scholarly journals Primary versus delayed primary skin closure for prevention of surgical site infections in contaminated abdominal surgery: A meta-analysis of randomized controlled trials.

2021 ◽  
Author(s):  
Almegdad Sharafaldin Mohamed Ahmed ◽  
Ali mohammed ali mohammed ahmed ◽  
Basil Abubakr Yagoub Ibrahim ◽  
Mohammed.a.adam ◽  
Ali Yasen Y. Mohamedahmed ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Surgical Site Infections ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Skin Closure ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background and purpose of the study: Surgical site infections (SSIs) are one of the most common hospital acquired infections. Delayed primary skin closure (DPC) is a technique that can be used when there is a contaminated or dirty wound. The purpose of this study was to evaluate the effectiveness of DPC in reducing SSIs in dirty and contaminated abdominal surgeries compared to primary skin closure (PC).Methods: An electronic search was conducted using six databases and clinical trials registers, only randomized controlled trials (RCTs) were included. selection of the included studies and data extraction were conducted by more than one reviewer independently. All of the included studies were assessed for the risk of bias. Pooling of the data was performed for surgical site infections as a primary outcome, and the length of hospital stay.Main findings:12 RCTs were included in the final analysis, including 1456 patients that were randomized to receive either PC or DPC. Complicated appendicitis was the most common type of wounds with a percentage of (82.8%). Pooling of the data showed a significant difference between the two methods, and DPC was found effective in reducing the risk for SSI with a risk ratio of 0.56([95% CI:0.44, 0.72], P < 0.001). The length of hospital stay was slightly lower in the PC group with a mean difference of 0.25(95% CI:0.02, 0.48) days from DPC group.Conclusions: DPC might be more effective than PC in reducing the risk of SSIs, however most of the studies included in this meta-analysis conveyed a high risk of bias, hence more well-designed RCTs are recommended in this area.

scholarly journals Is reiki or prayer effective in relieving pain during hospitalization for cesarean? A systematic review and meta-analysis of randomized controlled trials

2017 ◽  
Vol 135 (2) ◽  
pp. 123-132 ◽  
Author(s):  
Guilherme Augusto Rago Ferraz ◽  
Meline Rosseto Kron Rodrigues ◽  
Silvana Andrea Molina Lima ◽  
Marcelo Aparecido Ferraz Lima ◽  
Gabriela Lopes Maia ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Spiritual Healing ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Section Design

ABSTRACT CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. RESULTS: There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. CONCLUSION: Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction.

scholarly journals Exploring the Efficacy of Using Hypertonic Saline for Nebulizing Treatment in Children with Bronchiolitis: a Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Author(s):  
Chia-Wen Hsieh ◽  
Hui-Chuan Su ◽  
Kee-Hsin Chen ◽  
Chiehfeng Chen
Keyword(s):  
Respiratory Distress ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Hypertonic Saline ◽  
Saline Solution ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Controlled Trials ◽  
Acute Bronchiolitis ◽  
Randomized Controlled

Abstract Introduction: Acute bronchiolitis is the most common lower respiratory infection in children. It is particularly prone to dyspnea among children under two years old. Inhaled hypertonic saline (HS) has recently been shown to be a favorable therapy, because of its facility to draw fluid from the submucosa and adventitial spaces, decreasing airway edema. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of vapor treatment among children with bronchiolitis.Methods: A systematic literature search was conducted using Cochrane Library, PubMed, EMBASE and Airiti Library (Chinese Database) for randomized controlled trials from inception to July 2019. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3 for meta-analysis.Results: In total, 4186 children from 32 publications were included. Compared to the control group, the HS group exhibited significantly reducing the level of severity of respiratory distress, included studies used the Clinical Severity Score (95% CI −1.15, −0.27, I² = 73%) and Respiratory Distress Assessment Instrument (95% CI −0.95, −0.26, I²= 0%) for evaluation respectively. Further, the HS group decreased the length of hospital stay 0.54 days (95% CI −0.86, −0.32, I²= 81%). Conclusion: We conclude that nebulized with 3% saline solution is effective in decreasing the length of hospital stay and the severity of symptoms as compared with 0.9% saline solution among children with acute bronchiolitis. Further rigor randomize controlled trails with large sample size are needed.

scholarly journals Hydroxychloroquine plus standard of care compared with standard of care alone in COVID-19: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bahman Amani ◽  
Ahmad Khanijahani ◽  
Behnam Amani
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Standard Of Care ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

