scholarly journals Effectiveness of Acupuncture in Relieving Chemotherapy-induced Leukopenia in Patients With Breast Cancer: A Systematic Review With A Meta-Analysis and Trial Sequential Analysis

2021 ◽  
Vol 20 ◽  
pp. 153473542110638
Author(s):  
Ya Wen Shih ◽  
Jui Yuan Su ◽  
Yu Shan Kung ◽  
Yu Huei Lin ◽  
Duong Thi To Anh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Random Effects ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
White Blood Cells ◽  
Cochrane Library ◽  
Common Side Effect ◽  
Trial Sequential Analysis ◽  
Random Effects Model

Background: Breast cancer is one of the most common cancers and a major cause of death in women worldwide. Chemotherapy is mainly used to treat and control the progression of breast cancer. Leukopenia is the most common side effect of chemotherapy which may decrease immune function and further lead to serious fatal infections. The purpose of this study was to evaluate the effect of acupuncture on regulating hematopoietic function in chemotherapy-induced leukopenia among patients with breast cancer. Methods: PubMed, Embase, Cochrane Library, CINAHL Plus, Web of Science, and Chinese articles in the Airiti Library and China National Knowledge Infrastructure (CNKI) databases were searched to August 2021 for papers to include in a systematic review and meta-analysis. A random-effects model was applied. The effect size was calculated by Hedges’ g. Heterogeneity was determined using Cochran’s Q test. Moderator analyses were performed to examine potential sources of heterogeneity. A trial sequential analysis (TSA) was conducted to determine whether the current sample size was sufficient. Results: Ten randomized controlled trials involving 650 participants were eligible for inclusion. Analysis by the random-effects model showed a significant effect by acupuncture of ameliorating leukopenia during chemotherapy. Levels of white blood cells (WBCs) were increased (Hedges’ g = 0.70, P < .001, I2 = 34%), neutrophil counts (Hedges’ g = 0.80, P < .001, I2 = 0%) were significantly enhanced. Moreover, regardless of the manner through which acupuncture was applied, overall values of WBCs increased. Conclusions: The current meta-analysis supports acupuncture possibly ameliorating chemotherapy-induced leukopenia, as WBC and neutrophil values significantly increased after acupuncture in patients undergoing chemotherapy. Additionally, regardless of the type of acupuncture, values of WBCs increased. These findings are actionable and support both the clinical use of acupuncture to relieve chemotherapy-induced leukopenia and further research regarding the use of acupuncture in patients experiencing immunosuppression when undergoing chemotherapy. Trial Registration: PROSPERO-CRD42020215759.

scholarly journals Antibiotic regimens for neonatal sepsis - a protocol for a systematic review with meta-analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Steven Kwasi Korang ◽  
Sanam Safi ◽  
Christian Gluud ◽  
Ulrik Lausten-Thomsen ◽  
Janus C. Jakobsen
Keyword(s):  
Systematic Review ◽  
Health Care Professionals ◽  
Neonatal Sepsis ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Circulatory Support ◽  
Trial Sequential Analysis ◽  
Clinical Effects ◽  
Neonates And Infants

Abstract Background Sepsis is a major cause of morbidity and mortality among neonates and infants. Antibiotics are a central part of the first line treatment for sepsis in neonatal intensive care units worldwide. However, the evidence on the clinical effects of the commonly used antibiotic regimens for sepsis in neonates remains scarce. This systematic review aims to assess the efficacy and harms of antibiotic regimens for neonatal sepsis. Methods Electronic searches will be conducted in MEDLINE, Embase, The Cochrane Library, CINAHL, ZETOC and clinical trial registries (clinicaltrials.gov and ISRCTN). We will include randomised controlled trials of different antibiotic regimens for sepsis of neonates and infants. Eligible interventions will be any antibiotic regimen. Two reviewers will independently screen, select, and extract data. The methodological quality of individual studies will be appraised following Cochrane methodology. Primary outcomes will be ‘all-cause mortality’ and ‘serious adverse events’. Secondary outcomes will be ‘need for respiratory support’, ‘need for circulatory support’, ‘neurodevelopmental impairment’, ototoxicity, nephrotoxicity and necrotizing enterocolitis. We plan to perform a meta-analysis with trial sequential analysis. Discussion This is the study protocol for a systematic review on the effects of different antibiotic regimens for neonatal sepsis. The results of this systematic review intent to adequately inform stakeholders or health care professionals in the field of neonatal sepsis, and to aid appropriate development of treatment guidelines. Systematic review registration PROSPERO reference number: CRD42019134300.

