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Surgery Jun 2024Some observational data have suggested that anastomotic leak may be reduced with triple-row staple technology compared to double-row staple technology. We aimed to... (Review)
Review
BACKGROUND
Some observational data have suggested that anastomotic leak may be reduced with triple-row staple technology compared to double-row staple technology. We aimed to investigate this further by performing a systematic review comparing double- and triple-row staple technology for colorectal anastomoses.
METHODS
This systematic review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. MEDLINE, Embase, and Cochrane Central Register of Controlled Trials databases were searched up to November 2023. Articles were eligible for inclusion if they were comparing double-row staple and triple-row staple technology for left-sided colo-colic, colorectal, or coloanal anastomosis. The main outcomes included anastomotic leak, anastomotic hemorrhage, 30-day mortality, and reoperation. Meta-analyses with inverse variance random effects were performed. Certainty of evidence was assessed with Grading of Recommendations, Assessment, Development, and Evaluations.
RESULTS
After reviewing 340 relevant citations, 6 retrospective cohort studies met inclusion. Overall, 19,372 patients (mean age: 60.2 years, 52.7% female sex) had anastomoses with double-row staple technology, and 2,298 patients (mean age: 61.3 years, 50.3% female sex) with triple-row staple technology. Most operations were anterior resections (double-row: 55.3%; triple-row: 43.6%). Across all included studies, the risk of anastomotic leak was reduced with triple-row staple technology (6.3% vs 7.5%, risk ratio 0.54, 95% confidence interval 0.31-0.94, P = .03, I=75%). There were no significant differences in anastomotic hemorrhage (risk ratio 0.47, 95% confidence interval 0.15-1.49, P = .20, I = 57%), 30-day mortality (risk ratio 0.66, 95% confidence interval 0.17-2.55, P = .55, I = 0%), or reoperation (risk ratio 1.05, 95% confidence interval 0.42-2.64, P = .91, I = 56%).
CONCLUSION
Triple-row staple technology may reduce the risk of anastomotic leak in left-sided colorectal anastomoses.
PubMed: 38876899
DOI: 10.1016/j.surg.2024.04.039 -
Healthcare (Basel, Switzerland) Mar 2024The aim of this study was to evaluate the clinical effectiveness of craniosacral therapy (CST) in the management of any conditions. (Review)
Review
OBJECTIVES
The aim of this study was to evaluate the clinical effectiveness of craniosacral therapy (CST) in the management of any conditions.
METHODS
Two independent reviewers searched the PubMed, Physiotherapy Evidence Database, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases in August 2023, and extracted data from randomized controlled trials (RCT) evaluating the clinical effectiveness of CST. The PEDro scale and Cochrane Risk of Bias 2 tool were used to assess the potential risk of bias in the included studies. The certainty of the evidence of each outcome variable was determined using GRADEpro. Quantitative synthesis was carried out with RevMan 5.4 software using random effect models.
DATA SYNTHESIS
Fifteen RCTs were included in the qualitative and seven in the quantitative synthesis. For musculoskeletal disorders, the qualitative and quantitative synthesis suggested that CST produces no statistically significant or clinically relevant changes in pain and/or disability/impact in patients with headache disorders, neck pain, low back pain, pelvic girdle pain, or fibromyalgia. For non-musculoskeletal disorders, the qualitative and quantitative synthesis showed that CST was not effective for managing infant colic, preterm infants, cerebral palsy, or visual function deficits.
CONCLUSIONS
The qualitative and quantitative synthesis of the evidence suggest that CST produces no benefits in any of the musculoskeletal or non-musculoskeletal conditions assessed. Two RCTs suggested statistically significant benefits of CST in children. However, both studies are seriously flawed, and their findings are thus likely to be false positive.
PubMed: 38540643
DOI: 10.3390/healthcare12060679 -
Journal of Pharmacopuncture Dec 2023The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of... (Review)
Review
OBJECTIVES
The aim of this systematic review and meta-analysis is to assess and compare the effectiveness of manual therapy in alleviating infant crying, a common symptom of nocturnal crying (NC) and infantile colic (IC).
METHODS
Total effective rate, crying time and adverse events were used as outcome indicators. To assess the quality, the risk of bias was determined for each study by two authors, using the Cochrane Collaboration's risk of bias tool. RevMan 5.0 was used for data analysis. A total of 98 articles were identified from 6 electronic databases.
