scholarly journals Association of N-acetyltransferases 1 and 2 Polymorphisms with Susceptibility to Head and Neck Cancers—A Meta-Analysis, Meta-Regression, and Trial Sequential Analysis

Medicina ◽  
2021 ◽  
Vol 57 (10) ◽  
pp. 1095
Author(s):  
Hady Mohammadi ◽  
Mehrnoush Momeni Roochi ◽  
Masoud Sadeghi ◽  
Ata Garajei ◽  
Hosein Heidar ◽  
...  
Keyword(s):  
Head And Neck ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Head And Neck Cancers ◽  
Slow Acetylators ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Nat2 Polymorphism ◽  
Rapid Acetylator ◽  
Significant Factors

Background and objective: N-acetyltransferases 1 and 2 (NAT1 and NAT2) genes have polymorphisms in accordance with slow and rapid acetylator phenotypes with a role in the development of head and neck cancers (HNCs). Herein, we aimed to evaluate the association of NAT1 and NAT2 polymorphisms with susceptibility to HNCs in an updated meta-analysis. Materials and methods: A search was comprehensively performed in four databases (Web of Science, Scopus, PubMed/Medline, and Cochrane Library until 8 July 2021). The effect sizes, odds ratio (OR) along with 95% confidence interval (CI) were computed. Trial sequential analysis (TSA), publication bias and sensitivity analysis were conducted. Results: Twenty-eight articles including eight studies reporting NAT1 polymorphism and twenty-five studies reporting NAT2 polymorphism were involved in the meta-analysis. The results showed that individuals with slow acetylators of NAT2 polymorphism are at higher risk for HNC OR: 1.22 (95% CI: 1.02, 1.46; p = 0.03). On subgroup analysis, ethnicity, control source, and genotyping methods were found to be significant factors in the association of NAT2 polymorphism with the HNC risk. TSA identified that the amount of information was not large enough and that more studies are needed to establish associations. Conclusions: Slow acetylators in NAT2 polymorphism were related to a high risk of HNC. However, there was no relationship between NAT1 polymorphism and the risk of HNC.

scholarly journals Do low-dose corticosteroids improve survival or shock reversal from septic shock in adults? Meta-analysis with trial sequential analysis

2018 ◽  
Vol 46 (7) ◽  
pp. 2513-2524 ◽  
Author(s):  
Rui Xu ◽  
Qian Wang ◽  
Yan Huang ◽  
Ling Wu ◽  
Qi Liu ◽  
...  
Keyword(s):  
Septic Shock ◽  
Relative Risk ◽  
Confidence Interval ◽  
Sequential Analysis ◽  
Low Dose ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Control Group ◽  
Shock Reversal

Objective This meta-analysis with trial sequential analysis (TSA) was performed to determine whether low-dose corticosteroids (LDCs) can improve survival or shock reversal from septic shock in adults. Methods A literature search was performed using several databases (Medline, Cochrane Library, Embase, and Chinese Biological Medical Database) until 23 October 2017. The systematic review was registered in PROSPERO. Results Nine randomized controlled trials (RCTs) (n = 1182) were included. LDC intervention improved 7-day shock reversal compared with the control group (relative risk, 1.36; TSA-adjusted 95% confidence interval, 1.20–1.54). LDCs had no statistically significant effects on gastrointestinal bleeding or superinfection. LDCs did not reduce 28-day mortality from septic shock (relative risk, 0.96; TSA-adjusted 95% confidence interval, 0.74–1.24). The TSA indicated that RCTs of about 3000 patients would be needed to draw definitive conclusions; similar results were obtained in a subgroup analysis of nonresponders. Conclusions LDCs improve 7-day shock reversal. However, whether LDCs improve 28-day survival from septic shock in adults remains unclear. The results of well-designed larger RCTs are needed.

scholarly journals Pharmacological interventions for preventing post-operative atrial fibrillation in patients undergoing cardiac surgery: a network meta-analysis protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018544 ◽  
Author(s):  
Xiaoqin Wang ◽  
Liang Yao ◽  
Long Ge ◽  
Lun Li ◽  
Fuxiang Liang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cardiac Surgery ◽  
Systematic Reviews ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Pharmacological Interventions ◽  
Patient Consent ◽  
Meta Analyses

