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Artsitas S, Artsitas D, Koronaki I, Toutouzas KG, Zografos GC. Comparing robotic and open partial nephrectomy under the prism of surgical precision: a meta-analysis of the average blood loss rate as a novel variable. J Robot Surg 2024; 18:313. [PMID: 39112829 PMCID: PMC11306375 DOI: 10.1007/s11701-024-02060-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Accepted: 07/22/2024] [Indexed: 08/10/2024]
Abstract
Exploration of surgical precision in robotic procedures is extensive, yet lacks a unified framework for comparability. This study examines tissue handling precision by comparing the per-minute blood loss rate between robotic and open partial nephrectomy. A literature search from August 2022 to June 2024 identified 43 relevant studies providing data on estimated blood loss and procedure duration. The expected values and standard errors of these variables were used to compute the per-minute blood loss rate (Q). Meta-analytical methods estimated pooled and subgroup-level mean differences, favoring robotic surgery (MDQ = - 1.043 ml/min, CI95% = [- 1.338; - 0.747]). Subgroup analyses by publication year, patient matching, referral center count, and ROBINS-I status consistently supported this advantage. Sensitivity analyses confirmed the above benefit in studies with increased accuracy in reported results (MDQ = - 0.957 ml/min, CI95% = [- 1.269; - 0.646]), low risk of bias involving matched comparisons (MDQ = - 0.563 ml/min, CI95% = [- 0.716; - 0.410]), large sample sizes and increased statistical power (MDQ = - 0.780 ml/min, CI95% = [- 1.134; - 0.425]), and multicenter analyses with patient matching (MDQ = - 0.481 ml/min, CI95% = [- 0.698; - 0.263]). The subsequent analysis of correlation between the original variables suggested a slight reduction in the robotic advantage when the latter were proportionally related. Multilevel meta-regression at both temporal and qualitative scales consistently indicated a comparative benefit of the robotic approach. Potentially, lower per-minute blood loss compared to open surgery suggests that robotic partial nephrectomy demonstrates enhanced precision in tissue handling.
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Affiliation(s)
- Sotirios Artsitas
- Geniko Nosokomeio Athenon Ippokrateio, Vasilisis Sofias str. 114, 11527, Athens, Greece.
- 1st Propaedeutic Department of Surgery, School of Medicine, National and Kapodistrian University of Athens (NKUA), Mikras Asias str. 75, 11527, Athens, Greece.
- National and Kapodistrian University of Athens (NKUA), Mikras Asias str. 75, 11527, Athens, Greece.
| | - Dimitrios Artsitas
- 2nd Department of Orthopaedics, KAT Attica General Hospital, Nikis str. 2, Kifissia, 14561, Athens, Greece
| | - Irene Koronaki
- National Technical University of Athens (NTUA), Zografou Campus, Heroon Polytechniou str. 9, 15780, Athens, Greece
- Laboratory of Applied Thermodynamics, School of Mechanical Engineering, National Technical University of Athens (NTUA), Heroon Polytechniou str. 9, 15780, Athens, Greece
| | - Konstantinos G Toutouzas
- Geniko Nosokomeio Athenon Ippokrateio, Vasilisis Sofias str. 114, 11527, Athens, Greece
- 1st Propaedeutic Department of Surgery, School of Medicine, National and Kapodistrian University of Athens (NKUA), Mikras Asias str. 75, 11527, Athens, Greece
- National and Kapodistrian University of Athens (NKUA), Mikras Asias str. 75, 11527, Athens, Greece
| | - George C Zografos
- Geniko Nosokomeio Athenon Ippokrateio, Vasilisis Sofias str. 114, 11527, Athens, Greece
- 1st Propaedeutic Department of Surgery, School of Medicine, National and Kapodistrian University of Athens (NKUA), Mikras Asias str. 75, 11527, Athens, Greece
- National and Kapodistrian University of Athens (NKUA), Mikras Asias str. 75, 11527, Athens, Greece
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Bakovic M, Starsiak L, Bennett S, McCaffrey R, Mantilla-Rivas E, Manrique M, Rogers GF, Oh AK. Socioeconomic Influence on Surgical Management and Outcomes in Patients with Craniosynostosis - A Systematic Review. Cleft Palate Craniofac J 2024:10556656241261838. [PMID: 38881366 DOI: 10.1177/10556656241261838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024] Open
Abstract
OBJECTIVE Disparities in insurance and socioeconomic status (SES) may impact surgical management and subsequent postoperative outcomes for patients with craniosynostosis. This systematic review summarizes the evidence on possible differences in surgical care, including procedure type, age at surgery, and differences in surgical outcomes such as complications, length of hospital stay, and child development based on SES. DESIGN The databases Scopus, PubMed, and CINAHL were searched between May and July 2022. Following PICO criteria, studies included focused on patients diagnosed with craniosynostosis; corrective surgery for craniosynostosis; comparison of insurance, income, or zip code; and surgical management of postoperative outcomes. RESULTS The initial search yielded 724 articles. After three stages of screening, 13 studies were included. Assessed outcomes included: type of procedure (6 articles), age at time of surgery (3 articles), post-operative complications (3 articles), referral delay (2 articles), length of stay (2 articles), hospital costs (2 articles), and child development (1 article). Of the studies with significant results, insurance type was the main SES variable of comparison. While some findings were mixed, these studies indicated that patients with public medical insurance were more likely to experience a delay in referral, undergo an open rather than minimally-invasive procedure, and have more complications, longer hospitalization, and higher medical charges. CONCLUSIONS This study demonstrated that SES may be associated with several differences in the management of patients with craniosynostosis. Further investigation into the impact of SES on the management of patients with craniosynostosis is warranted to identify possible interventions that may improve overall care.
