Surgical Management of Craniopharyngiomas in Children: Meta-analysis and Comparison of Transcranial and Transsphenoidal Approaches

Neurosurgery ◽  
2011 ◽  
Vol 69 (3) ◽  
pp. 630-643 ◽  
Author(s):  
Robert E Elliott ◽  
John A Jane ◽  
Jeffrey H Wisoff
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Outcome Data ◽  
Inclusion Criteria ◽  
Lateral Extension ◽  
Increased Intracranial Pressure ◽  
Online Databases ◽  
Neurological Morbidity ◽  
Vascular Structures ◽  
Lower Morbidity

Abstract BACKGROUND: Controversy persists regarding the optimal treatment of pediatric craniopharyngiomas. OBJECTIVE: We performed a meta-analysis of reported series of transcranial (TC) and transsphenoidal (TS) surgery for pediatric craniopharyngiomas to determine whether comparisons between the outcomes in TS and TC approaches are valid. METHODS: Online databases were searched for English-language articles reporting quantifiable outcome data published between 1990 and 2010 pertaining to the surgical treatment of pediatric craniopharyngiomas. Forty-eight studies describing 2955 patients having TC surgery and 13 studies describing 373 patients having TS surgery met inclusion criteria. RESULTS: Before surgery, patients who had TC surgery had less visual loss, more frequent hydrocephalus and increased intracranial pressure, larger tumors, and more suprasellar disease. After surgery, patients in the TC group had lower rates of gross total resection (GTR), more frequent recurrence after GTR, higher neurological morbidity, more frequent diabetes insipidus, less improvement, and greater deterioration in vision. There was no difference in operative mortality, obesity/hyperphagia, or overall survival percentages. CONCLUSION: Directly comparing outcomes after TC and TS surgery for pediatric craniopharyngiomas does not appear to be valid. Baseline differences in patients who underwent each approach create selection bias that may explain the improved rates of disease control and lower morbidity of TS resection. Although TS approaches are becoming increasingly used for smaller tumors and those primarily intrasellar, tumors more amenable to TC surgery include large tumors with significant lateral extension, those that engulf vascular structures, and those with significant peripheral calcification.

scholarly journals 22. COMPARATIVE EFFICACY OF ALK-INHIBITORS IN ALK INHIBITOR-NAIVE ALK+ LUNG CANCER BRAIN METASTASES: A NETWORK META-ANALYSIS

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii3-ii4
Author(s):  
Philip Haddad ◽  
Dalia Hammoud ◽  
Kevin Gallagher
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Alk Inhibitors ◽  
Molecular Abnormalities ◽  
Online Databases ◽  
Previously Treated

Abstract BACKGROUND Lung cancer has been the leading cause of cancer death for both men and women worldwide. Non-small-cell lung cancer (NSCLC) displays an array of molecular abnormalities most commonly involving ALK and EGFR pathways. NSCLC with ALK rearrangements comprises around 5% of cases. Over the years, several ALK inhibitors (ALKI) have been approved with notable activity in brain metastases. However, there have been limited comparative studies exploring their relative efficacies. This analysis was conducted to compare the relative efficacy of ALKIs against ALKI-naïve ALK+ lung cancer brain metastases. METHODOLOGY A review of the medical literature was conducted using online databases. Inclusion criteria consisted of English language; diagnosis of ALKI-naïve ALK+ lung cancer trials with brain metastases; treatment with Crizotinib (CRZ), Alectinib (ALC), Brigatinib (BRG), and Ceritinib (CER); and comparative studies reporting brain metastases specific responses/events. A Bayesian and a frequentists network meta-analysis were conducted using netmeta package and the random-effects model. RESULTS Eight studies comprising a total of 665 participants with ALKI-naive ALK+ lung cancer brain metastases were included. When compared pair-wise to CRZ, ALC (RR=0.49;95%CI:0.36–0.66), BRG (RR=0.39;95%CI:0.24–0.64), and CER (RR=0.36;95%CI:0.19–0.68) demonstrated significantly superior response rates in patients with untreated or previously treated lung cancer brain metastases. When the efficacy of each ALKI was compared to each other, BRG and CER were ranked the highest followed by ALC then CRZ in decreasing order. CONCLUSIONS This network meta-analysis is the first to compare and rank ALKIs used in treating metastatic ALK+ lung cancer. It indicates that BRG, CER, and ALC are better therapeutic options for patients with ALK-naive ALK+ lung cancer brain metastases when compared to CRZ.

