scholarly journals Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Renal Cysts: Which is better?

2020 ◽  
Author(s):  
Xueling Zhang ◽  
Dehong Cao ◽  
Peizhen Han ◽  
Zhengju Ren ◽  
Jia Wang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Web Of Science ◽  
Treatment Time ◽  
Renal Cyst ◽  
Meta Analysis ◽  
Renal Cysts ◽  
Lower Recurrence Rate ◽  
Significant Difference ◽  
Review Manager ◽  
Comprehensive Literature Search

Abstract Background: To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies.Method: A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis.Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio(OR): 0.28; 95%Confidence Interval(CI): 0.09 to 0.86；P=0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P<0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p<0.01). Nevertheless, AS group had shorter treatment time [Mean Difference(MD)：-51.10; 95% CI：-73.01 to -29.20; p<0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P=0.28).Conclusions: In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.

scholarly journals Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Renal Cysts: Which is better?

2020 ◽  
Author(s):  
Xueling Zhang ◽  
Dehong Cao ◽  
Peizhen Han ◽  
Zhengju Ren ◽  
Jia Wang ◽  
...  
Keyword(s):  
Recurrence Rate ◽  
Web Of Science ◽  
Treatment Time ◽  
Renal Cyst ◽  
Meta Analysis ◽  
Renal Cysts ◽  
Lower Recurrence Rate ◽  
Significant Difference ◽  
Review Manager ◽  
Comprehensive Literature Search

Abstract Purpose: To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies. Method: A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis. Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio(OR): 0.28; 95%Confidence Interval(CI): 0.09 to 0.86；P=0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P<0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p<0.01). Nevertheless, AS group had shorter treatment time [Mean Difference(MD)：-51.10; 95% CI：-73.01 to -29.20; p<0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P=0.28). Conclusion: In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.

scholarly journals Aspiration-Sclerotherapy Versus Laparoscopic De-roofing in the Treatment of Symptomatic Renal Cysts: A Systematic review and meta-analysis

2019 ◽  
Author(s):  
Xueling Zhang ◽  
Dehong Cao ◽  
Peizhen Han ◽  
Zhengju Ren ◽  
Jia Wang ◽  
...  
Keyword(s):  
Literature Search ◽  
Treatment Time ◽  
Renal Cyst ◽  
Meta Analysis ◽  
Renal Cysts ◽  
Cochrane Library ◽  
Significant Difference ◽  
The World ◽  
The Cochrane Library ◽  
Comprehensive Literature Search

Abstract Background: Renal cyst is prevailing around the world and symptomatic renal cysts are recommended to be treated in the EUA guidelines. Currently, aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) are the main therapies of symptomatic renal cysts. This article aims to compare the clinical efficiency between them in the management of renal cysts through meta-analysis of comparative studies. Method: A comprehensive literature search was performed by PubMed, MEDLINE, EMBASE and the Cochrane Library to ascertain the relevant studies published up to March 2019. Articles with English full-text comparing aspiration-sclerotherapy and laparoscopic de-roofing in renal cyst treatment were included. Results: Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that although AS group had shorter treatment time (MD：-51.10; 95% CI：-73.01 to -29.20; p<0.01), radiological successful rate (RR: 0.64; 95%CI: 0.53 to 0.77) are higher in LD group, which also had less recurrence rate (RR: 4.96; 95%CI: 2.28 to 10.81; p<0.01). No statistically significant difference was showed in symptomatic successful rate (RR: 0.90; 95%CI: 0.79 to 1.03；P=0.13) and complications (RR: 2.11; 95% CI: 0.47 to 9.52; P=0.33). Conclusion: In our meta-analysis, laparoscopic de-roofing is superior to aspiration-sclerotherapy in radiological successful rate and recurrence, but the treatment time is longer.