AbstractThe efficacy and safety of Hydroxychloroquine (HCQ) in treating coronavirus disease (COVID-19) is disputed. This systematic review and meta-analysis aimed to examine the efficacy and safety of HCQ in addition to standard of care (SOC) in COVID-19. PubMed, the Cochrane Library, Embase, Web of sciences, and medRxiv were searched up to March 15, 2021. Clinical studies registry databases were also searched for identifying potential clinical trials. The references list of the key studies was reviewed to identify additional relevant resources. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Jadad checklist. Meta-analysis was performed using RevMan software (version 5.3). Eleven randomized controlled trials with a total number of 8161 patients were identified as eligible for meta-analysis. No significant differences were observed between the two treatment groups in terms of negative rate of polymerase chain reaction (PCR) (Risk ratio [RR]: 0.99, 95% confidence interval (CI) 0.90, 1.08; P = 0.76), PCR negative conversion time (Mean difference [MD]: − 1.06, 95% CI − 3.10, 0.97; P = 0.30), all-cause mortality (RR: 1.09, 95% CI 1.00, 1.20; P = 0.06), body temperature recovery time (MD: − 0.64, 95% CI − 1.37, 0.10; P = 0.09), length of hospital stay (MD: − 0.17, 95% CI − 0.80, 0.46; P = 0.59), use of mechanical ventilation (RR: 1.12, 95% CI 0.95, 1.32; P = 0.19), and disease progression (RR = 0.82, 95% CI 0.37, 1.85; P = 0.64). However, there was a significant difference between two groups regarding adverse events (RR: 1.81, 95% CI 1.36, 2.42; P < 0.05). The findings suggest that the addition of HCQ to SOC has no benefit in the treatment of hospitalized patients with COVID-19. Additionally, it is associated with more adverse events.

scholarly journals Exploring the efficacy of using hypertonic saline for nebulizing treatment in children with bronchiolitis: a meta-analysis of randomized controlled trials

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Chia-Wen Hsieh ◽  
Chiehfeng Chen ◽  
Hui-Chuan Su ◽  
Kee-Hsin Chen
Keyword(s):  
Respiratory Distress ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Hypertonic Saline ◽  
Saline Solution ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Controlled Trials ◽  
Acute Bronchiolitis ◽  
Randomized Controlled

Abstract Background Inhaled hypertonic saline (HS) has shown benefit in decreasing airway edema in acute bronchiolitis which is the most common lower respiratory infection resulting in dyspnea among infants under 2 years old. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of HS in the implementation of treatment with nebulized HS among children with bronchiolitis. Methods A systematic literature search was conducted using Cochrane Library, PubMed, EMBASE and Airiti Library (Chinese Database) for randomized controlled trials from inception to July 2019. We calculated pooled risk ratios (RR), mean difference (MD) and 95% CI using RevMan 5.3 for meta-analysis. Results There were 4186 children from 32 publications included. Compared to the control group, the HS group exhibited significant reduction of severity of respiratory distress, included studies used the Clinical Severity Score (n = 8; MD, − 0.71; 95% CI, − 1.15 to − 0.27; I2 = 73%) and full stop after Respiratory Distress Assessment Instrument (n = 5; MD, − 0.60; 95% CI, − 0.95 to − 0.26; I2 = 0%) for evaluation respectively. Further, the HS group decreased the length of hospital stay 0.54 days (n = 20; MD, − 0.54; 95% CI, − 0.86 to − 0.23; I2 = 81%). Conclusions We conclude that nebulization with 3% saline solution is effective in decreasing the length of hospital stay and the severity of symptoms as compared with 0.9% saline solution among children with acute bronchiolitis. Further rigorous randomized controlled trials with large sample size are needed.

scholarly journals Moxibustion for the Correction of Nonvertex Presentation: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Qin-hong Zhang ◽  
Jin-huan Yue ◽  
Ming Liu ◽  
Zhong-ren Sun ◽  
Qi Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Cessation Of Treatment

