scholarly journals Comparison of the effect of mesh-plug, Lichtenstein, transabdominal preperitoneal, and totally extraperitoneal hernia repair: A network meta-analysis

2020 ◽  
Vol 66 (5) ◽  
pp. 687-691
Author(s):  
Yi-Hua Shi ◽  
De-Shuang Xiao ◽  
Ling-Bo Dai ◽  
Qian Fang
Keyword(s):  
Hernia Repair ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Operation Time ◽  
Cochrane Collaboration ◽  
Cochrane Library ◽  
Mesh Plug ◽  
Totally Extraperitoneal ◽  
Transabdominal Preperitoneal ◽  
Randomized Controlled Studies

SUMMARY OBJECTIVE To compare Mesh-plug, Lichtenstein, transabdominal preperitoneal (TAPP), and totally extraperitoneal (TEP) repairs in regards to operation time, seroma, infection, and recurrence of inguinal hernia repair. METHODS Relevant literature was searched in the Cochrane Library, Pubmed, and Embase. Furthermore, the analysis of randomized controlled studies (RCTs) was performed using methods recommended by the Cochrane Collaboration. The main outcomes including operation time, seroma, infection, and recurrence were evaluated. RESULTS A total of 38 RCTs with 3255 patients were included in the meta-analysis. In addition, the comparison between Mesh-plug, Lichtenstein, TAPP, and TEP showed the differences were not significant regarding operation time, seroma, infection, and recurrence. CONCLUSIONS Meta-analysis suggests that Mesh-plug, Lichtenstein, TAPP, and TEP are comparable in the outcomes of hernia repair, such as operation time, seroma, infection, and recurrence.

scholarly journals Microscopic Versus Endoscopic Stapes Surgery: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
JIANNIS HAJIIOANNOU ◽  
Eleni Gkrinia ◽  
Konstantinos Tzimkas-Dakis ◽  
Effrosyni Palla ◽  
Alexandros Brotis ◽  
...  
Keyword(s):  
Success Rate ◽  
Meta Analysis ◽  
Operation Time ◽  
Stapes Surgery ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Quality Of Evidence ◽  
Randomized Controlled Studies ◽  
Significant Difference

Objectives Endoscopic approaches constitute a newly introduced and promising technique in the field of stapes surgery, presenting favorable outcomes, so far. This study aims to compare endoscopic and microscopic stapes surgery based on current literature evidence, in terms of their efficacy and safety characteristics. Design We conducted a systematic literature search of three medical databases (Pubmed, Cochrane Library, and Scopus). We focused on randomized controlled studies or observational studies comparing microscopic to endoscopic stapes surgery. Data related to the efficacy and safety of each technique were extracted. Outcome data were summarized using the pooled mean differences or pooled odds ratio along with their 95% confidence intervals, according to the available data. The quality of evidence was assessed according to the GRADE recommendations. Results Thirteen studies with 705 patients were included in the meta-analysis. Success rate was evaluated by estimating air-bone gap improvement, resulting in comparable outcomes for the two techniques (mean difference: -0.20; 95% CI: -0.53, 0.14). No statistically significant difference was detected concerning postoperative complications, except for dysgeusia that was in favor of the endoscopic approach (OR: -1.46; 95% CI: -2.45, -.047). The overall quality of evidence was assessed to range from “Low” to “Very Low”. Conclusion Endoscopic stapes surgery is an innovative alternative to the microscopic technique, resulting in commensurate outcomes in terms of success rate and complications. Further high-quality studies are needed, to adequately compare the two approaches, particularly in terms of operation time, learning curve, cost-effectiveness, and otology surgical skills acquisition.

scholarly journals Mitochondrial transplantation therapy for ischemia reperfusion injury: a systematic review of animal and human studies

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Kei Hayashida ◽  
Ryosuke Takegawa ◽  
Muhammad Shoaib ◽  
Tomoaki Aoki ◽  
Rishabh C. Choudhary ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reperfusion Injury ◽  
Animal Studies ◽  
Ischemia Reperfusion Injury ◽  
Myocardial Dysfunction ◽  
Ischemia Reperfusion ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Human Studies ◽  
Cochrane Library

