scholarly journals Whether stoma support rods have application value in loop enterostomy: a systematic review and meta-analysis

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Rui Du ◽  
Jiajie Zhou ◽  
Feng Wang ◽  
Dongliang Li ◽  
Guifan Tong ◽  
...  

Abstract Purpose The purpose of the systematic review and meta-analysis is to analyze the application value of the stoma support rods in loop enterostomy. Methods The studies on the application of stoma rods in loop enterostomy published from January 2000 to January 2020 were searched in the databases of PubMed, Embase, Cochrane library, and Clinical trials. All randomized controlled trials (RCTs) and cohort studies that observed the value of stoma rods were included according to inclusion criteria. The RevMan5.3 software was used for statistical analysis. Results A total of 1131 patients with loop enterostomy in six studies were included in this study; there were 569 cases in the experimental group and 562 cases in the control group. All six studies analyzed the effect of support rods on the incidence of stoma retraction; the meta-analysis showed that in a total of 32 patients, stoma retraction occurred, with a total incidence of about 2.8% in 1131 patients. The incidence of stoma retraction in the rod group was not significantly lower than that in the non-rod group, and the difference was not statistically significant (OR = 0.65, 95% CI 0.32~1.32, I2 = 0%, P = 0.23), and the studies were homogeneous. The incidences of stoma necrosis (OR = 6.41, 95% CI 2.22~18.55, I2 = 0%, P = 0.0006), peristomal dermatitis (OR = 2.93, 95% CI 2.01~4.27, I2 = 0%, P < 0.00001), and mucocutaneous separation (OR = 2.14, 95% CI 1.03~4.47, I2 = 0%, P = 0.04) were significantly increased in the rod group. Conclusions It is not recommended to routinely use stoma support rods in the clinical practice.

2020 ◽  
Author(s):  
Yun Diao ◽  
Hang Yang ◽  
Yang Chun Zhou ◽  
Biao Du

Abstract Objective: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound,the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45,P<0.00001, RR=1.63,95%CI:1.46~1.82,P<0.00001, RR=1.22,95%CI:1.15~1.29,P<0.00001, RR=1.32,95%CI:1.22~1.42,P<0.00001, RR=1.16,95%CI:1.05~1.27,P=0.002), all the differences were statistically significant. Conclusions: For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine.


Author(s):  
sijia Ma ◽  
mingming Zhao ◽  
zhiyu Pan ◽  
jiao Fan ◽  
xuexue Zhang ◽  
...  

Abstract:Objective: The purpose of this study was to investigate the effect of continuous renal replacement therapy(CRRT) on patients with acute pancreatitis(AP). Methods: A comprehensive search of seven databases without language restrictions includes PubMed, Cochrane Library, Scopus, Embase, Web of Science, China National Knowledge Infrastructure(CNKI) and Wan fang database. Randomized controlled trials (RCTs) for the treatment of acute pancreatitis with CRRT were searched. All the included literatures were published before December 2020. Two review authors independently selected the study and extracted the data according to the inclusion criteria. A third review author will and discuss with the first two review authors and resolve the differences. Weighted mean difference(WMD), risk ratio (RR), and 95% confidence interval (CI) were used for estimating the clinical efficacy of AP in CRRT and control treatment. Results: Fifty-three RCTs met the inclusion criteria and were used in the meta-analysis, with a total of 3,382 effective samples. A comprehensive review of the system shows that the mortality rate of the CRRT group was significantly lower than that of the control group, and the difference was statistically significant(RR=0.44,95%CI0.34 to 0.57,P< 0.000001), the patients using CRRT had lower APACHE Ⅱ scores level(WMD=-3.78, 95%CI-4.66 to -2.90,P<0.00001),higher CRP, PCT,TNF-αand IL-6 clearance effect. According to liver function, the patients using CRRT had lower ALT and AST levels. In the same way, according to renal function, the patients using CRRT had lower SCr (WMD=-94.28, 95%CI-125.47 to -63.10, P<0.00001). The patients using CRRT also had higher ALB levels(WMD=2.32, 95%CI-1.05 to 3.59 ,P=0.0003). Moreover, Results shown no statistical difference in Serum potassium level (WMD=-0.00, 95%CI-0.31 to 0.31,P=1.00)between the two groups. Conclusions: Our findings suggest that treatment with CRRT for acute pancreatitis may be more beneficial than conventional treatment. However, high-quality studies with a larger sample size are still needed to confirm our results.


