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Annals of Surgery Feb 2016To investigate the preventive effect of antireflux surgery against esophageal adenocarcinoma (EAC) compared with medical treatment of gastroesophageal reflux disease... (Comparative Study)
Comparative Study Meta-Analysis Review
OBJECTIVE
To investigate the preventive effect of antireflux surgery against esophageal adenocarcinoma (EAC) compared with medical treatment of gastroesophageal reflux disease (GERD) and to the background population.
BACKGROUND
GERD is causally associated with EAC. Effective symptomatic treatment can be achieved with medication and antireflux surgery; however the possible preventive effect on EAC development remains unclear.
METHODS
This systematic review identified 10 studies comparing EAC risk after antireflux surgery with nonoperated GERD patients, including 7 studies of patients with Barrett's esophagus, and 2 studies comparing EAC risk after antireflux surgery to the background population. A fixed-effects Poisson meta-analysis was conducted to calculate pooled incidence rate ratios (IRR) and 95% confidence intervals (CIs).
RESULTS
The pooled IRR in patients after antireflux surgery was 0.76 (95% CI 0.42-1.39) compared with medically treated GERD patients. In patients with Barrett's esophagus, the corresponding IRR was 0.46 (95% CI 0.20-1.08), and 0.26 (95% CI 0.09-0.79) when restricted to publications after 2000. There was no difference in EAC risk between antireflux surgery and medical treatment in GERD patients without known Barrett's esophagus (IRR 0.98, 95% CI 0.72-1.33). The EAC risk remained elevated in patients after antireflux surgery compared with the background population (IRR 10.78, 95% CI 8.48-13.71). Although the clinical heterogeneity of the included studies was high, the statistical heterogeneity was low.
CONCLUSIONS
Antireflux surgery may prevent EAC better than medical therapy in patients with Barrett's esophagus. The EAC risk after antireflux surgery does not seem to revert to that of the background population.
Topics: Adenocarcinoma; Antacids; Esophageal Neoplasms; Fundoplication; Gastroesophageal Reflux; Humans; Models, Statistical; Poisson Distribution; Proton Pump Inhibitors; Risk Factors; Treatment Outcome
PubMed: 26501714
DOI: 10.1097/SLA.0000000000001438 -
World Journal of Gastroenterology Jul 2015To perform a systematic review and meta-analysis on robotic-assisted vs laparoscopic liver resections. (Meta-Analysis)
Meta-Analysis Review
AIM
To perform a systematic review and meta-analysis on robotic-assisted vs laparoscopic liver resections.
METHODS
A systematic literature search was performed using PubMed, Scopus and the Cochrane Library Central. Participants of any age and sex, who underwent robotic or laparoscopic liver resection were considered following these criteria: (1) studies comparing robotic and laparoscopic liver resection; (2) studies reporting at least one perioperative outcome; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy rates.
RESULTS
A total of 7 articles, published between 2010 and 2014, fulfilled the selection criteria. The laparoscopic approach was associated with a significant reduction in blood loss and lower operative time (MD = 83.96, 95%CI: 10.51-157.41, P = 0.03; MD = 68.43, 95%CI: 39.22-97.65, P < 0.00001, respectively). No differences were found with respect to conversion rate, R1 resection rate, morbidity and hospital stay.
CONCLUSION
Laparoscopic liver resection resulted in reduced blood loss and shorter surgical times compared to robotic liver resections. There was no difference in conversion rate, R1 resection rate, morbidity and length of postoperative stay.
