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Ophthalmology Oct 2013To evaluate the association between refractive errors and age-related macular degeneration (AMD). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To evaluate the association between refractive errors and age-related macular degeneration (AMD).
MAIN OUTCOME MEASURES
A clear understanding of the relationship between refractive error and AMD provides insights into the pathophysiology of AMD.
METHODS
We searched PubMed and Embase from their inception to July 2012 for population-based studies with data on refractive error and AMD assessed from retinal photographs at baseline and follow-up. We performed separate meta-analyses for cross-sectional studies and cohort studies using adjusted odds ratios (ORs) and hazard ratios (HRs) under random effects models, respectively.
RESULTS
Analysis of the 6 cross-sectional studies showed that hyperopia was associated with higher odds of prevalent AMD (pooled OR hyperopia vs. emmetropia: 1.16; 95% confidence interval [CI], 1.04-1.29) and that myopia was associated with lower odds of prevalent AMD (pooled OR myopia vs. emmetropia: 0.75; 95% CI, 0.61-0.92). Analysis from the 3 cohort studies showed nonsignificant associations. Analysis of the 5 cross-sectional and 2 cohort studies showed that each diopter increase in spherical equivalent was associated with increased odds of both prevalent (pooled OR, 1.09; 95% CI, 1.06-1.12) and incident (pooled HR, 1.06; 95% CI, 1.02-1.10) AMD. In 3 cross-sectional studies with data on axial length, each millimeter increase in axial length was associated with a decreased odd of prevalent AMD (pooled OR, 0.76; 95% CI, 0.69-0.85).
CONCLUSIONS
Refractive error is associated with AMD, although a temporal relationship cannot be determined on the basis of current evidence. Ophthalmologists should be aware that risk of AMD clinically seems to vary by refractive status.
FINANCIAL DISCLOSURE(S)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Topics: Humans; Macular Degeneration; Refractive Errors
PubMed: 23706699
DOI: 10.1016/j.ophtha.2013.03.028 -
PloS One 2014To summarize relevant evidence investigating the associations between refractive error and age-related macular degeneration (AMD). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To summarize relevant evidence investigating the associations between refractive error and age-related macular degeneration (AMD).
DESIGN
Systematic review and meta-analysis.
METHODS
We searched Medline, Web of Science, and Cochrane databases as well as the reference lists of retrieved articles to identify studies that met the inclusion criteria. Extracted data were combined using a random-effects meta-analysis. Studies that were pertinent to our topic but did not meet the criteria for quantitative analysis were reported in a systematic review instead.
MAIN OUTCOME MEASURES
Pooled odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between refractive error (hyperopia, myopia, per-diopter increase in spherical equivalent [SE] toward hyperopia, per-millimeter increase in axial length [AL]) and AMD (early and late, prevalent and incident).
RESULTS
Fourteen studies comprising over 5800 patients were eligible. Significant associations were found between hyperopia, myopia, per-diopter increase in SE, per-millimeter increase in AL, and prevalent early AMD. The pooled ORs and 95% CIs were 1.13 (1.06-1.20), 0.75 (0.56-0.94), 1.10 (1.07-1.14), and 0.79 (0.73-0.85), respectively. The per-diopter increase in SE was also significantly associated with early AMD incidence (OR, 1.06; 95% CI, 1.02-1.10). However, no significant association was found between hyperopia or myopia and early AMD incidence. Furthermore, neither prevalent nor incident late AMD was associated with refractive error. Considerable heterogeneity was found among studies investigating the association between myopia and prevalent early AMD (P = 0.001, I2 = 72.2%). Geographic location might play a role; the heterogeneity became non-significant after stratifying these studies into Asian and non-Asian subgroups.
CONCLUSION
Refractive error is associated with early AMD but not with late AMD. More large-scale longitudinal studies are needed to further investigate such associations.
