Risk of Lower Eyelids Malposition in Subciliary Compared to Transconjunctival Approach in Maxillofacial Fractures Management: A Systematic Review and Meta-Analysis

BACKGROUND: Both subciliary and transconjunctival approaches have been used for decades to visualise the site of the maxillofacial fracture. The most common complication following those procedures is lower eyelids malposition. AIM: This meta-analysis will analyse which approach (subciliary and transconjunctival approaches) is more favourable to decrease lower eyelids malposition incidence. METHOD: This meta-analysis was conducted based on PRISMA guidelines. The electronic search was conducted using keywords (“Lower Eyelids Malposition” OR “Complications” OR “Ectropion” OR “Entropion”) AND (Transconjunctival) AND (Subciliary) AND (Maxillofacial Fractures) in PubMed, The Cochrane Library, and Directory of Open Access Journal (DOAJ). This review included full-text studies (observational and randomised controlled trials) in English comparing subciliary and transconjunctival approach in patients with maxillofacial fractures in the last 10 years. The data collected were the type of fractures and approaches, ectropion and entropion incidence as well as follow-up duration. The risk of bias was assessed using Joanna Briggs Institute critical appraisal checklist. Statistical analysis was done using Review Manager 5.3 (Cochrane, Denmark). RESULT: This study included 3 cohort studies and 2 Randomized Controlled Trial (RCT) studies from 2012 to 2017 with a total of 574 samples. Subciliary approach had a significant higher ectropion incidence when compared to transconjunctival approach (RR = 4.64, 95% CI: 1.68-12.81, p = 0.003). There was also a significant reduction of entropion incidence in patients with subciliary approach compared to transconjunctival approach (RR = 0.16, 95% CI: 0.04 – 0.69, p = 0.01). CONCLUSION: There was no superiority between one procedure toward another since each procedure related to different lower eyelids malpositions.

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KOLABORASI PUSTAKAWAN DALAM PENGAMBILAN KEPUTUSAN KLINIS BERBASIS BUKTI TERKINI (EVIDENCE BASED MEDICINE ): STUDI KASUS DI FAKULTAS KEDOKTERAN, KESEHATAN MASYARAKAT DAN KEPERAWATAN UNIVERSITAS GADJAH MADA

VISI PUSTAKA: Buletin Jaringan Informasi Antar Perpustakaan ◽

10.37014/visipustaka.v23i1.1132 ◽

2021 ◽

Vol 23 (1) ◽

pp. 67-75

Author(s):

Sukirno Sukirno

Keyword(s):

Systematic Review ◽

Evidence Based Medicine ◽

Controlled Trial ◽

Meta Analysis ◽

Cochrane Library ◽

Evidence Based ◽

Randomised Controlled ◽

The Cochrane Library ◽

Clinical Queries ◽

Based Medicine

Evidence Based Medicine (EBM) merupakan pemanfaatan bukti ilmiah berdasarkan penelitian klinis mutakhir yang sahih dalam tatalaksana proses penyembuhan penyakit. Salah satu syarat utama untuk memfasilitasi pengambilan keputusan klinik yang evidence-based, adalah dengan menyediakan bukti-bukti ilmiah yang relevan. Tipe kajian diutamakan yang berupa hasil review sistematik, meta-analisis, dan randomised controlled trial (RCT). Salah satu dari lima langkah dalam evidence based medicine yaitu yaitu menelusur bukti dari sumber database hasil penelitian yang memuat bukti-bukti ilmiah. PubMed Clinical Queries dan The Cochrane Library merupakan database berisi hasil riset sekunder (systematic-review/meta-analysis) yang mensintesis hasil riset primer. Kolaborasi pustakawan dalam pengambilan keputusan klinis yaitu dengan memberikan pelatihan atau menelusur artikel hasil penelitian yang akan digunakan dalam pengambilan klinis dari database yang memuat bukti ilmiah.

