scholarly journals The relationships between bariatric surgery and sexual function: current evidence based medicine

BMC Urology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shengzhuo Liu ◽  
Dehong Cao ◽  
Zhengju Ren ◽  
Jinze Li ◽  
Lei Peng ◽  
...  

Abstract Background Controversy remains despite several studies have discussed the role of bariatric surgery in improving male’s sexual function. This study aims to evaluate the efficacy of bariatric surgery in promoting male’s erectile function. Methods PubMed, EMbase, The Cochrane Library, CNKI and Clinical Trails.gov were searched from database inception to May 2019. The language of publication was limited in English. The International Index of Erectile Function (IIEF) score and Brief Male Sexual Function Inventory (BSFI) score were set as the primary outcome. Results Eleven studies with a total of 370 patients were enrolled in this meta-analysis. The results showed significant improvement in the IIEF score (erectile function: MD = 5.33, 95% CI 4.12–6.54; intercourse satisfaction: MD = 2.57, 95% CI 1.19–3.94; orgasmic function: MD = 0.50, 95%CI 0.60–0.94; overall satisfaction: MD = 1.67, 95% CI 0.78–2.56; sexual desire: MD = 1.27, 95% CI 0.61–1.93; total erectile function: MD = 7.21, 95% CI 4.33–10.10) and the BSFI score (erection: MD =2.53, 95% CI 2.39–2.67; ejaculation: MD = 1.40, 95% CI 1.28–1.51; desire: MD =1.40, 95% CI 1.32–1.49; problem assessment: MD = 2.20, 95% CI 2.06–2.34; sexual satisfaction: MD = 0.70, 95% CI 0.60–0.76) in obese individuals after bariatric surgery. Conclusions This systematic review and meta-analysis indicated that bariatric surgery could be effective in promoting males’s sexual function for obese individuals.

2019 ◽  
Author(s):  
Shengzhuo Liu ◽  
Dehong Cao ◽  
Zhengju Ren ◽  
Jinze Li ◽  
Lei Peng ◽  
...  

Abstract Background Controversial remains despite several studies have discussed the role of bariatric surgery for ameliorating male’s sexual function. This study aims to evaluate the efficacy of bariatric surgery in promoting male`s erectile function. Methods We performed a systematic review according to PubMed, EMbase, The Cochrane Library, CNKI and Clinical Trails.gov searching for eligible studies and conducted a meta-analysis to compare the International Index of Erectile Function (IIEF) score or Brief Male Sexual Function Inventory (BSFI) score preoperatively and postoperatively. Results 11 articles were included in this study. The meta-analysis showed bariatric surgery was associated with significantly improvement in the IIEF score (erectile function: MD = 5.33, 95% CI 4.12-6.54; intercourse satisfaction: MD = 2.57, 95% CI 1.19-3.94; orgasmic function: MD = 0.50, 95%CI 0.60-0.94; overall satisfaction: MD = 1.67, 95% CI 0.78-2.56; sexual desire: MD = 1.27, 95% CI 0.61- 1.93; total erectile function: MD = 7.21, 95% CI 4.33-10.10) and the BSFI score (erection: MD =2.53, 95% CI 2.39-2.67; ejaculation: MD = 1.40, 95% CI 1.28-1.51; desire: MD =1.40, 95% CI 1.32-1.49; problem assessment: MD = 2.20, 95% CI 2.06-2.34; sexual satisfaction: MD = 0.70, 95% CI 0.60-0.76). Conclusions To our knowledge, although the mechanism how Bariatric surgery helps improving male`s erectile function is not well interpreted yet, it`s supported by our results that bariatric surgery may be effective in sexual function promoting for obese individuals.