Topics: Aged; Aged, 80 and over; Female; Humans; Incidence; Macular Degeneration; Male; Middle Aged; Odds Ratio; Prevalence; Refractive Errors; Risk Factors; Time Factors
PubMed: 24603619
DOI: 10.1371/journal.pone.0090897 -
Arthroscopy : the Journal of... Dec 2020The purpose of this meta-analysis and systematic review was to critically evaluate the biomechanical outcomes of different fixation constructs for a variety of biceps... (Meta-Analysis)
Meta-Analysis
PURPOSE
The purpose of this meta-analysis and systematic review was to critically evaluate the biomechanical outcomes of different fixation constructs for a variety of biceps tenodesis techniques in cadaveric models based on both type of fixation and location.
METHODS
A PROSPERO-registered systematic review (CCRD42018109243) of the current literature was conducted with the terms "long head of biceps" AND "tenodesis" AND "biomechanics" and numerous variations thereof in the PubMed, Embase, and Cochrane databases, yielding 1,460 abstracts. After screening by eligibility criteria, 18 full-text articles were included. The individual biomechanical factors evaluated included ultimate load to failure (in newtons), stiffness (in newtons per millimeter), and cyclic displacement (in millimeters). After reviewing the included literature, we performed a quality analysis of the studies (Quality Appraisal for Cadaveric Studies scale score) and a meta-analysis comparing raw mean differences in data between the suprapectoral and subpectoral fixation location groups, as well as between the fixation construct groups.
RESULTS
Among the 18 included studies, 347 cadaveric specimens were evaluated for ultimate load to failure, stiffness, and cyclic displacement when comparing both location (suprapectoral vs subpectoral) and tenodesis fixation type (interference screw vs cortical button, suture anchor, or all-soft-tissue techniques). Interference screw fixation showed significantly greater mean stiffness by 8.0 N/mm (P = .013) compared with the other grouped techniques but did not show significant differences when evaluated for ultimate load to failure and cyclic displacement (P = .28 and P = .18, respectively). Additionally, no difference in construct strength was seen when comparing the fixation strength of suprapectoral versus subpectoral techniques for stiffness, ultimate load to failure, and cyclic loading (P = .47, P = .053, and P = .13, respectively).
CONCLUSIONS
In this meta-analysis, no significant biomechanical differences were found when the results were stratified by specific surgical technique (interference screw vs other tenodesis techniques) and location (suprapectoral vs subpectoral biceps tenodesis).
CLINICAL RELEVANCE
As a result of this study, when biomechanically evaluating specific tenodesis constructs, the individual clinician has the liberty of choosing the fixation technique based on his or her preference and knowledge of shortcomings of each type of fixation construct.
Topics: Arm; Biomechanical Phenomena; Bone Screws; Cadaver; Humans; Muscle, Skeletal; Suture Anchors; Tenodesis
PubMed: 32619605
DOI: 10.1016/j.arthro.2020.05.055 -
Hypertension (Dallas, Tex. : 1979) Feb 2012Lower birth weight because of fetal growth restriction is associated with higher blood pressure later in life, but the extent to which preterm birth (<37 completed... (Meta-Analysis)
Meta-Analysis Review
Lower birth weight because of fetal growth restriction is associated with higher blood pressure later in life, but the extent to which preterm birth (<37 completed weeks' gestation) or very low birth weight (<1500 g) predicts higher blood pressure is less clear. We performed a systematic review of 27 observational studies that compared the resting or ambulatory systolic blood pressure or diagnosis of hypertension among children, adolescents, and adults born preterm or very low birth weight with those born at term. We performed a meta-analysis with the subset of 10 studies that reported the resting systolic blood pressure difference in millimeters of mercury with 95% CIs or SEs. We assessed methodologic quality with a modified Newcastle-Ottawa Scale. The 10 studies were composed of 1342 preterm or very low birth weight and 1738 term participants from 8 countries. The mean gestational age at birth of the preterm participants was 30.2 weeks (range: 28.8-34.1 weeks), birth weight was 1280 g (range: 1098-1958 g), and age at systolic blood pressure measurement was 17.8 years (range: 6.3-22.4 years). Former preterm or very low birth weight infants had higher systolic blood pressure than term infants (pooled estimate: 2.5 mm Hg [95% CI: 1.7-3.3 mm Hg]). For the 5 highest quality studies, the systolic blood pressure difference was slightly greater, at 3.8 mm Hg (95% CI: 2.6-5.0 mm Hg). We conclude that infants who are born preterm or very low birth weight have modestly higher systolic blood pressure later in life and may be at increased risk for developing hypertension and its sequelae.
