scholarly journals The Role of Traditional Acupuncture in Patients with Fecal Incontinence—Mini-Review

2021 ◽  
Vol 18 (4) ◽  
pp. 2112
Author(s):  
Agne Sipaviciute ◽  
Tomas Aukstikalnis ◽  
Narimantas E. Samalavicius ◽  
Audrius Dulskas
Keyword(s):  
Fecal Incontinence ◽  
Randomized Controlled Trials ◽  
The Elderly ◽  
Bowel Dysfunction ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Treatment Technique ◽  
Randomized Controlled ◽  
Electronic Database Search ◽  
Irritable Bowel

Objective: Fecal incontinence affects up to 15% of the general population, with higher rates of incidence among women and the elderly. Acupuncture is an old practice of Traditional Chinese Medicine that might be used to treat fecal incontinence. The aim of this mini review was to assess the effect of acupuncture for fecal incontinence. Materials and Methods: Cochrane Library, Web of Science, Embase, PubMed, and CENTRAL electronic databases were searched until August 2020. The following keywords were used: acupuncture, electroacupuncture, moxibustion, fecal incontinence, diarrhea, irritable bowel syndrome, and bowel dysfunction. In addition, references were searched. Five studies (two randomized controlled trials), out of 52,249 predefined publications after an electronic database search, were included into the review. Results: Overall, 143 patients were included. All studies report significant improvements in continence, although they all apply different acupuncture regimens. Randomized controlled trials show significant differences in experimental groups treated with acupuncture in improving continence. Significant improvement in quality of life scores was reported. In addition, improvement in fecal continence remained significantly improved after 18 months of follow-up. Conclusion: Acupuncture is a promising treatment alternative for fecal incontinence. Based on small, low-quality studies, it might be a safe, inexpensive, and efficient method. However, more high-quality studies are needed in order to apply this treatment technique routinely.

scholarly journals A Meta-analysis of Acupuncture Treatment for Irritable Bowel Syndrome

2021 ◽  
Vol 10 (2) ◽  
Author(s):  
Biwei Chen ◽  
Lili Zhang ◽  
Shaozong Chen ◽  
Changzhen Gong
Keyword(s):  
Irritable Bowel Syndrome ◽  
Clinical Research ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Irritable Bowel ◽  
Experimental Group

To assess the efficacy of acupuncture for treatment of irritable bowel syndrome through meta-analysis of randomized controlled trials in recent 20 years. Online databases, including CNKI, VIP, WANFANG,PubMed, Cochrane Library, Web of Science and Embase were searched for randomized controlled trials (RCTs) of acupuncture for IBS. Retrieval time was from January 1, 2000 to January 31, 2021. According to Jadad scoring criteria,the bias risk and quality assessment of each RCT included were evaluated by two researchers. RevMan 5.3 software was used for the meta analysis. Eight RCTs were selected which include a total of 1181 patients.The control group has 425 patients and the experimental group has 756 patients. The result of meta-analysis indicates that the total effective rate for the experimental group was superior to that of the control group [OR=3.29,95%CI [2.16~5.03](P<0.01)], and the funnel plot was basically symmetric. Acupuncture therapy is shown to have a good safety and compliance record. However, the number of high-quality trials is small, and there are some deficiencies in the methodology of clinical research. Acupuncture, as a supplementary therapy for irritable bowel syndrome, has positive clinical significance and prospects for application. The methodology of clinical research needs to be further improved.

scholarly journals Moxibustion for Diarrhea-Predominant Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Bozong Tang ◽  
Jianliang Zhang ◽  
Zongguo Yang ◽  
Yunfei Lu ◽  
Qingnian Xu ◽  
...  
Keyword(s):  
Irritable Bowel Syndrome ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Abdominal Distension ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Serious Adverse Events ◽  
Randomized Controlled ◽  
Defecation Frequency ◽  
Irritable Bowel

