The impact of urinary incontinence on falls: A systematic review and meta-analysis

Objective Previous studies on the association between urinary incontinence (UI) and falls have reported conflicting results. We, therefore, aimed to evaluate and clarify this association through a systematic review and meta-analysis of relevant studies. Methods We performed a literature search for relevant studies in databases including PubMed and EMBASE from inception up to December 13, 2020, using several search terms related to UI and falls. Based on the data reported in these studies, we calculated the pooled odds ratios (ORs) for falls and the corresponding 95% confidence intervals (CIs) using the Mantel–Haenszel method. Results This meta-analysis included 38 articles and a total of 230,129 participants. UI was significantly associated with falls (OR, 1.62; 95% CI, 1.45–1.83). Subgroup analyses based on the age and sex of the participants revealed a significant association between UI and falls in older (≥65 years) participants (OR, 1.59; 95% CI, 1.31–1.93), and in both men (OR, 1.88; 95% CI, 1.57–2.25) and women (OR, 1.41; 95% CI, 1.29–1.54). Subgroup analysis based on the definition of falls revealed a significant association between UI and falls (≥1 fall event) (OR, 1.61; 95% CI, 1.42–1.82) and recurrent falls (≥2 fall events) (OR, 1.63; 95% CI, 1.49–1.78). According to the UI type, a significant association between UI and falls was observed in patients with urgency UI (OR, 1.76; 95% CI, 1.15–1.70) and those with stress UI (OR, 1.73; 95% CI, 1.39–2.15). Conclusions This meta-analysis, which was based on evidence from a review of the published literature, clearly demonstrated that UI is an important risk factor for falls in both general and older populations.

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Risk of nodal disease in patients with MRI-detected extramural vascular invasion in rectal cancer: a systematic review and meta-analysis

Tumori Journal ◽

10.1177/0300891620975867 ◽

2020 ◽

pp. 030089162097586

Author(s):

Pratik Tripathi ◽

Zhen Li ◽

Yaqi Shen ◽

Xuemei Hu ◽

Daoyu Hu

Keyword(s):

Systematic Review ◽

Rectal Cancer ◽

Lymph Node ◽

Vascular Invasion ◽

Literature Search ◽

Meta Analysis ◽

Adjuvant Chemoradiotherapy ◽

Cochrane Library ◽

Nodal Disease ◽

The Impact

Background: The impact of magnetic resonance imaging–detected extramural vascular invasion (mrEMVI) in distant metastasis is well known but its correlation with prevalence of lymph node metastasis is less studied. The aim of this systematic review and meta-analysis was to assess the prevalence of nodal disease in mrEMVI–positive and negative cases in rectal cancer. Methods: Following guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a systematic literature search in PubMed, Web of Science, Cochrane Library, and EMBase was carried out to identify relevant studies published up to May 2019. Results: Our literature search generated 10 studies (863 and 1212 mrEMVI–positive and negative patients, respectively). The two groups (mrEMVI–positive and negative) were significantly different in terms of nodal disease status (odds ratio [OR] 3.15; 95% confidence interval [CI] 2.12–4.67; p < 0.001). The prevalence of nodal disease was 75.90% vs 52.56% in the positive mrEMVI vs negative mrEMVI group, respectively ( p < 0.001). The prevalence of positive lymph node in positive mrEMVI patients treated with neoadjuvant/adjuvant chemoradiotherapy (nCRT/CRT) (OR 2.47; 95% CI 1.65–3.69; p < 0.001) was less compared with the patients who underwent surgery alone (OR 6.25; 95% CI 3.74–10.44; p < 0.001). Conclusion: The probability of positive lymph nodes in cases of positive mrEMVI is distinctly greater compared with negative cases in rectal cancer. Positive mrEMVI indicates risk of nodal disease prevalence increased by threefold in rectal cancer.

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Gastric ischemic preconditioning may reduce the incidence and severity of anastomotic leakage after οesophagectomy: a systematic review and meta-analysis

Diseases of the Esophagus ◽

10.1093/dote/doaa010 ◽

2020 ◽

Vol 33 (10) ◽

Author(s):

Adamantios Michalinos ◽

Stavros A Antoniou ◽

Dimitrios Ntourakis ◽

Dimitrios Schizas ◽

Konstantinos Ekmektzoglou ◽

...