Topics: Adolescent; Adult; Blood Pressure; Child; Female; Humans; Hypertension; Infant, Low Birth Weight; Infant, Newborn; Predictive Value of Tests; Pregnancy; Premature Birth; Risk Factors; Systole; Young Adult
PubMed: 22158643
DOI: 10.1161/HYPERTENSIONAHA.111.181784 -
Head & Neck May 2023There are limited data supporting the commonly suggested 5 mm margin cutoff as the optimum value in defining clear margins in oral cancer. A database search of... (Meta-Analysis)
Meta-Analysis Review
There are limited data supporting the commonly suggested 5 mm margin cutoff as the optimum value in defining clear margins in oral cancer. A database search of Pubmed/Medline, Web of Science, and EBSCOhost was performed from inception to June 2022. A random-effects model was chosen for this meta-analysis. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed throughout this study. Seven studies met study criteria (2215 patients). The risk ratio was significantly higher for margins <5 mm when compared to those ≥5 mm (2.09 (95%CI: 1.53-2.86, I = 0.47)). Subgroup analysis (I = 0.15) of margin distances of 0.0-0.9, 1.0-1.9, 2.0-2.9, 3.0-3.9, and 4.0-4.9 mm calculated risk ratios for local recurrence of 2.96, 2.01, 2.17, 1.8, and 0.98, respectively. Margins between 4.0 and 4.9 mm had similar risk ratios for local recurrence compared to ≥5 mm, while margins <4.0 were significantly higher.
Topics: Humans; Margins of Excision; Carcinoma, Squamous Cell; Mouth Neoplasms; Neoplasm Recurrence, Local
PubMed: 36891759
DOI: 10.1002/hed.27339 -
Knee Surgery, Sports Traumatology,... Jan 2015To determine the incidence and clinical significance of postoperative meniscus transplant extrusion. (Review)
Review
PURPOSE
To determine the incidence and clinical significance of postoperative meniscus transplant extrusion.
METHODS
A systematic search was performed using PubMed and Cochrane online databases. Inclusionary criteria were English language, clinical trials of meniscus transplantation published from 1984 to 2014, and meniscus extrusion measured on magnetic resonance imaging (MRI).
RESULTS
Twenty-three studies were included, in which 814 menisci were implanted into 803 patients. MRIs were obtained from 2 days to 10 years postoperatively. Eighteen studies used fresh-frozen meniscus transplants implanted with bone (n = 612) or suture fixation (n = 116); four studies, cryopreserved transplants; and one, irradiated transplants. Three measurements assessed extrusion: absolute millimeters of extrusion (0-8.8 mm), relative percentage of extrusion (0-100%), and the percent of transplants that were extruded (0-100 %). Relationships between transplant extrusion and clinical rating scales, joint space narrowing on standing radiographs, and arthrosis progression were inconclusive. Non-anatomic placement of lateral meniscus transplants and suture fixation of medial and lateral transplants were associated with greater extrusion in two studies.
CONCLUSIONS
Inconsistencies among studies prevent conclusions regarding the incidence and clinical significance of meniscus transplant extrusion. Even so, the short- to mid-term results were encouraging for knee function with daily activities and low rates of failure requiring transplant removal. A postoperative MRI showing more than 3-mm extrusion occurring in some studies suggested technique and/or implant sizing problems that required correction. Future studies should report absolute transplant extrusion, relative percent of extrusion, percent of transplant within the tibiofemoral compartment, and the percent of transplants that are extruded.
LEVEL OF EVIDENCE
IV.