Stent assisted coiling versus non-stent assisted coiling for the management of ruptured intracranial aneurysms: a meta-analysis and systematic review

2019 ◽  
Vol 11 (5) ◽  
pp. 489-496 ◽  
Author(s):  
Xiaoxi Zhang ◽  
Qiao Zuo ◽  
Haishuang Tang ◽  
Gaici Xue ◽  
Pengfei Yang ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Recurrence Rate ◽  
Complication Rate ◽  
Intracranial Aneurysms ◽  
Meta Analysis ◽  
Lower Recurrence Rate ◽  
Significant Difference ◽  
Favorable Clinical Outcome ◽  
Ruptured Intracranial Aneurysms

PurposeTo compare the safety and efficiency of stent assisted coiling (SAC) with non-SAC for the management of ruptured intracranial aneurysms.MethodsA meta-analysis that compared SAC with coiling alone and balloon assisted coiling was conducted by database searching. The primary outcomes of this study were immediate occlusion and progressive thrombosis rate, overall perioperative complication rate, and angiographic recurrence. Secondary outcomes included mortality at discharge, hemorrhagic and ischemic complications, and favorable clinical outcome at discharge and at follow-up.ResultsEight retrospective cohort studies with 1408 ruptured intracranial aneurysms (SAC=499; non-SAC=909) were included. The SAC group tended to show a lower immediate complete occlusion rate than the non-SAC group (54.3% vs 64.2%; RR 0.90; 95% CI 0.83 to 0.99; I2=17.4%) and achieved a significantly higher progressive complete rate at follow-up (73.4% vs 61.0%; RR 1.30; 95% CI 1.16 to 1.46; I2=40.5%) and a lower recurrence rate (4.8% vs 16.6%; RR 0.28; 95% CI 0.16 to 0.50; I2=0.0%). With respect to safety concerns, overall perioperative complications in the SAC group were significantly higher (20.2% vs 13.1%; RR 1.70; 95% CI 1.36 to 2.11; I2=0.0%). However, no significant difference was found for mortality rate at discharge (6.3% vs 6.2%; RR 1.29; 95% CI 0.86 to 1.94; I2=0.0%), or favorable clinical outcome rate at discharge (73.4% vs 74.2%; RR 0.95; 95% CI 0.88 to 1.02; I2=12.1%) and at follow-up (85.6% vs 87.9%; RR 0.98; 95% CI 0.93 to 1.02; I2=0.0%; P=0.338).ConclusionsSAC has a lower recurrence rate than non-SAC. Nevertheless, further validation by well designed prospective studies is warranted for determining whether stents improve angiographic outcome without an increased complication rate or unfavorable clinical outcome.

scholarly journals Association between CYP3A5 Polymorphism and Statin-Induced Adverse Events: A Systemic Review and Meta-Analysis

2021 ◽  
Vol 11 (7) ◽  
pp. 677
Author(s):  
Jeong Yee ◽  
Hamin Kim ◽  
Yunhee Heo ◽  
Ha-Young Yoon ◽  
Gonjin Song ◽  
...  
Keyword(s):  
Adverse Events ◽  
Web Of Science ◽  
Meta Analysis ◽  
Statistical Significance ◽  
Systemic Review ◽  
Event Risk ◽  
Total Data ◽  
Lipophilic Statin ◽  
The Relationship ◽  
Review Manager

Purpose: Cytochrome P450 (CYP) is involved in the metabolism of statins; CYP3A5 is the main enzyme responsible for lipophilic statin metabolism. However, the evidence of the association between CYP3A5*3 polymorphism and the risk of statin-induced adverse events remains unclear. Therefore, this study aimed to perform a systematic review and meta-analysis to investigate the relationship between the CYP3A5*3 polymorphism and the risk of statin-induced adverse events. Methods: The PubMed, Web of Science, and EMBASE databases were searched for qualified studies published until August 2020. Observational studies that included the association between statin-induced adverse events and the CYP3A5*3 polymorphism were reviewed. The odds ratios (ORs) and 95% confidence intervals (CIs) were evaluated to assess the strength of the relationship. The Mantel–Haenszel method was used to provide the pooled ORs. Heterogeneity was estimated with I2 statistics and publication bias was determined by Begg’s and Egger’s test of the funnel plot. Data analysis was performed using Review Manager (version 5.4) and R Studio (version 3.6). Results: In total, data from 8 studies involving 1614 patients were included in this meta-analysis. The CYP3A5*3 polymorphism was found to be associated with the risk of statin-induced adverse events (*3/*3 vs. *1/*1 + *1/*3: OR = 1.40, 95% CI = 1.08–1.82). For myopathy, the pooled OR was 1.30 (95% CI: 0.96–1.75). The subgroup analysis of statin-induced myopathy revealed a trend, which did not achieve statistical significance. Conclusions: This meta-analysis demonstrated that the CYP3A5*3 polymorphism affected statin-induced adverse event risk. Therefore, CYP3A5 genotyping may be useful to predict statin toxicity.

