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Zotto ED, Costa P, Morotti A, Poli L, Giuli VD, Giossi A, Volonghi I, Callea A, Padovani A, Pezzini A. Stroke and depression: A bidirectional link. World J Meta-Anal 2014; 2:49-63. [DOI: 10.13105/wjma.v2.i3.49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 04/07/2014] [Accepted: 06/11/2014] [Indexed: 02/05/2023] Open
Abstract
A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertension and diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.
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Shi MJ, Yang J, Meng XY, Li S, Liu T, Fang ZH, Cao R, Wang XH. Comparison of functional outcomes after retropubic, laparoscopic and robot-assisted radical prostatectomy: A meta-analysis. World J Meta-Anal 2014; 2:107-126. [DOI: 10.13105/wjma.v2.i3.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Revised: 05/10/2014] [Accepted: 06/18/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To assess the 6-mo and 12-mo functional outcomes after retropubic, laparoscopic and robot-assisted laparoscopic radical prostatectomy retropubic radical prostatectomy (RRP) laparoscopic radical prostatectomy (LRP); robot-assisted laparoscopic prostatectomy (RARP).
METHODS: A literature search was conducted using the PubMed, EMBASE, The Cochrane Library and the Web of Knowledge databases updated to March, 2014 for relevant published studies. After data extraction and quality assessment via the Newcastle-Ottawa Scale or the Cochrane collaboration’s tool for assessing risk of bias, meta-analysis was performed using RevMan 5.1. Either a random-effects model or a fixed-effects model was used. Potential publication bias was assessed using visual inspection of the funnel plots, and verified by the Egger linear regression test.
RESULTS: Thirty-seven studies were identified in total: 14 articles comparing LRP with RRP, 12 articles comparing RARP with RRP, and 11 articles comparing RARP with LRP. For urinary continence, a statistically significant advantage was observed in RARP compared with LRP or RRP both at 6 mo [odds ratio (OR) = 1.93; P < 0.01, OR = 2.23; P < 0.05, respectively] and 12 mo (OR = 1.47; P < 0.01, OR = 2.93; P < 0.01, respectively) postoperatively. The continence recovery rates after LRP and RRP, with obvious heterogeneity (6-mo: I2 = 74%; 12-mo: I2 = 75%), were equivalent (6-mo: P = 0.52; 12-mo: P = 0.75). In terms of potency recovery, for the first time, we ranked the three surgical approaches into a superiority level: RARP > LRP > RRP, with a statistically significant difference at 12 mo [RARP vs LRP (OR = 1.99; P < 0.01); RARP vs RRP (OR = 2.66; P < 0.01); LRP vs RRP (OR = 1.34; P < 0.05)], respectively. Meta-regression and subgroup analyses according to adjustment of the age, body mass index, prostate volume, Gleason score or prostate-specific antigen did not vary significantly.
CONCLUSION: Current evidence suggests that minimally invasive approaches (RARP or LRP) are effective procedures for functional recovery. However, more high-quality randomized control trials investigating the long-term functional outcomes are needed.
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MacIntyre NJ, Negm A, Loyola-Sánchez A, Bhandari M. Efficacy of therapeutic ultrasound vs sham ultrasound on pain and physical function in people with knee osteoarthritis: A meta-analysis of randomized controlled trials. World J Meta-Anal 2014; 2:78-90. [DOI: 10.13105/wjma.v2.i3.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 05/01/2014] [Accepted: 05/29/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the efficacy of therapeutic ultrasound vs sham for improving pain and physical function immediately post-intervention in people with knee osteoarthritis (OA).
METHODS: We hand searched meta-analyses on the topic published in 2010 and updated the search in three electronic databases (MEDLINE, EMBASE, CINAHL) January 1, 2009 to September 5, 2013 to identify relevant studies. The inclusion criteria were human randomized controlled trials published in the English language in which active therapeutic ultrasound was compared to sham ultrasound, data for people with knee OA were reported separately, participants were blinded to treatment allocation and outcomes assessed before and after treatment included pain, self-reported physical function and performance-based physical function. Two reviewers independently screened titles and abstracts retrieved in the search to identify trials suitable for full text review. Data extraction and risk of bias assessment of the identified trials were completed independently by two reviewers. Pooled analyses were conducted using inverse-variance random effects models.
RESULTS: We screened 1013 titles and abstracts. Meta-analysis of pain outcomes from 5 small trials (281 participants/OA knees) showed that, compared to sham ultrasound, therapeutic ultrasound improves pain [standardized mean difference (SMD) (95%CI) = -0.39 (-0.70, -0.08); P = 0.01] but not physical function [self-reported in 3 trials (130 participants/OA knees): SMD (95%CI) = -0.21 (-0.55, 0.14), P = 0.24; walking performance in 4 trials (130 participants/OA knees): SMD (95%CI) = -0.11 (-0.59, 0.37), P = 0.65). For the walking performance outcome, the dispersion of the estimated effects exceeded that expected due to sampling error (χ2 = 8.37, P = 0.04, I² = 64%). Subgroup analyses of three trials that administered high dose ultrasound improved the consistency (I2 = 28%) but the treatment effect remained insignificant.
CONCLUSION: Meta-analyzed double-blind placebo-controlled randomized trials provide low-strength evidence that therapeutic ultrasound decreases knee OA pain and very low-strength evidence that it does not improve physical function.
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Miller TA, Bannon BL, DiMatteo MR. Interventions to improve treatment adherence among adolescents: A meta-analysis. World J Meta-Anal 2014; 2:71-77. [DOI: 10.13105/wjma.v2.i3.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 04/17/2014] [Accepted: 07/17/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To examine the overall effectiveness of interventions designed to improve medical treatment adherence among adolescent patients.
