With or without internal limiting membrane peeling during idiopathic epiretinal membrane surgery: A meta-analysis

Background Although previously published meta-analyses have compared the surgical effects between the methods of Idiopathic epiretinal membrane (iERM) removal with or without ILM peeling, they did not reach an agreement. Purpose We aimed to provide more evidence for the treatment of iERM and whether additional ILM peeling was better or not by analyzing more updated studies and randomized control trials (RCTs). Method The search was conducted in Pubmed, Embase, Cochrane Library, Web of Science and Open Grey without language limitation and the studies included were from inception to December 2019. All studies of iERM with or without ILM peeling showed at least one of outcomes, such as best-corrected visual acuity (BCVA), central macular thickness (CMT) and recurrence of ERM. The pooled results between above groups were showed by the mean differences (MDs) and risk ratios (RR) with corresponding 95% confidence intervals (CIs). Result In total, 1645 eyes of five randomized controlled trials (RCTs) and fifteen retrospective studies were included. The short-term (<12 months) BCVA improvement in both groups showed no significant difference (MD = -0.01; 95% CI = -0.02 to 0.01; P = 0.36). However, the BCVA improvement was significantly better in ILM peeling eyes than in those without ILM peeling when considering the risk bias (MD = -0.04; 95% CI = -0.07 to -0.01; P = 0.008). The short-term (<12 months) CMT had a higher reduction in non ILM peeling group (MD = -9.02; 95% CI = -12.51 to -5.54; P < 0.00001) and the recurrence of ERM in ILM peeling group was lower (P < 0.00001). The long-term (≥12months) BCVA improvement ((MD = -0.00; 95% CI = -0.03 to 0.03; P = 0.97) and reduction of long-term (≥12months) CMT (MD = -1.14; 95% CI = -7.14 to -4.86; P = 0.71) were similar in both groups. Conclusion By considering the risk of bias, we should determine whether ILM peeling is beneficial for short-term changes in BCVA in patients with iERM. Nevertheless, further studies are needed to confirm this. iERM removal without ILM peeling can improve the short-term decrease in CMT and ILM peeling decreases the recurrence of ERM, but the long-term changes in BCVA and CMT are similar with or without ILM peeling. There is a need for a true large scale randomized trial that will also include microperimetry and other functional measures.

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Short-Term and Long-Term Outcomes of Self-Expanding Metallic Stent Versus Decompressing Stoma as the Bridge of Elective Surgery for Left-Sided Obstructive Colon Cancer A Meta-Analysis

Tobacco Regulatory Science ◽

10.18001/trs.7.5.107 ◽

2021 ◽

Vol 7 (5) ◽

pp. 1853-1864

Author(s):

Jin Jing ◽

Wei Xu ◽

Haiming Xu ◽

ZhengHong Yu ◽

Mengyun zhou ◽

...

Keyword(s):

Colon Cancer ◽

Elective Surgery ◽

Meta Analysis ◽

Complete Analysis ◽

Cochrane Library ◽

Metallic Stent ◽

Sems Placement ◽

Short Term ◽

Significant Difference

Background: Compared to emergency resection, elective surgery is a better choice for the people suffering from left-sided obstructive colon cancer (LOSCC). Both are considered as self-expanding decompressing stoma (DS) construction and metallic stent (SEMS) placement are accessible bridges for elective surgery (BTS). We aimed to perform meta-analysis of LOSCC databases to comparethe pros and cons of the two options. Method: LOSCC patients with curative intent were searched in medical databases, including PUBMED, MEDLINE, and the Cochrane Library. Results were expressed as risk ratios. The meta-analysis was performed by Revman5.3. Result: Three comparative studies were selected, including 847 LOSCC patients. The complete analysis showed that there is no statistically significant difference regarding primary anastomosis (0R=1.15, 95% CI 0.30-4.41, P=0.84), There was no significant difference in 90-day recurrence rate post resection (OR=0.90, 95% CI 0.68-1.20, P=0.47), and major complication (OR=1.86, 95% CI 0.98-3.54, P=0.06) between SEMS and DS group. In addition, the permanent stomas (OR=0.82; 95% CI 0.60-1.13, P=0.23), overall recurrence (OR=0.82, 95% CI 0.48-1.40, P=0.46), and overall survival of 3-years (OR=1.24, 95% CI 0.69-2.25, P=0.48) showed no statistical difference between SEMS and DS group. Conclusion: The after-effects of both short-term and long-term in patients who were treated by SEMS or DS as BTS for LSOCC were not statistically significant. Considering of the even complicated surgical interventions, prolonged hospital stays, and worse body image of DS construction, SEMS placement seems to be the preferred option in treating LSOCC patients.

