• 제목/요약/키워드: risk and meta-analysis

검색결과 911건 처리시간 0.028초

Clinical Outcomes following Primary Hip Replacement Arthroplasties in Patients with Solid Organ Transplantation: A Systematic Review and Meta-Analysis

  • Chul-Ho Kim;Eic Ju Lim;Jeuk Lee
    • Hip & pelvis
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    • 제34권3호
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    • pp.127-139
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    • 2022
  • There is still controversy regarding clinical outcomes following primary hip arthroplasty after solid organ transplantation (SOT). The aim of this study was to determine whether clinical outcomes after hip arthroplasty differ between previous SOT recipients and control subjects with no history of undergoing SOT. We conducted a systematic search of MEDLINE, Embase, and the Cochrane Library for studies comparing the clinical outcomes after hip arthroplasty following SOT published up to January 5, 2022. A comparison of medical and surgery-related complications, as well as the readmission rate and 90-day mortality rate between previous SOT recipients and control subjects was performed. Subgroup analyses of the SOT types, liver transplantation (LT) and kidney transplantation (KT), were also performed. Ten studies that included 3,631,861 cases of primary hip arthroplasty were included; among these, 14,996 patients had previously undergone SOT and 3,616,865 patients had not. Significantly higher incidences of cardiac complications, pneumonia, and acute kidney injury were observed in the SOT group compared with the control group. Regarding surgical complications, a higher transfusion rate was observed in the SOT group. The readmission rate and 90-day mortality rate were also significantly higher in the SOT group. A significantly higher incidence of deep vein thrombosis was observed in the KT subgroup compared with the control group. A higher risk of medical and surgical complications, as well as higher readmission and mortality rates after hip arthroplasty was observed for previous SOT recipients compared to patients with no history of SOT.

Glutathione S-transferase M1 Null Genotype and Hepatocellular Carcinoma Susceptibility in China and India: Evidence from an Updated Meta-analysis

  • Liu, Hong-Zhou;Peng, Jie;Peng, Chun-Yan;Yan, Ming;Zheng, Fang
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권12호
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    • pp.4851-4856
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    • 2014
  • Background: Glutathione S-transferase M1 (GSTM1) have been reported to be associated with hepatocellular carcinoma. However, the effect of the GSTMl null genotype was divergent in the literature and we therefore performed the present meta-analysis to explore the relationship in detail. Materials and Metbods: Reported studies were searched from 1990 to March 1, 2014 in PubMed and Wanfang Med Online. The total odds oatio (OR) and 95% CI were calculated and analyzed by Review Manager 5.1 and STATE 12. Results: Total OR was calculated from 26 articles with 3,769 cases and 5,517 controls and the association proved significant (OR [95%CI]=1.50 [1.25, 1.80], P<0.05) in the Chinese population. However, there was no significant association between hepatocellular carcinoma risk among subjects carrying the GSTM1 null genotype (OR [95%CI]=1.20 [0.88-1.64], P=0.24) in subgroups of publication in English and in Indian populations (OR [95%CI]=1.80 [0.80-4.20], P=0.15). Conclusions: The GSTM1 deletion polymorphism might not have a significant effect on the susceptibility of hepatocellular carcinoma overall.

The Long-term Efficacy of Domiciliary Noninvasive Positive-Pressure Ventilation in Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials

  • Park, So Young;Yoo, Kwang Ha;Park, Yong Bum;Rhee, Chin Kook;Park, Jinkyeong;Park, Hye Yun;Hwang, Yong Il;Park, Dong Ah;Sim, Yun Su
    • Tuberculosis and Respiratory Diseases
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    • 제85권1호
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    • pp.47-55
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    • 2022
  • Background: We evaluated the long-term effects of domiciliary noninvasive positive-pressure ventilation (NIPPV) used to treat patients with chronic obstructive pulmonary disease (COPD). Methods: Databases were searched to identify randomized controlled trials of COPD with NIPPV for longer than 1 year. Mortality rates were the primary outcome in this meta-analysis. The eight trials included in this study comprised data from 913 patients. Results: The mortality rates for the NIPPV and control groups were 29% (118/414) and 36% (151/419), suggesting a statistically significant difference (risk ratio [RR], 0.79; 95% confidence interval [CI], 0.65-0.95). Mortality rates were reduced with NIPPV in four trials that included stable COPD patients. There was no difference in admission, acute exacerbation and quality of life between the NIPPV and control groups. There was no significant difference in withdrawal rates between the two groups (RR, 0.99; 95% CI, 0.72-1.36; p=0.94). Conclusion: Maintaining long-term nocturnal NIPPV for more than 1 year, especially in patients with stable COPD, decreased the mortality rate, without increasing the withdrawal rate compared with long-term oxygen treatment.

