Prophylactic antibiotics in open distal phalanx fractures: systematic review and meta-analysis

2015 ◽  
Vol 41 (4) ◽  
pp. 423-430 ◽  
Author(s):  
D. Metcalfe ◽  
A. L. Aquilina ◽  
H. M. Hedley
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Prophylactic Antibiotics ◽  
Distal Phalanx ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Superficial Infection ◽  
Randomized Controlled ◽  
Irrigation And Debridement ◽  
Significant Difference

A systematic review was conducted on 30 December 2014 to determine whether prophylactic antibiotics reduce the risk of superficial infection and osteomyelitis following open distal phalanx fractures. Four randomized controlled trials (353 fractures) were suitable for meta-analysis. There was no statistically significant difference between rates of superficial infection in the two groups. This finding persisted when only the two most recent and highest quality trials were included. There were no reported cases of osteomyelitis in the pooled dataset, despite patients with 164 fractures not receiving antibiotics. These results fail to show any effect of prophylactic antibiotics on the rate of superficial infections following open distal phalanx fractures. The focus of treatment should be on prompt irrigation and debridement rather than administration of prophylactic antibiotics. Level of Evidence: I

scholarly journals The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Qin Yao ◽  
Shanshan Li ◽  
Xiaoxu Liu ◽  
Zongshi Qin ◽  
Zhishun Liu
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Chronic Urticaria ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Symptom Improvement ◽  
Control Groups ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Significant Difference

Background. Acupuncture might have effectiveness in relieving the symptoms of chronic urticaria. There are currently no systematic reviews of acupuncture for chronic urticaria published in English.Objective. We conducted a systematic review to assess the effectiveness and safety of acupuncture for chronic urticaria.Methods. A systematic review and meta-analysis of randomized, controlled trials were performed. The primary outcome was global symptom improvement.Results. We included 6 studies with 406 participants. Three trials showed significant difference between acupuncture and drugs in global symptom improvement (relative risk 1.37; 95% CI 1.11–1.70;P=0.003). As an adjuvant to medication, acupuncture was also beneficial for global symptom improvement (relative risk 1.77; 95% CI 1.41–2.22;P<0.01). There were no severe adverse events related to acupuncture.Limitations. Some methodological limitations were observed. The overall risk of bias in the 6 included trials was high and all included RCTs were conducted in China and published in Chinese. Besides, the lack of proper control groups and the use of different rating methods and cut-offs in the included trials also made the evidence of this review limited.Conclusions. Acupuncture might be effective and safe for chronic urticaria in relieving symptoms, based on a low level of evidence. To draw a reliable conclusion, more high quality trials are needed in the future. This trial is registered with PROSPEROCRD42015015702.

scholarly journals Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liping Gou ◽  
Zhenghao Wang ◽  
Ye Zhou ◽  
Xiaofeng Zheng
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Operative Time ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Bladder Stones ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficiency of nephroscopy and cystoscopy in transurethral cystolithotripsy (TUCL) for bladder stones (BS). Methods The PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases were searched up to January 2021 for studies assessing the effect of different types of endoscopes among patients who underwent TUCL. The search strategy and study selection process were in accordance with the PRISMA statement. Results Five randomized controlled trials were included in the meta-analysis. The results showed no difference in stone-free rate (RR = 1.00, CI = 0.98–1.02, p = 1.00) between the two groups and nonsignificant heterogeneity (I2 = 0%, p = 1.00), and all patients were rendered stone free. Use of the nephroscope significantly shortened the operative time compared with the cystoscope group (RR= − 26.26, CI = − 35.84 to − 16.68, p < 0.00001), and there was significant heterogeneity (I2= 87%, p < 0.00001). There was no significant difference in mean urethral entries (RR = 0.66, CI = − 0.71 to − 2.04, p = 0.35), hospitalization (MD = 0.08, 95% CI = − 0.07 to 0.23, p = 0.31) or total complication rate (RR=1.37, 95% CI = 0.47–4.00, p = 0.56) between the two groups. Conclusions In conclusion, this systematic review demonstrates that both nephroscopy and cystoscopy have high stone clearance efficiency, low rates of complications and short hospitalizations. The mean urethral entries depend on the treatment method for large stone fragments. However, the use of nephroscopy can significantly reduce the operative time.