scholarly journals EPID-05. COMPARATIVE EFFICACY OF FIRST-LINE ALK-INHIBITORS IN ALK+ LUNG CANCER BRAIN METASTASES: A NETWORK META-ANALYSIS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii79-ii79
Author(s):  
Philip Haddad ◽  
Dalia Hammoud ◽  
Kevin Gallagher
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Comparative Studies ◽  
English Language ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Alk Inhibitors ◽  
Molecular Abnormalities ◽  
Online Databases ◽  
Previously Treated

Abstract BACKGROUND Lung cancer has been the leading cause of cancer death for both men and women worldwide. Non-small-cell lung cancer (NSCLC) displays an array of molecular abnormalities most commonly involving ALK and EGFR pathways. NSCLC with ALK rearrangements comprises close to 5% of cases. Several ALK inhibitors (ALKI) have been approved with activity in brain metastases. However, there have been limited comparative studies exploring their relative efficacies. This meta-analysis was conducted to compare the relative efficacy of ALKIs against ALKI-naïve ALK+ lung cancer brain metastases. METHODS A review of the medical literature was conducted using online databases. Inclusion criteria consisted of English language; diagnosis of ALKI-naïve ALK+ lung cancer trials with brain metastases; treatment with Crizotinib (CRZ), Alectinib (ALC), Brigatinib (BRG), and Ceritinib (CER); and comparative studies reporting brain metastases specific responses/events. A Bayesian and a frequentists network meta-analysis were conducted using netmeta package and the random-effects model. RESULTS Eight studies comprising a total of 665 participants with ALKI-naive ALK+ lung cancer brain metastases were included. When compared pair-wise to CRZ, ALC (RR=0.49;95%CI:0.36–0.66), BRG (RR=0.39;95%CI:0.24–0.64), and CER (RR=0.36;95%CI:0.19–0.68) demonstrated significantly superior response rates in patients with untreated or previously treated lung cancer brain metastases. When the efficacy of each ALKI was compared to each other, BRG and CER were ranked the highest, followed by ALC and CRZ in decreasing order. CONCLUSIONS This network meta-analysis is the first to compare and rank approved ALKIs used in treating metastatic ALK+ lung cancer. It indicates that BRG, CER, and ALC are better therapeutic options for patients with ALK-naive ALK+ lung cancer brain metastases when compared to CRZ.

scholarly journals Intangible assets in the process of internationalization

2020 ◽  
Vol 56 (1) ◽  
pp. 63-78
Author(s):  
Łukasz Bryl
Keyword(s):  
English Language ◽  
Intangible Assets ◽  
Meta Analysis ◽  
Strong Relationship ◽  
Valuable Insight ◽  
Internationalization Process ◽  
Journal Articles ◽  
Employee Education ◽  
Current State ◽  
Online Databases

AbstractThe aim of this article is to determine the current state of impact of various forms of intangible assets on the internationalization process. For the purpose of the paper meta-analysis was adopted as a method of the study. English-language peer-reviewed journal articles were analyzed only with the help of: EBSCOhost, ScienceDirect, Emerald, JSTOR, ProQuest and Wiley Online databases. The search was aimed at newest papers (after 2012), however some older articles (with regard to their value) were included in the analysis as well. Based on the conducted analysis, there was observed a significant and positive link between the level of employee education and internationalization probability and extent. The effect of the wages on internationalization is stage dependent. Under certain assumptions there is a positive and strong relationship between R&D intensity and internationalization. Advertising spending do not foster the process of internationalization. The practical contribution of this research is twofold. First, it provides valuable insight for practitioners which intangible assets and how foster various modes of the internationalization process. Second, it describes upon which conditions the interrelation between firm intangible assets and internationalization is significant and positive.

scholarly journals Information Needs of Cancer Patients are Influenced by Time Since Diagnosis, Stage of Cancer, Patients’ Age, and Preferred Role in Treatment-related Decisions

2006 ◽  
Vol 1 (3) ◽  
pp. 80 ◽  
Author(s):  
John Loy
Keyword(s):  
Cancer Patients ◽  
Information Seeking ◽  
Information Needs ◽  
English Language ◽  
Meta Analysis ◽  
Active Role ◽  
Post Treatment ◽  
Inclusion Criteria ◽  
Information Need ◽  
Need For Information