Background. The complementary and alternative medicines in treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) are controversial.Methods. We searched PubMed, Ovid Embase, Web of Science, Cochrane Library databases, CNKI, Wanfang Database, CBM, VIP, and AMED for randomized controlled trials (RCTs) of moxibustion compared with pharmacological medications in patients with IBS-D. A meta-analysis was performed using both fixed and random-effects models based on heterogeneity across studies.Results. In total, 568 patients in 7 randomized controlled trials were randomly treated with moxibustion and pharmacological medications. The improvement of global IBS-D symptoms and overall scores was significant (P=0.0001andP<0.0001, resp.) in patients treated by moxibustion only compared to pharmacological medications. The specific IBS-D symptoms of abdominal pain, abdominal distension, abnormal stool, and defecation frequency were alleviated in patients treated by moxibustion compared to pharmacological medications, but no significance was found except for abdominal distension and defecation frequency (P=0.03andP=0.02, resp.). There were no serious adverse events related to moxibustion.Conclusions. Moxibustion appears to be effective in treating IBS-D compared with pharmacological medications. However, further large, rigorously designed trials are warranted due to insufficient methodological rigor in the included trials.

scholarly journals Dexmedetomidine reduces the incidence of postoperative delirium after cardiac surgery: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Li ◽  
Lu-xi Li ◽  
Zhen-zhen Zhao ◽  
Jian Xie ◽  
Cheng-long Zhu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Randomized Controlled Trials ◽  
Postoperative Delirium ◽  
Meta Analysis ◽  
Adult Population ◽  
The Elderly ◽  
Adult Patients ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled

Abstract Background The role of dexmedetomidine in preventing postoperative delirium (POD) after cardiac surgery remains controversial because of several recent trials with negative results. We aimed to perform an updated meta-analysis of randomized controlled trials (RCTs) to clarify this controversy. Methods RCTs investigating the perioperative administration of dexmedetomidine in cardiac surgery were retrieved from PubMed, Web of Science, and the Cochrane library until August,27,2020. Two researchers independently screened the literature, collected the data and evaluated the bias risk of the included studies. The meta-analysis was performed with the RevMan 5.3. Results A total of 15 studies including 2813 patients were included in the study. A pooled result showed that dexmedetomidine could reduce the risk of POD in adult population underwent cardiac surgery (OR 0.56, 95%CI 0.36–0.89, P = 0.0004, I2 = 64%). The subgroup analysis demonstrated that the protective effect of dexmedetomidine was only present in the patients injected with dexmedetomidine after surgery but not from the start of surgery, in the adult patients without specific age limitation but not in the elderly, and in the studies in comparison with other sedatives but not with placebo. There were no statistical differences when analyzing the secondary outcomes including hypotension (OR 1.13; 95% CI 0.54–2.37, P < 0.00001, I2 = 85%), bradycardia (OR 1.72; 95% CI 0.84–3.53, P = 0.04, I2 = 58%) and atrial fibrillation (OR 0.87; 95% CI 0.70–1.08, P = 0.43, I2 = 0). Conclusions Dexmedetomidine can reduce the incidence of POD compared to other sedatives and opioids after cardiac surgery in adult patients. The proper population and timing for perioperative use of dexmedetomidine after cardiac surgery remain to be further investigated.

scholarly journals Macular hole surgery recovery with and without face-down posturing: a meta-analysis of randomized controlled trials

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ting Ye ◽  
Ji-guo Yu ◽  
Lin Liao ◽  
Lan Liu ◽  
Ting Xia ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Macular Hole ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Internal Limiting Membrane ◽  
The Elderly ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Closure Rate ◽  
Randomized Controlled

