Magnetic Resonance Accuracy in the Diagnosis of Anterior Talo-Fibular Ligament Acute Injury: A Systematic Review and Meta-Analysis

Background: The studies about injury to the anterior talo-fibular ligament (ATFL) are focused mainly on chronic symptoms and chronic instability, and the literature about the accuracy of magnetic resonance imaging (MRI) in acute injuries is quite lacking. Methods: This systematic review with meta-analysis analyzes the diagnostic accuracy of MRI on acute ATFL injury. Relative studies were retrieved after searching three databases (MEDLINE, SCOPUS, and Cochrane Central Register of Controlled Trails). Eligible studies were summarized. The quality of the included articles was assessed using the revised Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Data were extracted to calculate pooled sensitivity and specificity of MRI. Results: Seven studies met our inclusion and exclusion criteria. For MRI, the pooled sensitivities and specificity in diagnosing acute ATFL injury were respectively 1.0 (95% CI: 0.58–1) and 0.9 (95% CI: 0.79–0.96). Pooled LR+ and LR− were respectively 10.4 (95% CI: 4.6–23) and 0 (95% CI: 0–0.82). Conclusion: This systematic review with meta-analysis investigated the accuracy of imaging for the diagnosis of acute ATFL injury. Our results demonstrated that MRI shows high diagnostic accuracy in the diagnosis of acute ATFL lesions. These results suggest that routine MRI in the case of suspected ATFL acute injury may be clinically useful, although this is not done in clinical practice due probably to high cost.

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Thoracic ultrasound for malignant pleural effusion: a systematic review and meta-analysis

ERJ Open Research ◽

10.1183/23120541.00464-2020 ◽

2020 ◽

Vol 6 (4) ◽

pp. 00464-2020

Author(s):

Akihiro Shiroshita ◽

Sayumi Nozaki ◽

Yu Tanaka ◽

Yan Luo ◽

Yuki Kataoka

Keyword(s):

Systematic Review ◽

Pleural Effusion ◽

Diagnostic Accuracy ◽

Malignant Pleural Effusion ◽

Meta Analysis ◽

Ultrasound Finding ◽

Cochrane Central Register ◽

Thoracic Ultrasound ◽

Central Register ◽

Low Sensitivity

This systematic review aimed to evaluate the diagnostic accuracy of thoracic ultrasound in malignant pleural effusion.Articles published until December 2019 in MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and the International Clinical Trials Registry Platform were screened by two authors independently to extract data and evaluate the risks of bias and applicability using the modified Quality Assessment of Diagnostic Accuracy Studies-2 tool. We described the forest plots of each thoracic ultrasound finding. We estimated the pooled sensitivity and specificity of pleural nodularity using the bivariate random-effects model.We included seven articles and found that each thoracic ultrasound finding had low sensitivity. The pooled specificity of pleural nodularity was 96.9% (95% CI 93.2%–98.6%).In conclusion, thoracic ultrasound is not useful in ruling out malignant pleural effusion. Physicians can proceed rigorously to repeat thoracentesis or other invasive procedures when pleural nodularity is detected.

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Use of opioids in patients with cancer with hepatic impairment—a systematic review

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2021-003065 ◽

2021 ◽

pp. bmjspcare-2021-003065

Author(s):

Lewis Thomas Hughes ◽

David Raftery ◽

Paul Coulter ◽

Barry Laird ◽

Marie Fallon

Keyword(s):

