Is 0.01% Atropine an Effective and Safe Treatment for Myopic Children? A Systemic Review and Meta-Analysis

Several conflicting results regarding the efficacy of 0.01% atropine in slowing axial elongation remain in doubt. To solve this issue and evaluate the safety of 0.01% atropine, we conducted a systematic review and meta-analysis with the latest evidence. The review included a total of 1178 participants (myopic children). The efficacy outcomes were the mean annual progression in standardized equivalent refraction (SER) and axial length (AL). The safety outcomes included mean annual change in accommodative amplitude, photopic and mesopic pupil diameter. The results demonstrated that 0.01% atropine significantly retarded SER progression compared with the controls (weighted mean difference [WMD], 0.28 diopter (D) per year; 95% confidence interval (CI) = 0.17, 0.38; p < 0.01), and axial elongation (WMD, −0.06 mm; 95% CI = −0.09, −0.03; p < 0.01) during the 1-year period. Patients receiving 0.01% atropine showed no significant changes in accommodative amplitude (WMD, −0.45 D; 95% CI = −1.80, 0.90; p = 0.51) but showed dilated photopic pupil diameter (WMD, 0.35 mm; 95% CI = 0.02, 0.68; p = 0.04) and mesopic pupil diameter (WMD, 0.20 mm; 95% CI = 0.08, 0.32; p < 0.01). In the subgroup analysis of SER progression, myopic children with lower baseline refraction (>−3 D) and older age (>10-year-old) obtained better responses with 0.01% atropine treatment. Furthermore, the European and multi-ethnicity groups showed greater effect than the Asian groups. In conclusion, 0.01% atropine had favorable efficacy and adequate safety for childhood myopia over a 1-year period.

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The Effect of Atropine Alone or Combined with Orthokeratology for Children with Myopia: A Meta-Analysis

10.21203/rs.3.rs-730221/v1 ◽

2021 ◽

Author(s):

zengying wang ◽

yifei meng ◽

sufang qie ◽

zhipeng yan

Keyword(s):

Weighted Mean Difference ◽

Meta Analysis ◽

Cochrane Library ◽

Moderate Degree ◽

Axial Elongation ◽

Low Degree ◽

Significant Difference ◽

The Mean ◽

Analysis System ◽

Myopia Control

Abstract Objective: To evaluate the effect of atropine alone or combined with orthokeratology on myopia control by meta-analysis system.Methods: The current study searched PubMed, Cochrane Library, EMBASE, MEDLINE, Web of science, Ovid to collect eligible studies. The Weighted mean difference (WMD) of mean changes in axial elongation between the atropine alone or combined with orthokeratology group and the orthokeratology (ortho-k) group was used as evaluation index. Results: Twelve studies were eventually included, involving 671 children in the atropine alone and 547 children in the atropine combined with orthokeratology（AOK） group. This meta-analysis showed that the mean axial elongation of atropine alone was faster than that of ortho-k alone. [WMD=0.06mm, 95％CI(0.02~0.10), p＜0.007]. The function of AOK for slowing axial elongation was affected by the baseline diopter of children. The WMD in -1~-3D subgroup was -0.10 mm(95％CI,-0.14~-0.05,P＜0.00001),which mens that the AOK was more effective than OK alone in retarding axial elongation. In -3~-6D, WMD is -0.04mm (95% Cl, -0.11~0.03), and there is not statistically significant between two groups (P<0.30).Conclusion: This study suggested that ortho-k monotherapy is better in slowing axial elongation than atropine monotherapy in children with myopia. For children with low degree of myopia, the combination of ortho-k and 0.01% atropine is more effective than ortho-k monotherapy in slowing axial elongation in children. But there is no significant difference between two treatments in children with moderate degree of myopia.

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Puerarin for OVX-Induced Postmenopausal Osteoporosis in Murine Model: Systematic Review and Meta-Analysis

Current Stem Cell Research & Therapy ◽

10.2174/1574888x14666190703143946 ◽

2020 ◽

Vol 15 (1) ◽

pp. 37-42 ◽

Cited By ~ 1

Author(s):

Xiaobin Yang ◽

Haishi Zheng ◽

Yuan Liu ◽

Dingjun Hao ◽

Baorong He ◽

...

