scholarly journals Probiotics for preventing and treating gastro-oesophageal reflux/gastro-oesophageal reflux disease in infants: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Jann Foster ◽  
Hannah Dahlen ◽  
Sabina Fijan ◽  
Nadia Badawi ◽  
Viginia Schmied ◽  
...  
Keyword(s):  
Systematic Review ◽  
Placebo Group ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Mean Difference ◽  
Oesophageal Reflux ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Probiotic Group ◽  
Oesophageal Reflux Disease

Abstract Background Gastro-oesophageal reflux (GOR) and Gastro-oesophageal reflux disease (GORD) are common during infancy and can cause substantial discomfort in infants, parental distress and financial burden on parents and the health care system. Effective treatment regimens, however, remain elusive. Probiotics given to women during pregnancy and lactation, and babies may have therapeutic effects when it comes to GOR/GORD. The objective of this systematic review and meta-analysis is to evaluate the efficacy of probiotic supplementation for the prevention and treatment of GOR/GORD in infants.Methods Literature searches were conducted using MEDLINE, EMBASE and the Cochrane Central Register of Controlled trials. Only randomised controlled trials (RCTs) were included. A meta-analysis of included trials was performed using the Cochrane Collaboration methodology where possible. Results Six RCTs examined the prevention or treatment with probiotics on GOR. There were no studies examining probiotics for GORD. A meta-analysis of 3 studies showed a statistically significant reduction in regurgitation episodes for the probiotic group compared to the placebo group [mean difference -1.44 episodes/day; 95% CI -1.71 to -1.17] but there was high heterogeneity (96%). Meta-analysis of two studies found a statistically significant increased number of stools per day in the probiotic group compared to the placebo group [mean difference 1.26, 95% CI 1.12 to 1.41]. However, there was moderate heterogeneity (69%). Individual studies reported: a decrease in crying time, increased gastric emptying rate, infant length and head circumference, visits to an emergency department or health professional, and loss of parent working days were significantly less with infants receiving probiotic compared to a placebo but more research is needed. Meta-analysis of two studies showed no difference in body weight between the two groups (minimal heterogeneity 23%). None of the studies reported any adverse effects for the women or infants. Conclusions Probiotic therapy appears promising with some evidence of benefit but most studies are small and there was high heterogeneity between the studies. The use of probiotics could potentially be a non-invasive, cost effective and preventative positive health strategy for both women and their babies. Further well controlled RCTs examining the effect of probiotics for GOR /GORD are warranted.

scholarly journals Acupuncture for refractory gastro-oesophageal reflux disease: a systematic review and meta-analysis protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e030713 ◽  
Author(s):  
Dacheng Li ◽  
Li Zhu ◽  
Daming Liu
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Adverse Events ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Oesophageal Reflux ◽  
Cochrane Central Register ◽  
Efficacy And Safety ◽  
Oesophageal Reflux Disease

IntroductionRefractory gastro-oesophageal reflux disease (rGORD) is a common disease, affecting patients’ quality of life. Since conventional medicines have limitations, like low effective rates and adverse events, acupuncture may be a promising therapy for rGORD. While no related systematic review has been published, the present study is designed to evaluate the efficacy and safety of acupuncture for rGORD.Methods and analysisPubMed, the Cochrane Central Register of Controlled Trials and Chinese electronic databases, including China National Knowledge Infrastructure, Wan Fang database, VIP, SinoMed and the Chinese Clinical Trial Registry, will be searched from establishment of the database to 31 August 2019. There will be no limitations on language, and all articles will be screened and collected by two reviewers independently. RevMan V.5.3.5 software will be used for meta-analysis, and the conduction of study will refer to the Cochrane Handbook for Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol guidelines. The efficacy and safety of acupuncture for rGORD will be evaluated based on outcomes, including global symptom improvement, oesophageal sphincter function test measured by high-resolution manometry, quality of life, recurrence rate and adverse events.Ethics and disseminationThere is no necessity for this study to acquire an ethical approval, and this review will be disseminated in a peer-reviewed journal or conference presentation.Trial registration numberCRD42018111912.

Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 026921552095193
Author(s):  
Alberto Saavedra-García ◽  
Jose A Moral-Munoz ◽  
David Lucena-Anton
Keyword(s):  
Systematic Review ◽  
Electrical Stimulation ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Mean Difference ◽  
Current Evidence ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Mirror Therapy

Objective: To evaluate the current evidence on the effectiveness of simultaneous combination of mirror therapy and electrical stimulation in the recovery of upper limb motor function after stroke, compared with conventional therapy, mirror therapy or electrical stimulation isolated. Data sources: Articles published in PubMed, Web of Science, Scopus, Physiotherapy Evidence Database (PEDro), Cochrane Central register of controlled trials and ScienceDirect up to July 2020. Review methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed. Methodological quality was assessed using the PEDro tool. The RevMan 5.4 statistical software was used to obtain the meta-analysis, through the standardized mean difference and 95% confidence intervals (CI), and to evaluate the risk of bias. The GRADE approach was employed to assess the certainty of evidence. Results: Eight articles were included in this systematic review, seven were included in the meta-analysis. A total of 314 participants were analyzed. The overall quality of the articles included in this review was good. There was no overall significant mean difference on upper limb motor function after stroke using the Upper-Extremity Fugl-Meyer Assessment by 1.56 (95% CI = –2.08, 5.20; P = 0.40; moderate-certainty evidence) and the Box and Block Test results by 1.39 (95% CI = –2.14, 4.92; P = 0.44; high-certainty evidence). There was overall significant difference in the Action Research Arm Test by 3.54 (95% CI = 0.18, 6.90; P = 0.04; high-certainty evidence). Conclusion: Direct scientific evidence about the effectiveness of the combined therapy of mirror therapy and electrical stimulation simultaneously for the improvement of the upper limb motor function after stroke is lacking. Further high-quality and well-designed research is needed.

scholarly journals Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Haonan Tian ◽  
Congman Xie ◽  
Min Lin ◽  
Hongmei Yang ◽  
Aishu Ren
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Mean Difference ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Canine Retraction ◽  
Temporary Anchorage Devices ◽  
The Mean ◽  
Implant Anchorage

Abstract Background: Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods: A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs) . The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean difference s and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results: Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1. 56 mm , 95% CI: 1.14 to 1.98, P <0.00001 ) and the mandible (1.62 mm , 95% CI: 1.24 to 2.01, P <0.00001 ) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm , 95% CI: 0.16 to 0.69, P =0.001 ) and the mandible (0.26 mm , 95% CI: 0.02 to 0.49, P =0.03 ). Conclusions: There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed. Keywords: Orthodontic implants; Canine retraction; Systematic review; Meta-analysis

Acupuncture for the Treatment of Gastro-Oesophageal Reflux Disease: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 35 (5) ◽  
pp. 316-323 ◽  
Author(s):  
Jiajie Zhu ◽  
Yu Guo ◽  
Shan Liu ◽  
Xiaolan Su ◽  
Yijie Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reflux Disease ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Oesophageal Reflux ◽  
Symptom Improvement ◽  
Significant Heterogeneity ◽  
Oesophageal Reflux Disease

Background Gastro-oesophageal reflux disease (GORD) is one of the most common diseases presenting to gastroenterology clinics. Acupuncture is widely used as a complementary and alternative treatment for patients with GORD. Objective To explore the effectiveness of acupuncture for the treatment of GORD. Methods Four English and four Chinese databases were searched through June 2016. Randomised controlled trials investigating the effectiveness of manual acupuncture or electroacupuncture (MA/EA) for GORD versus or as an adjunct to Western medicine (WM) were selected. Data extraction and quality evaluation were performed by two authors independently and RevMan 5.2.0 was used to analyse data. Results A total of 12 trials involving 1235 patients were included. Meta-analyses demonstrated that patients receiving MA/EA combined with WM had a superior global symptom improvement compared with those receiving WM alone (relative risk (RR) 1.17, 95% CI 1.09 to 1.26; p=0.03; six studies) with no significant heterogeneity (I2=0%, p=0.41). Recurrence rates of those receiving MA/EA alone were lower than those receiving WM (RR 0.42,95% CI 0.29 to 0.61; p<0.001; three studies) with low heterogeneity (I2=7%, p=0.34), while global symptom improvement (six studies) and symptom scores (three studies) were similar (both p>0.05). Descriptive analyses suggested that acupuncture also improves quality of life in patients with GORD. Conclusion This meta-analysis suggests that acupuncture is an effective and safe treatment for GORD. However, due to the small sample size and poor methodological quality of the included trials, further studies are required to validate our conclusions. Trial registration number PROSPERO Systematic review registration no. CRD42016041916.