scholarly journals Auricular Plaster Therapy for Comorbid Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Huimin Zhao ◽  
Dan Li ◽  
Ying Yang ◽  
Yueting Liu ◽  
Jie Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Effective Rate ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Comorbid Insomnia ◽  
Randomized Controlled ◽  
Significant Difference

Background. Although the effectiveness of auricular plaster therapy (APT) on primary insomnia has been systematically reviewed, no systematic review of studies has focused on the effect on comorbid insomnia. Objective. To evaluate the efficacy and safety of APT for comorbid insomnia. Methods. Fifteen databases were searched from inception to July 2018. Randomized controlled trials (RCTs) of APT as an exclusive intervention for comorbid insomnia against Western medications, sham APT or no treatment were identified. Results. Fourteen studies involving 928 participants were identified. The pooled outcomes revealed that APT was superior to control conditions for the global score on PSQI (SMD = -1.13, and 95% CI = -1.48—-0.78) and the effective rate (RR = 1.24, 95% CI = 1.13—1.36, NNT = 5, and 95% CI =4—7). Furthermore, the results of subgroup analyses were similar to the pooled results. Additionally, the pooled results were verified to be stable by sensitivity analyses. Regarding safety, no significant difference was identified between APT and Western medications. Conclusions. APT appears to be an effective and safe treatment for comorbid insomnia. However, the benefits of APT for comorbid insomnia could not be ascertained due to the paucity of the quantity and quality of the included studies. Large-scale studies using proper methodology are needed to yield a firm conclusion.

scholarly journals Is reiki or prayer effective in relieving pain during hospitalization for cesarean? A systematic review and meta-analysis of randomized controlled trials

2017 ◽  
Vol 135 (2) ◽  
pp. 123-132 ◽  
Author(s):  
Guilherme Augusto Rago Ferraz ◽  
Meline Rosseto Kron Rodrigues ◽  
Silvana Andrea Molina Lima ◽  
Marcelo Aparecido Ferraz Lima ◽  
Gabriela Lopes Maia ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Spiritual Healing ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Section Design

ABSTRACT CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. RESULTS: There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. CONCLUSION: Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction.

scholarly journals Effects of prophylactic antibiotics on patients with stable COPD: a systematic review and meta-analysis of randomized controlled trials

2018 ◽  
Vol 73 (12) ◽  
pp. 3231-3243 ◽  
Author(s):  
Yuanyuan Wang ◽  
Tanja R Zijp ◽  
Muh Akbar Bahar ◽  
Janwillem W H Kocks ◽  
Bob Wilffert ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Prophylactic Antibiotics ◽  
Controlled Trials ◽  
Randomized Controlled

scholarly journals The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Bin Cheng ◽  
Xinyi Zeng ◽  
Shaoyuan Liu ◽  
Jing Zou ◽  
Yan Wang
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
The Other ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Oral Pain ◽  
Significant Difference ◽  
Effective Drugs

AbstractThere is currently a lack of effective drugs to cure recurrent aphthous stomatitis. This study aimed to evaluate the efficacy of probiotics alone or as an adjunct in recurrent aphthous stomatitis (RAS) patients. Seven randomized controlled trials (RCTs) were included, of which three were included in quantitative analysis. Of five studies evaluating the efficacy of probiotics alone compared with placebo or Oracure gel, two reported no significant difference in relieving oral pain, while probiotics exhibited a higher capacity for decreasing oral pain in the other three. A significant decrease in ulcer severity was found in one, while no significant difference was found in the other four. The remaining two studies demonstrated that probiotics, as an adjunct to steroids or anaesthetic antiseptic gel, significantly reduced the ulcer severity and oral pain. The meta-analysis showed a significant decrease in oral pain (− 1.72, P = 0.0001) with probiotics compared with placebo. In conclusion, probiotics alone were capable of relieving oral pain but not effective in reducing ulcer severity. A combination of probiotics and steroids or anaesthetic antiseptic gel was more effective than steroids or anaesthetic antiseptic gel alone in RAS patients. Probiotics are promising for the treatment of recurrent aphthous stomatitis.