Keyword(s):

Systematic Review ◽

Bone Mass ◽

Postmenopausal Osteoporosis ◽

Murine Model ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Mean Difference ◽

Weighted Mean ◽

Enhancing Effect ◽

Searching Strategy

Aims/Background: Ovariectomy (OVX)-induced murine model is widely used for postmenopausal osteoporosis study. Our current study was conducted to systematically review and essentially quantified the bone mass enhancing effect of puerarin on treating OVX-induced postmenopausal osteoporosis in murine model. Methods: Literatures from PUBMED, EMBASE, and CNKI were involved in our searching strategy by limited the inception date to January 9th, 2019. Moreover, the enhancing effect of puerarin on bone mass compared to OVX-induced rats is evaluated by four independent reviewers. Finally, all the data were extracted, quantified and analyzed via RevMan, besides that in our current review study, we assessed the methodological quality for each involved study. Results: Based on the searching strategy, eight randomization studies were finally included in current meta-analysis and systematic review. According to the data analysis by RevMan, puerarin could improve bone mineral density (BMD); (eight studies, n=203; weighted mean difference, 0.05; 95% CI, 0.03-0.07; P<0.0001) using a random-effects model. There is no significant difference between puerarin and estrogen (seven studies, n=184; weighted mean difference, 0.00; 95% CI, -0.01 to 0.00; P=0.30). Conclusions: Puerarin showed upregulating effects on bone mass in OVX-induced postmenopausal osteoporosis in murine model. More studies of the effect of puerarin on bone density in OVX animals are needed.

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Comparison of clinical efficacy and safety between dexmedetomidine and propofol among patients undergoing gastrointestinal endoscopy: a meta-analysis

Journal of International Medical Research ◽

10.1177/03000605211032786 ◽

2021 ◽

Vol 49 (7) ◽

pp. 030006052110327

Author(s):

Weihua Liu ◽

Wenli Yu ◽

Hongli Yu ◽

Mingwei Sheng

Keyword(s):

Clinical Efficacy ◽

Lower Risk ◽

Gastrointestinal Endoscopy ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Similar Efficacy ◽

Cochrane Library ◽

Efficacy And Safety ◽

Inclusion Criteria ◽

Weighted Mean

Objective To compare the clinical efficacy and safety of dexmedetomidine and propofol in patients who underwent gastrointestinal endoscopy. Methods Relevant studies comparing dexmedetomidine and propofol among patients who underwent gastrointestinal endoscopy were retrieved from databases such as PubMed, Embase, and Cochrane Library. Results Seven relevant studies (dexmedetomidine group, n = 238; propofol group, n = 239) met the inclusion criteria. There were no significant differences in the induction time (weighted mean difference [WMD] = 3.46, 95% confidence interval [CI] = −0.95–7.88, I2 = 99%) and recovery time (WMD = 2.74, 95% CI = −2.72–8.19, I2 = 98%). Subgroup analysis revealed no significant differences in the risks of hypotension (risk ratio [RR] = 0.56, 95% CI = 0.25–1.22) and nausea and vomiting (RR = 1.00, 95% CI = 0.46–2.22) between the drugs, whereas dexmedetomidine carried a lower risk of hypoxia (RR = 0.26, 95% CI = 0.11–0.63) and higher risk of bradycardia (RR = 3.01, 95% CI = 1.38–6.54). Conclusions Dexmedetomidine had similar efficacy and safety profiles as propofol in patients undergoing gastrointestinal endoscopy.

