Velcro Ties in Early Postoperative Pediatric Tracheostomy Care: A Systematic Review and Meta-analysis

Objective To systematically review the literature to determine the difference in complications between standard twill and Velcro ties following pediatric tracheostomy. Data Sources MEDLINE, Embase, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, Web of Science, and CINAHL Plus were searched up to August 2020. Review Methods Two authors independently screened articles for eligibility. Retrospective and prospective studies were included as long as there was a direct comparison between twill and Velcro ties. Quantitative and qualitative analysis was performed. The main outcomes were skin-related complications and accidental decannulation. Results Three studies were included in the final analysis: 1 randomized prospective trial and 2 retrospective studies. There were 238 patients total (137 twill, 101 Velcro). Combined analysis showed skin-related complications in 23% of the Velcro group and 44% of the twill group. Meta-analysis for skin-related complications showed no significant difference when comparing Velcro with standard twill ties (risk ratio, 0.53 [95% CI, 0.24-1.17]; P = .12, n = 238 participants from 3 studies, I2 = 66%). Accidental decannulation rates were overall low and comparable between groups (1.0% of twill, 1.4% of Velcro). Conclusion Based on limited data, skin-related complications were not statistically different between Velcro and twill ties. Accidental decannulation is rare with Velcro and standard twill ties, and both are viable options following pediatric tracheostomy.

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Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: a systematic review and meta analysis

BMC Anesthesiology ◽

10.1186/s12871-019-0910-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Yang Zhou ◽

Abdul Mannan ◽

Yuan Han ◽

He Liu ◽

Hui-Lian Guan ◽

...

Keyword(s):

Side Effects ◽

Incidence Rate ◽

Meta Analysis ◽

Cochrane Central Register ◽

Efficacy And Safety ◽

Central Register ◽

Postanesthetic Shivering ◽

Significant Difference ◽

The Difference ◽

Prophylactic Use

Abstract Background Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering. Methods We searched the following databases: Medline, Embase, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the difference of the incidence rate of postanesthetic shivering between ketamine group and placebo group. The secondary outcomes were the sedation score and incidence of the side effects caused by ketamine and any other drugs utilized in the studies. Results In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P<0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions. Conclusions Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs.

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Should syndesmotic screws be removed or retained? A meta-analysis

10.21203/rs.3.rs-17528/v1 ◽

2020 ◽

Author(s):

Wanjin Qin ◽

Peng Yang ◽

Nanning Lv ◽

Kaiwen Chen ◽

Huilin Yang ◽

...

Keyword(s):

Clinical Outcomes ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Search Terms ◽

Central Register ◽

Significant Difference ◽

The Difference ◽

Mean Differences ◽

American Orthopaedic

Abstract Background The aim of this study was to evaluate the different clinical outcomes after removing or retaining syndesmotic screws, and the difference in clinical outcomes after retaining broken or loose syndesmotic screws was also evaluated. Methods A systematic literature search was performed using PubMed, Web of Science, EMBASE and the Cochrane Central Register of Controlled Trials. In this meta-analysis, we conducted online searches using the search terms “syndesmotic diastasis”, “syndesmotic injury”, “syndesmotic screw”, “syndesmotic fixation”, and “tibiofibular syndesmosis”. The analysis was performed on individual patient data from all the studies that met the selection criteria. Clinical outcomes were expressed as standard mean differences for continuous outcomes with 95% confidence intervals. Heterogeneity was assessed using the Chi 2 test and the I 2 statistic. Results There were 2 randomized controlled trials (RCTs) and 6 observational articles included in this analysis. In the comparison between retained and removed screws and the comparison between broken or loose and removed screws, no significant difference was found in terms of visual analogue scale (VAS), Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score. Broken or loose screws were associated with better AOFAS scores compared with removed or intact screws, and no significant difference was found in terms of VAS and OMAS scores. Conclusions According to our analysis, there was no significant difference in clinical outcomes between removed and retained screws. Broken or loose screws were not associated with bad functional outcomes and may even lead to better function compared with removed or retained screws.

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Effectiveness of influenza vaccine in children

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20182492 ◽

2018 ◽

Vol 5 (7) ◽

pp. 2632

Author(s):

Nof Saadi AlQarni ◽

Alzain Mohammid Abdulla ◽

Reham Hassan Abdulaziz Abdu ◽

Basim Faiqe Noor Khan ◽

Ahmed Hussain D. Alherz ◽

...

