-
The International Journal of... May 2014To conduct an updated systematic review and meta-analysis on the association between indoor air pollution and tuberculosis (TB). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To conduct an updated systematic review and meta-analysis on the association between indoor air pollution and tuberculosis (TB).
DESIGN
We searched for English or Chinese articles using PubMed and EMBASE up to 28 February 2013. We aimed to identify randomised controlled trials and observational epidemiological studies that reported the association between domestic use of solid fuel and TB. Two reviewers independently extracted the information from included studies and assessed the risk of bias of these studies using pre-defined criteria. The effect sizes of eligible studies were pooled using a random-effects model; the heterogeneity across studies was quantified using I(2) statistics.
RESULTS
We identified 15 studies on solid fuel use and active TB and one on solid fuel use and latent tuberculous infection. The summary odds ratios from case-control and cross-sectional studies were respectively 1.17 (95%CI 0.83 - 1.65) and 1.62 (95%CI 0.89 - 2.93), with substantial between-study heterogeneity (I(2) 56.2% and 80.5%, respectively). Subgroup analysis and meta-regression analysis did not identify any study-level factors that could explain the heterogeneity observed.
CONCLUSION
The level of evidence for the association between domestic use of solid fuels and TB was very low. High-quality studies are badly needed to clarify this association and to estimate the magnitude of the problem.
Topics: Air Pollution, Indoor; Biomass; Chi-Square Distribution; Coal; Cooking; Energy-Generating Resources; Feces; Heating; Housing; Humans; Inhalation Exposure; Odds Ratio; Risk Assessment; Risk Factors; Tuberculosis, Pulmonary; Wood
PubMed: 24903801
DOI: 10.5588/ijtld.13.0765 -
European Urology Oct 2017Retropubic (RP-TVT) and transobturator miurethral (TO-TVT) midurethral sling (MUS) are popular surgical treatments for female stress urinary incontinence. The long-term... (Meta-Analysis)
Meta-Analysis Review
Updated Systematic Review and Meta-analysis of the Comparative Data on Colposuspensions, Pubovaginal Slings, and Midurethral Tapes in the Surgical Treatment of Female Stress Urinary Incontinence.
CONTEXT
Retropubic (RP-TVT) and transobturator miurethral (TO-TVT) midurethral sling (MUS) are popular surgical treatments for female stress urinary incontinence. The long-term efficacy and safety of the procedures is still a topic of intense clinical research and several randomised controlled trials (RCTs) have been published in the last years OBJECTIVE: To evaluate the efficacy and safety of MUS compared with other surgical treatments for female stress urinary incontinence.
EVIDENCE ACQUISITION
A systematic review and meta-analysis of the literature was performed using the Medline, Scopus, and Web of Science databases to update our previously published analyses.
EVIDENCE SYNTHESIS
Twenty-eight RCTs were identified. In total, the meta-analyses included 15 855 patients. Patients receiving MUS had significantly higher overall (odds ratio [OR]: 0.59, p=0.0003) and objective (OR: 0.51, p=0.001) cure rates than those receiving Burch colposuspension. Patients undergoing MUS and pubovaginal slings had similar cure rates. Patients treated with RT-TVT had higher subjective (OR: 0.83, p=0.03) and objective (OR: 0.82, p=0.01) cure rates than those receiving TO-TVT. However, the latter had a lower risk of intraoperative bladder or vaginal perforation (OR: 2.4, p=0.0002), pelvic haematoma (OR: 2.61, p=0.002), urinary tract infections (OR: 1.31, p=0.04) and voiding lower urinary tract symptoms (OR: 1.66, p=0.002). Sensitivity analyses limited to RCTs with follow-up durations >60 mo demonstrated similar outcomes for RP-TVT and TO-TVT. No significant differences in efficacy were identified comparing inside-to-out and outside-to-in TO-TVT but vaginal perforations were less common with the former (OR: 0.21, p=0.0002).
CONCLUSIONS
The present analysis confirms the superiority of MUS over Burch colposuspension. The studies comparing insertion of RT-TVT and TO-TVT showed higher subjective and objective cure rates for the RP-TVT but at the cost of higher risks of some complications and voiding lower urinary tract symptoms. Efficacy of inside-out and outside-in techniques of TO-TVT insertion was similar, although the risk of vaginal perforation was lower in the inside-to-out TO-TVT.