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Affiliation(s)
- Melanie Bakovic
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Lilliana Starsiak
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Spencer Bennett
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Ryan McCaffrey
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Esperanza Mantilla-Rivas
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Monica Manrique
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Gary F Rogers
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
| | - Albert K Oh
- Division of Plastic and Reconstructive Surgery, Children's National Hospital, Washington, DC, USA
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Yu A, Truong Q, Whitfield K, Hale A, Taing MW, Barker N, D'Emden M. Impact of preoperative haemoglobin A 1c levels on postoperative outcomes in adults undergoing major noncardiac surgery: A systematic review. Diabet Med 2024:e15380. [PMID: 38853752 DOI: 10.1111/dme.15380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/28/2024] [Indexed: 06/11/2024]
Abstract
AIMS Diabetes is known to increase morbidity and mortality after major surgery. However, literature is conflicting on whether elevated preoperative haemoglobin A1c (HbA1c) levels are associated with worse outcomes following major noncardiac surgery. We aimed to investigate the effect of incremental preoperative HbA1c levels on postoperative outcomes in adults who had undergone major noncardiac surgery. METHODS We systematically searched PubMed, EMBASE and the Cochrane Library databases for eligible studies published between January 2012 and July 2023. Randomised controlled trials and observational studies (cohort and case-control studies) which measured HbA1c within 6 months before surgery and compared outcomes between at least three incremental subgroups or analysed HbA1c as a continuous variable were included. The systematic review protocol was registered with PROSPERO (CRD42023391946). RESULTS Twenty observational studies investigating outcomes across multiple surgical types were included. Higher preoperative HbA1c levels were associated with increased odds of overall postoperative complications, postoperative acute kidney injury, anastomotic leak, surgical site infections and increased length of stay. Each 1% increase in preoperative HbA1c was associated with increased odds of these complications. No association with reoperations and 30-day mortality was identified. The literature was highly variable with respect to composite major complications, perioperative cardiovascular events, hospital readmissions, postoperative pneumonia and systemic thromboembolism. CONCLUSIONS Current evidence suggested that higher preoperative HbA1c levels were associated with increased odds of postoperative complications and extended length of stay in adults undergoing major noncardiac surgery. Further high-quality studies would be needed to quantify the risks posed and determine whether early intervention improves outcomes.
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Affiliation(s)
- Abby Yu
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
- Department of Pharmacy, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Quynh Truong
- Department of Endocrinology, Cairns Base Hospital, Cairns, Queensland, Australia
| | - Karen Whitfield
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Andrew Hale
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Meng-Wong Taing
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Natalie Barker
- Herston Health Sciences Library, The University of Queensland, Herston, Queensland, Australia
| | - Michael D'Emden
- School of Medicine, The University of Queensland, Herston, Queensland, Australia
- Department of Endocrinology and Diabetes, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Bhadauria US, Purohit B, Priya H. Access to dental care in individuals with disability: a systematic review. Evid Based Dent 2024; 25:111. [PMID: 38225370 DOI: 10.1038/s41432-024-00970-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024]
Abstract
OBJECTIVE This systematic review was conducted to explore the factors influencing access to oral health services and to identify and examine the strategies to improve the access. MATERIALS AND METHODS PubMed, Scopus and Embase databases were searched. Studies except editorials reported in English regardless of the study design were included. Risk of Bias assessment was carried out using Agency for Healthcare Research and Quality, Newcastle Ottawa Scale and The Joanna Briggs Institute tool for cross-sectional, case-control and cohort and qualitative studies, respectively. RESULTS In total, 11,372 records were initially identified, eventually leading to 12 relevant publications to be included in the review. Individuals valued oral health but found it difficult to access oral health services. Dental care was mainly accessed during emergencies and participants felt apprehensive in visiting dentists. Caregiver's and dentist's perspective was also reported. CONCLUSION There is a need for provision of education, training and increasing awareness on dental hygiene and annual dental checkups to improve access.