Topics: Adult; Aged; Aged, 80 and over; Blood Loss, Surgical; Chi-Square Distribution; Female; Hepatectomy; Humans; Laparoscopy; Length of Stay; Male; Middle Aged; Odds Ratio; Operative Time; Postoperative Complications; Risk Factors; Robotic Surgical Procedures; Time Factors; Treatment Outcome
PubMed: 26217097
DOI: 10.3748/wjg.v21.i27.8441 -
European Journal of Cancer (Oxford,... Mar 2018Phosphoinositide 3-kinase (PI3K) inhibitors may overcome drug resistance and improve advanced breast cancer (ABC) outcomes. We conducted a systematic review and... (Meta-Analysis)
Meta-Analysis Review
Phosphoinositide 3-kinase (PI3K) inhibitors may overcome drug resistance and improve advanced breast cancer (ABC) outcomes. We conducted a systematic review and meta-analysis to assess the efficacy and safety of adding a PI3K inhibitor to the standard of care (SOC) treatment in ABC. The electronic databases Ovid, PubMed, Cochrane Central Register of Controlled Trials and Embase, were searched for relevant randomised trials. Pooled hazard ratios (HRs) for progression-free survival (PFS) and pooled risk ratios (RRs) for objective response rates (ORRs), disease control rates (DCRs) and toxicity were meta-analysed using the Mantel-Haenszel method and generic inverse variance. Five studies were included. In unselected patients, the addition of a PI3K inhibitor decreased the risk of progression by 21% (2329 participants, HR = 0.79; 95% confidence interval [CI], 0.71-0.88). A marginal improvement in ORR (2329 participants, RR = 1.26; 95% CI, 1.01-1.57) and no improvement in DCR (2146 participants, RR = 1.05; 95% CI, 0.94-1.18) were achieved with a significant increase in toxicity of any grade (2386 participants, RR = 1.05; 95% CI, 1.03-1.06) and of grade III and higher (2386 participants, RR = 1.91; 95% CI, 1.76-2.08). A PFS benefit was seen in patients with and without PI3K pathway activation assessed on tumour and only in patients with an activated PI3K pathway when it was assessed from the plasma using circulating tumour DNA (ct-DNA) analysis. The addition of a PI3K inhibitor decreases the risk of progression in unselected ABC patients and particularly in patients with an activated PI3K pathway detected on ct-DNA analysis. However, their significant dose-limiting toxicity is a limiting factor. Selective PI3K inhibitors are being tested to assess whether these better-tolerated agents have a role in ABC treatment.
Topics: Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Chi-Square Distribution; Clinical Trials, Phase II as Topic; Clinical Trials, Phase III as Topic; Disease Progression; Disease-Free Survival; Female; Humans; Odds Ratio; Phosphatidylinositol 3-Kinase; Phosphoinositide-3 Kinase Inhibitors; Protein Kinase Inhibitors; Randomized Controlled Trials as Topic; Risk Factors; Signal Transduction; Time Factors; Treatment Outcome
PubMed: 29331750
DOI: 10.1016/j.ejca.2017.12.010 -
Diagnostics (Basel, Switzerland) Aug 2022A limited number of studies investigated the association between the ABO blood groups and the incidence of venous thromboembolism in individuals with Factor V Leiden;... (Review)
Review
A limited number of studies investigated the association between the ABO blood groups and the incidence of venous thromboembolism in individuals with Factor V Leiden; however, discordant findings were reported. Consequently, this systematic review and meta-analysis aimed to evaluate the existing evidence on the susceptibility of the ABO blood group to venous thromboembolism in individuals with Factor V Leiden. All English-published articles on the Web of Science, Scopus, PubMed, EMBASE, and Google Scholar were comprehensively and systematically searched by the author without a time or region limit. Four studies were included in the qualitative synthesis and meta-analysis after the removal of studies that were not eligible. According to the analyses of the fixed and random effects, the point estimates of the effect size and the 95% confidence interval were 0.416 (95% CI: 0.397−0.435) and 0.392 (95% CI: 0.288−0.507), respectively. In contrast, the homogeneity test (Q value) reveals that blood group data distributions have a heterogenous structure (Q = 432.187; p-value < 0.001). The pooled event rates and the 95% CIs for the A, AB, B, and O-blood groups were 0.518 (95% CI: 0.411−0.622), 0.592 (95% CI: 0.495−0.683), 0.205 (95% CI: 0.041−0.612), and 0.283 (95% CI: 0.247−0.322), respectively. According to the findings, people with Factor V Leiden with blood group AB are more likely to develop venous thromboembolism than those with blood groups A, O, and B. The overall statistical significance of the ABO blood group’s susceptibility to venous thromboembolism in individuals with Factor V Leiden was <0.001 (pooled p-value). In conclusion, the current meta-analysis provides an additional indication that blood group AB individuals with Factor V Leiden are at higher risk of developing venous thromboembolism, and blood type B is connected to a lower risk of developing venous thromboembolism.