METHODS: PubMed and PsycINFO databases were searched to retrieve and analyze empirical journal articles (from 1948-2013). Only peer-reviewed, English language journals that defined a measure of adherence (or compliance), assessed an intervention aimed at improving adherence among adolescents, and provided information to calculate an r effect size were included. Studies were excluded if they lacked assessment of the effectiveness of interventions on improving adherence in adolescents as compared to no interventions or standard care. Case studies or journal articles that examined substance abuse or psychological disorders were also excluded. Analyses were conducted with fixed and random-effects methods, and moderators of intervention efficacy were also examined.
RESULTS: For each study that met the inclusion criteria (n = 45), an effect size r, reflecting the strength and direction of the interventions’ relationship to adherence was recorded; a positive r indicated that the intervention increased adolescent adherence, whereas a negative r indicated that the intervention decreased adolescent adherence. The overall effectiveness of adolescent adherence interventions was positive and significant (unweighted mean r = 0.27, 95%CI: 0.21-0.33, P = 0.001). Moderator analyses at the fixed effects level revealed that interventions were less effective when adolescents reported their adherence behaviors, when the type of adherence regimen was a medication regimen, and when the type of intervention was cognitive-modification based.
CONCLUSION: These findings contribute to understanding interventions for enhancing adolescent adherence. Future research should continue to examine the specific challenges faced by adolescents and create targeted interventions.
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Saha L, Kumar N, Khosla P, Kaur S. Role of statin on mortality outcome in pneumonia patients: A meta-analysis. World J Meta-Anal 2014; 2:91-97. [DOI: 10.13105/wjma.v2.i3.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 05/23/2014] [Accepted: 06/18/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the role of statin on mortality outcome in patient with pneumonia.
METHODS: For the present meta-analysis, we search the published literatures online through PubMed, Embase, Scopus and the Cochrane Library databases and the search words used were “statins’”, “bacteraemia”, “pneumonia”, and “ICU infections”. During the online search our focus was on full text articles, peer-reviewed, observational cohort or case control studies and randomized controlled trials. Those studies were selected whose outcome was hospital mortality among patients with pneumonia whether or not on statins. In this meta-analysis, 30 d mortality was used as the primary outcome as it has been demonstrated in the previous research that 30 d mortality is primarily because of community acquired pneumonia. As all studies were observational, where statin users were compared with historical rather than randomized controls, odds ratio for in-hospital or all-cause 30 d mortality was used as the primary effect measure used in the meta-analysis.
RESULTS: We came across the total 25 studies comprising 35355 patients (2734 statin users and 32621 statin non-users) during the electronic search. Four studies out of 25 were included in the final analysis. In this meta-analysis, when data regarding the use of statin in pneumonia patients on mortality was pooled, its results showed the non-significant effect of the statin on mortality outcome.
CONCLUSION: Although statins seems to be useful in the treatment of pneumonia patients but for statistical conclusion, further randomized controlled trials needs to be done or their results still waited to be published of ongoing trials, with the conclusion that presently statins showing no clinical benefit in the pneumonia patients.
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Al-Namankany A, Ashley P, Petrie A. Development of the first Arabic cognitive dental anxiety scale for children and young adults. World J Meta-Anal 2014; 2:64-70. [DOI: 10.13105/wjma.v2.i3.64] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Revised: 05/27/2014] [Accepted: 06/27/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To validate the Arabic version of abeer children dental anxiety scale.
METHODS: Two ethical approvals for this study were obtained from United Arab Emirates, Ministry of Health and Dubai Health Authority; reference number: 2011/57. The Abeer children dental anxiety scale (ACDAS) was translated from English to Arabic by the native speaker chief investigator, and then back translated by another native speaker in Dubai (AS) to ensure comparability with the original one. Part C of ACDAS was excluded for the schoolchildren because those questions were only applicable for children at the dentist with their parents or legal guardian. A total of 355 children (6 years and over) were involved in this study; 184 in Dubai, 96 from the Religious International Institute for boys and 88 from Al Khansaa Middle School for girls. A sample of 171 children was assessed for external validity (generalizability) from two schools in different areas of London in the United Kingdom.
RESULTS: Receiver operating characteristic curve showed that the cut-off ≥ 26 for ACDAS gave the optimal results for sensitivity = 90% (95%CI: 81.2%- 95.6%), and specificity = 86.6% (95%CI: 78.2%- 92.7%), with AUROC = 0.93 (95%CI: 0.90-0.97). Cronbach’s Alpha (α) was 0.90 which indicated good internal consistency. Results of the external validity assessing the agreement between ACDAS and dental subscale of the children's fear survey schedule was substantial for the East London school (κ = 0.68, 95%CI: 0.53-0.843); sensitivity = 92.9% (95%CI: 82.7%-98.0%); specificity = 73.5% (95%CI: 55.6%-87.1%) and almost perfect for the Central London school (κ = 0.79; 95%CI: 0.70-0.88); sensitivity = 96.4% (95%CI: 81.7%-99.9%); specificity = 65.9%, (95%CI: 57.4%-73.8%).
CONCLUSION: The Arabic ACDAS is a valid cognitive scale to measure dental anxiety for children age 6 years or over.
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Abstract
Varicocele is a relatively common condition that can impact men’s health in various ways. Unfortunately, its prevalence and the availability of various different methods of repairing it might lead to unnecessary treatment. An understanding of the various ways that this condition can impact men’s health is necessary in order to manage it appropriately. At present, there is substantial evidence to support varicocele repair in men who present with infertility, abnormal semen parameters, clinical varicocele and a female partner with normal fertility (or one with a potentially correctable abnormality). Varicocele repair appears to improve seminal fluid quality and might improve pregnancy rates. It might also have a role in managing men with non-obstructive azoospermia. Varicocele can also be a cause of scrotal pain that is usually of a dull character. Varicocele repair is an effective method of managing this type of pain, especially once proper measures have been taken to exclude other possible causes of orchalgia. Conservative measures are generally not effective in managing varicocele-related scrotal pain. There is growing evidence to suggest that varicocele repair might have a role in improving the serum testosterone level in men with hypogonadism, especially in the subfertile population. Well-designed prospective studies are needed to support the utilization of varicocele repair in managing these patients, as well as in preventing testicular dysfunction on a prophylactic basis.