A review of: Kalyani, Ankem. “Factors Influencing Information Needs Among Cancer Patients: A Meta-Analysis.” Library & Information Science Research; 28.1 (2006) 7-23. Objective – The author aims to study the aggregate influence of demographic and situational variables on the information needs of cancer patients, in order to inform the provision of information to those patients. Design – Meta-analysis. Setting – Research articles published in the MEDLINE and CINAHL databases. Subjects – English language studies published between 1993 and 2003. An initial search set of 196 studies from MEDLINE and 283 studies from CINAHL were identified. Following rigorous assessment, 12 studies met the inclusion criteria. Methods – A comprehensive search of the databases was conducted, initially combining “neoplasm” with “cancer patients” using the Boolean “or”. These results were then combined with five separate searches using the following terms; information need(s), information seeking, information seeking behaviour, information source(s) and information resource(s). This identified in total 479 English language articles. Based on a review of titles and abstracts, 110 articles were found covering information resources or the information needs of cancer patients. These articles were then subjected to the further inclusion criteria and limited to studies which included: analysis of information needs and/or information sources of cancer patients; adults as subjects of the research; and application of quantitative research methods and relevant statistics. This eliminated a further 35 papers. Twelve of the remaining 75 studies were selected for meta-analysis based on their use of the same variables measured consistently in comparable units. The final 12 studies included various forms of cancer, and no distinction was made among them. All 12 studies appeared in peer-reviewed journals. Main results – The meta-analysis found there was consistently no difference between the information needs of men and women. Five subsets were identified within the meta-analysis, and findings for each can be stated as follows: The younger the age of the patient, the greater their overall need for information was likely to be. During treatment, the time elapsed from the diagnosis to the information need was not significant. Once identified, the information need remained constant. During treatment and post-treatment phases, the time elapsed from the diagnosis to the information need made no significant difference, with the information need remaining constant and continuing into the post-treatment phase. The stage of cancer made no difference to the need for information. Those patients in the advanced stages of cancer required an equal amount of information to those in the early stages of cancer. The individual patient’s preferred role in treatment-related decisions made a difference to the information need. Patients who took an active role in treatment-related decisions had a greater need for information than those who did not take an active role. Conclusion – Findings from this meta-analysis can be used to guide information provision to cancer patients, specifically taking patient age and preferred role in treatment decision-making into consideration. Further research into the reasons behind the lower information needs among older patients is called for by the author.

scholarly journals Research Synthesis

2019 ◽  
Vol 83 (3) ◽  
pp. 598-626 ◽  
Author(s):  
Caroline Roberts ◽  
Emily Gilbert ◽  
Nick Allum ◽  
Léïla Eisner
Keyword(s):  
Data Quality ◽  
English Language ◽  
Survey Methodology ◽  
Future Research ◽  
Journal Articles ◽  
Inclusion Criteria ◽  
Response Error ◽  
Response Strategies ◽  
Online Databases ◽  
Different Types

Abstract Herbert Simon’s (1956) concept of satisficing provides an intuitive explanation for the reasons why respondents to surveys sometimes adopt response strategies that can lead to a reduction in data quality. As such, the concept rapidly gained popularity among researchers after it was first introduced to the field of survey methodology by Krosnick and Alwin (1987), and it has become a widely cited buzzword linked to different forms of response error. In this article, we present the findings of a systematic review involving a content analysis of journal articles published in English-language journals between 1987 and 2015 that have drawn on the satisficing concept to evaluate survey data quality. Based on extensive searches of online databases, and an initial screening exercise to apply the study’s inclusion criteria, 141 relevant articles were identified. Guided by the theory of survey satisficing described by Krosnick (1991), the methodological features of the shortlisted articles were coded, including the indicators of satisficing analyzed, the main predictors of satisficing, and the presence of main or interaction effects on the prevalence of satisficing involving indicators of task difficulty, respondent ability, and respondent motivation. Our analysis sheds light on potential differences in the extent to which satisficing theory holds for different types of response error, and highlights a number of avenues for future research.

scholarly journals Pre-, Pro-, and Synbiotics: Do They Have a Role in Reducing Uremic Toxins? A Systematic Review and Meta-Analysis

2012 ◽  
Vol 2012 ◽  
pp. 1-20 ◽  
Author(s):  
Megan Rossi ◽  
Kerenaftali Klein ◽  
David W. Johnson ◽  
Katrina L. Campbell
Keyword(s):  
English Language ◽  
Meta Analysis ◽  
Uremic Toxins ◽  
Population Estimates ◽  
Inclusion Criteria ◽  
Language Studies ◽  
Human Adults ◽  
Meta Analyses ◽  
Grade Approach