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Affiliation(s)
- Upendra Singh Bhadauria
- Division of Public Health Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India
| | - Bharathi Purohit
- Division of Public Health Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India
| | - Harsh Priya
- Division of Public Health Dentistry, Centre for Dental Education and Research, AIIMS, New Delhi, India.
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Farhadi Hassankiadeh R, Dobson A, Rahimi S, Jalilian A, Schmid VJ, Mahaki B. Spatial Distribution and Birth Prevalence of Congenital Heart Disease in Iran: A Systematic Review and Hierarchical Bayesian Meta-analysis. Int J Health Policy Manag 2024; 13:7931. [PMID: 39099509 PMCID: PMC11270618 DOI: 10.34172/ijhpm.2024.7931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 04/07/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND This study aimed to comprehensively analyze the overall congenital heart disease (CHD) prevalence in live births and children in Iran, along with evaluating the spatial distribution of CHD birth prevalence across various geographical regions within the country. METHODS A Bayesian hierarchical meta-analysis (PROSPERO 2022: CRD42022331281) was performed to determine the pooled prevalence. A systematic search was conducted using Web of Science, ScienceDirect, PubMed, Iranian Research Institute for Information Science and Technology (IranDoc), Scientific Information Database (SID), and Magiran until October 4, 2023. Cross-sectional and cohort studies in both English and Persian languages, focusing on the age range of 0-10 years, were considered for the study population. The study quality was evaluated using the Agency for Healthcare Research and Quality (AHRQ) Risk of Bias tool. Heterogeneity was assessed by I2 and τ2 statistics, and publication bias by Egger's and Begg's tests. RESULTS The meta-analysis included 62 studies, revealing an overall CHD prevalence of 2.5 per 1000 births. Over time, CHD birth prevalence in Iran has consistently increased. Spatial distribution analysis, including spatial autocorrelation and local spatial autocorrelation, indicated no spatial clustering (P=.46) or aggregation (P=.65) among Iran's provinces. Geographic disparities were significant (P=.000), with the northern and eastern regions showing the highest and lowest CHD prevalence, respectively. CONCLUSION The overall CHD prevalence in Iran is lower than global rates, but it continues to rise. Furthermore, there are variations in birth prevalence among different regions of Iran. Environmental, genetic, socioeconomic, and diagnostic accessibility differences are possibly involved in regional variation. The limitations like heterogeneity among studies, the potential inaccuracy of reports due to limited use of accurate diagnostic methods in some studies, and the absence of population-based models to investigate prevalence, underscore the urgent need for standardized diagnostic approaches, and the utilization of population-wide birth defect registries to accurately assess CHD prevalence in Iran.
