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1.
Medicine (Baltimore) ; 100(35): e26920, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477123

RESUMEN

BACKGROUND: Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder with recurrent abdominal pain and changes in bowel habits. Many pieces of evidence show that acupuncture and moxibustion therapy has advantages in the treatment of IBS, but there are many acupuncture and moxibustion therapy options, each of which has different therapeutic effects. This study will evaluate the clinical efficacy of different acupuncture and moxibustion therapies in the treatment of IBS by means of a network meta-analysis. METHODS: According to the retrieval strategy, we retrieved the randomized controlled trials of acupuncture and moxibustion treatment of IBS from China National Knowledge Infrastructure, Wanfang, VIP, Chinese biomedical databases, PubMed, Embase, Web of Science, and the Cochrane Library databases from the database establishment to July 2021. We assessed the quality of the studies using the Cochrane Risk Bias Assessment Tool and assessed the strength of the evidence using the Grading of Recommendation Assessment, Development, and Evaluation methodology. All data analyses were performed by RevMan5.3, Gemtc 0.14.3, and Stata 14.0. RESULTS: This study evaluated the efficacy of different acupuncture and moxibustion therapies in the treatment of IBS by evaluating the clinical efficacy rate, symptom scores, quality of life scores, adverse reactions, etc, and further explore the mechanism of action of each therapy. CONCLUSION: This study will provide a reliable evidence-based basis for selecting the best acupuncture and moxibustion therapy for IBS. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/3278Y.


Asunto(s)
Terapia por Acupuntura/normas , Protocolos Clínicos , Síndrome del Colon Irritable/terapia , Moxibustión/normas , Terapia por Acupuntura/métodos , Humanos , Metaanálisis como Asunto , Moxibustión/métodos , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
2.
Medicine (Baltimore) ; 100(35): e27087, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477143

RESUMEN

BACKGROUND: Diabetic nephropathy (DN) is one of the most serious complications in the development of diabetes mellitus, which has become the main cause of end-stage renal disease and one of the main causes of death in diabetic patients. With the prevalence of diabetes, the number of patients at risk for developing DN is increasing, with 20-40 percent of all patients with diabetes at risk for developing DN. Acupuncture and Chinese herbal medicine treatments are often combined to treat DN; however, there has been no meta-analysis on their synergistic effects. Therefore, we aimed to perform a systematic review and meta-analysis to estimate the effectiveness of acupuncture combined with Chinese herbal medicine for DN treatment. METHODS: Nine electronic databases were retrieved for this study. The English databases mainly retrieved PubMed, Web of Science, Embase, AMED, and the Cochrane Library, while the CNKI, VIP, CBM, and Wanfang databases were used to retrieve the Chinese literature. There is no definite time limit for the retrieval literature, and the languages are limited to Chinese and English. We will consider articles published between database initiation and August 2021. We used Review Manager 5.4, provided by the Cochrane Collaborative Network for statistical analysis. Clinical randomized controlled trials related to acupuncture combined with Chinese herbal medicine for DN were included in this study. Research selection, data extraction, and research quality assessments were independently completed by two researchers. We then assessed the quality and risk of the included studies and observed the outcome measures. RESULTS: This study provides a high-quality synthesis to assess the effectiveness and safety of acupuncture combined with Chinese herbal medicine for treating DN. CONCLUSION: This systematic review will provide evidence to determine whether acupuncture combined with Chinese herbal medicine is an effective and safe intervention for patients with DN. ETHICS AND DISSEMINATION: The protocol of the systematic review does not require ethical approval because it does not involve humans. This article will be published in peer-reviewed journals and presented at relevant conferences. REGISTRATION NUMBER: INPLASY202180018.


Asunto(s)
Terapia por Acupuntura/normas , Protocolos Clínicos , Nefropatías Diabéticas/tratamiento farmacológico , Medicamentos Herbarios Chinos/normas , Terapia por Acupuntura/métodos , Terapia por Acupuntura/estadística & datos numéricos , Nefropatías Diabéticas/fisiopatología , Medicamentos Herbarios Chinos/uso terapéutico , Humanos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
3.
Medicine (Baltimore) ; 100(35): e27090, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477144

