scholarly journals Operative versus Non-Operative Management of The Medial Malleolus in Bimalleolar and Trimalleolar Fractures – A Systematic Review

2021 ◽  
Vol 4 (1) ◽  
pp. 11-17
Author(s):  
Wan Wei Ang ◽  
◽  
Shanxi Alexandra Jen ◽  
Zhuo Zhi Lim ◽  
Bellamy Brodie ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Management ◽  
Cochrane Library ◽  
Complication Rates ◽  
Malleolar Fractures ◽  
Mesh Terms ◽  
Trimalleolar Fractures ◽  
Significant Difference ◽  
Functional Scores ◽  
Non Operative Management

Purpose Ankle fractures are the fifth most common fracture worldwide. Some reviews have shown that non-operative management of isolated medial malleolar fractures has satisfactory outcomes, and more recent studies have suggested the same may apply in bimalleolar and trimalleolar fractures (BTMF). Importantly, non-operative management has the added benefits of avoiding complications including wound infection, and protruding metalwork. This systematic review aims to compare operative and non-operative management of medial malleolar fractures in the context of BTMF. Methods A search syntax of MeSH terms was used to search ScienceDirect, Scopus, Cochrane Library, and PubMed databases. The methodological quality of the included studies was assessed according to the MINORS criteria. Data extracted included patient demographics, operative techniques, functional outcome scores (EQ-5D, OMAS, MOXFQ, VAS, AOFAS return to work/sports) and complication rates Results A total of four studies were included: one randomised-controlled and three prospective study. Two of these directly compared operative and non-operative approaches, while the remaining two reported solely an operative cohort. Of 373 total fractures, 274 were managed operatively and 99 non-operatively. There was no significant difference across all functional scores between operative and non-operative approaches to medial malleolar fractures in the comparative studies. However, there was an association for higher rates of mal/non-union in the non-operative groups (10.5% vs 5.0%). Conclusion Although there is existing belief that operative approach to BTMF would lead to better outcomes, there is currently no evidence that shows operative is superior to non-operative management. Orthopaedic surgeons should consider the morbidity of post-operative complications when deciding the treatment for medial malleolar fractures in BTMF, particularly in the elderly. Further studies need to be performed on this topic before a definitive conclusion can be made.

scholarly journals Protocol for a systematic review of the incidence of infection in operative vs non-operative management of Seymour fractures in children and adolescents

2020 ◽  
Author(s):  
Ailbhe Lynda Kiely ◽  
Grant Switzer Nolan ◽  
Lilli Cooper
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Children And Adolescents ◽  
Grey Literature ◽  
Operative Management ◽  
Fracture Pattern ◽  
Cochrane Library ◽  
Non Union ◽  
Fractures In Children ◽  
Non Operative Management

Abstract Background Seymour fractures are open, displaced juxta-epiphyseal fractures of the distal phalanx, with an overlying nail bed laceration that occur in children and adolescents with an open physis. This fracture occurs rarely, but its potential consequences are clinically significant. Due to anatomical particulars and proximity to the growth plate, this open fracture may result in soft tissue infection and osteomyelitis, leading to growth arrest and persistent mallet deformity. At present, there is no consensus as to the optimal management of Seymour fractures. The objective of this study will be to systematically evaluate the existing evidence to establish whether operative or non-operative management of Seymore fractures is associated with a lower incidence of infection. Methods We designed and registered a study protocol for a systematic review of comparative and observational studies. A comprehensive literature search will be conducted (from 1966 to present) in MEDLINE, EMBASE, CINAHL, Cochrane Library and Google Scholar databases. Grey literature will be identified through searching Open Grey and dissertation databases using an exhaustive search strategy. All clinical studies examining the management of Seymour fractures in children & adolescents will be included, comparing operative and non-operative groups. Operative management will be defined as formal washout and soft tissue debridement prior to reduction, whether in the emergency department or operating theatre. Non-operative management refers to washout without surgical debridement. Primary outcome measures will be the incidence of superficial and deep infection. Secondary outcomes will include adverse events such mal-union, non-union, need for re-operation, physeal disturbance, nail dystrophy/atrophy. Two independent reviewers will screen all citations, full-text articles, and abstract data. Conflicts will be resolved through discussion. The study methodological quality (or bias) will be appraised using an appropriate tool. A narrative synthesis will be performed and if two or more studies with comparable design and reporting the same outcome are identified, data will be pooled for comparative analysis. Discussion This review will provide robust evidence for the management of Seymour fractures, based on a cumulation of existing studies. Due to the rarity of this fracture pattern, included studies are expected to be mainly observational and prone to bias; however, there is value in summarising the evidence, assessing its risk of bias and performing meta-analysis where possible to guide clinicians. Registration PROSPERO CRD42020153726

