Reproductive outcomes of testicular and ejaculated sperm for ICSI in patients with previous ICSI failures: a systematic review and meta-analysis

2021 ◽  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Sperm Dna Fragmentation ◽  
Paired Data ◽  
Sperm Dna ◽  
Significant Difference ◽  
Unselected Population ◽  
The Cochrane Library

This systematic review aims to compare and evaluate the outcome of using either testicular sperm (Testi-ICSI) or ejaculated sperm (Ejac-ICSI) in intracytoplasmic sperm injections in patients with recurrent ICSI failure. The Cochrane Library, MEDLINE, EMBASE, and PubMed were used to search for relevant papers up till October 2020. Four cohort studies and two case series studies were included. Four studies investigated males with high sperm DNA fragmentation (SDF) and were classified as ''high SDF'', which included 247 couples and 2712 injected oocytes. The other three studies provided paired data to an unselected population of infertile men with either untested SDF or when anomalous SDF was not used as the basis for deciding to use Testi-ICSI, and were classified as ''noclassify'' in this study. This subgroup consisted of a total of 290 couples and 1061 injected oocytes. There was a higher level of clinical pregnancy rates (CPRs) in the ''high SDF'' subgroup when Testi-ICSI was used as compared to Ejac-ICSI, at 43.4% and 20.8% respectively, with a pooled odds ratio (OR) of 2.87 (95% confidence interval (CI) 1.44–5.71; P = 0.003). Furthermore, in the ''high SDF'' subgroup, Testi-ICSI use was associated with better take home baby rates (38%) as compared to Ejac-ICSI (16%), with a pooled OR of 3.24 (95% CI 1.20–8.76; P = 0.02). In the ''noclassify'' group, there was no statistically significant difference in the CPRs and take home baby rates of Testi-ICSI and Ejac-ICSI, although there was a trend of better CPRs and take home baby rates with Testi-ICSI use. Utilization of Testi-ICSI in recurrent ICSI failure couples, where males were confirmed to have high SDF in their ejaculated sperm, were correlated with greater CPRs and take home baby rates. However, Testi-ICSI may not result in better ICSI outcomes among men with untested SDF or when anomalous SDF was not the main factor influencing the decision to utilize Testi-ICSI.

scholarly journals SURG-16. SUPRATOTAL VERSUS GROSS TOTAL RESECTION OF GLIOBLASTOMA: A SYSTEMATIC REVIEW

2019 ◽  
Vol 21 (Supplement_6) ◽  
pp. vi243-vi243
Author(s):  
Christina Jackson ◽  
John Choi ◽  
Carrie Price ◽  
Chetan Bettegowda ◽  
Michael Lim ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Gross Total Resection ◽  
Cochrane Library ◽  
Study Quality ◽  
Total Resection ◽  
Significant Difference ◽  
Definition Of ◽  
Supratotal Resection ◽  
The Cochrane Library

Abstract INTRODUCTION Due to the infiltrative nature of glioblastoma(GBM) outside of the contrast enhancing region in the peritumoral zone, there is increasing movement to perform supratotal resections (SpTR) by extending the edge of resection beyond the contrast enhancing portion of the tumor. However, there is currently no consensus on the potential survival benefit of SpTR in GBM as compared to gross total resection (GTR). METHODS Therefore, we performed a systematic review using PRISMA guidelines and performed a comprehensive literature search on Pubmed, EMBASE, The Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov, from inception to August 16, 2018, to identify articles comparing overall survival (OS) after SpTR versus GTR. Furthermore, we assessed study quality using the Oxford Centre for Evidence-Based Medicine guidelines. RESULTS We identified 8902 unique citations, of which 11 articles and 2 abstracts met study inclusion criteria. 925 patients underwent SpTR out of a total of 2137 patients. 9 of the 13 studies demonstrated improved survival with SpTR compared to GTR (median improvement in OS of 10.5 months), with no significant difference in post-operative complication rate. Conversely, one abstract found worsened outcomes with SpTR compared to GTR (median decrease in OS of 4 months). However, overall study quality was poor, with 12 of the 13 studies of level IV evidence and one study of level IIIb evidence. We were unable to perform a meta-analysis due to significant clinical and methodological heterogeneity amongst the studies (e.g. differences in adjuvant therapy and lack of standardization of definition of supratotal resection). CONCLUSIONS Our systematic review indicates that SpTR may be associated with improved OS compared to GTR for GBM. However, this is limited by poor study quality and significant clinical and methodological heterogeneity amongst the studies. There is need for prospective clinical trials to further establish standardized guidelines for SpTR in GBM.