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Yuan ZN, Liu FH, Tang Y. Overview and a meta-analysis of pancreatic melanoma based on case reports. World J Meta-Anal 2014; 2:36-41. [DOI: 10.13105/wjma.v2.i2.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 01/03/2014] [Accepted: 02/18/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate the clinical characteristics of pancreatic malignant melanoma.
METHODS: Here we report a case of pancreatic malignant melanoma and present a meta-analysis of pancreatic melanoma based on data from well-documented case reports.
RESULTS: A 32-year-old male presented with abdominal pain and jaundice. Computed tomography showed a non-discrete mass in the head of the pancreas. A pancreatoduodenectomy was performed. Histology revealed pancreatic malignant melanoma. Immunostaining showed that the neoplastic cells were positive for Melan A and S100, and that they expressed HMB-45. A review of 13 publications reporting 15 cases identified main clinical symptoms as abdominal pain (nine cases) and jaundice (three cases). Nine patients had a history of extra-abdominal malignant melanoma. The overall median survival time was 10 mo.
CONCLUSION: Pancreatic malignant melanoma is not typified by any special clinical presentation. The diagnosis depends on biopsy or specimen histology. Surgical resection remains the best treatment choice.
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Hu C, Shen SQ, Chen ZB. Treatment strategy for gallstone pancreatitis and the timing of cholecystectomy. World J Meta-Anal 2014; 2:42-48. [DOI: 10.13105/wjma.v2.i2.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2013] [Revised: 01/18/2014] [Accepted: 03/04/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To reviewed the literature and evaluated the scope and timing of the application of endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (ES) and cholecystectomy.
METHODS: A pooled odds ratio (OR) and a pooled mean difference with the 95%CI were used to assess the enumeration data of included studies. A pooled weighted mean difference (WMD) and a pooled mean difference with the 95%CI were used to assess the measurement data of included studies. Statistical heterogeneity was tested with the χ2 test. According to forest plots, heterogeneity was not significant, so the fixed effect model was adopted. The significance of the pooled OR was determined by the Z test and statistical significance was considered at P < 0.05.
RESULTS: Data were collected from two studies (353 patients, 142 in the early cholecystectomy group and 211 in the delayed cholecystectomy group) regarding the length of hospital stay [The WMD was -2.87 (95%CI: -3.36--2.39, P < 0.01). Data were collected from four studies (618 patients, 211 in the early cholecystectomy group and 408 in the delayed cholecystectomy group) regarding perioperative complications (OR = 0.94, 95%CI: 0.41-2.12, P > 0.05). Data were collected from four studies (618 patients, 211 in the early cholecystectomy group and 408 in the delayed cholecystectomy group) on the number of patients who underwent ERCP± ES postoperatively (OR = 0.80, 95%CI: 0.45-1.41, P > 0.05).
CONCLUSION: Cholecystectomy offers better protection than ES against further bouts of pancreatitis in patients with gallstone pancreatitis, although ES is an acceptable alternative.
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Schiariti M, Iannetta L, Torromeo C, Gregorio MD, Puddu PE. Prognostic significance of post percutaneous coronary intervention thrombocytopenia. World J Meta-Anal 2014; 2:24-28. [DOI: 10.13105/wjma.v2.i2.24] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 01/25/2014] [Accepted: 02/19/2014] [Indexed: 02/05/2023] Open
Abstract
Several definitions of post percutaneous coronary intervention (PCI) thrombocytopenia (TC) were formulated. Recent studies demonstrated that a relative drop in platelet count ≥ 25% is the most appropriate criterion. By this definition a population is detected that is exposed not only to increased risk of hemorrhagic complications but also to increased risk of ischemic events, which may appear a paradox. In patients with acute coronary syndromes undergoing PCI, several conditions might be associated with TC: cardiopulmonary by-pass and the presence of extra corporeal membrane oxygenators, intra aortic balloon pump (IABP), cardiogenic shock, thrombolytic drugs and anticoagulant or antiplatelet drugs. Several studies demonstrated that TC and ischemic outcomes are related although it is unclear whether this is a direct relationship or TC is just a secondary effect of another cryptic protagonist. It is suggested that further investigations determine whether there is a real link between TC, a probably well defined covariate, and ischemic outcomes or whether IABP is the joining link between these two variables and whose presence needs in any case be considered in multivariable statistics. Post-PCI TC could be only a secondary effect of IABP use. On turn, the prolonged use of heparin necessarily accompanying the use of IABP, and producing a paradoxical pro-thrombotic TC, might also be implicated.
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Hinds AM, Ahmad D, Lopez KT, Matteson-Kome ML, Bechtold ML. Weekday vs weekend endoscopy: Is there a true difference in patient outcomes? A meta-analysis. World J Meta-Anal 2014; 2:29-35. [DOI: 10.13105/wjma.v2.i2.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Revised: 03/05/2014] [Accepted: 04/11/2014] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the “weekend effect” on outcomes in patient admitted on the weekend for upper gastrointestinal bleeding (UGIB).
METHODS: A comprehensive search was performed (March 2014). Studies comparing weekend and weekday endoscopy in patients with UGIB were included. All studies had at least 2 of 3 primary outcomes which included: mortality, need for surgery, time to endoscopy, endoscopy on admission day, and length of hospital stay. Three authors individually extracted data. Meta-analysis was performed using pooled estimates with odds ratio or mean difference by fixed and random effects models.
RESULTS: Eleven studies met the inclusion criteria. Patients admitted with UGIB on the weekend exhibited a statistically significant increase in mortality (OR = 1.13; 95%CI: 1.06-1.20; P < 0.01), need for surgery (OR = 2.46; 95%CI: 1.51-3.99; P < 0.01), and time to endoscopy (MD 2.68; 95%CI: 0.17-5.20; P = 0.04) as compared to patients admitted with UGIB on a weekday. Furthermore, patients with UGIB admitted on weekend experienced statistically significant less endoscopy on day of admission (OR = 0.72; 95%CI: 0.62-0.85; P < 0.01). No difference was noted between the two groups for length of hospital stay (MD -1.29; 95%CI: -3.03-0.45; P = 0.15).
