scholarly journals Sublingual microcirculatory alterations during the immediate and early postoperative period: A systematic review and meta-analysis

2021 ◽  
pp. 1-13
Author(s):  
Athanasios Chalkias ◽  
Nikolaos Papagiannakis ◽  
Georgios Mavrovounis ◽  
Konstantina Kolonia ◽  
Maria Mermiri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Postoperative Period ◽  
English Literature ◽  
Meta Analysis ◽  
Early Postoperative Period ◽  
Vessel Density ◽  
Flow Index ◽  
Randomized Controlled ◽  
Microcirculatory Flow ◽  
Significant Difference

BACKGROUND: The incidence of postoperative microcirculatory flow alterations and their effect on outcome have not been studied extensively. OBJECTIVE: This systematic review and meta-analysis was designed to investigate the presence of sublingual microcirculatory flow alterations during the immediate and early postoperative period and their correlation with complications and survival. METHODS: A systematic search of PubMed, Scopus, Embase, PubMed Central, and Google Scholar was conducted for relevant articles from January 2000 to March 2021. Eligibility criteria were randomized controlled and non-randomized trials. Case reports, case series, review papers, animal studies and non-English literature were excluded. The primary outcome was the assessment of sublingual microcirculatory alterations during the immediate and early postoperative period in adult patients undergoing surgery. Risk of bias was assessed with the Ottawa-Newcastle scale. Standard meta-analysis methods (random-effects models) were used to assess the difference in microcirculation variables. RESULTS: Thirteen studies were included. No statistically significant difference was found between preoperative and postoperative total vessel density (p = 0.084; Standardized Mean Difference (SMD): –0.029; 95%CI: –0.31 to 0.26; I2 = 22.55%). Perfused vessel density significantly decreased postoperatively (p = 0.035; SMD: 0.344; 95%CI: 0.02 to 0.66; I2 = 65.66%), while perfused boundary region significantly increased postoperatively (p = 0.031; SMD: –0.415; 95%CI: –0.79 to –0.03; I2 = 37.21%). Microvascular flow index significantly decreased postoperatively (p = 0.028; SMD: 0.587; 95%CI: 0.06 to 1.11; I2 = 86.09%), while no statistically significant difference was found between preoperative and postoperative proportion of perfused vessels (p = 0.089; SMD: 0.53; 95%CI: –0.08 to 1.14; I2 = 70.71%). The results of the non-cardiac surgery post-hoc analysis were comparable except that no statistically significant difference in perfused vessel density was found (p = 0.69; SMD: 0.07; 95%CI: –0.26 to 0.39; I2 = 0%). LIMITATIONS: The included studies investigate heterogeneous groups of surgical patients. There were no randomized controlled trials. CONCLUSIONS: Significant sublingual microcirculatory flow alterations are present during the immediate and early postoperative period. Further research is required to estimate the correlation of sublingual microcirculatory flow impairment with complications and survival.

scholarly journals Sublingual microcirculatory alterations during the immediate and early postoperative period: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Athanasios Chalkias ◽  
Nikolaos Papagiannakis ◽  
Georgios Mavrovounis ◽  
Konstantina Kolonia ◽  
Maria Mermiri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiac Surgery ◽  
Postoperative Period ◽  
Meta Analysis ◽  
Early Postoperative Period ◽  
Vessel Density ◽  
Flow Index ◽  
Full Group ◽  
Study Objective ◽  
Significant Difference