Should the duration of head bandaging be reduced after pinnaplasty? A systematic review

2014 ◽  
Vol 128 (11) ◽  
pp. 948-951 ◽  
Author(s):  
A E L McMurran ◽  
I Khan ◽  
S Mohamad ◽  
M Shakeel ◽  
H Kubba
Keyword(s):  
Systematic Review ◽  
Randomised Controlled Trials ◽  
Case Series ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Inclusion Criteria ◽  
National Library ◽  
Significant Difference ◽  
Randomised Controlled ◽  
The Cochrane Library

AbstractBackground:It is common practice to use head bandages for 7–10 days following pinnaplasty. However, head bandages are often troublesome for patients and can lead to serious complications.Method:A systematic review was performed to evaluate the use of head bandages after pinnaplasty. A search of Medline, Embase (Ovid) and CINAHL (EBSCO collections), the Cochrane Library, Pubmed (US National Library of Medicine) and Google Scholar identified 34 related articles. Of these, 14 were deemed relevant and 2 randomised controlled trials, 1 cohort study, 3 case series and 1 literature review met the inclusion criteria.Results:The two randomised controlled trials show no statistically significant difference in complications when a head bandage was used for the standard 7–10 days, for 24 hours or not at all. The three case series show that using a head bandage for 24 hours or not at all are safe alternatives. The review article recommended that when head bandages are applied after pinnaplasty it should be for the shortest duration possible.Conclusion:Based on the available evidence, not using a head bandage at all or using one for a maximum of 24 hours following pinnaplasty is recommended.

scholarly journals Comparison of Laminoplasty vs. Laminectomy for Cervical Spondylotic Myelopathy: A Systematic Review and Meta-Analysis

2022 ◽  
Vol 8 ◽  
Author(s):  
Huaguo Zhao ◽  
Rong Ren ◽  
Weihu Ma ◽  
Song Xu ◽  
Linrui Peng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Spondylotic Myelopathy ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Case Series ◽  
Cochrane Library ◽  
Superficial Infection ◽  
Sagittal Vertical Axis ◽  
Significant Difference ◽  
Curvature Index

ObjectivesLaminoplasty (LP) and laminectomy (LC) with or without fusion are recommended as treatment procedures for cervical spondylotic myelopathy (CSM). The purpose of this study is to conduct a meta-analysis to analyze the results of CSM patients undergoing LP or LC surgery.MethodsWe systematically and comprehensively searched Web of Science, Cochrane Library, PubMed, EMBASE, OVID, VIP database, Google Scholar, Chinese Bio-medicine Literature database, and China Scientific Journal Full-text database to July 2021 for randomized controlled trials (RCTs) and observational case series that compared LP and LC in patients with CSM. The main endpoints were the surgical process, radiographic outcomes, clinical outcomes, and surgical complications.ResultsA total of 19 were included the inclusion criteria in this meta-analysis (n = 4,348 patients). There was no significant difference in range of motion (ROM), sagittal vertical axis (SVA), Japanese Orthopedic Association (JOA), Cobb angle, visual analog scale (VAS), cervical curvature index (CCI), Nurick score, Neck Dysfunction Index (NDI), and complications. LP was found to be superior than LC in terms of complications of C5 radiculopathy and surperficial infection.ConclusionOur results indicate that LP can achieve better results in C5 radiculopathy and superficial infection in surgical treatment of CSM compared with LC. Further high-quality research is warranted to further verify our findings.Systematic Review RegistrationPRISMA: CRD42018107070.

scholarly journals Repurposing of drugs for Covid-19: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Pinky Kotecha ◽  
Alexander Light ◽  
Enrico Checcucci ◽  
Daniele Amparore ◽  
Cristian Fiori ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Adverse Events ◽  
Clinical Improvement ◽  
Case Reports ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Control Group ◽  
Significant Difference

