scholarly journals Mesothelin as a biomarker for ovarian carcinoma: a meta-analysis

2016 ◽  
Vol 88 (2) ◽  
pp. 923-932 ◽  
Author(s):  
KRISTIAN MADEIRA ◽  
EDUARDO R. DONDOSSOLA ◽  
BRUNA F. DE FARIAS ◽  
CARLA S. SIMON ◽  
MARIA C.M. ALEXANDRE ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Ovarian Tissue ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Cochrane Central Register ◽  
Central Register ◽  
Quantitative Systematic Review ◽  
Comprehensive Search ◽  
Sensitivity Specificity

The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.

scholarly journals The use of intraoperative triggered electromyography to detect misplaced pedicle screws: a systematic review and meta-analysis

2016 ◽  
Vol 24 (4) ◽  
pp. 624-638 ◽  
Author(s):  
Anthony L. Mikula ◽  
Seth K. Williams ◽  
Paul A. Anderson
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Pedicle Screws ◽  
High Specificity ◽  
Cochrane Central Register ◽  
Central Register ◽  
Current Threshold ◽  
Roc Area ◽  
Sensitivity Specificity

OBJECT Insertion of instruments or implants into the spine carries a risk for injury to neural tissue. Triggered electromyography (tEMG) is an intraoperative neuromonitoring technique that involves electrical stimulation of a tool or screw and subsequent measurement of muscle action potentials from myotomes innervated by nerve roots near the stimulated instrument. The authors of this study sought to determine the ability of tEMG to detect misplaced pedicle screws (PSs). METHODS The authors searched the US National Library of Medicine, the Web of Science Core Collection database, and the Cochrane Central Register of Controlled Trials for PS studies. A meta-analysis of these studies was performed on a per-screw basis to determine the ability of tEMG to detect misplaced PSs. Sensitivity, specificity, and receiver operating characteristic (ROC) area under the curve (AUC) were calculated overall and in subgroups. RESULTS Twenty-six studies were included in the systematic review. The authors analyzed 18 studies in which tEMG was used during PS placement in the meta-analysis, representing data from 2932 patients and 15,065 screws. The overall sensitivity of tEMG for detecting misplaced PSs was 0.78, and the specificity was 0.94. The overall ROC AUC was 0.96. A tEMG current threshold of 10–12 mA (ROC AUC 0.99) and a pulse duration of 300 µsec (ROC AUC 0.97) provided the most accurate testing parameters for detecting misplaced screws. Screws most accurately conducted EMG signals (ROC AUC 0.98). CONCLUSIONS Triggered electromyography has very high specificity but only fair sensitivity for detecting malpositioned PSs.

Use of opioids in patients with cancer with hepatic impairment—a systematic review

2021 ◽  
pp. bmjspcare-2021-003065
Author(s):  
Lewis Thomas Hughes ◽  
David Raftery ◽  
Paul Coulter ◽  
Barry Laird ◽  
Marie Fallon
Keyword(s):  
Systematic Review ◽  
Cancer Pain ◽  
Hepatic Impairment ◽  
Evaluation System ◽  
Meta Analysis ◽  
Hepatic Function ◽  
Cochrane Central Register ◽  
Assessment Development ◽  
Patients With Cancer ◽  
Central Register

PurposeOpioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in patients with cancer with hepatic impairment.MethodsA systematic review was conducted and the following databases searched: AMED (−2021), MEDLINE (−2021), EMBASECLASSIC + EMBASE (−2021) and Cochrane Central Register of Controlled Trials (−2021). Eligible studies met the following criteria: patients with cancer-related pain, taking an opioid (as defined by the WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents); >18 years of age; patients with hepatic impairment defined using recognised or study-defined definitions; clinical outcome hepatic impairment related; and primary studies. All eligible studies were appraised using the Grading of Recommendations Assessment, Development and Evaluation system.ResultsThree studies (n=95) were eligible but heterogeneity meant meta-analysis was not possible. Each individual study focused on only one each of oxycodone±hydrocotarnine, oxycodone/naloxone and morphine. No recommendations could be formulated on the preferred opioid in patients with hepatic impairment.ConclusionsMorphine is the preferred opioid in hepatic impairment owing to clinical experience and pharmacokinetics. This review, however, found little clinical evidence to support this. Dose adjustments of morphine and the oxycodone formulations reviewed remain necessary in the absence of quality evidence. Overall, the quality of existing evidence on opioid treatments in cancer pain and hepatic impairment is low and there remains a need for high-quality clinical studies examining this.