scholarly journals Statins in Healthy Adults: A Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 585
Author(s):  
Lee Sandwith ◽  
Patrice Forget
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Meta Analysis ◽  
Health Conditions ◽  
Current Evidence ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

Background and Objectives: In this paper, we investigated the efficacy of statin therapy on cardiovascular disease (CVD) reduction in adults with no known underlying health conditions by undertaking a meta-analysis and systematic review of the current evidence. Materials and Methods: We performed a systematic search to identify Primary Prevention Randomized Controlled Trials (RCTs) that compared statins with a control group where CVD events or mortality were the primary end point. Identified RCTs were evaluated and classified into categories depending on relevance in order to determine which type of meta-analysis would be feasible. Results: No differences were observed between categories with the exception of relative risk for all CVD events combined which showed a 12% statistically significant difference favouring studies which were known to include participants without underlying health conditions. Strong negative correlations between number-need-to-treat (NNT) and LDL-C reduction were observed for all Coronary Heart Disease (CHD) outcomes combined and all CVD outcomes combined. Conclusions: This project highlights the need for further research on the effects of statins on participants who do not suffer from underlying health conditions, given that no such studies have been conducted.

scholarly journals Effect of Internet-Based Rehabilitation Programs on Improvement of Pain and Physical Function in Patients with Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials (Preprint)

2020 ◽  
Author(s):  
Su-Hang Xie ◽  
Qian Wang ◽  
Li-Qiong Wang ◽  
Lin Wang ◽  
Kang-Ping Song ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Physical Function ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Rehabilitation Programs ◽  
Significant Difference

BACKGROUND Osteoarthritis (OA) is a chronic, debilitating, and degenerative joint disease. However, it is difficult for patients with knee OA to access conventional rehabilitation when discharging from the hospital. Internet-based rehabilitation is one of the promising telemedicine strategies to provide a means combining monitoring, guidance, and treatment for patients with knee OA. OBJECTIVE The aim of this study was to conduct a systematic review and meta-analysis for assessing the effect of internet-based rehabilitation programs on pain and physical function in patients with knee OA. METHODS Keywords related to knee OA and internet-based rehabilitation were systematically searched in the Web of Science, MEDLINE, EMBASE, CENTRAL, Scopus, PEDro (Physiotherapy Evidence Database), CNKI, SinoMed, and WANFANG databases from January 2000 to April 2020. Only randomized controlled trials were included. The authors independently screened the literature. The main outcome measures were focused on pain and physical function. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses. RESULTS The systematic review identified 6 randomized controlled trials, 4 of which were included in the meta-analysis, comprising a total of 791 patients with knee OA. The meta-analysis with the fixed-effects model showed that the internet-based rehabilitation programs could significantly alleviate the osteoarthritic pain for patients compared with conventional rehabilitation (standardized mean difference [SMD] –0.21, 95% CI  −0.4 to –0.01, <i>P</i>=.04). No significant difference was found in the improvement of physical function in patients with knee OA compared with conventional rehabilitation within 2 to 12 months (SMD –0.08, 95% CI −0.27 to 0.12, <i>P</i>=.43). CONCLUSIONS This systematic review shows that internet-based rehabilitation programs could improve the pain but not physical function for patients with knee OA. However, there was a very small number of studies that could be included in the review and meta-analysis. Thus, further studies with large sample sizes are warranted to promote the effectiveness of internet-based rehabilitation and to develop its personalized design.

scholarly journals Effect of Internet-Based Rehabilitation Programs on Improvement of Pain and Physical Function in Patients with Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials

10.2196/21542 ◽  
2021 ◽  
Vol 23 (1) ◽  
pp. e21542
Author(s):  
Su-Hang Xie ◽  
Qian Wang ◽  
Li-Qiong Wang ◽  
Lin Wang ◽  
Kang-Ping Song ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Physical Function ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Rehabilitation Programs ◽  
Significant Difference

