scholarly journals Predicting response to psychiatric surgery: a systematic review of neuroimaging findings

2020 ◽  
Vol 45 (6) ◽  
pp. 387-394
Author(s):  
Benjamin Davidson ◽  
Hrishikesh Suresh ◽  
Maged Goubran ◽  
Jennifer S. Rabin ◽  
Ying Meng ◽  
...  

Background: Psychiatric surgery, including deep brain stimulation and stereotactic ablation, is an important treatment option in severe refractory psychiatric illness. Several large trials have demonstrated response rates of approximately 50%, underscoring the need to identify and select responders preoperatively. Recent advances in neuroimaging have brought this possibility into focus. We systematically reviewed the psychiatric surgery neuroimaging literature to assess the current state of evidence for preoperative imaging predictors of response. Methods: We performed this study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Meta-analysis of Observational Studies in Epidemiology (MOOSE) frameworks, and preregistered it using PROSPERO. We systematically searched the Medline, Embase and Cochrane databases for studies reporting preoperative neuroimaging analyses correlated with clinical outcomes in patients who underwent psychiatric surgery. We recorded and synthesized the methodological details, imaging results and clinical correlations from these studies. Results: After removing duplicates, the search yielded 8388 unique articles, of which 7 met the inclusion criteria. The included articles were published between 2001 and 2018 and reported on the outcomes of 101 unique patients. Of the 6 studies that reported significant findings, all identified clusters of hypermetabolism, hyperconnectivity or increased size in the frontostriatal limbic circuitry. Limitations: The included studies were few and highly varied, spanning 2 decades. Conclusion: Although few studies have analyzed preoperative imaging for predictors of response to psychiatric surgery, we found consistency among the reported results: most studies implicated overactivity in the frontostriatal limbic network as being correlated with clinical response. Larger prospective studies are needed. Registration: www.crd.york.ac.uk/prospero/display_record.php?RecordID=131151.

2020 ◽  
Vol 12 ◽  
pp. 1759720X2098121
Author(s):  
Gustavo Constantino de Campos ◽  
Raman Mundi ◽  
Craig Whittington ◽  
Marie-Josée Toutounji ◽  
Wilson Ngai ◽  
...  

Aims: The objective of this review was to examine the relationship between osteoarthritis (OA) and mobility-related comorbidities, specifically diabetes mellitus (DM) and cardiovascular disease (CVD). It also investigated the relationship between OA and mortality. Methods: An overview of meta-analyses was conducted by performing two targeted searches from inception to June 2020. The association between OA and (i) DM or CVD ( via PubMed and Embase); and (ii) mortality ( via PubMed) was investigated. Meta-analyses were selected if they included studies that examined adults with OA at any site and reported associations between OA and DM, CVD, or mortality. Evidence was synthesized qualitatively. Results: Six meta-analyses met inclusion criteria. One meta-analysis of 20 studies demonstrated a statistically significant association between OA and DM, with pooled odds ratio of 1.41 (95% confidence interval: 1.21, 1.65; n = 1,040,175 patients). One meta-analysis of 15 studies demonstrated significantly increased risk of CVD among OA patients, with a pooled risk ratio of 1.24 (1.12, 1.37, n = 358,944 patients). Stratified by type of CVD, OA was shown to be associated with increased heart failure (HF) and ischemic heart disease (IHD) and reduced transient ischemic attack (TIA). There was no association reported for stroke or myocardial infarction (MI). Three meta-analyses did not find a significant association between OA (any site) and all-cause mortality. However, OA was found to be significantly associated with cardiovascular-related death across two meta-analyses. Conclusion: The identified meta-analyses reported significantly increased risk of both DM and CVD (particularly, HF and IHD) among OA patients. It was not possible to confirm consistent directional or causal relationships. OA was found to be associated with increased mortality, but mostly in relation to CVD-related mortality, suggesting that further study is warranted in this area.