scholarly journals The effectiveness and safety of LMWH for preventing thrombosis in patients with spinal cord injury: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Ze Lin ◽  
Yun Sun ◽  
Hang Xue ◽  
Lang Chen ◽  
Chenchen Yan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Venous Thrombosis ◽  
Meta Analysis ◽  
Therapeutic Effects ◽  
Significant Difference ◽  
Cord Injury ◽  
Review Manager ◽  
Evident Difference

Abstract Background Unfractionated heparin (UFH) and low molecular weight heparin (LMWH) are commonly used for preventing venous thrombosis of the lower extremity in patients with traumatic spinal cord injury. Although, LMWH is the most commonly used drug, it has yet to be established whether it is more effective and safer than UFH. Further, a comparison of the effectiveness of LMWH in preventing thrombosis at different locations and different degrees of spinal cord injury has also not been clearly defined. Materials and methods Cohort studies comparing the use of LMWH and UFH in the prevention of lower limb venous thrombosis in patients with spinal cord injury were identified using PubMed. The risk of bias and clinical relevance of the included studies were assessed using forest plots. The Newcastle-Ottawa quality assessment scale was used to evaluate the quality of the included studies. The main results of the study were analyzed using Review Manager 5.3. Results A total of five studies were included in this meta-analysis. Four studies compared the effectiveness and safety of LMWH and UFH in preventing thrombosis in patients with spinal cord injury. No significant differences were found between the therapeutic effects of the two drugs, and the summary RR was 1.33 (95% CI 0.42–4.16; P = 0.63). There was also no significant difference in the risk of bleeding between the two medications, and the aggregate RR was 0.78 (95% CI 0.55–1.12; P = 0.18). When comparing the efficacy of LMWH in preventing thrombosis in different segments and different degrees of spinal cord injury, no significant differences were found. Conclusions The results of this analysis show that compared with UFH, LMWH has no obvious advantages in efficacy nor risk prevention, and there is no evident difference in the prevention of thrombosis for patients with injuries at different spinal cord segments.

The global prevalence of familial multiple sclerosis: an updated systematic review and meta-analysis

2021 ◽  
Author(s):  
Naeim Ehtesham ◽  
Maryam Zare Rafie ◽  
Meysam Mosallaei
Keyword(s):  
Multiple Sclerosis ◽  
Web Of Science ◽  
Meta Analysis ◽  
Disease Onset ◽  
Inclusion Criteria ◽  
Multifactorial Diseases ◽  
Pooled Prevalence ◽  
Significant Difference ◽  
Meta Regression ◽  
Genetic And Environmental Factors

Abstract Background: Considering that familial multiple sclerosis (FMS) can reveal the extent to which genetic and environmental factors each involve in the etiopathogenesis of the disease, we performed an updated meta-analysis of the worldwide prevalence of FMS by addition of recent publications. Methods: A search in PubMed, Scopus, the ISI Web of Science, and Google Scholar up to 20 December 2020 was done. The inclusion criteria were based on the CoCoPop approach (condition, context, and population). The qualified studies entered the process of the meta-analysis by using comprehensive meta-analysis ver. 2 software.Results: The pooled prevalence of MS in relatives of 16179 FMS cases was estimated to be 11.8% (95% CI: 10.7-13) based on a random-effects model. The pooled mean age of disease onset in adult probands was calculated to be 28.7 years (95% CI: 27.2± 30.2). In 13 studies that reported the data of FMS in pediatrics (n=6636) and adults (n=877), the FMS prevalence was 10.8% (95% CI: 8.1-14.2) and 15.5% (95% CI: 13.8-17.4), respectively. Considering the data of 9 studies, the prevalence of FMS in males (n=5243) and females (n=11503) patients was calculated to be 13.7% (95% CI: 10.1-18.2) and 15.4% (95% CI: 10.3-22.4), respectively. The odds ratio of male/female in FMS cases was not statistically significant (OR= 0.9; 95% CI: 0.6-1.2, P=0.55). Subgroup analysis demonstrated a significant difference in the prevalence of FMS between the geographical areas (P= 0.007). The meta-regression model for FMS prevalence was significantly lower in terms of higher latitude (P< 0.001) and increased MS prevalence (P< 0.001). In contrast, meta-regression based on prevalence day was not statistically significant (P=0.29).Conclusions: The prevalence of FMS is more in the pediatric group than that of adults, is distinct between geographical areas, and diminishes with the increment of MS prevalence and latitude. Also, the symptoms initiate relatively at lower ages in FMS cases. By contrast with multifactorial diseases, our analysis unveiled that the prevalence of FMS was not more prevalent in men than women and the risk of MS development in relatives was not more when the affected proband was male.