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Recurrence Rate of Sporadic Pheochromocytomas After Curative Adrenalectomy: A Systematic Review and Meta-analysis

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa794 ◽

2020 ◽

Author(s):

Isabelle Holscher ◽

Tijs J van den Berg ◽

Koen M A Dreijerink ◽

Anton F Engelsman ◽

Els J M Nieveen van Dijkum

Keyword(s):

Systematic Review ◽

Recurrence Rate ◽

Meta Analysis ◽

Cochrane Library ◽

Weighted Mean ◽

Curative Surgery ◽

Endocrine Society ◽

Time To Recurrence ◽

The Cochrane Library

Abstract Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent, and current guidelines of the European Society of Endocrinology, American Association of Clinical Endocrinologists and Endocrine Surgeons, and the Endocrine Society are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase, and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate, and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients, and unclear data on the sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 < 25%) or intermediate (I2 26–75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations (SDs). Results A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95% confidence interval: 2–6%, I2 = 0%), with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.

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Drainage versus No Drainage after Laparoscopic Cholecystectomy for Acute Cholecystitis: A Meta-Analysis

The American Surgeon ◽

10.1177/000313481908500138 ◽

2019 ◽

Vol 85 (1) ◽

pp. 86-91

Author(s):

Ming Xu ◽

You-Liang Tao

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Randomized Clinical Trials ◽

Controlled Trial ◽

Meta Analysis ◽

Wound Infection Rate ◽

Cochrane Library ◽

Prophylactic Drainage ◽

Significant Difference ◽

The Cochrane Library

To conduct a randomized controlled trial (RCT), meta-analysis to assess the effectiveness of drains in reducing complications after laparoscopic cholecystectomy (LC) for acute cholecystitis needs to be carried out. An electronic search of PubMed, Embase, Science Citation Index, and the Cochrane Library from January 1990 to January 2018 was performed to identify randomized clinical trials that compare prophylactic drainage with no drainage in LC for acute cholecystitis. The outcomes were calculated as odds ratios (ORs) with 95 per cent confidence intervals (CIs) using RevMan 5.2. Four RCTs, which included 796 patients, were identified for analysis in our study. There was no statistically significant difference in the rate of morbidities (OR = 1.23, 95% CI 0.55–2.76, P = 0.61). Abdominal pain was more severe in the drain group 24 hours after surgery (mean difference = 0.80, 95% CI 0.47–1.14; P < 0.00001). No significant difference was present with respect to wound infection rate and hospital stay. The use of abdominal drainage does not appear to be of any benefit in patients having undergone early LC for acute cholecystitis.

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Face mask use in the Community for Reducing the Spread of COVID-19: a systematic review

10.1101/2020.08.25.20181651 ◽

2020 ◽

Author(s):

Daniela Coclite ◽

Antonello Napoletano ◽

Silvia Gianola ◽

Andrea Del Monaco ◽

Daniela D'Angelo ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Experimental Studies ◽

Community Setting ◽

Face Mask ◽

Cochrane Library ◽

Case Scenario ◽

Materials Used ◽

Randomised Controlled ◽

The Cochrane Library

Background: Evidence is needed on the effectiveness of wearing face masks in the community to prevent SARS-CoV-2 transmission. Methods: Systematic review and meta-analysis to investigate the efficacy and effectiveness of face mask use in a community setting and to predict the effectiveness of wearing a mask. We searched MEDLINE, EMBASE, SCISEARCH, The Cochrane Library and pre-prints from inception to 22 April 2020 without restriction by language. We rated the certainty of evidence according to Cochrane and GRADE approach. Findings: Our search identified 35 studies, including 3 randomised controlled trials (RCTs) (4017 patients), 10 comparative studies (18984 patients), 13 predictive models, 9 laboratory experimental studies. For reducing infection rates, the estimates of cluster-RCTs were in favour of wearing face masks versus no mask, but not at statistically significant levels (adjusted OR 0.90, 95%CI 0.78-1.05). Similar findings were reported in observational studies. Mathematical models indicated an important decrease in mortality when the population mask coverage is near-universal, regardless of mask efficacy. In the best-case scenario, when the mask efficacy is at 95%, the R0 can fall to 0.99 from an initial value of 16.90. Levels of mask filtration efficiency were heterogeneous, depending on the materials used (surgical mask: 45-97%). One laboratory study suggested a viral load reduction of 0.25 (95%CI 0.09-0.67) in favour of mask versus no mask. Interpretation: The findings of this systematic review and meta-analysis support the use of face masks in a community setting. Robust randomised trials on face mask effectiveness are needed to inform evidence-based policies.

