scholarly journals Inadequate Ultrasound Examination in Hepatocellular Carcinoma Surveillance: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (16) ◽  
pp. 3535
Author(s):  
Seung Baek Hong ◽  
Dong Hwan Kim ◽  
Sang Hyun Choi ◽  
So Yeon Kim ◽  
Ji Sung Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Ultrasound Examination ◽  
Meta Analysis ◽  
Significant Risk ◽  
High Body Mass Index ◽  
Random Effects Model ◽  
Cochrane Database ◽  
Patients At Risk ◽  
Hepatocellular Carcinoma Surveillance

We aimed to systematically evaluate the incidence of inadequate US in hepatocellular carcinoma (HCC) surveillance and determine the risk factors. Original studies reporting the incidence or risk factors for inadequate US were identified in MEDLINE, EMBASE, and the Cochrane database. The pooled incidence of inadequate US was calculated using a random effects model, and subgroup analyses were performed. The pooled odds ratio (OR) was calculated for each risk factor for inadequate US. Six eligible articles were identified from 756 screened articles (4250 patients). The pooled incidence of inadequate US was 21.5%. Significantly higher rates of inadequate US were noted in studies including patients with and without hepatic observations compared with those evaluating only patients with hepatic observations (23.2% vs. 18.8%), studies using US alone compared with US plus alpha-fetoprotein (28.0% vs. 20.8%), and those using pathology and imaging as a reference standard compared with imaging only (23.2% vs. 17.9%). Nonalcoholic steatohepatitis (OR = 2.3 (1.07–4.84)), Child–Pugh B cirrhosis (OR = 2.2 (1.10–4.37)), and high body mass index (OR = 2.2 (1.12–4.24)) were significant risk factors for inadequate US (p ≤ 0.04). In patients at risk of HCC, 21.5% of US surveillance was inadequate. An alternative surveillance modality might be considered in patients with risk factors.

scholarly journals Incidence and Characteristics of Kidney Stones in Patients on Ketogenic Diet: A Systematic Review and Meta-Analysis

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 39
Author(s):  
Prakrati Acharya ◽  
Chirag Acharya ◽  
Charat Thongprayoon ◽  
Panupong Hansrivijit ◽  
Swetha R. Kanduri ◽  
...  
Keyword(s):  
Uric Acid ◽  
Kidney Stones ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Ketogenic Diets ◽  
Cochrane Database ◽  
Uric Acid Stones ◽  
Low Carbohydrate

Very-low-carbohydrate diets or ketogenic diets are frequently used for weight loss in adults and as a therapy for epilepsy in children. The incidence and characteristics of kidney stones in patients on ketogenic diets are not well studied. Methods: A systematic literature search was performed, using MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews from the databases’ inception through April 2020. Observational studies or clinical trials that provide data on the incidence and/or types of kidney stones in patients on ketogenic diets were included. We applied a random-effects model to estimate the incidence of kidney stones. Results: A total of 36 studies with 2795 patients on ketogenic diets were enrolled. The estimated pooled incidence of kidney stones was 5.9% (95% CI, 4.6–7.6%, I2 = 47%) in patients on ketogenic diets at a mean follow-up time of 3.7 +/− 2.9 years. Subgroup analyses demonstrated the estimated pooled incidence of kidney stones of 5.8% (95% CI, 4.4–7.5%, I2 = 49%) in children and 7.9% (95% CI, 2.8–20.1%, I2 = 29%) in adults, respectively. Within reported studies, 48.7% (95% CI, 33.2–64.6%) of kidney stones were uric stones, 36.5% (95% CI, 10.6–73.6%) were calcium-based (CaOx/CaP) stones, and 27.8% (95% CI, 12.1–51.9%) were mixed uric acid and calcium-based stones, respectively. Conclusions: The estimated incidence of kidney stones in patients on ketogenic diets is 5.9%. Its incidence is approximately 5.8% in children and 7.9% in adults. Uric acid stones are the most prevalent kidney stones in patients on ketogenic diets followed by calcium-based stones. These findings may impact the prevention and clinical management of kidney stones in patients on ketogenic diets.

Poor adherence to hepatocellular carcinoma surveillance: A systematic review and meta-analysis of a complex issue

2017 ◽  
Vol 38 (3) ◽  
pp. 503-514 ◽  
Author(s):  
Changqing Zhao ◽  
Mingjuan Jin ◽  
Richard Hieu Le ◽  
Michael Huan Le ◽  
Vincent Lingzhi Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Systematic Review ◽  
Meta Analysis ◽  
Poor Adherence ◽  
Complex Issue ◽  
Hepatocellular Carcinoma Surveillance

scholarly journals Magnetic Resonance Imaging for Surveillance of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1665
Author(s):  
Dong Hwan Kim ◽  
Sang Hyun Choi ◽  
Ju Hyun Shim ◽  
So Yeon Kim ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Early Stage ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Resonance Imaging ◽  
Meta Regression