scholarly journals Diabetes in Pakistan: A systematic review and meta-analysis

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sohail Akhtar ◽  
Jamal Abdul Nasir ◽  
Tahir Abbas ◽  
Aqsa Sarwar
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Family History ◽  
Random Effects ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Continuous Increase ◽  
Family History Of Diabetes ◽  
Factors Associated

Objective: The purpose of this study was assess the time trend of the prevalence of prediabetes and diabetes and risk factors associated with diabetes in Pakistan by using a systematic review and meta–analysis. Methods: A systematic literature search of Embase, PubMed, and the Cochrane library was carried out between January 1, 1995 and August 30, 2018. Diabetes and prediabetes prevalence estimates were combined by the random–effects model. The existence of publication bias was tested by Egger regression. This systematic review was reported following the PRISMA guidelines. Results: The search conceded a total of 635 studies, only 14 studies were considered for meta-analysis. The prevalence of diabetes in Pakistan was revealed 14.62% (10.651%–19.094%; 14 studies) based on 49,418 people using the inverse–variance random–effects model. The prevalence of prediabetes was 11.43% (8.26%–15.03%; 10 studies) based on a total sample of 26,999 people. The risk factors associated with diabetes were mean age (β = 0.48%, 95% CI: 0.21–0.78, p<0.001), the proportion of participants with a family history of diabetes (β = 0. 45%, 95% CI: 0.08–0.82, p =0.018, p<0.001), hypertension (β = 0.40%, 95% CI: 0.06–0.75, p = 0.022), weight (BMI) (β = 0.21%, 95% CI: 0.02–0.4, p=0.030). Conclusions: There has been a continuous increase in the prevalence of prediabetes and diabetes in Pakistan. All parts of the country have been affected, with the highest in Sindh and lowest in Khyber Pakhtunkhwa. The main factors include growing age, family history, hypertension and obesity. A nationwide diabetes care survey on risk factors and prevention policy is highly recommended. doi: https://doi.org/10.12669/pjms.35.4.194 How to cite this:Akhtar S, Nasir JA, Abbas T, Sarwar A. Diabetes in Pakistan: A systematic review and meta-analysis. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.194 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Ear mould for congenital auricular deformities: a protocol for systematic review and meta-analysis

2020 ◽  
Author(s):  
Jincheng Huang ◽  
Kun Zou ◽  
Ping Yuan ◽  
Longhao Zhang ◽  
Min Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Random Effects ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Evidence Base ◽  
Small Sample ◽  
Cochrane Library ◽  
Random Effects Model ◽  
High Quality ◽  
Effectiveness Rate

Abstract Background: Congenital auricle deformities (CADs) not only affect the appearance, but may also result in social inferiority or difficulties, influence the hearing and mental health of the children. Although some studies have pointed out CADs have a natural improvement trend, there is still a lack of high-quality research to demonstrate the degree of that. Therefore, related studies agree that early treatment are necessary. Ear mold correction is currently main non-surgical treatment for CADs, but the existing research often involves a small sample size, and the research conclusions are inconsistent. More importantly, there is still no systematic review on ear mold correction for CADs. This study aims to systematically evaluate the effectiveness and safety of ear mold correction for CADs, so as to provide an evidence base for further research.Methods: The study has been designed according to the Preferred Reporting program for Systems Evaluation and Meta-analysis Protocol (PRISMA-P). We will search electronic literature databases of PubMed, Embase, Cochrane Library, Web of science, CBM, CNKI, Wanfang and VIP from their initiative to 1 June 2020 for interventional studies on ear mould for children with CADs. The study selection, data extraction and quality assessment will be performed by two authors. Meta-analysis will be conducted on primary outcome effectiveness rate of physician assessment and secondary outcomes of effectiveness rate of parents’ assessment, effectiveness score, hearing assessment, and adverse reactions using relative ratio or mean difference and their 95% confidence intervals. The heterogeneity of the included studies will be tested using Chi square test and I2, and random-effects model will be used when significant heterogeneity was found, otherwise, fixed-effects model will be used. Sensitivity analysis will be performed using trials with high quality and using alternative [1]models (fixed-effects or random effects model). Publication bias will be tested using funnel plot and Egger’s test. Discussion: This study will be the first to systematically evaluate the effectiveness and safety of ear mold correction for CADs, to provide evidence base for clinical guideline making, clinical decision and future research. Systematic review registration : CRD42020190982.