Keyword(s):

Systematic Review ◽

Anastomotic Leakage ◽

Ischemic Preconditioning ◽

Postoperative Morbidity ◽

Anastomotic Stricture ◽

Meta Analysis ◽

Subgroup Analyses ◽

Preconditioning Technique ◽

Life Threatening ◽

The Impact

Summary Anastomotic leakage after esophagectomy is a severe and life-threatening complication. Gastric ischemic preconditioning is a strategy for the improvement of anastomotic healing. Aim of this systematic review and meta-analysis is to investigate the impact of gastric ischemic preconditioning on postoperative morbidity. A systematic literature search was performed to identify studies comparing patients undergoing gastric ischemic preconditioning before esophagectomy with nonpreconditioned patients. Meta-analysis was conducted for the overall incidence of anastomotic leakage, severe anastomotic leakage, anastomotic stricture, postoperative morbidity, and mortality. Mantel–Haenszel odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Subgroup analyses were performed concerning preconditioning technique, the interval between preconditioning and surgery and the extent of preconditioning. Fifteen cohort studies were identified. Gastric preconditioning was associated with reduced overall incidence of anastomotic leakage (OR 0.73; 95% CI, 0.53–1.0; P = 0.050) and severe anastomotic leakage (OR 0.27; 95% CI, 0.14–0.50; P < 0.010), but not with anastomotic stricture (OR 1.18; 95% CI 0.38 to 3.66; P = 0.780), major postoperative morbidity (OR 1.03; 95% CI 0.45 to 2.36; P = 0.940) or mortality (OR 0.69; 95% CI 0.39 to 1,23; P = 0.210). Subgroup analyses did not identify any differences between embolization and ligation while increasing the interval between preconditioning and esophagectomy as well as the extent of preconditioning might be beneficial. Gastric ischemic preconditioning may be associated with a reduced incidence of overall and severe anastomotic leakage. Randomized studies are necessary to further evaluate its impact on leakage, refine the technique and define patient populations that will benefit the most.

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The impact of platelet-rich plasma on postoperative outcomes after spinal fusion: a systematic review and meta-analysis

Journal of Neurosurgery Spine ◽

10.3171/2020.3.spine2046 ◽

2020 ◽

Vol 33 (4) ◽

pp. 540-547 ◽

Cited By ~ 1

Author(s):

Yagiz Ugur Yolcu ◽

Waseem Wahood ◽

Abdullah T. Eissa ◽

Mohammed Ali Alvi ◽

Brett A. Freedman ◽

...

Keyword(s):

Systematic Review ◽

Bone Graft ◽

Spinal Fusion ◽

Literature Search ◽

Platelet Rich Plasma ◽

Meta Analysis ◽

Significant Difference ◽

Patient Reported ◽

Vas Scores ◽

The Impact

OBJECTIVEPlatelet-rich plasma (PRP) is a biological agent obtained by centrifuging a sample of blood and retrieving a high concentration of platelets and plasma components. The concentrate is then stimulated for platelet secretion of various growth factors and cytokines. Although it is not widely used in clinical practice, its role in augmenting bony union among patients undergoing spinal fusion has been assessed in several clinical studies. The objective of this study was to perform a systematic review and meta-analysis of the existing literature to determine the efficacy of PRP use in spinal fusion procedures.METHODSA comprehensive literature search was conducted using PubMed, Scopus, and EMBASE for studies from all available dates. From eligible studies, data regarding the fusion rate and method of assessing fusion, estimated blood loss (EBL), and baseline and final visual analog scale (VAS) scores were collected as the primary outcomes of interest. Patients were grouped by those undergoing spinal fusion with PRP and bone graft (PRP group) and those only with bone graft (graft-only group).RESULTSThe literature search resulted in 207 articles. Forty-five full-text articles were screened, of which 11 studies were included, resulting in a meta-analysis including 741 patients. Patients without PRP were more likely to have a successful fusion at the last follow-up compared with those with PRP in their bone grafts (OR 0.53, 95% CI 0.34–0.84; p = 0.006). There was no statistically significant difference with regard to change in VAS scores (OR 0.00, 95% CI −2.84 to 2.84; p > 0.99) or change in EBL (OR 3.67, 95% CI −67.13–74.48; p = 0.92) between the groups.CONCLUSIONSThis study found that the additional use of PRP was not associated with any significant improvement in patient-reported outcomes and was actually found to be associated with lower fusion rates compared with standard grafting techniques. Thus, PRP may have a limited role in augmenting spinal fusion.

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Incidence of neurotoxicity and ototoxicity with cisplatin vs. non-cisplatin regimens: A meta-analysis with subgroup analyses based on renal eligibility criteria.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e15555 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e15555-e15555

Author(s):

Brandon Kyle Bellows ◽

Arati Dahal ◽

Matt D. Galsky ◽

Guru Sonpavde ◽

Neeraj Agarwal

Keyword(s):

