scholarly journals Cumulative evidence of helmet effects on bicycle injuries

2020 ◽  
Author(s):  
Siyu Chen ◽  
Shan Ou ◽  
Huijie Cui ◽  
Mingshuang Tang ◽  
Yutong Wang ◽  
...  
Keyword(s):  
Key Words ◽  
Odds Ratio ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Head Injuries ◽  
Current Evidence ◽  
Protective Effects ◽  
Neck Injuries ◽  
Cumulative Evidence ◽  
Z Curve

Abstract Background: With widely-used use of bicycles, studies of helmet effects on bicycle injuries were intensively conducted after the problem of bicycle injuries emerged. This study aims to justify whether current evidence is sufficient to manifest the effects of helmets. Methods：We exhaustively searched the articles in the databases of Medline, Scopus, and Embase by the term of (helmet* AND (cycl* OR bicycle* OR bike*)) AND injur* by the time of April 10, 2019. The meta-analysis and SSA (study sequential analysis) were conducted. Results：A total of 55 studies are eligible for meta-analysis. The OR (odds ratio) of helmet effect on head injuries compared with other injuries is 0·50 (0·43, 0·59) and effect of helmets on serious head injuries compared with other injuries are protective with OR of 0·34 (0·28, 0·43). Compared with control injuries, the OR of helmet effect on facial injuries is 0·63 (0·45, 0·88). Helmets is not associated with protective effects of neck injuries and OR is 0·98 (0·82, 1·17). SSA results of head injuries, serious head injuries, and face injuries showed, the cumulative Z-curve crossed both the conventional and the trial sequential monitoring boundary. SSA results of neck injuries showed the cumulative Z-curve does not cross both the conventional and the trial sequential monitoring boundary. Conclusions：The helmet has protection effects on head injuries, serious head injuries, and face injuries. The SSA showed the current evidence was sufficient to support the results. More studies of helmet promotion are warranted in the future. Key words: helmet; bicycle injuries; head injuries; face injuriesKey words: helmet; bicycle injuries; head injuries; face injuries

scholarly journals Cumulative evidence of helmet effects on bicycle injuries

2020 ◽  
Author(s):  
Siyu Chen ◽  
Shan Ou ◽  
Huijie Cui ◽  
Mingshuang Tang ◽  
Yutong Wang ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Head Injuries ◽  
Current Evidence ◽  
Protective Effects ◽  
Neck Injuries ◽  
Facial Injuries ◽  
Cumulative Evidence ◽  
Z Curve

Abstract Background: With the wide use of bicycles, studies of helmet effects on bicycle injuries were intensively conducted after the problem of bicycle injuries emerged. This study aims to justify whether current evidence is sufficient to support the effects of helmets.Methods：We exhaustively searched the articles in the databases of Medline, Scopus, and Embase by the term of (helmet* AND (cycl* OR bicycle* OR bike*)) AND injur* by the time of April 10, 2019. The meta-analysis and SSA (study sequential analysis) were conducted. The protocol was registered in Prospero (www.crd.york.ac.uk/PROSPERO/, ID: CRD42019131751). Results: A total of 55 studies were eligible for meta-analysis. The OR (odds ratio) of helmet effect on head injuries compared with other injuries was 0·50 (0·43, 0·59) and effects of helmets on serious head injuries compared with other injuries were protective with an OR of 0·34 (0·28, 0·43). Compared with control injuries, the OR of helmets’ effects on facial injuries is 0·63 (0·45, 0·88). Helmets were not associated with protective effects with regards to neck injuries and the OR was 0·98 (0·82, 1·17). SSA results of head injuries, serious head injuries, and face injuries showed the cumulative Z-curve crossed both the conventional and the trial sequential monitoring boundary. SSA results of neck injuries showed the cumulative Z-curve does not cross both the conventional and the trial sequential monitoring boundary.Conclusions: The helmet has protection effects on head injuries, serious head injuries, and face injuries. The SSA showed the current evidence was sufficient to support the results. More studies of helmet promotion are warranted in the future.

scholarly journals Protective Effects of Statins Administration in European and North American Patients Infected with COVID-19: A Meta-analysis

2021 ◽  
Author(s):  
Mairi Pucci ◽  
Diletta Onorato ◽  
Giovanni Carpene ◽  
Brandon Michael Henry ◽  
Fabian Sanchis-Gomar ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Statin Therapy ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Protective Role ◽  
Favorable Effect ◽  
Current Evidence ◽  
Severe Illness ◽  
Protective Effects ◽  
Time Data