scholarly journals Outcome of endoscopic vs microsurgical transsphenoidal resection for Cushing’s disease

2018 ◽  
Vol 7 (1) ◽  
pp. R26-R37 ◽  
Author(s):  
Nidan Qiao
Keyword(s):  
Recurrence Rate ◽  
Cushing’S Disease ◽  
Meta Analysis ◽  
Cushing's Disease ◽  
Recurrence Rates ◽  
Microscopic Surgery ◽  
Significant Difference ◽  
Comprehensive Search ◽  
Definition Of

Introduction It is unclear whether the proportions of remission and the recurrence rates differ between endoscopic transsphenoidal surgery (TS) and microscopic TS in Cushing’s disease (CD); thus, we conducted a systematic review and meta-analysis to evaluate studies of endoscopic TS and microscopic TS. Methods We conducted a comprehensive search of PubMed to identify relevant studies. Remission and recurrence were used as outcome measures following surgical treatment of CD. Results A total of 24 cohort studies involving 1670 adult patients were included in the comparison. Among these studies, 702 patients across 9 studies underwent endoscopic TS, and 968 patients across 15 studies underwent microscopic TS. Similar baseline characteristics were observed in both groups. There was no significant difference in remission between the two groups: 79.7% (95% CI: 73.1–85.0%) in the endoscopic group and 76.9% (95% CI: 71.3–81.6%) in the microscopic group (P = 0.485). It appears that patients who underwent endoscopic surgery experience recurrence less often than patients who underwent microscopic surgery, with recurrence proportions of 11.0% and 15.9%, respectively (P = 0.134). However, if follow-up time is taken into account, both groups had a recurrence rate of approximately 4% per person per year (95% CI: 3.1–5.4% and 3.6–5.1%, P = 0.651). Conclusions We found that remission proportion and recurrence rate were the same in patients who underwent endoscopic TS as in patients who underwent microscopic TS. The definition of diagnosis, remission and recurrence should always be considered in the studies assessing therapeutic efficacy in CD.

scholarly journals Preoperative exercise and recovery after cardiac surgery: a meta-analysis

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yu-Ting Zheng ◽  
Jiang-Xu Zhang
Keyword(s):  
Cardiac Surgery ◽  
Meta Analysis ◽  
Exercise Group ◽  
Control Group ◽  
Inclusion Criteria ◽  
Blood Cell Count ◽  
Bias Analysis ◽  
Significant Difference ◽  
Preoperative Exercise ◽  
Review Manager

Abstract Background To evaluate the association between preoperative exercise and recovery after cardiac surgery. Methods Literature comparing preoperative exercise and the control group for patients receiving cardiac surgery was retrieved in multiple databases. Review Manager 5.2 was adopted for meta-analysis, sensitivity analysis and bias analysis. Results Finally, 6 relevant studies satisfied the inclusion criteria. There was significant difference in length of stay in intensive care unit (ICU) (MD- = 1.35, 95%CI [− 2.64, − 0.06], P = 0.04; P for heterogeneity < 0.0001, I2 = 88%) and physical function after operation (P of heterogeneity = 0.32, I2 = 12%, Z = 9.92, P of over effect< 0.00001). The meta-analysis suggested that there was no significant difference in white blood cell count (WBC) at postoperative day 7 and mental health after operation between the exercise group and the control group. Limited publication bias was observed in this study. Conclusion Preoperative exercise including inhaled muscle training, aerobics, resistance training and stretching could promote recovery after cardiac surgery.