2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Yin-mei Fu ◽  
Ming Chen ◽  
Ai-jun Liao

Purpose. This study aimed to evaluate the therapeutic value of adalimumab (ADA) for fistula in Crohn’s disease (CD). Methods. A computerized search of electronic databases, including PubMed, Web of Science, Embase, Google scholar, and the Cochrane Library from 2000 to October 2016, was performed. Randomized controlled trials (rcts) or nonrandomized controlled trials (n-rcts) were included in this article to evaluate the role of ADA in the management of fistula in CD. The methodological index for nonrandomized studies (MINORS evaluation tools) was used to assess the quality of every study. Result. Overall, seven studies and 379 patients comforted to the inclusion criteria of this meta-analysis. The result showed that 36% (95% CI: 0.31–0.41) of patients with complete fistula closure and 31% (95% CI: 0.031–0.61) of patients with partial response were received in CD with ADA treatment. Conclusion. We concluded that ADA is effective and safe for the treatment of fistula in CD according to current evidence.


2019 ◽  
Vol 8 (9) ◽  
pp. 1441 ◽  
Author(s):  
Malwina M. Naghibi ◽  
Richard Day ◽  
Samantha Stone ◽  
Ashton Harper

Migraine is a common and disabling neurological condition with a complex etiology. Recent advances in the understanding of the gut microbiome have shown the role of gut micro-organisms in disease outcomes for distant organs—including the brain. Interventions targeting the gut microbiome have been shown to be effective in multiple neurological diagnoses, but there is little research into the role of the microbiome in migraine. This systematic review seeks to assess the current research landscape of randomized placebo controlled trials utilizing probiotic interventions as migraine prophylaxis. Searches were conducted of scientific databases including PubMed, MEDLINE, and the Cochrane Library, following PRISMA guidelines. Of 68 screened studies, 2 were eligible for analysis. Due to methodological differences, meta-analysis was not possible. Qualitative comparison of the studies demonstrated a dichotomy of results—one trial reported no significant change in migraine frequency and intensity, while the second trial reported highly significant improvements. No clear ‘gold standard’ currently exists for microbiome research, let alone for migraine-related microbiome research. The heterogeneity of outcome measures used in the two trials included in this systematic review shows the need for a standardization of outcome measures, therefore a series of recommendations for future probiotic–migraine research are included.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Zijin Li ◽  
Li Song ◽  
Lihong Hao

Abstract Background Neonatal hyperbilirubinemia (NNH) is a common disease in newborns. This research study aimed to assess the associations between uridine diphospho-glucuronate-glucuronosyltransferase 1A1 (UGT1A1, c.-3279 T > G) polymorphisms and NNH risk. Methods We searched PubMed, the Cochrane Library, and the Embase electronic databases. All published eligible studies before July 1, 2019, were searched for this meta-analysis. Results We identified 7 independent studies including 1560 cases. The data showed that in the general population, compared with the GT + GG vs TT and GG vs TT, c.-3279 T > G (rs4124874) was significantly related to a higher NNH risk (GG vs TT: OR = 1.865, 95% CI: 1.031–3.373, P = 0.039; GT + GG vs TT: OR = 1.331, 95% CI: 1.055–1.679, P = 0.016). Although not statistically significant, the data showed that c.3279 T > G had a tendency to be associated with NNH under the allele model and GG vs GT + TT in the overall population (G vs T: OR = 1.288, 95% CI: 0.982–1.689, P = 0.067; GG vs TT + GT: OR = 1.583, 95% CI: 0.947–2.647, P = 0.080). Conclusion The UGT1A1 gene c.-3279 T > G (rs4124874) polymorphism increased susceptibility to NNH, especially for the comparison of GT + GG vs TT and GG vs TT. In the future, we can use homozygous state of the UGT1A1 gene c.-3279 T > G (rs4124874) polymorphism for the diagnosis and screening of molecular biomarkers in NNH patients.


2019 ◽  
Author(s):  
Shasha Cao ◽  
Wei Zhang ◽  
Peihong Shen ◽  
Ruiping Xu

Abstract Background The role of STMN1 in the development and progression of esophageal carcinoma is not yet determined. The present study aimed to systematically evaluate the correlation between STMN1 and prognosis of patients with esophageal carcinoma. Methods Electronic databases including PubMed, Embase, the Cochrane library, and Chinese Biomedical Literature Database (CBM) were searched to identify studies evaluating the impact of STMN1 on the survival of esophageal cancer patients, without the language limitation. Two investigators screened the literature according to the inclusion and exclusion criteria and evaluated the quality of the included studies. The combined analysis was performed using RevMan5.3 software. Results A total of 8 studies, involving 1240 esophageal carcinoma patients, were included in this retrospective design. Meta-analysis showed that esophageal carcinoma patients with low STMN1 had a superior overall survival (OS) and disease-free survival (DFS) than those with high expression of STMN1. Compared to the high expression of STMN1, the 5-year survival rate was significantly higher in patients with low level of STMN1. Patients with high STMN1 expression had a higher risk of experiencing clinical grade III-IV disease, lymph node metastasis, and tumor invasion than those with low STMN1. Conclusion STMN1 is an indicator for the prognosis of esophageal carcinoma patients.