Study objective: To systematically review the literature regarding the presence of sublingual microcirculatory alterations during the immediate and early postoperative period. Design: Systematic review and meta-analysis searching PubMed, Scopus, and Google Scholar. Patients/interventions: Studies comparing sublingual microcirculation before and after surgery. Measurement: The primary outcome was to investigate the severity of microcirculatory alterations during the immediate and early postoperative period in adult patients undergoing non-cardiac and cardiac surgery. Main results: Among 17 eligible studies, 13 were finally analyzed. A non-statistically significant difference was found between preoperative and postoperative total vessel density (p=0.084; estimate: -0.029; 95% CI: -0.31 to 0.26; I2 = 22.55%, Q = 10.23, p=0.24). Perfused vessel density significantly decreased postoperatively (p=0.035; estimate: 0.344; 95% CI: 0.02 to 0.66; I2 = 65.66%, Q = 41.77, p<0.001), while perfused boundary region significantly increased postoperatively (p=0.031; estimate: -0.415; 95% CI: -0.79 to -0.03; I2 = 37.21%, Q = 6.56, p=0.16). Microvascular flow index significantly decreased postoperatively (p=0.028; estimate: 0. 587; 95% CI: 0.06 to 1.11; I2 = 86.09%, Q = 96.28, p<0.001), while a non-statistically significant difference was found between preoperative and postoperative proportion of perfused vessels (p=0.089; estimate: 0.53; 95% CI: -0.08 to 1.14; I2 = 70.71%, Q = 18.99, p=0.002). The results in the non-cardiac surgery subgroup were comparable with the full group except that a statistically non-significant difference in PVD was found in the remaining seven studies (p=0.19; estimate: 0.26; 95% CI: -0.13 to 0.66; I2 = 71.94%, Q = 33.42, p=0.002). The other parameters did not differ significantly from their respective full group results. Conclusions: Significant sublingual microcirculatory alterations are present during the immediate and early postoperative period.

scholarly journals The Effectiveness and Safety of Acupuncture for Patients with Chronic Urticaria: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Qin Yao ◽  
Shanshan Li ◽  
Xiaoxu Liu ◽  
Zongshi Qin ◽  
Zhishun Liu
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Chronic Urticaria ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Symptom Improvement ◽  
Control Groups ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Significant Difference

Background. Acupuncture might have effectiveness in relieving the symptoms of chronic urticaria. There are currently no systematic reviews of acupuncture for chronic urticaria published in English.Objective. We conducted a systematic review to assess the effectiveness and safety of acupuncture for chronic urticaria.Methods. A systematic review and meta-analysis of randomized, controlled trials were performed. The primary outcome was global symptom improvement.Results. We included 6 studies with 406 participants. Three trials showed significant difference between acupuncture and drugs in global symptom improvement (relative risk 1.37; 95% CI 1.11–1.70;P=0.003). As an adjuvant to medication, acupuncture was also beneficial for global symptom improvement (relative risk 1.77; 95% CI 1.41–2.22;P<0.01). There were no severe adverse events related to acupuncture.Limitations. Some methodological limitations were observed. The overall risk of bias in the 6 included trials was high and all included RCTs were conducted in China and published in Chinese. Besides, the lack of proper control groups and the use of different rating methods and cut-offs in the included trials also made the evidence of this review limited.Conclusions. Acupuncture might be effective and safe for chronic urticaria in relieving symptoms, based on a low level of evidence. To draw a reliable conclusion, more high quality trials are needed in the future. This trial is registered with PROSPEROCRD42015015702.

scholarly journals Comparison of nephroscopy and cystoscopy used in the treatment of bladder stones: a systematic review and meta-analysis of randomized controlled trials

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liping Gou ◽  
Zhenghao Wang ◽  
Ye Zhou ◽  
Xiaofeng Zheng
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Operative Time ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Significant Heterogeneity ◽  
Bladder Stones ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background A systematic review and meta-analysis was conducted to compare the safety and efficiency of nephroscopy and cystoscopy in transurethral cystolithotripsy (TUCL) for bladder stones (BS). Methods The PubMed, Web of Science, Embase, EBSCO, and Cochrane Library databases were searched up to January 2021 for studies assessing the effect of different types of endoscopes among patients who underwent TUCL. The search strategy and study selection process were in accordance with the PRISMA statement. Results Five randomized controlled trials were included in the meta-analysis. The results showed no difference in stone-free rate (RR = 1.00, CI = 0.98–1.02, p = 1.00) between the two groups and nonsignificant heterogeneity (I2 = 0%, p = 1.00), and all patients were rendered stone free. Use of the nephroscope significantly shortened the operative time compared with the cystoscope group (RR= − 26.26, CI = − 35.84 to − 16.68, p < 0.00001), and there was significant heterogeneity (I2= 87%, p < 0.00001). There was no significant difference in mean urethral entries (RR = 0.66, CI = − 0.71 to − 2.04, p = 0.35), hospitalization (MD = 0.08, 95% CI = − 0.07 to 0.23, p = 0.31) or total complication rate (RR=1.37, 95% CI = 0.47–4.00, p = 0.56) between the two groups. Conclusions In conclusion, this systematic review demonstrates that both nephroscopy and cystoscopy have high stone clearance efficiency, low rates of complications and short hospitalizations. The mean urethral entries depend on the treatment method for large stone fragments. However, the use of nephroscopy can significantly reduce the operative time.