Our meta-analysis aimed to evaluate the diagnostic performance of surveillance magnetic resonance imaging (sMRI) for detecting hepatocellular carcinoma (HCC), and to compare the diagnostic performance of sMRI between different protocols. Original articles about the diagnostic accuracy of sMRI for detecting HCC were found in major databases. The meta-analytic pooled sensitivity and specificity of sMRI for detecting HCC were determined using a bivariate random effects model. The pooled sensitivity and specificity of full MRI and abbreviated MRI protocols were compared using bivariate meta-regression. In the total seven included studies (1830 patients), the pooled sensitivity of sMRI for any-stage HCC and very early-stage HCC were 85% (95% confidence interval, 79–90%; I2 = 0%) and 77% (66–85%; I2 = 32%), respectively. The pooled specificity for any-stage HCC and very early-stage HCC were 94% (90–97%; I2 = 94%) and 94% (88–97%; I2 = 96%), respectively. The pooled sensitivity and specificity of abbreviated MRI protocols were 87% (80–94%) and 94% (90–98%), values that were comparable with those of full MRI protocols (84% [76–91%] and 94% [89–99%]; p = 0.83). In conclusion, sMRI had good sensitivity for detecting HCC, particularly very early-stage HCC. Abbreviated MRI protocols for HCC surveillance had comparable diagnostic performance to full MRI protocols.

scholarly journals Predictors of Developing Hepatocellular Carcinoma in Treated HCV-Carriers in Morocco according to University Hospital Experience

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Younès Cherradi ◽  
Rajaa Afifi ◽  
Hanaa Benbrahim ◽  
Wafaa Essamri ◽  
Imane Benelbarhdadi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Predictive Factors ◽  
Antiviral Treatment ◽  
Significant Risk ◽  
University Hospital ◽  
Advanced Age ◽  
Previously Treated Patients ◽  
Previously Treated ◽  
Severe Fibrosis

Introduction. Hepatitis C is the first major cause for HCC in Morocco. Antiviral treatment reduces the risk of developing HCC but few cases of HCC in HCV-treated patients were reported. We aimed to define this population’s features and to identify predictive factors of developing HCC. Patients and Methods. We included all HCV carriers who developed HCC after antiviral treatment from January 2002 to April 2010. We compare HCV-treated patients with no developed HCC to HCC population using khi-2 and Fisher Exact analysis. Results. 369 HVC-treated patients were considered, and 20 HCC were reported. The risk of HCC was not significant according to gender and genotypes (resp., P=0.63 and P=0.87). Advanced age and severe fibrosis were significant risk factors (resp., P=0.003 and P=0.0001). HCC was reported in 2.6% of sustained virological responders versus 12.5% of nonresponders (P=0.004). Conclusion. In our series, 5% of previously treated patients developed an HCC. Advanced age and severe fibrosis at HCV diagnosis are predictive factors of HCC occurrence. Sustained virological response reduces considerably the risk of HCC occurrence but screening is indicated even after SVR.

scholarly journals Effects of Psychological Interventions on the Prevention of Sports Injuries: A Meta-analysis

2020 ◽  
Vol 8 (8) ◽  
pp. 232596712092832
Author(s):  
Shanshan Li ◽  
Qianjin Wu ◽  
Zichao Chen
Keyword(s):  
Sports Injuries ◽  
Meta Analysis ◽  
Significant Risk ◽  
Effect Sizes ◽  
Psychological Interventions ◽  
Random Effects Model ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Subgroup Analyses ◽  
Substantial Heterogeneity

Background: Studies have shown that preventive psychological interventions can reduce the occurrence of sports injuries. Purpose: To systematically evaluate the published literature on the effects of psychological interventions on rates of sports injuries and propose a set of psychological interventions to reduce such injuries. Study Design: Systematic review; Level of evidence, 1. Methods: A total of 11 randomized controlled trials and intervention control trials involving 1287 participants were included. A random-effects model was used to analyze the data. Pooled results were expressed as effect sizes and 95% CIs. Bias and heterogeneity among the studies were assessed, and sensitivity and subgroup analyses were performed. Results: Meta-analysis suggested that preventive psychological interventions effectively prevented the occurrence of sports injuries (effect size = –0.55; P < .001), although the studies showed substantial heterogeneity ( I 2 = 94.2%; P < .001), which could not be attributed to specific variables. Nevertheless, sensitivity analysis suggested that overall results were reliable. No significant risk of publication bias was found. Conclusion: Preventive psychological interventions moderately reduced the risk of sports injuries. Risk screening also significantly reduced the risk of sports injuries. These interventions should focus on cognitive behavior and be administered in 1 to 6 sessions over 7 to 12 weeks for 60 minutes per session.

scholarly journals Recalibrating the risk of hamstring strain injury (HSI): A 2020 systematic review and meta-analysis of risk factors for index and recurrent hamstring strain injury in sport

2020 ◽  
Vol 54 (18) ◽  
pp. 1081-1088 ◽  
Author(s):  
Brady Green ◽  
Matthew N Bourne ◽  
Nicol van Dyk ◽  
Tania Pizzari
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Significant Risk ◽  
Older Age ◽  
Future Research ◽  
Hamstring Strain ◽  
Best Evidence Synthesis ◽  
History Of

ObjectiveTo systematically review risk factors for hamstring strain injury (HSI).DesignSystematic review update.Data sourcesDatabase searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches.Eligibility criteria for selecting studiesStudies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI.MethodSearch result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI.ResultsThe 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury.Summary/conclusionOlder age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.

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