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Risk of newly developing visual field defect and neurodegeneration after pars plana vitrectomy for idiopathic epiretinal membrane

British Journal of Ophthalmology ◽

10.1136/bjophthalmol-2020-317478 ◽

2020 ◽

pp. bjophthalmol-2020-317478

Author(s):

Kunihiko Akino ◽

Norihiro Nagai ◽

Kazuhiro Watanabe ◽

Norimitsu Ban ◽

Toshihide Kurihara ◽

...

Keyword(s):

Visual Field ◽

Epiretinal Membrane ◽

Pars Plana Vitrectomy ◽

Internal Limiting Membrane ◽

Visual Field Defects ◽

Automated Perimetry ◽

Standard Automated Perimetry ◽

Ilm Peeling ◽

Idiopathic Epiretinal Membrane ◽

Pars Plana

Background/AimsPars plana vitrectomy (PPV) is widely performed in patients with idiopathic epiretinal membrane (iERM) to improve vision. Postoperative visual field defects (VFDs) have been previously reported. However, whether they occur when using the most recent PPV system, and the frequency of VFDs as measured by standard automated perimetry, remain poorly documented and were examined in this study.MethodsData of 30 eyes (30 patients; mean age, 66.1 years; 15 men) who underwent PPV for iERM during February 2016–June 2019 and had preoperative and postoperative visual field measurements using standard automated perimetry (Humphrey visual field analyser 30-2 program) were retrospectively analysed. Eyes with diseases other than iERM, including moderate-to-severe cataract or preoperative VFDs were excluded.ResultsVFD, defined by the Anderson and Patella’s criteria, was found in 73.3% of the eyes 1 month after PPV. After age adjustment, internal limiting membrane (ILM) peeling was identified as a risk factor for postoperative VFD (p=0.035; 95% CI 1.173 to 92.8). Postoperative VFD was frequently observed nasally (86.4%, p=0.002), and on optical coherence tomography measurements, ganglion cell layer (GCL) thinning was found temporal to the fovea (p=0.008). Thinning of the superior and inferior retinal nerve fibre layers and of the GCL temporal to the fovea were significant in eyes after ILM peeling (all p<0.05).ConclusionILM peeling may cause inner retinal degeneration and lead to the development of VFDs after PPV, which should be further examined.

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Preoperative Somatostatin Analogues in Patients with Newly-diagnosed Acromegaly: A Systematic Review and Meta-analysis of Comparative Studies

Scientific Reports ◽

10.1038/s41598-019-50639-6 ◽

2019 ◽

Vol 9 (1) ◽

Cited By ~ 2

Author(s):

Chengxian Yang ◽

Ge Li ◽

Shenzhong Jiang ◽

Xinjie Bao ◽

Renzhi Wang

Keyword(s):

