scholarly journals Punch Incision versus Elliptical Excision for Epidermal Inclusion Cysts: Systematic Review and Meta-Analysis

Surgeries ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 335-346
Author(s):  
Kengo Mukuda ◽  
Jun Watanabe

Punch incision is an alternative to elliptical excision for treating epidermal inclusion cysts, but its efficacy has not been systematically reviewed. This study assessed the efficacy and safety of punch incision versus elliptical excision for epidermal inclusion cysts. Randomized controlled trials published through January 2021 that evaluated the performance of punch incision versus elliptical excision on epidermal inclusion cysts were identified through electronic databases and clinical registries. Version 2 of the Cochrane risk-of-bias tool for randomized trials tool was used. Review Manager software was used for the meta-analysis. Two trials (100 participants) were identified. The primary outcomes were recurrence rate (risk ratio, 2.40; 95% confidence interval [CI], 0.37–15.60 [favoring elliptical excision]), mean operative time (mean difference [MD], −5.28; 95% CI, −12.72 to 2.16 [favoring punch incision]), and mean postoperative wound length (MD, −11.67; 95% CI, −20.59 to −2.76 [favoring punch incision]). The evidence was low to moderate due to the small sample size and its considerable heterogeneity. The use of punch incision shortened the mean postoperative wound length and had comparable safety to that of elliptical excision.

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Yulan Yang ◽  
Hairong Su ◽  
Jian Wen ◽  
Jianyun Hong

Objective. This study aimed to investigate the efficacy of acupoint injection for alleviating side effects of chemotherapy in people with cancer. Methods. PubMed, EMBASE, Cochrane library databases, CNKI, VIP, WanFang Date, and CBM were searched for randomized controlled trials (RCTs) from inception through December 28, 2020. This meta-analysis was performed using Review Manager 5.3. Results. A total of 8 RCTs including 557 participants were eligible and included in the meta-analysis. The selected RCTs studied acupoint injection for alleviating side effects of chemotherapy in people with cancer. Statistically significant improvements were observed for the incidence of nausea and vomiting (RR = 0.39; 95% CI 0.26, 0.58; P  < 0.00001), the number of leukocyte (MD = 1.89; 95%CI 0.74, 3.03; P  = 0.001), and the number of platelet (MD = 28.82; 95%CI 19.33, 38.30; P  < 0.00001). Two of these studies suggested that acupoint injection can also reduce some other adverse reactions, which showed a statistical difference (RR = 0.29; 95% CI 0.11, 0.75; P  = 0.01). Conclusion. The analysis indicated that acupoint injection can alleviate side effects of chemotherapy in people with cancer. However, due to the high risk of bias and small sample size in the included studies, the results need to be further confirmed by further large, rigorously designed trials.


Author(s):  
Nur Farhana Mohamed Noor ◽  
Teh Lay Kek ◽  
Mohd Arif Mohd Zim ◽  
Zamzurina Abu Bakar ◽  
Noor Izyani Zakaria ◽  
...  

Background: N-acetyltransferase (NAT2) polymorphisms were reported to play important roles in antituberculosis-induced hepatotoxicity (ATDIH). However, the allelic types with increased risks for ATDIH were inconsistent as most studies are of a small sample size. Objective: The objective of the study was to conduct a meta-analysis to identify NAT2 alleles associated with increased risks of ATDIH. Methods: Studies reported on NAT2 polymorphism with the risk of ATDIH were searched systematically in PubMed, Scopus, and the World of Sciences. Studies were included if they fulfilled the inclusion criteria and excluded accordingly. Quality assessments were done using Newcastle-Ottawa Score. Statistical analysis was performed using Review Manager version 5.3. Cochrane Q-statistic test and I2 statistic were used to assess and quantify heterogeneity. Results: A total of 12 studies involving 580 cases and 3129 controls were included. NAT2 polymorphism was significantly associated with the risk of ATDIH with an odd ratio (OR) of 2.76 (1.86 – 4.10, 95% CI). Among the slow acetylators genotypes, NAT2*5/*7 carry the highest risk associated with ATDIH. Conclusion: NAT2 polymorphism was significantly associated with ATDIH.