PATIENT SUMMARY
Retropubic and transobturator midurethral slings are a popular treatment for female stress urinary incontinence. The available literature suggest that those slings are either more effective or safer than other older surgical procedures. Retropubic tapes are followed with slightly higher continence rates as compared with the transobturator tapes but are associated with higher risk of intra- and postoperative complications.
Topics: Chi-Square Distribution; Female; Humans; Odds Ratio; Postoperative Complications; Prosthesis Design; Risk Factors; Suburethral Slings; Time Factors; Treatment Outcome; Urinary Incontinence, Stress; Urologic Surgical Procedures
PubMed: 28479203
DOI: 10.1016/j.eururo.2017.04.026 -
International Journal of Chronic... 2018Many studies have found that YKL-40 may play an important pathogenic role in COPD. However, the results of these studies were inconsistent. Therefore, we performed a... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Many studies have found that YKL-40 may play an important pathogenic role in COPD. However, the results of these studies were inconsistent. Therefore, we performed a systematic review and meta-analysis to investigate the role of YKL-40 in COPD.
METHODS
We performed a systematic literature search in many database and commercial internet search engines to identify studies involving the role of YKL-40 in patients with COPD. The standardized mean difference (SMD) and Fisher's -value with its 95% confidence interval (CI) were used to investigate the effect sizes.
RESULTS
A total of 15 eligible articles including 16 case-control/cohort groups were included in the meta-analysis. The results indicated that the serum YKL-40 levels in patients with COPD were significantly higher than those in healthy controls (SMD =1.58, 95% CI =0.68-2.49, =0.001), and it was correlated with lung function (pooled =-0.32; =-0.33; <0.001). The results of subgroup analysis found that the serum YKL-40 levels were statistically different between the exacerbation group and the stable group in patients with COPD (SMD =1.55, 95% CI =0.81-2.30, <0.001). Moreover, the results indicated that the sputum YKL-40 levels in patients with COPD were also significantly higher than those in healthy controls (SMD =0.70, 95% CI =0.10-1.30, =0.022).
CONCLUSION
The current study suggests that YKL-40 may be implicated in bronchial inflammation and remodeling in COPD and may be considered as a useful biomarker for COPD diagnosis and monitoring.
Topics: Adult; Aged; Aged, 80 and over; Airway Remodeling; Biomarkers; Chi-Square Distribution; Chitinase-3-Like Protein 1; Female; Humans; Lung; Male; Middle Aged; Predictive Value of Tests; Prognosis; Pulmonary Disease, Chronic Obstructive; Up-Regulation
PubMed: 29430175
DOI: 10.2147/COPD.S152655 -
Interactive Cardiovascular and Thoracic... May 2014Though once considered the gold standard, epidural anaesthesia has complications that may be significant and include hypotension, urinary retention, partial or patchy... (Meta-Analysis)
Meta-Analysis Review
Though once considered the gold standard, epidural anaesthesia has complications that may be significant and include hypotension, urinary retention, partial or patchy block and, in rare cases, devastating neurological injuries also. Paravertebral block (PVB) is an alternative technique for unilateral surgical procedures like thoracotomy, which may offer similar analgesic effectiveness and a more favourable side-effect profile than epidural analgesia. This systematic review and meta-analysis of published randomized clinical trials aims to compare thoracic paravertebral with thoracic epidural analgesia (TEA) in thoracotomy for lung surgery. Five hundred and forty-one patients from 12 clinical trials have been included in this systematic review and meta-analysis. We found that visual analogue scale (VAS) scores at rest and during activity/coughing at 4-8, 24 and 48 h postoperatively were similar in both the PVB and TEA groups. Considering studies not included in the previous meta-analysis, a VAS score on activity at 48 h is significantly better in the PVB group (mean difference 0.40 cm; 95% confidence interval [95% CI] 0.77, 0.02; Mantel-Haenszel (M-H) fixed). Hypotension (odds ratio 0.13; 95% CI 0.06, 0.31; M-H fixed) and urinary retention are more common in the epidural analgesia group. So, we conclude that thoracic PVB may be as effective as thoracic epidural analgesia for post-thoracotomy pain relief and is also associated with fewer complications.