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Affiliation(s)
| | - Annette Dobson
- School of Public Health, University of Queensland, Brisbane, QLD, Australia
| | - Somayeh Rahimi
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Volker J. Schmid
- Department of Statistics, LudwigMaximilians-University, Munich, Germany
| | - Behzad Mahaki
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Beech J, Jones B, Hughes T, Emmonds S. Injury Profile in Youth Female Athletes: A Systematic Review and Meta-Analysis. Sports Med 2024; 54:1207-1230. [PMID: 38263483 PMCID: PMC11127887 DOI: 10.1007/s40279-023-01988-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2023] [Indexed: 01/25/2024]
Abstract
BACKGROUND An increasing number of epidemiological studies assessing the incidence, prevalence and severity of injury in youth female sport are available. However, no study has sought to synthesise the current evidence base across all youth female sport. As such, a systematic review and meta-analysis of injury in this cohort is necessary to understand the diversity of injury and its associated burden between sports in addition to identifying the density of research available. OBJECTIVE To conduct a systematic review and meta-analysis of epidemiological data of injuries in youth female athletes with particular attention to injury incidence, mean days lost and injury burden. METHODS Searches were performed in PubMed, EBSCO (SPORTDiscus with Full Text MEDLINE, APA PsycINFO, CINAHL, Academic Search Complete) and Cochrane databases. Studies were considered if they reported time-loss injury incidence or prevalence in youth female (≤ 19 years old) athletes. Study quality and risk of bias were assessed using STROBE-SIIS extension, Newcastle-Ottawa Scale, and funnel plots, respectively. Injury incidence and burden rate data were modelled using a mixed-effect Poisson regression model. Days lost data were modelled using a generalised linear mixed model. RESULTS Thirty-two studies were included. The overall incidence rate, mean days lost per injury, and burden rate were 4.4 injuries per 1000 h (95% CI 3.3-5.9), 10 days (95% CI 6-15), and 46 days per 1000 h (95% CI 23-92), respectively. Forty percent of athletes sustained at least one time-loss injury. Competitive level was a significant moderator of match and training injury incidence, with elite youth athletes presenting greater pooled injury incidence estimates than non-elite athletes (p = 0.0315 and p = 0.0047, respectively). The influence of moderators on days lost and injury burden could not be determined due to an insufficient number of studies for analysis. CONCLUSION Despite a broad inclusion criterion, there is limited injury surveillance research available across youth female sport. Outside of soccer, little research density is evidenced with single studies available in popular team sports such as Australian football and rugby union. Insufficient study numbers reporting mean days lost and injury burden data were available for analysis, and pooled days lost data could only be estimated for soccer. This highlights a need for future research to report days lost data alongside injury number and exposure so burden can be calculated and the full risk of injury to youth female athletes can be identified.
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Affiliation(s)
- Jake Beech
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK.
- The Football Association, Burton-Upon-Trent, UK.
| | - Ben Jones
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- England Performance Unit, The Rugby Football League, Leeds, UK
- Leeds Rhinos Rugby League Club, Leeds, UK
- Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, the University of Cape Town and the Sports Science Institute of South Africa, Cape Town, South Africa
- School of Science and Technology, University of New England, Armidale, NSW, Australia
| | - Thomas Hughes
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| | - Stacey Emmonds
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
- The Football Association, Burton-Upon-Trent, UK
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Bhadauria US, Purohit B, Nilima N, Priya H. Oral health in individuals with bleeding disorders: A systematic review and meta-analysis. Haemophilia 2024; 30:658-670. [PMID: 38629184 DOI: 10.1111/hae.15009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 03/09/2024] [Accepted: 03/20/2024] [Indexed: 05/15/2024]
Abstract
BACKGROUND Individuals with bleeding disorders have been reported to have a number of oral health issues due to varying conditions. A comprehensive evaluation of the different oral health conditions has not been carried out in the past. This systematic review and meta-analysis was carried out to collate and critically analyse existing research, and provide a comprehensive overview of the current state of knowledge on oral health. METHODS A comprehensive search was conducted in electronic databases, including PubMed, Scopus and Embase, in October 2023. No restriction on time frame or language was applied. The risk of bias for cross-sectional studies was assessed using the Agency for Healthcare Research and Quality (AHRQ) tool, and case control studies were assessed using the New Castle Ottawa Scale (NOS). RESULTS Twenty-two articles were included in the final analysis with a total sample size of 2422 subjects. Of the 22 articles assessed, nine quantitative assessments were included in the Meta analysis. Pooled data analysis was carried out. A total of 13 studies reported medium risk whereas the remaining nine studies showed low risk of bias. The weighted mean DMFT scores in individuals with bleeding disorders were found to be 2.43 [0.62. 4.24], mean dmft was 2.79 [1.05, 4.53] and mean OHI-S was reported to be 1.79 [1.00, 2.57], respectively. CONCLUSION The findings emphasize that these individuals have fair oral hygiene and lower dmft/DMFT scores. Oral bleeding emerged as an important oral health component to be cautiously dealt with particularly during the stages of exfoliation/shedding.