2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Youfeng Zhu ◽  
Haiyan Yin ◽  
Rui Zhang ◽  
Xiaoling Ye ◽  
Jianrui Wei

Introduction.Previous studies have shown that the nasogastric (NG) route seems equivalent to the nasojejunal (NJ) route in patients with severe acute pancreatitis (SAP). However, these studies used a small sample size and old criteria for diagnosing SAP, which may include some patients with moderate SAP, according to the newly established SAP criteria (Atlanta 2012 classification). Based on the changes in the criteria for classifying SAP, we performed an up-to-date meta-analysis.Method.We reviewed the PubMed, EMbase, China National Knowledge Infrastructure, Wanfang Database, and Cochrane Central Register of Controlled Trials electronic databases. We included randomized controlled trials comparing NG and NJ nutrition in patients with SAP. We performed the meta-analysis using the Cochrane Collaborations’ RevMan 5.3 software.Results.We included four randomized controlled trials involving 237 patients with SAP. There were no significant differences in the incidence of mortality, infectious complications, digestive complications, achievement of energy balance, or length of hospital stay between the NG and NJ nutrition groups.Conclusions.NG nutrition was as safe and effective as NJ nutrition in patients with SAP. Further studies are needed to confirm our results.


2021 ◽  
Vol 38 (2) ◽  
pp. 96-109
Author(s):  
Seung Min Lee ◽  
Cham Kyul Lee ◽  
Kyung Ho Kim ◽  
Eun Jung Kim ◽  
Chan Yung Jung ◽  
...  

The purpose of this study was to evaluate the effectiveness and safety of acupotomy for the treatment of patients with knee osteoarthritis. There were 9 databases searched to retrieve randomized controlled trials until August 3, 2019 regarding acupotomy versus conventional Western medicine, conventional Western medicine treatment with and without acupotomy, and Korean medicine treatment with and without acupotomy, and meta-analysis was performed. Of 303 potentially relevant studies retrieved, 43 were systematically reviewed. All studies were conducted in China. Effective rate, visual analogue scale, and Western Ontario and McMaster Universities Osteoarthritis index were used as the evaluation scales. The Ashi point was selected most frequently. In all studies, the intervention group was more effective than the control group. Meta-analysis revealed that acupotomy showed statistically significant beneficial results. Although acupotomy had a beneficial effect on knee osteoarthritis, the risk of bias of the included studies was not low. The majority of the results from the evaluation scales used were highly heterogeneous (> 50%) which reduced confidence in the estimation of effect, or had a small sample size. Further clinical research and development is required in the future.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jiawei Wang ◽  
Xiao Ma ◽  
Shizhang Wei ◽  
Tao Yang ◽  
Yuling Tong ◽  
...  

Objective: This study was intended to provide data to support the effect of Shashen Maidong Decoction in improving mycoplasma pneumonia in pediatric patients through systematic evaluation.Methods: PubMed, the Web of Science, EMbase, CNKI, CQVIP, Wan-Fang, and CBM databases were comprehensively searched from established in June 2021. Randomized controlled trials of TRQI were selected by screening the literature and extracting information. The Cochrane RCT Evaluation Manual was used to evaluate the methodological quality of all included studies, and Meta-analysis was performed using Stata 14.0 and Review Manager 5.4 software.Results: A total of 1,127 patients from 12 clinical studies met the inclusion criteria. Meta-analysis results showed that the treatment group of Shashen Maidong Decoction was able to significantly increase the overall efficiency level and significantly reduce the incidence of adverse reactions, time for disappearance of cough, time for relief of cough, time for defervescence, time for disappearance of lung rales, time for return to normal of chest X-ray, T lymphocyte subpopulation (CD3+) and tumor necrosis factor-α (TNF-α) and other index levels (p &lt; 0.05).Conclusion: Shashen Maidong Decoction has a significant improvement in the levels of relevant indexes in pediatric mycoplasma pneumonia, which provides a basis for the safety and efficacy of pediatric mycoplasma pneumonia. However, due to the small sample size included in the study, the study quality was not high, and more randomized controlled trials of high quality are required for further validation.