RESULTS
Among them, twenty-seven studies which included 13 NC and 14 IC were included. Meta-analysis showed favorable effects tuina therapy on total effective rate (TER) of NC (RR 1.20 [95% CI 1.05 to 1.37], p = 0.007), chiropractic therapy on crying time change of IC (SMD -0.83 [95% CI -1.61 to -0.06], p = 0.04) and massage on total crying time of IC (SMD -0.86 [95% CI -1.09 to -0.63], p < 0.00001). This systematic review compares different manual therapies for the treatment of NC and IC. While tuina, chiropractic, and massage show results in alleviating symptoms, the overall evidence remains limited due to the low quality and heterogeneity of the included studies.
CONCLUSION
Therefore, further high-quality research with unified control groups is needed to establish manual therapy as a recommended treatment option for NC and IC. Protocol registration number is CRD42022348143 01/08/2022.
PubMed: 38162473
DOI: 10.3831/KPI.2023.26.4.285 -
Animals : An Open Access Journal From... Nov 2023This systematic review aimed to identify the evidence concerning the analgesic efficacy of non-steroidal anti-inflammatory drugs to treat abdominal pain in horses, and... (Review)
Review
This systematic review aimed to identify the evidence concerning the analgesic efficacy of non-steroidal anti-inflammatory drugs to treat abdominal pain in horses, and to establish whether one non-steroidal anti-inflammatory drug could provide better analgesia compared to others. This systematic review was conducted following the "Systematic Review Protocol for Animal Intervention Studies". Research published between 1985 and the end of May 2023 was searched, using three databases, namely, PubMed, Embase, and Scopus, using the words equine OR horse AND colic OR abdominal pain AND non-steroidal anti-inflammatory drug AND meloxicam OR flunixin meglumine OR phenylbutazone OR firocoxib OR ketoprofen. Risk of bias was assessed with the SYRCLE risk of bias tool, and level of evidence scored according to the Oxford Centre for Evidence-based Medicine. A total of 10 studies met the inclusion criteria. From those only one study judged pain with a validated pain score, and a high risk of bias was identified due to the presence of selection, performance, and "other" types of bias. Therefore, caution is required in the interpretation of results from individual studies. To date, the evidence on analgesic efficacy to determine whether one drug is more potent than another regarding the treatment of abdominal pain in horses is sparse.
PubMed: 38003065
DOI: 10.3390/ani13223447 -
Journal of Gastrointestinal Surgery :... Dec 2023The primary aim was to investigate the operative outcomes of intracorporeal (IA) and extracorporeal (EA) anastomosis in left-sided minimally-invasive colectomy. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
The primary aim was to investigate the operative outcomes of intracorporeal (IA) and extracorporeal (EA) anastomosis in left-sided minimally-invasive colectomy.
METHODS
A comprehensive literature search was conducted for studies comparing operative outcomes and follow-up data of IA versus EA in minimally-invasive left colectomy. Studies that investigated recto-sigmoid resections using transanal circular staplers were excluded. Data from eligible studies were extracted, qualitatively assessed, and included in a meta-analysis. Odds ratios (ORs) and mean differences with 95 per cent confidence intervals were calculated.
RESULTS
Eight studies with a total of 750 patients were included (IA n = 335 versus EA n = 415). IA was associated with significantly lower overall morbidity (OR 0.40, 95% CI 0.26-0.61, p < 0.0001) and less frequent surgical site infection (SSI) (OR 0.27, 95% CI 0.12-0.61, p = 0.002) as primary outcomes compared to EA. Of the secondary outcomes, length of incision (SMD -2.51, 95% CI -4.21 to -0.81, p = 0.004), time to first oral diet intake (SMD -0.49, 95% CI -0.76 to -0.22, p = 0. 0004) and time to first bowel movement (SMD -0.40, 95% CI -0.71 to -0.09, p = 0.01) were significantly in favor of IA, while operative time was significantly shorter in the EA group (SMD 0.36, 95% CI 0.14-0.59, p = 0.001).
CONCLUSIONS
IA proves to be a safe and feasible option as it demonstrates benefits in terms of lower overall morbidity, fewer rates of SSI, smaller incision length, and faster postoperative gastrointestinal recovery despite a longer operative time compared to EA.
