ResearchPad - systematic-review-meta-analysis https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[Association of circulating cystatin C levels with type 2 diabetes mellitus: a systematic review and meta-analysis]]> https://www.researchpad.co/article/elastic_article_9503 This study aimed to systemically summarize the present literature about circulating cystatin C (Cys C) levels in type 2 diabetes mellitus (T2DM) and provide a more precise evaluation of Cys C levels in T2DM.Material and methodsRelevant studies about Cys C concentrations in T2DM were searched in PubMed, EMBASE and the Cochrane Library database (up to Oct 31 2018). We computed the pooled standard mean difference (SMD) with its 95% confidence interval (CI) of Cys C levels through a random-effect model. The Q test and the I2 statistic were used to assess and quantify between-study heterogeneity; publication bias was evaluated through a funnel plot and Egger’s linear regression test.ResultsAfter the literature search and screening process, 14 studies with 723 T2DM patients and 473 healthy controls were finally included in the meta-analysis. The results showed that T2DM patients had significantly higher Cys C levels compared to healthy controls (SMD = 1.39, 95% CI: 0.92–1.86, p < 0.001). Publication bias was not detected based on the symmetrical shape of the funnel plot and the results of Egger’s test (p = 0.452). Subgroup analyses suggested that variables of human race, age, gender, study sample size and disease duration have a relationship with Cys C level in T2DM patients.ConclusionsOverall, our study suggests that patients with T2DM have an elevated circulating Cys C level compared to healthy controls, and it is associated with race, age, gender, study sample size and disease duration. Further investigations are still needed to explore the causal relationship of aberrant Cys C concentrations in T2DM. ]]> <![CDATA[Assessment of selected nutrient intake by Polish preschool children compared to dietary recommendations: a meta-analysis]]> https://www.researchpad.co/article/elastic_article_9484 In recent years a steady increase in the number of obese people has been observed worldwide. This problem is also increasingly applicable to children and adolescents. In this study, we conducted a meta-analysis of studies carried out in Poland over ten years (2005–2015) which analysed the diet of preschool children and assessed how significantly it affects the prevention of diet-dependent disease.Material and methodsTwo of the researchers independently performed a systematic search of Medline, Embase, Google Scholar, and the Polish Medical Bibliography to find studies published between 2005 and 2015. The variance of the means of differences between selected factors in relation to dietary guidelines and standards for preschool children was estimated by summing the individual variances of means. The means of differences between selected factors across the studies were pooled using random-effects model meta-analysis.ResultsThe analysis included a total of 2095 children. Mean protein content in the diet of children studied is 111% higher than indicated in dietary recommendations for this age group; mean consumption of carbohydrates in the study group is 24% higher than recommended. In moderately high calorie diets, analysis showed that the recommended norm is exceeded by 47%, CE 0.77, p < 0.001.ConclusionsNutrient intake is not compliant with recommendations for this age group and could not only inhibit physical development, but also increase the risk of diet-dependent diseases. ]]> <![CDATA[Water exchange versus air insufflation for colonoscopy: A meta-analysis]]> https://www.researchpad.co/article/5c1d8348d5eed0c484763033

Background/Aims:

To compare water exchange (WE) method with conventional air insufflation (AI) method for colonoscopy, evaluating the technical quality, screening efficacy, and patients' acceptance.

Materials and Methods:

Electronic databases were systematically searched for randomized controlled trials comparing WE colonoscopy with AI colonoscopy. The pooled data of procedure-associated and patient-related outcomes were assessed, using the weighted mean difference (WMD) with 95% confidence interval (CI) for continuous variables and relative risk (RR) with 95% CI for dichotomous variables, respectively.

Results:

A total of 13 studies involving 7056 patients were included. The cecum intubation rate was similar between WE and AI methods (RR = 1.01, 95% CI = 0.99–1.02, P = 0.37); however, a significantly longer cecum intubation time was shown in WE group (WMD = 1.56, 95% CI = 0.75–2.37, P = 0.002). Compared with AI, WE was associated with a higher risk of adenoma detection rate (ADR) (RR = 1.28, 95% CI = 1.18–1.38, P < 0.00001) and polyp detection rate (PDR) (RR = 1.30, 95% CI = 1.21–1.39, P < 0.00001). Patients in WE group experienced significantly less maximum pain score (WMD = −1.99, 95% CI = −2.68 to −1.30, P < 0.00001) and less requested on-demand sedation (RR = 0.58, 95% CI = 0.44–0.77, P = 0.0002). Likewise, they also experienced less abdominal compression (RR = 0.62, 95% CI = 0.51-0.74, P < 0.00001) and reposition (RR = 0.74, 95% CI = 0.63-0.86, P = 0.0001). Moreover, patients' willingness to repeat colonoscopy was significantly greater for WE (RR = 1.14, 95% CI = 1.07–1.21, P < 0.0001).

Conclusion:

This meta-analysis confirmed that WE method could significantly increase ADR/PDR and improve patients' acceptance of colonoscopy, while reducing the degree of pain and minimize the need for on-demand sedation and adjunct maneuvers, despite requiring more cecal intubation time.

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<![CDATA[Is water exchange superior to water immersion for colonoscopy? A systematic review and meta-analysis]]> https://www.researchpad.co/article/5c0e4da5d5eed0c484e39405

Background/Aims:

Recently, water exchange (WE) instead of water immersion (WI) for colonoscopy has been proposed to decrease pain and improve adenoma detection rate (ADR). This systematic review and meta-analysis is conducted to assess whether WE is superior to WI based on the published randomized controlled trials (RCTs).

Materials and Methods:

We searched studies from PubMed, Cochrane Central Register of Controlled Trials, EMBASE, and MEDLINE. Only RCTs were eligible for our study. The pooled risk ratios (RRs), pooled mean difference (MD), and pooled 95% confidence intervals (CIs) were calculated by using the fixed-effects model or random-effects model based on heterogeneity.

Results:

Five RCTs consisting of 2229 colonoscopies were included in this study. WE was associated with a significantly higher ADR than WI (RR = 1.18; CI = 1.05–1.32; P = 0.004), especially in right colon (RR = 1.31; CI = 1.07–1.61; P = 0.01). Compared with WI, WE was confirmed with lower pain score, higher Boston Bowel Preparation Scale score, but more infused water during insertion. There was no statistical difference between WE and WI in cecal intubation rate and the number of patients who had willingness to repeat the examination. Furthermore, both total procedure time and cecal intubation time in WE were significantly longer than that in WI (MD = 2.66; CI = 1.42–3.90; P < 0.0001; vs MD = 4.58; CI = 4.01–5.15; P < 0.0001).

Conclusions:

This meta-analysis supports the hypothesis that WE is superior to WI in improving ADR, attenuating insertion pain and providing better bowel cleansing, but inferior in time and consumption of infused water consumption during insertion.

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