scholarly journals Comparison of conventional, doppler and contrast-enhanced ultrasonography in differential diagnosis of ovarian masses: a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e052830
Author(s):  
Lizhang Xun ◽  
Lamei Zhai ◽  
Hui Xu
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Data Extraction ◽  
Meta Analysis ◽  
Diagnostic Value ◽  
Doppler Us ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Sensitivity Specificity ◽  
Ovarian Masses

ObjectivesTo assess the value of conventional, Doppler and contrast-enhanced ultrasonography (CEUS) (conventional ultrasonography (US), Doppler US and CEUS) for diagnosing ovarian cancer.DesignSystematic review and meta-analysis.Data sourcesPubMed, Embase and the Cochrane Library were conducted for studies published until October 2021.Eligibility criteriaStudies assessed the diagnostic value of conventional US, Doppler US or CEUS for detecting ovarian cancer, with no restrictions placed on published language and status.Data extraction and synthesisThe study selection and data extraction were performed by two independent authors. The sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), diagnostic OR (DOR) and area under the receiver operating characteristic curve (AUC) were pooled using the bivariate generalised linear mixed model and random effects model.ResultsThe meta-analysis included 72 studies and involved 9296 women who presented with ovarian masses. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for conventional US were 0.91 (95% CI: 0.87 to 0.94) and 0.87 (95% CI: 0.82 to 0.91), 6.87 (95% CI: 4.98 to 9.49) and 0.10 (95% CI: 0.07 to 0.15), 57.52 (95% CI: 36.64 to 90.28) and 0.95 (95% CI: 0.93 to 0.97), respectively. The sensitivity, specificity, PLR, NLR, DOR and AUC for Doppler US were 0.93 (95% CI: 0.91 to 0.95) and 0.85 (95% CI: 0.80 to 0.89), 6.10 (95% CI: 4.59 to 8.11) and 0.08 (95% CI: 0.06 to 0.11), 61.76 (95% CI: 39.99 to 95.37) and 0.96 (95% CI: 0.94 to 0.97), respectively. The pooled sensitivity, specificity, PLR, NLR, DOR and AUC for CEUS were 0.97 (95% CI: 0.92 to 0.99) and 0.92 (95% CI: 0.85 to 0.95), 11.47 (95% CI: 6.52 to 20.17) and 0.03 (95% CI: 0.01 to 0.09), 152.11 (95% CI: 77.77 to 297.51) and 0.99 (95% CI: 0.97 to 0.99), respectively. Moreover, the AUC values for conventional US (p=0.002) and Doppler US (p=0.005) were inferior to those of CEUS.ConclusionsConventional US, Doppler US and CEUS have a relatively high differential diagnostic value for differentiating between benign and malignant ovarian masses. The diagnostic performance of CEUS was superior to that of conventional US and Doppler US.

Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta-analysis

2022 ◽  
pp. 019459982110677
Author(s):  
Firas Sbeih ◽  
Malek H. Bouzaher ◽  
Swathi Appachi ◽  
Seth Schwartz ◽  
Michael S. Cohen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochlear Implants ◽  
Cochlear Implantation ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Ovid Medline ◽  
Central Register ◽  
Data Source ◽  
Anesthetic Complications ◽  
Full Text Screening

Objective To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger. Data Source Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021. Review Methods Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias. Results The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies. Conclusion The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.

scholarly journals Prognostic Value of N-terminal Probrain Natriuretic Peptide for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Qi Ni ◽  
Chaoqian Li ◽  
Hua Lin
Keyword(s):  
Systematic Review ◽  
Acute Respiratory Distress Syndrome ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Sensitivity Specificity

Objectives. The mortality rate of patients with acute respiratory distress syndrome (ARDS) is high. Hence, it is crucial to identify a reliable biomarker with wide clinical applications for predicting the prognosis of patients with ARDS. This systematic review and meta-analysis was conducted to investigate the value of plasma N-terminal probrain natriuretic peptide (NT-proBNP) for predicting mortality in patients with ARDS. Methods. An electronic search of databases including PubMed, Web of Science, Cochrane Library, and Chinese National Knowledge Infrastructure was conducted up to May 31, 2019, without language restrictions. The quality of the included studies was evaluated using QUADAS-2. Data were extracted and analyzed to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. A forest graph was used to evaluate heterogeneity. Potential causes of heterogeneity were further explored by subgroup analysis based on the testing day, testing method, observation endpoint, or cut-off points. A summary receiver operating characteristic curve was drawn to obtain the pooled area under the curve. Results. A total of 7 studies involving 581 patients with ARDS were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were as follows: 0.79 (95% CI: 0.72–0.84), 0.79 (95% CI: 0.66–0.88), 3.68 (95% CI: 2.16–6.28), 0.27 (95% CI: 0.20–0.38), and 13.58 (95% CI: 6.17–29.90), respectively. The results of subgroup analysis showed that the testing day influenced the summary sensitivity and that the cut-off points influenced the summary sensitivity and specificity. Conclusion. Our results indicate that elevated plasma NT-proBNP levels have a moderate value for predicting the mortality of patients with ARDS.