Systematic Review ◽

Cancer Pain ◽

Hepatic Impairment ◽

Evaluation System ◽

Meta Analysis ◽

Hepatic Function ◽

Cochrane Central Register ◽

Assessment Development ◽

Patients With Cancer ◽

Central Register

PurposeOpioids are recommended for moderate-to-severe cancer pain; however, in patients with cancer, impaired hepatic function can affect opioid metabolism. The aim of this systematic review was to evaluate the evidence for the use of opioids in patients with cancer with hepatic impairment.MethodsA systematic review was conducted and the following databases searched: AMED (−2021), MEDLINE (−2021), EMBASECLASSIC + EMBASE (−2021) and Cochrane Central Register of Controlled Trials (−2021). Eligible studies met the following criteria: patients with cancer-related pain, taking an opioid (as defined by the WHO Guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents); >18 years of age; patients with hepatic impairment defined using recognised or study-defined definitions; clinical outcome hepatic impairment related; and primary studies. All eligible studies were appraised using the Grading of Recommendations Assessment, Development and Evaluation system.ResultsThree studies (n=95) were eligible but heterogeneity meant meta-analysis was not possible. Each individual study focused on only one each of oxycodone±hydrocotarnine, oxycodone/naloxone and morphine. No recommendations could be formulated on the preferred opioid in patients with hepatic impairment.ConclusionsMorphine is the preferred opioid in hepatic impairment owing to clinical experience and pharmacokinetics. This review, however, found little clinical evidence to support this. Dose adjustments of morphine and the oxycodone formulations reviewed remain necessary in the absence of quality evidence. Overall, the quality of existing evidence on opioid treatments in cancer pain and hepatic impairment is low and there remains a need for high-quality clinical studies examining this.

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Safety of Cochlear Implantation in Children 12 Months or Younger: Systematic Review and Meta-analysis

Otolaryngology ◽

10.1177/01945998211067741 ◽

2022 ◽

pp. 019459982110677

Author(s):

Firas Sbeih ◽

Malek H. Bouzaher ◽

Swathi Appachi ◽

Seth Schwartz ◽

Michael S. Cohen ◽

...

Keyword(s):

Systematic Review ◽

Cochlear Implants ◽

Cochlear Implantation ◽

Meta Analysis ◽

Cochrane Central Register ◽

Ovid Medline ◽

Central Register ◽

Data Source ◽

Anesthetic Complications ◽

Full Text Screening

Objective To systematically review the literature to determine safety of cochlear implantation in pediatric patients 12 months and younger. Data Source Ovid MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched from inception to March 20, 2021. Review Methods Studies that involved patients 12 months and younger with report of intraoperative or postoperative complication outcomes were included. Studies selected were reviewed for complications, explants, readmissions, and prolonged hospitalizations. Two independent reviewers screened all studies that were selected for the systematic review and meta-analysis. All studies included were assessed for quality and risk of bias. Results The literature search yielded 269 studies, of which 53 studies underwent full-text screening, and 18 studies were selected for the systematic review and meta-analysis. A total of 449 patients and 625 cochlear implants were assessed. Across all included studies, major complications were noted in 3.1% of patients (95% CI, 0.8-7.1) and 2.3% of cochlear implantations (95% CI, 0.6-5.2), whereas minor complications were noted in 2.4% of patients (95% CI, 0.4-6.0) and 1.8% of cochlear implantations (95% CI, 0.4-4.3). There were no anesthetic complications reported across all included studies. Conclusion The results of this systematic review and meta-analysis suggest that cochlear implantation in patients 12 months and younger is safe with similar rates of complications to older cohorts.

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Diagnostic accuracy of magnetic resonance imaging for tumour staging of bladder cancer: systematic review and meta-analysis

BJU International ◽

10.1111/bju.14366 ◽

2018 ◽

Vol 122 (5) ◽

pp. 744-753 ◽

Cited By ~ 18

Author(s):

Niket Gandhi ◽

Satheesh Krishna ◽

Christopher M. Booth ◽

Rodney H. Breau ◽

Trevor A. Flood ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Bladder Cancer ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Tumour Staging ◽

Resonance Imaging

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Corrigendum to “What is the diagnostic accuracy of red flags related to cauda equina syndrome (CES), when compared to Magnetic Resonance Imaging (MRI)? A systematic review” [Musculoskelet. Sci. Pract. 42 (2019) 125–133]

Musculoskeletal Science and Practice ◽

10.1016/j.msksp.2019.07.001 ◽

2019 ◽

Vol 43 ◽

pp. 128

Author(s):

Nathalie Dionne ◽

Abiodun Adefolarin ◽

Dena Kunzelman ◽

Nitin Trehan ◽

Laura Finucane ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Systematic Review ◽

Magnetic Resonance ◽

Diagnostic Accuracy ◽

Cauda Equina Syndrome ◽

Cauda Equina ◽

Red Flags ◽

Resonance Imaging ◽

Magnetic Resonance Imaging Mri

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Mesothelin as a biomarker for ovarian carcinoma: a meta-analysis

Anais da Academia Brasileira de Ciências ◽

10.1590/0001-3765201620150107 ◽

2016 ◽

Vol 88 (2) ◽

pp. 923-932 ◽

Cited By ~ 9

Author(s):

KRISTIAN MADEIRA ◽

EDUARDO R. DONDOSSOLA ◽

BRUNA F. DE FARIAS ◽

CARLA S. SIMON ◽

MARIA C.M. ALEXANDRE ◽

...