2021 ◽  
Vol 06 (03) ◽  
pp. 1-1
Author(s):  
◽  
Holger C. Bringmann ◽  
Peter Sedlmeier ◽  
◽  
◽  
...  

Traditional yoga encompasses a variety of practices, such as postures, breathing techniques, meditation, and ethical teachings. However, little is known about how different components of yoga contribute to its overall effect. In this meta-synthesis, we comprehensively summarized the current evidence on differential and incremental effects of various yoga components collected from available meta-analyses. For this meta-analysis, we searched Medline/PubMed, Scopus, PsychInfo, and the Cochrane Library in July 2021. We selected only meta-analyses that performed subgroup analyses comparing the effects of different yoga components. There were no restrictions regarding yoga type, study population, or outcome variables. Nineteen meta-analyses were identified that evaluated a multitude of variables. These meta-analyses varied greatly with regard to population, study design, and yoga components under investigation. However, combined interventions incorporating multiple components consistently outperformed simple interventions. In this regard, adding breathing and/or meditation practices to yoga interventions proved particularly beneficial. However, specific components or combinations were more effective in enhancing certain variables or clinical conditions, suggesting a need for customized programs. Comparable multi-component mind–body interventions, such as yoga and mindfulness-based stress reduction, were often equally efficient. Nevertheless, most findings are preliminary, and certain components such as the ethical part of yoga are particularly under-researched. Conclusion: Future studies should isolate and compare all components of yoga and evaluate additive effects by investigating their different combinations. The researchers should refer to theoretical frameworks, use rigorous methodology, and consider individual factors.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0245154
Author(s):  
Yinyin Guo ◽  
Yichen Guo ◽  
Yanxin Luo ◽  
Xia Song ◽  
Hui Zhao ◽  
...  

Objective The application of robotic surgery for rectal cancer is increasing steadily. The purpose of this meta-analysis is to compare pathologic outcomes among patients with rectal cancer who underwent open rectal surgery (ORS) versus robotic rectal surgery (RRS). Methods We systematically searched the literature of EMBASE, PubMed, the Cochrane Library of randomized controlled trials (RCTs) and nonrandomized controlled trials (nRCTs) comparing ORS with RRS. Results Fourteen nRCTs, including 2711 patients met the predetermined inclusion criteria and were included in the meta-analysis. Circumferential resection margin (CRM) positivity (OR: 0.58, 95% CI, 0.29 to 1.16, P = 0.13), number of harvested lymph nodes (WMD: −0.31, 95% CI, −2.16 to 1.53, P = 0.74), complete total mesorectal excision (TME) rates (OR: 0.93, 95% CI, 0.48 to 1.78, P = 0.83) and the length of distal resection margins (DRM) (WMD: −0.01, 95% CI, −0.26 to 0.25, P = 0.96) did not differ significantly between the RRS and ORS groups. Conclusion Based on the current evidence, robotic resection for rectal cancer provided equivalent pathological outcomes to ORS in terms of CRM positivity, number of harvested lymph nodes and complete TME rates and DRM.


2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Andrea Sansone ◽  
Angelo Cignarelli ◽  
Massimiliano Sansone ◽  
Francesco Romanelli ◽  
Giovanni Corona ◽  
...  

