  
Efficacy And Safety ◽  
Risk Of Mortality ◽  
Significant Difference ◽  
Newcastle Ottawa Scale ◽  
Soc Control ◽  
Ottawa Scale

AbstractBackgroundThis systematic review and meta-analysis was aimed to evaluate the efficacy and safety of tocilizumab (TCZ) in treating severe coronavirus disease 2019 (COVID-19).MethodsThe electronic search was performed using PubMed, Scopus, CENTRAL, and Google scholar to identify the retrospective observational reports. The studies published from 01 January 2020 to 30th September 2020. Participants were hospitalized COVID-19 patients. Interventions included tocilizumab versus placebo/standard of care. The comparison will be between TCZ versus standard of care (SOC)/placebo. Inconsistency between the studies was evaluated with I2 and quality of the evidences were evaluated by Newcastle-Ottawa scale.ResultsBased on the inclusion criteria there were 24 retrospective studies involving 5686 subjects were included. The outcomes of the meta-analysis have revealed that the TCZ has reduced the mortality (M-H,RE-OR −0.11(−0.18 to −0.04) 95% CI, p =0.001, I2 =88%) and increased the incidences of super-infections (M-H, RE-OR 1.49(1.13 to 1.96) 95% CI, p=0.004, I2=47%). However, there is no significant difference in ICU admissions rate (M-H, RE-OR −0.06(−0.23 to 0.12), I2=93%), need of MV (M-H, RE-OR of 0.00(−0.06 to 0.07), I = 74%), LOS (IV −2.86(−0.91 to 3.38), I2=100%), LOS-ICU (IV: −3.93(−12.35 to 4.48), I2=100%), and incidences of pulmonary thrombosis (M-H, RE-OR 1.01 (0.45 to 2.26), I2=0%) compared to SOC/control.ConclusionBased on cumulative low to moderate certainty evidence shows that TCZ could reduce the risk of mortality in hospitalized patients. However, there is no statistically significant difference observed between the TCZ and SOC/control groups in other parameters.

scholarly journals Efficaciousness of dexmedetomidine in children undergoing cleft lip and palate repair: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046798
Author(s):  
Dengfeng Liu ◽  
Li Pan ◽  
Yin Gao ◽  
Jiefan Liu ◽  
Feng Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Random Effect Model ◽  
Control Group ◽  
Paediatric Patients ◽  
The Impact

ObjectiveTo systematically assess the efficacy and safety of dexmedetomidine as an anaesthesia adjuvant for cleft lip and palate (CLP) repair in children.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP) and Wanfang (up to October 2020). Studies in languages other than English and Chinese were excluded.Eligibility criteria for selecting studiesRandomised controlled trials (RCTs) evaluating the impact of dexmedetomidine on emergence agitation (EA), the need for postoperative rescue analgesics, postoperative nausea and vomiting (PONV), and other adverse events in paediatric patients during CLP repair.Data extraction and synthesisThe quality of evidence was assessed by using the Cochrane Review Methods and the Grading of Recommendations Assessment, Development and Evaluation approach. Data were screened, extracted and assessed by two independent authors. Outcomes were reported as a risk ratio (RR) with a 95% CI. A random-effect model was used when heterogeneity was detected.ResultsThirteen studies including 1040 children met the inclusion criteria. The incidence of EA was significantly decreased in the dexmedetomidine group (RR, 0.19; 95% CI 0.10 to 0.36; p<0.00001; I2=56%) as compared with the control group. Paediatric patients receiving dexmedetomidine had lower postoperative analgesic requirements (RR, 0.27; 95% CI 0.10 to 0.73; p=0.01; I2=84%) and a lower incidence of respiratory adverse events (RR, 0.49; 95% CI 0.31 to 0.78; p=0.003; I2=0%). There were no significant differences in the risk of PONV and cardiovascular adverse events.ConclusionsThere was a lack of high-quality studies in this field. Perioperative administration of dexmedetomidine reduced the need for postoperative rescue analgesics and the incidence of EA in children without side effects undergoing CLP repair. However, further verification with larger samples and higher-quality RCTs is needed.

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