Observational Studies ◽

Literature Search ◽

Randomized Trials ◽

Meta Analysis ◽

Phase 1 ◽

Exclusion Criteria ◽

Eligibility Criteria ◽

Subgroup Analyses ◽

Grade 3 ◽

The Impact

e15555 Background: Using glomerular filtration rate (GFR) to screen patients for trial eligibility may reduce the risk of cisplatin (CIS) associated nephrotoxicity compared to serum creatinine (SCr). The impact of using GFR or SCr on incidence of neurotoxicity and ototoxicity remains unknown. This meta-analysis compared incidence of neurotoxicity and ototoxicity among trials of solid tumors treated with CIS reporting nephrotoxicity when renal function was assessed using SCr or GFR. Methods: A PubMed literature search identified randomized trials comparing CIS to non-CIS containing chemotherapy regimens. Studies were included if performed from 1990-2010, used SCr or GFR as eligibility criteria, and reported incidence of WHO or NCI grade ≥3 nephrotoxic events. Separate analyses were performed on studies reporting grade ≥3 neurotoxic or ototoxic events. For neurotoxicity, studies comparing CIS to other neurotoxic drugs were excluded. Review articles, observational studies, phase 1 studies, non-randomized trials, studies without a comparator group, or studies not reported in English were excluded. Relative risk (RR) associated with CIS vs. non-CIS regimens was calculated and subgroup analyses were performed for studies using SCr, GFR, and either SCr or GFR for screening. Results: The literature search identified 2359 studies with 18 studies meeting all inclusion and exclusion criteria for neurotoxicity (N=3441 patients) and 9 for ototoxicity (N=2947). The RR for developing neurotoxicity was 1.27 (p=0.50) and ototoxicity was 2.32 (p=0.10) for CIS vs. non-CIS regimens. For neurotoxicity, the RR when SCr was used as eligibility criteria was 2.31 (p=0.11), 0.71 (p=0.54) when GFR was used, and 1.01 (p=0.99) when either was used. For ototoxicity, the RR for SCr was 2.33 (p=0.21) and 3.47 (p=0.20) for either. Studies using GFR reported zero ototoxic events. Conclusions: The risk of neurotoxicity and ototoxicity did not significantly change when SCr or GFR was used to screen patients. However, these analyses were performed on a subgroup of studies reporting nephrotoxicity and further research on all studies of neurotoxicity and ototoxicity is warranted.

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The impact of bariatric surgery on urinary incontinence: a systematic review and meta-analysis

International Urogynecology Journal ◽

10.1007/s00192-018-03865-x ◽

2019 ◽

Vol 30 (8) ◽

pp. 1225-1237 ◽

Cited By ~ 2

Author(s):

Bhawana Purwar ◽

Rufus Cartwright ◽

Geraldo Cavalcanti ◽

Giuseppe Alessandro Digesu ◽

Ruwan Fernando ◽

...

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Urinary Incontinence ◽

Meta Analysis ◽

The Impact

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Re: The Impact of Bariatric Surgery on Urinary Incontinence: A Systematic Review and Meta-Analysis

The Journal of Urology ◽

10.1097/01.ju.0000614924.61809.83 ◽

2020 ◽

Vol 203 (2) ◽

pp. 260-261

Author(s):

Alan J. Wein

Keyword(s):

Systematic Review ◽

Bariatric Surgery ◽

Urinary Incontinence ◽

Meta Analysis ◽

The Impact

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Do smartphone applications and activity trackers increase physical activity in adults? Systematic review, meta-analysis and metaregression

British Journal of Sports Medicine ◽

10.1136/bjsports-2020-102892 ◽

2020 ◽

pp. bjsports-2020-102892

Author(s):

Liliana Laranjo ◽

Ding Ding ◽

Bruno Heleno ◽

Baki Kocaballi ◽

Juan C Quiroz ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Text Messaging ◽

Data Extraction ◽

Meta Analysis ◽

Vigorous Physical Activity ◽

Mobile App ◽

Metabolic Equivalents ◽

Subgroup Analyses ◽

The Impact

ObjectiveTo determine the effectiveness of physical activity interventions involving mobile applications (apps) or trackers with automated and continuous self-monitoring and feedback.DesignSystematic review and meta-analysis.Data sourcesPubMed and seven additional databases, from 2007 to 2020.Study selectionRandomised controlled trials in adults (18–65 years old) without chronic illness, testing a mobile app or an activity tracker, with any comparison, where the main outcome was a physical activity measure. Independent screening was conducted.Data extraction and synthesisWe conducted random effects meta-analysis and all effect sizes were transformed into standardised difference in means (SDM). We conducted exploratory metaregression with continuous and discrete moderators identified as statistically significant in subgroup analyses.Main outcome measuresPhysical activity: daily step counts, min/week of moderate-to-vigorous physical activity, weekly days exercised, min/week of total physical activity, metabolic equivalents.ResultsThirty-five studies met inclusion criteria and 28 were included in the meta-analysis (n=7454 participants, 28% women). The meta-analysis showed a small-to-moderate positive effect on physical activity measures (SDM 0.350, 95% CI 0.236 to 0.465, I2=69%, T2=0.051) corresponding to 1850 steps per day (95% CI 1247 to 2457). Interventions including text-messaging and personalisation features were significantly more effective in subgroup analyses and metaregression.ConclusionInterventions using apps or trackers seem to be effective in promoting physical activity. Longer studies are needed to assess the impact of different intervention components on long-term engagement and effectiveness.

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