AbstractSevere acute respiratory syndrome coronavirus 2 has spread rapidly throughout the world, becoming an overwhelming global health emergency. The array of injuries caused by this virus is broad and not limited to the respiratory system, but encompassing also extensive endothelial and systemic tissue damage. Since statins effectively improve endothelial function, these drugs may have beneficial effects in patients with coronavirus disease 2019 (COVID-19). Therefore, this investigation aimed to provide an updated overview on the interplay between statins and COVID-19, with particular focus on their potentially protective role against progression toward severe or critical illness and death. A systematic electronic search was performed in Scopus and PubMed up to present time. Data on statins use and COVID-19 outcomes especially in studies performed in Europe and North America were extracted and pooled. A total of seven studies met our inclusion criteria, totaling 2,398 patients (1,075 taking statins, i.e., 44.8%). Overall, statin usage in Western patients hospitalized with COVID-19 was associated with nearly 40% lower odds of progressing toward severe illness or death (odds ratio: 0.59; 95% confidence interval: 0.35–0.99). After excluding studies in which statin therapy was started during hospital admission, the beneficial effect of these drugs was magnified (odds ratio: 0.51; 95% confidence interval: 0.41–0.64). In conclusion, although randomized trials would be necessary to confirm these preliminary findings, current evidence would support a favorable effect of statins as adjuvant therapy in patients with COVID-19. Irrespective of these considerations, suspension of statin therapy seems highly unadvisable in COVID-19 patients.

Urgent Carotid Endarterectomy for Patients with Unstable Symptoms: Systematic Review and Meta-Analysis of Outcomes

Vascular ◽  
2009 ◽  
Vol 17 (5) ◽  
pp. 243-252 ◽  
Author(s):  
Benjamin O. Patterson ◽  
Peter J. Holt ◽  
Robert J. Hinchliffe ◽  
Matt M. Thompson ◽  
Ian M. Loftus
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Confidence Interval ◽  
Carotid Endarterectomy ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Long Term Results ◽  
Current Evidence ◽  
Ischemic Attack

Current evidence suggests that carotid endarterectomy (CEA) performed within 2 weeks of symptoms produces better long-term results than if it is delayed. Urgent endarterectomy following unstable presentations such as crescendo transient ischemic attack (cTIA) or progressive stroke has been associated with variable results. The evidence for this treatment strategy required reviewing. A systematic review of articles related to urgent CEA between 1980 and 2008 was performed. For cTIA, there was an odds ratio of 5.6 (95% confidence interval 3.3–9.7, p ≤ .0001) for combined stroke or death compared with surgery for “standard” indications. For unstable stroke, the odds ratio was 5.5 (95% confidence interval 3.1–9.3, p ≤ .0001). Patients with unstable neurologic presentations are at higher risk of complications if operated on urgently. Clearer definitions would help more precise patient selection to avoid inadvertently operating on patients with an unacceptably high risk of poor outcome.

Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis

Pain Medicine ◽  
2019 ◽  
Author(s):  
Kelsey L Corcoran ◽  
Lori A Bastian ◽  
Craig G Gunderson ◽  
Catherine Steffens ◽  
Alexandria Brackett ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Spinal Pain ◽  
Chiropractic Care ◽  
Current Evidence ◽  
Inverse Association ◽  
Case Control Studies ◽  
Opioid Prescription

Abstract Objective To investigate the current evidence to determine if there is an association between chiropractic use and opioid receipt. Design Systematic review and meta-analysis. Methods The protocol for this review was registered on PROSPERO (CRD42018095128). The MEDLINE, PubMed, EMBASE, AMED, CINAHL, and Web of Science databases were searched for relevant articles from database inception through April 18, 2018. Controlled studies, cohort studies, and case–control studies including adults with noncancer pain were eligible for inclusion. Studies reporting opioid receipt for both subjects who used chiropractic care and nonusers were included. Data extraction and risk of bias assessment were completed independently by pairs of reviewers. Meta-analysis was performed and presented as an odds ratio with 95% confidence interval. Results In all, 874 articles were identified. After detailed selection, 26 articles were reviewed in full, and six met the inclusion criteria. Five studies focused on back pain and one on neck pain. The prevalence of chiropractic care among patients with spinal pain varied between 11.3% and 51.3%. The proportion of patients receiving an opioid prescription was lower for chiropractic users (range = 12.3–57.6%) than nonusers (range = 31.2–65.9%). In a random-effects analysis, chiropractic users had a 64% lower odds of receiving an opioid prescription than nonusers (odds ratio = 0.36, 95% confidence interval = 0.30–0.43, P < 0.001, I2 = 92.8%). Conclusions This review demonstrated an inverse association between chiropractic use and opioid receipt among patients with spinal pain. Further research is warranted to assess this association and the implications it may have for case management strategies to decrease opioid use.