Keyword(s):

Systematic Review ◽

Ovarian Cancer ◽

Ovarian Tissue ◽

Meta Analysis ◽

Diagnostic Odds Ratio ◽

Cochrane Central Register ◽

Central Register ◽

Quantitative Systematic Review ◽

Comprehensive Search ◽

Sensitivity Specificity

The objective of this work was to estimate the accuracy of mesothelin as a biomarker for ovarian cancer. A quantitative systematic review was performed. A comprehensive search of the Medline, LILACS, SCOPUS, Embase, Cochrane Central Register of Controlled Trials, Biomed Central, and ISI Web of Science databases was conducted from January 1990 to June 2015. For inclusion in this systematic review, the papers must have measured mesothelin levels in at least two histological diagnoses; ovarian cancer (borderline or ovarian tumor) vs. benign or normal ovarian tissue. For each study, 2 x 2 contingency tables were constructed. We calculated the sensitivity, specificity and diagnostic odds ratio. The verification bias was performed according to QUADAS-2. Statistical analysis was performed with the software Stata 11, Meta-DiSc(r) and RevMan 5.2. Twelve studies were analyzed, which included 1,561 women. The pooled sensitivity was 0.62 (CI 95% 0.58 - 0.66) and specificity was 0.94 (CI 95% 0.92 - 0.95). The DOR was 38.92 (CI 95% 17.82 - 84.99). Our systematic review shows that mesothelin cannot serve alone as a biomarker for the detection of ovarian cancer.

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Local anaesthetics combined with vasoconstrictors in patients with cardiovascular disease undergoing dental procedures: systematic review and meta-analysis protocol

BMJ Open ◽

10.1136/bmjopen-2016-014611 ◽

2017 ◽

Vol 7 (11) ◽

pp. e014611 ◽

Cited By ~ 1

Author(s):

Caio Chaves Guimaraes ◽

Rogério Heládio Lopes Motta ◽

Cristiane de Cássia Bergamaschi ◽

Jimmy de Oliveira Araújo ◽

Natalia Karol de Andrade ◽

...

Keyword(s):

Systematic Review ◽

Cardiovascular Disease ◽

Data Extraction ◽

Meta Analysis ◽

Local Anaesthetics ◽

Cochrane Central Register ◽

Assessment Development ◽

Dental Procedures ◽

Central Register ◽

Registration Number

IntroductionThe use of vasoconstrictors combined with local anaesthetics (LAs) in dentistry for patients with cardiovascular disease (CVD) is still controversial in the scientific literature. It raises concerns regarding the possibility of transient episodes, triggering negative cardiovascular outcomes.Method/designTrials eligible for our systematic review will enrol patients with CVD who have undergone dental treatments carried out with the use of LAs by comparing two arms: LAs with vasoconstrictors and LAs without vasoconstrictors. The research will be conducted in the electronic databases, namely Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Healthstar (via Ovid), Cumulative Index to Nursing and Allied Health Literature and Web of Science, from their inception to December 2017, without any restrictions in terms of language and status of publication. A team of reviewers will independently assess titles, abstracts and complete text to determine eligibility. For eligible studies, the same reviewers will perform data extraction and evaluate the risk of bias in the selected articles. The selected outcomes comprise death, mortality by a specific cause, stroke, acute myocardial infarction, hospitalisation, pain, bleeding, arrhythmias, ischaemic episodes, anxiety, adverse effects, changes in blood pressure, changes in heart rate, anxiety and results obtained via oximetry. Whenever possible, we will conduct a meta-analysis to establish the effects of LAs with and without vasoconstrictors in the patients with CVD, and the overall quality of evidence for each outcome will be determined using the Grading of Recommendations Assessment, Development and Evaluation classification system.Ethics and disseminationEthics committee approval was not necessary because this is a protocol of systematic review. This systematic review will be submitted for presentation at conferences and for publication in a peer-reviewed journal. Our review will assess the risks of cardiovascular events when using LAs with and without vasoconstrictors in patients with CVD, focusing on important clinical outcomes.PROSPERO registration numberCRD42016045421.

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