Objective. This paper assessed the effectiveness of pre-, pro-, and synbiotics on reducing two protein-bound uremic toxins, p-cresyl sulphate (PCS) and indoxyl sulphate (IS).Methods. English language studies reporting serum, urinary, or fecal PCS and/or IS (or their precursors) following pre-, pro-, or synbiotic interventions (>1 day) in human adults were included. Population estimates of differences in the outcomes between the pre- and the postintervention were estimated for subgroups of studies using four meta-analyses. Quality was determined using the GRADE approach.Results. 19 studies met the inclusion criteria, 14 in healthy adults and five in haemodialysis patients. Eight studies investigated prebiotics, six probiotics, one synbiotics, one both pre- and probiotics, and three studies trialled all three interventions. The quality of the studies ranged frommoderatetovery low. 12 studies were included in the meta-analyses with all four meta-analyses reporting statistically significant reductions in IS and PCS with pre- and probiotic therapy.Conclusion. There is a limited but supportive evidence for the effectiveness of pre- and probiotics on reducing PCS and IS in the chronic kidney disease population. Further studies are needed to provide more definitive findings before routine clinical use can be recommended.

scholarly journals Can early cranioplasty reduce the incidence of hydrocephalus after decompressive craniectomy? A meta-analysis

2020 ◽  
Vol 11 ◽  
pp. 94 ◽  
Author(s):  
Davide Nasi ◽  
Mauro Dobran
Keyword(s):  
Decompressive Craniectomy ◽  
Lower Incidence ◽  
English Language ◽  
Meta Analysis ◽  
Case Series ◽  
Cerebrospinal Fluid Dynamics ◽  
Inclusion Criteria ◽  
Postoperative Hydrocephalus ◽  
Meta Analyses ◽  
Early Cranioplasty

Background: Do alterations of cerebrospinal fluid dynamics secondary to decompressive craniectomy (DC) lead to hydrocephalus, and can this effect be mitigated by early cranioplasty (CP)? In this meta-analysis, we evaluated whether the timing of CP decreased the incidence of postoperative hydrocephalus. Methods: We performed a systematic search of PubMed/MEDLINE, Scopus, and the Cochrane databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for English language articles (1990–2020). We included case series, case–control, and cohort studies, and clinical trials assessing the incidence of hydrocephalus in adult patients undergoing early CP (within 3 months) versus late CP (after 3 months) after DC. Results: Eleven studies matched the inclusion criteria. The rate of postoperative hydrocephalus was not significantly different between the early (=96/1063; 9.03%) and late CP (=65/966; 6.72%) group (P = 0.09). Only in the three studies specifically reporting on the rate of hydrocephalus after DC performed to address traumatic brain injury (TBI) alone was there a significantly lower incidence of hydrocephalus with early CP (P = 0.01). Conclusion: Early CP (within 90 days) after DC performed in TBI patients alone was associated with a lower incidence of hydrocephalus. However, this finding was not corroborated in the remaining eight studies involving CP for pathology exclusive of TBI.

Obesity and the Risk of Suicide in Adults: A Meta-Analysis

2020 ◽  
Author(s):  
Hisyam Syafi’ie ◽  
◽  
Hanung Prasetya ◽  
Bhisma Murti ◽  
◽  
...  
Keyword(s):  
English Language ◽  
Normal Population ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Major Depression Disorder ◽  
Cross Sectional ◽  
Central Java ◽  
Cross Sectional Design ◽  
Suicidal Ideas ◽  
Depression Disorder

ABSTRACT Background: Some prospective studies reported that obesity is positively associated with depression. Adults with obese might have higher suicide risk, as patients with major depression disorder have a higher risk of committing suicide compared to the normal population. This study aimed to examine the association between obesity and the risk of suicide in adults. Subjects and Method: This was a meta-analysis and systematic review. The study was collected published articles from 2010 to 2020 in Google Scholar, PubMed, Springer Link, Hindawi, Clinical Key, and ProQuest electronic databases. Searching process by insert “obesity” AND “suicidal” AND “cross sectional” AND “adjusted odd ratio” keywords. The inclusion criteria were full text, in English language, cross-sectional design, and reporting adjusted odds ratio. The data were analyzed by PRISMA flow chart and Revman 5.3. Results: 4 articles reported that obesity increased the risk of suicidal ideas in adults (aOR= 1.12; 95% CI= 0.96 to 1.31; p= 0.14). Conclusion: Obesity increased the risk of suicide in adults. Keywords: obesity, suicidal Correspondence: Hisyam Syafi’ie. Masters Program in Public Health. Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email: [email protected]. Mobile: 081326002006. DOI: https://doi.org/10.26911/the7thicph.01.39