Author(s):  
Robinson Ramírez-Vélez ◽  
Yasmin Ezzatvar ◽  
Mikel Izquierdo ◽  
Antonio Garcia-Hermoso

Muscle tissue typically contains only small amounts of adipose tissue, and the excess deposition of adiposity is considered a pathological phenomenon termed myosteatosis. Several studies have assessed the effects of exercise alone on the severity of myosteatosis, and some studies have reported promising results. We performed a systematic review and meta-analysis to investigate the effects of exercise interventions on myosteatosis (i.e., lipid infiltration and muscle attenuation). Studies were identified through a systematic search of three databases and limited to randomized controlled trials (RCTs) focused on evaluating the effect of exercise interventions on lipid infiltration and/or muscle attenuation in adults. Thirteen studies met the inclusion criteria and twelve were included in the meta-analysis (n = 465, 84.7% women). The volume of lipid infiltration was decreased in the exercise group compared to the control group (Hedges'g = -0.45 95% confidence interval [CI] -0.74 to -0.16, p = 0.008, I2= 0%), and the degree of muscle attenuation was increased (Hedges'g = 0.67 95% CI 0.22 to 1.13, p = 0.009, I2= 59.3%). Based on meta-regression analyses, there were no significant effects of mean age at baseline (lipid infiltration, β=-0.008 95% CI, -0.035 to 0.019; p=0.495; muscle attenuation, β=-0.013 95% CI, -0.036 to 0.011; p=0.248) and intervention duration (lipid infiltration, β=-0.008 95% CI, -0.028 to 0.010; p=0.311; muscle attenuation, β=-0.018 95% CI, -0.050 to 0.014; p=0.230) on the effect sizes estimates. Overall, our findings indicate that exercise can significantly improve muscle quality in populations at risk of developing obesity - and sarcopenia-related disability.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Ahmad Al-Abdouh ◽  
Sadam Haddadin ◽  
Atul Matta ◽  
Ahmad Jabri ◽  
Mahmoud Barbarawi ◽  
...  

Purpose. To evaluate the efficacy and safety of midodrine use in intensive care units (ICU) to facilitate weaning off intravenous vasopressors (IVV). Methods. We searched PubMed/MEDLINE, Cochrane library, and Google Scholar (inception through October 18th, 2020) for studies evaluating adjuvant use of midodrine to IVV in the ICU. The outcomes of interest were ICU length of stay (LOS), hospital LOS, mortality, IVV reinstitution, ICU readmission, and bradycardia. Estimates were pooled using the random-effects model. We reported effect sizes as standardized mean difference (SMD) for continuous outcomes and risk ratios (RRs) for other outcomes with a 95% confidence interval (CI). Results. A total of 6 studies were found that met inclusion criteria and had sufficient data for our quantitative analysis (1 randomized controlled trial and 5 retrospective studies). A total of 2,857 patients were included: 600 in the midodrine group and 2,257 patients in the control group. Midodrine use was not associated with a significant difference in ICU LOS (SMD 0.16 days; 95% CI −0.23 to 0.55), hospital LOS (SMD 0.03 days; 95% CI −0.33 to 0.0.39), mortality (RR 0.87; 95% CI 0.52 to 1.46), IVV reinstitution (RR 0.47; 95% CI 0.17 to 1.3), or ICU readmission (RR 1.03; 95% CI 0.71 to 1.49) when compared to using only IVV. However, there were higher trends of bradycardia with midodrine use that did not reach significance (RR 7.64; 95% CI 0.23 to 256.42). Conclusion. This meta-analysis suggests that midodrine was not associated with a significant decrease in ICU LOS, hospital LOS, mortality, or ICU readmissions.