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Affiliation(s)
| | - Bharathi Purohit
- Division of Public Health Dentistry, CDER, -AIIMS, New Delhi, India
| | - Nilima Nilima
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Harsh Priya
- Division of Public Health Dentistry, CDER, -AIIMS, New Delhi, India
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Gamal-AbdelNaser A, A Elsabour MAA, Khattab NMA. Caries in orphan children: prevalence and determinants-a systematic review and meta-analysis. BMC Oral Health 2024; 24:381. [PMID: 38528487 PMCID: PMC10964678 DOI: 10.1186/s12903-024-04125-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/08/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Orphan children represent a category of children who lost their family support. Their health status is poorer when compared to their parented counterparts. As the most prevalent disease in the world, dental caries is expected to affect orphans greatly. Being vulnerable, health status of orphan children must be monitored and studied; so that health improvement plans would be formulated. Therefore, this systematic review focuses on the extent of the dental caries problem among institutionalized orphan children and its determinants. METHODS The review has two outcomes: comparing caries experience of institutionalized children to their parented counterparts, and reviewing the determinants of caries in the exposure group. Two systematic searches (one for each outcome) were run on MedLine via PubMed, Cochrane library, LILACS, Egyptian knowledge bank (EKB) and Google Scholar; beside hand search and searching grey literature. RESULTS The searches yielded 17,760, followed by 16,242 records for the first and second outcomes respectively. The full text was screened for 33 and 103 records for the two outcomes respectively; after translating non-English reports. Finally, the review included 9 records to address the first outcome and 21 records for the second. The pooled results showed that the exposure group may show slightly poorer caries experience regarding permanent teeth (pooled mean difference of DMF = 0.09 (-0.36, 0.55)); but they have a much poorer caries experience regarding primary teeth health (pooled mean difference of dmf = (0.64 (-0.74, 2.01)). Meta-analysis of the caries determinants showed that institutionalization increases the risk of caries by 19%. Gender showed slight effect on caries risk with males being more affected; while primary teeth revealed higher risk of caries when compared to permanent teeth. CONCLUSION Limited by the heterogeneity and risk of bias of the included studies, meta-analyses concluded that institutionalized orphan children have higher risk of caries. Yet, the institutionalization circumstances were not well-documented in all the included studies. So, the complete picture of the children's condition was not possibly sketched. TRIAL REGISTRATION Protocol has been registered online on the PROSPERO database with an ID CRD42023443582 on 24/07/2023.
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Affiliation(s)
- Ayat Gamal-AbdelNaser
- Department of Oral Medicine and Periodontology, Faculty of Oral and Dental Medicine, Ahram Canadian University, 4th Industrial Zone, Banks Complex, 6th of October City, Giza, Egypt.
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Beheshti Maal A, Shahrbaf MA, Sadri B, Hossein-Khannazer N, Mansournia MA, Vosough M. Prevalence of Hepatobiliary Manifestations in Inflammatory Bowel Disease: A GRADE Assessed Systematic Review and Meta-Analysis of more than 1.7 Million Patients. J Crohns Colitis 2024; 18:360-374. [PMID: 37695111 DOI: 10.1093/ecco-jcc/jjad157] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease [IBD] comprises an immune-mediated group of chronic gastrointestinal disorders. Patients with IBD may experience extraintestinal manifestations, such as hepatobiliary complications. This meta-analysis aims to assess the prevalence of different hepatic manifestations in IBD patients. METHODS For this systematic review and meta-analysis, PubMed, Scopus, Web of Science, and Embase were searched until July 20, 2022, by specifying keywords for IBD, hepatic manifestations, and study type. Full texts of cohort studies in English that examined the prevalence of different hepatic manifestations were included in this study. The primary outcome was the overall prevalence of hepatic manifestations in IBD patients. For the statistical analysis, a proportion by random effect model meta-analysis was performed. The registration number for the protocol of this study in PROSPERO is CRD42022369595. RESULTS From the 4421 articles retrieved from the primary search, 118 met the inclusion criteria and were included in the final analysis. After a pooled analysis of 1 729 128 patients, the overall prevalence of hepatic manifestations was 3.49% (95% confidence interval [CI]: 3.31-3.68%; I2: 99.55%). The pooled prevalence of non-alcoholic fatty liver disease in 228 216 patients was 26.1% [95% CI: 22.1-30.2%; I2: 99.018%]. After pooled analysis of 9642 patients, the prevalence of primary sclerosing cholangitis was 1.67% [95% CI: 1.47-1.88%; I2: 99.10%]. The pooled prevalence of biliary stones was 4.1% [95% CI: 3.6-4.7%; I2: 97.43%]. Autoimmune hepatitis (0.51% [95% CI: 0.26-0.75%]; I2: 85.36%) and portal vein thrombosis (0.21% [95% CI: 0.08-0.33%]; I2: 97.95%) are considered as rare manifestations. CONCLUSION This study summarizes the prevalence and importance of different hepatic manifestations in IBD patients. These findings are crucial for the management of extraintestinal manifestations, especially hepatic manifestations, in IBD patients.