scholarly journals The Association between Season and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Lingyun Liao ◽  
Xiaohong Wei ◽  
Min Liu ◽  
Yijie Gao ◽  
Yangxue Yin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Analysis ◽  
Random Effects ◽  
Web Of Science ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Hypertensive Disorders Of Pregnancy ◽  
Hypertensive Disorders ◽  
The Cochrane Library

Abstract Background: There is increasing and inconsistent evidence of a relationship between hypertensive disorders of pregnancy (HDP) and season of delivery or conception.Methods: Four databases, the Cochrane Library, PubMed, EMBASE and Web of Science, were searched until September 29th, 2021. Two authors extracted data independently. A random effects model and the Mantel-Haenszel method were used to calculate pooled ORs and 95% CIs.Results: Twenty articles were included in the systematic review, and 11 articles were included in the meta-analysis. The quantitative analysis of the association between delivery season and HDP showed that the odds of HDP was higher in women who deliver in winter than in those who delivered in summer (OR=1.18, 95% CI 1.02-1.38, p < 0.001) and all other seasons (OR = 1.17, 95% CI 1.03-1.34, p <0.001). In the qualitative analysis of the association between conception season and HDP, 4 of 7 studies suggested that women who conceived in summer had a higher risk of HDP than those who conceived in other seasons.Conclusions: Based on the evidence to date, we found weakly positive relationships between HDP and summer conception and winter delivery.

scholarly journals Bevacizumab for radiation necrosis following radiotherapy of brain metastatic disease: a systematic review & meta-analysis

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Khan ◽  
Zhihong Zhao ◽  
Sumbal Arooj ◽  
Guixiang Liao
Keyword(s):  
Systematic Review ◽  
Monoclonal Antibody ◽  
Random Effects ◽  
Metastatic Disease ◽  
Radiation Necrosis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Model ◽  
Efficacy And Safety ◽  
Radiographic Response

Abstract Background Radiotherapy is the mainstay of brain metastasis (BM) management. Radiation necrosis (RN) is a serious complication of radiotherapy. Bevacizumab (BV), an anti-vascular endothelial growth factor monoclonal antibody, has been increasingly used for RN treatment. We systematically reviewed the medical literature for studies reporting the efficacy and safety of bevacizumab for treatment of RN in BM patients. Materials and methods PubMed, Medline, EMBASE, and Cochrane library were searched with various search keywords such as “bevacizumab” OR “anti-VEGF monoclonal antibody” AND “radiation necrosis” OR “radiation-induced brain necrosis” OR “RN” OR “RBN” AND “Brain metastases” OR “BM” until 1st Aug 2020. Studies reporting the efficacy and safety of BV treatment for BM patients with RN were retrieved. Study selection and data extraction were carried out by independent investigators. Open Meta Analyst software was used as a random effects model for meta-analysis to obtain mean reduction rates. Results Two prospective, seven retrospective, and three case report studies involving 89 patients with RN treated with BV were included in this systematic review and meta-analysis. In total, 83 (93%) patients had a recorded radiographic response to BV therapy, and six (6.7%) had experienced progressive disease. Seven studies (n = 73) reported mean volume reductions on gadolinium-enhanced T1 (mean: 47.03%, +/− 24.4) and T2-weighted fluid-attenuated inversion recovery (FLAIR) MRI images (mean: 61.9%, +/− 23.3). Pooling together the T1 and T2 MRI reduction rates by random effects model revealed a mean of 48.58 (95% CI: 38.32–58.85) for T1 reduction rate and 62.017 (95% CI: 52.235–71.799) for T2W imaging studies. Eighty-five patients presented with neurological symptoms. After BV treatment, nine (10%) had stable symptoms, 39 (48%) had improved, and 34 (40%) patients had complete resolution of their symptoms. Individual patient data was available for 54 patients. Dexamethasone discontinuation or reduction in dosage was observed in 30 (97%) of 31 patients who had recorded dosage before and after BV treatment. Side effects were mild. Conclusions Bevacizumab presents a promising treatment strategy for patients with RN and brain metastatic disease. Radiographic response and clinical improvement was observed without any serious adverse events. Further class I evidence would be required to establish a bevacizumab recommendation in this group of patients.