IntroductionPostoperative atrial fibrillation (POAF) is the most common complication following cardiac surgery, and randomised clinical trials (RCTs) and systematic reviews have been conducted to compare and evaluate different pharmacological interventions for preventing POAF. This study aimed to explore the effect of different pharmacological interventions for prophylaxis against POAF after cardiac surgery using network meta-analysis (NMA).Methods and analysisA systematic search will be performed in PubMed, EMBASE and the Cochrane Library to identify RCTs, systematic reviews, meta-analyses or NMA of different pharmacological interventions for POAF. We will evaluate the risk of bias of the included RCTs according to the Cochrane Handbook V.5.1.0, and use GRADE to assess the quality of evidence. Standard pairwise meta-analysis, trial sequential analysis and Bayesian network meta-analysis will be used to compare the efficacy of different pharmacological interventions.Ethics and disseminationEthics approval and patient consent are not required as this study is a meta-analysis based on published studies. The results of this NMA and trial sequential analysis will be submitted to a peer-reviewed journal for publication.Protocol registration numberCRD42017067492.

scholarly journals Face-Down Posture versus Non-Face-Down Posture following Large Idiopathic Macular Hole Surgery: A Systemic Review and Meta-Analysis

2021 ◽  
Vol 10 (21) ◽  
pp. 4895
Author(s):  
Hou-Ren Tsai ◽  
Tai-Li Chen ◽  
Chun-Yu Chang ◽  
Huei-Kai Huang ◽  
Yuan-Chieh Lee
Keyword(s):  
Macular Hole ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Systemic Review ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Idiopathic Macular Hole ◽  
Closure Rate ◽  
Improvement Rate ◽  
Evaluation Approach

Evidence regarding the effect of a face-down posture (FDP) for large idiopathic macular hole (IMH) is inconsistent. We conducted a systematic review and meta-analysis to determine whether a postoperative FDP is required for the treatment of large IMH. Eligible randomized controlled trials published before September 2021 were retrieved from the Medline, Embase, and Cochrane Library databases. The efficacy outcome was the IMH closure rate and the visual acuity improvement rate. A meta-analysis was performed using a random effects model. The “Grading of Recommendations Assessment, Development, and Evaluation” approach was implemented, and the numbers needed-to-treat (NNTs) were calculated. Seven studies comprising 640 patients were included. We performed a predefined subgroup analysis of IMH size using a cut-off point of 400 µm. Compared with non-FDP, a significant effect of FDP was found in the IMH > 400 µm group (OR = 3.34; 95% CI = 1.57–7.14; trial sequential analysis-adjusted CI = 1.20–11.58; NNTs = 7.9). After stratifying by the posturing periods, the beneficial effect of FDP lasting at least five days, but not three days was observed for large IMH. Maintaining a FDP for at least five days postoperatively is an effective strategy (certainty of evidence: “moderate”) for treating large IMH.

scholarly journals Lack of association between NAT2 polymorphism and prostate cancer risk: a meta-analysis and trial sequential analysis

Oncotarget ◽  
2017 ◽  
Vol 8 (34) ◽  
pp. 57440-57450 ◽  
Author(s):  
Feng Wang ◽  
Zhiqiang Qin ◽  
Shuhui Si ◽  
Jingyuan Tang ◽  
Lingyan Xu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Risk ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Prostate Cancer Risk ◽  
Trial Sequential Analysis ◽  
Nat2 Polymorphism

scholarly journals Antibiotic regimens for neonatal sepsis - a protocol for a systematic review with meta-analysis

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Steven Kwasi Korang ◽  
Sanam Safi ◽  
Christian Gluud ◽  
Ulrik Lausten-Thomsen ◽  
Janus C. Jakobsen
Keyword(s):  
Systematic Review ◽  
Health Care Professionals ◽  
Neonatal Sepsis ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Circulatory Support ◽  
Trial Sequential Analysis ◽  
Clinical Effects ◽  
Neonates And Infants