PubMed: 36010287
DOI: 10.3390/diagnostics12081936 -
Nutrients Mar 2018The aim of is to determine the association of vitamins with glaucoma by performing a systematic review and meta-analyses. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The aim of is to determine the association of vitamins with glaucoma by performing a systematic review and meta-analyses.
METHODS
Studies on the relation of vitamins and glaucoma published up to December 2017 were identified in the PubMed and Embase database. Data on vitamins (method of assessment), glaucoma (type and method of assessment), study characteristics and quality were recorded. In case of multiple studies for one nutrient a meta-analysis was performed.
RESULTS
A total of 629 articles were identified of which 36 were included in the systematic review. The meta-analysis included five of them (940 open-angle glaucoma (OAG) cases and 123,697 controls in total) and resulted in an odds ratio [95% confidence interval] (OR [95% CI]) of 0.58 [0.37-0.91] for dietary vitamin A, though heterogeneity was high (I² = 51%). After omitting studies that contributed significantly to the heterogeneity, the pooled OR [95% CI] was 0.45 [0.30-0.68] for dietary vitamin A on OAG (I² = 0%). For vitamin B1, C and E no significant association with OAG was found (OR [95% CI]: 0.84 [0.47-1.51]; 0.68 [0.38-1.22]; 0.95 [0.75-1.19]; respectively). However, after addressing heterogeneity, vitamin C showed a protective effect as well. Especially, foods high in these vitamins (e.g., dark green vegetables) were protective for OAG.
CONCLUSIONS
Dietary intake of vitamin A and C showed a beneficial association with OAG; however, findings on blood levels of vitamins do not show a clear relation with OAG.
Topics: Adult; Aged; Ascorbic Acid; Chi-Square Distribution; Diet; Glaucoma, Open-Angle; Humans; Middle Aged; Odds Ratio; Prevalence; Prognosis; Protective Factors; Risk Factors; Vitamin A
PubMed: 29547516
DOI: 10.3390/nu10030359 -
International Journal of Rheumatic... Aug 2016To investigate the association between giant cell arteritis (GCA) and risk of peripheral arterial disease (PAD). (Meta-Analysis)
Meta-Analysis Review
AIM
To investigate the association between giant cell arteritis (GCA) and risk of peripheral arterial disease (PAD).
METHODS
We conducted a systematic review and meta-analysis of observational cohort studies that reported relative risks, hazard ratios or standardized incidence ratios with 95% confidence comparing PAD risk in patients with GCA versus non-GCA subjects. Pooled risk ratios and 95% confidence intervals were calculated using a random-effect, generic inverse variance of DerSimonian and Laird.
RESULTS
Four studies with 9789 patients with GCA and 236 728 controls were identified and included in our data analysis. The pooled risk ratio of PAD among patients with GCA compared with controls was 1.88 (95% CI 1.04-3.41). The statistical heterogeneity was high with an I(2) of 89%.
CONCLUSION
Our study demonstrated a statistically significant increased risk of PAD among patients with GCA.
Topics: Case-Control Studies; Chi-Square Distribution; Giant Cell Arteritis; Humans; Observational Studies as Topic; Odds Ratio; Peripheral Arterial Disease; Risk Factors
PubMed: 26218931
DOI: 10.1111/1756-185X.12631 -
Clinical Proteomics 2020During the last two decades, over 100 proteomics studies have identified a variety of potential biomarkers in CSF of Alzheimer's (AD) patients. Although several reviews... (Review)
Review
BACKGROUND
During the last two decades, over 100 proteomics studies have identified a variety of potential biomarkers in CSF of Alzheimer's (AD) patients. Although several reviews have proposed specific biomarkers, to date, the statistical relevance of these proteins has not been investigated and no peptidomic analyses have been generated on the basis of specific up- or down- regulation. Herein, we perform an analysis of all unbiased explorative proteomics studies of CSF biomarkers in AD to critically evaluate whether proteins and peptides identified in each study are consistent in distribution; direction change; and significance, which would strengthen their potential use in studies of AD pathology and progression.
