scholarly journals Efficacy of various core decompression techniques versus non-operative treatment for osteonecrosis of the femoral head: a systemic review and network meta-analysis of randomized controlled trials

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Quanzhe Liu ◽  
Wenlai Guo ◽  
Rui Li ◽  
Jae Hyup Lee
Keyword(s):  
Surgical Treatment ◽  
Bone Graft ◽  
Statistical Difference ◽  
Radiographic Progression ◽  
Meta Analysis ◽  
Core Decompression ◽  
Systemic Review ◽  
Current Evidence ◽  
Cochrane Library ◽  
Non Surgical Treatment

Abstract Background Various Joint-preserving therapy (JPT) methods have been performed and tried in recent decades, but their results and efficacy were inconsistent and controversial. The purpose of this study is to evaluate its effectiveness and whether there are statistical differences in treatment between different interventions based on published RCT studies. Methods Following the PRISMA-NMA checklist, Medline, EMBASE, Web of Science, and Cochrane Library databases were searched and collected related RCT studies. The sources were searched from inception up to October 30, 2020. The primary outcomes including the rate of radiographic progression and conversion to THA and the secondary outcome -Harris Hip Scores (HHS) were extracted and compared in a Network meta-analysis. Results Seventeen RCT studies involving 784 patients (918 hips) with seven interventions including CD (core decompression), CD + BG (bone graft), CD + TI (tantalum rod implantation), CD + CT (Cell therapy), CD + BG + CT, VBG (vascularized bone graft), and nonsurgical or conservative treatment for ONFH were evaluated. In the radiographic progression results, CD + CT showed a relatively better result than CD, CD + BG and non-surgical treatment, the surface under the cumulative ranking curve (SUCRA) plot displayed that CD + CT (96.4%) was the best, followed by CD (64.1%).In conversion to THA results, there were no significant differences between the JPT methods and non-surgical treatment. In HHS, there was also no significant difference, other than CD + BG showed a statistical difference than non-surgical treatment only in terms of Cis, but the SUCRA was highest in non-surgical treatment (80.5%) followed by CD + CT (72.8%). Conclusions This Net-work meta-analysis demonstrated that there was no statistical difference in the outcome of radiographic progression and conversion to THA, also in HHS, other than CD + CT showed a relatively superior result in radiographic progression than nonsurgical treatment, namely, it’s maybe an effective method for delaying disease progression or reducing disease development based on current evidence.

scholarly journals Risk of non-melanoma skin cancer with biological therapy in common inflammatory diseases: a systemic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ruolin Liu ◽  
Qianyi Wan ◽  
Rui Zhao ◽  
Haitao Xiao ◽  
Ying Cen ◽  
...  
Keyword(s):  
Skin Cancer ◽  
Biological Therapy ◽  
Inflammatory Diseases ◽  
Meta Analysis ◽  
Systemic Review ◽  
Current Evidence ◽  
Cochrane Library ◽  
Non Melanoma Skin Cancer ◽  
Increased Risk ◽  
Melanoma Skin

Abstract Background Most previous studies compared the risk for non-melanoma skin cancer (NMSC) in biologic-treated common inflammatory diseases with the general population. Whether the increased NMSC risk is caused by the disease itself, the biologics, or both remains unknown. Methods We systematically searched PubMed, Embase, Medline, Web of Science, and Cochrane Library from inception to May 2021. Studies were included if they assessed the risk of NMSC for rheumatoid arthritis (RA), inflammatory bowel disease (IBD), or psoriasis patients treated with biologics compared with patients not receiving biologics. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using the fixed- or random-effects model. Results The current meta-analysis included 12 studies. Compared with patients with the inflammatory disease without biologics, patients receiving biological therapy were associated with an increased risk for NMSC (RR 1.25, 95% CI 1.14 to 1.37), especially in patients with RA (RR 1.24, 95% CI 1.13 to 1.36) and psoriasis (RR 1.28, 95% CI 1.07 to 1.52), but not in patients with IBD (RR 1.49, 95% CI 0.46 to 4.91). The risks for squamous cell skin cancer and basal cell skin cancer were both increased for patients receiving biologics. However, the risk of NMSC did not increase in patients treated with biologics less than 2 years. Conclusions Current evidence suggests that increased risk of NMSC was identified in RA and psoriasis treated with biologics compared with patients not receiving biologics, but not in patients with IBD. The inner cause for the increased risk of NMSC in IBD patients should be further discussed.