scholarly journals The Effects of Ascorbic Acid Over Sepsis: Meta-analysis With Trial Sequential Analysis

2020 ◽  
Author(s):  
Ying Wang ◽  
Hui-chang Zhuo ◽  
Jiandong Lin
Keyword(s):  
Odds Ratio ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Trial Sequential Analysis ◽  
Random Errors ◽  
Quality Of Evidence ◽  
Randomized Controlled ◽  
Registration Number ◽  
Summary Odds Ratio

Abstract Background: This meta-analysis is performed to evaluate the effects of AA on the mortality over sepsis patients, focusing on the courses and initiation of treatment as well as AA doses.Methods: Randomized controlled trials concerning sepsis patients treated with intravenous AA were included when searching the database. The meta-analysis was performed using the random (M-H heterogeneity) model to produce summary odds ratio with 95% CI. Trial sequential analysis was applied to evaluated the effect of random errors.Results: The included 12 trials enrolled a total of 1232 patients. Intravenously administration of AA could not lower 28-day mortality over sepsis patients (OR = 0.81; 95% CI (0.54-1.23); p = 0.326). Subgroup analysis demonstrated that when administrating AA alone, in a dose ≥ 10 g/d, or within 6 h of admission, the result may turn to positive (OR = 0.36; 95% CI (0.15-0.86); p = 0.020, OR = 0.50; 95% CI (0.27-0.92); p = 0.025, OR = 0.49; 95% CI (0.27-0.89); p = 0.019, relatively). The quality of evidence is moderate.Conclusion: IV AA may have no effects to lower mortality over sepsis patients. However, when administrating AA alone, in a dose ≥ 10 g/d, or within 6 h of admission, the result may turn to positive. Due to a moderate GRADE certainty of evidence, further studies are required to fully elaborate the effectiveness of AA during the management of the sepsis patients.PROSPERO registration number: CRD 42020170825. 24 Feb, 2020 retrospectively registered.

scholarly journals Operative and Oncological Outcomes Comparing Sentinel Node Mapping and Systematic Lymphadenectomy in Endometrial Cancer Staging: Meta-Analysis With Trial Sequential Analysis

2021 ◽  
Vol 10 ◽  
Author(s):  
Yu Gu ◽  
Hongyan Cheng ◽  
Liju Zong ◽  
Yujia Kong ◽  
Yang Xiang
Keyword(s):  
Endometrial Cancer ◽  
High Risk ◽  
Blood Loss ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Current Evidence ◽  
Trial Sequential Analysis ◽  
High Risk Patients ◽  
Oncological Outcomes ◽  
Risk Patients

ObjectiveTo evaluate the utility of sentinel lymph node mapping (SLN) in endometrial cancer (EC) patients in comparison with lymphadenectomy (LND).MethodsComprehensive search was performed in MEDLINE, EMBASE, CENTRAL, OVID, Web of science databases, and three clinical trials registration websites, from the database inception to September 2020. The primary outcomes covered operative outcomes, nodal assessment, and oncological outcomes. Software Revman 5.3 was used. Trial sequential analysis (TSA) and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) were performed.ResultsOverall, 5,820 EC patients from 15 studies were pooled in the meta-analysis: SLN group (N = 2,152, 37.0%), LND group (N = 3,668, 63.0%). In meta-analysis of blood loss, SLN offered advantage over LND in reducing operation bleeding (I2 = 74%, P&lt;0.01). Z-curve of blood loss crossed trial sequential monitoring boundaries though did not reach TSA sample size. There was no difference between SLN and LND in intra-operative complications (I2 = 7%, P = 0.12). SLN was superior to LND in detecting positive pelvic nodes (P-LN) (I2 = 36%, P&lt;0.001), even in high risk patients (I2 = 36%, P = 0.001). While no difference was observed in detection of positive para-aortic nodes (PA-LN) (I2 = 47%, P = 0.76), even in high risk patients (I2 = 62%, P = 0.34). Analysis showed no difference between two groups in the number of resected pelvic nodes (I2 = 99%, P = 0.26). SLN was not associated with a statistically significant overall survival (I2 = 79%, P = 0.94). There was no difference in progression-free survival between SLN and LND (I2 = 52%, P = 0.31). No difference was observed in recurrence. Based on the GRADE assessment, we considered the quality of current evidence to be moderate for P-LN biopsy, low for items like blood loss, PA-LN positive.ConclusionThe present meta-analysis underlines that SLN is capable of reducing blood loss during operation in regardless of surgical approach with firm evidence from TSA. SLN mapping is more targeted for less node dissection and more detection of positive lymph nodes even in high risk patients with conclusive evidence from TSA. Utility of SLN yields no survival detriment in EC patients.