Topics: Arthroplasty; Humans; Incidence; Knee Joint; Magnetic Resonance Imaging; Menisci, Tibial; Postoperative Complications; Tissue Transplantation; Transplants
PubMed: 25246176
DOI: 10.1007/s00167-014-3329-2 -
European Journal of Vascular and... Jan 2024To evaluate the contemporary growth rate of small abdominal aortic aneurysms (AAAs) in view of recent epidemiological changes, such as decreasing smoking rates and... (Review)
Review
OBJECTIVE
To evaluate the contemporary growth rate of small abdominal aortic aneurysms (AAAs) in view of recent epidemiological changes, such as decreasing smoking rates and establishment of population screening programmes.
DATA SOURCES
MEDLINE, CENTRAL, PsycINFO, Web of Science Core Collection, and OpenGrey databases.
REVIEW METHODS
Systematic review following the PRISMA guidelines. In October 2021, databases were queried for studies reporting on AAA growth rates published from 2015 onwards. The primary outcome was contemporary AAA growth rates in mm/year. Data were pooled in a random effects model meta-analysis, and heterogeneity was assessed through the I statistic. GRADE assessment of the findings was performed. The protocol was published in PROSPERO (CRD42022297404).
RESULTS
Of 8 717 titles identified, 43 studies and 28 277 patients were included: 1 241 patients from randomised controlled trials (RCTs), 23 941 from clinical observational studies, and 3 095 from radiological or translational research studies. The mean AAA growth rate was 2.38 mm/year (95% CI 2.16 - 2.60 mm/year; GRADE = low), with meta-regression analysis adjusted for baseline diameter showing an increase of 0.08 mm/year (95% CI 0.024 - 0.137 mm/year; p = .005) for each millimetre of increased baseline diameter. When analysed by study type, the growth rate estimated from RCTs was 1.88 mm/year (95% CI 1.69 - 2.06 mm/year; GRADE = high), while it was 2.31 mm/year (95% CI 1.95 - 2.67 mm/year; GRADE = moderate) from clinical observational studies, and 2.85 mm/year (95% CI 2.44 - 3.26 mm/year; GRADE = low) from translational and radiology based studies (p < .001). Heterogeneity was high, and small study publication bias was present (p = .003), with 27 studies presenting a moderate to high risk of bias. The estimated growth rate from low risk studies was 2.09 mm/year (95% CI 1.87 - 2.32; GRADE = high).
CONCLUSION
This study estimated a contemporaneous AAA growth rate of 2.38 mm/year, being unable to demonstrate any clinically meaningful AAA growth rate reduction concomitant with changed AAA epidemiology. This suggests that the RESCAN recommendations on small AAA surveillance are still valid. However, sub-analysis results from RCTs and high quality study data indicate potential lower AAA growth rates of 1.88 - 2.09 mm/year, findings that should be validated in a high quality prospective registry.
PubMed: 37777049
DOI: 10.1016/j.ejvs.2023.09.039 -
International Journal of Oral and... Aug 2023The aim of this study was to determine whether arthrocentesis is superior to conservative treatment in the management of painful temporomandibular joint disorders with... (Meta-Analysis)
Meta-Analysis Review
The aim of this study was to determine whether arthrocentesis is superior to conservative treatment in the management of painful temporomandibular joint disorders with restricted opening. A systematic review was undertaken of prospective randomized controlled trials (RCT) comparing arthrocentesis to conservative management, identified in the MEDLINE and PubMed databases. Inclusion criteria included a 6-month follow-up, with clinical assessment of the patients and painful restricted mouth opening. Data extracted included pain measured on a visual analogue scale and maximum mouth opening measured in millimetres. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2 for RCTs, and a meta-analysis with the random-effects model was undertaken. Of 879 records retrieved, seven met the inclusion criteria; these RCTs reported the results at 6 months for 448 patients. One study had a low risk of bias, four studies had an uncertain risk, and two had a high risk of bias. In the meta-analysis, arthrocentesis was statistically superior to conservative management at 6 months for an increase in maximum mouth opening (1.12 mm, 95% confidence interval 0.45-1.78 mm; P = 0.001; I = 87%) and borderline superior for pain reduction (-1.09 cm, 95% confidence interval -2.19 to 0.01 cm; P = 0.05; I = 100%). However, these differences are unlikely to be clinically relevant.