CONCLUSION: A weekend effect seems to be apparent in patients with UGIB with significantly poorer outcomes.
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Petretta M, Petretta A, Pellegrino T, Nappi C, Cantoni V, Cuocolo A. Role of nuclear cardiology for guiding device therapy in patients with heart failure. World J Meta-Anal 2014; 2:1-16. [DOI: 10.13105/wjma.v2.i1.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Revised: 11/20/2013] [Accepted: 12/19/2013] [Indexed: 02/05/2023] Open
Abstract
Heart failure is a dynamic condition with high morbidity and mortality and its prognosis should be reassessed frequently, particularly in patients for whom critical treatment decisions may depend on the results of prognostication. In patients with heart failure, nuclear cardiology techniques are useful to establish the etiology and the severity of the disease, while fewer studies have explored the potential capability of nuclear cardiology to guide cardiac resynchronization therapy (CRT) and to select patients for implantable cardioverter defibrillators (ICD). Left ventricular synchrony may be assessed by radionuclide angiography or gated single-photon emission computed tomography myocardial perfusion scintigraphy. These modalities have shown promise as predictors of CRT outcome using phase analysis. Combined assessment of myocardial viability and left ventricular dyssynchrony is feasible using positron emission tomography and could improve conventional response prediction criteria for CRT. Preliminary data also exists on integrated positron emission tomography/computed tomography approach for assessing myocardial viability, identifying the location of biventricular pacemaker leads, and obtaining left ventricular functional data, including contractile phase analysis. Finally, cardiac imaging with autonomic radiotracers may be useful in predicting CRT response and for identifying patients at risk for sudden cardiac death, therefore potentially offering a way to select patients for both CRT and ICD therapy. Prospective trials where imaging is combined with image-test driven therapy are needed to better define the role of nuclear cardiology for guiding device therapy in patients with heart failure.
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Zhou TB, Jiang ZP, Yin SS, Qin YH. Relationship between apolipoprotein E gene polymorphism and total cholesterol level in patients with kidney diseases. World J Meta-Anal 2013; 1:138-146. [DOI: 10.13105/wjma.v1.i3.138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 06/13/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the association between apolipoprotein E (apoE) gene polymorphism and total cholesterol (TC) level in patients with kidney diseases.
METHODS: A predefined literature search was performed to collect data from the electronic databases of PubMed, Embase and the Cochrane Library and eligible relevant studies reporting the association of apoE gene polymorphism with TC level in patients with kidney diseases were recruited for meta-analysis.
RESULTS: Twenty-one studies were identified for the analysis of association between apoE gene polymorphism and TC level in patients with kidney disease. Subjects with E3E4 had a higher TC than those with E3E3 [weighted mean differences (WMD) = 2.14, P = 0.01] and subjects with E2E3 had a lower TC than those with E3E3 (WMD = -1.93, P = 0.01). Subjects with ε2 had a lower TC than those with ε3 (ε2 vs ε3: WMD = -1.23, P = 0.002; ε2 vs ε4: WMD = -2.77, P ﹤0.0001) and subjects with 3 had a lower TC than those with 4 (WMD = -0.79, P = 0.03).
CONCLUSION: Subjects with apoE E3E4 and ε4 had a higher TC level and subjects with apoE E2E3 and ε2 had a higher TC level in patients with kidney disease. However, more well-designed studies should be performed in the future to confirm these findings.
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Zhang H, Gao C, Fang L, Yao SK. Statin use and risk of liver cancer: A meta-analysis of 7 studies involving more than 4.7 million patients. World J Meta-Anal 2013; 1:130-137. [DOI: 10.13105/wjma.v1.i3.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 09/12/2013] [Accepted: 11/21/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To pool data currently available to determine the association between statin use and the risk of liver cancer.
METHODS: A computerized literature search was conducted to identify those relevant studies between January 1966 and March 2013. Stata 11.0 (Stata Corp, College Station, Texas) was used for statistical analyses. Pooled relative risk (RR) estimates with 95%CI were calculated for overall analysis and subgroup analyses, using the random- and fixed-effects models. Heterogeneities between studies were evaluated by Cochran’s Q test and I2 statistic. The Begg’s funnel plot and Egger’s regression asymmetry test were used to detect the publication bias.
RESULTS: Seven studies were included in our meta-analysis according to the selection criteria, including four cohort studies and three case-control studies. These studies involved 4725593 people and 9785 liver cancer cases. The overall analysis showed that statin use was statistically associated with a significantly reduced risk of liver cancer (random-effects model, RR = 0.61, 95%CI: 0.49-0.76, P < 0.001; fixed-effects model, RR = 0.64, 95%CI: 0.57-0.71, P < 0.001); however, significant heterogeneity was found between studies (Cochran’s Q statistic = 19.13, P = 0.004; I2 = 68.6%). All subgroup analyses provided supporting evidence for the results of overall analysis. Begg’s (Z = 0.15, P = 0.881) and Egger’s test (t =-0.44, P = 0.681) showed no significant risk of having a publication bias.
CONCLUSION: Statin use was associated with the reduced risk of liver cancer. To clearly clarify this relationship, more high quality studies are required.
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Linz K, Miller BJ. Meta-analysis of anti-ribosomal P antibodies in lupus psychosis. World J Meta-Anal 2013; 1:121-129. [DOI: 10.13105/wjma.v1.i3.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 10/03/2013] [Accepted: 10/20/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To perform a meta-analysis of the prevalence of anti-ribosomal P (aRP) antibodies in lupus psychosis, and the odds of psychosis in aRP-positive subjects.
METHODS: We identified articles by searching PubMed, PsychInfo, and ISI, and the reference lists of identified studies.