2017 ◽  
Vol 48 (2) ◽  
pp. 175-187
Author(s):  
Anita Pollak ◽  
Małgorzata Chrupała-Pniak ◽  
Patrycja Rudnicka ◽  
Mateusz Paliga

Abstract Over the past decade work engagement has gained both business and academia attention. With growing number of studies and meta-analyses the concept of work engagement is one of the pillars of positive work and organizational psychology. This systematic review presents the current state of research on work engagement in Poland. Results confirmed that work-engagement studies have not yet reached the threshold to conduct meta-analysis. The review of measurement methods and synthesis of findings allows to identify strengths and gaps in Polish studies. Discussion of limitations and biases in current research is accompanied with urge to overcome them and develop thriving stream of research on work engagement.


Author(s):  
Yazed Saleh Alsowaida ◽  
Abdulaziz Saleh Almulhim ◽  
Mok Oh ◽  
Brian Erstad ◽  
Ivo Abraham

Abstract Objective Macrolide antibiotics are among the most commonly used antibiotics; the association of macrolide antibiotics exposure with sensorineural hearing loss (SNHL) has been hypothesized. A systematic search was conducted in PubMed, EMBASE and Cochrane Library from inception to 15 July 2019 to identify studies used macrolide antibiotics for any indication. The results were reported as odds ratio (OR) with 95% confidence interval (CI) using random-effects model to derive the association of macrolide antibiotics exposure with SNHL. The objective of this meta-analysis was to estimate the association of macrolide antibiotics exposure and SNHL from up-to-date evidence. Key findings Nine studies met the inclusion criteria. There was no statistically significant association between macrolide antibiotics exposure and SNHL; the OR was 1.20 (95% CI: 0.96 to 1.49). No significant association was found with any of the subgroup meta-analyses. Summary Whilst the frequency of SNHL was higher with macrolide antibiotics exposure compared with controls, overall, no association was found between macrolide antibiotics and SNHL.


2020 ◽  
pp. 019459982094489
Author(s):  
Ryan Kendall Thorpe ◽  
Sohit Paul Kanotra

Objectives To examine and compare the outcomes of various types of glottic widening surgery (GWS) for initial management of bilateral vocal fold paralysis (BVFP) in children, the outcomes of different GWS procedures in children who underwent initial tracheostomy, and the rate of decannulation in children who underwent tracheostomy alone versus tracheostomy followed by GWS. Data Sources PubMed, Web of Science, Cochrane Library, and Embase were searched following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses) on September 9, 2019, with no date restriction. Review Methods Articles focusing on GWS or tracheostomy for initial management of BVFP were included. Articles describing patients who received no surgical intervention for BVFP were excluded. Results A total of 5989 articles were reviewed: 67 articles met inclusion criteria, and 240 patients were incorporated into the analysis. Patients who underwent primary GWS had an eventual tracheostomy rate of 6.0% (5/83). There were no statistically significant differences in the rate of tracheostomy, reoperation, or mortality among cricoid split, suture lateralization, and cordectomy/cordotomy. Patients who underwent primary tracheostomy failed to achieve decannulation in 36.9% (58/157) of cases. Decannulation was more likely in tracheostomized children who received GWS than those who did not (odds ratio, 6.336; P < .0001). Conclusions Most children who undergo primary GWS for BVFP avoid tracheostomy or reoperation. These data demonstrated no differences in surgical outcomes among the most common types of GWS for BVFP. For children who receive a tracheostomy as their first intervention for BVFP, GWS is associated with a significantly improved rate of decannulation.


Animals ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. 957 ◽  
Author(s):  
Dannielle Glencorse ◽  
Kate Plush ◽  
Susan Hazel ◽  
Darryl D’Souza ◽  
Michelle Hebart