Objectives. This study aims to assess the effectiveness and safety of moxibustion for the correction of nonvertex presentation.Methods. Records without language restrictions were searched up to February 2013 for randomized controlled trials (RCTs) comparing moxibustion with other therapies in women with a singleton nonvertex presentation. Cochrane risk of bias criteria were used to assess the methodological quality of the trials.Results. Seven of 392 potentially relevant studies met the inclusion criteria. When moxibustion was compared with other interventions, a meta-analysis revealed a significant difference in favor of moxibustion on the correction of nonvertex presentation at delivery (risk ratio (RR) 1.29, 95% confidence interval (CI) 1.12 to 1.49, andI2=0). The same findings applied to the cephalic presentation after cessation of treatment (RR 1.36, 95% CI 1.08 to 1.71, andI2=80%). A subgroup analysis that excluded two trials with a high risk of bias also indicated favorable effects (RR 1.63, 95% CI 1.42 to 1.86, andI2=0%). With respect to safety, moxibustion resulted in decreased use of oxytocin.Conclusion. Our systematic review and meta-analysis suggested that moxibustion may be an effective treatment for the correction of nonvertex presentation. Moreover, moxibustion might reduce the need for oxytocin.

scholarly journals Clinical Efficacy of Perioperative Immunonutrition Containing Omega-3-Fatty Acids in Patients Undergoing Hepatectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
pp. 1-12
Author(s):  
Benjian Gao ◽  
Jia Luo ◽  
Ying Liu ◽  
Furui Zhong ◽  
Xiaoli Yang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

<b><i>Background:</i></b> The effect of immunonutrition in patients undergoing hepatectomy remains unclear. This meta-analysis aimed to assess the impact of immunonutrition on postoperative clinical outcomes in patients undergoing hepatectomy. <b><i>Methods:</i></b> A literature search of PubMed, Cochrane Library, Web of Science, and Embase databases was performed to identify all randomized controlled trials (RCTs) exploring the effect of perioperative immunonutrition in patients undergoing hepatectomy until the end of March 10, 2020. Quality assessment and data extraction of RCTs were conducted independently by 3 reviewers. Mean difference (MD) and odds ratio (OR) with 95% confidence interval (CI) were calculated using a fixed-effects or random-effects model. The meta-analysis was performed with RevMan 5.3 software. <b><i>Results:</i></b> Nine RCTs involving a total of 966 patients were finally included. This meta-analysis showed that immunonutrition significantly reduced the incidences of overall postoperative complications (OR = 0.57, 95% CI: 0.34–0.95; <i>p</i> = 0.03), overall postoperative infectious complications (OR = 0.53, 95% CI: 0.37–0.75; <i>p</i> = 0.0003), and incision infection (OR = 0.50, 95% CI: 0.28–0.89; <i>p</i> = 0.02), and it shortened the length of hospital stay (MD = −3.80, 95% CI: −6.59 to −1.02; <i>p</i> = 0.007). There were no significant differences in the incidences of pulmonary infection (OR = 0.60, 95% CI: 0.32–1.12; <i>p</i> = 0.11), urinary tract infection (OR = 1.30, 95% CI: 0.55–3.08; <i>p</i> = 0.55), liver failure (OR = 0.54, 95% CI: 0.23–1.24; <i>p</i> = 0.15), and postoperative mortality (OR = 0.69, 95% CI: 0.26–1.83; <i>p</i> = 0.46). <b><i>Conclusion:</i></b> Given its positive impact on postoperative complications and the tendency to shorten the length of hospital stay, perioperative immunonutrition should be encouraged in patients undergoing hepatectomy.

Effects of Enteral Immunonutrition in Patients Undergoing Pancreaticoduodenectomy: A Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 74 (1) ◽  
pp. 53-61 ◽  
Author(s):  
Haonan Guan ◽  
Sanwei Chen ◽  
Qiang Huang
Keyword(s):  
Hospital Stay ◽  
Randomized Controlled Trials ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Postoperative Mortality ◽  
Length Of Hospital Stay ◽  
Infectious Complications ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Background: The effect of enteral immunonutrition (EIN) in patients undergoing pancreaticoduodenectomy (PD) is still doubtful. This meta-analysis aimed to assess the impact of EIN on postoperative clinical outcomes for patients undergoing PD. Methods: A literature search was carried out to identify all of the randomized controlled trials (RCTs) concerning the use of EIN for PD. Data collection ended on April 1, 2018. Pooled risk ratios (RRs) and the mean difference (MD) with a 95% CI were calculated using fixed effects or random effects models. The analyses were performed with RevMan 5.3.5. Results: Four RCTs with a total of 299 patients were included. Immunonutrition reduced the incidence of postoperative infectious complications (RR 0.58, 95% CI 0.37–0.92; p = 0.02) and shortened the length of hospital stay (MD –1.79, 95% CI –3.40 to 0.18; p = 0.03). Conversely, there were no significant differences in the incidence of overall postoperative complications (RR 0.81, 95% CI 0.62–1.05; p = 0.11), non-infectious complications (RR 0.94, 95% CI 0.69–1.28; p = 0.70) and postoperative mortality (RR 2.43, 95% CI 0.37–16.10; p = 0.36). Conclusions: EIN reduced postoperative infectious complications and shortened the length of the hospital stay; immunonutrition should be encouraged in patients undergoing PD.