scholarly journals Acupuncture for breathlessness in advanced cancer: a protocol for systematic review and meta-analysis with trial sequential analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (11) ◽  
pp. e054917
Author(s):  
Zihan Yin ◽  
Tao Xu ◽  
Mingsheng Sun ◽  
Ling Zhao ◽  
Fanrong Liang
Keyword(s):  
Systematic Review ◽  
Advanced Cancer ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register

IntroductionBreathlessness in advanced cancer, a frequent multicomponent and debilitating disorder, severely reduces function and quality of patients’ life. Multiple studies have shown that non-pharmacological therapies can effectively palliate breathlessness in advanced cancer. However, no systematic review has investigated the application of acupuncture, as a non-pharmacological treatment, for breathlessness in advanced cancer. A systematic review will be conducted to summarise evidence supporting the efficacy and safety of acupuncture as a therapeutic option for breathlessness in advanced cancer based on existing randomised controlled trials (RCTs).MethodsRCTs will be retrieved from nine scientific databases, including the MEDLINE via PubMed, Web of Science via the Web of Knowledge, Embase via Ovid, the Cochrane Central Register of Controlled Trials via the Cochrane Library, and Allied and Complementary Medicine Database via EBSCO, China National Knowledge Infrastructure, Wanfang Database, VIP Database, Chinese Biomedical Literature Database; three clinical registry platforms, including the WHO International Clinical Trials Registry Platform, NIH Clinical trials.gov and Chinese Clinical Trial Registry, as well as from other sources. Studies published since inception of these databases to 1 August 2021 will be retrieved. Search terms will include breathlessness, cancer, acupuncture and RCT. Two investigators will independently select and extract data from RCTs and assess the risk of bias. The primary outcome, which is alleviation of breathlessness, will be assessed. Meta-analysis will be performed using RevMan V.5.4 and STATA V.15.0. The TSA 0.9.5.10 β software will be used to conduct trial sequential analysis. Finally, the quality of evidence from RCTs will be assessed using the Grading of Recommendations Assessment, Development and Evaluation System tool.Ethics and disseminationResults will be disseminated through peer-reviewed journals or conference reports. Since this study involves acquisition of secondary data, ethical approval requirements will be waived.PROSPERO registration numberCRD42021240085.

scholarly journals Do GLP-1 Receptor Agonists Increase the Risk of Breast Cancer? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A352-A353
Author(s):  
Giovana Fagundes Piccoli ◽  
Leonardo A Mesquita ◽  
Cinara Stein ◽  
Marina M Aziz ◽  
Maira Zoldan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Breast Neoplasms ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Development Program ◽  
Trial Sequential Analysis ◽  
Obesity And Diabetes ◽  
Risk Of Cancer

Abstract Background: Risk of cancer is a major concern in the development of drugs for the treatment of obesity and diabetes. In randomized controlled trials (RCTs) of the liraglutide development program, a glucagon-like peptide-1 receptor agonist (GLP-1RA), subjects treated with the active drug had a higher absolute number of breast cancer events. Aim: To assess whether patients treated with GLP-1RAs had a higher risk of breast neoplasms. Methods: We searched MEDLINE, Embase, Web of Science, and CENTRAL from inception to February 8, 2020. Three pairs of reviewers examined and retrieved abstractsand full-text articles for RCTs of GLP-1RAs versus non-GLP-1RA controls(active or placebo) in adults with overweight, obesity, prediabetes, or diabetes,with a minimum follow-up period of 24 weeks and which reported at least oneevent of breast cancer or benign breast neoplasm. Divergences were dealt withby consensus. Researchers extracted study-level data and assessed within-study risk of bias with the RoB 2.0 tool and quality of evidence with GRADE. This study follows PRISMA reporting guidelines. Results: We included 52 trials, of which 50 reported breast cancer events and 11 reported benign breast neoplasms. Overall methodological quality was high. Among 48267 subjects treated with GLP-1RAs, 130 developed breast cancer compared to 107 of 40755 controls (relative risk [RR], 0.98; 95% confidence interval [CI], 0.76 to 1.26). Subset analyses according to follow-up, participant/investigator blinding, and type of GLP-1RA did not reveal any differences. The risk of benign breast neoplasms also did not differ between groups (RR, 0.99; 95% CI, 0.48 to 2.01). Trial sequential analysis provided evidence that the sample size was sufficient to avoid missing alternative results. Conclusion: Treatment with GLP-1RAs for obesity and diabetes does not increase the risk of breast neoplasms. Register: This systematic review was preregistered in PROSPERO (CRD42019132704).