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The Antihypertensive Effects and Safety of LCZ696 in Patients with Hypertension: A Systemic Review and Meta-Analysis of Randomized Controlled Trials

Journal of Clinical Medicine ◽

10.3390/jcm10132824 ◽

2021 ◽

Vol 10 (13) ◽

pp. 2824

Author(s):

Su-Kiat Chua ◽

Wei-Ting Lai ◽

Lung-Ching Chen ◽

Huei-Fong Hung

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Randomized Controlled Trials ◽

Diastolic Blood Pressure ◽

Publication Bias ◽

Meta Analysis ◽

Systemic Review ◽

Controlled Trials ◽

Randomized Controlled ◽

The Mean

Background: The management of hypertension remains suboptimal throughout the world. Methods: We performed a random-effects model meta-analysis of randomized controlled trials to determine the effectiveness and safety of sacubitril/valsartan (LCZ696) for the treatment of high arterial pressure. Relevant published articles from PubMed, Cochrane base, and Medline were examined, and the last search date was December 2020. Only published randomized controlled trials and double-blind studies were selected for further analysis. The mean reductions in systolic blood pressure (msSBP) and diastolic blood pressure (msDBP) in the sitting position, as well as the mean reductions in ambulatory systolic blood pressure (maSBP) and ambulatory diastolic blood pressure (maDBP), were assumed as efficacy endpoints. Adverse events (AEs) were considered as safety outcomes. Results: Ten studies with a total of 5931patients were included for analysis. Compared with placebo, LCZ696 had a significant reduction in msSBP (weight mean difference (WMD) = −6.52 mmHg, 95% confidence interval (CI): −8.57 to −4.47; p < 0.001), msDBP (WMD = −3.32 mmHg, 95% CI: −4.57 to −2.07; p < 0.001), maSBP (WMD = −7.08 mmHg, 95% CI: −10.48 to −3.68; p < 0.001), maDBP (WMD = −3.28 mmHg, 95% CI: −4.55 to −2.02, p < 0.001). In subgroup analysis, only 200 mg and 400 mg LCZ696 showed a significant BP reduction. There was no difference in the AE rate between the LCZ696 and placebo groups (WMD = 1.02, 95% CI: 0.83 to 1.27, p = 0.54). Egger’s test revealed a potential publication bias for msSBP (p = 0.025), but no publication bias for other outcomes. Conclusion: LCZ696 may reduce blood pressure more efficaciously than traditional therapy in hypertensive patients without increasing adverse effects.

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Effect of Earthworm on Wound Healing: A Systematic Review and Meta-Analysis

Frontiers in Pharmacology ◽

10.3389/fphar.2021.691742 ◽

2021 ◽

Vol 12 ◽

Author(s):

Dong Wang ◽

Zhen Ruan ◽

Rongchao Zhang ◽

Xuejing Wang ◽

Ruihui Wang ◽

...

Keyword(s):

Systematic Review ◽

Wound Healing ◽

Healing Rate ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Healing Process ◽

Risk Of Bias ◽

Mean Difference ◽

Cochrane Library ◽

Weighted Mean

Background: Earthworm, also called dilong (Chinese language), has been used as a traditional Chinese medicine for thousands of years. Recently, some scientists believe that earthworm extracts (EE) can promote wound healing. However, its effectiveness remains controversial. We conducted a meta-analysis to evaluate the effect of EE on wound healing based on the healing rate.Methods: We comprehensively reviewed literature that mentioned EE for wound healing in the PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), VIP database for Chinese Technical Periodicals, and WanFang database that have been published until January 2021. We computed weighted mean difference (WMD) for analysis with RevMan 5.3 software in animal and human models groups. Two researchers independently selected studies and evaluated the risk of bias with the Cochrane Collaboration tool. The quality of the evidence was assessed with the Cochrane risk of bias tool. This study is registered on PROSPERO (CRD42020168400).Results: From 2,486 articles, we selected 16 studies for analysis. EE treatment was associated with improvements in wound healing performance based on wound healing rate (mouse model: weighted mean difference (WMD) = 3.55, 95% confidence interval (CI): 2.34–4.77, p < 0.00001; rat model: WMD = 17.29, 95% CI: 5.75–28.82, p = 0.003; rabbit model: WMD = 19.29, 95% CI: 9.95–28.64, p < 0.0001). Clinical studies also confirmed that EE could reduce healing time in hospital (WMD = −8.94, 95% CI: −17.75 to −0.14, p = 0.05).Conclusion: The results of this meta-analysis demonstrated the efficacy of EE on wound healing process. As a corollary, EE can be a useful natural product for wound healing drug development.Systematic Review Registration:https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=168400, identifier CRD42020168400.

