scholarly journals Does Preoperative Halo-Gravity Traction Reduce the Degree of Deformity and Improve Pulmonary Function in Severe Scoliosis Patients With Pulmonary Insufficiency? A Systematic Review and Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Zhao Yang ◽  
Yang Liu ◽  
Longtao Qi ◽  
Shanshan Wu ◽  
Jingwen Li ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Cobb Angle ◽  
Meta Analysis ◽  
Perioperative Period ◽  
Radiographic Measurement ◽  
Cochrane Library ◽  
Pulmonary Insufficiency ◽  
Mean Deviation ◽  
Severe Scoliosis ◽  
Pulmonary Functions

Background: Halo-gravity traction is a commonly used clinical intervention to reduce surgical risk in patients with scoliosis before surgical correction. Some previous studies have focused on the application of halo-gravity traction on patients with severe spinal deformity and pulmonary insufficiency, but the overall effect of halo-gravity traction has not been fully understood. The object of the present study was to perform a meta-analysis exploring the efficacy of preoperative halo-gravity traction on radiographic measurement and pulmonary function in severe scoliosis patients with pulmonary insufficiency.Methods: We searched the medical works of literature completed before January 17, 2021, in the databases of Pubmed, Embase, and Cochrane Library. Studies that quantitatively analyzed the effects of halo-gravity traction on the deformity and pulmonary functions of patients with severe scoliosis were included. Two researchers independently conducted the literature search, data extraction, and quality assessment. We used the Review Manager Software (version 5.4) for statistical analysis and data analysis. Mean difference (MD) with 95% confidence intervals (CIs) were calculated to evaluate the effects of halo-gravity traction.Results: Seven studies involving 189 patients received halo-gravity traction therapy preoperatively were analyzed in our study. Preoperative halo-gravity traction significantly ameliorated the degree of deformity in severe scoliosis patients with pulmonary insufficiency, especially reduced coronal Cobb angle and sagittal Cobb angle effectively [mean deviation (MD) = 2 7.28 (95%CI 21.16–33.4), p < 0.001; MD = 22.02 (95%CI 16.8–27.23), p < 0.001]. Preoperative halo-gravity traction also improved the pulmonary functions in patients, especially increasing %FVC and %FEV1 [MD = −0.0662 (95%CI −0.0672–−0.0652), p < 0.001; MD = −0.0824 (95%CI −0.0832–−0.081), p < 0.001].Conclusions: Preoperative halo-gravity traction for severe scoliosis patients shows significant improvement in the degree of deformity and pulmonary functions. Halo-gravity traction is an effective method to improve the tolerance of patients to surgery in the perioperative period.

scholarly journals Reconstruction Methods and Complications of Esophagogastrostomy and Jejunal Interposition in Proximal Gastrectomy for Gastric Cancer: A Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Nan Du ◽  
Pei Wu ◽  
Pengliang Wang ◽  
Yuwei Du ◽  
Kai Li ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Lower Risk ◽  
Meta Analysis ◽  
Proximal Gastrectomy ◽  
Operating Time ◽  
Perioperative Period ◽  
Jejunal Interposition ◽  
Cochrane Library ◽  
Reconstruction Methods ◽  
Significant Difference

Background. Proximal gastrectomy is used for the treatment of primary gastric cancer by open or laparoscopic surgery in the upper third of the stomach. Esophagogastrostomy (EG) or jejunal interposition (JI) is widely used in various reconstruction methods after proximal gastrectomy. We conducted a meta-analysis of EG and JI for treatment of gastric cancer. Materials and Methods. A search of PubMed, Embase, MEDLINE, J-STAGE, and Cochrane Library identified retrospective series on EG and JI. Weight mean differences (WMDs), odds ratios (ORs), and 95% confidence intervals (CIs) were used to analyze the operation-related data and postoperative complications. Heterogeneity was evaluated by the I2 test, and potential publication bias was assessed with Egger regression tests and sensitivity analysis. Results. Eight studies were selected, and 496 patients were included. EG group benefits were 44.81 min shorter operating time (P<0.001), 56.58 mL less blood loss (P=0.03), and 7.4 days shorter hospital stay time (P<0.001) than the JI group. Between the two groups, there was no significant difference in anastomotic leakage; otherwise, the EG group had a lower risk of anastomotic stenosis (OR=0.44, 95%CI=0.20 to 0.97, P=0.04), lower risk of intestinal obstruction (OR=0.07, 95%CI=0.01 to 0.43, P=0.004), and higher risk of reflux esophagitis (OR=2.47, 95%CI=1.07 to 5.72, P=0.03). Conclusion. The results of our study indicated that EG has significant advantages during the perioperative period and in short-term outcomes compared to JI.