뇌졸중 후 중추성 통증 및 시상증후군에 대한 한약치료의 효과 : 체계적 고찰 및 메타분석 - 중의학 저널을 중심으로 (Clinical Effectiveness of Traditional Herbal Medicine in the Treatment of Central Post-Stroke Pain and Thalamic Syndrome: a Systemic Review and Meta-analysis of Randomized Clinical Trials Based on Traditional Chinese Medicine Journals)

  • 정유진;강은진;홍상훈
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.295-311
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    • 2019
  • Objectives: This research aimed to investigate Chinese clinical studies on the treatment of central post-stroke pain (CPSP) and thalamic syndrome after stroke with traditional herbal medicine (THM). Methods: Randomized controlled trials verifying the effects of herbal medicine on treating CPSP and thalamic syndrome after stroke were included in the study. Electrical and hand search were conducted in the China National Knowledge Infrastructure (CNKI), National Discovery for Science Leaders (NDSL), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (Oasis) for CPSP and thalamic syndrome after stroke. A literature search was performed in the Chinese and Korean databases for papers published from January 1, 2010 to October 1, 2018. The selected literature was assessed by Cochrane's risk of bias. Results: Twelve reports on randomized controlled trials met the inclusion criteria from the 227 identified reports. Effective rate, comparison of visual analogy scale, present pain intensity, pain grading index, recurrence rate, follow-up, and a 36-item short form survey instrument were used to evaluate the treatments. The effective rate of the treatment group was significantly higher than that of the control group in all papers. Side effects occurred less frequently in the treatment group than in the western medicine control group. Conclusions: The treatment of CPSP and thalamic syndrome after stroke with THM was shown to be highly effective. Additional well-designed clinical trials are needed. This study can be used as a basis for further research on the treatment of CPSP and thalamic syndrome after stroke.

강직성 척추염 환자의 폐기능에 미치는 운동효과에 대한 메타분석 (A Meta-analysis for the Effects of Exercise on Pulmonary Function in Patients with Ankylosing Spondylitis)

  • 김은정;이은남;유은정
    • 근관절건강학회지
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    • 제26권2호
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    • pp.141-154
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    • 2019
  • Purpose: This study aimed to analyze the effects of exercise on pulmonary function in patients with ankylosing spondylitis (AS). Methods: Randomized controlled trials (RCTs) were identified by searching MEDLINE, EMBASE, CENTRAL, and CINAHL (through Jan 2019). Three reviewers independently retrieved articles, extracted data, and assessed methodological quality using the Cochrane's Risk of Bias for randomized studies. Results: Fourteen studies met the inclusion criteria with a total of 729 participants. CE (SMD 0.58, 95% CI 0.41~0.75, p<.001) and $VO_2peak$ (SMD 0.56, 95% CI 0.24~0.88, p=.001) had a significant effect on the most exercise interventions. As a secondary variable, BASFI (SMD -0.53, 95% CI -0.70~-0.37, p<.001), BASMI (SMD -0.75, 95% CI -0.92~-0.58, p<.001) showed an effect size of more than medium. However, PFT and QoL did not produce a significant results. Conclusion: Pulmonary involvement is common in patients with AS and might have disturbed functionality and exercise modality. Exercise can be an effective intervention to improve pulmonary function in patients with AS. More attention is needed to improve the chest and spinal mobility to maintain the appropriate pulmonary function. It is also necessary to consider how to construct a patient-tailored exercise program to increase performance, accuracy and safety of exercise.