2019 ◽  
Vol 18 ◽  
pp. 153473541987340 ◽  
Author(s):  
Seungcheol Hong ◽  
Bongki Park ◽  
Hyeonseok Noh ◽  
Dong-Jun Choi

Background: Dumping syndrome is a common complication of surgical treatment of gastric cancer, but conventional therapy has limitations related to symptom care due to its structural cause and the decreased quality of life. Objectives: The objective of this review was to assess the clinical evidence for the effectiveness of herbal medicine as a treatment for dumping syndrome. Methods: A literature review was conducted using 16 databases from their inceptions to March 2018. All randomized controlled trials (RCTs) of herbal medicine used to treat dumping syndrome patients were included and meta-analyzed. Methodological quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results: A total of 174 dumping syndrome patients of 3 trials met all inclusion criteria. Two trials assessed the effectiveness of herbal medicine on the symptom response rate compared with conventional pharmacotherapy. Their results suggested significant effects in favor of herbal medicine (risk ratio [RR] = 1.37, 95% confidence interval [CI] = 1.16-1.63, P = .0003, heterogeneity τ2 = 0, χ2 = 0.02, P = .88, I2 = 0%). One trial assessed its effectiveness on the improvement rate of overall symptoms compared with conventional conservative complex therapy, such as postural management, diet regulation, and counseling (RR = 1.23, 95% CI = 0.96-1.58). Conclusions: Due to the small sample size, scarcity of reported articles, and lack of quality of the current RCTs, it was concluded that the effectiveness of herbal medicine in treating dumping syndrome is unclear.


2015 ◽  
Vol 9 (7-8) ◽  
pp. 453 ◽  
Author(s):  
Linda C. Lee ◽  
Niki Kanaroglou ◽  
Joseph M. Gleason ◽  
Joao L. Pippi Salle ◽  
Darius J. Bägli ◽  
...  

Introduction: Pediatric pyeloplasty with double J (DJ) stent drainage requires manipulation of the uretero-vesical junction (UVJ) and a second anesthetic for removal. Externalized uretero-pyelostomy (EUP) stents avoid these issues. We report outcomes of laparoscopic and open pyeloplasty with EUP compared to DJ stents in children.Methods: We retrospectively reviewed 76 consecutive children who underwent pyeloplasty for ureteropelvic junction (UPJ) obstruction over a 1-year period by 5 pediatric urologists at a single institution. The exclusion criteria included patients with concomitant urological procedures, other urinary drainage strategies, “stentless” pyeloplasty or patients without follow-up data. Based on surgeon preference, 24 patients had a EUP stent and 38 had a DJ stent placed.Results: The mean follow-up was 23.8 ± 10.9 months and 21.1 ± 11.1 months for the EUP and DJ stent groups, respectively (p = 0.32). The mean age was 40 ± 54 months and 80 ± 78 months for the EUP and DJ groups, respectively (p = 0.04). The EUP group had a greater proportion of open pyeloplasties (n = 17, 71%) versus the DJ group (n = 16, 42%; p = 0.04). There were no statistically significant differences in operative time, length of stay, and overall complication rate between groups. Complications were divided by timing of complication (intraoperative, before and after 3 months) and according to the Clavien Classification system. There were no statistically significant differences between these subgroups. The limitations of this study include small sample size, potential selection bias, and heterogeneity between both study groups.Conclusions: Pyeloplasty using EUP stents does not incur prolonged operative time, longer length of stay or higher complication rate when compared to DJ stents. Within the limitations of this study, EUP stents may be a safe alternative to DJ stents.