RESUMEN

BACKGROUND: Glaucoma is the second most-common blinding ophthalmic disease in the world, and its incidence has been rising year by year in recent years. Currently, the main treatment of glaucoma still relies on surgery. Glaucoma patients often suffer from various psychological problems like anxiety and depression not only because of the lack of understanding of the surgical treatment of glaucoma, but also the long-term stress and the poor prognosis. As alternative therapies, non-pharmacological interventions can greatly alleviate psychological burdens and improve sleep quality in surgically treated glaucoma patients. Randomized controlled trials of non-pharmacologic interventions for glaucoma have been reported, although the results remain conflicting. Evidences for determining the efficacy of non-pharmacologic interventions for glaucoma are scant. This study aims to assess the effects of non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma through a network meta-analysis. METHODS: A systematic search of relevant literatures published before August 2021 about the effects of non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma will be performed in Wanfang, VP Information Chinese Journal Service Platform, China National Knowledge Infrastructure, Chinese BioMedicine Literature Database, Pubmed, Embase, Cochrane, and Web of science. Two reviewers will be independently responsible for literature screening and selection, quality assessment, and data extraction. WinBUGS 1.4 will be used for the network meta-analysis. RESULTS: This meta-analysis will provide additional and stronger evidences for non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma, which will help clinicians and decision makers to make an optimal therapeutic strategy. CONCLUSION: This study will provide a reliable evidence-based basis for the clinical application of non-pharmacological interventions on anxiety, depression, and sleep quality in patients with postoperative glaucoma. ETHICS AND DISSEMINATION: Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms. This review would be disseminated in a peer-reviewed journal or conference presentations. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/TYJPK.


Asunto(s)
Ansiedad/terapia , Protocolos Clínicos , Depresión/terapia , Glaucoma/complicaciones , Trastornos del Sueño-Vigilia/terapia , Ansiedad/psicología , Depresión/psicología , Glaucoma/terapia , Humanos , Metaanálisis como Asunto , Trastornos del Sueño-Vigilia/psicología , Revisiones Sistemáticas como Asunto
4.
Medicine (Baltimore) ; 100(35): e27110, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477151

RESUMEN

BACKGROUND: Constipation is one of the common complications of thoracolumbar compression fractures, which seriously affects the quality of life and increases pain of patients. External treatment of traditional Chinese medicine (TCM) has been widely used clinically for constipation after thoracolumbar compression fractures, but there are no systematic review and meta-analysis of its efficacy. Therefore, we will conduct this study to systematically evaluate the clinical effects of external treatment of TCM for patients with constipation after thoracolumbar compression fractures. METHODS: We will search the following electronic databases: PubMed, Embase, Cochrane Library, Web of Science, China National Knowledge Infastructure, Chinese Biomedical Literatures Database, Chinese Scientific Journal Database, and Wanfang Database. Randomized controlled trials on the treatment of constipation after thoracolumbar compression fractures with external treatment of TCM published from inception to May 2021 will be included in the search scope. The observation group was treated with Simple external treatment of TCM (such as external application of Chinese medicine, Chinese drugs at the acupoint, acupuncture, moxibustion, etc) or external treatment of TCM combined with conventional treatment/nursing of Western medicine, while the control group only was treated by conventional treatment/nursing of Western medicine. After screening literatures, extracting data, and assessing the risk of bias in the included studies, meta-analysis will be performed by Revman 5.3 software. RESULTS: This study is expected to provide an evidence of the efficacy of external treatment of TCM for constipation after thoracolumbar compression fractures. CONCLUSION: The results of this meta-analysis may help provide evidence to determine whether external treatment of TCM can be effective interventions for thoracolumbar compression fractures patients with constipation. TRIAL REGISTRATION NUMBER: INPLASY202150005.


Asunto(s)
Protocolos Clínicos , Estreñimiento/tratamiento farmacológico , Fracturas por Compresión/complicaciones , Medicina China Tradicional/normas , Estreñimiento/etiología , Humanos , Medicina China Tradicional/métodos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto
5.
BMJ Open ; 11(9): e045912, 2021 09 02.
Artículo en Inglés | MEDLINE | ID: mdl-34475148

RESUMEN

INTRODUCTION: Patients with end-stage renal disease are at higher risk of cardiovascular morbidity and mortality, a risk mediated in part by increased aortic stiffness. Arterial stiffness is assessed at different anatomical locations (central elastic or peripheral muscular arteries) using a variety of mechanical biomarkers. However, little is known on the robustness of each of these mechanical biomarkers following a haemodynamic stress caused by a single haemodialysis (HD) session. METHODS AND ANALYSIS: A systematic review has been designed and reported in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. A targeted search strategy applicable in key databases (PubMed, Embase, the Cochrane Library, Web of Science and grey literature) is constructed to search articles and reviews from inception to 16 October 2020. Only articles of studies conducted with adults under chronic HD for kidney failure, with repeated measures of arterial stiffness metrics (pulse wave velocity, Augmentation Index, arterial distensibility or stiffness) following a before-and-after design surrounding a HD session will be selected. The screening process, data extraction and assessment of risk bias will be done by two independent pairs of reviewers. Meta-analysis will enable adjustments for potential confounders and subgroup analyses will be performed to discriminate changes in arterial stiffness metrics from elastic, muscular or global arterial territories. ETHICS AND DISSEMINATION: This study does not require ethical approval. Findings will be submitted for publication to relevant peer-reviewed journals and will be presented at profession-specific conferences. PROSPERO REGISTRATION NUMBER: CRD42020213946.