RESULTS: Twenty-four studies met the inclusion criteria. Positive aRP antibodies were found in 51% (91 of 179 total cases) of cases of lupus psychosis. There was an almost 3.5-fold increased odds of psychosis in aRP-positive patients (OR = 3.46, 95%CI: 1.97-6.09, P < 0.001). The population attributable risk percentage was 36% for aRP antibodies.
CONCLUSION: aRP antibodies are common in lupus psychosis, although the potential mechanism(s) underlying this association remain unclear. Given the overlap between the clinical presentation and risk factors for lupus psychosis and schizophrenia, further investigation of aRP antibodies in schizophrenia is warranted.
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Qi XS, Bai M, Yang ZP, Ren WR. Duplicates in systematic reviews: A critical, but often neglected issue. World J Meta-Anal 2013; 1:97-101. [DOI: 10.13105/wjma.v1.i3.97] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/15/2013] [Accepted: 11/21/2013] [Indexed: 02/05/2023] Open
Abstract
The number of systematic reviews is gradually increasing over time. Also, the methods to perform a systematic review are being improved. However, little attention has been paid for the issue regarding how to find duplicates in systematic reviews. On the basis of the survey and systematic reviews by our team and others, we review the prevalence, significance and classification of duplicates and the method to find duplicates in a systematic review. Notably, although a preliminary method to find duplicates is established, its usefulness and convenience need to be further confirmed.
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McFarland LV, Goh S. Preventing pediatric antibiotic-associated diarrhea and Clostridium difficile infections with probiotics: A meta-analysis. World J Meta-Anal 2013; 1:102-120. [DOI: 10.13105/wjma.v1.i3.102] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 10/01/2013] [Accepted: 10/20/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To assess the efficacy and safety of probiotics for preventing pediatric: (1) antibiotic associated diarrhea and (2) Clostridium difficile (C. difficile) infections.
METHODS: On June 3, 2013, we searched PubMed (1960-2013), EMBASE (1974-2013), Cochrane Database of Systematic Reviews (1990-2013), CINAHL (1981-2013), AMED (1985-2013), and ISI Web of Science (2000-2013). Additionally, we conducted an extensive grey literature search including contact with National Institutes of Health Clinical Trials Registry, abstracts from annual infectious disease and gastroenterology meetings, experts in the field and correspondence with authors. The primary outcomes were the incidence of antibiotic-associated diarrhea (AAD) and C. difficile infections (CDI). Dichotomous outcomes (e.g., incidence of AAD or CDI) were pooled using a random-effects model to calculate the relative risk and corresponding 95% confidence interval (95%CI) and weighted on study quality. To explore possible explanations for heterogeneity, a priori subgroup analysis were conducted on probiotic strain type, daily dose, quality of study and safety of probiotics. The overall quality of the evidence supporting each outcome was assessed using the grading of recommendations, assessment, development and evaluation criteria.
RESULTS: A total of 1329 studies were identified with 22 trials (23 treatment arms and 4155 participants) meeting eligibility requirements for our review of prevention of AAD and 5 trials (1211 participants) for the prevention of CDI. Trials in adult populations, trials of uncertain antibiotic exposure or studies which did not provide incidence of AAD were excluded. We found 12 trials testing a single strain of probiotic and 10 trials testing a mixture of probiotic strains. Probiotics (all strains combined) significantly reduced the incidence of pediatric AAD (pooled RR = 0.42, 95%CI: 0.33-0.53) and significantly reduced pediatric CDI (pooled RR = 0.35, 95%CI: 0.13-0.92). Of the two strains with multiple trials, both significantly reduced pediatric AAD: Saccharomyces boulardii lyo (pooled RR = 0.43, 95%CI: 0.32-0.60) and Lactobacillus rhamnosus GG (pooled RR = 0.36, 95%CI: 0.19-0.69). There was no significant effect by type of antibiotic, or by duration or dose of probiotic. No adverse events associated were found in the 22 controlled trials relating to the use of probiotics.
CONCLUSION: This meta-analysis found that probiotics significantly prevented pediatric antibiotic associated diarrhea and pediatric CDI, but the efficacy varies significantly by the strain of the probiotic.
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Zhang H, Zhu YQ, Qi J, Wang QX, Cai SS, Zhu SY, Zhu XW, Wang XT. Accuracy of early detection of colorectal tumours using stool methylation markers: A meta-analysis. World J Meta-Anal 2013; 1:147-156. [DOI: 10.13105/wjma.v1.i3.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 10/07/2013] [Accepted: 11/05/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the accuracy of methylation of genes in stool samples for diagnosing colorectal tumours.
METHODS: Electronic databases including PubMed, Web of Science, Chinese Journal Full Text Database and Wanfang Journals Full-text Database were searched to find relevant original articles about methylated genes used in diagnosing colorectal tumours. Quality assessment of diagnostic accuracy studies items were used to evaluate the quality of the included articles, and the Meta-disc 1.4 and SPSS 13.0 software programs were used for data analysis.
RESULTS: Thirty-four articles met the inclusion criteria, and 4151 patients were included. Pooled diagnostic performances of SFRP2 methylation for colorectal cancer (CRC) provided the following results: the sensitivity was 79% (95%CI: 75%-82%), the specificity was 93% (95%CI: 90%-96%), the diagnostic odds ratio (DOR) was 47.57 (95%CI: 20.08-112.72), and the area under the curve was 0.9565. Additionally, the results of accuracy of SFRP2 methylation for detecting colorectal adenomas were as follows: the sensitivity was 43% (95%CI: 38%-49%), the specificity was 94% (95%CI: 91%-97%), the DOR was 11.06 (95%CI: 5.77-21.18), and the area under the curve was 0.9563.
CONCLUSION: Stool-based DNA testing may be useful for non-invasively diagnosing colorectal tumours, and SFRP2 methylation is a promising marker that has great potential in early CRC diagnosis.