scholarly journals The Influence of Diabetes Mellitus on Patients Undergoing Primary Total Lower Extremity Arthroplasty: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Wanjin Qin ◽  
Xiaoxiong Huang ◽  
Huilin Yang ◽  
Minjie Shen
Keyword(s):  
Diabetes Mellitus ◽  
Postoperative Complications ◽  
Lower Extremity ◽  
Meta Analysis ◽  
Demographic Data ◽  
Perioperative Period ◽  
Deep Infection ◽  
Cochrane Library ◽  
Common Disease ◽  
Vein Thrombosis

Background. Diabetes mellitus (DM) is a common disease that has an adverse impact on most orthopedic surgeries, and its prevalence has gradually increased in recent years. We aim to investigate the influence of DM on comorbidities and complications of patients undergoing primary total lower extremity arthroplasty. Methods. PubMed, Embase, Cochrane Library, Medline, and Web of Science were systematically searched for relevant studies published before December 2019. Demographic data, comorbidities, and postoperative complications after primary total hip arthroplasties (THA) or primary total knee arthroplasties (TKA) were assessed between DM and non-DM patients. Meta-analysis was conducted using Review Manager 5.3, and forest plots were drawn for each variable. Results. A total of 1,560,461 patients (215,916 patients with DM and 1,344,545 patients without DM) from 23 studies were included in this meta-analysis. The incidences of several preoperative comorbidities (hypertension (HTN), kidney disease, cardiac and cerebrovascular disease) were generally higher in patients with DM. Moreover, DM patients had a higher rate of postoperative complications (superficial and deep infection, deep vein thrombosis (DVT), and in-hospital mortality) compared to non-DM patients. Conclusions. DM patients were more likely to suffer from comorbidities and had a higher risk of complications in total lower extremity arthroplasty compared to non-DM patients. It is necessary to identify DM and control hyperglycemia in the perioperative period to prevent postoperative complications in patients with DM.

scholarly journals TL 18144 - Percutaneous chevron/akin (PECA) versus open scarf/akin (SA) osteotomy treatment in hallux valgus

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 92S
Author(s):  
Kelly Cristina Stéfani ◽  
Gabriel Ferraz Ferreira ◽  
Vinícius Quadros Borges ◽  
Leonardo Vinicius De Matos Moraes
Keyword(s):  
Systematic Review ◽  
Hallux Valgus ◽  
Meta Analysis ◽  
Perioperative Period ◽  
Fixed Effect Model ◽  
Cochrane Library ◽  
Percutaneous Technique ◽  
Radiographic Outcomes ◽  
Effect Model ◽  
The Cochrane Library

Introduction: The surgical treatment of hallux valgus presents several techniques described in the literature. Recently, the percutaneous technique has appeared as a less invasive option in the correction of the deformity and is increasingly used by surgeons.  Methods: A meta-analysis was performed using studies discovered by the systematic review of articles included in electronic databases (Medline, Scopus, Embase and the Cochrane Library) until June 2018 (Systematic Review Registry PROSPERO: CRD42018096613). A pooling analysis was synthesized from clinical outcomes such as the visual analogue scale of pain (VAS) and AOFAS score, radiographic outcomes and evaluation of complications.  Results: Two studies, including 137 feet with a hallux valgus diagnosis were added to the analysis, comparing open surgery using the Scarf and Akin (SA) technique versus percutaneous Chevron and Akin (PECA). In the synthesis of the results, pain in the perioperative period was lower in the PECA group, with a reduction of 1.68 points in the fixed effect model (95% CI = -2.09 a -1.27, p < 0.01, i2 = 87%, t2 = 0.60). There were no differences between techniques in the radiographic results or in the risk of complications. The PECA technique demonstrated a longer radioscopy time compared with SA. Conclusion: Use of the PECA method to correct hallux valgus compared with the open SA technique demonstrated less pain in the perioperative period, a similar potential for radiographic correction and an equal risk of complications, with a longer radioscopy time.

scholarly journals Comparison of transesophageal echocardiography findings after different anticoagulation strategies in patients with atrial fibrillation: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Jian Yang ◽  
Xuan Zhang ◽  
Xi-ying Wang ◽  
Chi Zhang ◽  
Song-zan Chen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Transesophageal Echocardiography ◽  
Vitamin K ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Perioperative Period ◽  
Chronic Atrial Fibrillation ◽  
Cochrane Library ◽  
Significant Difference