Non-audiofacial morbidity after Gamma Knife surgery for vestibular schwannoma

2009 ◽  
Vol 27 (6) ◽  
pp. E4 ◽  
Author(s):  
Michael E. Sughrue ◽  
Isaac Yang ◽  
Seunggu J. Han ◽  
Derick Aranda ◽  
Ari J. Kane ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
English Language ◽  
Outcome Data ◽  
Vestibular Schwannomas ◽  
Review Of The Literature ◽  
Inclusion Criteria ◽  
Dose Cohort ◽  
Shunt Treatment ◽  
Comprehensive Search ◽  
Language Literature

Object While many studies have been published outlining morbidity following radiosurgical treatment of vestibular schwannomas, significant interpractitioner and institutional variability still exists. For this reason, the authors conducted a systematic review of the literature for non-audiofacial-related morbidity after the treatment of vestibular schwannoma with radiosurgery. Methods The authors performed a comprehensive search of the English-language literature to identify studies that published outcome data of patients undergoing radiosurgery treatment for vestibular schwannomas. In total, 254 articles were found that described more than 50,000 patients and were analyzed for satisfying the authors' inclusion criteria. Patients from these studies were then separated into 2 cohorts based on the marginal dose of radiation: ≤ 13 Gy and > 13 Gy. All tumors included in this study were < 25 mm in their largest diameter. Results A total of 63 articles met the criteria of the established search protocol, which combined for a total of 5631 patients. Patients receiving > 13 Gy were significantly more likely to develop trigeminal nerve neuropathy than those receiving < 13 Gy (p < 0.001). While we found no relationship between radiation dose and the rate of developing hydrocephalus (0.6% for both cohorts), patients with hydrocephalus who received doses > 13 Gy appeared to have a higher rate of symptomatic hydrocephalus requiring shunt treatment (96% [> 13 Gy] vs 56% [≤ 13 Gy], p < 0.001). The rates of vertigo or balance disturbance (1.1% [> 13 Gy] vs 1.8% [≤ 13 Gy], p = 0.001) and tinnitus (0.1% [> 13 Gy] vs 0.7% [≤ 13 Gy], p = 0.001) were significantly higher in the lower dose cohort than those in the higher dose cohort. Conclusions The results of our review of the literature provide a systematic summary of the published rates of nonaudiofacial morbidity following radiosurgery for vestibular schwannoma.

scholarly journals Systematic review of interventions to increase the use of arteriovenous fistulae and grafts in incident haemodialysis patients

2021 ◽  
pp. 112972982110069
Author(s):  
Jonathan De Siqueira ◽  
Alexander Jones ◽  
Mohammed Waduud ◽  
Max Troxler ◽  
Deborah Stocken ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
English Language ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Education Programme ◽  
Outcome Data ◽  
Arteriovenous Fistulae ◽  
Structured Education ◽  
Significant Difference

Background: Patients who commence haemodialysis (HD) through arteriovenous fistulae and grafts (AVF/G) have improved survival compared to those who do so by venous lines. Objectives: This systematic review aims to assimilate the evidence for any strategy which increases the proportion of HD patients starting dialysis through AVF/G. Data sources: Medline, Embase, Cochrane Central and Scopus. Study eligibility, participants and interventions: English language studies comparing any educational, clinical or service organisation intervention for adult patients with end stage renal failure and reporting incident AVF/G use. Study appraisal and synthesis: Two reviewers assessed studies for eligibility independently. Outcome data was extracted and reported as relative risk. Reporting was performed with reference to the PRISMA statement. Results: Of 1272 studies, 6 were eligible for inclusion. Studies varied in design and intervention. Formal meta-analysis was not appropriate. One randomised controlled trial and two cohort studies assessed the role of a renal access coordinator. Two cohort studies assessed the implementation of qualitive initiative programmes and one cohort study assessed a national, structured education programme. Results between studies were contradictory with some reporting improvements in incident AVF/G use and some no significant difference. Quality was generally low. Conclusions: It is not possible to reach firm conclusions nor make strategic recommendations. A comprehensive package of care which educates and identifies patients approaching dialysis in a timely manner may improve incident AVF/G use. An unbiased, robust comparison of different strategies for timing AVF/G referral is required.

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