슬개대퇴통증증후군의 침 치료에 대한 체계적 문헌고찰의 프로토콜 (Acupuncture Treatment for Patellofemoral Pain Syndrome: A Protocol for a Systematic Review)

  • 지민준;서경준;김호걸;구지향;하현주;오민석
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.29-35
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    • 2022
  • Objectives The purpose of this systematic review is to analyse randomized controlled trials about acupuncture for patellofemoral pain syndrome (PFPS) and evaluate it's pain improvement effect. Methods Studies will be searched from ten databases (Medline/PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure [CNKI], WanFang Data, Citation Information by NII [CiNII], ScienceON, Koreanstudies Information Service System [KISS], KMBASE, and KoreaMed). Participants will be patients diagnosed with PFPS, regardless of cause, gender, age or race, and interventions will be acupuncture, electroacupuncture, dry needling, fire needle, and acupotomy. Other treatments than interventions will be the control group and the main outcome will be reviewed by visual analogue scale (VAS). Results Data will be extracted and assessed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis flow chart and Cochrane risk of bias tools. Meta-analysis will be conducted using random effect model within 95% confidence interval. Conclusions We expect this systematic review to provide useful data about the pain improvements of patellofemoral pain using acupuncture and expect to stimulate and systematize acupuncture treatment on PFPS in the future.

주산기 가사가 있는 신생아에서 theophylline의 신기능 개선 효과에 대한 체계적 문헌고찰 및 메타분석 (The Effect of Theophylline on Improvement of Renal Function in Asphyxiated Neonates: A Systematic Review and Meta-analysis)

  • 이주원;이소연;안숙희
    • 한국임상약학회지
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    • 제29권2호
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    • pp.115-124
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    • 2019
  • The purpose of this systematic review and meta-analysis was to assess the preventive effect of theophylline on acute kidney injury and the ameliorative effect of theophylline on renal function in asphyxiated neonates. A literature search of the PubMed/Medline, Embase, and Cochrane Library databases for information published up to February 2019 was conducted. All studies that reported the incidence rate of acute kidney injury, serum creatinine level, and glomerular filtration rate after the randomized administration of theophylline or placebo were included. In total, eight studies involving 498 neonates were eligible. The incidence rate of acute kidney injury was significantly lower in the theophylline group than in the placebo group (risk ratio [RR]: 0.42, 95% confidence interval [CI]: 0.32-0.55, p < 0.001). The changes in serum creatinine level in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 and 5 days of age (weighted mean difference [WMD]: -0.51, 95% CI: -0.62 to -0.40, p < 0.001, and WMD: -0.26, 95% CI: -0.34 to -0.18, p < 0.001, respectively). The changes in glomerular filtration rate in the theophylline group were significantly higher than those in the placebo group from the first day of life to 3 days of age and the last day of follow-up (WMD: 12.30, 95% CI: 9.39-15.21, p < 0.001, and WMD: 9.35, 95% CI: 6.43-12.27, p < 0.001, respectively). These results suggested that theophylline has a beneficial effect on the prevention of acute kidney injury in neonates with perinatal asphyxia.

Somatostatin Analogues Do Not Prevent Carcinoid Crisis

  • Guo, Lin-Jie;Tang, Cheng-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권16호
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    • pp.6679-6683
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    • 2014
  • Background: Carcinoid crisis is a life-threating syndrome of neuroendocrine tumors (NETs) characterized by dramatic blood pressure fluctuation, arrhythmias, and bronchospasm. In the era of booming anti-tumor therapeutics, this has become more important since associated stresses can trigger carcinoid crisis. Somatostatin analogues (SSTA) have been recommended for prophylactic administration before intervention procedures for functioning NETs. However, the efficacy is still controversial. The aim of this article is to review efficacy of SSTA for preventing carcinoid crisis. Materials and Methods: PubMed, Cochrane Controlled trials Register, and EMBASE were searched using 'carcinoid crisis' as a search term combining terms with 'somatostatin'; 'octreotide'; 'lanreotide' and 'pasireotide' until December 2013. Results: Twenty-eight articles were retrieved with a total of fifty-three unique patients identified for carcinoid crisis. The most common primary sites of NETs were the small intestine and respiratory tract. The triggering factors for carcinoid crisis included anesthesia/surgery (63.5%), interventional therapy (11.5%), radionuclide therapy (9.6%), examination (7.7%), medication (3.8%), biopsy (2%) and spontaneous (2%). No randomized controlled trials (RCTs) were identified and two case-control studies were included to assess the efficacy of SSTA for preventing carcinoid crisis by meta-analysis. The overall pooled risk of perioperative carcinoid crisis was similar despite the prophylactic administration of SSTA (OR 0.44, 95% CI: 0.14 to 1.35, p=0.15). Conclusions: SSTA wasnot helpful for preventing carcinoid crisis based on a meta-analysis of retrospective studies. Attentive monitoring and careful intervention are essential. Future studies with better quality are needed to clarify any effect of SSTA for preventing carcinoid crisis.