scholarly journals Cannabinoids versus placebo or no intervention for pain: protocol for a systematic review with meta-analysis and trial sequential analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e031574 ◽  
Author(s):  
Jehad Ahmad Barakji ◽  
Steven Kwasi Korang ◽  
Joshua Feinberg ◽  
Mathias Maagard ◽  
Christian Gluud ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Well Being ◽  
Primary Data ◽  
Current Evidence ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Clinical Effects ◽  
Harmful Effects

IntroductionPain is a frequent clinical symptom with significant impact on the patient’s well-being. Therefore, adequate pain management is of utmost importance. While cannabinoids have become a more popular alternative to traditional types of pain medication among patients, the quality of evidence supporting the use of cannabinoids has been questioned. The beneficial and harmful effects of cannabinoids in patients with pain is unknown. Accordingly, we aim to assess the efficacy, tolerability and safety of cannabinoids (herbal, plant-derived extracts and synthetic) compared with placebo or no intervention for any type of pain.Methods and analysesWe will conduct a systematic review of randomised clinical trials with meta-analysis and Trial Sequential Analysis to assess the beneficial and harmful effects of cannabinoids in any dose, formulation and duration. We will accept placebo or no treatment as control interventions. We will include participants with any type of pain (acute and chronic pain, cancer-related pain, headache, neuropathic pain or any other types of pain). We will systematically search The Cochrane Library, MEDLINE, Embase, Science Citation Index and BIOSIS for relevant literature. We will follow the recommendations by Cochrane and the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. The risk of systematic errors (bias) and random errors (play of chance) will be assessed. The overall certainty of evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach.Ethics and disseminationEthical approval is not a requirement since no primary data will be collected. The findings of this systematic review will be submitted for peer-reviewed publication and disseminated in national and international conferences.DiscussionAlthough cannabinoids are now being used to manage different pain conditions, the evidence for the clinical effects are unclear. The present review will systematically assess the current evidence for the benefits and harms of cannabinoids to inform practice and future research.

scholarly journals Prognostic Significance of MicroRNAs in Glioma: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-14 ◽  
Author(s):  
Yanming Zhang ◽  
Jigang Chen ◽  
Qiang Xue ◽  
Junyu Wang ◽  
Liang Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Intervals ◽  
Random Effects ◽  
Meta Analysis ◽  
Prognostic Significance ◽  
Cochrane Library ◽  
Clinical Settings ◽  
Random Effects Model ◽  
Hazard Ratios ◽  
The Relationship

Purpose. Different microRNAs (miRs) have been demonstrated to relate with the outcome of glioma patients, while the conclusions are inconsistent. We perform a meta-analysis to clarify the relationship between different miRs and prognosis of glioma.Methods. Related studies were retrieved from PubMed, Embase, and Cochrane Library. Pooled hazard ratios (HRs) of different miRs expression for survival and 95% confidence intervals (CIs) were calculated using random-effects model.Results. A total of 15 miRs with 4708 glioma patients were ultimately included. Increased expression of miR-15b (HR, 1.584; 95% CI, 1.199-2.092), 21 (HR, 1.591; 95% CI, 1.278-1.981), 148a (HR, 1.122; 95% CI, 1.023-1.231), 196 (HR, 1.877; 95% CI, 1.033-3.411), 210 (HR, 1.251; 95% CI, 1.010-1.550), and 221 (HR, 1.269; 95% CI, 1.054-1.527) or decreased expression of miR-106a (HR, 0.809; 95% CI, 0.655-0.998) and 124 (HR, 0.833; 95% CI, 0.729-0.952) was correlated with poor outcome of glioma patients.Conclusions. miR-15b, 21, 148a, 196, 210, 221, 106a, and 124 are valuable biomarkers for the prognosis of glioma which might be used in clinical settings.

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