Abstract Background High risk of embolic events exists in both patients with chronic atrial fibrillation (AF) and patients in the perioperative period of ablation (effective treatment for AF). Therefore, anticoagulant therapy is important. Oral anticoagulants can be divided into two major categories: vitamin K antagonists (VKAs) and non-vitamin K antagonist oral anticoagulants (NOACs). VKAs, represented by warfarin, have been widely used as traditional anticoagulants, whereas NOACs have been used in clinical practice, but their anticoagulant effects and side effects are still the focus of research. We used a meta-analysis to compare the incidence of left atrial thrombi (LAT) between different anticoagulants. Methods We searched PubMed, EMBASE, Web of Science, and the Cochrane Library databases for observational studies that compared the transesophageal echocardiography (TEE) findings for patients treated with NOACs and VKAs. The incidence of LAT and dense spontaneous echocardiographic contrast (dense SEC) were extracted as the basis of the meta-analysis. Results Fifteen studies were included in the meta-analysis. We found that patients anticoagulated with NOACs and VKAs had similar incidence of LAT (OR = 0.74, 95%CI: 0.55–1.00). After excluding the heterogeneous article by sensitivity analysis, we found the incidence of LAT in patients anticoagulated with NOACs is lower than VKAs (OR = 0.59, 95%CI: 0.42–0.84). The results of subgroup analysis showed that the incidence of LAT among three types of NOACs have no significant difference (dabigatran vs. rivaroxaban, OR = 1.16 [0.75, 1.81]; rivaroxaban vs. apixaban, OR = 0.97 [0.54, 1.74]; dabigatran vs. apixaban, OR = 1.09 [0.55, 2.16]). Conclusion Patients anticoagulated with NOACs may have lower incidence of LAT than VKAs. The incidence of LAT among different type of NOACs are similar.

scholarly journals Percutaneous Chevron/Akin (Peca) Versus Open Scarf/Akin (Sa) Osteotomies Treatment in Hallux Valgus: A Systematic Review and Meta-Analysis of 137 Feet

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0017
Author(s):  
Kelly Cristina Stéfani ◽  
Leonardo Moraes ◽  
Gabriel Ferraz Ferreira ◽  
Vinicius Borges
Keyword(s):  
Systematic Review ◽  
Hallux Valgus ◽  
Meta Analysis ◽  
Perioperative Period ◽  
Fixed Effect Model ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Percutaneous Technique ◽  
Radiographic Outcomes ◽  
Fixed Model

Category: Bunion Introduction/Purpose: The surgical treatment of hallux valgus presents several techniques described in the literature. Recently the percutaneous technique appeared as a less invasive option in the correction of the deformity and more and more used by the surgeons. Methods: The meta-analysis was performed through studies found from the systematic review of articles included in electronic databases (Medline, Scopus, Embase and the Cochrane Library) until June 2018 (Systematic Review Registry PROSPERO: CRD42018096613). The pooled analysis was synthesized from clinical outcomes such as visual analogue scale of pain and AOFAS score, radiographic outcomes and evaluation of complications, with 95% confidence interval. The pooled data were weighted using the fixed model effect. Results: Two studies, including 137 feet with hallux valgus diagnosis were added in the analysis, comparing open surgery using the Scarf and Akin (SA) technique versus the percutaneous Chevron and Akin (PECA). In the synthesis of the result, pain in the perioperative period was lower in the PECA group, with a reduction of 1.96 points in the fixed effect model (95% CI = -2.28 to - 1.65, p = 0.53, i2 = 0%, t2 = 0), without presenting differences between techniques in the radiographic result, nor in the risk of complications. The PECA technique demonstrated longer radioscopy time when compared to SA. Conclusion: The use of the percutaneous method (PECA) to correct hallux valgus when compared to the open technique (SA) demonstrated less pain in the perioperative period, similar potential of radiographic correction and an equal risk of complications, with a longer radioscopy time.

Efficacy of Glutathione for Patients With Cystic Fibrosis: A Meta-analysis of Randomized-Controlled Studies

2019 ◽  
Vol 34 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Jinqiu Zhao ◽  
Wenxiang Huang ◽  
Shujun Zhang ◽  
Jing Xu ◽  
Wei Xue ◽  
...  
Keyword(s):  
Cystic Fibrosis ◽  
Pulmonary Function ◽  
Positive Impact ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Cochrane Library ◽  
Control Group ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
The Impact