AbstractObjectiveThe aim of this systematic review is to evaluate the data currently available regarding the repurposing of different drugs for Covid-19 treatment. Participants with suspected or diagnosed Covid-19 will be included. The interventions being considered are drugs being repurposed, and comparators will include standard of care treatment or placebo.MethodsWe searched Ovid-MEDLINE, EMBASE, Cochrane library, clinical trial registration site in the UK(NIHR), Europe (clinicaltrialsregister.eu), US (ClinicalTrials.gov) and internationally (isrctn.com), and reviewed the reference lists of articles for eligible articles published up to April 22, 2020. All studies in English that evaluated the efficacy of the listed drugs were included. Cochrane RoB 2.0 and ROBINS-I tool were used to assess study quality. This systematic review adheres to the PRISMA guidelines. The protocol is available at PROSPERO (CRD42020180915).ResultsFrom 708 identified studies or clinical trials, 16 studies and 16 case reports met our eligibility criteria. Of these, 6 were randomized controlled trials (763 patients), 7 cohort studies (321 patients) and 3 case series (191 patients). Chloroquine (CQ) had a 100% discharge rate compared to 50% with lopinavir-ritonavir at day 14, however a trial has recommended against a high dosage due to cardiotoxic events. Hydroxychloroquine (HCQ) has shown no significant improvement in negative seroconversion rate which is also seen in our meta-analysis (p=0.68). Adverse events with HCQ have a significant difference compared to the control group (p=0.001). Lopinavir-ritonavir has shown no improvement in time to clinical improvement which is seen in our meta-analyses (p=0.1). Remdesivir has shown no significant improvement in time to clinical improvement but this trial had insufficient power.DiscussionDue to the paucity in evidence, it is difficult to establish the efficacy of these drugs in the treatment of Covid-19 as currently there is no significant clinical effectiveness of the repurposed drugs. Further large clinical trials are required to achieve more reliable findings. A risk-benefit analysis is required on an individual basis to weigh out the potential improvement in clinical outcome and viral load reduction compared to the risks of the adverse events. (1-16)

scholarly journals Evaluation of bone capital after orthodontic-surgical traction of the maxillary impacted canines: systematic review

2021 ◽  
Vol 8 ◽  
Author(s):  
Abdoul Hafizou Rabe ◽  
Abdelali Halimi ◽  
Fatima Salek ◽  
Mohamed Faouzi Azaroual ◽  
Asmae Benkaddour ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Loss ◽  
Alveolar Bone ◽  
Meta Analysis ◽  
Case Series ◽  
Cochrane Library ◽  
Pubmed Central ◽  
Randomized Controlled ◽  
Impacted Canines ◽  
Significant Difference

Background: The aim of our study is to evaluate, through a systematic review, the bone capital of the maxillary impacted canines vestibular or palatine trailed compared to their contralateral counterpart. Method: five databases were consulted: PubMed; PubMed Central, Google Scholar, Cochrane Library, and Ebscohost. The research included published studies from 2010 to 2018, meta-analysis studies, randomized and non-randomized controlled trials, prospective and retrospective studies, case series, control cases. Results: Among the 299 selected references, only 4 studies met our inclusion criteria. There is no statistically significant difference in alveolar bone loss between the two closed and open techniques for palatal canine traction. Bone loss ranged from 0.03 mm to 0.39 mm compared to the contralateral normal canine. For vestibular traction, bone resorption compared to the normally located canine varies from 0.82 to 0.89 mm. Conclusion: Canine traction is accompanied by a statistically significant bone loss compared to the contralateral canine. This bone defect is more aggravated when the inclusion is vestibular but remains clinically acceptable.

scholarly journals Efficacy and safety of thromboprophylaxis in cancer patients: a systematic review and meta-analysis

2020 ◽  
Vol 12 ◽  
pp. 175883592090754
Author(s):  
Miao Liu ◽  
Guiyue Wang ◽  
Yuhang Li ◽  
Hongliang Wang ◽  
Haitao Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Efficacy And Safety ◽  
Bleeding Events ◽  
Patients With Cancer ◽  
Significant Difference ◽  
All Cause Mortality ◽  
The Cochrane Library

Background: Thrombosis is a common complication in patients with cancer. Whether thromboprophylaxis could benefit patients with cancer is unclear. The aim of this systematic review was to determine the efficacy and safety of thromboprophylaxis in patients with cancer undergoing surgery or chemotherapy. Methods: We searched the Cochrane Library, EMBASE, MEDLINE, EBSCOhost, and Web of Science for studies published before May 2018 to investigate whether thromboprophylaxis measures were more effective than a placebo in patients with cancer. Results: In total, 33 trials with 11,942 patients with cancer were identified. In patients with cancer undergoing surgery, the administration of thromboprophylaxis was associated with decreasing trends in venous thromboembolism (VTE) [relative risk (RR) 0.51, 95% confidence interval (CI) 0.32–0.81] and DVT (RR 0.53, 95% CI 0.33–0.87). In patients with cancer undergoing chemotherapy, the administration of thromboprophylaxis reduced the incidences of VTE, DVT, and pulmonary embolism compared with no thromboprophylaxis (RR 0.54, 95% CI 0.40–0.73; RR 0.47, 95% CI 0.31–0.73; RR 0.51, 95% CI 0.32–0.81, respectively). The pooled results regarding major bleeding showed no significant difference between prophylaxis and no prophylaxis in either the surgical or the chemotherapy groups (RR 2.35, 95% CI 0.74–7.52, p = 0.1482, I2 = 0%; RR 1.30, 95% CI 0.93–1.83, p = 0.1274, I2 = 0%, respectively). Conclusion: Thromboprophylaxis did not increase major bleeding events or the incidence of thrombocytopenia. All-cause mortality was not significantly different between those who received thromboprophylaxis and those who did not. This meta-analysis provides evidence that thromboprophylaxis can reduce the number of VTE and DVT events, with no apparent increase in the incidence of major bleeding in patients with cancer.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