METHODS
We generated a database containing all CSF proteins whose levels are known to be significantly altered in human AD from 47 independent, validated, proteomics studies. Using this database, which contains 2022 AD and 2562 control human samples, we examined whether each protein is consistently present on the basis of reliable statistical studies; and if so, whether it is over- or under-represented in AD. Additionally, we performed a direct analysis of available mass spectrometric data of these proteins to generate an AD CSF peptide database with 3221 peptides for further analysis.
RESULTS
Of the 162 proteins that were identified in 2 or more studies, we investigated their enrichment or depletion in AD CSF. This allowed us to identify 23 proteins which were increased and 50 proteins which were decreased in AD, some of which have never been revealed as consistent AD biomarkers (i.e. SPRC or MUC18). Regarding the analysis of the tryptic peptide database, we identified 87 peptides corresponding to 13 proteins as the most highly consistently altered peptides in AD. Analysis of tryptic peptide fingerprinting revealed specific peptides encoded by CH3L1, VGF, SCG2, PCSK1N, FBLN3 and APOC2 with the highest probability of detection in AD.
CONCLUSIONS
Our study reveals a panel of 27 proteins and 21 peptides highly altered in AD with consistent statistical significance; this panel constitutes a potent tool for the classification and diagnosis of AD.
PubMed: 32518535
DOI: 10.1186/s12014-020-09276-9 -
Nutrition, Metabolism, and... Mar 2017The generation of reactive oxygen species (ROS) plays an important role in the etiology of several pathological conditions. High levels of 8-hydroxy-2-deoxyguanosine... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND AND AIMS
The generation of reactive oxygen species (ROS) plays an important role in the etiology of several pathological conditions. High levels of 8-hydroxy-2-deoxyguanosine (8-OHdG), a biomarker of oxidative damage of DNA, have been found in patients with heart failure (HF). We performed a meta-analysis of the literature to investigate the association between 8-OHdG levels and HF.
METHODS AND RESULTS
A systematic search was performed in the PubMed, Web of Science, Scopus, EMBASE databases and studies evaluating 8-OHdG levels in HF patients and controls were included. Differences between cases and controls were expressed as standard mean difference (SMD) or mean difference (MD) with pertinent 95% confidence intervals (95%CI). Impact of clinical and demographic features on effect size was assessed by meta-regression. Six studies (446 HF patients and 140 controls) were included in the analysis. We found that HF patients showed higher 8-OHdG levels than controls (SMD:0.89, 95%CI: 0.68, 1.10). The difference was confirmed both in studies in which 8-OHdG levels were assessed in urine (MD:6.28 ng/mg creatinine, 95%CI: 4.01, 8.56) and in blood samples (MD:0.36 ng/ml, 95%CI: 0.04, 0.69). Interestingly, 8-OHdG levels progressively increased for increasing New York Heart Association (NYHA) class. Meta-regression models showed that none of clinical and demographic variables impacted on the difference in 8-OHdG levels among HF patients and controls.
CONCLUSIONS
8-OHdG levels are higher in HF patients HF than in controls, with a progressive increase for increasing NYHA class. However, larger prospective studies are needed to test 8-OHdG as a biomarker of HF severity and progression.