Introduction The impact of glutathione on pulmonary function remains elusive for patients with cystic fibrosis. The aim of this systematic review and meta-analysis is to explore the influence of glutathione versus placebo on pulmonary function of cystic fibrosis. Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2019, and randomized-controlled trials (RCTs) regarding the effect of glutathione on pulmonary function of cystic fibrosis are included in this meta-analysis. Results Four RCTs are included. Compared with control group in patients with cystic fibrosis, glutathione treatment shows positive impact on forced expiratory volume 1 second (FEV1) (mean difference [MD] = 0.19; 95% confidence interval (CI), 0.10–0.28; P < .0001) and body mass index (MD = 0.27; 95% CI, 0.02–0.51; P = .03), but has no obvious influence on 6-minute walk test (standard MD = 0.28; 95% CI, −0.08 to 0.64; P = .13), number of exacerbations (MD = −0.10; 95% CI, −0.34 to 0.15; P = .43), abdominal pain or distal intestinal obstruction (risk ratios [RR] = 0.78; 95% CI, 0.32–1.90; P = .58), or hemoptysis (RR = 1.87; 95% CI, 0.43–8.26; P = .41). Conclusions Glutathione treatment provides some benefits to improve pulmonary function of patients with cystic fibrosis, as evidenced by the increase in FEV1.

scholarly journals Effectiveness and Safety of Surgical Interventions for Treating Adolescent Idiopathic Scoliosis: a Bayesian Meta-analysis

2020 ◽  
Author(s):  
Long Chen ◽  
Zeyu Sun ◽  
Jingming He ◽  
Yunwen Xu ◽  
Zhuhai Li ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pulmonary Function ◽  
Cobb Angle ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Practical Recommendation ◽  
Surgical Interventions ◽  
Post Operation

Abstract Background Adolescent idiopathic scoliosis (AIS) is the most common form of spinal deformity in children and adolescents which presents as complex three-dimensional (3D) deformity of the spine and rib cage. This study aimed to estimate the effectiveness and safety of surgical interventions for AIS using Bayesian meta-analysis.Methods The PubMed, EMBASE, and Cochrane Controlled Register of Trials were searched through Oct 1, 2019, without language restrictions. Relevant studies evaluating combined effectiveness and safety of surgical interventions for AIS were included according to eligibility criteria. The primary outcome measures included pulmonary function (change of absolute forced vital capacity and forced expiratory volume in one second from pre-operation to post-operation) and incidence of complications. The secondary outcome measure was change of Cobb angle from pre-operation to post-operation. Data was pooled using a random effects model in pairwise meta-analysis. Bayesian meta-analysis combined direct and indirect evidence using a Bayesian framework.Results 28 case-controlled studies with totally 1970 participants were included. This Bayesian meta-analysis combining direct and indirect evidences indicated that posterior fusion with instrumentation without thoracoplasty (PSF) had the highest probability to achieve better pulmonary function and lower complication rate; video assisted anterior fusion with instrumentation without thoracoplasty (VAT) had the highest probability to obtain better Cobb angle correction based on analysis of rank probability.Conclusion This Bayesian meta-analysis gives a practical recommendation of PSF as a primary surgical treatment for AIS. The results also support statistics that current surgeries adopted more PSF but less open anterior approach surgery and thoracoplasty. More research work is required to address the effectiveness and safety of VAT for treating AIS more convincingly.

scholarly journals Decreased mortality in acute respiratory distress syndrome patients treated with corticosteroids: an updated meta-analysis of randomized clinical trials with trial sequential analysis

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Ping Lin ◽  
Yuean Zhao ◽  
Xiaoqian Li ◽  
Faming Jiang ◽  
Zongan Liang
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Sequential Analysis ◽  
Randomized Clinical Trials ◽  
Distress Syndrome ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Mean Deviation

Abstract Background The possible benefits associated with corticosteroid treatment in acute respiratory distress syndrome (ARDS) patients are not fully known. We conducted an updated meta-analysis to assess the effect of corticosteroids in the treatment of patients with ARDS. Methods We systematically searched MEDLINE, Embase, and the Cochrane Library from inception to January 2021 via Ovid to identify randomized controlled trials evaluating the efficacy of glucocorticoids in the treatment of patients with ARDS. The primary outcome was hospital mortality. Secondary outcomes included the number of ventilator-free days at day 28, oxygenation improvement (PaO2/FIO2 ratios), and adverse events. Results Nine studies with 1371 participants were analyzed. The pooled analysis revealed that glucocorticoid use was associated with reduced mortality [relative risk (RR), 0.83; 95% confidence interval (CI) 0.74–0.93; P < 0.01; I2 = 37], and the statistical power was confirmed by trial sequential analysis. Glucocorticoids might also significantly increase the number of ventilator-free days at day 28 (mean deviation 3.66 days, 95% CI 2.64–4.68; P < 0.01) and improve oxygenation (standardized mean difference 4.17; 95% CI 2.32–6.02; P < 0.01). In addition, glucocorticoid use was not associated with increased risks of new infection (RR 0.84; 95% CI 0.70–1.01; P = 0.07) and hyperglycemia (RR 1.11; 95% CI 0.99–1.23; P = 0.06). Conclusions The use of glucocorticoids might result in reduced mortality in patients with ARDS. Glucocorticoids might be recommended as an adjunct to standard care for ARDS; however, the optimal dose and duration of steroid therapy remains unknown and further studies are needed.