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Materials for pulpotomy in immature permanent teeth: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-019-0917-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 4

Author(s):

Yuan Chen ◽

Xinlei Chen ◽

Yali Zhang ◽

Fangjie Zhou ◽

Jiaxin Deng ◽

...

Keyword(s):

Systematic Review ◽

Success Rate ◽

Meta Analysis ◽

Mineral Trioxide Aggregate ◽

Systemic Review ◽

Permanent Teeth ◽

Cochrane Library ◽

Success Rates ◽

The Cochrane Library

Abstract Background Pulpotomy is one of the most widely used methods in preserving vital pulp in teeth, which is of great significance in achieving continue root formation in immature permanent teeth suffering from dental caries or trauma. The aim of this meta-analysis and systemic review is to synthesize the available evidences to compare different pulpotomy dressing agents for pulpotomy treatment in immature permanent teeth. Methods Electronic databases including MEDLINE (via Pubmed), EMBASE, the Cochrane library (CENTRAL) and the clinicaltrials.gov database were searched. The references of all included articles or relevant reviews were cross-checked. Only randomized controlled trials (RCTs) comparing two or more pulp dressing agent in permanent teeth with open apex would be included. Also, the studies should have at least 6 months of follow-up, report clinical and radiographic success in detail and publish in English. Results Five RCTs were included for a systematic review, and all of them had a high risk of bias. There is little difference in success rate between mineral trioxide aggregate (MTA) and calcium hydroxide (CH) at 6-month follow-up (risk ratio (RR) 1; 95% confidence interval (CI) 0.94 to 1.06) and 12-month follow-up (RR 1.04; 95% CI 0.96 to 1.13). There is no difference between MTA versus platelet-rich fibrin and MTA versus calcium-enriched mixture (CEM). There is only weak evidence of increased success rate in using MTA and triple antibiotic paste (TAP) rather than abscess remedy. Conclusions Based on the present evidence, similar success rates with MTA were found between the dressing agents CH, CEM, RPF and TAP as pulpotomy-dressing agents in the treatment of immature permanent teeth. More high-quality RCTs are needed in this field in future studies.

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The Prognostic Value of Early Repolarization Pattern for the Ventricular Tachyarrhythmias of Acute Myocardial Infarction Patients: A Meta-Analysis

Cardiology ◽

10.1159/000501474 ◽

2019 ◽

Vol 144 (3-4) ◽

pp. 69-75

Author(s):

Shangbo Xu ◽

Lihua Yang ◽

Danhua Hong ◽

Lan Chen ◽

Xin Wang

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Prognostic Value ◽

Meta Analysis ◽

Cochrane Library ◽

Ventricular Tachyarrhythmias ◽

Early Repolarization ◽

The Cochrane Library ◽

The Relationship

Several studies have indicated that early repolarization (ER) is a risk factor for ventricular tachyarrhythmias (VTAs) in acute myocardial infarction (AMI) patients. The prognostic values of ER detail characteristics except J-point morphology, and inferior leads ER location for VTAs are still unclear. We searched PubMed, Embase, and the Cochrane Library for eligible studies up to March 4, 2019. Studies to investigate the relationship between ER and the incidence of VTAs in AMI patients were extracted. A total of 10 studies with 2,672 participants were included in the analysis. ER significantly predicted the incidence of VTAs (odds ratio [OR] 3.62, 95% confidence intervals [CI] 2.77–4.73), regardless of the type of AMI. The presence of ER before AMI (OR 5.58, 95% CI 3.41 to 9.12) and after AMI (OR 3.02, 95% CI 2.19–4.15) increased the risk of VTAs. The prognostic value of ER for VTAs in the long follow-up (≥30 days) (OR 2.39, 95% CI 1.59–3.59) fell by half compared to the short follow-up duration (<30 days) (OR 4.97, 95% CI 3.48–7.09). Patients with ER displayed a higher risk of developing ventricular fibrillation (VF) (OR 6.94, 95% CI 3.87–12.43) than those without ER. However, neither J-point elevation with OR = 2.48 nor lateral leads’ ER location with OR = 3.83 remarkably increased the risk of VTAs in patients with AMI. ER is significantly associated with increasing risk of VTAs, particularly VF, in AMI patients. This relationship is weaker in the 30-day follow-up and is not reinforced by J-point elevation and lateral leads’ ER location.