Topics: 8-Hydroxy-2'-Deoxyguanosine; Biomarkers; Chi-Square Distribution; DNA Damage; Deoxyguanosine; Heart Failure; Humans; Myocardium; Oxidative Stress; Predictive Value of Tests; Prognosis; Risk Factors; Severity of Illness Index; Stroke Volume; Up-Regulation; Ventricular Function, Left
PubMed: 28065503
DOI: 10.1016/j.numecd.2016.10.009 -
BMC Cancer Oct 2019Studies on relationship between tubal ligation and endometrial cancer have led to contradictory findings. In several studies, however, a reduced endometrial cancer risk... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Studies on relationship between tubal ligation and endometrial cancer have led to contradictory findings. In several studies, however, a reduced endometrial cancer risk was suggested following tubal ligation. Therefore, a systematic review and meta-analysis was conducted to examine the relationship between tubal ligation and endometrial cancer risk.
METHODS
In this systematic review and meta-analysis, PubMed/Medline, Web of Science, Scopus, Embase, and Google Scholar were searched for relevant studies published up to May 30th, 2018. We compared endometrial cancer risk in women with and without tubal ligation in retrieved studies.
RESULTS
Two hundred nine studies were initially retrieved from the data bases. After exclusion of duplicates and studies which did not meet inclusion criteria, ten cohort and case-control studies, including 6,773,066 cases, were entered into the quantitative meta-analysis. There was 0.90% agreement between two researchers who searched and retrieved the studies. The summary OR (SOR) was reported using a random effect model. Begg's test suggested that there was no publication bias, but a considerable heterogeneity was observed (I = 95.4%, P = 0.001). We pooled the raw number of tables cells (i.e. a, b, c, and d) of eight studies. The SOR suggested that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR = 0.577, 95% CI = 0.420-0.792). Also, given the rare nature of endometrial cancer (< 5%), different effect sizes were considered as comparable measures of risk. Therefore we pooled ten studies and SOR of these studies revealed that tubal ligation was significantly associated with a lower risk of endometrial cancer (SOR = 0.696, 95% CI = 0.425-0.966). Besides that, we pooled eight studies in which adjusted effect sizes were reported and a subsequent analysis revealed that the summary estimate of adjusted odds ratio (SAOR) was significant (SAOR = 0.862, 95% CI = 0.698-1.026).
CONCLUSIONS
This study revealed a protective effect of tubal ligation on endometrial cancer risk (approximately 42% lower risk of cancer). It is recommended that studies should be designed to reveal mechanisms of this relationship.
Topics: Adolescent; Adult; Aged; Chi-Square Distribution; Endometrial Neoplasms; Female; Humans; Incidence; Middle Aged; Odds Ratio; Risk; Sterilization, Tubal; Young Adult
PubMed: 31604465
DOI: 10.1186/s12885-019-6174-3 -
Expert Review of Gastroenterology &... Jan 2017The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. Areas covered: Studies conducted... (Meta-Analysis)
Meta-Analysis Review
The safety of laparoscopic resections (LPS) of pancreatic neuroendocrine neoplasms (PNENs) has been well established in the literature. Areas covered: Studies conducted between January 2003 and December 2015 that reported on LPS and open surgery (OPS) were reviewed. The primary outcomes were the rate of post-operative complications and the length of hospital stay (LoS) after laparoscopic and open surgical resection. The rate of recurrence was the secondary outcome. Eleven studies were included with a total of 907 pancreatic resections for PNENs, of whom, 298 (32.8%) underwent LPS and 609 (67.2%) underwent open surgery. LPS resulted in a significantly shorter LoS (p < 0.0001) and lower blood loss (p < 0.0001). The meta-analysis did not show any significant difference in the pancreatic fistula rate, recurrence rate or post-operative mortality between the two groups. Expert commentary: LPS is a safe approach even for PNENs and it is associated with a shorter LoS.
Topics: Blood Loss, Surgical; Chi-Square Distribution; Humans; Laparoscopy; Length of Stay; Neoplasm Recurrence, Local; Neuroendocrine Tumors; Odds Ratio; Pancreatectomy; Pancreatic Fistula; Pancreatic Neoplasms; Risk Factors; Time Factors; Treatment Outcome
PubMed: 27781493
DOI: 10.1080/17474124.2017.1253473