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Affiliation(s)
- Alireza Beheshti Maal
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Shahrbaf
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Bahareh Sadri
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Nikoo Hossein-Khannazer
- Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Massoud Vosough
- Department of Regenerative Medicine, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
- Experimental Cancer Medicine, Institution for Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
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Zhang W, Shen Y, Ou X, Wang H, Liu S. Sleep disordered breathing and neurobehavioral deficits in children and adolescents: a systematic review and meta-analysis. BMC Pediatr 2024; 24:70. [PMID: 38245707 PMCID: PMC10799548 DOI: 10.1186/s12887-023-04511-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 12/26/2023] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Sleep disordered breathing (SDB) is broadly recognized to be associated with neurobehavioral deficits, which have significant impacts on developing-aged children and adolescents. Therefore, our study aimed to quantify the proportion of neurobehavioral impairments attributed to SDB in general children and adolescents by population attributable fraction (PAF). METHODS The study was registered at PROSPERO (ID: CRD42023388143). We collected two types of literature on the prevalence of SDB and the risk of SDB-related neurobehavioral deficits from ten electronic databases and registers, respectively. The pooled effect sizes (Pe, Pc, RR) by random-effects meta-analysis were separately substituted into Levin's formula and Miettinen's formula to calculate PAFs. RESULTS Three prevalence literature and 2 risk literature, all with moderate/high quality, were included in the quantitative analysis individually. The prevalence of SDB was 11% (95%CI 2%-20%) in children and adolescents (Pe), while the SDB prevalence was 25% (95%CI 7%-42%) in neurobehavioral patients (Pc). SDB diagnosis at baseline was probably associated with about threefold subsequent incidence of neurobehavioral deficits (pooled RR 3.24, 95%CI 1.25-8.41), after multi-adjustment for key confounders. Up to 19.8% or 17.3% of neurobehavioral consequences may be attributed to SDB from Levin's formula and Miettinen's formula, respectively. CONCLUSIONS A certain number of neurobehavioral consequences may be attributable to SDB. It is essential for clinicians to identify and treat SDB timely, as well as screen for SDB in patients with neurobehavioral impairments. More longitudinal studies of SDB and neurobehavioral deficits are needed in the future to further certify the association between them.
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Affiliation(s)
- Weiyu Zhang
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Yubin Shen
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Xiwen Ou
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Hongwei Wang
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China
| | - Song Liu
- Department of Respiratory Medicine and Sleep Lab, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200092, China.
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Marcolin P, Machado Berleze M, Polettini J, Marchesan Rodrigues MA, Augustin Silveira D. The Impact of Helicobacter pylori on Laparoscopic Sleeve Gastrectomy Postoperative Complications: a Systematic Review and Meta-analysis. Obes Surg 2023; 33:3649-3657. [PMID: 37798512 DOI: 10.1007/s11695-023-06858-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/13/2023] [Accepted: 09/24/2023] [Indexed: 10/07/2023]
Abstract
We aimed to assess the impact of Helicobacter pylori infection on postoperative outcomes following laparoscopic sleeve gastrectomy (LSG). We searched Cochrane, Scopus, and PubMed databases, reviewed 1026 studies, and thoroughly analyzed 42 of them. Our final analysis included 13 studies comprising 6199 patients. We found that H. pylori infection was correlated with higher rates of risk of overall postoperative complications (OR 1.56; 95% CI 1.13, 2.16; P = 0.007) and staple line leak (OR 1.89; 95% CI 1.05, 3.41; P = 0.03). There were no significant differences in hospital length of stay or postoperative bleeding rates. Despite observed correlations between H. pylori positivity in gastric specimen and postoperative complications in LSG, definitive causation remains elusive, emphasizing the need for prospective randomized studies evaluating the effect of preoperative H. pylori screening and eradication.
