The time interval between hCG priming and oocyte retrieval in ART program: a meta-analysis

Objective  

To evaluate the relationship between different hCG priming-to-oocyte retrieval intervals and assisted reproductive technology (ART) outcome.     

The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis

CONTEXT: Antimuscarinic agents are currently the first-line pharmacotherapy for overactive bladder. OBJECTIVES: A systematic review published in 2005 was updated, including data on a newly licensed antimuscarinic (fesoterodine). The primary aim of this study was to systematically review evidence on the efficacy of licensed administration of antimuscarinic treatments in overactive bladder from randomised controlled trials. Secondary aims were to review evidence on tolerability and safety and health-related quality of life (HRQL). EVIDENCE ACQUISITION: All relevant data sources from randomised controlled trials were searched, and two independent reviewers considered publications for inclusion and extracted relevant data. Meta-analysis was used to pool efficacy, tolerability, safety, and HRQL outcomes by treatment. Efficacy was measured by continent days, mean voided volume, urgency episodes, and micturition frequency. Tolerability and safety were measured by means of adverse event and withdrawal rates. HRQL was measured by various instruments. EVIDENCE SYNTHESIS: An additional 1118 references were retrieved with data on 83 studies extracted. Antimuscarinics were found to be more effective than placebo. Tolerability was good; few of the antimuscarinics were found to have significantly higher withdrawal rates in comparison to placebo. No serious adverse event for any product was statistically significant compared to placebo. Dry mouth (mild, moderate, severe) was the most commonly reported adverse event (29.6% on treatment vs 7.9% on placebo), followed by pruritus (15.4% on treatment vs 5.2% on placebo). Improvements were seen in HRQL with treatment by darifenacin, fesoterodine, oxybutynin transdermal delivery system, propiverine extended release (ER), solifenacin, tolterodine ER and immediate release, and trospium. Limitations of the study include restrictions on the types of patients typically included in overactive bladder trials and topics that have not been adequately addressed in the current antimuscarinic literature. CONCLUSIONS: Antimuscarinics are efficacious, safe, and well-tolerated treatments that improve HRQL. Profiles of each drug and dosage differ and should be considered in making treatment choices.     

Genetic polymorphism of <Emphasis Type="Italic">XRCC3</Emphasis> Thr<Superscript>241</Superscript>Met and breast cancer risk: case-control study in Korean women and meta-analysis of 12 studies

To evaluate the relationship of genetic polymorphism in XRCC3 Thr²⁴¹Met and the risk of breast cancer, a hospital-based case-control study was conducted in Korea. Histologically confirmed breast cancer cases (n = 574) and controls (n = 502) with no present or previous history of cancer were recruited from several teaching hospitals in Seoul during 1995–2001. Information on demographic characteristics and other information were collected by interviewed questionnaire. Genetic polymorphisms of XRCC3 Thr²⁴¹Met (C > T) was determined by single base extention assay. The frequency of Thr/Thr, Thr/Met, and Met/Met genotype were 89.4, 10.4, 0.2% in cases and 92.3, 7.7, 0.0% in controls, respectively. Genotype distribution in controls fit well to the Hardy–Weinberg equilibrium (P = 0.74). XRCC3 codon 241 Thr/Met or Met/Met genotype moderately increased the risk of breast cancer (OR = 1.4, 95% CI: 0.87–2.33), but not significant in this study. In the results of meta-analysis using twelve reports, however, Thr/Met or Met/Met genotype increased the risk of breast cancer (OR = 1.08, 95%CI: 1.00–1.17). In conclusion, although the genetic polymorphism of XRCC3 Thr²⁴¹Met was unlikely to have a substantial overall association in Korean women, the meta-analysis of studies, including ours, provided that Thr/Met and Met/Met was weakly increased the risk of breast cancer compare to Thr/Thr genotype.     

虚拟现实语言训练对卒中后失语患者干预效果的Meta分析

目的 评价虚拟现实（virtual reality,VR）技术对卒中后失语（post-stroke aphasia,PSA）患者语言功能的康复疗效,比较该方法 与常规语言康复训练的疗效差异,为临床更规范有效地应用VR技术提供证据。方法 检索Pub Med、CINAHL等9个数据库及临床试验注册平台中关于VR语言训练治疗PSA的随机对照试验,检索时限为建库至2022年3月。由2名研究者独立筛选文献,评价文献质量及提取信息。采用Rev Man 5.4软件进行Meta分析,并采用推荐分级的评价、制订与评估（grades of recommendations assessment,development and evaluation,GRADE）系统进行证据质量评级。结果 共纳入9篇文献,包括311例患者。Meta分析结果 显示：VR语言训练能提高PSA患者的自发言语能力[SMD=0.88,95%CI(0.57,1.20),P<0.001],命名能力[SMD=0.60,95%CI(0.30,0.90),P=0.001],听理解能力[SMD=0.81,95%CI (0.40,1.22),P...     

急性非静脉曲张性上消化道出血患者早期经口进食效果的Meta分析

目的 系统评价急性非静脉曲张性上消化道出血（acute non-variceal upper gastrointestinal bleeding,ANVUGIB）患者止血后24 h内早期经口进食的安全性及有效性,为临床实践提供参考依据。方法 计算机检索中国知网、万方数据库、维普数据库、中国生物医学文献数据库、PubMed、Web of Science、Embase、Cochrane Library、CINAHL中关于ANVUGIB患者早期经口进食的随机对照试验和队列研究,检索时限为建库至2022年9月。由2名研究者对文献进行筛选、资料提取及方法 学质量评价,并应用RevMan 5.4和Stata 13.0软件进行统计分析。结果 共纳入4篇随机对照试验和1篇队列研究,文献质量评价结果 均为B级。共纳入803例患者,其中试验组（早期经口进食）384例,对照组（常规禁食）419例。Meta分析结果 示,两组再出血率[RR=0.87,95%CI(0.47,1.64),P=0.670]、病死率[RR=0.46,95%CI(0.19,1.08),P=0.080]、住院费用[SMD=-1.50,95...     