Background Osteoarthritis (OA) is a chronic, debilitating, and degenerative joint disease. However, it is difficult for patients with knee OA to access conventional rehabilitation when discharging from the hospital. Internet-based rehabilitation is one of the promising telemedicine strategies to provide a means combining monitoring, guidance, and treatment for patients with knee OA. Objective The aim of this study was to conduct a systematic review and meta-analysis for assessing the effect of internet-based rehabilitation programs on pain and physical function in patients with knee OA. Methods Keywords related to knee OA and internet-based rehabilitation were systematically searched in the Web of Science, MEDLINE, EMBASE, CENTRAL, Scopus, PEDro (Physiotherapy Evidence Database), CNKI, SinoMed, and WANFANG databases from January 2000 to April 2020. Only randomized controlled trials were included. The authors independently screened the literature. The main outcome measures were focused on pain and physical function. A meta-analysis was performed on the collected data. Review Manager (RevMan, version 5.3) was used for all analyses. Results The systematic review identified 6 randomized controlled trials, 4 of which were included in the meta-analysis, comprising a total of 791 patients with knee OA. The meta-analysis with the fixed-effects model showed that the internet-based rehabilitation programs could significantly alleviate the osteoarthritic pain for patients compared with conventional rehabilitation (standardized mean difference [SMD] –0.21, 95% CI  −0.4 to –0.01, P=.04). No significant difference was found in the improvement of physical function in patients with knee OA compared with conventional rehabilitation within 2 to 12 months (SMD –0.08, 95% CI −0.27 to 0.12, P=.43). Conclusions This systematic review shows that internet-based rehabilitation programs could improve the pain but not physical function for patients with knee OA. However, there was a very small number of studies that could be included in the review and meta-analysis. Thus, further studies with large sample sizes are warranted to promote the effectiveness of internet-based rehabilitation and to develop its personalized design.

scholarly journals Effects of Acupuncture and Moxibustion on Breast Cancer-Related Lymphedema: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 20 ◽  
pp. 153473542110441
Author(s):  
Yu Gao ◽  
Tingting Ma ◽  
Mei Han ◽  
Mingwei Yu ◽  
Xiuhui Wang ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Meta Analysis ◽  
Routine Care ◽  
Effective Index ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Arm Circumference ◽  
Significant Difference ◽  
Breast Cancer Related Lymphedema

Objective: The aim of this systematic review and meta-analysis of randomized controlled trials (RCTs) was to evaluate the effects of acupuncture and moxibustion (AM) in women with breast cancer-related lymphedema (BCRL). Methods: We retrieved RCTs published before January 24, 2021, from the MEDLINE, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP (VIP), and Wanfang databases. RCTs that compared acupuncture and/or moxibustion intervention with other treatments were included. A random effects or fixed effects model was used based on the heterogeneity findings. Study quality was evaluated using the Cochrane risk of bias tool. Results: We included 14 RCTs in the analyses, of which 4 RCTs adopted acupuncture, 4 RCTs used moxibustion, and the rest used both. AM significantly reduced arm circumference at the elbow crease compared to routine care (Mean deviation (MD) = −7.26, 95% confidence interval (CI) = −8.30 to −6.21, P < .00001). There was a significant difference between AM and diosmin tablets in the effective index for upper limb lymphedema (MD = 24.68, 95% CI = 24.82-30.53, P < .00001), the range of motion of the shoulder during protraction (MD = 6.77, 95% CI = 2.81-10.73, P = .0008), and adduction (MD = 4.17, 95% CI = 1.02-7.32, P = .01). There was a significant difference between moxibustion and pneumatic circulation (MD = −0.51, 95% CI = −0.85 to −0.17, P = .003) in the visual analog score (VAS) for swelling. Finally, compared to the blank control, acupuncture reduced the VAS for pain (MD = −1.33, 95% CI = −1.52 to −1.15, P < .00001; heterogeneity ( I2) = 0%, P = .57). Conclusion: Our results suggest that AM is effective in the treatment of BCRL. AM may reduce arm circumference at the elbow crease (compared to routine care), increase effective index for upper limb lymphedema (compared to oral diosmin tablets), improve the range of motion of the shoulder during protraction and adduction (compared to oral diosmin tablets), and decrease the VAS for both swelling (compared to pneumatic circulation) and pain (compared to blank control).

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