Abstract Background Sepsis is a major cause of morbidity and mortality among neonates and infants. Antibiotics are a central part of the first line treatment for sepsis in neonatal intensive care units worldwide. However, the evidence on the clinical effects of the commonly used antibiotic regimens for sepsis in neonates remains scarce. This systematic review aims to assess the efficacy and harms of antibiotic regimens for neonatal sepsis. Methods Electronic searches will be conducted in MEDLINE, Embase, The Cochrane Library, CINAHL, ZETOC and clinical trial registries (clinicaltrials.gov and ISRCTN). We will include randomised controlled trials of different antibiotic regimens for sepsis of neonates and infants. Eligible interventions will be any antibiotic regimen. Two reviewers will independently screen, select, and extract data. The methodological quality of individual studies will be appraised following Cochrane methodology. Primary outcomes will be ‘all-cause mortality’ and ‘serious adverse events’. Secondary outcomes will be ‘need for respiratory support’, ‘need for circulatory support’, ‘neurodevelopmental impairment’, ototoxicity, nephrotoxicity and necrotizing enterocolitis. We plan to perform a meta-analysis with trial sequential analysis. Discussion This is the study protocol for a systematic review on the effects of different antibiotic regimens for neonatal sepsis. The results of this systematic review intent to adequately inform stakeholders or health care professionals in the field of neonatal sepsis, and to aid appropriate development of treatment guidelines. Systematic review registration PROSPERO reference number: CRD42019134300.

scholarly journals Comparison of short and long axis ultrasound-guided approaches to internal jugular vein puncture: a meta-analysis

2019 ◽  
Vol 47 (9) ◽  
pp. 4069-4082 ◽  
Author(s):  
Jian Zhang ◽  
Xiaohan Wang ◽  
Shuai Miao ◽  
Mengzhu Shi ◽  
Guanglei Wang ◽  
...  
Keyword(s):  
Success Rate ◽  
Internal Jugular Vein ◽  
Sequential Analysis ◽  
Jugular Vein ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Ultrasound Guided ◽  
Dichotomous Data ◽  
Standard Mean Difference

Objective To compare short-axis versus long-axis plane for ultrasound-guided internal jugular vein puncture. Methods PubMed, Embase, Cochrane Library and CNKI databases were searched for randomized controlled trials, published to 1 June 2019, that compared short- versus long-axis plane in ultrasound-guided internal jugular vein puncture. Statistical analyses were performed using RevMan software, version 5.3. Statistical results are presented as risk ratio (RR) (95% confidence interval [CI]) for dichotomous data and standard mean difference (SMD) (95% CI) for continuous data. Results Ten studies fulfilled the inclusion criteria. Analyses of pooled results showed no statistically significant differences in arterial puncture incidence between the two planes (RR 0.73 [95% CI 0.38, 1.39]). First-pass success rate (RR 1.08 [95% CI 0.95, 1.22]), total success rate (RR 1.00 [95% CI 0.99, 1.02]) and number of attempts required (SMD –0.09 [95% CI –0.37, 0.18]) were also similar between the two approaches. Trial sequential analysis indicated that the available evidence was insufficient to detect potential differences between the two techniques. Conclusions There is insufficient data for an evidence-based choice of either short- or long-axis plane in ultrasound-guided internal jugular vein puncture.

scholarly journals A meta-analysis of exosome in the treatment of spinal cord injury

Open Medicine ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. 1043-1060
Author(s):  
Hanxiao Yi ◽  
Yang Wang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Therapeutic Effects ◽  
Locomotor Function ◽  
Cord Injury

Abstract Context There are no recommended therapeutic agents for acute spinal cord injury (SCI) due to the pathophysiological complexity of the injury. Objective The objective of this study is to investigate the efficacy of various exosomes and potential factors impacting the efficacy of exosomes. Methods We searched the PubMed, EMBASE, Web of Science, Medline, Scopus, and Cochrane Library databases to systematically collect articles comparing the locomotor function of SCI rodents undergoing exosome treatment and untreated SCI rodents. No language was preferred. Results Pooled analysis revealed that the locomotor function recovery of SCI rodents receiving exosomes was greatly improved (583 rats, 3.12, 95% CI: 2.56–3.67, p < 0.01; 116 mice, 2.46, 95% CI: 1.20–3.72, p < 0.01) compared to those of control rodents. The trial sequential analysis demonstrated the findings of the meta-analysis with the cumulative Z-curve crossing the upper monitoring boundary for the benefit and reaching the adjusted required information size. However, the origin of the exosome, SCI model, and administration method determined the therapeutic effect to some extent. Conclusions Despite the proven therapeutic effects of exosomes on SCI rodents, the results should be interpreted cautiously considering the diversity in vivo and in vitro in relation to future trials.

scholarly journals Chitosan modifies glycemic levels in people with metabolic syndrome and related disorders: meta-analysis with trial sequential analysis