The effects of fennel on menstrual bleeding: A systematic review and meta-analysis

2018 ◽  
Vol 15 (3) ◽  
Author(s):  
Nafiseh Ghassab Abdollahi ◽  
Mojgan Mirghafourvand ◽  
Sanaz Mollazadeh
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Intervention Group ◽  
Poor Quality ◽  
Mean Difference ◽  
Menstrual Bleeding ◽  
Cochrane Library ◽  
Foeniculum Vulgare ◽  
Mesh Terms ◽  
Significant Difference

Abstract Introduction Fennel has many medicinal properties and is used in the treatment of dysmenorrhea. Given the widespread use of herbal medicine among women for menstrual problems and considering the fact that there has been no study to date about the effect of fennel on menstrual bleeding and duration of menstrual bleeding through systematic review, the present study was conducted to determine the effect of fennel on the amount (primary outcome) and duration of menstrual bleeding and its side-effects (secondary outcomes). Materials All articles, including Persian and English, with no time limit were searched for in the following databases: Medline (through PubMed), Scopus, EMBASE (through Ovid), Cochrane Library, Web of Sciences, Google Scholar, ProQuest, Clininaltrial.gov, SID, Magiran, Irandoc, and Iranmedex, using MeSH terms, including menstrual bleeding, menstruation, severity of bleeding, hypermenorrhea, menorrhagia, fennel, fennelin, Foeniculum vulgare, dysmenorrhea, and painful menstruation, which were searched separately or in combination. Two authors separately reviewed articles to determine the inclusion criteria, and any disagreement was resolved by reaching consensus with a third person. Results A total of 7993 articles were identified through searching the databases, of which 7327 were excluded as duplicates and 666 were screened for inclusion. Six hundread and forty six were excluded by title and abstract based on not being relevant to the review and being conducted on animals. Eventually, six articles were included in the study and four articles entered into the meta-analysis. The results from meta-analysis showed that using fennel caused a significant increase in mean menstrual bleeding in the first cycle after treatment in the intervention group compared to the control (Std. mean difference: 0.46; 95 % CI: 0.18–0.73; p = 0.001; I2 = 9 %). However, it had no significant effect on menstrual bleeding in the second cycle after treatment (Mean difference: 1.44; 95 % CI:-5.09 to 7.96; p = 0.67; I2 = 0 %). Conclusions The results of meta-analysis of four articles showed that in the first cycle after treatment, use of fennel increased menstrual bleeding in the intervention group compared to the control, but meta-analysis of two articles showed no significant difference between intervention and control groups in the amount of menstrual bleeding in the second cycle after treatment. Given the poor quality of articles, conducting clinical trials to determine the effect of fennel on menstrual bleeding appears necessary.

scholarly journals The Role of Hydroxychloroquine in COVID-19 Treatment: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 49 (10) ◽  
Author(s):  
Amir Shamshirian ◽  
Amirhossein Hessami ◽  
Keyvan Heydari ◽  
Reza Alizadeh-Navaei ◽  
Mohammad Ali Ebrahimzadeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Group ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Mesh Terms ◽  
Significant Difference ◽  
Mortality Difference ◽  
Meta Regression Analysis ◽  
And Control

Objective: A systematic review and meta-analysis was carried out to examine the role of hydroxychloroquine (HCQ) in the treatment of COVID-19. Methods: We performed a systematic search in PubMed, Scopus, Embase, Cochrane- Library, Web of Science, Google Scholar, and medRxiv pre-print databases using available MeSH terms for COVID-19 and hydroxychloroquine. Data from all studies that focused on the effectiveness of HCQ with or without the addition of azithromycin (AZM) in confirmed COVID-19 patients, which were published up to 12 September 2020, were collated for analysis using CMA v.2.2.064. Results: Our systematic review retrieved 41 studies. Among these, 37 studies including 45,913 participants fulfilled the criteria for subsequent meta-analysis. The data showed no significant difference in treatment efficacy between the HCQ and control groups (RR: 1.02, 95% CI, 0.81–1.27). Combination of HCQ with AZM also did not lead to improved treatment outcomes (RR: 1.26, 95% CI, 0.91–1.74). Furthermore, the mortality difference was not significant, neither in HCQ treatment group (RR: 0.86, 95% CI, 0.71–1.03) nor in HCQ plus AZM treatment group (RR: 1.28, 95% CI, 0.76–2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality (P<0.00001). Conclusion: The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease. Keywords: Azithromycin, coronavirus outbreaks, pandemic, SARS-CoV-2 disease

scholarly journals The Role of Hydroxychloroquine in COVID-19 Treatment: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Amir Shamshirian ◽  
Amirhossein Hessami ◽  
Keyvan Heydari ◽  
Reza Alizadeh-Navaei ◽  
Mohammad Ali Ebrahimzadeh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Treatment Group ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Mesh Terms ◽  
Significant Difference ◽  
Mortality Difference ◽  
Meta Regression Analysis ◽  
And Control

