Arthroscopic single-row versus double-row repair rotator cuff tear: a meta-analysis of randomized controlled trials at 2-years minimum follow-up

2019 ◽  
Author(s):  
Pu Chen ◽  
Liuwei Huang ◽  
Xiaozhe Zhang ◽  
Jun Zhou ◽  
Anmin Ruan ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Randomized Controlled Trials ◽  
Clinical Outcomes ◽  
Constant Score ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Double Row ◽  
Single Row ◽  
Randomized Controlled

Abstract Objective: The purpose of this study was to perform a meta-analysis of all available randomized controlled trials at 2-years minimum follow-up, to compare the clinical outcomes and radiological re-tear rates between single-row (SR) and double-row (DR) fixation. Methods: PubMed, EMBASE, and Cochrane databases search were performed for meta-analysis. Randomized controlled trials at 2-years minimum follow-up which comparing clinical outcomes and radiological re-tear rates between single-row and double-row fixation for rotator cuff repair. Clinical outcomes included the American Shoulder and Elbow Surgeons score (ASES), University of California–Los Angeles score (UCLA), and Constant score; the radiological re-tear rate was assessed by Magnetic Resonance Imaging (MRI), Magnetic Resonance Angiography (MRA)or Ultrasonic (US). Two trained authors extracted data from all included articles, and if there are different opinions, the final decision would be made by the senior professor after reviewed the article.Results: Six Level Ⅰ articles and two Level Ⅱ articles were included. In clinical outcomes, ASES, Constant score and forward flexion range of motion (ROM) showed no statistically significant difference between DR fixation and SR fixation technique at 2-years follow-up (P=0.61, P=0.19, P=0.17). UCLA score and internal rotation ROM were significantly better in DR group (P=0.005, P=0.001). DR repair showed less overall re-tear and partial re-tear rate and more intact rotator cuff than SR repair in radiological outcomes after 2-years follow-up (P=0.0002, P=0.02, P=0.0003).Conclusion: The best current available evidence suggest that DR fixation technique have similar outcomes in ASES, Constant score and forward flexion ROM with SR fixation. However, DR group show higher UCLA score, greater internal rotation ROM and better radiological outcomes (include less overall re-tear and partial re-tear rate and more intact rotator cuff) than SR group after 2-years follow-up.Level of Evidence: Level Ⅱ, meta-analysis

scholarly journals Conservative oxygen therapy for critically ill patients: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Xiao-Li Chen ◽  
Bei-Lei Zhang ◽  
Chang Meng ◽  
Hui-Bin Huang ◽  
Bin Du
Keyword(s):  
Sensitivity Analysis ◽  
Randomized Controlled Trials ◽  
Critically Ill Patients ◽  
Oxygen Therapy ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Icu Patients ◽  
Randomized Controlled

Abstract Objective Conservative oxygen strategy is recommended in acute illness while its benefit in ICU patients remains controversial. Therefore, we sought to conduct a systematic review and meta-analysis to examine such oxygen strategies’ effect and safety in ICU patients. Methods We searched PubMed, Embase, and the Cochrane database from inception to Feb 15, 2021. Randomized controlled trials (RCTs) that compared a conservative oxygen strategy to a conventional strategy in critically ill patients were included. Results were expressed as mean difference (MD) and risk ratio (RR) with a 95% confidence interval (CI). The primary outcome was the longest follow-up mortality. Heterogeneity, sensitivity analysis, and publication bias were also investigated to test the robustness of the primary outcome. Results We included seven trials with a total of 5265 patients. In general, the conventional group had significantly higher SpO2 or PaO2 than that in the conservative group. No statistically significant differences were found in the longest follow-up mortality (RR, 1.03; 95% CI, 0.97–1.10; I2=18%; P=0.34) between the two oxygen strategies when pooling studies enrolling subjects with various degrees of hypoxemia. Further sensitivity analysis showed that ICU patients with mild-to-moderate hypoxemia (PaO2/FiO2 >100 mmHg) had significantly lower mortality (RR, 1.24; 95% CI, 1.05–1.46; I2=0%; P=0.01) when receiving conservative oxygen therapy. These findings were also confirmed in other study periods. Additional, secondary outcomes of the duration of mechanical ventilation, the length of stay in the ICU and hospital, change in sequential organ failure assessment score, and adverse events were comparable between the two strategies. Conclusions Our findings indicate that conservative oxygen therapy strategy did not improve the prognosis of the overall ICU patients. The subgroup of ICU patients with mild to moderate hypoxemia might obtain prognosis benefit from such a strategy without affecting other critical clinical results.