Author(s):  
Yuting Chen ◽  
Shanshan Xu ◽  
Jiran Shen ◽  
Hui Yang ◽  
Wei Xu ◽  
...  

AbstractFew studies have directly compared the effects of different exercise therapies on reducing fatigue in patients with multiple sclerosis. Thus, we conducted a Frequentist network meta-analysis to analyze and compare the effectiveness of different types of exercise on reducing multiple sclerosis-related fatigue. Relevant randomized controlled trials were searched in PubMed, Web of Science and Cochrane Library databases from the date of their inception up to April 1, 2021. In total, 27 articles involving 1470 participants and 10 types of interventions met the inclusion criteria. The results indicated that aquatic exercise ranked as the most effective among these interventions, and aerobic exercise had small-to-moderate effect sizes. Most of the interventions were shown to be better than the control group, except for climbing. Climbing was the only intervention that ranked worse than the controls. All of these findings merit further investigation in future clinical trials.


2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Biwei Chen ◽  
Lili Zhang ◽  
Shaozong Chen ◽  
Changzhen Gong

To assess the efficacy of acupuncture for treatment of irritable bowel syndrome through meta-analysis of randomized controlled trials in recent 20 years. Online databases, including CNKI, VIP, WANFANG,PubMed, Cochrane Library, Web of Science and Embase were searched for randomized controlled trials (RCTs) of acupuncture for IBS. Retrieval time was from January 1, 2000 to January 31, 2021. According to Jadad scoring criteria,the bias risk and quality assessment of each RCT included were evaluated by two researchers. RevMan 5.3 software was used for the meta analysis. Eight RCTs were selected which include a total of 1181 patients.The control group has 425 patients and the experimental group has 756 patients. The result of meta-analysis indicates that the total effective rate for the experimental group was superior to that of the control group [OR=3.29,95%CI [2.16~5.03](P<0.01)], and the funnel plot was basically symmetric. Acupuncture therapy is shown to have a good safety and compliance record. However, the number of high-quality trials is small, and there are some deficiencies in the methodology of clinical research. Acupuncture, as a supplementary therapy for irritable bowel syndrome, has positive clinical significance and prospects for application. The methodology of clinical research needs to be further improved.


2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21139-e21139
Author(s):  
Yi Hu ◽  
Xiaochen Zhao ◽  
Yuezong Bai ◽  
Longgang Cui ◽  
Fan Zhang

e21139 Background: Several therapies based on immune checkpoint inhibitors (ICIs) have been approved as the 1L standard of care for PD-L1≥ 50% advanced non-small cell lung cancer (NSCLC). However, little is known about the difference in efficacy between different strategies. We conducted a systematic review and meta-analysis to help clinicians choose more reasonable treatment options. Methods: We searched PubMed, Cochrane library, Embase and major conference proceedings from January 2010 to December 2020 for randomized controlled trials that had available subgroup hazard ratios (HRs) for overall survival according to PD-L1≥ 50%. Only drugs met primary outcome or approved by FDA were included for analysis. The primary outcome was the difference in overall survival (OS). HRs and 95% CI were calculated for the pooled OS using a random-effects model. p<0.05 was considered as statistical difference. Results: A total of 10 randomized controlled trials were included for this meta-analysis. The pooled HR and 95% CI for monotherapy, ICI plus chemotherapy and ICI plus ICI were 0.64 (0.55, 0.74), 0.64 (0.51, 0.79) and 0.70 (0.55, 0.90), respectively. There was no statistical differences between ICI monotherapy and ICI plus chemotherapy (HR 1.00, 95% CI 0.77- 1.30), between ICI monotherapy and ICI plus ICI (HR 0.91, 95% CI 0.69- 1.22) or between ICI plus chemotherapy and ICI plus ICI (HR 0.91, 95% CI 0.66- 1.27). Conclusions: For PD-L1≥ 50% NSCLC patients, active ICI monotherapies showed no different efficacy when compared with ICI combination therapies.