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Fry JS, Lee PN, Forey BA, Coombs KJ. Dose-response relationship of lung cancer to amount smoked, duration and age starting. World J Meta-Anal 2013; 1:57-77. [DOI: 10.13105/wjma.v1.i2.57] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Revised: 05/09/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To quantify smoking/lung cancer relationships accurately using parametric modelling.
METHODS: Using the International Epidemiological Studies on Smoking and Lung Cancer database of all epidemiological studies of 100+ lung cancer cases published before 2000, we analyzed 97 blocks of data for amount smoked, 35 for duration of smoking, and 27 for age started. Pseudo-numbers of cases and controls (or at risk) estimated from RRs by dose level formed the data modelled. We fitted various models relating loge RR to dose (d), including βd, βdY and βloge (1 + Wd), and investigated goodness-of-fit and heterogeneity between studies.
RESULTS: The best-fitting models for loge RR were 0.833 loge [1 + (8.1c/10)] for cigarettes/d (c), 0.792 (y/10)0.74 for years smoked (y) and 0.176 [(70 - a)/10]1.44 for age of start (a). Each model fitted well overall, though some blocks misfitted. RRs rose from 3.86 to 22.31 between c = 10 and 50, from 2.21 to 13.54 between y = 10 and 50, and from 3.66 to 8.94 between a = 30 and 12.5. Heterogeneity (P < 0.001) existed by continent for amount, RRs for 50 cigarettes/d being 7.23 (Asia), 26.36 (North America) and 22.16 (Europe). Little heterogeneity was seen for duration of smoking or age started.
CONCLUSION: The models describe the dose-relationships well, though may be biased by factors including misclassification of smoking status and dose.
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Ye YC, Xie HZ, Zhao XL, Zhang SY. Subclinical hypothyroidism and the metabolic syndrome: A meta-analysis of cross-sectional studies. World J Meta-Anal 2013; 1:90-96. [DOI: 10.13105/wjma.v1.i2.90] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Accepted: 08/06/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the relationship between subclinical hypothyroidism (SCH) and the metabolic syndrome (MS).
METHODS: We performed a systematic search of databases [MEDLINE (July 1950 to July 2012), EMBASE (July 1966 to July 2012)] and the references of identified studies. Completely published cross-sectional studies of a general population involving SCH and the MS were included. The pooled odds ratio and weighted mean difference (WMD) for the outcomes were calculated using random-effects models.
RESULTS: Six cross-sectional studies with 19546 participants were included. In total, 398 of 1324 participants (30.06%) in the SCH group had the MS compared with 4975 of 18222 participants (27.30%) in the euthyroid group [OR = 1.20; 95%CI: 1.05-1.36; P = 0.004; χ2 = 2.53 (P = 0.773); I2 = 0%]. Further analysis of the components of the MS showed that SCH was associated with increased body mass index (WMD, 0.32 kg/m2; 95%CI: 0.04-0.61; P = 0.026), systolic blood pressure (WMD, 2.62 mmHg; 95%CI: 1.35-3.89; P < 0.001) and triglyceride (WMD, 0.25 mmol/L; 95%CI: 0.23-0.28; P < 0.001).
CONCLUSION: Based on the cross-sectional data, SCH may be associated with an increased risk of the MS, which could be attributed to the increased risk of metabolic components.
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Midha T, Nath B, Kumari R, Rao YK, Pandey U. Prevalence of hypertension in India: A meta-analysis. World J Meta-Anal 2013; 1:83-89. [DOI: 10.13105/wjma.v1.i2.83] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 04/26/2013] [Accepted: 06/04/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To determine the prevalence of hypertension in the urban and rural population of India.
METHODS: Relevant studies were identified through computer based and manual searches using MEDLINE/ PubMed, Google scholar, EMBASE, Cochrane Library and reference lists of prevalence studies from January 2000 to June 2012. A total of 12 studies were included in the meta-analysis of hypertension in urban India and 10 studies in the analysis of hypertension in rural India after applying the inclusion and exclusion criteria. Estimates of prevalence were calculated using the random effect model for meta-analysis.
RESULTS: The electronic search using appropriate keywords identified 177 titles for prevalence of hypertension in urban India, of which 165 were excluded, and 133 titles for prevalence in rural India, of which 123 were excluded after applying the inclusion criteria. Twelve studies including 125333 subjects were analyzed to assess the prevalence of hypertension in the urban Indian population, whereas ten studies including 24800 subjects were analyzed to determine the prevalence of hypertension in the rural Indian population. The prevalence of hypertension in the urban population was estimated to be 40.8% (95%CI: 40.5%-41.0%) and that of hypertension in the rural population was 17.9% (95%CI: 17.5%-18.3%). It is evident that the prevalence of hypertension is significantly higher in the urban population of India compared to the rural.
CONCLUSION: Current evidence suggests that policies and interventions should be prioritized for reduction of hypertension in the adult Indian population, especially the urban population.
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272
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Miguel A, Henriques F, Marques B, Marques J, Freitas A, Lopes F, Azevedo L, Pereira AC. Ophthalmic adverse drug reactions: A nationwide detection using hospital databases. World J Meta-Anal 2013; 1:78-82. [DOI: 10.13105/wjma.v1.i2.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 07/19/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To detect ophthalmic adverse drug reactions (ADRs), that occurred in Portugal from 2000 to 2009, through the utilization of administrative hospital databases. We also intended to compare the results of this methodology with spontaneous reporting.
METHODS: We conducted a retrospective nationwide study using hospital administrative databases, which included all inpatients and outpatients in all public hospitals in Portugal, from 2000 to 2009. We used International Classification of Diseases - 9th Revision - Clinical Modification (ICD-9-CM) coding data that allowed the detection of ADRs. We used WHO’s definition for ADR. We searched all of ICD-9-CM terms in Ophthalmology for codes that included “drug-induced”, “iatrogenic”, “toxic” and all other that could signal an ADR, such as “362.55 - toxic maculopathy” or “365.03 - steroid responders”, and also “E” codes (codes from E930 to E949.9, that exclude intoxications and errors).