Systematic Review ◽

Comparative Studies ◽

Meta Analysis ◽

Somatostatin Analogues ◽

Long Term Results ◽

Current Evidence ◽

Cochrane Library ◽

Cure Rate ◽

Short Term

Abstract Biochemical remission after transsphenoidal surgery is still unsatisfied in acromegaly patients with macroadenomas, especially with invasive macroadenomas. Concerning the impact of preoperative somatostatin analogues (SSAs) on surgical outcomes, previous studies with limited cases reported conflicting results. To assess current evidence of preoperative medical treatment, we performed a systematic review and meta-analysis of comparative studies. A literature search was conducted in Pubmed, Embase, and the Cochrane Library. Five randomized controlled trials (RCT) and seven non-RCT comparative studies were included. These studies mainly focused on pituitary macroadenomas though a small number of microadenoma cases were included. For safety, preoperative SSAs were not associated with elevated risks of postoperative complications. With respect to efficacy, the short-term cure rate was improved by preoperative SSAs, but the long-term cure rate showed no significant improvement. For invasive macroadenomas, the short-term cure rate was also improved, but the long-term results were not evaluable in clinical practice because adjuvant therapy was generally required. In conclusion, preoperative SSAs are safe in patients with acromegaly, and the favorable impact on surgical results is restricted to the short-term cure rate in macroadenomas and invasive macroadenomas. Further well-designed RCTs to examine long-term results are awaited to update the finding of this meta-analysis.

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Comparison of the Effectiveness of Pars Plana Vitrectomy with and without Internal Limiting Membrane Peeling for Idiopathic Retinal Membrane Removal: A Meta-Analysis

Journal of Ophthalmology ◽

10.1155/2015/974568 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 9

Author(s):

Hanhan Liu ◽

Shanru Zuo ◽

Chun Ding ◽

Xunzhang Dai ◽

Xiaohua Zhu

Keyword(s):

Pars Plana Vitrectomy ◽

Retrospective Studies ◽

Meta Analysis ◽

Internal Limiting Membrane ◽

Ilm Peeling ◽

Internal Limiting Membrane Peeling ◽

Randomized Controlled ◽

Long Term Effect ◽

Pars Plana

We conducted a meta-analysis of published retrospective studies and compared the effectiveness of pars plana vitrectomy with and without internal limiting membrane (ILM) peeling for idiopathic epiretinal membrane (IERM). The results revealed that patients in the IERM+ILM peeling group had better BCVA after surgery within 12 months than those in IERM peeling group. But patients in the IERM peeling group showed better BCVA in the 18th month. More retrospective studies or randomized controlled trials are required to investigate and compare the long-term effect of IERM removal with and without ILM peeling.

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Effect of endoscopic resection on short-term surgical outcomes of subsequent laparoscopic gastrectomy: a meta-analysis

World Journal of Surgical Oncology ◽

10.1186/s12957-021-02230-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Dong Peng ◽

Yu-Xi Cheng ◽

Gang Liao

Keyword(s):

Endoscopic Resection ◽

Laparoscopic Gastrectomy ◽

Surgical Outcomes ◽

Meta Analysis ◽

Operation Time ◽

Oral Feeding ◽

Cochrane Library ◽

Short Term ◽

Significant Difference ◽

Grade Ii

Abstract Background Endoscopic resection (ER) might affect subsequent laparoscopic gastrectomy (LG) because of the electrical coagulation, but the effect remains controversial. The purpose of this meta-analysis was to analyze the effect of ER on the short-term surgical outcomes of subsequent LG. Materials and methods The PubMed, EMBASE, and Cochrane Library databases were searched to find eligible studies published from inception to March 21, 2021. Short-term surgical outcomes were compared between the ER-LG group and the LG-only group. The registration ID of this current meta-analysis on PROSPERO is CRD42021238031. Results Nine studies involving 3611 patients were included in this meta-analysis. The LG-only group had a higher T stage (T1-T2: OR=2.42, 95% CI=1.09 to 5.34, P=0.03; T3-T4: OR=0.41, 95% CI=0.19 to 0.91, P=0.03) than the ER-LG group. The ER-LG group showed a shorter operation time than the LG-only group (MD=−5.98, 95% CI=−10.99 to −0.97, P=0.02). However, no difference was found in operation time after subgroup analysis of propensity score matching studies. No significant difference was found in intraoperative blood loss, time to first oral feeding, or postoperative hospital stay between the ER-LG group and the LG-only group. And no significance was found in overall complications (OR=1.16, 95% CI=0.89 to 1.50, P=0.27), complications of grade ≥ II (OR=1.11, 95% CI=0.71 to 1.73, P=0.64), complications of grade ≥ III b (OR=1.47, 95% CI=0.49 to 4.43, P=0.49) between the ER-LG group and the LG-only group. Conclusions ER did not affect subsequent LG in terms of short-term outcomes, and the ER-LG group might have a shorter operation time than the LG-only group.