Objectives. Elevated levels of serum homocysteine (Hcy) have been associated with cardiovascular diseases and endothelial dysfunction, conditions closely associated with erectile dysfunction (ED). This meta-analysis was aimed to assess serum Hcy levels in subjects with ED compared to controls in order to clarify the role of Hcy in the pathogenesis of ED. Methods. Medline, Embase, and the Cochrane Library were searched for publications investigating the possible association between ED and Hcy. Results were restricted by language, but no time restriction was applied. Standardized mean difference (SMD) was obtained by random effect models. Results. A total of 9 studies were included in the analysis with a total of 1320 subjects (489 subjects with ED; 831 subjects without ED). Pooled estimate was in favor of increased Hcy in subjects with ED with a SMD of 1.00, 95% CI 0.65–1.35, p<0.0001. Subgroup analysis based on prevalence of diabetes showed significantly higher SMD in subjects without diabetes (1.34 (95% CI 1.08–1.60)) compared to subjects with diabetes (0.68 (95% CI 0.39–0.97), p<0.0025 versus subgroup w/o diabetes). Conclusions. Results from our meta-analysis suggest that increased levels of serum Hcy are more often observed in subjects with ED; however, increase in Hcy is less evident in diabetic compared to nondiabetic subjects. This study is registered with Prospero registration number CRD42018087558.


Author(s):  
Sukirno Sukirno

Evidence Based Medicine (EBM) merupakan pemanfaatan bukti ilmiah berdasarkan penelitian klinis mutakhir yang sahih dalam tatalaksana proses penyembuhan penyakit. Salah satu syarat utama untuk memfasilitasi pengambilan keputusan klinik yang evidence-based, adalah dengan menyediakan bukti-bukti ilmiah yang relevan. Tipe kajian  diutamakan yang berupa hasil review sistematik, meta-analisis, dan randomised controlled trial (RCT). Salah satu dari lima langkah dalam evidence based medicine yaitu yaitu menelusur  bukti  dari sumber database hasil penelitian yang memuat bukti-bukti ilmiah. PubMed Clinical Queries dan The Cochrane Library merupakan database berisi hasil riset sekunder (systematic-review/meta-analysis) yang mensintesis hasil riset primer. Kolaborasi pustakawan dalam pengambilan keputusan klinis yaitu dengan  memberikan pelatihan  atau menelusur artikel hasil penelitian yang akan digunakan dalam pengambilan klinis dari database yang memuat bukti ilmiah.


2020 ◽  
Vol 2020 ◽  
pp. 1-16
Author(s):  
Haoran Liu ◽  
Tao Ye ◽  
Xiaoqi Yang ◽  
Peng Lv ◽  
Xiaoliang Wu ◽  
...  

Recently, checkpoint inhibition of the PD-1/PD-L1 axis has been shown to be therapeutically relevant in urothelial carcinoma (UC). To evaluate the predictive and prognostic value of PD-L1 on response and survival in UC patients after cystectomy, chemotherapy, or anti-PD-1/PD-L1 therapy, a systematic review of PubMed, Embase, Web of Science, and the Cochrane Library was performed. A total of 2154 patients from 14 published studies were included. In all UC patients after cystectomy, tumour cell (TC) PD-L1 expression was not associated with the OS or PFS. For the subset of patients with organ-confined disease, TC PD-L1 expression significantly predicted OS after cystectomy (P=0.0004). There was no significant evidence of an association between TC PD-L1 status and ORR or OS for UC patients treated with platinum-based chemotherapy. For UC patients treated with anti-PD-1/PD-L1 therapy, TC PD-L1 expression≥5% could predict the response (P=0.005), but not for the 1% cut-off (P≥0.05). As for PD-L1 expression in tumour-inflating immune cells (TIICs), both subsets with IC2/3 vs. IC0/1 and IC1/2/3 vs. IC0 were associated with ORR to anti-PD-1/PD-L1 therapy. In the TIIC subset, IC2/3 vs. IC0/1 of PD-L1 was associated with higher CR (P=0.002), PR (P=0.04), and PD (P=0.007). Further, higher TIIC PD-L1 status benefited from longer PFS (P<0.001), but was not associated with OS in UC patients with anti-PD-1/PD-L1 therapy. Our study suggested that TIIC PD-L1 expression with 5% cut-off was valuable as a predictive and prognostic biomarker for ORR and PFS in UC patients with anti-PD-1/PD-L1 therapy.


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