Probiotics for preventing gestational diabetes mellitus in overweight or obese pregnant women: A systematic review and meta-analysis.

BACKGROUND: Gestational diabetes mellitus was associated with increased risks of complications during pregnancy and delivery. The efficacy of probiotics for preventing atopic disease among overweight and obese pregnant women has not been a unified conclusion. Therefore, we aimed to determine the efficacy and safety of probiotics supplementation for overweight and obese pregnant women. METHODS: We searched the Cochrane Library, Embase, PubMed, and Web of Science for randomized controlled trials from the earliest publication date available to September 23, 2020, regardless of language or publication status. Two reviewers independently extracted data with a standardized form. When disagreements arose, a third investigator was consulted. Data was pooled using the generic inverse variance method and expressed as mean differences and relative risk with 95% confidence interval (CI). Heterogeneity was measured and quantified by I2 statistic. RESULTS: There were no significant differences between probiotics and placebo on GDM (RR = 1.03; 95% CI, 0.81-1.30; P = 0.821; I2 = 38.7%, P = 0.180), excess gestational weight gain (RR = 0.92; 95% CI, 0.79-1.06; P = 0.223; I2 = 91.2%, P = 0.001) and neonatal birth weight (WMD = 28.47; 95% CI, -34.80-91.73; P = 0.383; I2 = 4.5%, P = 0.381). In addition, probiotics might increase the risk of preeclampsia including superimposed (RR = 1.91; 95% CI, 1.03-3.55; P = 0.001; I2 = 0.0%, P = 0.994). CONCLUSIONS: Probiotics had no better efficacy for prevention of atopic disease in overweight or obese pregnant women. In contrast, excessive probiotics supplementation might increase the risk of preeclampsia. More data will be necessary to determine the prevention efficacy of probiotics with consideration of real-world and other epidemiological settings.

The efficacy and safety of intermittent preventive treatment with sulphadoxine-pyrimethamine vs artemisinin-based drugs for malaria: a systematic review and meta-analysis.

BACKGROUND: Malaria is one of the most serious global problems. The objective of this study is to assess whether intermittent preventive treatment (IPT) using artemisinin-based combination therapies (ACTs) was a promising alternative to IPT with sulphadoxine-pyrimethamine (IPT-SP). METHODS: We searched the following sources up to 12 August 2020: PubMed, The Cochrane Library, Embase, Web of Science, CNKI, CBM, VIP and WanFang Database from inception. The randomized controlled trials comparing SP with ACTs for malaria were included. Data were pooled using Stata.14 software. We performed subgroup analysis based on the different types of ACTs groups and participants. RESULTS: A total of 13 studies comprising 5180 people were included. The meta-analysis showed that ACTs had the lower risk of number of any parasitemia (RR=0.46; 95% CI 0.22 to 0.96, p=0.039; I2=90.50%, p<0.001), early treatment failure (RR=0.17; 95% CI 0.06 to 0.48, p<0.001; I2=66.60%, p=0.011) and late treatment failure (RR=0.34; 95% CI 0.13 to 0.92, p<0.001; I2=87.80%, p<0.001) compared with SP. There was no significant difference in adequate clinical response, average hemoglobin and adverse neonatal outcomes. CONCLUSION: Combinations with ACTs appear promising as suitable alternatives for IPT-SP.

T-tube or no T-tube for biliary tract reconstruction in orthotopic liver transplantation: an updated systematic review and meta-analysis.

Objectives: Biliary tract reconstruction with or without T-tube is commonly used in orthotopic liver transplantation (OLT). However, the efficacy and safety of T-tube usage remain controversial. This meta-analysis was conducted to assess the latest evidence of clinical outcomes.Methods: Embase, Cochrane Library, PubMed, and Web of Science were systematically searched from inception to 20 January 2021 for eligible studies. The analyses were performed using Review Manager and Stata.Results: A total of 24 trials involving 3320 participants were included in the meta-analysis. Compared with the no T-tube group, there was a higher incidence of overall biliary complications (OR:1.54; 95%CI, 1.06-2.24; P = 0.02), bile leaks (OR:2.34; 95%CI,1.57-3.48; P < 0.0001), cholangitis (OR:2.78; 95%CI,1.19-6.51; P = 0.002), and longer cold ischemia time (MD:22.27; 95%CI,0.80-43.74; P = 0.04) in the T-tube group. Furthermore, the no T-tube group had significantly higher odds of biliary strictures than the T-tube group (OR:0.60; 95%CI, 0.47-0.78; P = 0.0001).Conclusion: T-tube is still not routinely recommended, but is a good choice for OLT patients at high risk of biliary strictures. Notably, the higher rate of biliary complications in the T-tube group did not translate into an increase in endoscopic or re-operative interventions.

A scientometric study of the top 100 most-cited publications based on Web-of-Science regarding robotic versus laparoscopic surgery.

Minimally invasive surgery includes traditional laparoscopic and robot-assisted surgery. Although many studies related to robotic surgery and laparoscopic surgery have been published, when doing our search, scientometric studies that focus on related robotic surgery versus laparoscopic surgery were limited. In this study, we aimed to analyze and review the research hots and research status of robotic surgery versus laparoscopic surgery. We searched publications that involved robotic surgery versus laparoscopic surgery in the Web of Science database from 1980 to May 23, 2020. The top 100 publications were published in 2012 with the number of 17 and citations ranged from 618 to 64. Published across 34 different journals, namely European urology (n = 17) and others, the greatest contribution among 36 institutes was made by the Cleveland Clinic (n = 11). Of the top 100 publications, a total of 429 unique words were identified and the most frequently occurring keyword was laparoscopy (n = 33). The co-occurrence of keywords in the top 100 publications indicated that the study of diseases mainly focused on prostatectomy, complications, prostate cancer, retropubic prostatectomy, nephron-sparing surgery, lymph-node dissection, total mesenteric excision, sexual function, rectal cancer, and assisted distal gastrectomy. In recent years, comparative research on robot and laparoscopic surgery has decreased and most studies focus on cancer.