Benefit of antibiotic therapy on pouchitis after ileal pouch anal anastomosis: A systematic review and meta-analysis of clinical trials

Open Medicine ◽  
2009 ◽  
Vol 4 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Behzad Elahi ◽  
Shekoufeh Nikfar ◽  
Saeed Derakhshani ◽  
Mohammad Vafaie ◽  
Mohammad Abdollahi
Keyword(s):  
Clinical Trials ◽  
Odds Ratio ◽  
Ileal Pouch ◽  
Web Of Science ◽  
Meta Analysis ◽  
Ileal Pouch Anal Anastomosis ◽  
Current Evidence ◽  
Cochrane Library ◽  
Controlled Clinical Trials ◽  
Anal Anastomosis

AbstractThe aim of the study was to evaluate and collect current evidence on the effect of antibiotics in pretreatment of pouchitis after restorative ileal pouch anal anastomosis (IPAA). Pubmed, Embase, Web of Science, Scopus, and Cochrane Library databases were searched between 1966 and July 2008; and relevant clinical trials extracted, reviewed, and validated according to the study protocol. The outcome of interest was clinical improvement after treatment. Nine randomized, placebo-controlled clinical trials were found relevant and studied but 3 of them with 70 patients were entered into meta-analysis. Pooling of the results from these trials yielded an odds ratio of 15.96 with a 95% CI of 4.20–60.70, indicating a significant OR (p<0.0001) in treatment group in comparison to the placebo group. In conclusion, the meta-analysis confirms benefit of antibiotics in management of pouchitis after IPAA operation.

scholarly journals The effect of polymorphisms (174G> C and 572C> G) on the Interleukin-6 gene in coronary artery disease: a systematic review and meta-analysis

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Nader Salari ◽  
Kamran Mansouri ◽  
Amin Hosseinian-Far ◽  
Hooman Ghasemi ◽  
Masoud Mohammadi ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Interleukin 6 ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Serum Levels ◽  
Protective Effects ◽  
Increased Risk ◽  
Artery Disease ◽  
The Relationship

Abstract Background Coronary Artery Disease (CAD) is caused by the blockage of the coronary arteries. it is argued that there has an association between the Interleukin-6 gene and the occurrence of atherosclerosis, coronary artery disease, Due to the short half-life and high variability of Interleukin-6 (IL-6), limited studies have been performed on the association of serum levels of interleukin-6 with coronary artery disease. The aim of this study is to investigate the relationship between IL-6 gene polymorphisms and coronary artery disease. Methods This study was conducted as a meta-analysis of selected articles with no lower time limit and upto March 2020. Articles related to the subject were obtained by searching several data sources,such as the SID, IranDoc, Scopus, Embase, Web of Science (ISI), PubMed, Science Direct, and Google Scholar databases. The heterogeneity of the studies was assessed using the I2 index in the Comprehensive Meta-Analysis software. Results The GG genotype of the IL-6174 G> C polymorphism with a 0.8 odds ratio tended to reduce the risk of CAD by 20%. The odds ratio of CAD in CG and GG genotypes were found to be 1.16 and 1.48 times respectively, indicating the increasing effect of these two genotypes. In the IL-6-572 C>G polymorphism, CG and GG genotypes increased the risk of CAD by 1.21 and 1.27 times respectively, and the CC genotype tended to reduce the risk of CAD by 15%, considering the odds ratio of 0.85. Conclusion This study showed a relationship between IL-6174G> C and Interleukin-6 (IL-6) 572 C>G genes and coronary artery disease. Moreover, the protective effects of GG genotype in IL-6 gene 174 G> C and CC genotype in IL-6 gene 572 C>G gene were reported. The study also confirmed that the CG and CC genotypes of the G>C IL-6174 gene have an increasing effect on coronary artery disease. Moreover, CG and GG genotypes in the IL-6 gene 572 C>G increased the risk of developing CAD. It should be noted that the increased risk of developing CAD was limited to meta-analytic studies in reported literatures.

scholarly journals The Decisive Case-Control Study Elaborates the Null Association between ESR1 XbaI and Osteoarthritis in Asians: A Case–Control Study and Meta-Analysis