scholarly journals Adjunctive therapies for the nonsurgical treatment of peri-implant diseases: systemic review and meta-analysis

2020 ◽  
Author(s):  
yuhan xiao ◽  
Yichun Qin ◽  
Haiyang Yu
Keyword(s):  
Photodynamic Therapy ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Local Antibiotics ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Systemic Antibiotics ◽  
Non Surgical Treatment

Abstract Background Peri-implant diseases are mainly caused by biofilms around the implant and may lead to implant failure. Non-surgical mechanical debridement with different adjunctive therapies has being applied in the treatment of peri-implant diseases. This systematic review aims to figure out whether one adjunctive therapy is superior to any other. Methods Two independent authors screened the literature via the MEDLINE, Cochrane Library and Science Direct. Only clinical randomized controlled trials (RCTs) that compared the efficacy of adjunctive therapies in the treatment of peri-implant diseases with non-surgical mechanical debridement (MD) were included in this review. The studies selected were published before June 2020. Comparisons of clinical outcomes were estimated using meta-analysis Results: A total of eighteen RCTs met the inclusion criteria, of which 13 articles were included in the meta-analysis. The following adjunctive interventions were compared in the included studies: modifying the prosthesis; air abrasive; photodynamic therapy; local antibiotics; systemic antibiotics; probiotics. Statistically significant difference was observed between MD with photodynamic therapy and MD alone at 3 months follow-up ( P < 0.01). There is no statistical difference between MD with chlorhexidine and MD alone in the treatment of peri-implant diseases at 3 months follow-up ( P = 0.84), so is MD with probiotics and MD alone ( P = 0.96), and so is systemic antibiotics and MD alone ( P = 0.47). Conclusion. MD adjunct with PDT is an effective treatment for peri-implant mucositis. However, there is still no effective non-surgical treatment for peri-implantitis.

scholarly journals Comparison of the effectiveness of sacrospinous ligament fixation and sacrocolpopexy: a meta-analysis

2021 ◽  
Author(s):  
Wenju Zhang ◽  
Willy Cecilia Cheon ◽  
Li Zhang ◽  
Xiaozhong Wang ◽  
Yuzhen Wei ◽  
...  
Keyword(s):  
Operative Time ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Surgical Approaches ◽  
Sacrospinous Ligament ◽  
Gastrointestinal Complications ◽  
Sacrospinous Ligament Fixation ◽  
Apical Support ◽  
Abdominal Sacrocolpopexy

Abstract Introduction and hypothesis Sacrocolpopexy and sacrospinous ligament fixation (SSLF) have been used for the restoration of apical support. Studies comparing sacrocolpopexy and SSLF have reported conflicting results. We aim to assess the current evidence regarding efficiency and the complications of sacrocolpopexy compared with SSLF. Methods We searched PubMed, Embase, and Cochrane Library and performed a systematic review meta-analysis to assess the two surgical approaches. Results 5Five randomized controlled trials, 8 retrospective studies, and 2 prospective studies including 4,120 cases were identified. Compared with abdominal sacrocolpopexy (ASC), SSLF was associated with a lower success rate (88.32% and 91.45%; OR 0.52; 95% CI 0.29–0.95; p = 0.03), higher recurrence (11.58% and 8.32%; OR 1.97; 95% CI 1.04–3.46; p = 0.04), and dyspareunia rate (14.36% and 4.67%; OR 3.10; 95% CI 1.28–7.50; p = 0.01). Patients in this group may benefit from shorter operative time (weighted mean difference −25.08 min; 95% CI −42.29 to −7.88; p = 0.004), lower hemorrhage rate (0.85% and 2.58%; OR 0.45; 95% CI 0.25–0.85; p = 0.009), wound infection rate (3.30% and 5.76%; OR 0.55; 95% CI 0.39–0.77; p = 0.0005), and fewer gastrointestinal complications (1.33% and 6.19%; OR 0.33; 95% CI 0.15–0.76; p = 0.009). Conclusion Both sacrocolpopexy and SSLF offer an efficient alternative to the restoration of apical support. When anatomical durability and sexual function is a priority, ASC may be the preferred option. When considering factors of mesh erosion, operative time, gastrointestinal complications, hemorrhage, and wound infections, SSLF may be the better option.