RESULTS: From 11944725 hospitalizations or ambulatory episodes within that period of time, we identified 1524 probable ophthalmic ADRs (corresponding to a frequency of 1.28 per 10000 episodes) and an additional 100 possible ophthalmic ADRs. We used only 4 person-hours in the application of this methodology. A total of 113 spontaneous reports arose from ophthalmic ADRs from 2000 to 2009 in Portugal (frequency of 0.095 per 10000 episodes).To our knowledge, this was the first estimate of the frequency of ophthalmic ADRs through the use of databases, and the first nationwide estimate of ophthalmic ADRs, in Portugal. We identified 1524 probable ADRs and 100 possible ADRs.
CONCLUSION: This database methodology adapted for Ophthalmology may represent a new approach for the detection of ophthalmic ADRs, since these codes exist in the ICD-9-CM classification. Its performance was clearly superior to spontaneous reporting.
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273
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Godfrey JD, Clark RE, Choudhary A, Ashraf I, Matteson ML, Puli SR, Bechtold ML. Ascorbic acid and low-volume polyethylene glycol for bowel preparation prior to colonoscopy: A meta-analysis. World J Meta-Anal 2013; 1:10-15. [DOI: 10.13105/wjma.v1.i1.10] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 03/20/2013] [Accepted: 04/10/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the benefits of low-volume polyethylene glycol (PEG) with ascorbic acid compared to full-dose PEG for colonoscopy preparation.
METHODS: MEDLINE, Cochrane Central Register of Controlled Trials and Database of Systematic Reviews, CINAHL, PubMed, and recent abstracts from major conferences were searched (January 2012). Only randomized-controlled trials on adult subjects comparing low-volume PEG (2 L) with ascorbic acid vs full-dose PEG (3 or 4 L) were included. Meta-analysis for the efficacy of low-volume PEG with ascorbic acid and full-dose PEG were analyzed by calculating pooled estimates of number of satisfactory bowel preparations as well as adverse patient events (abdominal pain, nausea, vomiting). Separate analyses were performed for each main outcome by using OR with fixed and random effects models. Heterogeneity was assessed by calculating the I2 measure of inconsistency. RevMan 5.1 was utilized for statistical analysis.
RESULTS: The initial search identified 242 articles and trials. Nine studies (n = 2911) met the inclusion criteria and were analyzed for this meta-analysis with mean age range from 53.0 to 59.6 years. All studies were randomized controlled trials on adult patients comparing large-volume PEG solutions (3 or 4 L) with low-volume PEG solutions and ascorbic acid. No statistically significant difference was noted between low-volume PEG with ascorbic acid and full-dose PEG for number of satisfactory bowel preparations (OR 1.07, 95%CI: 0.86-1.33, P = 0.56). No statistically significant difference was noted between low-volume PEG with ascorbic acid and full-dose PEG for abdominal pain (OR 1.09, 95%CI: 0.81-1.48, P = 0.56), nausea (OR 0.70, 95%CI: 0.49-1.00, P = 0.05), or vomiting (OR 0.99, 95%CI: 0.78-1.26, P = 0.95). No publication bias was noted.
CONCLUSION: Low-volume PEG with the addition of ascorbic acid demonstrates no statistically significant difference to full-dose PEG for satisfactory bowel preparation and side-effects.
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Leng WD, Zeng XT, Chen YJ, Zhan ZQ, Yang Y. Periodontal disease is associated with increased coronary heart disease risk: A meta-analysis based on 38 case-control studies. World J Meta-Anal 2013; 1:47-56. [DOI: 10.13105/wjma.v1.i1.47] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 04/04/2013] [Accepted: 05/08/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To investigate whether periodontal disease (PD) is associated with increasing coronary heart disease (CHD) risk by performing a meta-analysis.
METHODS: Two authors independently searched PubMed and China National Knowledge Infrastructure up to January 10th, 2013 for relevant case-control studies that investigated the association between PD and CHD. After quality assessment using Newcastle-Ottawa Scale and data extraction by two independent authors, the overall and subgroup meta-analyses were performed and publication bias were examined using the Comprehensive Meta-Analysis V2 software. Potential publication bias was assessed using visual inspection of the funnel plots, Egger linear regression test, and trims and fill method.
RESULTS: Finally 38 relevant case-control studies were identified, involving 4950 CHD patients and 5490 controls. Eleven studies were rated low quality and 27 were high quality. Based on random-effects, a significant association was identified between PD and CHD (OR 3.79, 95%CI: 2.23-6.43, P < 0.001, I2 = 98.59%), and sensitivity analysis showed that this result was robust. Subgroup analyses according to adjusted/unadjusted ORs, source of control, methodological quality, end point, assessment of PD/CHD, and ethnicity also indicated a significant association. Publication bias was detected, and the estimated OR including the “missing” studies did not substantially differ from our estimate with adjustment for missing studies (OR 4.15, 95%CI: 2.62-6.54, P < 0.001).
CONCLUSION: Based on the meta-analysis, PD is probably associated with CHD risk independently and significantly.
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Sato F, Sawamura M, Ojima M, Tanaka K, Hanioka T, Tanaka H, Matsuo K. Smoking increases risk of tooth loss: A meta-analysis of the literature. World J Meta-Anal 2013; 1:16-26. [DOI: 10.13105/wjma.v1.i1.16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 05/08/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To quantitatively evaluate the impact of smoking on tooth loss.
METHODS: We performed a PubMed search to identify published articles that investigated the risk of tooth loss by smoking, from which RRs and their variance with characteristics of each study were extracted. The random-effects models were used to derive a pooled effect across studies. Potential sources of heterogeneity on the characteristics of the study and their influence on the pooled effect size were investigated using meta-regression models.