Objective: A systematic review and meta-analysis was carried out to examine the role of hydroxychloroquine (HCQ) in the treatment of COVID-19. Methods: We performed a systematic search in PubMed, Scopus, Embase, Cochrane- Library, Web of Science, Google-Scholar, and medRxiv pre-print databases using available MeSH terms for COVID-19 and hydroxychloroquine. Data from all studies that focused on the effectiveness of HCQ with or without the addition of azithromycin (AZM) in confirmed COVID-19 patients, which were published up to 12 September 2020, were collated for analysis using CMA v.2.2.064. Results: Our systematic review retrieved 41 studies. Among these, 37 studies including 45,913 participants fulfilled the criteria for subsequent meta-analysis. The data showed no significant difference in treatment efficacy between the HCQ and control groups (RR: 1.02, 95% CI, 0.81–1.27). Combination of HCQ with AZM also did not lead to improved treatment outcomes (RR: 1.26, 95% CI, 0.91–1.74). Furthermore, the mortality difference was not significant, neither in HCQ treatment group (RR: 0.86, 95% CI, 0.71–1.03) nor in HCQ+AZM treatment group (RR: 1.28, 95% CI, 0.76–2.14) in comparison to controls. Meta-regression analysis showed that age was the factor that significantly affected mortality (P<0.00001). Conclusion: The meta-analysis found that there was no clinical benefit of using either HCQ by itself or in combination with AZM for the treatment of COVID-19 patients. Hence, it may be prudent for clinicians and researchers to focus on other therapeutic options that may show greater promise in this disease. Keywords: Azithromycin, coronavirus outbreaks, pandemic, 2019-nCoV disease

Characteristics of the Frequency-Following Response to Speech in Neonates and Potential Applicability in Clinical Practice: A Systematic Review

2020 ◽  
Vol 63 (5) ◽  
pp. 1618-1635
Author(s):  
Céline Richard ◽  
Mary Lauren Neel ◽  
Arnaud Jeanvoine ◽  
Sharon Mc Connell ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cochrane Library ◽  
Neurodevelopmental Outcomes ◽  
Frequency Following Response ◽  
Ovid Medline ◽  
Published Evidence ◽  
Mesh Terms ◽  
Potential Applicability ◽  
Clinical Potential

Purpose We sought to critically analyze and evaluate published evidence regarding feasibility and clinical potential for predicting neurodevelopmental outcomes of the frequency-following responses (FFRs) to speech recordings in neonates (birth to 28 days). Method A systematic search of MeSH terms in the Cumulative Index to Nursing and Allied HealthLiterature, Embase, Google Scholar, Ovid Medline (R) and E-Pub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily, Web of Science, SCOPUS, COCHRANE Library, and ClinicalTrials.gov was performed. Manual review of all items identified in the search was performed by two independent reviewers. Articles were evaluated based on the level of methodological quality and evidence according to the RTI item bank. Results Seven articles met inclusion criteria. None of the included studies reported neurodevelopmental outcomes past 3 months of age. Quality of the evidence ranged from moderate to high. Protocol variations were frequent. Conclusions Based on this systematic review, the FFR to speech can capture both temporal and spectral acoustic features in neonates. It can accurately be recorded in a fast and easy manner at the infant's bedside. However, at this time, further studies are needed to identify and validate which FFR features could be incorporated as an addition to standard evaluation of infant sound processing evaluation in subcortico-cortical networks. This review identifies the need for further research focused on identifying specific features of the neonatal FFRs, those with predictive value for early childhood outcomes to help guide targeted early speech and hearing interventions.

scholarly journals Influence of Femoral Version on the Outcomes of Hip Arthroscopic Surgery for Femoroacetabular Impingement or Labral Tears: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110091
Author(s):  
Chenghui Wang ◽  
Yaying Sun ◽  
Zheci Ding ◽  
Jinrong Lin ◽  
Zhiwen Luo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Femoroacetabular Impingement ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Femoral Version ◽  
Labral Tears ◽  
Significant Difference ◽  
Secondary Outcomes