Abstract Background After pars plana vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade, patients are often required to remain in a face-down position (FDP) to allow the gas bubble to push against the macular hole (MH) to promote hole closure. However, this position may be uncomfortable and inconvenient for the elderly and those with medical comorbidities; it may also lead to certain postoperative complications. Hence, this study aimed to evaluate and compare the effect of postoperative FDP and non-face-down position (nFDP) on the closure rate of MHs following MH surgery. Methods Randomized controlled trials (RCTs) were selected through an electronic search of the Cochrane Library, Pubmed, and Embase databases. Trial eligibility and risk of bias were assessed according to Cochrane review methods. The primary measures included overall MH closure rate and subgroup analysis based on MH size. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Statistical analysis was performed using RevMan 5.0 software and Stata software 15.0. Results Five RCTs composed of a total of 183 eyes in the FDP group and 175 eyes in the nFDP group were included in this meta-analysis. Statistical meta-analysis revealed that the overall MH closure rate in the FDP group was significantly higher than that in the nFDP group (OR = 2.27, 95% CI: 1.02 to 5.05, P = 0.04). For MH sizes smaller than 400 μm, the subgroup meta-analysis indicated that the closure rate of the FDP group was not significantly higher than that of the nFDP group (OR = 1.32, 95% CI: 0.39 to 4.49, P = 0.66). However, when MH size was larger than 400 μm, there was a significantly higher closure rate in the FDP group (OR = 2.95, 95% CI: 1.10 to 7.94, P = 0.03). Conclusions Our results provide evidence that a face-down postoperative position seems to be unnecessary when MHs are smaller than 400 μm but may be highly recommended for MHs larger than 400 μm. Further RCTs with large sample sizes are warranted to validate these findings in future.

scholarly journals Macular hole surgery recovery with and without face-down posturing: a meta-analysis of randomized controlled trials

2019 ◽  
Author(s):  
Ting Ye ◽  
Ji-guo Yu ◽  
Lin Liao ◽  
Lan Liu ◽  
Ting Xia ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Macular Hole ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Internal Limiting Membrane ◽  
The Elderly ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Closure Rate ◽  
Randomized Controlled

Abstract Background: After pars plana vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade, patients are often required to remain in a face-down position (FDP) to allow the gas bubble to push against the macular hole (MH) to promote hole closure. However, this position may be uncomfortable and inconvenient for the elderly and those with medical comorbidities; it may also lead to certain postoperative complications. Hence, this study aimed to evaluate and compare the effect of postoperative FDP and non-face-down position (nFDP) on the closure rate of MHs following MH surgery. Methods: Randomized controlled trials (RCTs) were selected through an electronic search of the Cochrane Library, Pubmed, and Embase databases. Trial eligibility and risk of bias were assessed according to Cochrane review methods. The primary measures included overall MH closure rate and subgroup analysis based on MH size. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were estimated. Statistical analysis was performed using RevMan 5.0 software and Stata software 15.0. Results: Five RCTs composed of a total of 183 eyes in the FDP group and 175 eyes in the nFDP group were included in this meta-analysis. Statistical meta-analysis revealed that the overall MH closure rate in the FDP group was significantly higher than that in the nFDP group (OR = 2.27, 95% CI: 1.02 to 5.05, P = 0.04). For MH sizes smaller than 400 µm, the subgroup meta-analysis indicated that the closure rate of the FDP group was not significantly higher than that of the nFDP group (OR = 1.32, 95% CI: 0.39 to 4.49, P = 0.66). However, when MH size was larger than 400 µm, there was a significantly higher closure rate in the FDP group (OR = 2.95, 95% CI: 1.10 to 7.94, P = 0.03). Conclusions: Our results provide evidence that a face-down postoperative position seems to be unnecessary when MHs are smaller than 400 µm but may be highly recommended for MHs larger than 400 µm. Further RCTs with large sample sizes are warranted to validate these findings in future.

scholarly journals Dexmedetomidine reduces the incidence of postoperative delirium after cardiac surgery: A meta-analysis of randomized controlled trials

2021 ◽  
Author(s):  
Peng Li ◽  
Lu-xi Li ◽  
Zhen-zhen Zhao ◽  
Jian Xie ◽  
Cheng-long Zhu ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Adult Population ◽  
The Elderly ◽  
Adult Patients ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Negative Results