Abstract Background Mitochondria are essential organelles that provide energy for cellular functions, participate in cellular signaling and growth, and facilitate cell death. Based on their multifactorial roles, mitochondria are also critical in the progression of critical illnesses. Transplantation of mitochondria has been reported as a potential promising approach to treat critical illnesses, particularly ischemia reperfusion injury (IRI). However, a systematic review of the relevant literature has not been conducted to date. Here, we systematically reviewed the animal and human studies relevant to IRI to summarize the evidence for mitochondrial transplantation. Methods We searched MEDLINE, the Cochrane library, and Embase and performed a systematic review of mitochondrial transplantation for IRI in both preclinical and clinical studies. We developed a search strategy using a combination of keywords and Medical Subject Heading/Emtree terms. Studies including cell-mediated transfer of mitochondria as a transfer method were excluded. Data were extracted to a tailored template, and data synthesis was descriptive because the data were not suitable for meta-analysis. Results Overall, we identified 20 animal studies and two human studies. Among animal studies, 14 (70%) studies focused on either brain or heart IRI. Both autograft and allograft mitochondrial transplantation were used in 17 (85%) animal studies. The designs of the animal studies were heterogeneous in terms of the route of administration, timing of transplantation, and dosage used. Twelve (60%) studies were performed in a blinded manner. All animal studies reported that mitochondrial transplantation markedly mitigated IRI in the target tissues, but there was variation in biological biomarkers and pathological changes. The human studies were conducted with a single-arm, unblinded design, in which autologous mitochondrial transplantation was applied to pediatric patients who required extracorporeal membrane oxygenation (ECMO) for IRI–associated myocardial dysfunction after cardiac surgery. Conclusion The evidence gathered from our systematic review supports the potential beneficial effects of mitochondrial transplantation after IRI, but its clinical translation remains limited. Further investigations are thus required to explore the mechanisms of action and patient outcomes in critical settings after mitochondrial transplantation. Systematic review registration The study was registered at UMIN under the registration number UMIN000043347.

scholarly journals Intravenous dexmedetomidine during spinal anaesthesia for caesarean section: A meta-analysis of randomized trials

2017 ◽  
Vol 45 (3) ◽  
pp. 924-932 ◽  
Author(s):  
Zeqing Bao ◽  
Chengmao Zhou ◽  
Xianxue Wang ◽  
Yu Zhu
Keyword(s):  
Caesarean Section ◽  
Spinal Anaesthesia ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Relevant Literature ◽  
Nausea And Vomiting ◽  
Cochrane Library ◽  
Control Group ◽  
Efficacy And Safety ◽  
The Cochrane Library

Objective To evaluate the efficacy and safety of spinal anaesthesia using dexmedetomidine for caesarean section. Methods PubMed, The Cochrane Library, and CNKI were searched for relevant literature. Results The incidence of nausea and vomiting in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.21, 95% CI: 0.12–0.35, P < 0.00001). No difference was found in the incidence of pruritus between the two groups (OR = 1.21, 95% CI: 0.36–4.09, P = 0.76).The dexmedetomidine group had a higher incidence of bradycardia than did the control group (OR = 2.20, 95% CI: 1.02–4.77, P = 0.05). The incidence of shivering in the dexmedetomidine group was significantly lower than that in the control group (OR = 0.20, 95% CI: 0.13–0.32, P < 0.00001). The incidence of hypotension was not different between the two groups (OR = 0.88, 95% CI: 0.49–1.56, P = 0.65). Conclusion Dexmedetomidine can decrease the incidence of nausea, vomiting, bradycardia, and shivering with spinal anaesthesia during caesarean section.

scholarly journals The Role of L-ornithine-L-aspartate in the Management of Minimal Hepatic Encephalopathy among Patients with Liver cirrhosis: a Systemic review and Meta-analysis

2018 ◽  
Vol 52 (1) ◽  
Author(s):  
Henry Winston C. Li ◽  
Maria Ana Louise M. Naidas ◽  
Karen Anjela M. Mondragon ◽  
Ruter M. Maralit
Keyword(s):  
Liver Cirrhosis ◽  
Hepatic Encephalopathy ◽  
Meta Analysis ◽  
Block Design ◽  
Cochrane Collaboration ◽  
Minimal Hepatic Encephalopathy ◽  
Systemic Review ◽  
Cochrane Library ◽  
P Value ◽  
Picture Completion

Objective. To evaluate the efficacy of L-ornithine-L-aspartate (LOLA) in improving minimal hepatic encephalopathy in adult patients with liver cirrhosis. Methods. A search in PubMed, Cochrane Library, Google Scholar, and Medline was made obtaining four qualified randomized controlled trials. Studies included adult cirrhotic patients with minimal hepatic encephalopathy measured by the number connection test (NCT-A, B), figure connection test (FCT-A, B), picture completion, block design test, and critical flicker frequency (CFF) testing with a cut-off score of <39Hz. Methodologic assessment of studies was performed using Cochrane Collaboration Risk of Bias Tool and Review Manager (RevMan) version 5.3 for statistical analysis. Results. Of the 29 studies identified, 4 fulfilled the inclusion criteria, which entailed analysis of 238 participants (LOLA: 116, Control: 122). Three out of the four studies were used in meta-analysis and one study was analyzed separately due to a difference in the neuropsychometric measure. The metaanalysis favored experimental group (LOLA), with a mean difference of 2.29 (95% CI 0.72 – 3.86), p-value = 0.004, and an I2 of 18%. Conclusion. LOLA provided great potential in managing encephalopathy since treating earlier related to better survival and prevention of disease progression. The results of our study supported such evidence and its use may be encouraged.