Keyword(s):

Otitis Media ◽

Influenza Infection ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Duration Of Illness ◽

Cochrane Database ◽

Central Register ◽

Comprehensive Search ◽

The Difference

Oseltamivir delivers modest clinical advantages to children with influenza when started within 48 hours of symptom beginning. Nevertheless, effectiveness and safety stay controversial. We conducted the current meta-analysis using a comprehensive search of EMBASE, MEDLINE, PubMed, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials till 15 February 2018 for randomized controlled trials of oseltamivir therapy in children. Four studies met the search criteria. Overall, oseltamivir treatment significantly reduced the duration of illness in the ITTI population (RMST difference, -18.2 hours; 95% CI, −32.2 to −0.6 hours). In trials that enrolled patients without asthma, the difference was larger (RMST difference −26.7 hours; 95% CI, −49.8 to −6.1 hours).Risk of otitis media was 34% lower in the ITTI population. Vomiting was the only adverse event with a significantly higher risk in the treatment group. Regardless of considerable heterogeneity in pediatric trials, we found that treatment with oseltamivir treatment started within 24 hours of symptom onset provides substantial benefits to children with influenza infection and lowered the risk of developing otitis media.

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Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: A system review and meta analysis

10.21203/rs.2.10245/v3 ◽

2019 ◽

Author(s):

Yang Zhou ◽

Abdul Mannan ◽

Yuan Han ◽

He Liu ◽

Hui-Lian Guan ◽

...

Keyword(s):

Side Effects ◽

Incidence Rate ◽

Meta Analysis ◽

Cochrane Central Register ◽

Efficacy And Safety ◽

Central Register ◽

Postanesthetic Shivering ◽

Significant Difference ◽

The Difference ◽

Prophylactic Use

Abstract Background Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering. Methods We used a systematic approach, also known as meta-analysis, to further address postoperative shivering. We searched the following databases: Medline, Embase, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the difference of the incidence rate of postanesthetic shivering between ketamine group and placebo group . The secondary outcomes were the sedation score and incidence of the side effects caused by ketamine and any other drugs utilized in the studies. Results In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P＜0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions. Conclusions Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs.

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Should syndesmotic screws be removed or retained? A meta-analysis

10.21203/rs.3.rs-17528/v2 ◽

2020 ◽

Author(s):

Wanjin Qin ◽

Peng Yang ◽

Nanning Lv ◽

Kaiwen Chen ◽

Huilin Yang ◽

...

Keyword(s):

Clinical Outcomes ◽

Meta Analysis ◽

Controlled Trials ◽

Cochrane Central Register ◽

Search Terms ◽

Central Register ◽

Significant Difference ◽

The Difference ◽

Mean Differences ◽

American Orthopaedic

Abstract Background The aim of this study was to evaluate the different clinical outcomes after removing or retaining syndesmotic screws, and the difference in clinical outcomes after retaining broken or loose syndesmotic screws was also evaluated.Methods A systematic literature search was performed using PubMed, Web of Science, EMBASE and the Cochrane Central Register of Controlled Trials. In this meta-analysis, we conducted online searches using the search terms “syndesmotic diastasis”, “syndesmotic injury”, “syndesmotic screw”, “syndesmotic fixation”, and “tibiofibular syndesmosis”. The analysis was performed on data from all the studies that met the selection criteria. Clinical outcomes were expressed as standard mean differences for continuous outcomes with 95 % confidence intervals. Heterogeneity was assessed using the Chi2 test and the I2 statistic.Results There were 2 randomized controlled trials (RCTs) and 6 observational articles included in this analysis. In the comparison between retained and removed screws and the comparison between broken or loose and removed screws, no significant difference was found in terms of visual analogue scale (VAS), Olerud-Molander Ankle Score (OMAS) and American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score. Broken or loose screws were associated with better AOFAS scores compared with removed or intact screws, and no significant difference was found in terms of VAS and OMAS scores.Conclusions According to our analysis, there was no significant difference in clinical outcomes between removed and retained screws. Broken or loose screws were not associated with bad functional outcomes and may even lead to better function compared with removed or retained screws.

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Systematic Review and Meta-analysis of Eculizumab, Inebilizumab, Tocilizumab, and Satralizumab for Neuromyelitis Optica

10.1101/2021.07.22.21261005 ◽

2021 ◽

Author(s):

Rajan Chamlagain ◽

Sangam shah ◽

Suman Gaire ◽

Anuj Krishna Paudel ◽

Krishna Dahal ◽

...