Asunto(s)
Fallo Renal Crónico , Rigidez Vascular , Humanos , Fallo Renal Crónico/terapia , Metaanálisis como Asunto , Análisis de la Onda del Pulso , Diálisis Renal , Proyectos de Investigación , Revisiones Sistemáticas como Asunto
6.
BMJ Open ; 11(9): e047858, 2021 09 06.
Artículo en Inglés | MEDLINE | ID: mdl-34489275

RESUMEN

INTRODUCTION: The circadian rhythm of melatonin secretion is disturbed after general anaesthesia, leading to postoperative sleep disturbance. Small studies investigating the preventive effect of melatonin administration on postoperative sleep disturbance have not reached any conclusions. Therefore, we will conduct a systematic review and meta-analysis to obtain conclusive results. METHODS AND ANALYSIS: We prepared this protocol following the 2015 Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols guidelines. We will conduct a search for randomised controlled trials that evaluated the effect of melatonin and melatonin agonists on postoperative sleep quality in adult patients undergoing general anaesthesia or regional anaesthesia with sedation. We will exclude patients undergoing regional anaesthesia without sedation. Relevant studies will be searched in the following eight databases: MEDLINE, the Cochrane Central Register of Controlled Trials, Embase, Web of Science and four preregistration sites from inception to 1 January 2021. No language restrictions will be applied. Two authors will independently scan and select eligible studies and perform data extraction and assessment of the risk of bias. The Visual Analogue Scale scores for sleep quality will be combined as the mean difference with a 95% CI using a random-effect model; we will use I2 to assess heterogeneity. We will evaluate the quality of trials using the Cochrane methodology and assess the quality of evidence using the Grading of Recommendation Assessment, Development and Evaluation approach. If appropriate, trial sequential analysis will be performed. ETHICS AND DISSEMINATION: No ethical approval is required for this meta-analysis, as it does not include individual patient data. We will disseminate the results of this meta-analysis in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020180167.


Asunto(s)
Melatonina , Trastornos del Sueño-Vigilia , Adulto , Humanos , Melatonina/uso terapéutico , Metaanálisis como Asunto , Sueño , Trastornos del Sueño-Vigilia/prevención & control , Revisiones Sistemáticas como Asunto
7.
BMJ Open ; 11(9): e050754, 2021 09 08.
Artículo en Inglés | MEDLINE | ID: mdl-34497083

RESUMEN

INTRODUCTION: Sepsis is a dysregulated host response to infection characterised by activation of proinflammatory and procoagulant mechanisms. Protein C (PC)'s activity as an anticoagulant and antiinflammatory molecule makes it an appealing target for sepsis biomarker studies. To date, there has been no systematic review of PC as a sepsis biomarker. OBJECTIVES: To evaluate the diagnostic accuracy and prognostic strength of PC as a biomarker for adult sepsis. METHODS AND ANALYSIS: Medline, Embase, Cochrane Library, PubMed and Cumulative Index to Nursing and Allied Health Literature (CINAHL) will be searched from inception through 20 January 2021 for prospective observational studies that evaluate the use of PC as a diagnostic or prognostic biomarker for adult sepsis. Title and abstract screening, full-text screening and data extraction will be conducted in duplicate. Risk of bias will be assessed using the Quality Assessment of Diagnostic Accuracy Studies and Quality in Prognostic Studies tools. If sufficient data are available, a meta-analysis will be conducted. The standardised mean difference and 95% CI will be calculated for prognostic and diagnostic studies. If possible, a hierarchical summary receiver operator characteristic curve will be generated to assess overall prognostic and diagnostic biomarker accuracy. I2 statistics will be used to assess heterogeneity. Sensitivity analysis will be performed by removing studies with a high risk of bias and re-examining the meta-analysis results. ETHICS AND DISSEMINATION: Given this is a systematic review and meta-analysis, there is no requirement for ethics approval. Findings will be disseminated through a peer-reviewed publication and social media. PROSPERO REGISTRATION NUMBER: CRD42021229786.