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Augmentation of clozapine with ECT: a retrospective case analysis

Acta Neuropsychiatrica ◽

10.1017/neu.2020.32 ◽

2020 ◽

pp. 1-6

Author(s):

John Lally ◽

Emily Breese ◽

Mugtaba Osman ◽

Cai Hua Sim ◽

Hitesh Shetty ◽

...

Keyword(s):

Controlled Trial ◽

Meta Analysis ◽

Retrospective Case ◽

Clozapine Treatment ◽

Duration Of Illness ◽

Maintenance Ect ◽

The Mean ◽

Randomised Controlled ◽

Clinical Global Impression Improvement

Abstract Objective: We sought to assess the effectiveness of clozapine augmentation with Electroconvulsive therapy (ECT) (C+ECT) in patients with clozapine-resistant schizophrenia. Methods: We conducted a retrospective review of electronic health records to identify patients treated with C+ECT. We determined the response to C+ECT and the rate of rehospitalisation over the year following treatment with C+ECT. Results: Forty-two patients were treated with C+ECT over a 10-year period. The mean age of the patients at initiation of ECT was 46.3 (SD = 8.2) years (range 27–62 years). The mean number of ECTs given was 10.6 (SD = 5.3) (range 3–25) with the majority receiving twice weekly ECT. Seventy-six per cent of patients (n = 32) showed a Clinical Global Impression-Improvement (CGI-I) score of ≤3 (at least minimally improved) following C+ECT. The mean number of ECT treatments was 10.6 (SD = 5.3) (range 3–25) with the majority receiving twice weekly ECT. Sixty-four per cent of patients experienced no adverse events. Response to C+ECT was not associated with gender, age, duration of illness or duration of clozapine treatment. Seventy-five per cent of responders remained out of hospital over the course of 1-year follow-up, while 70% of those with no response to C+ECT were not admitted to hospital. Three patients received maintenance ECT, one of whom was rehospitalised. Conclusion: This study lends support to emerging evidence for the effectiveness of C+ECT in clozapine-resistant schizophrenia. These results are consistent with the results of a meta-analysis and the only randomised controlled trial (RCT) of this intervention. Further RCTs are required before this treatment can be confidently recommended.

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Comparison of complications attributable to enteral and parenteral nutrition in predicted severe acute pancreatitis: a systematic review and meta-analysis

British Journal Of Nutrition ◽

10.1017/s0007114510000887 ◽

2010 ◽

Vol 103 (9) ◽

pp. 1287-1295 ◽

Cited By ~ 42

Author(s):

Maxim S. Petrov ◽

Kevin Whelan

Keyword(s):

Acute Pancreatitis ◽

Parenteral Nutrition ◽

Severe Acute Pancreatitis ◽

Meta Analysis ◽

Tube Feeding ◽

Infectious Complications ◽

Cochrane Library ◽

Randomised Controlled ◽

The Cochrane Library ◽

Complications And Mortality

Enteral nutrition (EN) reduces infectious complications and mortality compared with parenteral nutrition (PN) in patients with predicted severe acute pancreatitis. However, to date the complications attributable to the administration of EN and PN in this patient group have not been comprehensively studied. The aim of the study was to systematically review the complications related to the use of nutrition in patients with predicted severe acute pancreatitis receiving EN v. PN. The Cochrane Library, MEDLINE and Scopus were searched. Randomised controlled trials (RCT) of EN v. PN in predicted severe acute pancreatitis were selected. Pooled estimates of complications were expressed as OR with corresponding 95 % CI. Data from five RCT were meta-analysed. Diarrhoea occurred in six of ninety-two (7 %) patients receiving PN and twenty-four of eighty-two (29 %) patients receiving EN (OR 0·20; 95 % CI 0·09, 0·43; P < 0·001). Hyperglycaemia developed in twenty-one of ninety-two (23 %) patients receiving PN and nine of eighty-two (11 %) receiving EN (OR 2·59; 95 % CI 1·13, 5·94; P = 0·03). Given a significant reduction in infectious complications and mortality associated with the use of EN over PN that has been consistently demonstrated in previous studies, the former should be the treatment of choice in acute pancreatitis. Further clinical studies should investigate the strategies to mitigate the complications of enteral tube feeding in patients with acute pancreatitis.