scholarly journals Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e014611 ◽  
Author(s):  
Caio Chaves Guimaraes ◽  
Rogério Heládio Lopes Motta ◽  
Cristiane de Cássia Bergamaschi ◽  
Jimmy de Oliveira Araújo ◽  
Natalia Karol de Andrade ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Data Extraction ◽  
Meta Analysis ◽  
Local Anaesthetics ◽  
Cochrane Central Register ◽  
Assessment Development ◽  
Dental Procedures ◽  
Central Register ◽  
Registration Number

IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes.Method/designTrials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors. The research will be conducted in the electronic databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Healthstar (via Ovid), Cumulative Index to Nursing and Allied Health Literature and Web of Science, from their inception to December 2017, without any restrictions in terms of language and status of publication. A team of reviewers will independently assess titles, abstracts and complete text to determine eligibility. For eligible studies, the same reviewers will perform data extraction and evaluate the risk of bias in the selected articles. The selected outcomes comprise death, mortality by a specific cause, stroke, acute myocardial infarction, hospitalisation, pain, bleeding, arrhythmias, ischaemic episodes, anxiety, adverse effects, changes in blood pressure, changes in heart rate, anxiety and results obtained via oximetry. Whenever possible, we will conduct a meta-analysis to establish the effects of LAs with and without vasoconstrictors in the patients with CVD, and the overall quality of evidence for each outcome will be determined using the Grading of Recommendations Assessment, Development and Evaluation classification system.Ethics and disseminationEthics committee approval was not necessary because this is a protocol of systematic review. This systematic review will be submitted for presentation at conferences and for publication in a peer-reviewed journal. Our review will assess the risks of cardiovascular events when using LAs with and without vasoconstrictors in patients with CVD, focusing on important clinical outcomes.PROSPERO registration numberCRD42016045421.

Effect of Obesity on Survival of Women With Epithelial Ovarian Cancer: A Systematic Review and Meta-Analysis of Observational Studies

2011 ◽  
Vol 21 (9) ◽  
pp. 1525-1532 ◽  
Author(s):  
Hyun-Sik Yang ◽  
Chan Yoon ◽  
Seung-Kwon Myung ◽  
Sang Min Park
Keyword(s):  
Ovarian Cancer ◽  
Confidence Interval ◽  
Epithelial Ovarian Cancer ◽  
Meta Analysis ◽  
Early Adulthood ◽  
Harmful Effect ◽  
Advanced Ovarian Cancer ◽  
Final Analysis ◽  
Cochrane Central Register ◽  
Central Register

ObjectiveAlthough obesity is shown to be a risk factor for epithelial ovarian cancer, its role as a prognostic factor has been remained inconclusive. In this study, available evidences on this matter to date have been assembled for a meta-analysis to determine the effect of obesity on the survival of patients with epithelial ovarian cancer.Materials and MethodsEligible studies published up to December 2010 were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, and manual review of relevant bibliography to look for additional studies was done. Adjusted hazard ratios (HRs) from individual studies were pooled using a random-effects model.ResultsTen cohort studies of 331 screened articles were included in the final analysis. The meta-analysis showed overweight or obesity at early adulthood to be associated with higher mortality among patients with ovarian cancer (HR, 1.60; 95% confidence interval, 1.10–2.34). Among patients with advanced ovarian cancer, premorbid obesity was associated with worse prognosis (HR, 1.45; 95% confidence interval, 1.09–1.93). However, there was no significant relationship between prognosis and obesity around the time of diagnosis.ConclusionsThis study suggests a possible relationship between obesity at early adulthood and higher mortality among patients with ovarian cancer. Further studies are needed to elucidate the harmful effect of obesity on the survival of patients with ovarian cancer.

scholarly journals Acupuncture in oncological pain relief: A systematic review of randomized clinical trials

2021 ◽  
Vol 34 ◽  
Author(s):  
Michel Marcos Dalmedico ◽  
Caroline Machado de Toledo ◽  
Paula Karina Hembecker ◽  
Juliana Londero Silva Ávila ◽  
Chayane Karla Lucena de Carvalho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cancer Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Cochrane Central Register ◽  
Opioid Use ◽  
Central Register ◽  
Considerable Impact ◽  
Analgesic Use