scholarly journals Inverted internal limiting membrane flap technique versus internal limiting membrane peeling for large macular holes: A meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Ji-Guo Yu ◽  
Jing Wang ◽  
Yi Xiang
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Internal Limiting Membrane ◽  
Controlled Trials ◽  
Ilm Peeling ◽  
Closure Rate ◽  
Flap Technique ◽  
Randomized Controlled ◽  
Macular Holes

Background: Vitrectomy with internal limiting membrane (ILM) peeling is an effective surgical procedure for the treatment of macular holes (MHs). However, there is a possibility of poor postoperative anatomical closure with conventional ILM peeling for MHs larger than 400 μm. Therefore, a novel inverted ILM flap technique was developed for such cases. Objectives: This meta-analysis study was performed to evaluate and compare the anatomical and visual outcomes of the inverted ILM flap technique and ILM peeling in large MHs. Methods: The Cochrane Library, PubMed, and Embase databases were searched to identify randomized controlled trials (RCTs). The trial eligibility and risk of bias were assessed according to Cochrane review methods. The primary outcome measures included MH closure rate and postoperative visual acuity (VA). Subgroup analysis of postoperative VA based on follow-up time was also conducted. Pooled odds ratios (ORs), weighted mean difference (WMD), and 95% confidence intervals (CIs) were calculated. Statistical analysis was performed using RevMan 5.3 software. Results: Five RCTs with a total of 155 eyes in the inverted ILM flap group and 161 eyes in the ILM peeling group were included in this meta-analysis. Statistical meta-analysis revealed that the overall MH closure rate in the inverted ILM flap group was significantly higher than that in the ILM peeling group (OR, 3.10; 95% CI, 1.25 to 7.66; P = 0.01). The postoperative VA was significantly better in the inverted ILM flap group than ILM peeling group (WMD, -0.14; 95% CI, -0.21 to -0.07; P = 0.0002). The subgroup meta-analysis indicated that the postoperative VA was significantly better in the inverted ILM flap group than ILM peeling group (WMD, -0.17; 95% CI, -0.26 to -0.08; P = 0.0004) at the 3-month follow-up. However, no significant difference was observed between the two groups at the 6-month follow-up (WMD, -0.09; 95% CI, -0.20 to 0.02; P = 0.10). Conclusions: Vitrectomy with inverted ILM flap technique showed a higher anatomical closure rate as well as visual gain—although only in the short-term as no difference in visual recovery was found at the 6-month follow-up—than did ILM peeling in large MHs. The inverted ILM flap technique should be considered as a preferred and routine procedure for the treatment of patients with MHs larger than 400 µm.

Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 51 (14) ◽  
pp. 2321-2336
Author(s):  
Alice Lannes ◽  
Eric Bui ◽  
Catherine Arnaud ◽  
Jean-Philippe Raynaud ◽  
Alexis Revet
Keyword(s):  
Mental Illness ◽  
Mental Disorders ◽  
Randomized Controlled Trials ◽  
Internalizing Symptoms ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Short Term ◽  
Randomized Controlled ◽  
Post Test

AbstractChildren with parents suffering from a psychiatric disorder are at higher risk for developing a mental disorder themselves. This systematic review and meta-analysis of randomized controlled trials aims to evaluate the efficacy of psychosocial interventions to prevent negative mental health outcomes in the offspring of parents with mental illness. Eight electronic databases, grey literature and a journal hand-search identified 14 095 randomized controlled trials with no backward limit to June 2021. Outcomes in children included incidence of mental disorders (same or different from parental ones) and internalizing and externalizing symptoms at post-test, short-term and long-term follow-up. Relative risks and standardized mean differences (SMD) for symptom severity were generated using random-effect meta-analyses. Twenty trials were selected (pooled n = 2689 children). The main therapeutic approaches found were cognitive-behavioural therapy and psychoeducation. A significant effect of interventions on the incidence of mental disorders in children was found with a risk reduction of almost 50% [combined relative risk = 0.53, 95% confidence interval (CI) 0.34–0.84]. Interventions also had a small but significant effect on internalizing symptoms at post-test (SMD = −0.25, 95% CI −0.37 to −0.14) and short-term follow-up (−0.20, 95% CI −0.37 to −0.03). For externalizing symptoms, a decreasing slope was observed at post-test follow-up, without reaching the significance level (−0.11, 95% CI −0.27 to 0.04). Preventive interventions targeting the offspring of parents with mental disorders showed not only a significant reduction of the incidence of mental illness in children, but also a diminution of internalizing symptoms in the year following the intervention.

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