Effects of abdominal binders on postoperative pain and functional recovery: a systematic review and meta-analysis

Pain Medicine ◽  
2021 ◽  
Author(s):  
Xin Sun ◽  
Qingchuan Wei ◽  
Chenying Fu ◽  
Qing Zhang ◽  
Zejun Liang ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Pulmonary Function ◽  
Physical Function ◽  
Functional Recovery ◽  
Meta Analysis ◽  
Forced Expiratory Volume ◽  
Cochrane Library ◽  
Control Group ◽  
Vas Score

Abstract Objective This study aimed to assess the effectiveness of abdominal binders (ABs) on postoperative pain and functional recovery in patients receiving abdominal surgery. Methods The Pubmed, Embase, Cochrane Library, and PEDro databases were searched for clinical trials published up to November 30, 2019. Randomized controlled trials that compared the effects of wearing an AB to not wearing an AB in participants after abdominal surgery were included. The primary outcomes were pain, pulmonary function, and physical function, as assessed by the visual analog scale (VAS) score, a spirometry device, and the 6-min walk test (6MWT), respectively. The registration number of this review in PROSPERO is CRD42020165303. Results Fourteen trials involving 1317 participants were included. Pooled estimates for the VAS score and the 6MWT showed significant differences between the AB group and the control group, especially on the fourth day following surgery (Mean Difference (MD) = -2.82, 95% Confidence Interval (CI) -3.41 to -2.22, P &lt; 0.00001; MD = 50.97 m, 95% CI 39.99 to 61.95 m, P &lt; 0.00001). However, no significant differences were found in pulmonary function (forced vital capacity (FVC): MD = 0.01, 95% CI -0.29 to -0.32, P = 0.94; forced expiratory volume during 1 s (FEV1): MD = -0.05; 95% CI -0.24 to 0.14; p = 0.63; FEV1/FVC: MD = 3.14, 95% CI -2.78 to 9.06, P = 0.30). Conclusion ABs probably improve postoperative pain and physical function, especially on the fourth day or more following abdominal surgery, but they have no effects on pulmonary function.

scholarly journals Artificial Intelligence for the Prediction of Acute Kidney Injury During the Perioperative Period: Systematic Review and Meta-Analysis of Diagnostic Test Accuracy

2022 ◽  
Author(s):  
hanfei zhang ◽  
Amanda Y Wang ◽  
Shukun Wu ◽  
Johnathan Ngo ◽  
Yunlin Feng ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Acute Kidney Injury ◽  
Early Recognition ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Perioperative Period ◽  
Cochrane Library ◽  
Test Accuracy ◽  
Operating Characteristics ◽  
Wide Range

Abstract Background: Acute kidney injury (AKI) is independently associated with morbidity and mortality in a wide range of surgical settings. Nowadays, with the increasing use of electronic health records (EHR), advances in patient information retrieval, and cost reduction in clinical informatics, artificial intelligence is increasingly being used to improve early recognition and management for perioperative AKI. However, there is no quantitative synthesis of the performance of these methods.Objective: To estimate the sensitivity and specificity of artificial intelligence for the prediction of acute kidney injury during the perioperative period.Methods: Pubmed, Embase, and Cochrane Library were searched to 2nd October 2021. Studies presenting diagnostic performance of artificial intelligence in the early detection of perioperative acute kidney injury were included. Two independent evaluators extracted data. The risk of bias of eligible studies was assessed using the PROBAST tool.Results: Nineteen studies involving 304,076 patients were included. Quantitative random-effects meta-analysis using the Rutter and Gatsonis hierarchical summary receiver operating characteristics (HSROC) model revealed pooled sensitivity, specificity, and diagnostic odds ratio of 0.77 (95% CI: 0.73 to 0.81),0.75 (95% CI: 0.71 to 0.80), and 10.7 (95% CI 8.5 to 13.5), respectively. Threshold effect was found to be the only source of heterogeneity, and there was no evidence of publication bias.Conclusions: Our review demonstrates the promising performance of artificial intelligence for early prediction of perioperative AKI. Further studies should focus on the improvement of existing models, novel biomarkers, and clinical effectiveness.

Sign in / Sign up

Export Citation Format

Share Document