Abstract Introduction: Cancer pain has a considerable impact on patients’ health and quality of life, and its treatment is essentially based on opioid use. Objective: To report the effectiveness of acupuncture in relieving cancer pain (secondary to the disease or to the corresponding therapy) or in decreasing opioid use compared to other interventions. Methods: A systematic review of randomized clinical trials was conducted following the guidelines of the Cochrane Handbook for Systematic Reviews of Interventions. The trials were selected from the PubMed, Web of Science, and Cochrane Central Register of Controlled Trials (CENTRAL) databases. Results: The search strategy resulted in the inclusion of eight trials, of which five compared acupuncture and drug therapy and three compared acupuncture and placebo. Seven trials reported decreased pain and analgesic use. The trials showed clinical heterogeneity, making a meta-analysis unfeasible. Conclusion: The findings herein provided no robust evidence to support the routine use of acupuncture as an adjuvant therapy in the treatment of cancer pain. However, its use is promising since the results showed a trend toward decreased pain and analgesic use, thus justifying further studies in the future.

scholarly journals Effects of Kinesio Taping versus McConnell Taping for Patellofemoral Pain Syndrome: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Wen-Dien Chang ◽  
Fu-Chen Chen ◽  
Chia-Lun Lee ◽  
Hung-Yu Lin ◽  
Ping-Tung Lai
Keyword(s):  
Systematic Review ◽  
Motor Function ◽  
Muscle Activity ◽  
Meta Analysis ◽  
Pain Syndrome ◽  
Patellofemoral Pain Syndrome ◽  
Patellofemoral Pain ◽  
Cochrane Central Register ◽  
Kinesio Taping ◽  
Central Register

Objectives. To conduct a systematic review comparing the effects of Kinesio taping with McConnell taping as a method of conservative management of patients with patellofemoral pain syndrome (PFPS).Methods. MEDLINE, PUBMED, EMBASE, AMED, and the Cochrane Central Register of Control Trials electronic databases were searched through July 2014. Controlled studies evaluating the effects of Kinesio or McConnell taping in PFPS patients were retrieved.Results. Ninety-one articles were selected from the articles that were retrieved from the databases, and 11 articles were included in the analysis. The methods, evaluations, and results of the articles were collected, and the outcomes of patellar tapings were analyzed. Kinesio taping can reduce pain and increase the muscular flexibility of PFPS patients, and McConnell taping also had effect in pain relief and patellar alignment. Meta-analysis showed small effect in pain reduction and motor function improvement and moderate effect in muscle activity change among PFPS patients using Kinesio taping.Conclusions. Kinesio taping technique used for muscles can relieve pain but cannot change patellar alignment, unlike McConnell taping. Both patellar tapings are used differently for PFPS patients and substantially improve muscle activity, motor function, and quality of life.

scholarly journals Right versus left thoracic approach oesophagectomy for oesophageal cancer: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e030157
Author(s):  
Tianci Chai ◽  
Zhimin Shen ◽  
Sui Chen ◽  
Yuhan Lin ◽  
Zhenyang Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Oesophageal Cancer ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Malignant Tumours ◽  
Central Register ◽  
Registration Number ◽  
Thoracic Approach ◽  
Randomised Controlled

IntroductionOesophageal cancer is one of the most common malignant tumours and has been identified as one of the leading causes of cancer death worldwide. Surgery is considered to be the optimal treatment for patients with resectable oesophageal cancer. Oesophagectomy for oesophageal cancer can significantly extend the survival period of patients and provide a potential opportunity for a cure. However, there is still controversy regarding which thoracic approach (right or left) during oesophagectomy for oesophageal cancer can lead to better surgical outcomes globally. This systematic review and meta-analysis will be performed to determine which thoracic approach during oesophagectomy will achieve longer patient survival and will be more beneficial for patients.Methods and analysisWe will search PubMed, Web of Science, Embase, Cancerlit, the Cochrane Central Register of Controlled Trials and Google Scholar databases for relevant clinical trials published in any language before 1 October 2019. Randomised controlled trials (RCTs), quasi-RCTs, propensity score-matched comparative studies and prospective cohort studies of interest, published or unpublished, that meet the inclusion criteria will be included. Subgroup analysis of the type of operation, tumour pathological stage and ethnicity will be performed.PROSPERO registration numberCRD42019124133.Ethics and disseminationBecause this study will be based on published or unpublished records and studies, there is no need for ethics approval. The results of the study will be published in a peer-reviewed journal.

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