There are conflicting reports regarding the effect of farrowing house accommodation on piglet performance. The aim of this investigation was to use a systematic review and meta-analyses to summarise the results of publications that focused on direct comparisons between full confinement conventional crates and various designs of loose-housed farrowing pens from loading until weaning. Literature searches in Scopus, BIOSIS Previews, Cab Abstracts, and Web of Science identified 6695 articles. Twenty-two publications were retained for the systematic review and individual meta-analyses after screening for inclusion criteria. The random effects meta-analyses were performed on crate versus pen for number of piglets born alive, number of stillborn piglets, pre-weaning mortality, and number of piglets weaned. Additionally, the modifiers of confinement length (no confinement from loading until weaning or partial confinement for shorter periods of time in the early stages post parturition), enrichment (no enrichment or enrichment provided), and pen size (small, medium, or large) were examined. There was a 14% increase in the relative risk of piglet mortality in farrowing pens when they were compared with crates (p = 0.0015). The number of stillborns per litter was not different between the pen and crate. However, when providing enrichment in the pens, there was an increase in stillborns within farrowing crates versus pens (p = 0.009). There was no overall effect on piglets that were born alive or number weaned. As there is no difference between piglets born alive and mortality is significantly higher in farrowing pens, a reduction in the number of piglets weaned was expected but not observed, which was possibly due to the lack of weaning details provided in the publications. This was the first systematic review and meta-analysis conducted on the performance of farrowing accommodation and identified that farrowing pens do compromise post-natal piglet survival. Future efforts should focus on improving sow comfort in the farrowing crate to maximize both piglet and sow welfare.


2020 ◽  
Vol 29 ◽  
Author(s):  
Nickolas D. Frost ◽  
Thomas W. Baskin ◽  
Bruce E. Wampold

Abstract Aims The purpose of this review is to examine the replication attempts of psychotherapy clinical trials for depression and anxiety. We focus specifically on replications of trials that exhibit large differences between psychotherapies. The replicability of these trials is especially important for meta-analysis, where the inclusion of false-positive trials can lead to erroneous conclusions about treatment efficacy. Methods Standard replication criteria were developed to distinguish direct from conceptual replication methodologies. Next, an exhaustive literature search was conducted for published meta-analyses of psychotherapy comparisons. Trials that exhibited large effects (d > 0.8) were culled from these meta-analyses. For each trial, a cited replication was conducted to determine if the trial had been subsequently replicated by either ‘direct’ or ‘conceptual’ methods. Finally, a broader search was conducted to examine the extent of replication efforts in the psychotherapy literature overall. Results In the meta-analytic search, a total of N = 10 meta-analyses met the inclusion criteria. From these meta-analyses, N = 12 distinct trials exhibited large effect sizes. The meta-analyses containing more than two large effect trials reported evidence for treatment superiority. A cited replication search yielded no direct replication attempts (N = 0) for the trials with large effects, and N = 4 conceptual replication attempts of average or above average quality. However, of these four attempts, only two partially corroborated the results from their original trial. Conclusion Meta-analytic reviews are influenced by trials with large effects, and it is not uncommon for these reviews to contain several such trials. Since we find no evidence that trials with such large effects are directly replicable, treatment superiority conclusions from these reviews are highly questionable. To enhance the quality of clinical science, the development of authoritative replication criteria for clinical trials is needed. Moreover, quality benchmarks should be considered before trials are included in a meta-analysis, or replications are attempted.


2016 ◽  
Vol 40 (3) ◽  
pp. 425-446 ◽  
Author(s):  
Barbara L. Cannella ◽  
Adela Yarcheski ◽  
Noreen E. Mahon

The aims of this study were to identify predictors of health practices of pregnant women in the literature reviewed, to use meta-analysis to ascertain the mean effect size (ES) across studies between each predictor and health practices, and to examine four moderators on each predictor–health practices relationship. Using preferred reporting items for systematic reviews and meta-analyses guidelines for the literature assessed, 32 published studies or doctoral dissertations completed between 1992 and 2015 met the inclusion criteria. Twelve predictors were identified, and each predictor in relation to health practices was subjected to meta-analysis. One predictor (maternal–fetal attachment) of health practices had a large ES, two predictors (depression and stress) had medium ESs, six predictors (income, education, parity, social support, employment, and age) had small ESs, and three predictors (gestational age, marital status, and race) had trivial ESs. Findings are interpreted relative to health practices in pregnant women.


2019 ◽  
Vol 16 (12) ◽  
pp. 1187-1195
Author(s):  
Nathanial J. Kapsal ◽  
Theresa Dicke ◽  
Alexandre J.S. Morin ◽  
Diego Vasconcellos ◽  
Christophe Maïano ◽  
...  