당뇨환자에서 자가관리형 베타케톤검사의 유효성: 체계적 문헌 고찰 및 메타분석 (The Effectiveness of Blood β-ketone Testing in Patients with Diabetic Ketosis: A Systematic Review & Meta-analysis)

  • 모진아;장선영;방희영
    • 보건교육건강증진학회지
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    • 제31권4호
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    • pp.1-10
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    • 2014
  • Objectives: The effectiveness of Blood ${\beta}$-ketone testing by using self-monitoring strip on diabetic patients. Methods: Clinical effectiveness of blood ${\beta}$-ketone testing was assessed through correlation with reference test that measured blood ${\beta}$-ketone value through gas chromatography or enzyme method, diagnostic accuracy, time taken for the test and time taken for confirmative diagnosis of diabetic ketosis by selecting literatures on researches that conducted this test on ketosis(suspected) patients or diabetic ketosis(suspected) patients. Each of the stages from literature search to application of selection standards and extraction of data were carried out independently by the Subcommittee along with 2 researchers. Results: 7 reports were selected. ${\beta}$-ketone testing displayed high level of correlation in the range of r=0.92~0.99 with test using enzyme method as the reference standard. Regarding the diagnostic accuracy, sensitivity of 0.82, specificity of 0.74. The time taken for the test was 30seconds for the index test, which is shorter than reference standard test. Conclusion: Blood ${\beta}$-ketone testing was assessed to be a safe and effective test to monitor ketosis and assess the level of risk of ketosis by measuring the blood ${\beta}$-ketone on ketosis patients and diabetic ketosis patients since it has high level of correlation with reference test and short period of testing.

Pretreatment Thrombocytosis as a Prognostic Factor in Women with Gynecologic Malignancies: a Meta-analysis

  • Yu, Min;Liu, Lei;Zhang, Bing-Lan;Chen, Qi;Ma, Xue-Lei;Wu, Yu-Ke;Liang, Chun-Shui;Niu, Zhi-Min;Qin, Xin;Niu, Ting
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권12호
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    • pp.6077-6081
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    • 2012
  • Background: This study was performed to analyze the prognostic implications of pretreatment or preoperative thrombocytosis in women with gynecologic malignancies. Material and Methods: We surveyed 2 medical databases, PubMed and EMBASE, to identified all relevant studies. A total of 14 (n=3,490) that evaluated the link between thrombocytosis and 5-year survival were included. REVMAN version 5.1 was used for our analysis and publication bias was evaluated using the Begg's funnel plot and tested by STATA 11.0. Risk ratios (RRs) with 95% confidence intervals (CIs) generated by the random effect model were used to assess the strength of any association. Results: 709(20.3%) of the 3,490 patients exhibited thrombocytosis (platelet counts > $400{\times}10^9/L$) at primary diagnosis, and their mortality was 1.62-fold higher compared with the others (RR=1.62, 95%CI=[1.28-2.05], p<0.0001). Thrombocytosis failed to have a stronger effect on the survival of advanced patients of stages III to IV in our study (n=478, RR=1.29, 95% CI=[1.13-1.48], p=0.0003), nor in women with cervical cancer in stage IB (n=1371, RR=1.73, 95% CI=[1.71-2.58], p=0.007). In addition, when adjusted for different carcinoma, it was associated with worse prognosis for all except the ones with vulvar cancer (n=201, RR=0.43, 95% CI=[0.14-1.29], p=0.13). Conclusions: This meta-analysis indicated that thrombocytosis might be associated with a worse prognosis for patients with gynecologic malignancies but without specificity or sensitivity for the ones in advanced stage. When adjusted for different gynecologic malignancies, it showed a significant effect on survival of all except vulvar cancers.