Asunto(s)
Proteína C , Sepsis , Adulto , Humanos , Metaanálisis como Asunto , Estudios Observacionales como Asunto , Pronóstico , Sepsis/diagnóstico , Revisiones Sistemáticas como Asunto
8.
Medicine (Baltimore) ; 100(35): e27111, 2021 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-34477152

RESUMEN

BACKGROUND: We aimed to conduct a meta-analysis to assess the impact of coronavirus disease 2019 (COVID-19) on college students' physical activity. METHODS: All cohort studies comparing college students undertaking physical exercise at school before the COVID-19 pandemic and physical exercise at home during the COVID-19 pandemic will be included in this review. We will use index words related to college students, physical exercise, and COVID-19 to perform literature searches in the PubMed, Medline, Embase, and CNKI databases, to include articles indexed as of June 20, 2021, in English and Chinese. Two reviewers will independently select trials for inclusion, assess trial quality, and extract information for each trial. The primary outcomes are exercise frequency, duration, intensity, and associated factors. Based on the Cochrane assessment tool, we will evaluate the risk of bias of the included studies. Revman 5.3 (the Cochrane collaboration, Oxford, UK) will be used for heterogeneity assessment, data synthesis, subgroup analysis, sensitivity analysis, and funnel plot generation. RESULT: We will discuss the impact of COVID-19 on college students' physical activity. CONCLUSION: Stronger evidence about the impact of COVID-19 on college students' physical activity will be provided to better guide teaching practice. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021262390.


Asunto(s)
Ejercicio Físico , Estudiantes/estadística & datos numéricos , COVID-19/epidemiología , Femenino , Humanos , Masculino , Metaanálisis como Asunto , Pandemias , SARS-CoV-2 , Revisiones Sistemáticas como Asunto , Universidades
9.
Artículo en Inglés | MEDLINE | ID: mdl-34444181

RESUMEN

Medication-related osteonecrosis of the jaw (MRONJ) is a serious adverse reaction of antiresorptive and antiangiogenic agents, and it is also a potentially painful and debilitating condition. To date, no specific studies have prospectively evaluated the efficacy of its treatment and no robust standard of care has been established. Therefore, a systematic review (2007-2020) with a pooled analysis was performed in order to compare MRONJ surgical techniques (conservative or aggressive) versus combined surgical procedures (surgery plus a non-invasive procedure), where 1137 patients were included in the pooled analysis. A statistically significant difference in the 6-month improvement rate, comparing combined conservative surgery versus only aggressive (91% versus 72%, p = 0.05), was observed. No significant difference regarding any group with respect to the 6-month total resolution rate (82% versus 72%) was demonstrated. Of note, conservative surgery combined with various, adjuvant, non-invasive procedures (ozone, LLLT or blood component + Nd:YAG) was found to achieve partial or full healing in all stages, with improved results and the amelioration of many variables. In conclusion, specific adjuvant treatments associated with minimally conservative surgery can be considered effective and safe in the treatment of MRONJ, although well-controlled studies are a requisite in arriving at definitive statements.


Asunto(s)
Osteonecrosis de los Maxilares Asociada a Difosfonatos , Conservadores de la Densidad Ósea , Osteonecrosis de los Maxilares Asociada a Difosfonatos/epidemiología , Osteonecrosis de los Maxilares Asociada a Difosfonatos/cirugía , Conservadores de la Densidad Ósea/efectos adversos , Difosfonatos , Humanos , Metaanálisis como Asunto , Revisiones Sistemáticas como Asunto
10.
BMJ Open ; 11(8): e047560, 2021 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-34404702

RESUMEN

INTRODUCTION: As the largest and most rapidly ageing population, Chinese people are now the major driver of the continued growth in dementia prevalence globally. The need for evidence-based interventions in Chinese communities is urgent. Although a wide range of pharmacological and non-pharmacological interventions for dementia have been trialled in Chinese populations, the evidence has not been systematically synthesised. This systematic review and meta-analysis aims to map out the interventions for people living with dementia and their carers in Chinese communities worldwide and compare the effectiveness of these interventions. METHODS AND ANALYSIS: This protocol followed the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist. We will search Chinese (China National Knowledge Infrastructure, WanFang DATA) and English bibliographical databases (MEDLINE, EMBASE, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Cochrane CENTRAL, Social Care Online, BASE, MODelling Outcome and cost impacts of interventions for DEMentia (MODEM) Toolkit, Cochrane Database of Systematic Reviews), complemented by hand searching of reference lists. We will include studies evaluating the effectiveness of interventions for dementia or mild cognitive impairment in Chinese populations, using a randomised controlled trial design, and published between January 2008 and June 2020. We will use a standardised form to extract data and Version 2 of the Cochrane risk-of-bias tool for randomised trials to assess the risk of bias of the included studies. Collected data will be fully interpreted with narrative synthesis and analysed using pairwise and network meta-analyses to pool intervention effects where sufficient information is available. We will perform subgroup analysis and meta-regression to explore potential reasons for heterogeneity. ETHICS AND DISSEMINATION: No formal ethics approval is required for this protocol. The findings will facilitate the development of studies on interventions for dementia and timely inform dementia policymaking and practice. Planned dissemination channels include peer-reviewed publications, conference presentations, public events and websites. PROSPERO REGISTRATION NUMBER: CRD42019134135.