scholarly journals Adjuvant Transarterial Chemoembolization Following Curative-Intent Hepatectomy Versus Hepatectomy Alone for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Cancers ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2984
Author(s):  
Stepan M. Esagian ◽  
Christos D. Kakos ◽  
Emmanouil Giorgakis ◽  
Lyle Burdine ◽  
J. Camilo Barreto ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Transarterial Chemoembolization ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Curative Intent ◽  
Randomized Controlled

The role of adjuvant transarterial chemoembolization (TACE) for patients with resectable hepatocellular carcinoma (HCC) undergoing hepatectomy is currently unclear. We performed a systematic review of the literature using the MEDLINE, Embase, and Cochrane Library databases. Random-effects meta-analysis was carried out to compare the overall survival (OS) and recurrence-free survival (RFS) of patients with resectable HCC undergoing hepatectomy followed by adjuvant TACE vs. hepatectomy alone in randomized controlled trials (RCTs). The risk of bias was assessed using the Risk of Bias 2.0 tool. Meta-regression analyses were performed to explore the effect of hepatitis B viral status, microvascular invasion, type of resection (anatomic vs. parenchymal-sparing), and tumor size on the outcomes. Ten eligible RCTs, reporting on 1216 patients in total, were identified. The combination of hepatectomy and adjuvant TACE was associated with superior OS (hazard ratio (HR): 0.66, 95% confidence interval (CI): 0.52 to 0.85; p < 0.001) and RFS (HR: 0.70, 95% CI: 0.56 to 0.88; p < 0.001) compared to hepatectomy alone. There were significant concerns regarding the risk of bias in most of the included studies. Overall, adjuvant TACE may be associated with an oncologic benefit in select HCC patients. However, the applicability of these findings may be limited to Eastern Asian populations, due to the geographically restricted sample. High-quality multinational RCTs, as well as predictive tools to optimize patient selection, are necessary before adjuvant TACE can be routinely implemented into standard practice. PROSPERO Registration ID: CRD42021245758.

scholarly journals Effects of Supervised Multimodal Exercise Interventions on Cancer-Related Fatigue: Systematic Review and Meta-Analysis of Randomized Controlled Trials

2015 ◽  
Vol 2015 ◽  
pp. 1-13 ◽  
Author(s):  
José Francisco Meneses-Echávez ◽  
Emilio González-Jiménez ◽  
Robinson Ramírez-Vélez
Keyword(s):  
Systematic Review ◽  
Resistance Training ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Exercise Interventions ◽  
Training Interventions ◽  
Randomized Controlled ◽  
Cancer Related Fatigue

Objective. Cancer-related fatigue (CRF) is the most common and devastating problem in cancer patients even after successful treatment. This study aimed to determine the effects of supervised multimodal exercise interventions on cancer-related fatigue through a systematic review and meta-analysis.Design. A systematic review was conducted to determine the effectiveness of multimodal exercise interventions on CRF. Databases of PubMed, CENTRAL, EMBASE, and OVID were searched between January and March 2014 to retrieve randomized controlled trials. Risk of bias was evaluated using the PEDro scale.Results. Nine studiesn=772were included in both systematic review and meta-analysis. Multimodal interventions including aerobic exercise, resistance training, and stretching improved CRF symptoms (SMD=-0.23; 95% CI: −0.37 to −0.09;P=0.001). These effects were also significant in patients undergoing chemotherapyP<0.0001. Nonsignificant differences were found for resistance training interventionsP=0.30. Slight evidence of publication bias was observedP=0.04. The studies had a low risk of bias (PEDro scale mean score of 6.4 (standard deviation (SD) ± 1.0)).Conclusion. Supervised multimodal exercise interventions including aerobic, resistance, and stretching exercises are effective in controlling CRF. These findings suggest that these exercise protocols should be included as a crucial part of the rehabilitation programs for cancer survivors and patients during anticancer treatments.

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