Topics: Analgesia, Epidural; Anesthetics, Local; Chi-Square Distribution; Humans; Nerve Block; Odds Ratio; Pain Measurement; Pain, Postoperative; Risk Factors; Thoracotomy; Time Factors; Treatment Outcome
PubMed: 24488821
DOI: 10.1093/icvts/ivt551 -
BioMed Research International 2022This is the first meta-analysis that assessed the association between maternal smoking and the risk of placenta accreta spectrum (PAS), so this study was aimed at... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This is the first meta-analysis that assessed the association between maternal smoking and the risk of placenta accreta spectrum (PAS), so this study was aimed at investigating the association between maternal smoking and PAS based on observational studies. PAS is defined as a severe obstetric complication due to the abnormal invasion of the chorionic villi into the myometrium and uterine serosa.
METHODS
We searched electronic bibliographic databases including PubMed, Web of Science, Scopus, Science Direct, and Google Scholar until January 2022. The results were reported using a random effect model. The chi-square test and the statistic were used to assess heterogeneity. Egger's and Begg's tests were used to examine the probability of publication bias. All statistical analyses were performed at a significance level of 0.05 using Stata software, version 11.
RESULTS
Based on the random effect model, the estimated OR of the risk of PAS associated with smoking was 1.21 (95% CI: 1.02, 1.41; = 4.7%). Subgroup analysis was conducted based on study design, and the result showed that the association between smoking and PAS among cohort studies was significant 1.35 (95% CI: 1.15, 1.55; = 0.0%).
CONCLUSION
Our results suggested that maternal smoking is a risk factor for the PAS. There was no heterogeneity among studies that reported an association between smoking and the PAS. The Newcastle-Ottawa Scale (NOS) was used to measure study quality.
Topics: Chi-Square Distribution; Cohort Studies; Female; Humans; Observational Studies as Topic; Placenta Accreta; Pregnancy; Risk Factors; Smoking
PubMed: 35860796
DOI: 10.1155/2022/2399888 -
European Urology Sep 2012Perioperative complications are a major surgical outcome for radical prostatectomy (RP). (Meta-Analysis)
Meta-Analysis Review
CONTEXT
Perioperative complications are a major surgical outcome for radical prostatectomy (RP).
OBJECTIVE
Evaluate complication rates following robot-assisted RP (RARP), risk factors for complications after RARP, and surgical techniques to improve complication rates after RARP. We also performed a cumulative analysis of all studies comparing RARP with retropubic RP (RRP) or laparoscopic RP (LRP) in terms of perioperative complications.
EVIDENCE ACQUISITION
A systematic review of the literature was performed in August 2011, searching Medline, Embase, and Web of Science databases. A free-text protocol using the term radical prostatectomy was applied. The following limits were used: humans; gender (male); and publications dating from January 1, 2008. A cumulative analysis was conducted using Review Manager software v.4.2 (Cochrane Collaboration, Oxford, UK).
EVIDENCE SYNTHESIS
We retrieved 110 papers evaluating oncologic outcomes following RARP. Overall mean operative time is 152 min; mean blood loss is 166 ml; mean transfusion rate is 2%; mean catheterization time is 6.3 d; and mean in-hospital stay is 1.9 d. The mean complication rate was 9%, with most of the complications being of low grade. Lymphocele/lymphorrea (3.1%), urine leak (1.8%), and reoperation (1.6%) are the most prevalent surgical complications. Blood loss (weighted mean difference: 582.77; p<0.00001) and transfusion rate (odds ratio [OR]: 7.55; p<0.00001) were lower in RARP than in RRP, whereas only transfusion rate (OR: 2.56; p=0.005) was lower in RARP than in LRP. All the other analyzed parameters were similar, regardless of the surgical approach.
CONCLUSIONS
RARP can be performed routinely with a relatively small risk of complications. Surgical experience, clinical patient characteristics, and cancer characteristics may affect the risk of complications. Cumulative analyses demonstrated that blood loss and transfusion rates were significantly lower with RARP than with RRP, and transfusion rates were lower with RARP than with LRP, although all other features were similar regardless of the surgical approach.