Appendectomy Does Not Increase the Risk of Future Emergence of Parkinson’s Disease: A Meta-analysis

2021 ◽  
pp. 000313482198903
Author(s):  
Mitsuru Ishizuka ◽  
Norisuke Shibuya ◽  
Kazutoshi Takagi ◽  
Hiroyuki Hachiya ◽  
Kazuma Tago ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Random Effects Models ◽  
Significant Difference ◽  
The Cochrane Library ◽  
The Impact ◽  
The Relationship ◽  
Observation Period

Objective To explore the impact of appendectomy history on emergence of Parkinson’s disease (PD). Background Although there are several studies to investigate the relationship between appendectomy history and emergence of PD, the results are still controversial. Methods We performed a comprehensive electronic search of the literature (the Cochrane Library, PubMed, and the Web of Science) up to April 2020 to identify studies that had employed databases allowing comparison of emergence of PD between patients with and those without appendectomy history. To integrate the impact of appendectomy history on emergence of PD, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI) for the selected studies, and heterogeneity was analyzed using I2 statistics. Results Four studies involving a total of 6 080 710 patients were included in this meta-analysis. Among 1 470 613 patients with appendectomy history, 1845 (.13%) had emergences of PD during the observation period, whereas among 4 610 097 patients without appendectomy history, 6743 (.15%) had emergences of PD during the observation period. These results revealed that patients with appendectomy history and without appendectomy had almost the same emergence of PD (RR, 1.02; 95% CI, .87-1.20; P = .83; I2 = 87%). Conclusion This meta-analysis has demonstrated that there was no significant difference in emergence of PD between patients with and those without appendectomy history.

scholarly journals Lumbar Roll Usage While Sitting Reduces the Forward Head Posture in Healthy Individuals: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 18 (10) ◽  
pp. 5171
Author(s):  
Yusuke Handa ◽  
Kenya Okada ◽  
Hiroshi Takasaki
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Grade System ◽  
Cochrane Library ◽  
Forward Head Posture ◽  
Quality Of Evidence ◽  
Head Posture ◽  
Head Extension ◽  
The Cochrane Library

This systematic review and meta-analysis investigated whether the use of a lumbar roll reduced forward head posture (FHP) while sitting among individuals with or without musculoskeletal disorders. EMBASE, MEDLINE, and the Cochrane Library were systematically searched from their inception to August 2020. The quality of evidence for variables used in the meta-analysis was determined using the GRADE system. Five studies satisfied the criteria for data analysis. All studies included individuals without any spinal symptoms. Data from five studies on neck angle showed a statistically significant (p = 0.02) overall effect (standardized mean difference (SMD) = 0.77), indicating a lesser neck flexion angle while sitting with a lumbar roll than without it. Data from two studies on head angle showed a statistically significant (p = 0.04) overall effect (SMD = 0.47), indicating a lesser head extension angle while sitting with a lumbar roll than without it. In each meta-analysis, the quality of evidence was very low in the GRADE system. The use of a lumbar roll while sitting reduced FHP among individuals without spinal symptoms.

447 What Age is Best to Perform Myringoplasty?

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
L Wilks ◽  
R Mcleod ◽  
V Unadkat
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Cochrane Library ◽  
Clear Correlation ◽  
Success Rates ◽  
Prisma Statement ◽  
Transitional Point ◽  
The Cochrane Library

Abstract Aim This systematic review and meta-analysis aims to assess this relationship and determine the most appropriate age for recommendation of surgery. Method According to the “Preferred Reporting items for systematic review and meta-analysis” (PRISMA) statement, a literature search was performed across Medline, EMBASE and the Cochrane library from 1946-2018. Articles examining a relationship between age and myringoplasty or type 1 tympanoplasty success rates were screened. Results 20 articles encompassing data from 2244 procedures were included. The overall results conveyed a clear correlation between increasing age and rising success rate. A t-test was conducted which demonstrated a significant (P = 0.05) transition at aged 10, whereby success rate below age 10 was 70.6% and above 10 was 86%. Conclusions This systematic review and meta-analysis has uncovered a clear correlation between increasing age and increasing success rate for myringoplasty in the paediatric population. Furthermore, a significant transitional point has been demonstrated at the age of 10 and We hope that knowledge of increased success rates particularly after the age of 10 helps clinicians make more informed decisions about when to operate

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