The risk assessment tool for intensive care unit readmission: A systematic review and meta-analysis

ObjectiveTo review and evaluate existing risk assessment tools for intensive care unitreadmission.MethodsNine electronic databases (Medline, CINAHL, Web of Science, Cochrane Library, Embase, Sino Med, CNKI, VIP, and Wan fang) were systematically searched from their inception to September 2022. Two authors independently extracted data from the literature included. Meta-analysis was performed under the bivariate modeling and summary receiver operating characteristic curve method.ResultsA total of 29 studies were included in this review, among which 11 were quantitatively Meta-analyzed. The results showed Stability and Workload Index for Transfer: Sensitivity = 0.55, Specificity = 0.65, Area under curve = 0.63. And Early warning score: Sensitivity = 0.78, Specificity = 0.83, Area under curve = 0.88. The remaining tools included scores, nomograms, machine learning models, and deep learning models. These studies, with varying reports on thresholds, case selection, data preprocessing, and model performance, have a high risk of bias.ConclusionWe cannot identify a tool that can be used directly in intensive care unit readmission risk assessment. Scores based on early warning score are moderately accurate in predicting readmission, but there is heterogeneity and publication bias that requires model adjustment for local factors such as resources, demographics, and case mix. Machine learning models present a promising modeling technique but have a high methodological bias and require further validation.Implications for clinical practiceUsing reliable risk assessment tools is essential for the early identification of unplanned intensive care unit readmission risk in critically ill patients.  A reliable risk assessment tool must be developed, which is the focus of further research.     

Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis

PurposeThe purpose of study was to identify the socio-personal factors affecting adherence to the treatment of patients with type 2 diabetes.MethodsCross-sectional articles were extracted from databases such as Web of Science, PubMed, Elsevier. A meta-analysis was performed using integrated odds ratios (OR) and 95% confidence interval (CIs) for age, BMI, depression, educational level, gender, employment status, marital status, smoking status. STATA 12.0 was used to estimate pooled RR in definite subgroups. The quality of the studies included was evaluated using the STROBE checklist.ResultsThirty-one studies out of 7407 extracted articles were finally selected for the meta-analysis. The results showed that younger people had a 17% higher risk than older people, smokers had a 22% higher risk than non-smokers, and the employed had a 15% higher risk of non-adherence to treatment.ConclusionIn conclusion, older age, smoking and employment can lead to non-adherence to T2D treatment. Interventions are suggested to be made besides common health care considering the socio-personal features on type 2 diabetes patients' treatment adherence.     

个体化PEEP对腹腔镜手术后肺部并发症影响的Meta分析

目的 评价术中采用个体化呼气末正压（PEEP）对腹腔镜手术后肺部并发症（PPCs）的影响。

方法 检索PubMed、Embase、Cochrane Library、中国知网、万方数据库、维普,收集腹腔镜手术中使用个体化PEEP的随机对照试验（RCT）,检索时间为建库至2022年1月。采用RevMan 5.4软件进行Meta分析。

结果 共纳入15篇RCT研究,共计患者917例,个体化PEEP组460例,对照组457例。与对照组比较,个体化PEEP组PPCs发生率明显降低（RR=0.27,95%CI 0.14～0.51,P<0.001）,驱动压明显减小（MD=-3.06 cmH₂O,95%CI -3.38～-2.23 cmH₂O,P<0.001）。两组生理无效腔、MAP、血管活性药物、住院时间差异无统计学意义。

结论 与固定PEEP或呼气末零压通气比较,腹腔镜手术中应用个体化PEEP可降低PPCs发生率,同时不增加血流动力学紊乱的风险。     

The effect of bariatric surgery on reducing the risk of colorectal cancer: a meta-analysis of 3,233,044 patients

BackgroundThe published literature presents conflicting results regarding the impact of bariatric surgery on the incidence of colorectal cancer. There are important new studies that have addressed this question with longer follow-up.ObjectiveTo investigate the effect of bariatric surgery on the risk of developing colorectal cancer in patients with obesity.SettingMeta-analysis.MethodsPubMed and Scopus were searched for relevant articles. Articles published by November 2021 were retrieved; data were extracted according to the evidence-based PICO (population, intervention, control, outcome) model and analyzed using a random-effects model to estimate the pooled relative risk (RR) and its 95% confidence interval. The heterogeneity of studies was tested and quantified using Cochran’s Q.ResultsThe initial search yielded 327 articles. After evaluation, 13 studies were analyzed. The thorough evaluation resulted in 13 articles, which were analyzed. A total number of 3,233,044 patients were included in the meta-analysis. The mean time of follow-up was 9.5 ± 7.9 years. The pooled estimate of the adjusted RR was .63 (95% confidence interval, .50–.79). Heterogeneity χ² was 107.96 (df = 12; P < .001; I² = 89%).ConclusionPatients who underwent bariatric surgery had a 37% reduction in the risk of developing colorectal cancer compared with patients with obesity who had no surgery.