scholarly journals Global Prevalence and Risk Factors of Gastro-oesophageal Reflux Disease (GORD): Systematic Review with Meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Jorabar Singh Nirwan ◽  
Syed Shahzad Hasan ◽  
Zaheer-Ud-Din Babar ◽  
Barbara R. Conway ◽  
Muhammad Usman Ghori
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Oesophageal Reflux ◽  
Global Prevalence ◽  
Oesophageal Reflux Disease

Systematic review and meta-analysis of laparoscopic Nissen (posterior total) versus Toupet (posterior partial) fundoplication for gastro-oesophageal reflux disease

2010 ◽  
Vol 97 (9) ◽  
pp. 1318-1330 ◽  
Author(s):  
J. A. J. L. Broeders ◽  
F. A. Mauritz ◽  
U. Ahmed Ali ◽  
W. A. Draaisma ◽  
J. P. Ruurda ◽  
...  
Keyword(s):  
Systematic Review ◽  
Reflux Disease ◽  
Meta Analysis ◽  
Oesophageal Reflux ◽  
Partial Fundoplication ◽  
Oesophageal Reflux Disease ◽  
Laparoscopic Nissen

scholarly journals Efficacy of Probiotics and Prebiotics in Prevention of Infectious Complications Following Hepatic Resections: Systematic Review and Meta-Analysis

2019 ◽  
Vol 28 ◽  
pp. 205-211 ◽  
Author(s):  
Yu Gan ◽  
Song Su ◽  
Bo Li ◽  
Chen Fang
Keyword(s):  
Systematic Review ◽  
Placebo Group ◽  
Hepatic Resection ◽  
Infection Rate ◽  
Meta Analysis ◽  
Antibiotic Use ◽  
Infectious Complications ◽  
Controlled Trials ◽  
Probiotic Group ◽  
Statistical Heterogeneity

Background & Aims: Infections occurring after hepatic resection cause significant morbidity, mortality, and prolonged hospitalization. Probiotics and prebiotics are considered to offer protection against post-operative infections. We aimed to determine the effect of probiotics and prebiotics on the post-operative infection rate after hepatic resection by conducting a systematic review and a meta-analysis. Method: We searched various databases, namely, the PubMed, Medline, Embase, and Cochrane Controlled Trials Registry (CENTRAL), for randomized controlled trials evaluating the effect of probiotics and/or prebiotics on the infection rate following hepatic resection. Extracted data were pooled and subsequently used in a meta-analysis with a random-effects model. Review was reported following the PRISMA guidelines. Results: A total of 4 studies comprising 205 patients were included for our meta-analysis. The infection rates in the probiotic group and placebo group were 11.7% and 30.3%, respectively (p<0.001). The pooled risk ratio (RR) was 0.41 (95% confidence interval [CI]: 0.128–0.730). Subgroup analysis indicated that the wound infection rate in the probiotic group (5.3%) was significantly lower than that in the placebo group (RR: 0.387, 95% CI: 0.155–0.970, p=0.043). Furthermore, probiotics/prebiotics decreased the duration of hospital stay (-0.57 days; 95% CI: -0.861 to -0.274; p<0.001) and antibiotic use (mean difference: -3.89 days, 95% CI: -4.17 to -3.60; p<0.001). There was no significant statistical heterogeneity. Conclusion: Our findings show that administration of probiotics and/or prebiotics prior to operation day decreases the infection rate post-liver resection and could shorten the duration of hospitalization and antibiotics use.

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