Asunto(s)
Cuidadores , Demencia , China , Demencia/terapia , Humanos , Metaanálisis como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Revisiones Sistemáticas como Asunto
11.
BMJ Open ; 11(8): e048367, 2021 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-34404706

RESUMEN

INTRODUCTION: Idiopathic Parkinson syndrome (iPS) is one of the most common neurodegenerative disorders characterised by the triad of bradykinesia, rigidity and tremor. Tremor at rest predominantly at one side is often perceived by patients as severely disabling and yet ranges among the most difficult symptoms to treat. In medically refractory cases, lesional approaches have proven to be effective alternatives. However, to date, there is no comprehensive analysis of non-surgical therapies to manage iPS-patients' tremor. We therefore present a detailed study protocol for a systematic literature review assessing efficacy/effectiveness and safety of non-lesional treatments for tremor in iPS. METHODS AND ANALYSIS: We will search three electronic databases (MEDLINE, EMBASE and PsycINFO) using a combination of title/abstract keywords. Additionally, hand-searched reference and citation lists of key reviews identified through the search strategy will be screened. Eligible studies should investigate the efficacy/effectiveness and safety of therapeutic options for tremor in iPS excluding lesional interventions. Publications will be independently assessed for inclusion criteria by two investigators and study information summarised using a standardised template including quality assessment according to the QualSyst tool. We will provide a narrative synthesis of results and conduct a meta-analysis whenever possible. ETHICS AND DISSEMINATION: We commit to present contemporary evidence on the efficacy/effectiveness and safety of non-lesional interventions for tremor in iPS in a future publication. We aim to compile rich data of published studies to inform healthcare professionals in order to ultimately improve patient outcomes. PROSPERO REGISTRATION NUMBER: CRD42020202911).


Asunto(s)
Enfermedad de Parkinson , Temblor , Personal de Salud , Humanos , Metaanálisis como Asunto , Enfermedad de Parkinson/complicaciones , Revisiones Sistemáticas como Asunto , Temblor/tratamiento farmacológico , Temblor/etiología
12.
BMJ Open ; 11(8): e050451, 2021 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-34404715

RESUMEN

INTRODUCTION: Post-stroke depression (PSD) is a severe complication of cerebrovascular stroke affecting about one-third of stroke survivors. Moreover, PSD is associated with functional recovery and quality of life (QOL) in stroke survivors. Screening for PSD is recommended. There are, however, differences in the literature on the impact of early screening on functional outcomes. In this systematic review, we synthesise the currently available literature regarding the associations between timing and setting of PSD screening and mortality, QOL and functional outcomes in stroke survivors. METHODS AND ANALYSIS: We will systematically search electronic databases including PubMed, Embase, APA PsycINFO, Web of Science, Scopus and CINAHL from inception to August 2021. Four reviewers will screen the title and abstract and full-text level records identified in the search in a blinded fashion to determine the study eligibility. Any selection disagreements between the reviewers will be resolved by the study investigator. Data extraction of eligible studies will be conducted by two reviewers using a predefined template. We will complete the quality assessment of included articles independently by two reviewers using the Newcastle Ottawa Scale. Eventual discrepancies will be resolved by the principal investigator. ETHICS AND DISSEMINATION: Due to the nature of the study design, ethical approval is not required. The systematic review and meta-analysis findings will be published and disseminated in a peer-reviewed journal. Our results will also be disseminated through posters and presentations at appropriate scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42021235993.


Asunto(s)
Calidad de Vida , Accidente Cerebrovascular , Depresión/diagnóstico , Depresión/etiología , Humanos , Metaanálisis como Asunto , Accidente Cerebrovascular/complicaciones , Revisiones Sistemáticas como Asunto
13.
BMJ Open ; 11(8): e053302, 2021 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-34404717

RESUMEN

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is performed to diagnose and manage conditions of the biliary and pancreatic ducts. Though effective, it is associated with common adverse events (AEs). The purpose of this study is to systematically review ERCP AE rates and report up-to-date pooled estimates. METHODS AND ANALYSIS: A comprehensive electronic search will be conducted of relevant medical databases through 10 November 2020. A study team of eight data abstracters will independently determine study eligibility, assess quality and abstract data in parallel, with any two concordant entries constituting agreement and with discrepancies resolved by consensus. The primary outcome will be the pooled incidence of post-ERCP pancreatitis, with secondary outcomes including post-ERCP bleeding, cholangitis, perforation, cholecystitis, death and unplanned healthcare encounters. Secondary outcomes will also include rates of specific and overall AEs within clinically relevant subgroups determined a priori. DerSimonian and Laird random effects models will be used to perform meta-analyses of these outcomes. Sources of heterogeneity will be explored via meta-regression. Subgroup analyses based on median dates of data collection across studies will be performed to determine whether AE rates have changed over time. ETHICS AND DISSEMINATION: Ethics approval is not required for this study as it is a planned meta-analysis of previously published data. Participant consent is similarly not required. Dissemination is planned via presentation at relevant conferences in addition to publication in peer-reviewed journals.PROSPERO registration numberCRD42020220221.