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Effect of Digoxin Therapy on Mortality in Patients With Atrial Fibrillation: An Updated Meta-Analysis

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.731135 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaoxu Wang ◽

Yi Luo ◽

Dan Xu ◽

Kun Zhao

Keyword(s):

Atrial Fibrillation ◽

Meta Analysis ◽

Cochrane Library ◽

Clinical Effects ◽

Hazard Ratios ◽

Risk Of Mortality ◽

Increased Risk ◽

All Cause Mortality ◽

The Cochrane Library

Background: Whether digoxin is associated with increased mortality in atrial fibrillation (AF) remains controversial. We aimed to assess the risk of mortality and clinical effects of digoxin use in patients with AF.Methods: PubMed, Embase, and the Cochrane library were systematically searched to identify eligible studies comparing all-cause mortality of patients with AF taking digoxin with those not taking digoxin, and the length of follow-up was at least 6 months. Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted and pooled.Results: A total of 29 studies with 621,478 patients were included. Digoxin use was associated with an increased risk of all-cause mortality in all patients with AF (HR 1.17, 95% CI 1.13–1.22, P < 0.001), especially in patients without HF (HR 1.28, 95% CI 1.11–1.47, P < 0.001). There was no significant association between digoxin and mortality in patients with AF and HF (HR 1.06, 95% CI 0.99–1.14, P = 0.110). In all patients with AF, regardless of concomitant HF, digoxin use was associated with an increased risk of sudden cardiac death (SCD) (HR 1.40, 95% CI 1.23–1.60, P < 0.001) and cardiovascular (CV) mortality (HR 1.27, 95% CI 1.08–1.50, P < 0.001), and digoxin use had no significant association with all-cause hospitalization (HR 1.13, 95% CI 0.92–1.39, P = 0.230).Conclusion: We conclude that digoxin use is associated with an increased risk of all-cause mortality, CV mortality, and SCD, and it does not reduce readmission for AF, regardless of concomitant HF. Digoxin may have a neutral effect on all-cause mortality in patients with AF with concomitant HF.Systematic Review Registration:https://www.crd.york.ac.ukPROSPERO.

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Dezocine prevents sufentanil-induced cough during general anesthesia induction: a meta-analysis of randomised controlled trials

10.21203/rs.2.17370/v1 ◽

2019 ◽

Cited By ~ 1

Author(s):

Zhencheng Xiong ◽

Ping Yi ◽

Jipeng Song ◽

Mingsheng Tan

Keyword(s):

General Anesthesia ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Vital Signs ◽

Cochrane Library ◽

Controlled Trials ◽

Anesthesia Induction ◽

China National Knowledge Infrastructure ◽

Randomised Controlled ◽

The Cochrane Library

Abstract Background Sufentanil is one of the opioids currently used to induce general anesthesia, and cough is one of the most common complications. Many drugs have been used to prevent sufentanil-induced cough (SIC), and dezocine is one of them. The purpose of our meta-analysis is to evaluate the efficacy of dezocine on SIC.Methods We searched multiple databases including PubMed, Embase, ScienceDirect, the Cochrane Library, and China National Knowledge Infrastructure databases (CNKI) to identify studies that met the inclusion criteria. This meta-analysis focused on the incidence and severity of SIC after dezocine intervention, as well as adverse effects.Results Five randomised controlled trials (RCTs) were identified, including 890 patients. Each study was a comparison of dezocine with an equal volume of 0.9% saline. When the injection dose of dezocine was 0.1 mg/kg, the incidence (pooled risk ratio [RR]=0.03, [95% CI: 0.02 to 0.07], P<0.00001, I2=0%) and severity (mild: RR=0.07, [95% CI: 0.03 to 0.18], P<0.00001, I2=0%; moderate: RR=0.05, [95% CI: 0.02 to 0.16], P<0.00001, I2=0%; severe: RR=0.04, [95% CI: 0.01 to 0.16], P<0.00001, I2=0%) of SIC were significantly decreased. There were no statistically significant differences in vital signs between the two groups based on the results of the pooled analysis.Conclusion This meta-analysis showed that dezocine significantly reduced the incidence and severity of SIC in the induction of general anesthesia, but had no significant effect on vital signs. More high-quality RCTs are needed to complement existing conclusions.

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