Topics: Chi-Square Distribution; Evidence-Based Medicine; Humans; Laparoscopy; Male; Odds Ratio; Postoperative Complications; Prostatectomy; Prostatic Neoplasms; Risk Assessment; Risk Factors; Robotics; Surgery, Computer-Assisted; Time Factors; Treatment Outcome
PubMed: 22749853
DOI: 10.1016/j.eururo.2012.05.044 -
European Journal of Preventive... Jan 2014Increasing evidence suggests an association between insomnia and cardiovascular disease. We performed a systematic review with meta-analysis of all the available... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Increasing evidence suggests an association between insomnia and cardiovascular disease. We performed a systematic review with meta-analysis of all the available prospective studies that investigated the association between insomnia and risk of developing and/or dying from cardiovascular disease.
DESIGN
Systematic review and meta-analysis of prospective cohort studies.
METHODS
We conducted an electronic literature search through MedLine, Embase, Google Scholar, Web of Science, The Cochrane Library and bibliographies of retrieved articles up to December 2011. Studies were included if they were prospective, had assessment of insomnia or sleep complaints at baseline, evaluated subjects free of cardiovascular disease at baseline and measured the association between insomnia and risk of developing and/or dying from cardiovascular disease.
RESULTS
After the review process 13 prospective studies were included in the final analysis. These studies included 122,501 subjects followed for a time ranging from three to 20 years. A total of 6332 cardiovascular events occurred during the follow-up. Insomnia was assessed through questionnaire and defined as either difficulty of initiating or maintaining sleep or presence of restless, disturbed nights. The cumulative analysis for all the studies under a random-effects model showed that insomnia determined an increased risk (+45%) of developing or dying from cardiovascular disease during the follow-up (relative risk 1.45, 95% confidence interval 1.29-1.62; p < 0.00001), with no evidence of heterogeneity across the studies (I 2: 19%; p = 0.14).
CONCLUSION
Insomnia is associated with an increased risk of developing and/or dying from cardiovascular disease.
Topics: Cardiovascular Diseases; Chi-Square Distribution; Humans; Odds Ratio; Risk Assessment; Risk Factors; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 22942213
DOI: 10.1177/2047487312460020 -
International Journal of Environmental... Oct 2017Asian tiger and yellow fever mosquitoes ( and ) are global nuisances and are competent vectors for viruses such as Chikungunya (CHIKV), Dengue (DV), and Zika (ZIKV).... (Review)
Review
Asian tiger and yellow fever mosquitoes ( and ) are global nuisances and are competent vectors for viruses such as Chikungunya (CHIKV), Dengue (DV), and Zika (ZIKV). This review aims to analyze available spatiotemporal distribution models of mosquitoes and their influential factors. A combination of five sets of 3-5 keywords were used to retrieve all relevant published models. Five electronic search databases were used: PubMed, MEDLINE, EMBASE, Scopus, and Google Scholar through 17 May 2017. We generated a hierarchical decision tree for article selection. We identified 21 relevant published studies that highlight different combinations of methodologies, models and influential factors. Only a few studies adopted a comprehensive approach highlighting the interaction between environmental, socioeconomic, meteorological and topographic systems. The selected articles showed inconsistent findings in terms of number and type of influential factors affecting the distribution of vectors, which is most likely attributed to: (i) limited availability of high-resolution data for physical variables, (ii) variation in sampling methods; feeding and oviposition behavior; (iii) data collinearity and statistical distribution of observed data. This review highlights the need and sets the stage for a rigorous multi-system modeling approach to improve our knowledge about presence/abundance within their flight range in response to the interaction between environmental, socioeconomic, and meteorological systems.
Topics: Aedes; Animals; Ecosystem; Humans; Insect Vectors; Meteorological Concepts; Risk; Socioeconomic Factors; Virus Diseases
PubMed: 29035317
DOI: 10.3390/ijerph14101230 -
International Journal of Chronic... 2018The effectiveness of meditative movement (tai chi, yoga, and qigong) on COPD remained unclear. We undertook a systematic review and meta-analysis to determine the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The effectiveness of meditative movement (tai chi, yoga, and qigong) on COPD remained unclear. We undertook a systematic review and meta-analysis to determine the effectiveness of meditative movement on COPD patients.
METHODS
We searched PubMed, Web of Science, EMBASE, and the Cochrane Center Register of Controlled Trials for relevant studies. The methods of standard meta-analysis were utilized for identifying relevant researches (until August 2017), quality appraisal, and synthesis. The primary outcomes were the 6-minute walking distance (6MWD), lung function, and dyspnea levels.