2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Li Bing Zhu ◽  
Wai Chung Chan ◽  
Kwai Ching Lo ◽  
Tin Pui Yum ◽  
Lei Li

Routine acupuncture incorporates wrist-ankle acupuncture (WAA) for its analgesic effect, but WAA is not widely used in clinics due to incomplete knowledge of its effectiveness and concerns about less clinical research and because less people know it. This study aimed to assess the efficacy and possible adverse effects of WAA or WAA adjuvants in the treatment of pain symptoms. This study compared WAA or WAA adjuvant with the following therapies: western medication (WM), sham acupuncture (SA), or body acupuncture (BA). Randomized controlled trials (RCTs) were searched systematically in related electronic databases by two independent reviewers. 33 RCTs were finally included, in which 7 RCTs were selected for meta-analysis. It was found that WAA or WAA adjuvant was significantly more effective than WM, SA, or BA in pain relief. There was nothing different between WAA and SA in adverse events, but WAA was marginally significantly safer than WM. Although both WAA and WAA adjuvant appeared to be more effective than WM, SA, or BA in the treatment of pain symptoms with few side effects, further studies with better and more rigorously designed are still necessary to ensure the efficacy and safety issue of WAA due to the poor methodology and small sample size of previous studies.


2021 ◽  
Author(s):  
Xiyan Xie

Abstract Background: Baduanjin is a fitness routine that has been developed in accordance with the appeal of the General Administration of Sport of China and promoted both in China and abroad. This paper aims to systematically evaluate the effect of Baduanjin on the rehabilitation of stroke patients.Methods: We searched the Web of Science, Cochrane Library, Wanfang Database, Pubmed, Embase, CNKI, and VIP Chinese Journal Database for randomized controlled trials (RCTs) evaluating the rehabilitation effect of Baduanjin exercise on stroke patients. All manuscripts published before October 30, 2021 were considered. Results: A total of 1332 stroke patients were included in the 14 selected RCTs. Results of the meta-analysis showed that Baduanjin effectively improved the lower extremity balance function [MD = 9.74, 95% CI (5.32, 14.15), P < 0.0001], sensory-motor function [MD = 5.37, 95% CI (1.59, 9.16), P = 0.005], neurological function [MD = -2.41, 95% CI (-3.07, -1.75), P < 0.00001], the ability to perform daily activities [MD = 14.00, 95% CI (6.17, 21.83), P = 0.0005], sleep quality [MD = -3.08, 95% CI (-3.90, -2.25), P < 0.00001], and quality of life [MD = 31.71, 95% CI (13.68, 49.73), P = 0.06]. Compared to conventional treatment, the rehabilitation effect was greater with Baduanjin combined with conventional treatment. Conclusions: Baduanjin is an effective method to treat stroke patients and improve their functional performance. However, due to the small sample size and low data quality, further multicenter RCTs with large sample sizes are required to verify the results.


Author(s):  
Peter Cox ◽  
Sonal Gupta ◽  
Sizheng Steven Zhao ◽  
David M. Hughes

AbstractThe aims of this systematic review and meta-analysis were to describe prevalence of cardiovascular disease in gout, compare these results with non-gout controls and consider whether there were differences according to geography. PubMed, Scopus and Web of Science were systematically searched for studies reporting prevalence of any cardiovascular disease in a gout population. Studies with non-representative sampling, where a cohort had been used in another study, small sample size (< 100) and where gout could not be distinguished from other rheumatic conditions were excluded, as were reviews, editorials and comments. Where possible meta-analysis was performed using random-effect models. Twenty-six studies comprising 949,773 gout patients were included in the review. Pooled prevalence estimates were calculated for five cardiovascular diseases: myocardial infarction (2.8%; 95% confidence interval (CI)s 1.6, 5.0), heart failure (8.7%; 95% CI 2.9, 23.8), venous thromboembolism (2.1%; 95% CI 1.2, 3.4), cerebrovascular accident (4.3%; 95% CI 1.8, 9.7) and hypertension (63.9%; 95% CI 24.5, 90.6). Sixteen studies reported comparisons with non-gout controls, illustrating an increased risk in the gout group across all cardiovascular diseases. There were no identifiable reliable patterns when analysing the results by country. Cardiovascular diseases are more prevalent in patients with gout and should prompt vigilance from clinicians to the need to assess and stratify cardiovascular risk. Future research is needed to investigate the link between gout, hyperuricaemia and increased cardiovascular risk and also to establish a more thorough picture of prevalence for less common cardiovascular diseases.


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