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Affiliation(s)
- Patrícia Marcolin
- Universidade Federal da Fronteira Sul (UFFS), Rua Capitão Araújo, 20, Passo Fundo, RS, 99010121, Brazil
| | - Matheus Machado Berleze
- Universidade Federal da Fronteira Sul (UFFS), Rua Capitão Araújo, 20, Passo Fundo, RS, 99010121, Brazil.
| | - Jossimara Polettini
- Universidade Federal da Fronteira Sul (UFFS), Rua Capitão Araújo, 20, Passo Fundo, RS, 99010121, Brazil
| | - Maria A Marchesan Rodrigues
- Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Avenida Professor Mário Rubens Guimarães Montenegro, S/N, Botucatu, SP, 18618687, Brazil
| | - Daniela Augustin Silveira
- Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Avenida Professor Mário Rubens Guimarães Montenegro, S/N, Botucatu, SP, 18618687, Brazil
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Mukhtar NB, Ibrahim AA, Mohammed J. Prevalence of neck pain and its associated factors in Africa: a systematic review and meta-analysis protocol. BMJ Open 2023; 13:e074219. [PMID: 37723112 PMCID: PMC10510921 DOI: 10.1136/bmjopen-2023-074219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023] Open
Abstract
INTRODUCTION Neck pain is one of the most prevalent musculoskeletal pain conditions with multifactorial impact including pain, disability and reduced quality of life. To the best of our knowledge, no systematic review and meta-analysis is available to provide reliable data on the pooled prevalence of neck pain and its associated factors in Africa. Thus, the objective of this study is to describe a protocol for a systematic review and meta-analysis on the prevalence of neck pain and its associated factors in Africa. METHODS This systematic review protocol has been designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). A systematic search will be conducted among six key electronic databases including PubMed/MEDLINE, Scopus, African Journals Online, EMBASE, CINAHL and Web of Science, from inception onwards. Population-based cross-sectional studies reporting prevalence of neck pain in the African continent will be included. The primary outcome will be the prevalence of neck pain, whereas the secondary outcomes will be the factors associated with neck pain prevalence. Two independent reviewers will screen the titles/abstracts and relevant full-text articles of potentially relevant studies. Data from eligible studies will be extracted using a customised data extraction form. The risk of bias and methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale and critical appraisal tool, respectively. A narrative synthesis will be used to summarise the prevalence estimates of neck pain and associated factors. However, if feasible, random-effects meta-analysis will be conducted with Revman V.5.4 software. Additionally, subgroup, sensitivity and publication bias analyses will be conducted. DISCUSSION This will be the first systematic review and meta-analysis to systematically identify and synthesise available literature on the prevalence of neck pain and its associated factors in Africa. The results of this review may assist health professionals and policymakers to plan and implement evidence-based strategies that will lessen the burden of neck pain. ETHICS AND DISSEMINATION Data from previously published studies will be collected and analysed and hence ethical approval will not be sought for this study. The results of this review will be disseminated through publication in a peer-reviewed academic journal and presentation at relevant academic conferences. PROSPERO REGISTRATION NUMBER CRD42021273585.
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Affiliation(s)
- Naziru Bashir Mukhtar
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
- Department of Physiotherapy, School of Health Sciences, Maryam Abacha American University of Nigeria, Kano, Nigeria
| | - Aminu Alhassan Ibrahim
- Department of Physiotherapy, School of Basic Medical Sciences, Skyline University Nigeria, Kano, Nigeria
| | - Jibril Mohammed
- Department of Physiotherapy, Faculty of Allied Health Sciences, College of Health Sciences, Bayero University, Kano, Nigeria
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Moreira J, Silva B, Faria H, Santos R, Sousa ASP. Systematic Review on the Applicability of Principal Component Analysis for the Study of Movement in the Older Adult Population. SENSORS (BASEL, SWITZERLAND) 2022; 23:205. [PMID: 36616803 PMCID: PMC9823400 DOI: 10.3390/s23010205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/28/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Principal component analysis (PCA) is a dimensionality reduction method that has identified significant differences in older adults' motion analysis previously not detected by the discrete exploration of biomechanical variables. This systematic review aims to synthesize the current evidence regarding PCA use in the study of movement in older adults (kinematics and kinetics), summarizing the tasks and biomechanical variables studied. From the search results, 1685 studies were retrieved, and 19 studies were included for review. Most of the included studies evaluated gait or quiet standing. The main variables considered included spatiotemporal parameters, range of motion, and ground reaction forces. A limited number of studies analyzed other tasks. Further research should focus on the PCA application in tasks other than gait to understand older adults' movement characteristics that have not been identified by discrete analysis.