2020 ◽  
Author(s):  
Yun Diao ◽  
Hang Yang ◽  
Chun Yang Zhou ◽  
Biao Du

BACKGROUND The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. OBJECTIVE To evaluate the efficacy and tolerability of ubrogepant in patients with acute migraine. METHODS We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. RESULTS A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that:compared to the control group, the percentage of participants with PF, the percentage of participants with PR, the percentage of participants with SPF, the percentage of participants with SPR,the absence of phonophobia in sound,the absence of phonophobia in light and the absence of nausea (RR=1.31,95%CI:1.18~1.45,P<0.00001, RR=1.63,95%CI:1.46~1.82,P<0.00001, RR=1.22,95%CI:1.15~1.29,P<0.00001, RR=1.32,95%CI:1.22~1.42,P<0.00001, RR=1.16,95%CI:1.05~1.27,P=0.002), all the differences were statistically significant. CONCLUSIONS For adult patients with acute migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for acute migraine. CLINICALTRIAL PROSPERO registration number CRD42019145125


2020 ◽  
Vol 11 ◽  
Author(s):  
Chen qi Zhang ◽  
Bao ming He ◽  
Mei ling Hu ◽  
Hong bin Sun

Purpose: To evaluate the incidence and risk of tremor in patients treated with valproic aid (VPA) monotherapy.Methods: We searched the PubMed, Embase, and Cochrane Library databases to gather relevant data on tremor in patients taking VPA and other drugs and performed a meta-analysis using Stata15.1 software.Results: Twenty-nine randomized controlled trials (RCTs) met the inclusion criteria and were included in the meta-analysis. The overall incidence of tremor in patients receiving VPA therapy was 14% [OR = 0.14, 95% CI (0.10–0.17)]. The pooled estimate risk of tremor showed a significant difference between patients treated with VPA and all other drugs [OR = 5.40, 95% CI (3.22–9.08)], other antiepileptic drugs (AEDs) [OR = 5.78, 95% CI (3.18–10.50)], and other non-AEDs [OR = 4.77, 95% CI (1.55–14.72)]. Both a dose of &lt;1,500 mg/d of VPA [included 500 mg/d: OR = 3.57, 95% CI (1.24–10.26), 500–999 mg/d: OR = 3.99, 95% CI (1.95–8.20), 1,000–1,499 mg/d: OR = 8.82, 95% CI (3.25–23.94)] and a VPA treatment duration of &lt;12 m [included ≤ 3 months: OR = 3.06, 95% CI (1.16–8.09), 3–6 months: OR = 16.98, 95% CI (9.14–31.57), and 6–12 months: OR = 4.15, 95% CI (2.74–6.29)] led to a higher risk of tremor than did other drugs, as did higher doses and longer treatment times.Conclusion: Compared with other drugs, VPA led to a higher risk of tremor, and the level of risk was associated with the dose and duration of treatment.


Author(s):  
Yun Diao ◽  
Hang Yang ◽  
Yang Chun Zhou ◽  
Biao Du

Abstract Background: The aim of this review was to evaluate the efficacy and tolerability of ubrogepant in patients with episodic migraine. Methods: We systematically searched PubMed, Embase, MEDLINE, Cochrane Library, and clinicaltrials.gov from inception to JULY, 2019. Randomized controlled trials of the efficacy and/or tolerability of ubrogepant for migraine were included. Meta-analysis was conducted by RevMan 5.3 software. Results: A total of 4 RCTs involving 4 163 patients were included. The meta-analysis showed that there were significant differences in the percentage of subjects with PF, PR, SPF, SPR, sound without phobia, light without phobia and nausea compared with the control group. (RR=1.31,95%CI:1.18~1.45,P<0.00001, RR=1.63,95%CI:1.46~1.82,P<0.00001, RR=1.22,95%CI:1.15~1.29,P<0.00001, RR=1.32,95%CI:1.22~1.42,P<0.00001, RR=1.16,95%CI:1.05~1.27,P=0.002), all the differences were statistically significant. Conclusions: For adult patients with episodic migraine, ubrogepant could effectively abort the acute attack. High-quality, adequately powered RCTs are needed to fully evaluate the efficacy and tolerability of ubrogepant for episodic migraine.


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