Topics: Humans; Colic; Laparoscopy; Colectomy; Anastomosis, Surgical; Surgical Wound Infection; Surgical Wound; Treatment Outcome; Retrospective Studies; Colonic Neoplasms
PubMed: 37698813
DOI: 10.1007/s11605-023-05827-1 -
Annals of Medicine and Surgery (2012) Sep 2023Postoperative ileus (PI) after colorectal surgery is a common surgical problem. This systematic review aimed to investigate the available data in the literature to... (Review)
Review
Postoperative ileus (PI) after colorectal surgery is a common surgical problem. This systematic review aimed to investigate the available data in the literature to reduce the PI in the area of colorectal surgery out of the enhanced recovery after surgery principles, referring to published randomized controlled trials (RCTs) and meta-analyses, and to provide recommendations according to the Oxford Centre for Evidence-Based Medicine. The authors conducted bibliographic research on 1 December 2022. The authors retained meta-analyses and RCTs. The authors concluded that when we combined colonic mechanical preparation with oral antibiotic decontamination, the authors found a significant reduction in PI. The open approach was associated with a higher PI rate. The robotic and laparoscopic approaches had similar PI rates. Low ligation of the inferior mesenteric artery presented a PI similar to that of high ligation of the inferior mesenteric artery. There was no difference between the isoperistaltic and antiperistaltic anastomoses or between the intracorporeal and extracorporeal anastomoses. This study summarized the available data in the literature, including meta-analyses and RCTs. For a higher level of evidence, additional multicenter RCTs and meta-analyses of RCTs remain necessary.
PubMed: 37663708
DOI: 10.1097/MS9.0000000000001099 -
Molecules (Basel, Switzerland) Jul 2023The use of medicinal plants to treat inflammatory conditions and painful processes has attracted the attention of scientists and health professionals due to the evidence... (Review)
Review
The use of medicinal plants to treat inflammatory conditions and painful processes has attracted the attention of scientists and health professionals due to the evidence that natural products can promote significant therapeutic benefits associated with fewer adverse effects compared to conventional anti-inflammatory drugs. The genus is composed of various plants with pharmacological potential, which are used to treat various diseases in traditional communities worldwide. The present study systematically reviewed species with anti-inflammatory and analgesic potential. To this end, a systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. The search was conducted on the following databases: PubMed, ScienceDirect, SciVerse Scopus, and Web of Science. Different combinations of search terms were used to ensure more excellent article coverage. After the selection, a total of 45 articles were included in this review. This study identified twelve species indicated for the treatment of different inflammatory conditions, such as wounds, fever, bronchitis, abscess, asthma, hepatitis, labyrinthitis, tonsillitis, and uterine inflammation. The indications for pain conditions included headache, sore throat, heartburn, menstrual cramp, colic, toothache, stomachache, migraine, chest pain, abdominal pain, local pain, labor pain, and recurring pain. Among the listed species, ten plants were found to be used according to traditional knowledge, although only four of them have been experimentally studied. When assessing the methodological quality of preclinical in vivo assays, most items presented a risk of bias. The SR results revealed the existence of different species used to treat inflammation and pain. The results of this systematic review indicate that species have the potential to be used in the treatment of diseases with an inflammatory component, as well as in the management of pain. However, given the risk of biases, the experimental analysis of these species through preclinical testing is crucial for their safe and effective use.
Topics: Female; Pregnancy; Humans; Ethnopharmacology; Phytotherapy; Plectranthus; Abdominal Pain; Analgesics; Anti-Inflammatory Agents; Inflammation; Phytochemicals
PubMed: 37570622
DOI: 10.3390/molecules28155653 -
Pain and Therapy Aug 2023Renal colic is one of the most common urological emergencies, and is usually caused by ureteral colic spasms. Pain management in renal colic remains the central focus of...
INTRODUCTION
Renal colic is one of the most common urological emergencies, and is usually caused by ureteral colic spasms. Pain management in renal colic remains the central focus of emergency treatment. The purpose of this meta-analysis is to identify the efficacy and safety of ketamine versus opioids in the treatment of patients with renal colic.
METHODS
We searched PubMed, EMBASE, Cochrane Library, and Web of Science databases for published randomized controlled trials (RCTs) that referred to the use of ketamine and opioids for patients with renal colic. The methodology was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The mean difference (MD) or odds ratio (OR) with a 95% confidence interval (CI) was used to analyze the data. The results were pooled using a fixed-effects model or random-effects model. The primary outcome measure was patient-reported pain scores 5, 15, 30, and 60 min after drug administration. The secondary outcome measure was side effects.
RESULTS
The data analysis revealed that ketamine was similar to opioids in pain intensity at the time of 5 min post-dose (MD = - 0.40, 95% CI - 1.82 to 1.01, P = 0.57), 15 min post-dose (MD = - 0.15, 95% CI - 0.82 to 0.52, P = 0.67), 30 min post-dose (MD = 0.38, 95% CI - 0.25 to 1.01, P = 0.24). Also, the pain score of ketamine was better than that of opioids at 60 min after administration (MD = - 0.12, 95% CI - 0.22 to - 0.02, P = 0.02). As for safety, the ketamine group was linked to a significant decrease in the incidence of hypotensive (OR = 0.08, 95% CI 0.01-0.65, P = 0.02). The two groups did not statistically differ in the incidence of nausea, vomiting, and dizziness.