Asunto(s)
Colangitis , Pancreatitis , Colangiopancreatografia Retrógrada Endoscópica/efectos adversos , Humanos , Metaanálisis como Asunto , Pancreatitis/epidemiología , Pancreatitis/etiología , Revisiones Sistemáticas como Asunto
14.
BMJ Open ; 11(8): e045978, 2021 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-34408030

RESUMEN

INTRODUCTION: The gradual changes over the decades in the longevity and ageing of European society as a whole can be directly related to the prolonged decline in the birth rate and increase in the life expectancy. According to the WHO, there is an increased risk of dementia or other cognitive disorders as the population ages, which have a major impact on public health. Mild cognitive impairment (MCI) is described as a greater than expected cognitive decline for an individual's age and level of education, but that does not significantly interfere with activities of daily living. Patients with MCI exhibit a higher risk of dementia compared with others in the same age group, but without a cognitive decline, have impaired walking and a 50% greater risk of falling.The urban lifestyle and advent of smartphones, mobility and immediate access to all information via the internet, including health information, has led to a totally disruptive change in most general aspects.This systematic review protocol is aimed at evaluating the effectiveness of technology-based interventions in the detection, prevention, monitoring and treatment of patients at risk or diagnosed with MCI. METHODS AND ANALYSIS: This review protocol follows the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols reporting guidelines. The search will be performed on MEDLINE (PubMed), CENTRAL, CINAHL Plus, ISI Web of Science and Scopus databases from 2010 to 2020. Studies of interventions either randomised clinical trials or pre-post non-randomised quasi-experimental designs, published in English and Spanish will be included. Articles that provide relevant information on the use of technology and its effectiveness in interventions that assess improvements in early detection, prevention, follow-up and treatment of the patients at risk or diagnosed with MCI will be included. ETHICS AND DISSEMINATION: Ethics committee approval not required. The results will be disseminated in publications and congresses.


Asunto(s)
Actividades Cotidianas , Disfunción Cognitiva , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/prevención & control , Diagnóstico Precoz , Humanos , Metaanálisis como Asunto , Proyectos de Investigación , Revisiones Sistemáticas como Asunto , Tecnología
15.
BMJ Open ; 11(8): e048451, 2021 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-34408050

RESUMEN

INTRODUCTION: The thyroid cancer incidence has been increasing all over the world. However, the aetiology of thyroid cancer remains unclear. A growing body of evidence suggested exposure to persistent organic pollutants (POPs) may play a role in the initiation of thyroid cancer, but the results are generally inconsistent across studies. This review aims to synthesise the evidence for the health effects of POPs on the risk of thyroid cancer. METHODS AND ANALYSIS: This protocol was reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) statements. A comprehensive search, including electronic database search (eg, PubMed, Embase, ProQuest and CNKI), website search and manual search, will be performed to identify all eligible studies. The Population, Exposure, Comparator and Outcome framework was used to clarify the inclusion and exclusion criteria. The Newcastle-Ottawa Scale will be used to assess the quality of included studies. Maximally adjusted effect estimates from individual studies will be summarised with random-effect models in a conservative manner. I 2 statistics and Q-tests will be used to test the heterogeneity across studies. We will perform extensive sensitivity analyses, such as confounding risk ratio (confounding), E-value, fixed-effect models, excluding the most relatively weighted study, including only the high-quality studies and many predesigned subgroup analyses, etc. The findings will be reported in accordance to the PRISMA guidelines. ETHICS AND DISSEMINATION: Ethical approval is not required in this systematic review of published literatures. The results will be published in a peer-reviewed journal and presented at relevant conferences. PROSPERO REGISTRATION NUMBER: CRD42020181343.


Asunto(s)
Contaminantes Orgánicos Persistentes , Neoplasias de la Tiroides , Humanos , Incidencia , Metaanálisis como Asunto , Investigación Cualitativa , Revisiones Sistemáticas como Asunto , Neoplasias de la Tiroides/inducido químicamente , Neoplasias de la Tiroides/epidemiología
16.
BMJ Open ; 11(8): e052212, 2021 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-34408058