scholarly journals Auricular Plaster Therapy for Comorbid Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Huimin Zhao ◽  
Dan Li ◽  
Ying Yang ◽  
Yueting Liu ◽  
Jie Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Effective Rate ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Comorbid Insomnia ◽  
Randomized Controlled ◽  
Significant Difference

Background. Although the effectiveness of auricular plaster therapy (APT) on primary insomnia has been systematically reviewed, no systematic review of studies has focused on the effect on comorbid insomnia. Objective. To evaluate the efficacy and safety of APT for comorbid insomnia. Methods. Fifteen databases were searched from inception to July 2018. Randomized controlled trials (RCTs) of APT as an exclusive intervention for comorbid insomnia against Western medications, sham APT or no treatment were identified. Results. Fourteen studies involving 928 participants were identified. The pooled outcomes revealed that APT was superior to control conditions for the global score on PSQI (SMD = -1.13, and 95% CI = -1.48—-0.78) and the effective rate (RR = 1.24, 95% CI = 1.13—1.36, NNT = 5, and 95% CI =4—7). Furthermore, the results of subgroup analyses were similar to the pooled results. Additionally, the pooled results were verified to be stable by sensitivity analyses. Regarding safety, no significant difference was identified between APT and Western medications. Conclusions. APT appears to be an effective and safe treatment for comorbid insomnia. However, the benefits of APT for comorbid insomnia could not be ascertained due to the paucity of the quantity and quality of the included studies. Large-scale studies using proper methodology are needed to yield a firm conclusion.

scholarly journals Is reiki or prayer effective in relieving pain during hospitalization for cesarean? A systematic review and meta-analysis of randomized controlled trials

2017 ◽  
Vol 135 (2) ◽  
pp. 123-132 ◽  
Author(s):  
Guilherme Augusto Rago Ferraz ◽  
Meline Rosseto Kron Rodrigues ◽  
Silvana Andrea Molina Lima ◽  
Marcelo Aparecido Ferraz Lima ◽  
Gabriela Lopes Maia ◽  
...  
Keyword(s):  
Systematic Review ◽  
High Risk ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Spiritual Healing ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Section Design

ABSTRACT CONTEXT AND OBJECTIVE: This systematic review compared reiki and prayer with drug use for relieving pain during hospitalization for cesarean, given that the popularity of integrative medicine and spiritual healing has been increasing. It had the aim of evaluating whether reiki or prayer is effective in relieving pain during cesarean section. DESIGN AND SETTING: Systematic review with meta-analysis conducted at Botucatu Medical School, UNESP, São Paulo, Brazil. METHODS: The following databases were searched up to March 2016: MEDLINE, Embase, LILACS and CENTRAL. Randomized controlled trials published in English or Portuguese were included in the review. Two reviewers independently screened eligible articles, extracted data and assessed the risk of bias. A GRADE table was produced to evaluate the risk of bias. RESULTS: There was evidence with a high risk of bias showing a statistically significant decrease in pain score through use of reiki and prayer, in relation to the protocol group: mean difference = -1.68; 95% confidence interval: -1.92 to -1.43; P < 0.00001; I2 = 92%. Furthermore, there was no statistically significant difference in heart rate or systolic or diastolic blood pressure. CONCLUSION: Evidence with a high risk of bias suggested that reiki and prayer meditation might be associated with pain reduction.

scholarly journals Effects of Sodium-Glucose Cotransporter 2 on Amputation Events: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Pharmacology ◽  
2021 ◽  
pp. 1-8
Author(s):  
Ray Meng See ◽  
Yao Neng Teo ◽  
Yao Hao Teo ◽  
Nicholas L. Syn ◽  
Alicia Swee Yan Yip ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Sglt2 Inhibitor ◽  
Sglt2 Inhibitors ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Sodium Glucose Cotransporter ◽  
Cardiovascular Assessment ◽  
Significant Difference