Background: It remains controversial whether abnormal femoral version (FV) affects the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) or labral tears. Purpose: To review the outcomes of hip arthroscopic surgery for FAI or labral tears in patients with normal versus abnormal FV. Study Design: Systematic review; Level of evidence, 4. Methods: Embase, PubMed, and the Cochrane Library were searched in July 2020 for studies reporting the outcomes after primary hip arthroscopic surgery for FAI or labral tears in patients with femoral retroversion (<5°), femoral anteversion (>20°), or normal FV (5°-20°). The primary outcome was the modified Harris Hip Score (mHHS), and secondary outcomes were the visual analog scale (VAS) for pain, Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), failure rate, and patient satisfaction. The difference in preoperative and postoperative scores (Δ) was also calculated when applicable. Results: Included in this review were 5 studies with 822 patients who underwent hip arthroscopic surgery for FAI or labral tears; there were 166 patients with retroversion, 512 patients with normal version, and 144 patients with anteversion. Patients with retroversion and normal version had similar postoperative mHHS scores (mean difference [MD], 2.42 [95% confidence interval (CI), –3.42 to 8.26]; P = .42) and ΔmHHS scores (MD, –0.70 [96% CI, –8.56 to 7.15]; P = .86). Likewise, the patients with anteversion and normal version had similar postoperative mHHS scores (MD, –3.09 [95% CI, –7.66 to 1.48]; P = .18) and ΔmHHS scores (MD, –1.92 [95% CI, –6.18 to 2.34]; P = .38). Regarding secondary outcomes, patients with retroversion and anteversion had similar ΔNAHS scores, ΔHOS-SSS scores, ΔVAS scores, patient satisfaction, and failure rates to those with normal version, although a significant difference was found between the patients with retroversion and normal version regarding postoperative NAHS scores (MD, 5.96 [95% CI, 1.66-10.26]; P = .007) and postoperative HOS-SSS scores (MD, 7.32 [95% CI, 0.19-14.44]; P = .04). Conclusion: The results of this review indicated that abnormal FV did not significantly influence outcomes after hip arthroscopic surgery for FAI or labral tears.

scholarly journals Is the use of contraceptives associated with periodontal diseases? A systematic review and meta-analyses

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Micaele Maria Lopes Castro ◽  
Maria Karolina Martins Ferreira ◽  
Iasmin Encaua Essashika Prazeres ◽  
Paula Beatriz de Oliveira Nunes ◽  
Marcela Baraúna Magno ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quantitative Analysis ◽  
Periodontal Diseases ◽  
Hormonal Contraceptive ◽  
Cochrane Library ◽  
Hormonal Contraceptives ◽  
Clinical Parameters ◽  
Significant Difference ◽  
Meta Analyses ◽  
The Impact

Abstract Background Previous studies indicated an impact of hormonal contraceptive use on oral health. This systematic review aimed to investigate the evidence supporting the impact of the use of hormonal contraceptives and periodontal diseases. Methods This study is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and based on the PECO acrostic. Inclusion criteria comprised observational studies including women (P), which evaluated hormonal contraceptive users (E) and hormonal contraceptive non-users (C), to verify the association between this hormonal therapy and the periodontal diseases (O). Searches were performed on 5 databases: PubMed, Scopus, Web of Science, Cochrane Library, LILACS and grey literature (OpenGrey and Google Scholar). After the selection process, the included studies were evaluated qualitatively. Moreover, quantitative data were analyzed in two meta-analyses for clinical attachment loss (CAL) and probing depth (PD). Finally, the level of certainty was measured with the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) tool between periodontal clinical parameters. Results 18 articles were eligible for the qualitative synthesis and 7 of them were selected for quantitative analysis. Hence, 15 of the eligible articles reported an association between the use of hormonal contraceptives and severity of periodontal disease. However, 6 articles demonstrated high risk of bias and were excluded from quantitative synthesis. The meta-analysis showed a statistically significant difference for CAL (MD 0.24 [0.09, 0.40]; p = 0.002), but in PD (MD 0.05 [− 0.05, 0.15]; p = 0.33) such difference was not identified. A very low level of evidence was found between the clinical parameters. Conclusions The use of hormonal contraceptives may be associated to severity of periodontal diseases. However, the quantitative analysis points to an inconclusive outcome due to the high level of heterogeneity. The association is biologically plausible, however additional studies are warranted to better elucidate the clinical significance of this possible association.

Sign in / Sign up

Export Citation Format

Share Document