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Impact of extended lymphadenectomy on morbidity, mortality, recurrence and 5-year survival after gastrectomy for cancer: meta-analysis of randomized clinical trials

Acta Cirurgica Brasileira ◽

10.1590/s0102-86502008000600009 ◽

2008 ◽

Vol 23 (6) ◽

pp. 520-530 ◽

Cited By ~ 19

Author(s):

Suzana Angélica Silva Lustosa ◽

Humberto Saconato ◽

Álvaro Nagib Atallah ◽

Gaspar de Jesus Lopes Filho ◽

Delcio Matos

Keyword(s):

Hospital Mortality ◽

Recurrent Disease ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Mean Difference ◽

Weighted Mean ◽

D3 Lymphadenectomy ◽

Statistical Heterogeneity ◽

Significant Difference ◽

Significant Statistical Heterogeneity

PURPOSE: To compare morbidity, mortality, recurrence and 5-year survival between D1 and D2 or D3 for treatment of gastric cancer. METHODS: Systematic review and meta-analysis of RCTs. Metaview in RevMan 4.2.8 for analysis; statistical heterogeneity by Cochran's Q test (P<0.1) and I² test (P>50%). Estimates of effect were calculated using random effects model. RESULTS: D2 or D3 was associated with higher in-hospital mortality, with RR = 2.13, p=0.0004, 95% CI, 1.40 to 3.25, I²=0%, P=0.63; overall morbidity showed higher incidence in D2 or D3, RR = 1.98, p<0.00001, 95% CI, 1.64 to 2.38, I² = 33.9%, P=0.20; operating time showed longer duration in D2 or D3, weighted mean difference of 1.05, p<0.00001, 95% CI, 0.71 to 1.38, I² = 78.7%, P=0.03, with significant statistical heterogeneity; reoperation showed higher rate in D2 or D3, with RR = 2.33, p<0.0001, 95% CI, 1.58 to 3.44, I² = 0%, P=0.99; hospital stay showed longer duration in the D2 or D3, with weighted mean difference of 4.72, p<0.00001, 95% CI, 3.80 to 5.65, I² = 89.9%, P<0.00001; recurrence was analyzed showed lower rate in D2 or D3, with RR = 0.89, p=0.02, 95% CI, 0.80 to 0.98, I² = 71.0%, P = 0.03, with significant statistical heterogeneity; mortality with recurrent disease showed higher incidence in D1, with RR = 0.88, p=0.04, 95% CI, 0.78 to 0.99, I² =51.8%, P=0.10; 5-year survival showed no significant difference, with RR = 1.05, p=0.40, 95% CI, 0.93 to 1.19, I² = 49.1% and P=0.12. CONCLUSIONS: D2 or D3 lymphadenectomy procedure is followed by higher overall morbidity and higher in-hospital mortality; D2 or D3 lymphadenectomy shows lower incidence of recurrence and lower mortality with recurrent disease, when analysed altogether with statistical heterogeneity; D2 or D3 lymphadenectomy has no significant impact on 5-year survival.

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Diagnostic Value of sST2 in Cardiovascular Diseases: A Systematic Review and Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.697837 ◽

2021 ◽

Vol 8 ◽

Author(s):

Tianyi Zhang ◽

Chengyang Xu ◽

Rui Zhao ◽

Zhipeng Cao

Keyword(s):

Myocardial Infarction ◽

Cardiac Troponin ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Diagnostic Value ◽