Abstract Background The role of dexmedetomidine in preventing delirium after cardiac surgery remains controversial because of several recent trials with negative results. We aimed to perform an updated meta-analysis of randomized controlled trials (RCTs) to clarify this controversy. Methods RCTs investigating the perioperative administration of dexmedetomidine in cardiac surgery were retrieved from PubMed, Web of Science, and the Cochrane library until August,27,2020. Two researchers independently screened the literature, collected the data and evaluated the bias risk of the included studies. The meta-analysis was performed with the RevMan 5.3. Results A total of 15 studies including 2813 patients were included in the study. A pooled result showed that dexmedetomidine could reduce the risk of delirium in adult population underwent cardiac surgery (OR 0.56, 95%CI 0.35–0.89, P = 0.0003, I = 64%). The subgroup analysis demonstrated that the protective effect of dexmedetomidine was only present in the patients injected with dexmedetomidine after surgery but not from the start of surgery, in the adult patients without specific age limitation but not in the elderly, and in the studies in comparison with other sedatives but not with placebo. There were no statistical differences when analyzing the secondary outcomes including hypotension (OR 1.13; 95% CI 0.54–2.37, P < 0.00001, I²=85%), bradycardia (OR 1.72; 95% CI 0.84–3.53, P = 0.04, I²=58%) and atrial fibrillation (OR 0.87; 95% CI 0.70–1.08, P = 0.43, I²=0). Conclusions Dexmedetomidine can reduce the incidence of delirium compared to other sedatives and opioids after cardiac surgery in adult patients. The proper population and timing for perioperative use of dexmedetomidine after cardiac surgery remain to be further investigated.

Efficacy and Safety of Non-Steroidal Anti-Androgens in Patients with Metastatic Prostate Cancer: Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 15 (1) ◽  
pp. 34-47 ◽  
Author(s):  
Muhammed Rashid ◽  
Madhan Ramesh ◽  
K. Shamshavali ◽  
Amit Dang ◽  
Himanshu Patel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Quality Assessment ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Significant Difference

Background: Prostate cancer (PCa) is the sixth primary cause of cancer death. However, conflicts are present about the efficacy and safety of Non-steroidal anti-androgens (NSAA) for its treatment. The aim of this study was to assess the efficacy and safety of NSAAs versus any comparator for the treatment of advanced or metastatic PCa (mPCa). Methodology: MEDLINE and the Cochrane Library were searched. References of included studies and clinicaltrials.gov were also searched for relevant studies. Only English language studies after 1990 were considered for review. Randomized controlled trials (RCTs) examining the efficacy and safety of NSAAs as compared with any other comparator including surgery or chemotherapy in mPCa patients were included. The outcomes include efficacy, safety and the tolerability of the treatment. The Cochrane Risk of Bias Assessment Tool was used for quality assessment. Two authors were independently involved in the selection, extraction and quality assessment of included studies and disagreements were resolved by discussion or by consulting a third reviewer. Results: Fifty-eight out of 1307 non-duplicate RCTs with 29154 patients were considered for the review. NSAA showed significantly better progression-free survival [PFS] (Hazard ratio [HR], 0.60; 95% confidence interval [CI], 0.46-0.78; P=0.0001), time to distant metastasis or death [TTD] (HR, 0.80; 95% CI 0.73-0.91; p<0.0001), objective response (Odds ratio [OR], 1.64; 95% CI 1.06-2.54; P=0.03) and clinical benefits (OR, 1.33; 95% CI 1.08-1.63; P=0.006) as compared to the control group. There was no significant difference observed between the groups in terms of overall survival (HR, 0.95; 95%CI, 0.87-1.03; P=0.18) and time to progression (HR, 0.93; 95% CI 0.77-1.11; P=0.43). Treatment-related adverse events were more with the NSAA group, but the discontinuation due to lack of efficacy reason was 43% significantly lesser than the control group in patients with mPCa. Rest of the outcomes were appeared to be non-significant. Conclusion: Treatment with NSAA was appeared to be better efficacious with respect to PFS, TTD, and response rate with considerable adverse events when compared to the control group in patients with metastatic PCa.

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 Intra-articular magnesium to alleviate postoperative pain after arthroscopic knee surgery: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lijun Shi ◽  
Haiyun Zhu ◽  
Jinhui Ma ◽  
Li-Li Shi ◽  
Fuqiang Gao ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Pain Intensity ◽  
Opioid Consumption ◽  
Knee Surgery ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Arthroscopic Knee Surgery ◽  
Randomized Controlled ◽  
Arthroscopic Knee

Abstract Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.

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