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Insulin Treatment May Increase Adverse Outcomes in Patients With COVID-19 and Diabetes: A Systematic Review and Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2021.696087 ◽

2021 ◽

Vol 12 ◽

Author(s):

Yan Yang ◽

Zixin Cai ◽

Jingjing Zhang

Keyword(s):

Hospital Admission ◽

Insulin Therapy ◽

Large Scale ◽

Insulin Treatment ◽

Meta Analysis ◽

Adverse Outcomes ◽

Cochrane Library ◽

Hospitalization Time ◽

Increased Risk ◽

Significant Difference

Background and ObjectiveRecently, insulin treatment has been found to be associated with increased mortality and other adverse outcomes in patients with coronavirus disease 2019 (COVID-19) and diabetes, but the results remain unclear and controversial, therefore, we conducted this meta-analysis.MethodsFour databases, namely, PubMed, Web of Science, EMBASE and the Cochrane Library, were used to identify all studies concerning insulin treatment and the adverse effects of COVID-19, including mortality, incidence of severe/critical complications, in-hospital admission and hospitalization time. To assess publication bias, funnel plots, Begg’s tests and Egger’s tests were used. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to access the effect of insulin therapy on mortality, severe/critical complications and in-hospital admission. The association between insulin treatment and hospitalization time was calculated by the standardized mean difference (SMD) with 95% CIs.ResultsEighteen articles, involving a total of 12277 patients with COVID-19 and diabetes were included. Insulin treatment was significantly associated with an increased risk of mortality (OR=2.10; 95% CI, 1.51-2.93) and incidence of severe/critical COVID-19 complications (OR=2.56; 95% CI, 1.18-5.55). Moreover, insulin therapy may increase in-hospital admission in patients with COVID-19 and diabetes (OR=1.31; 95% CI, 1.06-1.61). However, there was no significant difference in the hospitalization time according to insulin treatment (SMD=0.21 95% CI, -0.02-0.45).ConclusionsInsulin treatment may increase mortality and severe/critical complications in patients with COVID-19 and diabetes, but more large-scale studies are needed to confirm and explore the exact mechanism.

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The predictive value of lymphocyte-to-monocyte ratio in the prognosis of acute coronary syndrome patients: A systematic review and meta-analysis

10.21203/rs.2.17238/v2 ◽

2020 ◽

Author(s):

Xiao-Qing Quan ◽

Run-Chang Wang ◽

Qing Zhang ◽

Cun-Tai Zhang ◽

Lei Sun

Keyword(s):

Systematic Review ◽

Acute Coronary Syndrome ◽

Meta Analysis ◽

Cochrane Library ◽

Short Term ◽

Coronary Syndrome ◽

Lymphocyte To Monocyte Ratio ◽

Short Term Mortality ◽

Long Term Mortality

Abstract Background: The association between the lymphocyte-to-monocyte ratio (LMR) and prognosis of patients with acute coronary syndrome (ACS) is not fully understood. We performed this systematic review and meta-analysis to evaluate the correlation between LMR and mortality or major adverse cardiac events (MACE) in patients with ACS. Methods: A systematic search was performed in PubMed, MEDLINE, EMBASE, the Cochrane Library, Scopus and Web of science. The association between LMR and mortality or MACE was analyzed in patients with ACS. The search was updated to April 15, 2020. Results: A total of 5 studies comprising 4343 patients were included in this meta-analysis. The results showed that lower LMR predicted short-term mortality/MACE (hazard ratio [HR] = 3.44, 95% confidence interval [CI]: 1.46–8.14, P < 0.05) and higher long-term mortality/MACE (HR = 1.70, 95% CI: 1.36– 2.13, P < 0.05). According to our subgroup analysis, there is still has a statistical significance for LMR to predict long-term mortality/MACE in any subgroups. Conclusions: This study suggested that lower LMR value might be associated with higher short-term mortality/MACE and long-term mortality/MACE in ACS patients. Especially for younger ACS patients, low LMR was more closely associated with poor prognosis.