scholarly journals The Role of Local Bupivacaine Irrigation in Postoperative Pain Control After Augmentation Mammoplasty: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 25 (1) ◽  
pp. 32-39
Author(s):  
Shan Shan Qiu ◽  
Marta Roque ◽  
Yi-Chieh Chen
Keyword(s):  
Systematic Review ◽  
Postoperative Pain ◽  
Normal Saline ◽  
Pain Control ◽  
Meta Analysis ◽  
A Priori ◽  
Cochrane Collaboration ◽  
Cochrane Library ◽  
Augmentation Mammoplasty ◽  
Mesh Terms

Background: The objective of this study is to analyze the efficacy of local bupivacaine irrigation after augmentation mammoplasty for the control of postoperative pain. Methods: A systematic review and meta-analysis was conducted including all randomized controlled trials (RCTs) that compared the irrigation of bupivacaine (±ketorolac) versus normal saline or no irrigation for pain control after breast augmentation. The primary outcome was postoperative pain measured by visual analog scale. The study protocol was established a priori according to the recommendations of the Cochrane Collaboration. A bibliographical search was conducted in September 2015 in the following Cochrane Library databases: CENTRAL, MEDLINE, EMBASE, and Scielo. The strategy used for the search was ((augmentation AND (“mammoplasty”[MeSH Terms] OR “mammoplasty”)) OR ((“breast”[MeSH Terms] OR “breast”) AND augmentation)) AND ((“pain, postoperative”[MeSH Terms])). Results: Four RCTs with a total of 264 participants were included. Two trials compared bupivacaine alone versus placebo (normal saline or no irrigation) and 3 trials compared bupivacaine plus ketorolac versus placebo. The combined irrigation of bupivacaine and ketorolac showed a clinically significant reduction of pain in the first postoperative hour and on postoperative day 5. The irrigation with bupivacaine compared with placebo significantly reduced pain assessed on postoperative day 4. Conclusion: The irrigation of bupivacaine with or without ketorolac was associated with a reduction of postoperative pain compared with control groups for the first 5 postoperative days. Due to the few number of trials included, these results should be correlated further clinically.

scholarly journals Safety and efficacy of mycophenolate mofetil in treating neuromyelitis optica spectrum disorders: a protocol for systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040371
Author(s):  
Mengyu Han ◽  
Luqi Nong ◽  
Ziqiang Liu ◽  
You Chen ◽  
Yang Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mycophenolate Mofetil ◽  
Neuromyelitis Optica ◽  
Meta Analysis ◽  
Grey Literature ◽  
Relevant Literature ◽  
Biomedical Literature ◽  
Cochrane Library ◽  
Neuromyelitis Optica Spectrum Disorders ◽  
Spectrum Disorders

IntroductionNeuromyelitis optica spectrum disorders (NMOSD) is an inflammatory and heterogeneous astrocyte disorder of the central nervous system with the characteristic of higher incidence in women and Asian people. Most patients with NMOSD have a course of recurrence and remission that is prone to cause paralysis and blindness. Several studies have confirmed the efficacy and promising prospect of mycophenolate mofetil (MMF) in the treatment of NMOSD. Yet its therapeutic effect and safety are controversial. Although there has been two published literature that is relevant to the topic of this study, both of them have certain defects, and they can only provide answers about the efficacy or safety of MMF in the treatment of NMOSD from partial perspectives or conclusions. This research aims to perform a direct and comprehensive systematic review and meta-analysis to evaluate MMF’s effectiveness and safety in treating NMOSD.Methods and analysisThis systematic review will cover all comparative researches, from randomised controlled trials to cohort studies, and case–control study. A relevant literature search will be conducted in PubMed, Web of Science, EMBASE, the Cochrane Library, China National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database and Chinese Biomedical Literature Database from their inception to 31 June 2020. We will also search registers of clinical trials, potential grey literature and abstracts from conferences. There are no limits on language and publication status. The reporting quality and risk of bias will be assessed by two researchers independently. Expanded Disability Status Scales and annualised relapse rate will be evaluated as the primary outcome. The secondary outcomes will consist of the frequency and severity of adverse events, best-corrected visual acuity, relapse-free rate and time to the next attack. A meta-analysis will be performed using RevMan V.5.3 software provided by the Cochrane Collaboration and Stata V.12.0.Ethics and disseminationBecause the data used for this systematic review will be exclusively extracted from published studies, ethical approval and informed consent of patients will not be required. The systematic review will be published in a peer-reviewed journal, presented at conferences and will be shared on social media platforms.PROSPERO registration numberCRD42020164179.

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