Mean Difference ◽

Diagnostic Biomarker ◽

Healthy Individuals ◽

Weighted Mean ◽

Standard Mean Difference

Biomarkers such as B-type natriuretic peptide (BNP), N-terminal pro-BNP (NT-proBNP), cardiac troponin (cTn), and CK-MB contribute significantly to the diagnosis of cardiovascular disease (CVD). Recent studies have demonstrated that suppression of tumorigenicity 2 (ST2) is associated with CVD, but a meta-analysis of ST2 levels in different CVDs has yet to be conducted. Therefore, the present study aimed to investigate soluble ST2 (sST2) levels in patients with ischemic heart disease (IHD), myocardial infarction (MI), and heart failure (HF). A total of 1,425 studies were searched across four databases, of which 16 studies were included in the meta-analysis. The Newcastle–Ottawa Quality Assessment Scale (NOS) values of all 16 studies were ≥7. The meta-analysis results indicated that the sST2 level was not correlated with IHD (standard mean difference [SMD] = 0.58, 95% confidence interval [95% CI] = 0.00 to 1.16, p = 0.05) or MI (weighted mean difference [WMD] = 0.17, 95% CI = −0.22 to 0.55, p = 0.40) but was significantly associated with HF (WMD = 0.21, 95% CI = 0.04 to 0.38, p = 0.02; I2 = 99%, p < 0.00001). sST2 levels did not differ significantly between patients with IHD or MI and healthy individuals; however, we believe that ST2 could be used as an auxiliary diagnostic biomarker of HF.

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The effect of levosimendan on postoperative bleeding and blood transfusion in cardiac surgical patients: a PRISMA-compliant systematic review and meta-analysis

Perfusion ◽

10.1177/0267659120963909 ◽

2020 ◽

pp. 026765912096390

Author(s):

Yun-tai Yao ◽

Li-xian He ◽

Yuan-yuan Zhao

Keyword(s):

Blood Transfusion ◽

Blood Loss ◽

Treatment Effects ◽

Transfusion Requirement ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Postoperative Bleeding ◽

Surgical Patients ◽

Systemic Review ◽

Increased Risk

Background: Levosimendan (LEVO), is an inotropic agent which has been shown to be associated with better myocardial performance, and higher survival rate in cardiac surgical patients. However, preliminary clinical evidence suggested that LEVO increased the risk of post-operative bleeding in patients undergoing valve surgery. Currently, there has been no randomized controlled trials (RCTs) designed specifically on this issue. Therefore, we performed present systemic review and meta-analysis. Methods: Electronic databases were searched to identify all RCTs comparing LEVO with Control (placebo, blank, dobutamine, milrinone, etc). Primary outcomes include post-operative blood loss and re-operation for bleeding. Secondary outcomes included post-operative transfusion of red blood cells (RBC), fresh frozen plasma (FFP) and platelet concentrates (PC). For continuous variables, treatment effects were calculated as weighted mean difference (WMD) and 95% confidential interval (CI). For dichotomous data, treatment effects were calculated as odds ratio (OR) and 95% CI. Results: Search yielded 15 studies including 1,528 patients. Meta-analysis suggested that, LEVO administration was not associated with increased risk of reoperation for bleeding post-operatively (OR = 1.01; 95%CI: 0.57 to 1.79; p = 0.97) and more blood loss volume (WMD = 28.25; 95%CI: –19.21 to 75.72; p = 0.24). Meta-analysis also demonstrated that, LEVO administration did not increase post-operative transfusion requirement for RBC (rate: OR = 0.97; 95%CI: 0.72 to 1.30; p = 0.83 and volume: WMD = 0.34; 95%CI: –0.55 to 1.22; p = 0.46), FFP (volume: WMD = 0.00; 95%CI: –0.10 to 0.10; p = 1.00) and PC (rate: OR = 1.01; 95%CI: 0.41 to 2.50; p = 0.98 and volume: WMD = 0.00; 95%CI: –0.05 to 0.04; p = 0.95). Conclusion: This meta-analysis suggested that, peri-operative administration of LEVO was not associated with increased risks of post-operative bleeding and blood transfusion requirement in cardiac surgical patients.

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A dose-response and meta-analysis of phytosterols consumption on liver enzymes

Nutrition & Food Science ◽

10.1108/nfs-06-2019-0182 ◽

2019 ◽

Vol 50 (3) ◽

pp. 579-600

Author(s):

Somayeh Tajik ◽

Kevan Jacobson ◽

Sam Talaei ◽

Hamed Kord-Varkaneh ◽

Zeinab Noormohammadi ◽

...