RESUMEN

INTRODUCTION: Tuberculosis (TB) continues to be a significant health burden, most commonly affecting the lungs and referred to as pulmonary TB (PTB). Diagnostic techniques of PTB primarily rely on expectorated sputum samples. However, the diagnostic yields are often hindered due to insufficient volume and quality of the sputum specimens. Moreover, some individuals are unable to provide sputum samples due to scanty sputum production or difficulty in coughing up and require an invasive procedure to obtain a respiratory sample, such as bronchoscopic or gastric aspiration. Thus, challenges in the acquisition of respiratory specimens warrant an alternate specimen. Therefore, this systematic review aims to evaluate the diagnostic accuracy of a stool specimen for the diagnosis of PTB in adults. METHODS AND ANALYSIS: We will search MEDLINE (Ovid), Embase (Ovid), Web of Science and Cochrane database from inception to April 2021 using a comprehensive search strategy. Two reviewers will independently perform screening, data extraction and quality assessment. The risk of bias assessment and applicability of results of eligible studies will be performed using the Quality of Diagnostic Accuracy Studies-2 tool. Bivariate random-effects models will be performed to calculate pooled sensitivity, specificity, positive likelihood ratio and negative likelihood ratio and diagnostic odds ratio along with 95% CI of stool specimen for each reported diagnostic method against any of the reference standard test (ie, mycobacterial culture or smear microscopy or Xpert assay using respiratory specimens). Heterogeneity between studies will be assessed by I2 statistics and Q statistic of the χ2 test. ETHICS AND DISSEMINATION: The results will be disseminated through publishing in a peer-reviewed medical journal and public presentations in relevant national and international conferences. As this is a systematic review of publicly available data, ethics approval is not required. PROSPERO REGISTRATION NUMBER: CRD42021245203.


Asunto(s)
Antibióticos Antituberculosos , Mycobacterium tuberculosis , Tuberculosis Pulmonar , Adulto , Antibióticos Antituberculosos/uso terapéutico , Humanos , Metaanálisis como Asunto , Rifampin , Sensibilidad y Especificidad , Revisiones Sistemáticas como Asunto , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico
17.
BMJ Open ; 11(8): e049563, 2021 08 19.
Artículo en Inglés | MEDLINE | ID: mdl-34413104

RESUMEN

INTRODUCTION: Shoulder pain affects approximately one in four adults and is thus one of the most common musculoskeletal problems. Only 50% of patients who begin treatment for shoulder pain are cured within 6 months. There is a need for systematic reviews to estimate the effectiveness of shoulder treatments. We decided to evaluate the effect of mobilisation with movement (MWM) on chronic shoulder pain in a systematic review. METHODS AND ANALYSIS: The review will include controlled trial articles identified via five electronic databases (PubMed, Embase, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database and Cochrane Central Register of Controlled Trials), reference lists, citations searches and experts in the field. Only controlled trials involving participants with a mean duration of pain of ≥3 months, in which the effectiveness of MWM has been compared with non-invasive treatments, sham mobilisation or wait-and-see will be included. The included trials will be synthesised with random effects meta-analyses. Risk-of-bias will be assessed with the Physiotherapy Evidence Database 0-10 point scale. ETHICS AND DISSEMINATION: The review does not require ethics approval as it is based on anonymised data from trial reports. The results of the review will be disseminated through a peer-reviewed publication. PROSPERO REGISTRATION NUMBER: CRD42018109380.


Asunto(s)
Proyectos de Investigación , Dolor de Hombro , Humanos , Metaanálisis como Asunto , Modalidades de Fisioterapia , Dolor de Hombro/terapia , Revisiones Sistemáticas como Asunto
18.
Medicine (Baltimore) ; 100(33): e26921, 2021 Aug 20.
Artículo en Inglés | MEDLINE | ID: mdl-34414948

RESUMEN

BACKGROUND: The molecular mechanism of Glioma is still unclear, and there are few early diagnostic markers. Therefore, it is urgent to figure out effective preventive measures, active diagnostic methods and rapid treatment measures. In recent years, relevant studies have revealed that long non-coding RNA (lncRNA) is associated with the prognosis of Glioma. However, these results have not been supported by any evidence. Therefore, this study carried out a meta-analysis method to analyze the relationship between lncRNA and the prognosis of Glioma. In addition, bioinformatics analysis was conducted to investigate the mechanism and related pathways of lncRNAs in Glioma. METHODS: We performed a systematic search in electronic databases, including China National Knowledge Infrastructure, Chinese Biomedical literature Database, Chinese Scientific and Journal Database, Wan Fang database, PubMed, EMBASE, Cochrane Library and Web of Science, to investigate the potential association between lncRNA expression and prognostic significance and clinical features in glioma patients. Hazards ratios (HRs) with corresponding 95% confidence intervals (CIs) were pooled to estimate the prognosis value of lncRNA by Stata16.0 software. The online tool AnnoLnc was applied to screen the co-expressed gene related to each lncRNA, David was used for gene ontology (GO) analysis and enrichment analysis of the signal pathway, and through Starbase, the possible competitive endogenous RNA network of lncRNAs was constructed. RESULTS: The results of this meta-analysis would be submitted to peer-reviewed journals for publication. CONCLUSION: This study will provide evidence-based medical evidence for lncRNA, so as to predict the prognosis of Glioma and bioinformatics analysis will provide ideas for the mechanism study on Glioma.