Keyword(s):

Monoclonal Antibody ◽

Monoclonal Antibodies ◽

Neuromyelitis Optica ◽

Treatment Guidelines ◽

Meta Analysis ◽

Cochrane Central Register ◽

Central Register ◽

Significant Difference ◽

Quantitative Synthesis ◽

The Central Nervous System

Neuromyelitis optica is rare, autoimmune-mediated inflammation and demyelination of the central nervous system with a prevalence of 1-2 persons per 100,000 populations. We aim to generate a head-to-head comparison of these drugs with appropriate evidence to guide future trials and treatment guidelines in a patient with recurrent attacks of NMO. We searched the databases like PubMed, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL) and Embase for studies published prior to April 2021 using the keywords. Over all 929 patients from 11 different publications were included in the study. Five studies were included for quantitative synthesis. Pooling of studies showed significant mean reduction of ARR in the monoclonal antibody group (-0.26 [-0.35, -0.17], P <0.00001, I2=0%) and the mean difference in EDSS score from baseline in monoclonal antibodies was -0.23(95% CI [-0.43, -0.03], P=0.02, I2=0%). There was no significant difference in frequency of total reported adverse events between monoclonal antibody and the comparator arm (RR: 1.01 [0.95, 1.07], P=0.74, I2=14%). Our findings, particularly seen from the context of a few RCTs, support the pursuit of larger, multi-center RCTs that evaluate the effectiveness of each of the currently available monoclonal antibodies and better describe their adverse risk profile.

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Effect of Obesity on Survival of Women With Epithelial Ovarian Cancer: A Systematic Review and Meta-Analysis of Observational Studies

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31822eb5f8 ◽

2011 ◽

Vol 21 (9) ◽

pp. 1525-1532 ◽

Cited By ~ 45

Author(s):

Hyun-Sik Yang ◽

Chan Yoon ◽

Seung-Kwon Myung ◽

Sang Min Park

Keyword(s):

Ovarian Cancer ◽

Confidence Interval ◽

Epithelial Ovarian Cancer ◽

Meta Analysis ◽

Early Adulthood ◽

Harmful Effect ◽

Advanced Ovarian Cancer ◽

Final Analysis ◽

Cochrane Central Register ◽

Central Register

ObjectiveAlthough obesity is shown to be a risk factor for epithelial ovarian cancer, its role as a prognostic factor has been remained inconclusive. In this study, available evidences on this matter to date have been assembled for a meta-analysis to determine the effect of obesity on the survival of patients with epithelial ovarian cancer.Materials and MethodsEligible studies published up to December 2010 were searched using MEDLINE (PubMed), EMBASE, and Cochrane Central Register of Controlled Trials, and manual review of relevant bibliography to look for additional studies was done. Adjusted hazard ratios (HRs) from individual studies were pooled using a random-effects model.ResultsTen cohort studies of 331 screened articles were included in the final analysis. The meta-analysis showed overweight or obesity at early adulthood to be associated with higher mortality among patients with ovarian cancer (HR, 1.60; 95% confidence interval, 1.10–2.34). Among patients with advanced ovarian cancer, premorbid obesity was associated with worse prognosis (HR, 1.45; 95% confidence interval, 1.09–1.93). However, there was no significant relationship between prognosis and obesity around the time of diagnosis.ConclusionsThis study suggests a possible relationship between obesity at early adulthood and higher mortality among patients with ovarian cancer. Further studies are needed to elucidate the harmful effect of obesity on the survival of patients with ovarian cancer.

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Effectiveness of rigorously evaluated behavior change interventions delivered via mobile application: Systematic review and meta-analysis (Preprint)

10.2196/preprints.21563 ◽

2020 ◽

Author(s):

Sarah J Iribarren ◽

Tokunbo O Akande ◽

Kendra J Kamp ◽

Dwight Barry ◽

Yazan G Kader ◽

...

Keyword(s):

Behavior Change ◽

Health Outcomes ◽

Meta Analysis ◽

Outcome Data ◽

Cochrane Central Register ◽

Pilot Studies ◽

Behavior Change Interventions ◽

Cochrane Database ◽

Central Register

BACKGROUND Background: Mobile applications can deliver more efficiently behavior change interventions that are traditionally resource-intensive and difficult to scale. OBJECTIVE Objectives: To summarize the evidence of app-driven behavior change interventions on health outcomes and identify whether certain features contribute to improved outcomes. METHODS Methods: We conducted a literature search in seven databases (MEDLINE; Scopus; PsycINFO, CINAHL, Global Index Medicus; Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews). Five reviewers independently screened and extracted sample characteristics. We used a random-effects model to calculate pooled effect size estimates for meta-analysis. Sensitivity analysis was conducted based on follow-up time, stand-alone app interventions, level of personalization, and pilot studies. Logistic regression was used to examine the structure of app features. RESULTS Results: From the database searches, 8230 records were initially identified. Of these, 172 met inclusion criteria. Studies were predominantly conducted in high-income countries (164, 94.3%). The majority had follow-up periods of six months or less (143, 83.1%). Over half of the interventions were delivered by a standalone app (106, 61.6%). Static/one size fits all (97,56. 4.0%) was the most common level of personalization. Intervention frequency was mostly at least daily (123, 71.5%). A total of 156 studies involving 21,422 participants reported continuous health outcome data. The use of a behavior change app (either as a stand-alone or as part of a larger intervention) confers a slight/weak advantage over standard care in health interventions [standardized mean difference = 0.38 (95% CI: 0.31-0.45), I2 = 80%] though heterogeneity is high. CONCLUSIONS Conclusion: Rigorous evaluation of behavior-change related intervention apps is increasing substantially. The evidence that behavior change apps improve health outcomes is weak, which may reflect the need for improved methodological and evaluative approaches to assessment of healthcare improvement apps. CLINICALTRIAL PROSPERO, CRD42018106868