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Is arthroscopic decompression better than conservative management for shoulder impingement? A systematic review and meta-analysis

10.21203/rs.2.15903/v1 ◽

2019 ◽

Author(s):

Shujing Liu ◽

Yingying Yu ◽

Guangxu Lu ◽

Hui Dong ◽

Wenliang Wang

Keyword(s):

Conservative Treatment ◽

Conservative Management ◽

Meta Analysis ◽

Arthroscopic Surgery ◽

Shoulder Function ◽

Controlled Trials ◽

Short Term ◽

Shoulder Impingement ◽

Significant Difference

Abstract Background Arthroscopic decompression is commonly used to treat shoulder impingement, while the role of conservative treatment in these patients remains unclear. The objective of this paper is to synthesise available evidence regarding the effectiveness of subacromial decompression for shoulder impingement compared with conservative treatment to verify whether arthroscopic surgery is superior to conservative treatment. Methods We systematicly retrieved the Cochrane databases, Embase as well as Pubmed (from inception to July. 02, 2019) for randomized controlled trials. Cochrane risk-of-bias tool was used to assess all referred studies’ quality and we pooled outcomes with a random-effects model. We divided the outcomes into short-term subgroup(<2 years) and long-term subgroup (≥2 years). Results 7 randomised controlled trials (RCTs) were included, involving a total of 607 patients, 297 patients operated arthroscopic decompression, compared to 310 patients treated with conservative management. We found no significant differences either in shoulder pain scores or shoulder function scores between arthroscopic decompression and conservative management wether in long-term or short-term follow-up subgroups. Conclusion No significant difference was demonstrated on the treatment outcomes of shoulder impingement between arthroscopic decompression and conservative management in our meta-analysis. Thus, we suggested that conservative management should be chosen firstly for patients with shoulder impingement, when patients’ symptom cannot be relieved from the conservative treatment, arthroscopic decompression should be taken into consideration.Levels of Evidence Level-I study

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Reproducibility and Variability of Protein Analytes Measured Using a Multiplexed Modified Aptamer Assay

The Journal of Applied Laboratory Medicine ◽

10.1373/jalm.2018.027086 ◽

2019 ◽

Vol 4 (1) ◽

pp. 30-39 ◽

Cited By ~ 4

Author(s):

Adrienne Tin ◽

Bing Yu ◽

Jianzhong Ma ◽

Kunihiro Masushita ◽

Natalie Daya ◽

...

Keyword(s):

Large Scale ◽

Intraclass Correlation ◽

Principal Component ◽

Short Term ◽

Atherosclerosis Risk In Communities ◽

Significant Difference ◽

Aptamer Assay ◽

Aric Study ◽

Protein Analytes

Abstract Background There is growing interest in the use of multiplexed aptamer-based assays for large-scale proteomic studies. However, the analytic, short- and long-term variation of the measured proteins is largely uncharacterized. Methods We quantified 4001 plasma protein analytes from 42 participants in the Atherosclerosis Risk in Communities (ARIC) Study in split samples and at multiple visits using a multiplexed modified aptamer assay. We calculated the CV, Spearman correlation, and intraclass correlation (ICC) between split samples and evaluated the short-term (4–9 weeks) and long-term (approximately 20 years) variability using paired t-tests with log-transformed protein concentrations and Bonferroni-corrected significance thresholds. We performed principal component (PC) analysis of protein analyte concentrations and evaluated their associations with age, sex, race, and estimated glomerular filtration rate (eGFR). Results The mean baseline age was 57 years at the first visit, 43% of participants were male and 57% were white. Among 3693 protein analytes that passed quality control, half (n = 1846) had CVs < 5.0%, Spearman correlations > 0.89, and ICCs > 0.96 among the split samples. Over the short term, only 1 analyte had a statistically significant difference between the 2 time points, whereas, over approximately 20 years, 866 analytes (23.4%) had statistically significant differences (P < 1.4 × 10−5, 681 increased, 185 decreased). PC1 had high correlations with age (−0.73) and eGFR (0.60). PC2 had moderate correlation with male sex (0.18) and white race (0.31). Conclusions Multiplexed modified aptamer technology can assay thousands of proteins with excellent precision. Our results support the potential for large-scale studies of the plasma proteome over the lifespan.

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