scholarly journals Aflatoxin M1 in Milk Worldwide from 1988 to 2020: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-14
Author(s):  
Nader Salari ◽  
Mohsen Kazeminia ◽  
Aliakbar Vaisi-Raygani ◽  
Rostam Jalali ◽  
Masoud Mohammadi
Keyword(s):  
Systematic Review ◽  
Sample Size ◽  
Web Of Science ◽  
Animal Feed ◽  
Meta Analysis ◽  
Food Contamination ◽  
Aflatoxin M1 ◽  
Significant Difference ◽  
Animal Milk ◽  
Review Study

Background. Aflatoxins are found in various types of food and animal feed. Food contamination with aflatoxin toxin is of particular importance today. Various studies have reported different prevalence of aflatoxin M1 in animal milk. Therefore, due to the importance of this toxin, its role in health, and lack of general statistics about it worldwide, the present study aimed to determine the prevalence of aflatoxin M1 in milk worldwide with a systematic review and meta-analysis study. Methods. In this review study, national and international databases were extracted from SID, MagIran, IranMedex, IranDoc, Embase, ScienceDirect, Scopus, PubMed, and Web of Science (ISI) between January 1988 and February 2020. A random effects model was used for analysis, and heterogeneity of studies with an I2 index was investigated. Data were analyzed using Comprehensive Meta-Analysis (version 2). Results. The prevalence of aflatoxin M1 in milk worldwide from January 1988 to February 2020 in 122 articles with a sample size of 18921 was 79.1% (95% CI: 75.5–82.3%). Regarding the heterogeneity based on metaregression, there was a significant difference between the effect of the year of study (p≤0.001) and sample size (p≤0.001) with the prevalence of aflatoxin M1 in animal milk. Conclusion. The results of this study show that the prevalence of aflatoxin M1 in milk is high worldwide. Therefore, considering the importance of the milk group and its products, special measures should be taken to protect the ration from aflatoxin molds and milk quality.

scholarly journals Comparison of Conservative versus Surgical Treatment Protocols in Treating Idiopathic Granulomatous Mastitis: A Meta-Analysis

Breast Care ◽  
2019 ◽  
Vol 15 (4) ◽  
pp. 415-420
Author(s):  
Fei Zhou ◽  
Lu Liu ◽  
Liyuan Liu ◽  
Lixiang Yu ◽  
Fei Wang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Recurrence Rate ◽  
Meta Analysis ◽  
Clinical Effectiveness ◽  
Breast Disease ◽  
Granulomatous Mastitis ◽  
Idiopathic Granulomatous Mastitis ◽  
Treatment Protocols ◽  
Significant Difference ◽  
Conservative And Surgical Treatment

Background: Idiopathic granulomatous mastitis (IGM) is a rare, benign breast disease without any definitive therapeutic strategy. It is controversial whether to use conservative or surgical treatment of IGM and high-level evidence-based medicine data are lacking. The purpose of this study was to systemically evaluate the clinical effectiveness of the conservative versus surgical treatment for IGM. Methods: In this meta-analysis, we searched PubMed, EMbase, ScienceDirect, and Web of Science for comparative studies about the conservative versus surgical treatment of IGM. Two researchers independently identified reports and extracted data. We used Stata 11 for data analysis. A meta-analysis was performed to investigate the differences in the recurrence rate of conservative and surgical treatment using a random effects model. Results: A total of 10 studies involving 1,101 patients were included. The results demonstrated that there was no significant difference in the recurrence rate among patients who were treated by nonsurgical therapy and surgical treatment. No publication bias was detected. Conclusion: This meta-analysis demonstrates that both the conservative and surgical treatment approaches have appropriate efficacy in IGM treatment and relapse. Further randomized controlled trials with longer follow-up periods are required to confirm the advantages of each approach.

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