scholarly journals The Effectiveness of Acupuncture in Management of Functional Constipation: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-17
Author(s):  
Lu Wang ◽  
Mingmin Xu ◽  
Qianhua Zheng ◽  
Wei Zhang ◽  
Ying Li
Keyword(s):  
Quality Of Life ◽  
Meta Analysis ◽  
Safety Evaluation ◽  
Functional Constipation ◽  
Responder Rate ◽  
Current Evidence ◽  
Cochrane Library ◽  
China National Knowledge Infrastructure ◽  
Increased Risk

Objective. The purpose of this study was to assess the effectiveness and safety of acupuncture for functional constipation (FC). Methods. A rigorous literature search was performed in English (PubMed, Web of Science, the Cochrane Library, and EMBASE) and Chinese (China National Knowledge Infrastructure (CNKI), Chinese Biological Medical (CBM), Wanfang database, and China Science and Technology Journal (VIP)) electronic databases from their inception to October 2019. Included randomized controlled trials (RCTs) compared acupuncture therapy with sham acupuncture or pharmacological therapies. The outcome measures were evaluated, including the primary outcome of complete spontaneous bowel movement (CSBM) and secondary outcomes of Bristol Stool Form Scale (BSFS), constipation symptoms scores (CSS), responder rate, the Patient Assessment of Constipation Quality of Life (PAC-QOL) questionnaire, and safety evaluation. Meta-analysis was performed by using RevMan5.3. Results. The merged data of 28 RCTs with 3525 participants indicated that acupuncture may be efficient for FC by increasing CSBMs (p<0.00001; MD = 0.84 [95% CI, 0.65 to 1.03]; I2 = 0%) and improving constipation symptoms (p=0.03; SMD = −0.4 [95% CI, −0.78 to −0.03]; I2 = 74%), stool formation (p<0.00001; MD = 0.24 [95% CI, 0.15 to 0.34]; I2 = 0%), quality of life (p<0.00001; N = 1, MD = −0.33 [95% CI, −0.45 to −0.21]), and responder rates (p=0.02; RR = 2.16; [95% CI, 1.1 to 4.24]; I2 = 69%) compared with the effects of sham treatment. No increased risk of adverse events was observed (p=0.44; RR = 1.18; [95% CI, 0.77 to 1.81]; I2 = 0%). With regard to medication comparisons, the pooled data indicated that acupuncture was more effective in increasing CSBMs (p=0.004; MD = 0.53 [95% CI, 0.17 to 0.88]; I2 = 88%) and improving patients’ quality of life (p<0.00001; SMD = −0.73 [95% CI, −1.02 to −0.44]; I2 = 64%), with high heterogeneity. However, there were no significant differences in responder rate (p=0.12; RR = 1.31; [95% CI, 0.94 to 1.82]; I2 = 53%), BSFS (p=0.5; MD = 0.17 [95% CI, −0.33 to 0.68]; I2 = 93%), or CSS (p=0.05; SMD = −0.62 [95% CI, −1.23 to −0.01]; I2 = 89%). Regarding safety evaluation, acupuncture was safer than medications (p<0.0001; RR = 0.3; [95% CI, 0.18 to 0.52]; I2 = 30%). Conclusions. Current evidence suggests that acupuncture is an efficient and safe treatment for FC. Acupuncture increased stool frequency, improved stool formation, alleviated constipation symptoms, and improved quality of life. However, the evidence quality was relatively low and the relationship between acupuncture and drugs is not clear. More high-quality trials are recommended in the future. PROSPERO registration number: CRD42019143347.