<b><i>Introduction:</i></b> Sodium-glucose cotransporter 2 (SGLT2) inhibitors are increasingly utilized in the treatment of diabetes mellitus as well as therapeutic extra-glycemic effects. However, there are still concerns over complications such as amputation events, given the results from the Canagliflozin Cardiovascular Assessment Study (CANVAS) trial. Hence, we conducted a systematic review and meta-analysis of randomized-controlled trials to investigate the effect of SGLT2 inhibitors on amputation events. <b><i>Methods:</i></b> Four electronic databases (PubMed, Embase, Cochrane, and SCOPUS) were searched on November 21, 2020, for articles published from January 1, 2000, up to November 21, 2020, for studies that examined the effect of SGLT2 inhibitors on amputation events. Random-effect pair-wise meta-analysis for hazard ratios and fixed-effect Peto odds ratio meta-analysis were utilized to summarize the studies. <b><i>Results:</i></b> A total of 15 randomized-controlled trials were included with a combined cohort of 63,716 patients. We demonstrated that there was no significant difference in amputation events across different types of SGLT2 inhibitors, different baseline populations, and different duration of SGLT2 inhibitor use. <b><i>Discussion/Conclusions:</i></b> In this meta-analysis, SGLT2 inhibitors were not associated with a significant difference in amputation events.

scholarly journals The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Bin Cheng ◽  
Xinyi Zeng ◽  
Shaoyuan Liu ◽  
Jing Zou ◽  
Yan Wang
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Recurrent Aphthous Stomatitis ◽  
Aphthous Stomatitis ◽  
The Other ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Oral Pain ◽  
Significant Difference ◽  
Effective Drugs

AbstractThere is currently a lack of effective drugs to cure recurrent aphthous stomatitis. This study aimed to evaluate the efficacy of probiotics alone or as an adjunct in recurrent aphthous stomatitis (RAS) patients. Seven randomized controlled trials (RCTs) were included, of which three were included in quantitative analysis. Of five studies evaluating the efficacy of probiotics alone compared with placebo or Oracure gel, two reported no significant difference in relieving oral pain, while probiotics exhibited a higher capacity for decreasing oral pain in the other three. A significant decrease in ulcer severity was found in one, while no significant difference was found in the other four. The remaining two studies demonstrated that probiotics, as an adjunct to steroids or anaesthetic antiseptic gel, significantly reduced the ulcer severity and oral pain. The meta-analysis showed a significant decrease in oral pain (− 1.72, P = 0.0001) with probiotics compared with placebo. In conclusion, probiotics alone were capable of relieving oral pain but not effective in reducing ulcer severity. A combination of probiotics and steroids or anaesthetic antiseptic gel was more effective than steroids or anaesthetic antiseptic gel alone in RAS patients. Probiotics are promising for the treatment of recurrent aphthous stomatitis.

scholarly journals A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia

2016 ◽  
Vol 29 (8) ◽  
pp. 1308-1349 ◽  
Author(s):  
Kate Laver ◽  
Rachel Milte ◽  
Suzanne Dyer ◽  
Maria Crotty
Keyword(s):  
Systematic Review ◽  
Psychological Symptoms ◽  
Meta Analysis ◽  
Randomized Controlled ◽  
People With Dementia ◽  
Significant Difference ◽  
Person With Dementia ◽  
Multicomponent Interventions ◽  
Behavioral And Psychological Symptoms

Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.

scholarly journals Statins in Healthy Adults: A Meta-Analysis

Medicina ◽  
2021 ◽  
Vol 57 (6) ◽  
pp. 585
Author(s):  
Lee Sandwith ◽  
Patrice Forget
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Meta Analysis ◽  
Health Conditions ◽  
Current Evidence ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Significant Difference

Background and Objectives: In this paper, we investigated the efficacy of statin therapy on cardiovascular disease (CVD) reduction in adults with no known underlying health conditions by undertaking a meta-analysis and systematic review of the current evidence. Materials and Methods: We performed a systematic search to identify Primary Prevention Randomized Controlled Trials (RCTs) that compared statins with a control group where CVD events or mortality were the primary end point. Identified RCTs were evaluated and classified into categories depending on relevance in order to determine which type of meta-analysis would be feasible. Results: No differences were observed between categories with the exception of relative risk for all CVD events combined which showed a 12% statistically significant difference favouring studies which were known to include participants without underlying health conditions. Strong negative correlations between number-need-to-treat (NNT) and LDL-C reduction were observed for all Coronary Heart Disease (CHD) outcomes combined and all CVD outcomes combined. Conclusions: This project highlights the need for further research on the effects of statins on participants who do not suffer from underlying health conditions, given that no such studies have been conducted.

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