RESULTS: We identified 24 studies containing a total of 95973 participants for analysis. The pooled RR of ever-smokers compared with never- smokers was 1.73 (95%CI: 1.60-1.86, P < 0.001). In meta-regression analysis, only the mean age of participants alone was identified as a statistically significant source of heterogeneity. The effect of smoking on tooth loss was stronger when the mean age of study participants was higher, indicating possible enhancement of tooth loss due to aging by smoking. RR was significantly lower in former smokers (1.49, 95%CI: 1.32-1.69, P < 0.001) than in current smokers (2.10, 95%CI: 1.87-2.35, P < 0.001), indicating the substantial benefit of smoking cessation for reducing the risk of tooth loss.
CONCLUSION: Smoking is an independent risk factor for tooth loss regardless of many other confounders. Smoking cessation may attenuate this effect.
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276
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Biondi-Zoccai G, Anderson LA. What is the purpose of launching World Journal of Meta-Analysis? World J Meta-Anal 2013; 1:1-4. [DOI: 10.13105/wjma.v1.i1.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 05/08/2013] [Indexed: 02/05/2023] Open
Abstract
The exponential growth of scientific evidence (i.e., primary research) and the ongoing development of methods to summarize such evidence, such as meta-analyses and mixed treatment comparisons (i.e., secondary research), make the worldwide dissemination of high-quality meta-analyses and pertinent articles a key scientific priority. The World Journal of Meta-Analysis will apply an electronic open access publishing approach combined with a timely and thorough peer-review of submitted manuscripts, weighing more on quality than priority, in order to improve the dissemination of systematic reviews and meta-analyses, as well as novelties and advancements in methods related to them, focusing on clinical medicine, but spanning all biomedical, epidemiological, and psychological research fields.
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Brigo F, Igwe SC. Meta-analyses in the wonderland of neurology. World J Meta-Anal 2013; 1:5-7. [DOI: 10.13105/wjma.v1.i1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2013] [Revised: 03/23/2013] [Accepted: 04/10/2013] [Indexed: 02/05/2023] Open
Abstract
Meta-analyses are often misused and underused in neurology. This editorial provides some comments on the role of meta-analyses in neurological research. Recently, a huge increase in the number of meta-analyses and systematic reviews has been observed in neurological journals. The major strengths of meta-analyses are the increase of statistical power. However, as for any other investigative tool, meta-analytic research is a research method itself which can produce severe shortcomings. Specifically, the issues of search terms, time periods of published studies, databases used for searching, the definitions of inclusion and exclusion criteria for papers (which greatly affect clinical heterogeneity), publication bias; and the statistical methods used, dramatically influence the results of meta-analyses. The main problem of meta-analyses is that they cannot be expected to overcome the limitations of the studies they include (the so-called “garbage in, garbage out” phenomenon). Furthermore, most systematic reviews in the neurological literature lead to the unsatisfying and clinically frustrating statement “further studies are needed”. However it is much more frustrating to see how the gaps in scientific knowledge identified by meta-analyses have not been translated into serious efforts to fill them. Besides their role in evaluating efficacy and tolerability of drugs, meta-analyses may be used to assess diagnostic values of debatable clinical findings, as they represent powerful tools to try to answer questions not posed by individual studies and to settle controversies arising from conflicting claims.
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Undela K. Sirturo (Bedaquiline): The first new anti tubercular drug in decades. World J Meta-Anal 2013; 1:8-9. [DOI: 10.13105/wjma.v1.i1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 02/22/2013] [Accepted: 03/07/2013] [Indexed: 02/05/2023] Open
Abstract
Tuberculosis (TB) is an infection caused by Mycobacterium tuberculosis and is one of the world’s deadliest diseases. Multidrug resistant TB (MDR-TB) is a serious form of TB and it implies resistance for at least two essential first-line agents like, Isoniazid and Rifampicin. The US Food and Drug Administration (FDA) granted accelerated approval to Janseen Therapeutics “Sirturo (Bedaquiline)”, a diarylquinoline anti mycobacterial drug on December 28, 2012 as part of combination therapy in adults (≥ 18 years) to treat MDR-TB when other alternatives are not available. The FDA also granted Sirturo fast track designation, priority review and orphan-product designation. Bedaquiline inhibits mycobacterial ATP (adenosine 5’-triphosphate) synthase, an enzyme that is essential for the generation of energy in Mycobacterium tuberculosis.
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Kamioka H, Tsutani K, Yamada M, Park H, Okuizumi H, Honda T, Okada S, Park SJ, Kitayuguchi J, Handa S, Mutoh Y. Effectiveness of rehabilitation based on recreational activities: A systematic review. World J Meta-Anal 2013; 1:27-46. [DOI: 10.13105/wjma.v1.i1.27] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 04/16/2013] [Accepted: 05/10/2013] [Indexed: 02/05/2023] Open
Abstract
AIM: To summarize the evidence from randomized controlled trials (RCTs) on the rehabilitation effects of recreational activities.
METHODS: Studies were eligible if they were RCTs. Studies included one treatment group in which recreational activity was applied. We searched the following databases from 1990 to May 31, 2012: MEDLINE via PubMed, CINAHL, Web of Science, and Ichushi-Web. We also searched all Cochrane Databases and Campbell Systematic Reviews up to May 31, 2012.
RESULTS: Eleven RCTs were identified, which included many kinds of target diseases and/or symptoms such as stroke, dementia, Parkinson’s disease, acquired brain injury, chronic non-malignant pain, adolescent obesity, high-risk pregnancy, and the frail elderly. Various intervention methods included gaming technology, music, dance, easy rider wheelchair biking, leisure education programs, and leisure tasks. The RCTs conducted have been of relatively low quality. A meta-analysis (pooled sample; n = 44, two RCTs) for balance ability using tests such as “Berg Balance Scale” and “Timed Up and Go Test” based on game intervention revealed no significant difference between interventions and controls. In all other interventions, there were one or more effects on psychological status, balance or motor function, and adherence as primary or secondary outcomes.
CONCLUSION: There is a potential for recreational activities to improve rehabilitation-related outcomes, particularly in psychological status, balance or motor function, and adherence.
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