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Affiliation(s)
- Juliana Moreira
- Center for Rehabilitation Research–Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
- Research Center in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, 4200-450 Porto, Portugal
| | - Bruno Silva
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Hugo Faria
- School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Rubim Santos
- Center for Rehabilitation Research–Human Movement System (Re)habilitation Area, Department of Physics, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
| | - Andreia S. P. Sousa
- Center for Rehabilitation Research–Human Movement System (Re)habilitation Area, Department of Physiotherapy, School of Health, Polytechnic of Porto, 4200-072 Porto, Portugal
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Wang X, Liu Q. Prevalence of anxiety symptoms among Chinese university students amid the COVID-19 pandemic: A systematic review and meta-analysis. Heliyon 2022; 8:e10117. [PMID: 35965987 PMCID: PMC9364719 DOI: 10.1016/j.heliyon.2022.e10117] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/11/2022] [Accepted: 07/25/2022] [Indexed: 12/23/2022] Open
Abstract
College students in China are particularly vulnerable to worry. In the meanwhile, the COVID-19 pandemic might worsen anxiety symptoms. However, due to the inconsistency of many studies regarding anxiety symptoms, it has proven challenging to provide accurate psychiatric health treatments to undergraduates. Therefore, in order to determine the prevalence of anxiety among Chinese university students during the COVID-19 epidemic, this study will undertake a systematic review and meta-analysis. English databases (i.e Embase (Ovid), APA PsycInfo, Medline, Pubmed, Cochrane Library) were utilized to identify papers that provide information on the incidence of anxiety among Chinese college students during the pandemic. Two authors evaluated the qualifications of relevant studies, assessed the risk of bias (RoB), and retrieved data. RoB was evaluated using the cross-sectional study quality evaluation criteria from the American Agency for HealthCare Quality and Research (AHRQ). Three hundred seventy-three records were retrieved. Twenty-five studies were eventually included, involving 1,003,743 Chinese college students. The findings of the study identified that the pooled prevalence of anxiety symptoms was 25.0% (95% CI: 21%–29%, P < 0.001), and those among medical-related professionals were lower than those of the general population (22.1% vs. 25%, P < 0.001). In addition, the prevalence of studies with more female respondents was higher than those with fewer female respondents (26.4% vs. 8%). In the later phases of the COVID-19 pandemic compared to the early stages, anxiety prevalence is higher (29.1% vs. 17.2%). Finally, using meta-regression to explore the source of heterogeneity, this study found that the most potential source was whether the graduate students or otherwise. This meta-analysis revealed that during the COVID-19 pandemic, a quarter of Chinese college students had anxiety symptoms. Therefore, it is necessary to provide continuous psychological assessment and treatment services for college students.
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Affiliation(s)
- Xiaohang Wang
- School of Public Administration, Hohai University, 211100, Nanjing, Jiangsu, China
| | - Quzhi Liu
- Center for Mental Health and Psychological Service, Hohai University, 211100, Nanjing, Jiangsu, China
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Wu Y, Amirfakhraei A, Ebrahimzadeh F, Jahangiry L, Abbasalizad-Farhangi M. Screen Time and Body Mass Index Among Children and Adolescents: A Systematic Review and Meta-Analysis. Front Pediatr 2022; 10:822108. [PMID: 35620148 PMCID: PMC9127358 DOI: 10.3389/fped.2022.822108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background There is no summative quantitative study that report the difference in BMI in high screen user children and adolescents or give a difference in screen time in children and adolescents with obesity vs. children and adolescents without obesity. In the current meta-analysis we systematically summarized the association between obesity and screen time and meta-analyzed the results. Methods A systematic search from Scopus, PubMed and Embase electronic databases. Studies that evaluated the association between screen time and obesity up to June 2021. Results Results revealed that those at the highest screen time category had 0.7 kg/m2 higher BMI (WMD = 0.703; CI = 0.128, 1.278; P < 0.016; I 2 = 95.8%). Moreover, children and adolescents with obesity had a mean value of 0.313 h higher screen time compared with children and adolescents without obesity (WMD: 0.313; OR = 0.219, 0.407; P < 0.001; I 2 = 96%). The results of subgrouping showed that study quality, continent and sample size could reduce the heterogeneity values. No evidence of publication bias was reported according to visual asymmetry of funnel plots and the results of Begg's and Egger's tests. Conclusion For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and obesity among children and adolescents. Due to the cross-sectional design of the included studies, causal inference is impossible, therefore, further studies in separate analysis of both genders are suggested to better elucidate gender-specific results. Systematic Review Registration [www.ClinicalTrials.gov], identifier [CRD4202123 3899].
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Affiliation(s)
- Yiling Wu
- Department of Pediatrics, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Azita Amirfakhraei
- Department of Psychology, Bandar Abbas Branch, Islamic Azad University, Bandar Abbas, Iran
| | - Farnoosh Ebrahimzadeh
- Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Leila Jahangiry
- Department of Health Education and Health Promotion, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
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