CONCLUSIONS
Compared with opioids, ketamine showed a longer duration of analgesia in renal colic, with satisfactory safety.
TRIAL REGISTRATION
The PROSPERO registration number is CRD42022355246.
PubMed: 37284927
DOI: 10.1007/s40122-023-00530-0 -
Revista Da Associacao Medica Brasileira... 2023The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The aim of this study was to systematically review the colic and sleep outcomes of nonpharmacological intervention in infants with infantile colic and perform a meta-analysis of the available evidence.
METHODS
The literature review for this systematic review was conducted between December 2022 and January 2023 using five electronic databases, namely PubMed, CINAHL, Scopus, Web of Science, and ULAKBİM. Published articles were scanned using MeSH-based keywords. Only randomized controlled trials conducted in the past 5 years were included. The data were analyzed using the Review Manager computer program.
RESULTS
This meta-analysis included three studies involving a total of 386 infantile colic infants. After nonpharmacological treatment, it was found that infants with infantile colic reduced crying time (standardized mean difference: 0.61; 95%CI 0.29-0.92; Z=3.79; p=0.00002), improved sleep duration (standardized mean difference: 0.22; 95%CI -0.04 to 0.48; Z=1.64; p=0.10), and decreased crying intensity (mean difference: -17.24; 95%CI -20.11 to 14.37; Z=11.77; p<0.000001).
CONCLUSION
According to the meta-analysis findings, it was determined that the risk of bias was low in the studies included and that nonpharmacological chiropractic, craniosacral, and acupuncture treatments applied to infantile colic infants in the three included studies reduced crying time and intensity and increased sleep duration.
Topics: Humans; Infant; Colic; Sleep; Sleep Duration; Databases, Factual
PubMed: 37222334
DOI: 10.1590/1806-9282.20230071 -
Journal of Global Health May 2023Probiotics are non-invasive therapies composed of live bacteria and yeast. Administration of prebiotics improved the health status of pregnant and lactating women, as... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Probiotics are non-invasive therapies composed of live bacteria and yeast. Administration of prebiotics improved the health status of pregnant and lactating women, as well as newborns. This review aimed to appraise the evidence concerning the effectiveness of probiotics on the mental health of pregnant women, lactating mother and the microbiota of the newborn.
METHODS
This systematic review and meta-analysis ascertained quantitative studies published in Medline (PubMed), Clinical Key, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Cochrane Library, and Google scholar. Two authors independently screened and extracted the data from the primary studies that analysed the efficacy of probiotics on the mental health of pregnant and lactating women and the microbiota of the newborn. We adopted Cochrane Collaboration guidelines and reported using the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA) statement. The qualities of included trials were assessed by Cochrane collaboration's risk of bias tool (ROB-2).
RESULTS
Sixteen trials comprised 946 pregnant women, 524 were lactating mothers, and 1678 were infants. The sample size of primary studies ranged from 36 to 433. Probiotics were administered as interventions, using either a single strain of Bifidobacterium or Lactobacillus or a double-strain combination of Lactobacillus and Bifidobacterium. Probiotics supplementation reduced anxiety in pregnant (n = 676, standardised mean difference (SMD) = 0.01; 95% confidence interval (CI) = -0.28,0.30, P = 0.04, I = 70) and lactating women (n = 514, SMD = -0.17; 95% CI = -1.62,1.27, P = 0.98, I = 0). Similarly, probiotics decreased depression in pregnant (n = 298, SMD = 0.05; 95% CI = -0.24,0.35, P = 0.20, I = 40) and lactating women (n = 518, SMD = -0.10; 95% CI = -1.29,-1.05, P = 0.11, I = 60%). Similarly, probiotics supplementation improved the gut microbiota and reduced the duration of crying, abdominal distension, abdominal colic and diarrhoea.
CONCLUSION
Non-invasive probiotic therapies are more useful to pregnant and lactating women and newborns.
REGISTRATION
The review protocol was registered with PROSPERO (CRD42022372126).
Topics: Infant; Infant, Newborn; Humans; Female; Pregnancy; Depression; Lactation; Probiotics; Anxiety; Gastrointestinal Microbiome
PubMed: 37218177
DOI: 10.7189/jogh.13.04038