Asunto(s)
Biomarcadores de Tumor/genética , Glioma/genética , Metaanálisis como Asunto , ARN Largo no Codificante/genética , Proyectos de Investigación , Revisiones Sistemáticas como Asunto/métodos , Humanos , Pronóstico
19.
BMJ Open ; 11(8): e045733, 2021 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-34376442

RESUMEN

INTRODUCTION: Hepatocellular adenomas (HCAs) are solid liver tumours that are usually found incidentally during routine medical check-ups. Multiple modifiable and non-modifiable factors constitute a risk for the malignant transformation of HCAs to hepatocellular carcinoma (HCC), which has emerged to be one of the fastest growing causes of cancer-related mortality globally. This study protocol for a planned systematic review and meta-analysis documents the methodological approach to identify risk factors and their risk estimates for the transformation from HCA to HCC. METHODS AND ANALYSIS: Two independent reviewers will systematically search and extract data from studies in patients of all ages published between January 1970 and June 2021 on PubMed, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Scopus Web of Science, Ovid, The Cochrane Hepatobiliary Group Controlled Trials Register and The Cochrane Central Register of Controlled Trials by using an a priori defined search strategy. Study quality will be rated with the National Institute of Health quality assessment tools. Disagreements will be resolved by consensus with a third independent reviewer. The primary outcome will be the odds ratio (OR) of developing HCC in patients with prediagnosed HCA depending on the exposure to risk factors. HCC diagnosis must be inferred based on imaging techniques or pathology. We will use R V.4.0.2 to conduct meta-analyses and generate pooled ORs based on random effects models. Results will be presented as forest plots. Cochran's Q and I2 test will be performed to assess heterogeneity between included studies. Funnel plots and Egger's weighted regression will be used to evaluate publication bias. ETHICS AND DISSEMINATION: No ethical approval is required as we will use and analyse data from previously published studies in which informed consent was obtained. The results will be disseminated in a peer-reviewed journal on completion. PROSPERO REGISTRATION NUMBER: CRD42020206578.


Asunto(s)
Adenoma de Células Hepáticas , Carcinoma Hepatocelular , Neoplasias Hepáticas , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/etiología , Humanos , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/etiología , Metaanálisis como Asunto , Proyectos de Investigación , Factores de Riesgo , Revisiones Sistemáticas como Asunto
20.
BMJ Open ; 11(8): e046727, 2021 08 10.
Artículo en Inglés | MEDLINE | ID: mdl-34376444

RESUMEN

INTRODUCTION: Takotsubo syndrome (TTS) is a sudden reversible weakening of the left ventricle function induced by severe stress and resembles many features as acute coronary syndrome. Even though many guidelines had been published about TTS, there is no consensus regarding the long-term treatment. Aspirin is one of the most common prescribed medicines at discharge for patients with the intention to reduce thrombus events and improve the overall prognosis. However, existing studies yielded conflicting results concerning its effects. This study aims to evaluate the impact of long-term maintenance treatment of aspirin in TTS and provides insights in clinical management. METHODS AND ANALYSIS: After searching through electronic databases (PubMed, Embase, Cochrane Library, Web of Science, National Library of Medicine Gateway, CNKI, Wanfang and VIP), grey literatures, conference abstract and trial registries for clinical studies investigating the impact of aspirin on patients with TTS, a systemic review and meta-analysis will be conducted. The search will be limited from inception of each database to 1 August 2020. The outcomes including all-cause death, TTS recurrence, stroke, transient ischaemic attack or myocardial infarction at 30-day and 5-year follow-up will be examined. Risk of bias will be assessed by Newcastle-Ottawa quality assessment scale for observational studies and Cochrane Effective Practice and Organization of Care evaluation tool for interventional studies. Grading of Recommendations Assessment, Development and Evaluations method will be applied to assess the quality of evidence. If available, the effects of aspirin on the above outcomes for patients with TTS will be evaluated using random-effect modelling with relative risk at 95% CIs. Subgroup analysis and sensitivity analysis will also be performed when possible. ETHICS AND DISSEMINATION: Ethics approval was not required due to the retrospective nature of the study. Results of the review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020212729.


Asunto(s)
Ataque Isquémico Transitorio , Accidente Cerebrovascular , Cardiomiopatía de Takotsubo , Aspirina/uso terapéutico , Humanos , Metaanálisis como Asunto , Proyectos de Investigación , Estudios Retrospectivos , Revisiones Sistemáticas como Asunto
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