Genes ◽  
2021 ◽  
Vol 12 (3) ◽  
pp. 404
Author(s):  
Yu-Hao Huang ◽  
Wen-Hui Fang ◽  
Dung-Jang Tsai ◽  
Yu-Hsuan Chen ◽  
Yu-Chiao Wang ◽  
...  
Keyword(s):  
Estrogen Receptor ◽  
Gender Difference ◽  
Sequential Analysis ◽  
Case Control Study ◽  
Meta Analysis ◽  
Case Control ◽  
Current Evidence ◽  
Trial Sequential Analysis ◽  
Knee Oa ◽  
Control Study

(1) Background: The prevalence of knee osteoarthritis (OA) in women is significantly higher than in men. The estrogen receptor α (ERα) has been considered to play a key role due to a large gender difference in its expression. ERα is encoded by the gene estrogen receptor 1 (ESR1), which is widely studied to explore the gender difference in knee OA. Several polymorphisms in ESR1 [PvuII (rs2234693) and BtgI (rs2228480)] were confirmed as the risk factors of OA. However, the evidence of the last widely investigated polymorphism, ESR1 Xbal (rs9340799), is still insufficient for concluding its effect on knee OA. (2) Objective: This study proposed a case–control study to investigate the association between ESR1 Xbal and knee OA. Moreover, a meta-analysis and trial sequential analysis (TSA) were conducted to enlarge the sample size for obtaining a conclusive evidence. (3) Methods: In total, 497 knee OA cases and 473 healthy controls were recruited between March 2015 and July 2018. The Kellgren–Lawrence grading system was used to identify the knee OA cases. To improve the evidence level of our study, we conducted a meta-analysis including the related studies published up until December 2018 from PubMed, Embase, and previous meta-analysis. The results are expressed as odds ratios (ORs) with corresponding 95% confidence intervals (CI) for evaluating the effect of this polymorphism on knee OA risk. TSA was used to estimate the sample sizes required in this issue. (4) Results: We found non-significant association between the G allele and knee OA [Crude-OR: 0.97 (95% CI: 0.78–1.20) and adjusted-OR: 0.90 (95% CI: 0.71–1.15) in allele model] in the present case–control study, and the analysis of other genetic models showed a similar trend. After including six published studies and our case–control studies, the current evidence with 3174 Asians showed the conclusively null association between ESR1 XbaI and knee OA [OR: 0.78 (95% CI: 0.59–1.04)] with a high heterogeneity (I2: 78%). The result of Caucasians also concluded the null association [OR: 1.05 (95% CI: 0.56–1.95), I2: 87%]. (5) Conclusions: The association between ESR1 XbaI and knee OA was not similar with other polymorphisms in ESR1, which is not a causal relationship. This study integrated all current evidence to elaborate this conclusion for suggesting no necessity of future studies.

The effect of cranberry supplementation on Helicobacter pylori eradication in H. pylori positive subjects: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2021 ◽  
pp. 1-33
Author(s):  
Ronak Nikbazm ◽  
Zahra Rahimi ◽  
Yousef Moradi ◽  
Meysam Alipour ◽  
Farzad Shidfar
Keyword(s):  
Helicobacter Pylori ◽  
Odds Ratio ◽  
Bacterial Infections ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Current Evidence ◽  
Duration Of Treatment ◽  
Helicobacter Pylori Eradication ◽  
H Pylori ◽  
Positive Effect

Abstract Helicobacter pylori infection is one of the most common chronic bacterial infections. Cranberry has been suggested for Helicobacter pylori eradication. We aimed to conduct the first meta-analysis to summarize current evidence on effects of cranberry supplementation on Helicobacter pylori eradication in H. pylori positive subjects. We searched the online databases up to December 2020. Four randomized clinical trials (RCTs) were included with human subjects, investigating the effect of cranberry on Helicobacter pylori eradication. The pooled results were expressed as the odds ratio with 95% confidence intervals. Based on 5 effect sizes with a total sample size of 1935 individuals, we found that according to the odds ratio, there was a positive effect of cranberry supplementation on Helicobacter pylori eradication, increasing the chance of Helicobacter pylori eradication by 1.27 times, but this relationship was not statistically significant (overall OR: 1.27; 95% CI: 0.63, 2.58). The results also indicated the moderate between-study heterogeneity (I2=63.40%; P=0.03) of the studies. However, there were no significant differences in some subgroup analyses in the duration of treatment, the duration of follow up and the Jadad score. Our findings revealed that although cranberry had a positive effect on Helicobacter pylori eradication in adults, this effect was not statistically significant. Due to the small number of included studies and moderate heterogeneities, the potential of cranberry supplementation on Helicobacter pylori eradication should be validated in large, multicenter, and well-designed RCTs in the future.

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