RESULTS
Sixteen studies involving 1,176 COPD patients were included. When comparing with the control group, the 6MWD was significantly enhanced in the treatment group (3 months: mean difference [MD]=25.40 m, 95% CI: 16.25 to 34.54; 6 months: MD=35.75 m, 95% CI: 22.23 to 49.27), as well as functions on forced expiratory volume in 1 s (FEV) (3 months: MD=0.1L, 95% CI: 0.02 to 0.18; 6 months: MD=0.18L, 95% CI: 0.1 to 0.26), and FEV % predicted (3 months: 4L, 95% CI: 2.7 to 5.31; 6 months: MD=4.8L, 95% CI: 2.56 to 7.07). Quality of life for the group doing meditative movement was better than the control group based on the Chronic Respiratory Disease Questionnaire dyspnea score (MD=0.9 units, 95% CI: 0.51 to 1.29) and fatigue score (MD=0.75 units, 95% CI: 0.42 to 1.09) and the total score (MD=1.92 units, 95% CI: 0.54 to 3.31).
CONCLUSION
Meditative movement may have the potential to enhance lung function and physical activity in COPD patients. More large-scale, well-designed, multicenter, randomized controlled trials should be launched to evaluate the long-range effects of meditative movement.
Topics: Adult; Aged; Aged, 80 and over; Chi-Square Distribution; Exercise Movement Techniques; Exercise Tolerance; Female; Forced Expiratory Volume; Health Status; Humans; Lung; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Qigong; Quality of Life; Recovery of Function; Respiratory Function Tests; Surveys and Questionnaires; Tai Ji; Treatment Outcome; Walk Test; Yoga
PubMed: 29713157
DOI: 10.2147/COPD.S159042 -
European Journal of Preventive... Feb 2016Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors. (Meta-Analysis)
Meta-Analysis Review
The effectiveness of yoga in modifying risk factors for cardiovascular disease and metabolic syndrome: A systematic review and meta-analysis of randomized controlled trials.
BACKGROUND
Yoga, a popular mind-body practice, may produce changes in cardiovascular disease (CVD) and metabolic syndrome risk factors.
DESIGN
This was a systematic review and random-effects meta-analysis of randomized controlled trials (RCTs).
METHODS
Electronic searches of MEDLINE, EMBASE, CINAHL, PsycINFO, and The Cochrane Central Register of Controlled Trials were performed for systematic reviews and RCTs through December 2013. Studies were included if they were English, peer-reviewed, focused on asana-based yoga in adults, and reported relevant outcomes. Two reviewers independently selected articles and assessed quality using Cochrane's Risk of Bias tool.
RESULTS
Out of 1404 records, 37 RCTs were included in the systematic review and 32 in the meta-analysis. Compared to non-exercise controls, yoga showed significant improvement for body mass index (-0.77 kg/m(2) (95% confidence interval -1.09 to -0.44)), systolic blood pressure (-5.21 mmHg (-8.01 to -2.42)), low-density lipoprotein cholesterol (-12.14 mg/dl (-21.80 to -2.48)), and high-density lipoprotein cholesterol (3.20 mg/dl (1.86 to 4.54)). Significant changes were seen in body weight (-2.32 kg (-4.33 to -0.37)), diastolic blood pressure (-4.98 mmHg (-7.17 to -2.80)), total cholesterol (-18.48 mg/dl (-29.16 to -7.80)), triglycerides (-25.89 mg/dl (-36.19 to -15.60), and heart rate (-5.27 beats/min (-9.55 to -1.00)), but not fasting blood glucose (-5.91 mg/dl (-16.32 to 4.50)) nor glycosylated hemoglobin (-0.06% Hb (-0.24 to 0.11)). No significant difference was found between yoga and exercise. One study found an impact on smoking abstinence.
CONCLUSIONS
There is promising evidence of yoga on improving cardio-metabolic health. Findings are limited by small trial sample sizes, heterogeneity, and moderate quality of RCTs.
Topics: Aged; Cardiovascular Diseases; Chi-Square Distribution; Female; Health Status; Humans; Male; Metabolic Syndrome; Middle Aged; Protective Factors; Randomized Controlled Trials as Topic; Risk Assessment; Risk Factors; Treatment Outcome; Yoga
PubMed: 25510863
DOI: 10.1177/2047487314562741