Background: The physical and psychosocial benefits of physical activity for typically developing youth are well established; however, its impact on youth with intellectual disabilities is not as well understood. The aims of this review and meta-analysis were to synthesize the literature and quantify the effects of physical activity on the physical and psychosocial health of youth with intellectual disabilities. Method: Studies meeting the inclusion criteria were grouped by their focus on physical health and/or psychosocial health outcomes. Meta-analyses were performed using 3-level, random effects and mixed effects models. Results: One hundred nine studies met the inclusion criteria. Physical activity had a large effect on physical health (g = 0.773, P < .001) and a moderately large effect (g = 0.682, P < .001) on psychosocial health. Participant age, intellectual disability level, other developmental disabilities, outcome type, and intervention type moderated the effects of physical activity on physical health, whereas study design, risk of bias, other developmental disabilities, outcome type, and intervention type were moderators on psychosocial health. Conclusions: Physical activity has positive effects on the physical and psychosocial health of youth with intellectual disabilities. Although resistance training shows the most physical benefits, teaching movement and sports skills appear to benefit their physical and psychosocial health.


2019 ◽  
Vol 39 (7) ◽  
Author(s):  
Yingqi Xiao ◽  
Hui Liu ◽  
Li Chen ◽  
Yang Wang ◽  
Xiang Yao ◽  
...  

Abstract Objective: To investigate whether microRNAs genes’ polymorphisms are associated with arthritis. Methods: The PubMed, Cochrane Library et al. were systematically searched to identify case–control studies, systematic reviews and meta-analyses. A meta-analysis was performed to calculate odds ratios (ORs), and confidence intervals (CIs) at 95% using fixed-effect model or random-effects model. Results: Twenty-two case–control studies involving 10489 participants fulfilled the inclusion criteria. MiR-146a rs2910164 (G/C) was not significantly associated with the risk of rheumatoid arthritis (RA) in any model. Significant associations were found between miR-146a rs2910164 (G/C) and the risk of psoriatic arthritis (PsA) in the heterozygous model and the dominant model. The heterozygous model showed a significant association between the miR-146a rs2910164 (G/C) polymorphism and ankylosing spondylitis (AS). And there was no significant association of miR-146a rs2910164 (G/C) with risk of juvenile rheumatoid arthritis (JRA) at any model. Additionally, there was a significant association of miR-499 rs3746444 (T/C) with risk of RA at two genetic models, and with a moderate heterogeneity. When subgroup analysis by ethnicity, significant associations were almost found between miR-499 rs3746444 (T/C) and the risk of RA in any model in Caucasian populations, and there is no heterogeneity. Conclusions: The association of miR-146a rs2910164 (G/C) with RA was not found. And there was a significant association between miR-146a rs2910164(G/C) and PsA or AS. MiR-499 rs3746444 (T/C) was associated with RA in Caucasian populations. These findings did not support the genetic association between miR-146a rs2910164 (G/C) and JRA susceptibility, as well as the association of miR-196a-2 rs11614913 (C/T), miR-146a rs2431697, miR-146a rs57095329, miR-149 rs22928323 with arthritis.


2012 ◽  
Vol 2012 ◽  
pp. 1-20 ◽  
Author(s):  
Megan Rossi ◽  
Kerenaftali Klein ◽  
David W. Johnson ◽  
Katrina L. Campbell

Objective. This paper assessed the effectiveness of pre-, pro-, and synbiotics on reducing two protein-bound uremic toxins, p-cresyl sulphate (PCS) and indoxyl sulphate (IS).Methods. English language studies reporting serum, urinary, or fecal PCS and/or IS (or their precursors) following pre-, pro-, or synbiotic interventions (>1 day) in human adults were included. Population estimates of differences in the outcomes between the pre- and the postintervention were estimated for subgroups of studies using four meta-analyses. Quality was determined using the GRADE approach.Results. 19 studies met the inclusion criteria, 14 in healthy adults and five in haemodialysis patients. Eight studies investigated prebiotics, six probiotics, one synbiotics, one both pre- and probiotics, and three studies trialled all three interventions. The quality of the studies ranged frommoderatetovery low. 12 studies were included in the meta-analyses with all four meta-analyses reporting statistically significant reductions in IS and PCS with pre- and probiotic therapy.Conclusion. There is a limited but supportive evidence for the effectiveness of pre- and probiotics on reducing PCS and IS in the chronic kidney disease population. Further studies are needed to provide more definitive findings before routine clinical use can be recommended.


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