Keyword(s):

Liver Function ◽

Design Methodology ◽

Liver Enzymes ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Serum Biochemistry ◽

Effect Sizes ◽

Random Effects Model ◽

Weighted Mean ◽

Content Type

Purpose The results of human studies evaluating the efficacy of plant Phytosterols on liver function were inconsistent. Therefore, the purpose of this paper is to eliminate these controversies about the Phytosterols consumption on liver serum biochemistry in adult subjects. Design/methodology/approach The literatures systematically searched throughout PubMed and Scopus databases up to June 2018; it was conducted by using related keywords. Estimates of effect sizes were expressed based on weighted mean difference (WMD) and 95% CI from the random-effects model (erSimonian and Laird method). Heterogeneity across studies was assessed by using I2 index. Eighteen studies reported the effects of Phytosterols (PS) supplementation on liver serum biochemistry. Findings The current meta-analysis did not show a significant effect on ALT (MD: 0.165 U/L, 95% CI: −1.25, 1.58, p = 0.820), AST (MD: −0.375 IU/Liter, 95% CI: −1.362, 0.612, p = 0.457), ALP (MD: 0.804 cm, 95% CI: −1.757, 3.366, p = 0.538), GGT (MD: 0.431 U/L, 95% CI: −1.803, 2.665, p = 0.706) and LDH (MD: 0.619 U/L, 95% CI: −4.040, 5.277, p = 0.795) following PS consumption. Originality/value The authors found that no protective or toxic effects occur after the consumption of Phytosterols on liver enzymes including ALT, AST, ALP, LDH and GGT.

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Protein Intake Greater than the RDA Differentially Influences Whole-Body Lean Mass Responses to Purposeful Catabolic and Anabolic Stressors: A Systematic Review and Meta-analysis

Advances in Nutrition ◽

10.1093/advances/nmz106 ◽

2019 ◽

Vol 11 (3) ◽

pp. 548-558 ◽

Cited By ~ 6

Author(s):

Joshua L Hudson ◽

Yu Wang ◽

Robert E Bergia III ◽

Wayne W Campbell

Keyword(s):

Systematic Review ◽

Lean Mass ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Energy Restriction ◽

Whole Body ◽

Weighted Mean ◽

Randomized Controlled ◽

Body Lean Mass ◽

Apparently Healthy

ABSTRACT Under stressful conditions such as energy restriction (ER) and physical activity, the RDA for protein of 0.8 g · kg−1 · d−1 may no longer be an appropriate recommendation. Under catabolic or anabolic conditions, higher protein intakes are proposed to attenuate the loss or increase the gain of whole-body lean mass, respectively. No known published meta-analysis compares protein intakes greater than the RDA with intakes at the RDA. Therefore, we conducted a systematic review and meta-analysis to assess the effects of protein intakes greater than the RDA, compared with at the RDA, on changes in whole-body lean mass. Three researchers independently screened 1520 articles published through August 2018 using the PubMed, Scopus, CINAHL, and Cochrane databases, with additional articles identified in published systematic review articles. Randomized, controlled, parallel studies ≥6 wk long with apparently healthy adults (≥19 y) were eligible for inclusion. Data from 18 studies resulting in 22 comparisons of lean mass changes were included in the final overall analysis. Among all comparisons, protein intakes greater than the RDA benefitted changes in lean mass relative to consuming the RDA [weighted mean difference (95% CI): 0.32 (0.01, 0.64) kg, n = 22 comparisons]. In the subgroup analyses, protein intakes greater than the RDA attenuated lean mass loss after ER [0.36 (0.06, 0.67) kg, n = 14], increased lean mass after resistance training (RT) [0.77 (0.23, 1.31) kg, n = 3], but did not differentially affect changes in lean mass [0.08 (−0.59, 0.75) kg, n = 7] under nonstressed conditions (no ER + no RT). Protein intakes greater than the RDA beneficially influenced changes in lean mass when adults were purposefully stressed by the catabolic stressor of dietary ER with and without the anabolic stressor of RT. The RDA for protein is adequate to support lean mass in adults during nonstressed states. This review was registered at www.crd.york.ac.uk/prospero as CRD 42018106532.

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