Abstract P391: Marine N-3 Fatty Acids Reduce Atherosclerosis Cardiovascular Disease: A Systemic Review and Meta-analysis of Clinical Trials

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Akira Sekikawa ◽  
Nobutake Hirooka ◽  
Abhishek Vishnu ◽  
Vashudha Ahuja ◽  
Emmanuel Sampene ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Fatty Acids ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Imaging Techniques ◽  
Meta Analysis ◽  
Quantitative Information ◽  
Systemic Review ◽  
Cochrane Library ◽  
Cardiac Imaging Techniques

Introduction: Although marine n-3 fatty acids are believed to be cardioprotective through their anti-arrhythmic, anti-thrombotic, anti-atherogenic and other effects, results from recent meta-analyses of marine n-3 fatty acids on cardiovascular disease (CVD) are controversial. We performed a meta-analysis of marine n-3 fatty acids on CVD outcomes in randomized clinical trials (RCTs) to test the hypothesis that marine n-3 fatty acids are anti-atherogenic. We also tested the hypothesis that such benefit is dose-dependent. Methods: A systematic review of English language articles using PubMed, EMBASE and Cochrane Library through Aug 2012 was performed selecting RCTs evaluating the effect of marine n-3 fatty acids intake for 2 years or more on cardiovascular diseases, coronary disease, arteriosclerosis, cardiac imaging techniques, and carotid artery ultrasound. Descriptive and quantitative information was extracted. Odds ratios were calculated for cardiac event outcome. Correlation coefficients were obtained from studies of which outcome is intima-media thickness (IMT) and coronary lumen diameter (CD). We converted the estimates into a single effect size; the log odds ratio and its corresponding standard error. Results: Of 14,236 citations retrieved, 13 studies were selected, including studies reporting IMT (n=3) and CD (n=2) and major CVD events (n=8). Overall, marine n-3 fatty acids significantly reduced atherosclerotic CVD (RR 0.94: 95%CI 0.90 to 0.99, p<0.05). There was no evidence of heterogeneity (p=0.65) or publication bias (p=0.37, Begg’s test). A sub-analysis among 8 studies of major CVD events showed the similar results (RR 0.94: 95% CI 0.89 to 0.99, p<0.05). Another sub-analysis among 4 studies excluding sudden cardiac death as an outcome showed RR of 0.91 (95% CI 0.82 to 1.02, p=0.097). A meta-regression analysis shows that dose of marine n-3 fatty acids was inversely associated with CVD outcome, although the association was not statistically significant (p=0.06). Conclusions: The result of our meta-analysis supports a modest anti-atherogenic effect of marine n-3 fatty acids. This benefit may be proportional to the amount of marine n-3 fatty acids consumed.

scholarly journals Kinesio Taping for Balance Function after Stroke: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-15 ◽  
Author(s):  
Yijuan Hu ◽  
Dongling Zhong ◽  
Qiwei Xiao ◽  
Qiang Chen ◽  
Juan Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Duration ◽  
Meta Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Clinical Effects ◽  
Balance Function ◽  
Balance Impairment ◽  
Kinesio Taping ◽  
Significant Difference

Objective. With the increasing social and economic burdens of balance impairment after stroke, the treatment for balance impairment after stroke becomes a major public health problem worldwide. Kinesio taping (KT) as a part of clinical practice has been used widely in the treatment of balance impairment after stroke. However, the clinical effects of KT for balance function have not been confirmed. The objective of this study is to investigate the effects and safety of KT for balance impairment after stroke. Methods. We conducted a systematic review (SR) and meta-analysis of randomized controlled trials (RCTs) on the effects of KT for balance impairment after stroke. We searched the following databases: (1) English databases: EMBASE (via Ovid), MEDLINE (via Ovid), the Cochrane library, PubMed, and PEDro; (2) Chinese databases: China Biology Medicine (CBM), Wan Fang database, China National Knowledge Infrastructure (CNKI), and VIP. Besides, hand searches of relevant references were also conducted. We systematically searched from the inception to December 2018, using the keywords (Kinesio, Kinesio Tape, tape, or Orthotic Tape) and (stroke, hemiplegia, or hemiplegic paralysis) and (balance or stability). The search strategies were adjusted for each database. The reference lists of included articles were reviewed for relevant trials. For missing data, we contacted the authors to get additional information. Results. 22 RCTs involved 1331 patients, among which 667 patients in the experimental group and 664 patients in the control group were included. Results of meta-analysis showed that, compared with conventional rehabilitation (CR), there was significant difference in Berg Balance Scale (BBS) (MD=4.46, 95%CI 1.72 to 7.19, P=0.001), Time Up and Go Test (TUGT) (MD=-4.62, 95%CI -5.48 to -3.79, P < 0.00001), functional ambulation category scale (FAC) (MD=0.53, 95%CI 0.38 to 0.68, P < 0.00001), Fugl-Meyer assessment (FMA-L) (MD=4.20, 95%CI 3.17 to 5.24, P < 0.00001), and Modified Ashworth Scale (MAS) (MD=-0.38, 95%CI -0.49 to -0.27, P < 0.00001). The results of subgroup analysis showed that there was no significant difference between KT and CR with ≤4 weeks treatment duration (< 4 weeks: MD=5.03, 95%CI -1.80 to 11.85, P=0.15; =4 weeks: MD=4.33, 95%CI -1.50 to 10.15, P=0.15), while there was significant difference with more than 4-week treatment duration (MD=4.77, 95%CI 2.58 to 6.97, P < 0.0001). Conclusions. Based on current evidence, KT was more effective than CR for balance function, lower limb function, and walking function in poststroke patients. Longer treatment duration may be associated with better effects. However, more well-conducted RCTs are required in the future.