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Efficacy and safety of prophylactic use of ketamine for prevention of postanesthetic shivering: A system review and meta analysis

10.21203/rs.2.10245/v2 ◽

2019 ◽

Author(s):

Yang Zhou ◽

Abdul Mannan ◽

Yuan Han ◽

He Liu ◽

Hui-Lian Guan ◽

...

Keyword(s):

Side Effects ◽

Incidence Rate ◽

Meta Analysis ◽

Cochrane Central Register ◽

Efficacy And Safety ◽

Central Register ◽

Postanesthetic Shivering ◽

Significant Difference ◽

Risk Patients ◽

Prophylactic Use

Abstract Background Postanesthetic shivering is a common complication of anesthesia, which accounts for much discomfort in postoperative patients and may increase postoperative complications in high-risk patients. Due to the lack of high-quality evidence, it is difficult to draw a conclusion about optimal anti-shivering medication. The main purpose of this meta-analysis was to analyze and evaluate the efficacy and safety of prophylactic use of ketamine for preventing postanesthetic shivering. Methods We used a systematic approach, also known as meta-analysis, to further address postoperative shivering. We searched the following databases: Medline, EMBASE, and the Cochrane Central Register of Controlled Trails for randomized controlled trials. The primary outcome observed was the incidence rate of postanesthetic shivering. The secondary outcomes were the sedation score and incidence of the side effects caused by drugs utilized in the studies. Results In this meta-analysis, we analyzed a total of 16 trials including 1485 patients. Ketamine reduced the incidence rate of postanesthetic shivering compared to a placebo (odds ratio [OR]: 0.13, 95% confidence interval [CI]: 0.06 to 0.26, P＜0.01). Regarding side effects, there was no evident variability of the incidence of nausea and vomiting. Usage of ketamine was associated with a lower rate of hypotension and bradycardia when compared to a placebo. Hallucinations were more frequently observed in patients who received higher doses of ketamine. No significant difference was found in the incidence of postanesthetic shivering with ketamine versus other pharmacological interventions. Conclusions Ketamine can prevent postanesthetic shivering without severe side effects. However, ketamine shows no advantage over other anti-shivering drugs.

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Conjoined versus separate technique: a meta-analysis of anastomosis techniques for urinary diversion after bladder cancer

10.21203/rs.2.11111/v1 ◽

2019 ◽

Author(s):

Liu Daqian ◽

Wang Yonghua ◽

Zhao Yang ◽

Yang Xuecheng ◽

wang xinsheng ◽

...

Keyword(s):

Bladder Cancer ◽

Urinary Diversion ◽

Odds Ratio ◽

Meta Analysis ◽

Anastomosis Group ◽

Separate Group ◽

Cochrane Central Register ◽

Central Register ◽

The Difference

Abstract Introduction: This was a meta-analysis of studies on conjoined and separate anastomosis for urinary diversion after radical cystectomy due to bladder cancer. Methods: We searched databases (PubMed, Embase and the Cochrane Central Register of Controlled Trials) for studies regarding anastomosis for urinary diversion due to bladder cancer. The meta-analysis was designed to determine the difference between conjoined and separate anastomosis. Six studies including 1601 patients were considered in the meta-analysis (654 in the separate group and 947 in the conjoined group). Results: There were no significant differences with respect to age, gender or duration of follow-up. There were seven studies that compared the rate of stricture and the rate of hydronephrosis. For overall stricture, there were 186 of 1163 ureters in the separate group and 64 of 1718 ureters in the conjoined group (odds ratio, 4.53; 95% CI, 2.01-10.22; P = 0.0003). For overall hydronephrosis patients, there were 55 of 205 ureters in the separate group and 51 of 254 ureters in the conjoined group (odds ratio, 1.48; 95% CI, 0.95-2.29; P = 0.08). Conclusion: The separate anastomosis had a higher ratio of strictures than did the conjoined group. The separate anastomosis group experienced hydronephrosis more often than did the conjoined anastomosis group. The separate anastomosis is the better choice for surgery during the operation.

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