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenfang Guo ◽  
Letai Yi ◽  
Baochang Zhou ◽  
Minhui Li
Keyword(s):  
Metabolic Syndrome ◽  
Sequential Analysis ◽  
Fasting Glucose ◽  
Meta Analysis ◽  
Glycosylated Hemoglobin ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Glucose Levels ◽  
Randomized Controlled Studies

Abstract Background Chitosan supplementation has been shown to modulate glycemic levels; however, studies have reported conflicting results. The present meta-analysis with trial sequential analysis was conducted to verify the overall influence of chitosan on glycemic levels in patients with metabolic syndrome. Methods The PubMed, Cochrane library, and EMBASE databases were systematically searched for randomized controlled studies of chitosan intake and glycemic levels. Results A total of ten clinical trials including 1473 subjects were included in this meta-analysis. Pooled effect sizes were determined by random-effects meta-analysis. Subgroup analysis was performed to analyze the sources of heterogeneity and their influence on the overall results. The results revealed a significant reduction in fasting glucose levels (SMD: − 0.39 mmol/L, 95% CI: − 0.62 to − 0.16) and hemoglobin A1c (HbA1c) levels (SMD: -1.10; 95% CI: − 2.15 to − 0.06) following chitosan supplementation but no effect on insulin levels (SMD: − 0.20 pmol/L, 95% CI: − 0.64 to 0.24). Subgroup analyses further demonstrated significant reductions in fasting glucose levels in subjects administered 1.6–3 g of chitosan per day and in studies longer than 13 weeks. Trial sequential analysis of the pooled results of the hypoglycemic effect demonstrated that the cumulative Z-curve crossed both the conventional boundary and trial sequential monitoring boundary for glucose and HbA1c. Conclusions The glucose level of patients who are diabetic and obese/overweight can be improved by supplementation with chitosan for at least 13 weeks at 1.6–3 g per day. Additional clinical research data are needed to confirm the role of chitosan, particularly in regulating glycosylated hemoglobin and insulin.

scholarly journals Is metoclopramide beneficial for the post-pyloric placement of nasoenteric tubes? A systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Xin Ouyang ◽  
Rong Qu ◽  
Bei Hu ◽  
Yifan Wang ◽  
Fen Yao ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Success Rate ◽  
Sequential Analysis ◽  
Meta Analysis ◽  
Effect Sizes ◽  
Cochrane Library ◽  
Trial Sequential Analysis ◽  
Controlled Trials ◽  
Beneficial Effects ◽  
Randomized Controlled

Abstract BackgroundMetoclopramide is frequently prescribed as an adjuvant for the post-pyloric placement of nasoenteric tubes (NETs). However, the efficacy and safety of metoclopramide remain controversial. The latest meta-analysis showed that metoclopramide was not beneficial in adults. Thus, this study aimed to reevaluate the effect of metoclopramide on the post-pyloric placement of NETs.MethodsA systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), and Wanfang data was conducted up to August 2020 for randomized controlled trials (RCTs) comparing metoclopramide with placebo or no intervention. The effect sizes of eligible studies were pooled using the relative risk (RR) and 95% confidence interval (CI) in a random-effects model. Trial sequential analysis (TSA) was used for the primary outcomes (the success rate of the post-pyloric placement of NETs).ResultsSeven eligible RCTs that included 520 participants were identified. The results of the pooled effect sizes showed that metoclopramide significantly facilitated the post-pyloric placement of NETs (RR, 1.48; 95% CI, 1.11–1.97; P = 0.007; I2 = 37%). However, the risk of bias assessment and the TSA results indicated that the qualities of the RCTs and the sample sizes were insufficient to confirm the efficacy of metoclopramide. Further subgroup analysis revealed that successful post-pyloric placement was more pronounced in studies in which spiral NETs were employed (RR, 1.85; 95% CI, 1.41–2.43; P < 0.001; I2 = 0%). Additionally, a significant increase in the success rate was also observed for post-D1 (reaching the second portion of the duodenum or beyond), post-D2 (reaching the third portion of the duodenum or beyond), and post-D3 (reaching the fourth portion of the duodenum or beyond) placement of spiral NETs. Overall adverse events were minimal.ConclusionsThe evidence accumulated so far was not strong enough to demonstrate metoclopramide’s beneficial effects on the post-pyloric placement of NETs; however, it might be effective for spiral NETs. Further high-quality, large-sample RCTs are required to elucidate the effects of metoclopramide.Trial registrationPROSPERO CRD42019123424 (10 July 2019)

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