scholarly journals Pooled analysis of T2 Candida for rapid diagnosis of candidiasis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Dong-Lan Tang ◽  
Xiao Chen ◽  
Chang-Guo Zhu ◽  
Zhong-wei Li ◽  
Yong Xia ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Web Of Science ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Pooled Analysis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Research Subjects

Abstract Background The present meta-analysis examined the diagnostic accuracy of T2 Candida for candidiasis. Methods The literature databases, such as PubMed, Embase, DVIO, Cochrane library, Web of Science, and CNKI, were searched on T2 Candida detection. Results A total of 8 articles, comprising of 2717 research subjects, were included in the study. The pooled sensitivity and specificity were 0.91 (95% confidence interval (CI): 0.88–0.94) and 0.94 95% CI: 0.93–0.95), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 10.16 (95% CI: 2.75–37.50) and 0.08 (95% CI: 0.02–0.35), respectively. The combined diagnostic odds ratio is 133.65 95% CI: 17.21–1037.73), and the AUC of SROC is 0.9702 [(SE = 0.0235), Q* = 0.9201(SE = 0.0381)]. Conclusions The current evidence supported that T2 Candida has high accuracy and sensitivity and is of major clinical significance in the diagnosis of Candida infection.

scholarly journals Prevalence of pneumonia and its associated factors among under five children in East Africa. Meta-analysis and systemic review

2020 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Melaku Getahun Bimrew ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw Wudu ◽  
Molla Azmeraw
Keyword(s):  
East Africa ◽  
Associated Factors ◽  
Meta Analysis ◽  
Eastern Africa ◽  
Systemic Review ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
The Impact ◽  
National Prevalence

Abstract Introduction Pneumonia is defined as an acute inflammation of the Lungs’ parenchymal structure. It is a major public health problem and the leading cause of morbidity and mortality in under-five children especially in developing countries. In 2015, it was estimated that about 102 million cases of pneumonia occurred in under-five children, of which 0.7 million were end up with death. Different primary studies in Eastern Africa showed the burden of pneumonia. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review aimed to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Objective The aim of this systematic review and meta-analysis was to assess the magnitude of pneumonia and its associated factors among under-five children in East Africa. Methods Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that examined the prevalence and associated factors of pneumonia from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to estimate the national prevalence and the effect size of associated factors. The subgroup analysis was conducted by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Sensitivity analysis was also done to identify the impact of studies. Result A total of 34 studies with 87, 984 participants were used for analysis. The pooled prevalence of hypothermia in East Africa was 34% (95%CI; 23.80–44.21). Use of wood as fuel source (AOR= 1.53; 95%CI:1.30-1.77; I 2 = 0.0% ;P=0.465), cook food in living room (AOR= 1.47;95%CI:1.16-1.79; I 2 = 0.0% ;P=0.58), caring of a child on mother during cooking (AOR= 3.26; 95%CI:1.80-4.72; I 2 = 22.5% ;P=0.26), Being unvaccinated (AOR= 2.41; 95%CI:2.00-2.81; I 2 = 51.4% ;P=0.055), Child history of ARTI(AOR= 2.62; 95%CI:1.68-3.56; I 2 = 11.7% ;P=0.337) were identified factors of pneumonia. Conclusions The prevalence of pneumonia in Eastern Africa remains high. This review will help policy-makers and program officers to design pneumonia preventive interventions.

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