Topics: Humans; Arthrocentesis; Conservative Treatment; Treatment Outcome; Randomized Controlled Trials as Topic; Temporomandibular Joint Disorders; Pain; Temporomandibular Joint; Range of Motion, Articular
PubMed: 36732095
DOI: 10.1016/j.ijom.2022.12.005 -
Archives of Gynecology and Obstetrics Oct 2023Several small studies have evaluated the association between epicardial adipose tissue (EAT) and pregnancy-related cardiovascular risk factors such as gestational... (Meta-Analysis)
Meta-Analysis Review
Association between maternal epicardial adipose tissue, gestational diabetes mellitus, and pregnancy-related hypertensive disorders: a systematic review and meta-analysis.
Several small studies have evaluated the association between epicardial adipose tissue (EAT) and pregnancy-related cardiovascular risk factors such as gestational diabetes mellitus (GDM) or hypertensive disorders. The objective of this study was to quantitatively compare EAT thickening between patients with GDM or pregnancy-related hypertensive disorders and healthy controls. This systematic review and meta-analysis were performed according to PRISMA guidelines. A literature search was performed to detect studies that have quantified EAT in women with GDM and pregnancy-related hypertensive disorders compared to a control group. The primary outcome was EAT thickening estimated by ultrasound expressed in millimeters. Random or fixed effects models were used. Nine observational studies including 3146 patients were identified and considered eligible for this systematic review. The quantitative analysis showed that patients with GDM have a higher EAT thickness (mean difference: 1.1 mm [95% confidence interval: 1.0-1.2]; I = 24%) compared to the control group. Moreover, patients with pregnancy-related hypertensive disorders showed higher EAT thickness (mean difference: 1.0 mm [95% confidence interval: 0.6-1.4]; I = 83%) compared to the control group. In conclusion, this study demonstrated that EAT thickening is increased in patients with GDM and pregnancy-related hypertensive disorders compared with healthy controls. Whether or not this association is causal should be evaluated in prospective studies.
Topics: Pregnancy; Humans; Female; Diabetes, Gestational; Hypertension, Pregnancy-Induced; Prospective Studies; Adipose Tissue; Ultrasonography
PubMed: 36695898
DOI: 10.1007/s00404-023-06933-w -
Journal of Clinical Periodontology Jun 2023To evaluate the efficacy of access flap and pocket elimination procedures in the surgical treatment of peri-implantitis. (Meta-Analysis)
Meta-Analysis Review
AIM
To evaluate the efficacy of access flap and pocket elimination procedures in the surgical treatment of peri-implantitis.
MATERIALS AND METHODS
Systematic electronic searches (Central/MEDLINE/EMBASE) up to March 2022 were conducted to identify prospective clinical studies evaluating surgical therapy (access flap or pocket elimination procedures) of peri-implantitis. Primary outcome measures were reduction of probing depth (PD) and bleeding on probing (BOP). Risk of bias was evaluated according to study design. Meta-analysis and meta-regression were performed. Results were expressed as standardized mean effect with 95% confidence interval (CI).
RESULTS
Evidence from studies directly comparing surgical with non-surgical therapy is lacking. Based on pre-post data originating from 13 prospective patient cohorts, pronounced reductions of PD (standardized mean effect: 2.2 mm; 95% CI 1.8-2.7) and BOP% (27.0; 95% CI 19.8-34.2) as well as marginal bone level gain (0.2 mm; 95% CI -0.0 to 0.5) were observed at evaluation time points ranging from 1 to 5 years. Wide prediction intervals suggested a high degree of heterogeneity. Reduction of mean PD increased by 0.7 mm (95% CI 0.5-0.9) for every millimetre in increase of mean PD at baseline. During the follow-up period ranging from 1 to 5 years, disease recurrence occurred frequently and implant loss was not uncommon.
CONCLUSIONS
Access flap and pocket elimination surgery are effective procedures in the management of peri-implantitis, although rates of disease recurrence during 5 years were high. Treatment outcomes were affected by baseline conditions.
Topics: Humans; Dental Implants; Peri-Implantitis; Prospective Studies; Surgical Flaps; Oral Surgical Procedures
PubMed: 36217689
DOI: 10.1111/jcpe.13732